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Covid vaccine: First ‘milestone’ vaccine offers 90% protection

bbc.co.uk

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Re: Covid vaccine: First ‘milestone’ vaccine offers 90% protection

#921
-80C storage requirement may really complicate distribution logistics even in developed countries. We'd really need special locations to be setup to administer the vaccine, unless it's viable for some reasonable period of time at higher temperatures. Even something like 24-48 hours, so it can be transported on demand from centralized locations to doctors offices, pharmacies, etc.

Otherwise, medical cryo storage is highly specialized and expensive equipment. Definitely not what you'd find in a doctors office or pharmacy. It might be a more convenient option if the vaccine remains viable at much colder temperatures. Somewhat cheaper (though still not cheap) LN2 transport containers ~180C could be used to deliver it to locations, provide a supply of LN2 to keep it cold, and then warm on demand.

The point is, this isn't going to be a rollout that can be done without a lot of infrastructure planning way up front. If the data here is validated and it looks like it's going to get FDA approval, we need to begin planning that stage ASAP.

Re: Covid vaccine: First ‘milestone’ vaccine offers 90% protection

#922

Earlier quoted context omitted.

-80C storage is an issue, you are definitely right, but it is a common requirement for many biological samples and protein-based drug therapies. -80C lab freezers are not that expensive and all over the place. I used to work in biotech and, at one company, all of our intermediate drug substance storage was -80C. we had freezers big enough to drive a forklift into; one such a freezer could store millions of doses... a…

Why, biologically speaking, does it need to be that cold? I'm guessing something breaks down at higher temperatures? (That's -112 F, for anyone else wondering.)

It’s an RNA vaccine. RNA degrades at room temperature.

Re: Covid vaccine: First ‘milestone’ vaccine offers 90% protection

#924
post #697

Earlier quoted context omitted.

> - two doses needed, 3 weeks apart, immunity after one month from first dose. Slow rollout. Yeah, this alone is bad news. Last year my parents got a two-dose shingles vaccine. The two doses are supposed to be separated by two to six months. My parents struggled to find their second doses in the window. Apparently there was limited supply and no one had the foresight to reserve second doses when people received their…

It will be an incredible challenge, but there is at least some economy of scale on our side. Wendover did a nice video[0] on this topic month ago, explaining how UPS/FedEx/DHL/… are already massively upscaling their cold chain infrastructure. Retrofitting planes, building giant freezers in transport hubs. [0] The Greatest Logistics Challenge Ever - https://www.youtube.com/watch?v=byW1GExQB84

Thanks for sharing this. I learned a lot from watching this video and I have another channel to subscribe to now :)

One thing that I found interesting was how they identified today's announcement of the BNT162b2 vaccine candidate (back in September) as one that would require the massive investment in cold chain infrastructure. They also highlight Pfizer's engineering of a separate series of cold boxes that would keep the vaccine at temperature for up to 10 days, thereby enabling it to be shipped through standard logistics networks. Great stuff.

Re: Covid vaccine: First ‘milestone’ vaccine offers 90% protection

#926

Earlier quoted context omitted.

How long, exactly, are they good for once they warm up? I assume you aren't injecting people with something at -80C. How big of a window is there for injections?

Other comments here are saying something between 24 hours and a week at standard refrigerator temperatures.

Thanks for the summary, I must have missed that.

Re: Covid vaccine: First ‘milestone’ vaccine offers 90% protection

#927

Good: + ~90% of individuals achieve immunity. + no significant side-effects. Not so good: - two doses needed, 3 weeks apart, immunity after one month from first dose. Slow rollout. - -80C storage and transport needed. Challenging, but doable in developed countries, but still may slow down mass rollout. Not feasible in many developing countries. I still wonder about long-term immunity. Anyone can share any insight?

How do we know that there are no significant long-term side-effects? These vaccines seem to be developed so quickly while others take years or even decades... I do not know if this is irrational fear, but I fear that this is rushed and there might be potentially serious side-effects that are missed. Why am I being down-voted? Is it really of no concern?

Short-answer: we don't and can't, since you'd need to use the vaccine for a long time.

Better answer: the vaccines are new but the individual systems used to develop them are not, and we have historical trials of a lot of the same techniques which show no long term risks. The biggest unknown has always been the risk of triggering a short-term, unexpected primary immune response that causes harm to the recipient. In the vaccines being developed, that has generally not been found to be the case, and since they're based on the virus currently infecting people we would not expect a response worse then that (which is to say: the components of vaccine use are all well studied, these are understood and safe materials).

The other issue is when we talk about "rushing" vaccine research, this does not involve shirking safety research - i.e. consider the influenza vaccine which year over year is basically a new vaccine we develop quite quickly. What it does mean is that you overlap the stages of vaccine development: normally if you have a P3-trial vaccine, you'd wait till that trial was successful before building the factory to make it. Instead, companies are being paid (or paying themselves) to build facilities and scale up production as soon as they get to the P3 trial stage - financially it's a huge risk, since what they have might not work, or might have an unacceptable risk profile in those trials - which means all the investment is a dead-loss.

This is where government steps in (and has stepped in in places): by guaranteeing the investment on getting those facilities out, it means if your vaccine works then you're ready to go and it's in production right away - as opposed to being another year to 2 years down the line while you work on manufacturing.

Re: Covid vaccine: First ‘milestone’ vaccine offers 90% protection

#928

Earlier quoted context omitted.

The latest data (preprint, not peer reviewed etc etc) mention memory B and T cells up to 8 months after recovery from the illness. This means that an immunity of one year is probably likely. This would be probably enough to quench the spread, but not to eradicate the virus.

I think we can eradicate it by contact tracing. With 90% efficiency it will be extremely tough for the virus to spread. For any new cases you simply test everyone in the vicinity of the infected person. But I don't think even that will be necessary. 90% efficiency reduces R so much, it will probably die out on its own. The real problem is mutations that are not covered by the vaccine. If it mutates as efficiently as…

That will work in Europe, it will never go over in the USA people are very averse to being tracked or giving up privacy or health information.

Re: Covid vaccine: First ‘milestone’ vaccine offers 90% protection

#929

Earlier quoted context omitted.

> Thank God. God also gave us this virus, if we stick to the religious logic.

Actually, no - if one follows the 'religious logic' as you call it, we live in a Fallen World under the dominion of Principalities and Power of Darkness. It is from there that the virus came. The 'God will smite thee' beliefs largely came about as a form of control over people, and do not line up with New Testament biblical teaching.

> New Testament biblical teaching

For amen I say unto you, till heaven and earth pass, one jot, or one tittle shall not pass of the law, till all be fulfilled.

Re: Covid vaccine: First ‘milestone’ vaccine offers 90% protection

#930
They've made a terribly flawed assumption which drives that 90% number. VE is modeled using a beta binomial model with a fixed prior of an infection rate of 1.5% per year. Obviously this number is going to vary a lot depending on the sample. [1]

By putting a fixed point vs the appropriate wide ranging distribution as the prior, the model scores the results far higher than otherwise.

This is a non-result and it was wildly inappropriate to publish this as proof of any finding.

[1] https://pfe-pfizercom-d8-prod.s3.amazonaws.com/2020-11/C4591... Page 15

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