[HN Gopher] Oxford vaccine shows sustained protection of 76% in ...
       ___________________________________________________________________
        
       Oxford vaccine shows sustained protection of 76% in 3-month gap til
       second dose
        
       Author : timthorn
       Score  : 113 points
       Date   : 2021-02-02 18:55 UTC (4 hours ago)
        
 (HTM) web link (www.ox.ac.uk)
 (TXT) w3m dump (www.ox.ac.uk)
        
       | ummonk wrote:
       | The case for a one-dose first strategy gets stronger and
       | stronger, but due to slavish proceduralism, the FDA wouldn't
       | consider it.
        
         | gojomo wrote:
         | 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.
        
         | thehappypm wrote:
         | 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.
        
           | mchusma wrote:
           | 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 - <30 day boosters are almost never tried in
           | the real world because larger time gaps typically illicit
           | better protective responses.
           | 
           | 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.
        
           | gojomo wrote:
           | 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).
        
           | endgame wrote:
           | There is also minimal data that parachutes are better than
           | placebo for people who jump out of planes. This situation
           | needs wartime thinking, not peacetime proceduralism.
           | 
           | What you're saying is that we must assume the worst case,
           | that the FDA-approved vaccines are like 2-pack epoxies: that
           | first doses give 0% immunity, and all the efficacy comes from
           | applying the second. That seems completely absurd.
        
       | dhbradshaw wrote:
       | What exactly does "percent protection" mean in these
       | announcements? Can we use the definition to derive a percent
       | protection associated with having been through the virus? Is
       | there a percent protection associated with your age / gender /
       | race profile?
       | 
       | It feels like the number doesn't mean much without having a
       | similar number for the null cases.
        
         | aqme28 wrote:
         | Protection of antibodies from a previous infection is somewhere
         | above 90%.
         | 
         | https://www.medrxiv.org/content/10.1101/2021.01.15.21249731v...
        
         | lbeltrame wrote:
         | It is a reduction of the risk of symptomatic disease by 76%
         | once vaccinated.
         | 
         | But more importantly, there were _no_ hospitalizations or
         | deaths in the vaccinated people. This is a point the media
         | often overlooks.
        
           | nmca wrote:
           | Because the "no hospitalisations or deaths" claim from the
           | first Oxford paper was comparing n=2 to n=0 and thus was
           | miles from significance. If the new paper has updated data on
           | this happy to be corrected.
        
             | lbeltrame wrote:
             | It is a constant in any vaccine, including the "lowest"
             | performers from Sinovac and Sinopharm. At this point, I'm
             | inclined to believe that any resonably effective vaccine
             | will have this effect.
        
             | disgruntledphd2 wrote:
             | Tbh, the reductions in hospitalisations has been super high
             | for almost all the vaccines, which is great news.
        
           | orra wrote:
           | Indeed. These are some of the best vaccines ever invented[1].
           | 
           | Look at the two charts[2] in this paper from the UK's JCVI.
           | They show the number of severe incidents (severe COVID or
           | death). The linear or exponential growth curves are for
           | people on the placebos. The almost flat lines are for people
           | on the Pfizer-BioNTech and the Oxford-AstraZeneca vaccines,
           | respectively.
           | 
           | Oh, after just the initial dose, not the booster!
           | 
           | [1] https://www.nytimes.com/2021/01/18/briefing/donald-trump-
           | par...
           | 
           | [2] https://www.cas.mhra.gov.uk/ViewandAcknowledgment/ViewAtt
           | ach...
        
           | adamc wrote:
           | It's huge. On the whole, avoiding hospitalizations is far
           | more important than whether people had mild cases.
        
         | lawl wrote:
         | 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.
        
           | reportingsjr wrote:
           | 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.
        
             | jackweirdy wrote:
             | In the Oxford trial, participants take weekly PCR swabs
             | (https://www.bbc.com/future/article/20200721-coronavirus-
             | vacc...)
             | 
             | This was posited (but has not been confirmed) as one of the
             | reasons it was posting lower numbers - it was catching some
             | asymptomatic cases
        
             | lamontcg wrote:
             | 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.
        
             | timthorn wrote:
             | > There haven't been any studies on vaccines preventing
             | infections
             | 
             | This study has looked at that. From the press release:
             | "Analyses of PCR positive swabs in UK population suggests
             | vaccine may have substantial effect on transmission of the
             | virus with 67% reduction in positive swabs among those
             | vaccinated"
        
             | lawl wrote:
             | Maybe i misunderstood OPs question but i don't think that
             | changes much. It's the difference between $measurement
             | between the control group and the test group.
             | 
             | If that's the reduction of symptoms here, ok.
        
             | Eric_WVGG wrote:
             | IANAD but I'm nearly positive you're incorrect.
             | 
             | I spent last night puzzling over what "efficacy" means vis
             | a vis this video: https://www.technologynetworks.com/immuno
             | logy/videos/covid-1...
             | 
             | The author explains that the efficacy number is derived
             | from the the number of the number of people in the
             | control/placebo group infected divided by the total number
             | of infections in the study.
             | 
             | 76% efficacy means that, for a given population of people
             | who contracted a disease (ignoring all uninfected), 24%
             | were vaccinated (vaccine failures), 76% were not
             | vaccinated. It has nothing to do with reduction of
             | symptoms.
             | 
             | I think this is unintuitive because the "real" solution
             | that laypersons want is, what percentage of vaccinated
             | people exposed to a disease get infected? We can't measure
             | that directly because we can't just expose a bunch of folks
             | to Covid and hope for the best. But if the sample of
             | placebo and vaccinated people is truly random, this would
             | appear to arrive at the same ratio. (re: when I said
             | "ignoring all uninfected"? in a good sample, the ratio of
             | unexposed vaccinated and control units should be about the
             | same)
        
               | StavrosK wrote:
               | > The author explains that the efficacy number is derived
               | from the the number of the number of people in the
               | control/placebo group infected divided by the total
               | number of infections in the study.
               | 
               | Wouldn't that make a vaccine that does nothing 50%
               | effective, instead of 0% effective (which is what one
               | would expect)?
        
               | Eric_WVGG wrote:
               | Well, let's see... say you had 2000 participants in the
               | trial, 1000 with a junk vaccine, and 1000 with placebos.
               | 
               | Furthermore, let's say you had 200 infections, split
               | equally between the junk and the placebo.
               | 
               | So yeah, 100 / 200 = 50% effective. A coin toss, which is
               | to say, no better or worse than not getting the vaccine.
               | 
               | Again, this isn't measuring "what one would expect" (how
               | many vaccinated people, exposed to the virus, get the
               | disease), it's "what proportion of vaccinated people get
               | sick relative to unvaccinated people." (again IANAD)
        
               | iggldiggl wrote:
               | No, 50 % means the infection rate (or whatever you're
               | actually measuring) in the vaccine group is half that of
               | the control group. In your example the infection rate are
               | exactly the same, giving an efficacy of 0 % (+- whatever
               | confidence interval the size of your trial and placebo
               | groups gives you). See e.g. https://blogs.sciencemag.org/
               | pipeline/archives/2020/09/21/th...
        
               | StavrosK wrote:
               | Kind of seems odd, given that you can never have 0%
               | efficacy (unless your vaccine somehow caused every
               | vaccinated person to get the disease instead of a non-
               | vaccinated person). It seems like you're wasting half
               | your "spread", basically.
               | 
               | If you measured efficacy as "1 - (vaccinated infections /
               | unvaccinated infections)", it would be much more
               | intuitive, and you could even get a bit of negative
               | efficacy in the case where your vaccine did nothing.
        
               | renewiltord wrote:
               | > _We can 't measure that directly because we can't just
               | expose a bunch of folks to Covid and hope for the best._
               | 
               | We can, but medical ethics hasn't caught up yet. I would
               | participate in a challenge trial, for instance.
        
               | throwaway2245 wrote:
               | A randomly controlled challenge trial would involve
               | deliberately infecting scores of unvaccinated people,
               | putting them at risk, along with anyone involved in the
               | procedure and anyone they come into contact.
               | 
               | It would mean handling live virus, which requires a
               | Biosafety Level 3 facilities.
               | 
               | And, it's not going to get your vaccine approved any
               | quicker.
        
               | renewiltord wrote:
               | 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, no one can blame you for that
               | part.
               | 
               | And of course it's not going to get the vaccine
               | 'approved' quicker because yeah, 'approval' is also
               | subject to the same people. But it will let us know if it
               | works and whether it hurts.
        
               | throwaway2245 wrote:
               | > 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 harm of intentionally
               | infecting people.
        
               | renewiltord wrote:
               | 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.
        
               | travismark wrote:
               | FDA still hasn't authorized the AZ vaccine
        
               | dmurray wrote:
               | 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.
        
               | jMyles wrote:
               | > I would participate in a challenge trial, for instance.
               | 
               | Me too. And nearly everyone I know in my risk tier.
               | 
               | We had an entire globe of low-risk people willing to be
               | part of the most acute spread, whether for research, for
               | personal immunity, or to be able to isolate for a defined
               | time to protect loved ones, and we squandered it in favor
               | of pseudoscientific horizontal interdictions like
               | lockdowns. It's really an incredible abandonment of basic
               | principles of public health.
        
               | carschno wrote:
               | If the sample consists of volunteers, it's hardly random.
               | In particular, given that these volunteers are "low-risk
               | people", it means that the results of this experiment
               | will yield virtually no useful conclusions for the
               | higher-risk groups
        
               | renewiltord wrote:
               | Medical ethicists believe they've solved the trolley
               | problem by turning their back on the lever and letting
               | Jesus take the wheel.
        
               | [deleted]
        
               | elliekelly wrote:
               | That was a super interesting video, thanks for sharing!
        
               | hutzlibu wrote:
               | It is so frustrating, trying to figure out at least a bit
               | of whats going on and understanding some numbers, but
               | apparently I cannot do this, without having to dive into
               | papers, too?
               | 
               | There is so much confusion and missinformation flying
               | around, when even here on HN there is discussion about
               | the meaning of basic numbers.
               | 
               | (but please carry on discussing it)
        
               | akiselev wrote:
               | To be clear, this isn't some settled math like basic
               | algebra or science like Newtonian physics - this is
               | cutting edge stuff at the intersection of medicine,
               | public health, and biotechnology. Experts disagree about
               | the nuances of measuring the efficacy of drugs, vaccines,
               | and therapeutics so throw in the glaring ethical concerns
               | into the mix and you have a recipe for a complex field.
               | It's rare (unheard of?) to find a clinical trial where
               | the company (or their CRO) scientists didn't sit down
               | with FDA regulators and negotiate over key features &
               | risk indicators, benchmarking, patient selection, and so
               | on because they bring expertise the FDA is unlikely to
               | have.
               | 
               | It's very difficult to get even a basic grasp of the
               | details because you need to grok some complex statistics,
               | biology, and public health to really dig in. Journalists
               | sure aren't going to get the nuances so of course you
               | have to read the academic literature.
        
               | hutzlibu wrote:
               | I get it, that I won't really get it, without studying
               | it. But it would be nice, to know what important numbers
               | roughly mean, without that amount of work.
        
       | the_mitsuhiko wrote:
       | 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.
        
         | whycombagator wrote:
         | The U.K. like to big up/get behind their own. Relevancy on the
         | world stage in anything is big over there, AstraZeneca (AZ)
         | makes the U.K. relevant. Remember there's also Brexit & having
         | a "winning" vaccine produced by a U.K. company & university is
         | clearly a huge deal.
         | 
         | In the EU AZ is under delivering doses at present[0], also they
         | had that whole trial dosing mishap.
         | 
         | In the US AZ wasn't as fast at delivering a vaccine as Pfizer &
         | Moderna & AZ isn't a US company, but Moderna & Pfizer are. So
         | not really a shock that they get most of the buzz in the US.
         | 
         | Interestingly the US has ordered more AZ doses than any other
         | vaccine & AZ is the most ordered/purchased vaccine
         | worldwide[1].
         | 
         | It's no surprise to me that countries are hyping up their own
         | products and/or getting them approved first. As for the EU,
         | they are certain to be sore given the lack of doses they've
         | been able to acquire & their vaccination strategy in general.
         | 
         | [0] https://news.ycombinator.com/item?id=25964197
         | 
         | [1] https://www.bloomberg.com/graphics/covid-vaccine-tracker-
         | glo...
        
         | lbeltrame wrote:
         | > 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.
        
         | robotmay wrote:
         | 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 way to go and that
         | the EU being cautious might backfire. We know the
         | Oxford/AstraZeneca vaccine is pretty safe and the UK has been
         | giving it to over-65s quite happily. If it does turn out that
         | it's less effective, then we'll still have gotten some efficacy
         | across the vast majority of our population much quicker, and
         | probably not added to the deaths. If it turns out that it's
         | just as effective as on everyone else, then the EU will have
         | lost time yet again and have left their older population at
         | risk for longer.
        
           | alkonaut wrote:
           | 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 elderly now because it can
           | afford to due to large quantities of rna vaccine.
           | 
           | A few thousand elderly will die waiting for the slow buildup
           | of rna delivieries while AZ could be made available. That's
           | the obvious drawback of this caution.
        
             | krzyk wrote:
             | > Pfizer to the elderly and AZ to healthcare workers.
             | 
             | With Pfizers (and Moderna) ~95% efficacy and AZ at 60% I
             | would give AZ to only those that want to jump the line or
             | as the last resort.
             | 
             | You don't want doctors to spread COVID (40% vs 5% that can
             | spread is huge).
             | 
             | Poland wants to give AZ to teachers, a group that has
             | contact with many children (which have contact with their
             | families) - this is poor thinking. AZ should go to people
             | that don't have much contact with others, e.g. unemployed
             | or volunteers.
        
             | orra wrote:
             | > 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.
        
         | caffeine wrote:
         | 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.
        
           | orra wrote:
           | 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
        
           | LawnGnome wrote:
           | Interestingly, the interim Sputnik results were published in
           | the Lancet today, and they're good: https://www.thelancet.com
           | /journals/lancet/article/PIIS0140-6...
           | 
           | I don't disagree about the process, though.
        
         | ghaff wrote:
         | 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_mitsuhiko wrote:
           | 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.
        
         | alistairSH wrote:
         | Astra Zeneca bungled their FDA trials in 2020. They went from
         | being one of the most promising vaccines to an also-ran.
         | 
         | https://www.nytimes.com/2020/12/08/business/covid-vaccine-ox...
        
         | oska wrote:
         | 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. 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.
        
       | jaynetics wrote:
       | 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.
        
         | xvedejas wrote:
         | 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.
        
           | strstr wrote:
           | 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
           | single dose moderna/pfizer would take about as long as it
           | will take to ramp up production.
        
       | krzyk wrote:
       | 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?
        
         | mrtksn wrote:
         | "The initial data from Astra and Oxford last month appeared
         | positive but raised concern over how much protection the shot
         | would offer after the trials produced two different results
         | from two dosing regimens. The partners said their vaccine was
         | 90% effective when a half-dose was given before a full-dose
         | booster, and that two full doses showed an efficacy of 62%."
         | 
         | https://www.bloomberg.com/news/articles/2020-12-08/astra-vac...
         | 
         | Turks also find that the Sinovac vaccine is %91 effective when
         | others reported less.
         | 
         | I guess it depends on the variant, on what do you understand by
         | "protected" or on how much you want it to work.
        
         | lbeltrame wrote:
         | 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.
        
         | sgt101 wrote:
         | 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.
        
       | [deleted]
        
       | simonswords82 wrote:
       | 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.
        
         | CodeGlitch wrote:
         | Not sure why you're being down voted. It's not like you said
         | anything incorrect or controversial.
         | 
         | Anyway I agree with you.
        
           | simonswords82 wrote:
           | Yeah I keep meaning to ask dang why I get pummeled with down
           | votes whenever I comment on something.
        
             | jariel wrote:
             | The majority of votes on HN I believe are instinctive -
             | someone liked or didn't like what you said, or the tone or
             | whatever and that's it. Often there isn't much rhyme or
             | reason.
             | 
             | Clearly there are low/high value comments, or flame-wars
             | but generally that's not it.
             | 
             | Apparently, PG himself was fond of voting for
             | disagreement/agreement, but even he I don't think quite has
             | seen the degree of arbitrary voting.
             | 
             | You will notice that people in the moments after your
             | comment are much more likely to hate on it arbitrarily than
             | later on when you might see some upswing.
             | 
             | If you comment on anything even _remotely_ controversial,
             | that even _hints_ at something like Brexit, EU nationalism,
             | Transgender etc. - expect to see a lot of volatility. It 's
             | really quite an interesting phenom to see.
             | 
             | Frankly it's pointless to meander about it and after much
             | speculation I would say just don't worry about it - and -
             | don't put too much stock in any kind of 'points system' it
             | really doesn't matter that much at all.
             | 
             | The Oxford vaccine is doing well, the UK is way ahead due
             | to the locality of it all, which is great, because they
             | need the help what with having a considerably higher death
             | reate.
             | 
             | I would recommend you see here [1] for a really good
             | breakdown of vaccination and other COVID data.
             | 
             | [1] https://ourworldindata.org/covid-vaccinations
        
           | CodeGlitch wrote:
           | Now I'm being downvoted? Wtf HN
        
             | lucb1e wrote:
             | I don't see anything in particular to agree or disagree
             | about. Dashboard link, saying lockdown helps against the
             | pandemic, things looking up for the UK... yeah I'd also be
             | curious how this is objectionable. The trouble is that
             | talking about votes is discouraged in the guidelines. Not
             | sure I agree, but that discussion is pretty meta, so we'll
             | just have to keep guessing until someone provides the
             | reason why this was deemed harmful to the thread.
        
             | dang wrote:
             | You were breaking the site guidelines, so the downvotes are
             | correct. Please review
             | https://news.ycombinator.com/newsguidelines.html (note the
             | second-last).
             | 
             | Comments like the two you posted here are particularly off-
             | topic because once users have fixed the situation with
             | corrective upvotes, such complaints become uncollected
             | garbage. That is, they linger on, even though they're false
             | in addition to off-topic.
             | 
             | https://hn.algolia.com/?dateRange=all&page=0&prefix=true&so
             | r...
        
         | nine_zeros wrote:
         | That's pretty good. Is the vaccination drive going on in full
         | speed?
        
           | pityJuke wrote:
           | Very much so, the UK is currently only behind the UAE and
           | Israel in vaccine rollout per 100 residents* [1].
           | 
           | * for major countries (incidentally, the UK territory
           | Gibraltar is 2nd in the world if you include minor
           | countries), and only considering the first dosage, which in
           | fairness, appears to be the correct for this specific
           | vaccine.
           | 
           | [1]: https://ig.ft.com/coronavirus-vaccine-tracker/
        
           | mprovost wrote:
           | Yes, there have been over 10 million vaccinations so far.
           | They did over 900,000 last weekend alone.
        
         | sterlind wrote:
         | That R number is pretty good. I hope it holds up!
        
         | throwaway2245 wrote:
         | "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...
        
           | bluGill wrote:
           | Note that deaths are very lagging. It can be a couple months
           | between being exposed to COVID and death, maybe even more as
           | medical science has learned about treating COVID over time.
           | It is reasonable to assume that everyone dieing today got
           | COVID before there was a vaccine, though there have been a
           | few deaths by now that could have been prevented if the first
           | vaccines were not given to someone else (if that person who
           | got it would have got COVID and died instead is not something
           | we can answer)
           | 
           | Deaths will start to stop soon, COVID infections are already
           | dropping in many countries, with vaccines being part of the
           | reason (but only part - again we cannot know how much)
        
           | sgt101 wrote:
           | 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.
        
           | twoslide wrote:
           | Agreed, important to keep in mind the UK has highest per
           | capita mortality of any large country. But this is good news
           | for the government's gamble to increase spacing between doses
           | to 3 months
        
       | password321 wrote:
       | Strangely, this news went under the radar:
       | https://www.bmj.com/content/372/bmj.n149 23 deaths in Norway,
       | possibly from vaccine.
        
         | Veen wrote:
         | 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 everyone
         | already knows about. Death rates in Norway are well within the
         | historical range, so it's fairly likely that there were no
         | excess deaths caused by the vaccine at all.
         | 
         | Them dying after having the vaccine does not mean they died
         | because of the vaccine.
        
           | jmorse2 wrote:
           | 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
        
       | mchusma wrote:
       | 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.
        
         | CodeGlitch wrote:
         | 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.
        
           | pb7 wrote:
           | I think you'll find that data or lack thereof wasn't what was
           | driving anti-vaxxers. :)
        
           | fweespeech wrote:
           | You cannot reason people out of a position they did not
           | reason themselves into. These people are not thinking
           | logically and reacting to facts, they are reacting to what
           | influencers in their sphere say and accepting that appeal to
           | authority as fact.
        
           | hutzlibu wrote:
           | Well, just check about Polio, which is allmost erradicated
           | and what Antivaxxers think about it.
           | 
           | (or rather don't)
        
           | mchusma wrote:
           | 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 :(
        
           | macintux wrote:
           | 7 _billion_ people taking a vaccine; some percentage of them
           | will die or experience significant illness after. Even if the
           | two events aren't related, the anti-vaxxers will seize on the
           | timing and blame the vaccine.
        
             | carlmr wrote:
             | Exactly, that's also where anti-vaxx started. Kids get
             | diagnosed with autism usually just after getting their last
             | childhood vaccines.
             | 
             | Correlation is enough.
        
               | _ph_ wrote:
               | It should also be noted, that shortly after getting
               | vaccinated, most children start to talk! :)
        
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