Are vaccines the light at the end of the tunnel?

[Arizona Wildcat]

51 minutes ago, jagoffee said:

Perhaps you have not seen the numbers in the last month?  Case counts are improving significantly.  Of course they have to continue the improvement.

About 12% of adults have been inoculated.  About 18% have been diagnosed with COVID - since February 2020.  In an antibody study late last year almost 35% showed antibodies.  Simply by the numbers we will quickly get or are already at over 50% with some immunity.

There are two groups where case counts are still high.  Those 18 to 35 who are "invincible" - about half of new cases.  And a smaller group that denies COVID exists - this group across all ages. 

Cases will drop especially if we get more vaccine.  

If the J&J vaccine starts rolling out in a week or two and the two new Pfizer lines ramp up to full capacity within a month or less the vaccination appointment games can cease.  

Edited February 15, 2021 by Arizona Wildcat

[upwarduk]

14 minutes ago, TeeRick said:

Also heard this on the news this morning.  Tried to find an article and found this.  A bit vague for me (maybe not to someone with a scientific background) but still hopeful.  Maybe this will prove to be true with Moderna as well.

 

Pfizer’s vaccine appears to reduce coronavirus transmission | Science News

Promising news. Just wish I could get my second dose ( 1st Pfizer shot 6 weeks ago).

Promising news in UK, cases & hospitalisation down by 35% last week. 
15m target by 15.02.21 was met yesterday and 95% of over 70’s have taken the vaccine offer.

Obviously this age group take no notice of the anti- Vaxers 

Surprisingly only 65% of Care Home staff have taken up the offer.

Edited February 15, 2021 by upwarduk

[D C]

4 minutes ago, Arizona Wildcat said:

About 12% of adults have been inoculated.  About 18% have been diagnosed with COVID - since February 2020.  In an antibody study late last year almost 35% showed antibodies.  Simply by the numbers we will quickly get or are already at over 50% with some immunity.

There are two groups where case counts are still high.  Those 18 to 35 who are "invincible" - about half of new cases.  And a smaller group that denies COVID exists - this group across all ages. 

Cases will drop especially if we get more vaccine.  

Some models projected a herd immunity point of around 40%.   The falling cases may be evidence to support that. 

 

Though I'm amused and saddened that there are seemingly no real reports about why cases are dropping so rapidly, despite there being no shortage of assertions about how far off and how high the % is for herd immunity.  If you think you know the latter, then your models should be able to account for the current drop. 

[Charles4515]

14 minutes ago, D C said:

Some models projected a herd immunity point of around 40%.   The falling cases may be evidence to support that. 

 

Though I'm amused and saddened that there are seemingly no real reports about why cases are dropping so rapidly, despite there being no shortage of assertions about how far off and how high the % is for herd immunity.  If you think you know the latter, then your models should be able to account for the current drop. 

 

The cases numbers are coming down but are still higher than before the holidays. So the decline may be a result of the end of the holiday surge. Seems too early in the vaccination rollout for that to be  reason for the US drop.. 

[cangelmd]

22 hours ago, TeeRick said:

If you want to look into the issue of transmission of the virus after vaccination, read through this medical opinion.  The title is very misleading.  The author concludes that the data are beginning to show that increased transmission (ie, more asymptomatic carriers)  is not likely to be the case post-vaccination.  Hopefully the transmission issue will be thoroughly studied and put to rest for the sake of normal lives and of course normal cruising.

 

https://www.medscape.com/viewarticle/945433?src=wnl_edit_tpal&uac=370300SV&impID=3185913&faf=1#vp_2

Thanks for this TeeRick, I missed this. Glad to hear someone say in print what I've been thinking the whole time - it would be really weird for a vaccine to not reduce transmission at least to some degree, and if it significantly reduces disease (in the >90% range like these do), then does it really matter if transmission isn't reduced (that depends on the mutation rate and what sort of mutations are being seen). Persons on this board, who I feel are thoughtful lay people, seem to be concerned that we need absolute protection from any infection or transmission - but that's not how this works at all. What we need is to mightily reduce the viral "load" of the community - through vaccination, therapies, social distancing, masks. If we get transmission down to a point where it can't be easily measured at a population level or, more to the point, where hospitalizations and deaths greatly reduced, then we are likely done, even if transmission continues.

Natural selection should not favor a variant that is too virulent, although SARS Co-V2 gets around that to some extent with the long incubation/asymptomatic period.

[Ken the cruiser]

48 minutes ago, D C said:

Though I'm amused and saddened that there are seemingly no real reports about why cases are dropping so rapidly, despite there being no shortage of assertions about how far off and how high the % is for herd immunity.  If you think you know the latter, then your models should be able to account for the current drop. 

Here's my totally unofficial guess as to why the sudden drop.

 

1. The country went through a BIG reality check during the Holiday season and a BUNCH of folks got COVID while others saw their friends and family get it.

 

2. The vaccines started to flow after the first of the year, with 53.8 million doses being given so far. So with the possible "light at the end of the tunnel" starting to flicker with multiple vaccines becoming available, some more folks have started realizing if they just play the mask game for just a little while longer, they might have a chance to get through all of this.

 

3. There are millions of folks that have already got COVID and don't want to get it again, so they as well as their friends and family are continuing to play it safe as well.

 

4. Then, finally, there is a unified position coming from the government that wearing a mask, social distancing and taking proactive steps by getting the ANG and other government agencies involved to get the vaccine out to as many folks as possible in the shortest amount of time is the smart way to go to get COVID in the rearview mirror.

 

Add that all together and you get my unofficial "peanut gallery" reasoning behind why the curve is starting to flatten.

Edited February 15, 2021 by Ken the cruiser

[4774Papa]

1 hour ago, upwarduk said:

Promising news. Just wish I could get my second dose ( 1st Pfizer shot 6 weeks ago).

Promising news in UK, cases & hospitalisation down by 35% last week. 
15m target by 15.02.21 was met yesterday and 95% of over 70’s have taken the vaccine offer.

Obviously this age group take no notice of the anti- Vaxers 

Surprisingly only 65% of Care Home staff have taken up the offer.

The UK is doing very well with its vaccinations.  Per capita, it is doing better than the USA and the USA has vaccinated more than 52 million doses.   The EU is way behind.  What happened to the EU?   Israel and the UAE have been amazing with vaccinations.

[TeeRick]

50 minutes ago, Ken the cruiser said:

Here's my totally unofficial guess as to why the sudden drop.

 

1. The country went through a BIG reality check during the Holiday season and a BUNCH of folks got COVID while others saw their friends and family get it.

 

2. The vaccines started to flow after the first of the year, with 53.8 million doses being given so far. So with the possible "light at the end of the tunnel" starting to flicker with multiple vaccines becoming available, some more folks have started realizing if they just play the mask game for just a little while longer, they might have a chance to get through all of this.

 

3. There are millions of folks that have already got COVID and don't want to get it again, so they as well as their friends and family are continuing to play it safe as well.

 

4. Then, finally, there is a unified position coming from the government that wearing a mask, social distancing and taking proactive steps by getting the ANG and other government agencies involved to get the vaccine out to as many folks as possible in the shortest amount of time is the smart way to go to get COVID in the rearview mirror.

 

Add that all together and you get my unofficial "peanut gallery" reasoning behind why the curve is starting to flatten.

Ken I think it is point 3 but for a different reason.   Let's think about some numbers.  About 28 million confirmed COVID cases (positives) cumulative in the US as of today.  But CDC estimates about 3-4X that number of infections conservatively.  Most people carry immunity if previously infected to some degree or even full degree.  So with the number vaccinated (52 million doses, or 25 million people) and the number infected or previously infected (100 million?) we are at about 125 million with some sort of COVID immunity.  And not counting the people who seem to be naturally immune or resistant to infection (most kids- the US Population 0-18 years old is 74 million).   So we are really on the verge of developing some amount of herd immunity to start to make a difference.  Not full herd immunity.  But trending in the right direction for sure.  

[Ken the cruiser]

5 minutes ago, TeeRick said:

Ken I think it is point 3 but for a different reason.   Let's think about some numbers.  About 28 million confirmed COVID cases (positives) cumulative in the US as of today.  But CDC estimates about 3-4X that number of infections conservatively.  Most people carry immunity if previously infected to some degree or even full degree.  So with the number vaccinated (52 million doses, or 25 million people) and the number infected or previously infected (100 million?) we are at about 125 million with some sort of COVID immunity.  And not counting the people who seem to be naturally immune or resistant to infection (most kids- the US Population 0-18 years old is 74 million).   So we are really on the verge of developing some amount of herd immunity to start to make a difference.  Not full herd immunity.  But trending in the right direction for sure.  

Works for me! As long as the curve keeps flattening and the vaccine flow continues to expand, that's what really counts. 

Edited February 15, 2021 by Ken the cruiser

[GerScot]

39 minutes ago, 4774Papa said:

The UK is doing very well with its vaccinations.  Per capita, it is doing better than the USA and the USA has vaccinated more than 52 million doses.   The EU is way behind.  What happened to the EU?   Israel and the UAE have been amazing with vaccinations.

The EU delayed placing orders with vaccine suppliers (3 months behind UK) and once the vaccines were approved they did not get what was expected due to manufacturing issues. They are under a lot of pressure to ramp up.

[UnorigionalName]

7 hours ago, upwarduk said:

Promising news. Just wish I could get my second dose ( 1st Pfizer shot 6 weeks ago).

Promising news in UK, cases & hospitalisation down by 35% last week. 
15m target by 15.02.21 was met yesterday and 95% of over 70’s have taken the vaccine offer.

Obviously this age group take no notice of the anti- Vaxers 

Surprisingly only 65% of Care Home staff have taken up the offer.

 

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)00183-5/fulltext

 

The hopes on natural immunity may be too optimistic.  At this point, the immunity conferred from the first (winter 2019-2020) and second (summer 2020) waves may not actually be protective anymore.

 

edit: whoops, quoted wrong post... sorry...

Edited February 15, 2021 by UnorigionalName

[Ken the cruiser]

Looks like the EU might grant regulatory clearance for the J&J vaccine by mid March. 

 

Unlike the three shots already approved in Europe, J&J’s vaccine can be given in a single dose, an advantage as countries seek to speed up inoculations. The EU has ordered 200 million doses, though deliveries probably won’t start before early April, Von der Leyen warned earlier this month. 

 

J&J Seeks EU Clearance for Single-Dose Covid-19 Vaccine (msn.com)

[nocl]

On 2/15/2021 at 9:33 AM, TeeRick said:

Ken I think it is point 3 but for a different reason.   Let's think about some numbers.  About 28 million confirmed COVID cases (positives) cumulative in the US as of today.  But CDC estimates about 3-4X that number of infections conservatively.  Most people carry immunity if previously infected to some degree or even full degree.  So with the number vaccinated (52 million doses, or 25 million people) and the number infected or previously infected (100 million?) we are at about 125 million with some sort of COVID immunity.  And not counting the people who seem to be naturally immune or resistant to infection (most kids- the US Population 0-18 years old is 74 million).   So we are really on the verge of developing some amount of herd immunity to start to make a difference.  Not full herd immunity.  But trending in the right direction for sure.  

Except for the variants, while the current vaccines do appear to provide some protection against the SA variant, there are documented cases of those that had been previously infected by the original strain getting re-infected by the SA strain.  Since the duration of natural immunity is unknown, we are now starting to approach 1 year since the fist infections.  Between the variants and the time since infection I would not be overly reliant on previous infections.

 

They help, but the benefit is unknown.  One well documented SA re-infection case is far worse than the individuals original infection (both strains were analyzed and the strains identified).

[CRUISEFAN0001]

14 hours ago, nocl said:

Except for the variants, while the current vaccines do appear to provide some protection against the SA variant, there are documented cases of those that had been previously infected by the original strain getting re-infected by the SA strain.

4 people per million hardly represents anything. Exceptions exist to nearly every rule, and it's also proven that underlying conditions lead to immunity sustainability.

 

If vaccination is mandatory for all passengers and crew, and the vaccines themselves also exponentially reduce symptoms for the 0.4% of anyone who contracts COVID...you can pretty much put a fork in this pandemic...it's virtually done.

[4774Papa]

15 hours ago, nocl said:

Except for the variants, while the current vaccines do appear to provide some protection against the SA variant, there are documented cases of those that had been previously infected by the original strain getting re-infected by the SA strain.  Since the duration of natural immunity is unknown, we are now starting to approach 1 year since the fist infections.  Between the variants and the time since infection I would not be overly reliant on previous infections.

 

They help, but the benefit is unknown.  One well documented SA re-infection case is far worse than the individuals original infection (both strains were analyzed and the strains identified).

A Pfizer news release said laboratory studies show its vaccine “elicits antibodies that neutralize SARS-CoV-2 with key mutations present in U.K. and South African variants.” 

The vaccine was “slightly” less effective against the South African variant, the news release said, but Pfizer and its European partner BioNTech “believe the small differences in viral neutralization observed in these studies are unlikely to lead to a significant reduction in the effectiveness of the vaccine.”

Pfizer said it doesn’t think a new kind of vaccine is necessary to battle the variants, but if there’s evidence the variants are resistant to the vaccine, it will do so.

[TeeRick]

One thing to keep in mind is that the immune response to a virus infection or vaccine includes a whole host of components.  Particularly T-Cells as well as antibodies.  And both responses get turned on quickly if the virus or antigen is seen again. They are primed and ready.  Even if they are waning post original infection.  So even if a variant is successful at evading some antibodies, the T-cells in the normal immune system will likely have some protective effect.

[jagoffee]

1 hour ago, 4774Papa said:

A Pfizer news release said laboratory studies show its vaccine “elicits antibodies that neutralize SARS-CoV-2 with key mutations present in U.K. and South African variants.” 

The vaccine was “slightly” less effective against the South African variant, the news release said, but Pfizer and its European partner BioNTech “believe the small differences in viral neutralization observed in these studies are unlikely to lead to a significant reduction in the effectiveness of the vaccine.”

Pfizer said it doesn’t think a new kind of vaccine is necessary to battle the variants, but if there’s evidence the variants are resistant to the vaccine, it will do so.

Thanks, very interesting.  It would appear that those that were pushing the narrative that the current vaccines will not be effective against the new variants  instead of may not (because it has not been tested) were incorrect.

[mimbecky]

If phase 3 studies started last summer and are continued to be followed, shouldn't we know sometime this summer if the efficacy of these vaccines last at least a year? We would now be at 6 months with initial vaccinations yet I haven't heard any updates.  I would think they would start releasing this data.

M

[cangelmd]

2 hours ago, TeeRick said:

One thing to keep in mind is that the immune response to a virus infection or vaccine includes a whole host of components.  Particularly T-Cells as well as antibodies.  And both responses get turned on quickly if the virus or antigen is seen again. They are primed and ready.  Even if they are waning post original infection.  So even if a variant is successful at evading some antibodies, the T-cells in the normal immune system will likely have some protective effect.

THIS

 

We are in the stage where tincture of time is almost the only thing that can answer the questions we have. If, by about the end of March, hospitalizations and deaths are still declining or at least flattened at a low level - then we will know that immunity is long enough lived to suppress transmission. It will be years before we truly know how long lasting immunity will be. I think that there will be at least one round of boosters for the variants, but that may not end up being the case.

I also think that we will have one more smaller bump up of infections between now and late March due to the variants, the big question is will there be an increase in hospitalizations or perhaps a drop in age of those hospitalized (because the older folks have been vaccinated in large numbers).

[cangelmd]

3 minutes ago, mimbecky said:

If phase 3 studies started last summer and are continued to be followed, shouldn't we know sometime this summer if the efficacy of these vaccines last at least a year? We would now be at 6 months with initial vaccinations yet I haven't heard any updates.  I would think they would start releasing this data.

M

Long term followup is an expensive piece of clinical trials and it is harder to get people to remember and cooperate if the trial participants are bearing some responsibility - that's to say data will be spottier and take longer to appear.

The T cell immunity TeeRick talks about is not easily directly measurable, particularly on the scale necessary for a vaccine study, so you have to look for the failure of immunity - people getting sick. The less virus circulates, the less people will get sick, so even the good outcomes make it take longer to get data.

[TeeRick]

8 minutes ago, jagoffee said:

Thanks, very interesting.  It would appear that those that were pushing the narrative that the current vaccines will not be effective against the new variants  instead of may not (because it has not been tested) were incorrect.

It depends how people define effective vs. protective.  For example, the one-shot J&J vaccine  was actually tested in South Africa against the variant.  It had 57% efficacy so in that case 43% of vaccinated people were not fully protected after getting exposed to the variant virus and were virus- positive and some had mild to moderate symptoms.  But 100% of these infected people were not hospitalized and there were no deaths.  So most would define this as an effective vaccine as it eliminated hospitalizations and deaths.  

[4774Papa]

27 minutes ago, TeeRick said:

It depends how people define effective vs. protective.  For example, the one-shot J&J vaccine  was actually tested in South Africa against the variant.  It had 57% efficacy so in that case 43% of vaccinated people were not fully protected after getting exposed to the variant virus and were virus- positive and some had mild to moderate symptoms.  But 100% of these infected people were not hospitalized and there were no deaths.  So most would define this as an effective vaccine as it eliminated hospitalizations and deaths.  

TeeRick,

You are the gift that keeps on giving on this subject.

[Ken the cruiser]

Whelp, I guess the J&J vaccine may come in handy when the Group 2 folks finally get to receive their shots. Thank goodness Pfizer and Moderna are currently ramping up their efforts to get more vaccines out the door a lot sooner than previously estimated.

 

U.S. Sees ‘Few Million’ Doses to Start Once J&J Vaccine Arrives (msn.com)

 

Any word yet on how AstraZeneca is doing in their US stage 3 trial and/or when they might release their data to the FDA? Although after reading this article, I'm not feeling too positive about an EUA anytime soon.

 

FDA could reject AstraZeneca’s COVID vaccine on efficacy and manufacturing shortfalls: analyst | FiercePharma 

Edited February 17, 2021 by Ken the cruiser

[markeb]

Well, Ken...

 

Let's see how things go with J&J. I'm a little surprised they don't have more doses on hand in the US, but they apparently are delivering elsewhere around the world.

 

I don't know what to make of AstraZeneca. They will have to present ALL data, regardless of source of the trial. And they're going to have to be able to explain it. I frankly think an EUA is unlikely, but not impossible. If J&J had 100M doses ready to deliver once an EUA is granted, or if Moderna and Pfizer are able to produce enough doses to exceed downstream vaccination capabilities, then I'd go with impossible instead of improbable.

 

There's a brief note in the WAPO today that South Africa has initiated their vaccine program with the J&J product after the AZ trial showed no protection against mild and moderate effects of the circulating variant. I don't see AZ restarting their trial in South Africa to look for protection against severe effects if they can get enough other vaccines. And if the article you linked is accurate, I'm concerned they've lost control of their global manufacturing process. Which you really don't want to do during clinical trials. You want a clean process through the trials, then bridge to other manufacturers.

 

The AZ vaccine always had a lot of promise, and a lot of potential problems. I probably didn't think efficacy was really one of them, but throw that on top of some of the other challenges, and they've got problems. And the FDA doesn't like problems...

[nocl]

5 hours ago, 4774Papa said:

A Pfizer news release said laboratory studies show its vaccine “elicits antibodies that neutralize SARS-CoV-2 with key mutations present in U.K. and South African variants.” 

The vaccine was “slightly” less effective against the South African variant, the news release said, but Pfizer and its European partner BioNTech “believe the small differences in viral neutralization observed in these studies are unlikely to lead to a significant reduction in the effectiveness of the vaccine.”

Pfizer said it doesn’t think a new kind of vaccine is necessary to battle the variants, but if there’s evidence the variants are resistant to the vaccine, it will do so.

The point I was making is that while the vaccines may provide some protection from the variants, data is starting to appear that infection from the original strain may not.  As such one may not be able to count the previously infected in looking at numbers for herd immunity if some of the new strains (SA for example) get wide spread.