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Oxford vaccine shows sustained protection of 76% in 3-month gap til second dose

ox.ac.uk

71–80 of 187 posts

Re: Oxford vaccine shows sustained protection of 76% in 3-month gap til second dose

#71

Earlier quoted context omitted.

See, this is a classic example. You need BSL3 facilities if you want to have a hundred people have it. But the alternative is 27 million people getting it in planes, boats, and buses - none of which are BSL3. That part is okay. Quite the example of the asymmetry. If you engage with the problem you have to operate absolutely perfectly. Way better not to engage with it and kill a few hundred thousand people. After all,…

> You need BSL3 facilities if you want to have a hundred people have it. But the alternative is 27 million people getting it in planes, boats, and buses - none of which are BSL3. Those things are not true alternatives. I said "it's not going to get your vaccine approved any quicker" in the hope that you would understand: vaccines have reached the point of global distribution without doing the additional deliberate ha…

Well, we've taken your approach and killed 300k in the process, so I guess we could play at being tankies in the '90s and say "If only the Communism were properly done" or we could revisit the approach.

Of course I am healthy, my family has had the vaccine or the disease and punched through, so I don't really care all that much.

Re: Oxford vaccine shows sustained protection of 76% in 3-month gap til second dose

#72
post #57

How that compares to the announcement from https://www.ema.europa.eu/en/news/ema-recommends-covid-19-va... where they state the the efficacy is 59.5%? Is it a different dose or different timeline?

The data the EMA (at least, the public stuff) is from the first "lock" of the data for analysis - November 4th. The current preprint from Oxford is from about one month later.

Re: Oxford vaccine shows sustained protection of 76% in 3-month gap til second dose

#73

Earlier quoted context omitted.

See, this is a classic example. You need BSL3 facilities if you want to have a hundred people have it. But the alternative is 27 million people getting it in planes, boats, and buses - none of which are BSL3. That part is okay. Quite the example of the asymmetry. If you engage with the problem you have to operate absolutely perfectly. Way better not to engage with it and kill a few hundred thousand people. After all,…

> You need BSL3 facilities if you want to have a hundred people have it. But the alternative is 27 million people getting it in planes, boats, and buses - none of which are BSL3. Those things are not true alternatives. I said "it's not going to get your vaccine approved any quicker" in the hope that you would understand: vaccines have reached the point of global distribution without doing the additional deliberate ha…

FDA still hasn't authorized the AZ vaccine

Re: Oxford vaccine shows sustained protection of 76% in 3-month gap til second dose

#74

It’s interesting how the Astra Zeneca vaccine is such an emotional topic. In the UK it’s seen as the greatest weapon against the pandemic, in the US it is not playing much of a role and in the EU public perception is super negative.

> in the US it is not playing much of a role

That's because the FDA is waiting for the completion of AZ's trial in the US. This should be definitely better run than the meta-trials done elsewhere and give clearer numbers.

A likely readout would be in March, or April.

Re: Oxford vaccine shows sustained protection of 76% in 3-month gap til second dose

#75
post #48

The case for a one-dose first strategy gets stronger and stronger, but due to slavish proceduralism, the FDA wouldn’t consider it.

Indeed, even the practice of calling certain vaccines "2-dose" or "1-dose" is somewhat arbitrary & misleading, reflecting rushed early decisions about which courses to test.

The Pfizer/Moderna mRNA vaccines might be just as effective, 30d-onward after one dose, as the "1-dose" J&J.

The tested 21d/28d spacing for the mRNA vaccines might be far shorter than optimal, so the ad-hoc "emergency" delays of booster shots by many jurisdictions might actually be benefitting long-term immunity.

The "1-dose" J&J might benefit greatly from a booster 30d, 90d, 180d later.

Even the dosings could be far from optimal, with some hints that half or less of the mRNA vaccines may be just as effective, especially in younger patients. And of course there was the AZ/Oxford glitch that mistakenly gave half the intended dose in the 1st shot - & that subgroup seemed to have even less disease after the 2nd full-dose shot. (While this could be a statistical fluke, maybe also a "booster" that's stronger is read by the immune system to mean that the disease is continuing to become even more of a threat, so it reacts even more strongly than to a "same as we beat before" dose. Until lots more study is done – who knows?)

So: people who treat the officially/rigorously evaluated doses/schedules as "optimal" or "the only safe course" are way overclaiming what the data shows. They data we have are a series of singular draws from the possibility-space, showing some points of reasonably-safe and -effective approach.

With plenty of other data constantly arriving, hinting at other equally- or more-effective approaches, regions & practitioners should be free to use their best-judgement to navigate risk/reward tradeoffs.

Re: Oxford vaccine shows sustained protection of 76% in 3-month gap til second dose

#76
post #48

The case for a one-dose first strategy gets stronger and stronger, but due to slavish proceduralism, the FDA wouldn’t consider it.

There is 0 data that any of the vaccines approved by the FDA are efficacious with a single dose. There is 0 data to support that a delayed dose is efficacious. The FDA is making a very, very valid choice so far.

Your claim of "0 data" is completely wrong. The original phase 3 trials already showed limited support for partial one-dose efficacy. (They even broke it down in their writeups! That's non-zero data!)

Observational reports so far on the tens of millions additional doses given (compared to a mere ~15-20K in phase 3 trials) is also suggestive of 1-dose efficiency. (Most recently, a retrospective study in Israel – the nation with the highest proportion of its population immunized – found 51% efficacy against "confirmed COVID" looking at just days 13-24 after a single dose – and that's in a world with far more variants than the original mRNA studies. It's reasonable to conjecture from other results that the efficacy would be even better later, and better against "severe disease".)

Plus, there's everything we can reason about from similar diseases & vaccines.

The reason to wait for 2nd-dose-plus-7d in study "primary endpoints" is to have a singular, legible, stark readout for rather-simpleminded regulatory processes. But smart people who live in the real world know the actual mechanisms are far more fluid/incremental, with immune processes starting immediately from one dose, then accelerating over weeks (even without a booster).

Re: Oxford vaccine shows sustained protection of 76% in 3-month gap til second dose

#77
post #30

It’s interesting how the Astra Zeneca vaccine is such an emotional topic. In the UK it’s seen as the greatest weapon against the pandemic, in the US it is not playing much of a role and in the EU public perception is super negative.

The main EU issue was that they weren't getting supplies they said they were promised, right? [1] And, presumably, if the supplies are short, there wouldn't be enough available near-term in the US to make a difference. (Added: And, right, there were testing issues in US trials early-on.) [1] https://www.npr.org/2021/02/01/962705729/eu-to-get-9-million...

The negative public perception of AZ in the EU is independent of delivery issues. Those exist with most vaccine manufacturers as the EU did not introduce export controls.

Re: Oxford vaccine shows sustained protection of 76% in 3-month gap til second dose

#78

Earlier quoted context omitted.

The EU seems to keep bringing focus back onto the over-65 efficacy. The German government has said it shouldn’t be used on over-65s, Poland has now followed, and Macron has been out in the press regurgitating incorrect statistics he misread somewhere (saying it’s only 10% effective, rather than the correct stat being that the age group made up around 10% of test subjects). Personally I think the UK approach is the wa…

Countries that have a supply of Pfizer/Moderna as well as AZ can understandably be more cautious with AZ to over-65 at least early on. It’s just a matter of assigning the right vaccine to the respective groups, e.g Pfizer to the elderly and AZ to healthcare workers. In a month or two there will be more data, but in Q2 there will also be more supply of Pfizer and Moderna in the EU. The EU can be cautious with AZ to el…

> Countries that have a supply of Pfizer/Moderna

I'm very excited that RNA vaccines are now a reality.

But the logistics for these RNA vaccines is much more difficult. Specialist freezers are required. Meaning it takes longer to vaccinate folk.

Re: Oxford vaccine shows sustained protection of 76% in 3-month gap til second dose

#79

Even more consequential than the fact from the headline is the preliminary result that a spacing of 12 weeks does not seem to reduce efficiency. I wish my country and others would take note and give priority to handing out as many first doses as possible, but my hope for such quick adoption of scientific findings has been rather diminished by the whole event.

The first dose prevents hospitalization. Right now, for every second dose we give, that's a decision to deny someone a life-saving dose in favor of someone already protected. What a strange prioritization to make.

The bright side is that, if the rate of vaccination continues to increase, those denied the first dose now should still get the first dose soon after. Let's hope we don't hit some manufacturing bottleneck.

Re: Oxford vaccine shows sustained protection of 76% in 3-month gap til second dose

#80

It’s interesting how the Astra Zeneca vaccine is such an emotional topic. In the UK it’s seen as the greatest weapon against the pandemic, in the US it is not playing much of a role and in the EU public perception is super negative.

My perception of the Oxford/AstraZeneca vaccine is that their credibility is compromised. I take claims of its efficacy with a similar dose of salt to claims about the Russian and Chinese vaccines. Reason is that early on they were rushing data and approvals on grounds of national pride, in a very similar way to the Chinese and Russian authorities. Pfizer and Moderna seem to have been more thorough.

This is nonsense. It's not about national pride. The UK authorised Pfizer first.

We knew back in December how effective just one dose[1] of the Oxford-AstraZeneca vaccine is, at stopping death. See figure 2 on page 28.

[1] https://www.fda.gov/media/144434/download

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