Are vaccines the light at the end of the tunnel?

[TeeRick]

Sorry I posted this one too in the Saga cruises thread by mistake so repeating it here again.

 

 

A good news story for the Pfizer vaccine from the country of Israel which has one of the highest rates of vaccination at this point in time.  In the real world scenario of vaccinating the population,  the 95% efficacy of the Pfizer vaccine seems to be holding true.  Only 20 out of 128,000 vaccinated were positive for the virus.  None of these 20 infected were seriously ill or were hospitalized.  This is the first analysis to date of the post-vaccinated population so it is early but highly encouraging.  As I've stated before we want to see vaccine effectiveness in the real world scenario and in this one case it seems to match the clinical trial efficacy.

 

https://www.timesofisrael.com/week-after-2nd-pfizer-vaccine-shot-only-20-of-128000-israelis-get-covid/

Edited January 26, 2021 by TeeRick

[TeeRick]

48 minutes ago, hcat said:

After  the vaccine has been widely administered, will  we possibly need  annual boosters?  Like the flu vaccine which is modifed each time, rather than the polio vaccine which seems not to need it. I expect the experts will let us know.

 

At some point hopefully  pharmacies, hosp facilities and drs could take this over if bosters are in fact needed. If we started with Moderna for first and second shots, winder if we will we always need to take that same one in the future ?  

 

Hope folks are having good luck with appts!

hcat- it is possible you might need a booster.    It is just not very clear yet how long your protective immunity will hold up for the long term or how effective it will be against major variant strains.  You might need an annual booster (against the same strains) vs. a new shot against a new strain.  Moderna is already working on a variant vaccine (see link below) - just in case the S Africa strain takes off.  All of this is still very new and undetermined.  Unlike Flu vaccine which has been with us since the 1940's.

 

https://www.cnbc.com/2021/01/25/covid-vaccine-moderna-working-on-covid-booster-shots-for-south-african-strain.html

[D C]

22 minutes ago, TeeRick said:

Sorry I posted this one too in the Saga cruises thread by mistake so repeating it here again.

 

 

A good news story for the Pfizer vaccine from the country of Israel which has one of the highest rates of vaccination at this point in time.  In the real world scenario of vaccinating the population,  the 95% efficacy of the Pfizer vaccine seems to be holding true.  Only 20 out of 128,000 vaccinated were positive for the virus.  None of these 20 infected were seriously ill or were hospitalized.  This is the first analysis to date of the post-vaccinated population so it is early but highly encouraging.  As I've stated before we want to see vaccine effectiveness in the real world scenario and in this one case it seems to match the clinical trial efficacy.

 

https://www.timesofisrael.com/week-after-2nd-pfizer-vaccine-shot-only-20-of-128000-israelis-get-covid/

I recall reading that hospitalizations were dropping as well in Israel. 

[Homosassa]

1 hour ago, hcat said:

 

 

Hope folks are having good luck with appts!

 

The Covid Hunger Games continue for those of us fighting for a vaccine.

[deadzone1003]

3 hours ago, hcat said:

After  the vaccine has been widely administered, will  we possibly need  annual boosters?  Like the flu vaccine which is modifed each time, rather than the polio vaccine which seems not to need it. I expect the experts will let us know.

 

At some point hopefully  pharmacies, hosp facilities and drs could take this over if bosters are in fact needed. If we started with Moderna for first and second shots, winder if we will we always need to take that same one in the future ?  

 

Hope folks are having good luck with appts!

In the two shot vaccination regiment, the 2nd shot works in conjunction with the 1st shot.  Mixing them could make them less effective.  Once you are immunized, you are supposed to be protected from virus for which the vaccine was designed for.  If variants develop, a booster shot would target the new variant so I would think another company's booster shot (targeting the new variant) could do the job.  Now, if it is to boost the effectiveness against the original variant, I don't know.  It would seem logical that the company of the original vaccine would be best as it would be targeting the deficiencies of their original vaccine.  I wouldn't worry about it now as we really don't know how long-term this vaccine is, but since coronavirus can easily mutate, we can assume we will be needing booster shots to target the new variants sometime in the future.  I hope it will not be like the annual flu shots, but I wouldn't be surprised if it is.  

[Caymus88]

Moderna is saying a booster 3rd shot in the fall

[markeb]

3 hours ago, TeeRick said:

Sorry I posted this in the Saga cruises thread by mistake so repeating it here too.

 

J&J earnings call today. J&J Chief Financial Officer Joseph Wolk told CNBC on Tuesday the company expects the phase three trial data to be “robust.” Also indications are the data will be released possibly by next week.

 

https://www.cnbc.com/2021/01/26/johnson-johnson-jnj-earnings-q4-2020.html

 

Fingers crossed their efficacy results are in the ballpark of the mRNA vaccines. Not because there's likely to be a real world difference, but the optics of sending out a "less effective" vaccine, especially to underserved communities without the ability to manage the Pfizer storage requirements, will be horrible. If they're down where AZ was in early results, you're going to have noninferiority discussions in the advisory committee...

 

In keeping with simplification, "noninferiority" is a pretty bureaucratic term, but once there's an approved drug, vaccine, treatment, etc., the FDA generally will only approve another product that's at least as good as the approved product. If the side effects are similar, that's probably efficacy. What makes it "as good as" is both science and art, there's no magic number, and we'll see how this goes.

[deadzone1003]

6 minutes ago, markeb said:

 

Fingers crossed their efficacy results are in the ballpark of the mRNA vaccines. Not because there's likely to be a real world difference, but the optics of sending out a "less effective" vaccine, especially to underserved communities without the ability to manage the Pfizer storage requirements, will be horrible. If they're down where AZ was in early results, you're going to have noninferiority discussions in the advisory committee...

 

In keeping with simplification, "noninferiority" is a pretty bureaucratic term, but once there's an approved drug, vaccine, treatment, etc., the FDA generally will only approve another product that's at least as good as the approved product. If the side effects are similar, that's probably efficacy. What makes it "as good as" is both science and art, there's no magic number, and we'll see how this goes.

I beg to differ since the J&J vaccine is expected to a 1-dose vaccine and is reported to have milder side effects.  If the efficacy rate is high enough (this will depend on the individual), it will be popular, but it will be allocated to rural areas and small towns first because of the storage requirements of the mRNA vaccines, especially the Pfizer vaccine, that will force them to be use in high demand usage that is only possible in metropolitan areas.  Not everyone will be happy with the allocation, but I think most people could live with it.  If I live in a rural area and if the only choice was Pfizer, I would worry if it would be still be effective because of the storage requirements.  If it is not distributed right away, how much will be thrown away?  

[markeb]

1 minute ago, deadzone1003 said:

I beg to differ since the J&J vaccine is expected to a 1-dose vaccine and is reported to have milder side effects.  If the efficacy rate is high enough (this will depend on the individual), it will be popular, but it will be allocated to rural areas and small towns first because of the storage requirements of the mRNA vaccines, especially the Pfizer vaccine, that will force them to be use in high demand usage that is only possible in metropolitan areas.  Not everyone will be happy with the allocation, but I think most people could live with it.  If I live in a rural area and if the only choice was Pfizer, I would worry if it would be still be effective because of the storage requirements.  If it is not distributed right away, how much will be thrown away?  

 

I think it could go either way. And I agree if the efficacy is "high enough", it's not an issue. But if the numbers look low, and get picked up in the press as low, it's anyone's guess how it plays out. And other than AZ's numbers being lower than expected, using a similar but different technology, I have no reason to believe J&J won't be in the ballpark of the two mRNA vaccines. 

 

BTW, if you look at the CDC vaccine tracker, it's actually some of the most rural states in the country hitting the highest per-capita vaccine rates, and it looks like West Virginia is leading, with the Dakotas not far behind. That's probably Moderna, not Pfizer, obviously.

[TeeRick]

51 minutes ago, deadzone1003 said:

I beg to differ since the J&J vaccine is expected to a 1-dose vaccine and is reported to have milder side effects.  If the efficacy rate is high enough (this will depend on the individual), it will be popular, but it will be allocated to rural areas and small towns first because of the storage requirements of the mRNA vaccines, especially the Pfizer vaccine, that will force them to be use in high demand usage that is only possible in metropolitan areas.  Not everyone will be happy with the allocation, but I think most people could live with it.  If I live in a rural area and if the only choice was Pfizer, I would worry if it would be still be effective because of the storage requirements.  If it is not distributed right away, how much will be thrown away?  

Funny. Maybe if we were back in the 1950's perhaps!   😄  I see from your post you are from SF which is obviously a big city.  What do you consider a rural area?  Get out much?? 😄 

 

But seriously people in rural areas and small towns find access to things like MRI's and have complicated medical procedures when they need them.  Many small towns (like the one I live in) are quite close to metropolitan areas too.  Here in the USA I do believe that rural areas and small towns are actually quite capable of being equipped with freezers, or they are as close as the nearest rural hospital or medical center or urgent care center that likely has the ultralow freezer needed for the Pfizer vaccine.  Or they are within a drive to an area where their populous can get a properly stored vaccine. Even if it is a long drive.   It might be an issue for really, really remote locations.  But not for a vast majority of the non-city population.  

Edited January 26, 2021 by TeeRick

[TeeRick]

16 hours ago, D C said:

Bottom line is that in just a few months, the US will have more vaccines than can be reasonably expected to be administered.  

Yes a nice problem to have!  But I share your concern about the daily administration of vaccines.  It is an enormous task that has been not focused on until now.

[hcat]

21 minutes ago, TeeRick said:

Funny. Maybe if we were back in the 1950's perhaps!   😄  I see from your post you are from SF which is obviously a big city.  What do you consider a rural area?  Get out much?? 😄 

 

But seriously people in rural areas and small towns find access to things like MRI's and have complicated medical procedures when they need them.  Many small towns (like the one I live in) are quite close to metropolitan areas too.  Here in the USA I do believe that rural areas and small towns are actually quite capable of being equipped with freezers, or they are as close as the nearest rural hospital or medical center or urgent care center that likely has the ultralow freezer needed for the Pfizer vaccine.  Or they are within a drive to an area where their populous can get a properly stored vaccine. Even if it is a long drive.   It might be an issue for really, really remote locations.  But not for a vast majority of the non-city population.  

We had our vaccine  at a clinic next door to a hospital with 37 beds.  Drove an hour or so on mostly country  roads.  We used to live out that way and remembered how competent a facility it was....If we waited to be called  by  a nearby suburban/ urban vaccine site..we'd still be waiting.  Bigger not always better,  . Hope we can stop at he farm stand on our way home from the second shot!

 

Thanks to all who replied about booster shots.  Hope by then the process of booking it will be easier!

Edited January 26, 2021 by hcat

[cruise kitty]

Just another update from our trials.  A pfizer participant from kansas who was fully vaccinated Aug/Sept. just tested positive for C-19...  person has very, very mild symptoms, & they are running tests to see if it's a variant.    As of mid December person  was still testing positive for spike antibodies.   Only symptoms are a slight loss of taste/smell.  So far I believe this person is the first post two weeks after both  shots to get it.  Question is, is it a variant, or just the unlucky 5%?  Also, are they able to transmit to others ?  For myself, reassures me that they did not get sick.   Will update if I hear more.     (& full disclosure, I'm not a Dr. or scientist, only reporting what I hear through the grapevine, so please take with a grain of salt)

 

 

[deadzone1003]

35 minutes ago, cruise kitty said:

Just another update from our trials.  A pfizer participant from kansas who was fully vaccinated Aug/Sept. just tested positive for C-19...  person has very, very mild symptoms, & they are running tests to see if it's a variant.    As of mid December person  was still testing positive for spike antibodies.   Only symptoms are a slight loss of taste/smell.  So far I believe this person is the first post two weeks after both  shots to get it.  Question is, is it a variant, or just the unlucky 5%?  Also, are they able to transmit to others ?  For myself, reassures me that they did not get sick.   Will update if I hear more.     (& full disclosure, I'm not a Dr. or scientist, only reporting what I hear through the grapevine, so please take with a grain of salt)

 

 

Technically, he would be considered part of that 5% unless he was stupid enough to go into an ICU full of covid patients and allow someone to cough on him/her.  The best vaccines may not work that well if you get exposed to high enough viral load.  Remember getting a covid vaccine reduces the probability of getting the virus.  It does not eliminate the possibility.  The larger the viral load that you expose yourself the greater probability of getting sick.   The vaccine trials use people who are doing just normal things.  People who work in ICU's are not included in any trial unless it was a trial only for them.  The vaccine just preps your immune system so that it can fight off the virus as soon as it invades your body.   It is all about probability and not absolutes.  It is analogous to driving a car and accidents.  I will drive my car safely so I won't get into accidents, but there is no guarantee that I won't have an accident no matter how safely I will drive.

[deadzone1003]

4 hours ago, TeeRick said:

Funny. Maybe if we were back in the 1950's perhaps!   😄  I see from your post you are from SF which is obviously a big city.  What do you consider a rural area?  Get out much?? 😄 

 

But seriously people in rural areas and small towns find access to things like MRI's and have complicated medical procedures when they need them.  Many small towns (like the one I live in) are quite close to metropolitan areas too.  Here in the USA I do believe that rural areas and small towns are actually quite capable of being equipped with freezers, or they are as close as the nearest rural hospital or medical center or urgent care center that likely has the ultralow freezer needed for the Pfizer vaccine.  Or they are within a drive to an area where their populous can get a properly stored vaccine. Even if it is a long drive.   It might be an issue for really, really remote locations.  But not for a vast majority of the non-city population.  

The freezers for the Pfizer vaccine is ultra-low, basically dry ice cold.  Who would even have a freezer that has to be at least -60 C cold?  Maybe a research hospital might have one or a very large medical center.  Rural areas are getting the Moderna right now.  I would be surprised if any got the Pfizer.  When I say the rural areas will get the J&J vaccine, it is more about Pfizer having to be used exclusively in Metropolitan areas.  This is just a common sense approach as you want to minimize the chance of spoilage.   

[UnorigionalName]

1 hour ago, deadzone1003 said:

The freezers for the Pfizer vaccine is ultra-low, basically dry ice cold.  Who would even have a freezer that has to be at least -60 C cold?  Maybe a research hospital might have one or a very large medical center.  Rural areas are getting the Moderna right now.  I would be surprised if any got the Pfizer.  When I say the rural areas will get the J&J vaccine, it is more about Pfizer having to be used exclusively in Metropolitan areas.  This is just a common sense approach as you want to minimize the chance of spoilage.   

 

-80's aren't that esoteric.  They are pretty common.  ~$10k'ish is not a huge barrier of entry.  More of if you needed one or not before this.

[Crazy planning mom]

Biden said they are buying more Pfizer and Moderna vaccines and now have bought 600 million vaccines.  My question is does that number include Johnson & Johnson?

[deadzone1003]

1 hour ago, UnorigionalName said:

 

-80's aren't that esoteric.  They are pretty common.  ~$10k'ish is not a huge barrier of entry.  More of if you needed one or not before this.

I can't recall anyone saying they will subsidize the cost of said freezer.  They probably have no need for it other than for the Pfizer vaccine.  It may make sense if they were giving out tens of thousands of vaccines, but when it is alot lower and you have to eat the cost, I think they would request Moderna or J&J if it is available.  

[Arizona Wildcat]

21 minutes ago, Crazy planning mom said:

Biden said they are buying more Pfizer and Moderna vaccines and now have bought 600 million vaccines.  My question is does that number include Johnson & Johnson?

No.  AZ and J&J also purchased.  Delivery dates of the latest purchase was not stated in the CNN report today.  J&J will announce in a few days.  Huge importance as Pfizer not workable in most countries and Moderna difficult.

[deadzone1003]

33 minutes ago, Crazy planning mom said:

Biden said they are buying more Pfizer and Moderna vaccines and now have bought 600 million vaccines.  My question is does that number include Johnson & Johnson?

It appears that it doesn't include J&J.  Well they already have contracted out 200,000,000 for each of the two mRNA companies.  100,000,000 are to be delivered in each quarter (1st & 2nd).  J&J is obligated for 100,000,000 due by the end of April though it may be 90 days after approval and the NY Times said they may only be able to supply 60,000,000 doses by the end of April.  Gee, if Biden goes through with his plan, we have enough vaccines to then immunize 400,000,000 Americans except that we have only 330,000,000 Americans, maybe there are 70,000,000 illegal aliens in our country?  Don't forget the anti-vaxxers.  Is he planning forced vaccination?  Any volunteers to vaccinate multiple times?  Those additional vaccines are not even available until the 3rd quarter, before then almost 90% of the country could be vaccinated.  I think someone forgot to tell Biden that J&J vaccine is in the pipeline.  By the time these vaccines become available during the 3rd quarter, the market may already dictate which will still be around in the USA.  People then may be willing to pay for the vaccine of their choice.  Waste of money if the J&J vaccine comes through. 

P.S.  I'm assuming the Pfizer & Moderna vaccines totals are for both adults and kids.  If not, it's a mega waste of money.

Edited January 27, 2021 by deadzone1003
spelling

[dreaminofcruisin]

If the U.S. ends up with too many vaccines....that would be a GREAT problem. I am pretty sure they could sell them to another country...

[deadzone1003]

My apologies to everyone.  I forgot back in May the USA bought 300,000,000 doses from Astra Zeneca which equates to 150,000,000 immunizations.  Now, we are up to 550,000,000 people who could be immunized.  What it means is we could have immunize 450,000,000 people before Biden bought even more vaccines from Moderna and Pfizer.  Considering we have only 330,000,000 people in our country, do you think the taxpayer's money is being spent wisely?  Granted, when we ordered the vaccines, we didn't know which would work if any, diversifying your suppliers was like hedging your bets.  I expect the USA to sell off most of its AZ vaccine to others, probably at a discount.  It still doesn't justified buying additional mRNA vaccines unless the J&J vaccine is not as good as expected, i.e. no different than AZ in efficacy.

[nocl]

7 minutes ago, deadzone1003 said:

My apologies to everyone.  I forgot back in May the USA bought 300,000,000 doses from Astra Zeneca which equates to 150,000,000 immunizations.  Now, we are up to 550,000,000 people who could be immunized.  What it means is we could have immunize 450,000,000 people before Biden bought even more vaccines from Moderna and Pfizer.  Considering we have only 330,000,000 people in our country, do you think the taxpayer's money is being spent wisely?  Granted, when we ordered the vaccines, we didn't know which would work if any, diversifying your suppliers was like hedging your bets.  I expect the USA to sell off most of its AZ vaccine to others, probably at a discount.  It still doesn't justified buying additional mRNA vaccines unless the J&J vaccine is not as good as expected, i.e. no different than AZ in efficacy.

Except AZ is not approved in the US, and depending upon the large US clinical trial may or may not be.  As such the AZ doses don't count at this time. 

 

No one (except for the Monitoring and Safety Board and they would only know what their last check would have indicated, not final numbers) knows what the J&J efficacy is, the trials has not yet been unblinded.

Edited January 27, 2021 by nocl

[markeb]

OK. The announcements today are policy decisions; they don't buy anything. Some poor GS 12 contracting officer in HHS, making around $100K a year if they're in DC, will actually sign a contract, which they're pecuniarily liable for (i.e., can actually be held financially liable) to execute one or more contracts to buy the vaccine. And they'll will be based on available funding, etc. Even if they're using Other Transaction Authority, which they may well be, policy announcements are translated into action through the system.

 

I'm not in the mood to look tonight, but I'm pretty sure the initial contracts have base amounts and options. So adding up possible total procurements is an exercise in futility.

[cangelmd]

On 1/25/2021 at 7:50 PM, D C said:

So those who are actually vulnerable will be "eligible" in name only and will sit on the sidelines while younger, less at-risk people cut to the front.   It really will be interesting to see how hospitalizations and deaths drop in various states with various prioritizations.

Maybe, maybe not entirely. Yes, there should be special outreach to disadvantaged populations and to people, African-Americans particularly who have history that makes then leery of some medical care, and to older folks of all races who may have difficulty getting out to a site. BUT, people who are resistant to vaccination or who have reduced access for whatever reason, are also protected by herd immunity generated by everyone else who gets a vaccine. Getting more people vaccinated buys time to reach out to those people who may have more issues with access or are simply afraid. It’s a balancing act.

What is happening in Israel is what should happen. There’s been a lot of conjecture in this thread about transmissibility and preventing infection and transmission vs just preventing disease. But while we don’t know for certain and won’t know until data from trials emerges, the most likely scenario has always been that you get people vaccinated with a vaccine with 95% efficacy for disease, hospitalization should go way, way down - the rate should fall off a cliff.  And not a minute too soon, because with the rate of transmission in the US, we are just a breeding ground for more mutation.