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Oxford University breakthrough on global COVID-19 vaccine

ox.ac.uk

471–480 of 569 posts

Re: Oxford University breakthrough on global COVID-19 vaccine

#471
post #180

Earlier quoted context omitted.

I talked to a bunch of CROs about the cost of Phase 3 trials. It varies, but is roughly $10,000 to $15,000 per patient year. Pfizer’s trial will run for 2 years, so ~$900M for the trial alone. That’s excluding all the work to scale up the production, regulatory filing, distribution, etc. Edit: my math sucks. $900M, not $90M

Is it really $10-15k each additional patient year requires or it's more of "total cost was this much, we divide it by number of patients". Where do this money go to? Fx, with these covid trials, 40000 people in pfizer trial, half a year cost would be $200-300 mln. People presumably weren't paid for this. Of course there's some work by doctors that needs to be paid for, but that can't be this large amount. Also, does…

I'm a volunteer for this vaccine, in the first month I have three in-patients visits, involving two inoculations, 6 blood draws, 2 Covid tests, and three nasal absorption tests. My first visit lasted a little over three hours including a very comprehensive medical history and physical exam, and time taken to ensure that I was giving truely informed consent. I interacted with three medical professionals on the first visit, sometimes in the exam room, and sometimes via phone from the exam room to protect each other from long in person indoor exposure. Like any medical visit this year, a considerable amount of PPE was used. I was given an app use daily to record my health, and a digital thermometer so that all subjects are using the same calibrated equipment. Having reported a headache two days in a row in the app, there was a remote phone call follow up by a research clinician, in addition to the planned check in phone calls that I haven't mentioned. They do pay me a very modest ammount, so I've bought myself a couple of ebooks after paying for big city parking near the research clinic. They need to pay for that office space. Before I entered the study I needed to interact with recruiters, to qualify that it was safe enough for me to participate and to ensure that they were getting people from a variety of backgrounds. They needed to be ready to respond if I had a severe adverse reaction to the the trial vaccine. There is an entirely separate independent review board that I can go to with questions. In the event that I had Covid symptoms, there is an entirely separate set of assessments, visits and samples taken.

Given the amount of work being done by this and other research labs hired Astrazeneca, and comparing this to quotes I've received for a very modest UX usability studies, it's hard to see see this an sort of money grab.

Re: Oxford University breakthrough on global COVID-19 vaccine

#472
post #446

Earlier quoted context omitted.

Your points are baked into the data that I linked. The metric within is "HAQ Index" which stands for "Healthcare Access and Quality". I.e., access is part of the measure. In the US everybody has access, which is part of the problem that drives costs higher. E.g., if you don't have insurance you can walk into an emergency room and get treated even if it's not an emergent situation. If you don't have insurance, there i…

In Europe, Canada, Australia, etc everyone has access. Why doesn’t access drive up their cost? Clearly access isn’t what is driving up the costs in the USA.

Because it's not as simple a model as "access vs. cost". It's access vs. quality vs. cost.

Canada's HAQ index in 2015 was 87.6 vs. 81.3 for the US. However, Canada spent about $27B US on R&D vs. $495B for the US. On a per capita basis, the US outspends most the world on medical R&D. That drives the US total healthcare costs up while helping to drive down the healthcare quality costs elsewhere. To a certain extent, the US subsidizes the healthcare costs through much of the world, effectively allowing them to optimize for a 2 parameter model while the U.S. must still deal with a 3 parameter model.

Re: Oxford University breakthrough on global COVID-19 vaccine

#473
post #461

Earlier quoted context omitted.

The risk of death in kids without underlying diseases is is approximately 0. It is not clear that giving (e.g. in the US) 30,000 of these kids narcolepsy is reasonable. It might be, but it’s not open and shut.

As far as I know, none of the COVID19 vaccines have been tested on children under 12 or are currently planned on being given to children. Additionally, it's not as if the average vaccine has a 0.005% chance of giving you narcolepsy. That figure was for the one vaccine in one country which appears to be the only example in most people's living memory of a vaccine possibly causing long-term side effects (it's not even…

I've also mentioned the cutter polio vaccine and the 1976 swine flu vaccine which seems to have caused an uptick of GBS.

> There have been tens of billions of vaccines given during this time period and this is the only example where there may have been long term side effects.

No, there are other examples, the other two I just mentioned are from memory, I suspect if I go research I will find more (I don't have the time). You know what else is common to those other two cases? They were rushed (pandemrix wasn't AFAIK).

SARS-Cov-2 vaccines were all rushed, and the safety protocols used to confidently ascertain those billions of vaccines were NOT followed - The standard is to wait 2-4 years to see that there's no ADE or other issues.

I am pro-vaccination. I don't understand why it is hard to acknowledge and discuss the risk profile of vaccines - they re not risk free. Excuse me if I don't automatically think a rushed vaccine is perfectly safe.

Re: Oxford University breakthrough on global COVID-19 vaccine

#474

Earlier quoted context omitted.

Actively preventing someone from saving a third person is murder. Even if there is risk involved.

Who is preventing whom from being saved?

The people and government organizations that opposed challenge trials are preventing the participants in challenge trails from saving people who actually did die from Covid.

Re: Oxford University breakthrough on global COVID-19 vaccine

#475
post #456

Earlier quoted context omitted.

You probably don't know how the US system works. The only access that is guaranteed by law is to emergency services. If you don't have a paid insurance (through your employer or yourself), then you cannot access preventive care or otherwise normal medical consultation. Millions of people in the US don't have access. For example, if someone needs to treat cancer, it doesn't make any good to go to an emergency unit: th…

> if someone needs to treat cancer, it doesn't make any good to go to an emergency unit That's because the ER is meant to stabilize a patient, not cure chronic disease. Which is to my point: people will forgo preventative medicine until their condition deteriorates and they need to be stabilized in an ER. People get their non-emergent conditions treated all the time in American emergency rooms. E.g., if I have diabet…

Curious, in your healthcare experience, what would you estimate is the percentage of people who do have good insurance, but don't get preventative care by choice?

E.g. for myself, I have good insurance, but I don't have a "primary care doctor." I don't go to the doctor unless I'm injured or sick. And I don't mean a sniffle or cough, I mean sick as in I have felt awful for several days.

Re: Oxford University breakthrough on global COVID-19 vaccine

#476
post #348

Earlier quoted context omitted.

how about compared to the covid risk of a perfectly healthy young adult?

covid risk varies wildly depending on socioeconomic factors. Educated, WFH, small family, stable or low IRL social interaction: pretty low risk. Low-education, multiple in-person jobs, lots of casual social interaction, large family: very high risk. We've seen it very starkly in England. When entire communities are being ravaged by exponentially-growing transmission, it's hard to argue that a vaccine might be worse,…

I think GP is talking about severity of symptoms if you get COVID, rather than your chance of getting it at all.

Re: Oxford University breakthrough on global COVID-19 vaccine

#477
post #456

Earlier quoted context omitted.

> if someone needs to treat cancer, it doesn't make any good to go to an emergency unit That's because the ER is meant to stabilize a patient, not cure chronic disease. Which is to my point: people will forgo preventative medicine until their condition deteriorates and they need to be stabilized in an ER. People get their non-emergent conditions treated all the time in American emergency rooms. E.g., if I have diabet…

Curious, in your healthcare experience, what would you estimate is the percentage of people who do have good insurance, but don't get preventative care by choice? E.g. for myself, I have good insurance, but I don't have a "primary care doctor." I don't go to the doctor unless I'm injured or sick. And I don't mean a sniffle or cough, I mean sick as in I have felt awful for several days.

I don't think I have a good representative sample because facilities I worked for were a specific sub-population that would probably have a very high percentage that fall into the category of "no need for healthcare until something is broken or bleeding profusely"

With that said, it seems to be quite a bit and skewing higher for males than females.

Re: Oxford University breakthrough on global COVID-19 vaccine

#478
post #390

Earlier quoted context omitted.

Challenge trials. https://www.1daysooner.org/ If it were considered ethical to do them, we could have known in a few weeks. "Medical ethics" claims another million lives.

We've subsequently learned that even young healthy and initially asymptomatic people can become permanently ill from so called "long COVID". The ethicists were right to say no.

This makes no sense to me. Preventing challenge trials causes more people to die and become permanently ill. What ethical system are you operating under where that is morally preferable?

FWIW, ethicists were split, but mostly on board with HCTs. It was mostly the government that was opposed.

Re: Oxford University breakthrough on global COVID-19 vaccine

#479
post #358
post #274

Earlier quoted context omitted.

Only to the extent that you don't value human life. If you value human life, then you'll see that both have costs associated.

This isn't responding to the OP's point, which was that war profiteering (making money by providing weapons to kill people) is morally different from selling vaccines (making money by providing medicines to save people's lives).

I'm not sure I follow? Profiteering off of healthcare has a cost, in terms of people not cared for due to various market reasons.

Re: Oxford University breakthrough on global COVID-19 vaccine

#480

Earlier quoted context omitted.

> Historically, two cases of rushed vaccines (cutter polio and Gullah barre) were worse than the disease - and these were for diseases worse than covid. This is just patently untrue. The Cutter Incidence gave patients Polio due to an improperly activated virus. While this is bad, it could not be worse than the disease itself - since it is the disease itself, no worse, no less. Regarding risk of Gullain-Barre syndrome…

No, the cutter incidence was worse than the disease, because the activated virus was injected into a population, whereas naturally only a tiny part would be exposed at the same level, and the rest would be exposed at a much lower level - that would give them immunity but not disease. Cutter was, most definitely, much worse than the disease if you look at it from a population perspective. The 1976 Guilian barre was at…

> No, the cutter incidence was worse than the disease, because the activated virus was injected into a population, whereas naturally only a tiny part would be exposed at the same level, and the rest would be exposed at a much lower level - that would give them immunity but not disease.

This is a more reasonable assessment, but it is still patently false. According to Wikipedia, 0.04% vaccinations resulted in paralysis in the Cutter Incident, compared to 0.1-0.5% of wild type polio. So the vaccine was 2-10x safer than wild polio. Without vaccinations, virtually all children were infected with polio virus early in life [1], so being administered the defective vaccine was still a lot better than taking a chance with the real disease.

Of course, you are correct regarding the 1976 flu outbreak. If you administer something to a large segment of the healthy population, even a small risk of side-effects will add upp to a large number of cases. If the disease itself turns out to be very rare, as was the case with the flu outbreak, the vaccine itself could cause more damage than the disease even if the disease is much worse.

However, this is clearly not applicable Covid-19, which we already know is spreading very fast and will need to infect a large number of the population before herd immunity is achieved. The situations are simply not comparable at all – even the vaccine from the 1976 flu outbreak would be less risky than the odds of being infected with a serious case of Covid 19 (of which the long term effects are also unknown, to be clear).

> But whenever I mention that immunizations have risks, I’m treated like a heretic.

Mainstream media, healthcare professionals and social media are all worried about the risks of a rushed vaccine. I literally see articles and hear conversations about this several times a month. Nobody is denying that large scale vaccinations have risks.

I'm not criticizing you because I'm against being cautious of vaccination risks. The criticism is that you are spreading false facts and misleading analysis that grossly mischaracterise what the risks of vaccinations really are, both presently and historically.

"Some vaccines can have rare but serious side effects" is a perfectly alright statement. But "Historically, two cases of rushed vaccines (cutter polio and Gullah barre) were worse than the disease - and these were for diseases worse than covid" is just not. Some of it is false and the comparison to Covid19 is misleading.

[1] https://www.ecdc.europa.eu/en/poliomyelitis/facts

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