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

ox.ac.uk

81–90 of 187 posts

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

#81

It just gets better and better for the UK - which is a relief because early January had some grim sickness and death numbers. Check out the data on the UK Gov dashboard if you've not seen it: https://coronavirus.data.gov.uk/ Also - we are all in lockdown, which helps.

"Better" is doing a lot of work here. The UK (in particular, England) is currently reporting the second highest new death rate per capita in the world, still higher than it was at any point in 2020. It continues to report 1000+ unnecessary deaths per day. And, is it still the case that the UK has 50% more excess deaths than it is reporting in the daily coronavirus figures? A mystery...

It's worth looking here : https://github.com/dkobak/excess-mortality for clear statistics. There is a big difference between what is reported and what the actual numbers work out to be.

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

#82
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?

I think that the early oxford trials reported infections from day 1 of the shot, later reports are talking about what happens after 21 days.

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

#83

It just gets better and better for the UK - which is a relief because early January had some grim sickness and death numbers. Check out the data on the UK Gov dashboard if you've not seen it: https://coronavirus.data.gov.uk/ Also - we are all in lockdown, which helps.

That's pretty good. Is the vaccination drive going on in full speed?

Yes, there have been over 10 million vaccinations so far. They did over 900,000 last weekend alone.

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

#84

Earlier quoted context omitted.

> 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

Other countries have, though, and they don't have millions of doses waiting for approval or factories waiting to spin up production.

The bottleneck has generally been manufacturing rather than approval so far. It may shift to distribution.

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

#85
post #12

Earlier quoted context omitted.

Afaik it means that if you have a control group that isn't vaccinated vs this group (both should be drawn randomly of course), you will see 76% less infections in this group.

That is not what any of the vaccine studies have said so far. I haven't read this one, but I bet it also doesn't say this. The stated efficacy/protection percentages that have been presented so far have been for the reduction of _symptoms_. There haven't been any studies on vaccines preventing infections, probably due to lack of resources for testing everyone in a trial multiple times.

The vaccines which are administered intramuscularly aren't expected to prevent infection at all.

You won't have neutralizing antibodies in the mucosal surfaces in the upper respiratory tract which would be required to completely prevent infection.

You will have NAbs in the bloodstream which should very effectively isolate the infection to the upper respiratory tract. Immune responses will also be primed so that the infection in the upper respiratory tract will be dramatically reduced. In many cases though the infection will be detectable via rtPCR but that won't be significant since the person won't be symptomatic, won't "feel sick" (or very sick) and will be very unlikely to transmit the virus. It should also entirely cut out the multi-organ involvement of covid since the neutralizing antibodies in the blood will prevent spread to the lungs/kidney/heart/brain/etc.

Testing via rtPCR for "infection" would be an expensive waste of time in a vaccine which isn't expected to confer that level of protection. And when it failed to confer that level of protection you're left trying to explain why that low number doesn't matter to a population expecting some kind of medical miracle.

Instead they watch for symptoms and then they confirm that is a SARS-CoV-2 infection via rtPCR, and this is the typical "efficacy number" which is reported (I think the initial Oxford trial results did report the results of randomized rtPCR testing so their numbers were dramatically lower, which has caused all kinds of confusion since its not apples-to-apples with the mRNA vaccine results).

Reduction in transmissibility is more difficult to determine which is why those numbers aren't reported, it is assumed that reduction in symptoms correlates with reduction in transmissibility. So none of the vaccine trials can conclusively rule out asymptomatic spread in vaccinated individuals. However since the people are being followed over time what is caught is any infection which subsequently produces symptoms. So the vaccinated asymptomatic individuals would be truly asymptomatic and not just presymptomatic. Dramatically cutting down symptoms is expected to be a pretty good proxy to dramatically cutting transmission.

Relevant quote from a recent BMJ article on truly asymptomatic transmission:

> The transmission rates to contacts within a specific group (secondary attack rate) may be 3-25 times lower for people who are asymptomatic than for those with symptoms.1121415 A city-wide prevalence study of almost 10 million people in Wuhan found no evidence of asymptomatic transmission.16 Coughing, which is a prominent symptom of covid-19, may result in far more viral particles being shed than talking and breathing, so people with symptomatic infections are more contagious, irrespective of close contact.17 On the other hand, asymptomatic and presymptomatic people may have more contacts than symptomatic people (who are isolating), underlining the importance of hand washing and social distancing measures for everyone.

https://www.bmj.com/content/371/bmj.m4851

The title study here on HN on the Oxford vaccine is pretty clear that they're looking for "primary symptomatic COVID-19" which means they're not screening for asymptomatic infection, they're waiting for symptoms, then confirming.

They found that one shot conferred good protection (76%) for at least 90 days post vaccination (after the first 2 weeks) with little waning and some evidence that it gets better. They also found that the BEST boosting interval was 12+ weeks or more, reaching 82% efficacy. This matches what I've heard some virologists yap about informally online that longer boosting intervals are generally what is recommended (more or less letting the learning immune response bake longer while letting the immediate response to the vaccine vector wane) but the early studies used short intervals due to pandemic driven concerns around giving health providers and the elderly the best immunity in the shortest period possible. Now that we're transitioning to needing to vaccinate literally everyone the message may unfortuntely shift in ways that make people suspicious.

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

#86
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.

This is very innacurate. We have the following data: -Moderna data between the 1st and 2nd dose at 28 days -Pfizer data between the 1st and 2nd dose at 21 days -Aztrazeneca data between 1st & second dose at various dosing schedules -J&J data -Novavax data -Data from Isreal real world deployments of the vaccine -Data from UK First Dose First effort -Our Bayseian priors - You can read the FDA briefings for Moderna & Pfizer which review the 1 dose data, its very readable.

The empirical data is overwhelming from many sources and the data matches our current disease models. All signs suggest overwhelmingly that: (1) 1 dose appears to be 100% effective at preventing death in all candidates >14 days after the 1st dose. (2) The marginal benefit of the second dose is real but comparatively much smaller. (3) The delaying the second dose appears to confer additional immunity.

Focusing on 1st doses is by far the best decision.

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

#87

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.

The problem is the lack of certainty. Most suspect that you won't lose protection by waiting longer than the suggested timeline, but what you really don't want to do is sleep-walk into throwing away the currently administered doses.

Frustratingly, I'm guessing the timelines for a study on the durability of single dose moderna/pfizer would take about as long as it will take to ramp up production.

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

#88
post #68

Strangely, this news went under the radar: https://www.bmj.com/content/372/bmj.n149 23 deaths in Norway, possibly from vaccine.

First, it was 33 people out of around 50,000 elderly and vulnerable people who were vaccinated. Your source is outdated. Second, it went under the radar because it's probably not attributable to the vaccine. The people who died were over 80 and already extremely frail with pre-existing conditions. They either died from those conditions or from their inability to cope with the mild side-effects of the vaccine, which e…

To reinforce this, one of the statistics that the beeb have wheeled out is that in the most vulnerable group being vaccinated (in the UK), aged 80+, one in ten of them will die regardless of covid in the next year. Quoted from "How to vaccinate the world -- Vaccine Hesitancy" [0] from 12 minutes in to 15 minutes. (And because it's BBC sounds, for some reason it randomly skips episodes when I load the page).

The entire series is well worth a listen, data driven and statistics heavy.

[0] https://www.bbc.co.uk/sounds/play/m000qblw

Edit - because the beeb want registration, alternate link: https://podcasts.apple.com/gb/podcast/vaccine-hesitancy/id15...

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

#89
post #10

Hopefully this additional data will get the US to act the way they should have in November. Lift the ban on Astrazeneca. It's been given safely to millions now, with zero deaths from covid in the vaccinated (+14 days). The FDAs failure to approve Astrazeneca is the most horrifying government agency failure I have ever seen.

I was thinking the other day whether whether the world-wide effort to vaccinate as many people as possible will be a major blow to the anti-vax movement - in that once it is shown that there's no negative consequences of so many people taking a vaccine. E.g. no increase in autism rates. Fingers crossed.

I suspect it will hurt the anti-vax movement. There wasn't a lot of Anti-Vax activity before 1980 because so many people watched diseases get eradicated by vaccines in realtime. But, I don't expect it to make a giant difference :(

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

#90

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.

Reporting from Australia I think the general feeling here about the AZ vaccine is positive, as we feel fortunate to have access to a vaccine that is robust (doesn't require an extreme cold chain) and, most importantly, that we can manufacture ourselves. Not just for Australia but also for the Pacific nations in our area (e.g. Papua New Guinea, Fiji, Tahiti, etc).

I can't speak for India but I imagine that they are happy to have access to this vaccine as well, as they are similarly going to manufacture it, and to a scale that will dwarf everyone else. And it not needing a special cold chain is even more of a plus in India of course.

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