Pfizer 91% effective in updated data, protective against South African variant
reuters.com
reuters.com
I'm not an expert, so don't take this as advice to go coughing on everyone. But we all have to make some decisions based on imperfect information and it seems like covid is nearly knocked out.
There is some concern over another wave, but it might just be minor cases from unvaccinated young people. That hopefully won't lead to a lot more deaths.
It’s great to see the light at the end of the tunnel. Perhaps it will be a bit later but I strongly believe this will be possible.
Will only do it once scientists recommend and countries are welcoming me. I could travel today as a Norwegian citizen and green card holder, but that would not be very smart and nice so I’ll wait for answers similar to your questions.
> But she said the most significant increase in hospitalizations in the state is in people in their 50s, a group still at risk of becoming severely ill or dying from Covid-19. Younger people have driven the rapid increase in cases recently, she said, including high school students who participate in sports and have contracted the virus through those activities.
> “I do think this could be the beginning of a third surge,” Dr. Khaldun said, after an initial rush of cases in Michigan last March and April, followed by a surge in October and November. “I am concerned. But I also think there are things that we can do today that will start to turn that curve down.”
https://www.nytimes.com/2021/04/01/us/michigan-covid-outbrea...
In the US, most (59%) deaths come from people aged 75+ according to CDC. People aged 75+ make up roughly 12% of the population.
Some places are at much lower percentages. "Fully vaccinated" varies from ~12% in Utah to ~24% in New Mexico. 17% overall for the US.
Probably not. And in 6 weeks, that just means millions more will be vaccinated and younger people will have even more organic immunity.
In other words, there may be another surge, but it will probably be the last one, and probably over by May 15.
Again, non expert, don't cough on people, etc.
So things are better than in most places and will continually get better.
It's always been a bad thing and will continue to be a bad thing.
(EDIT: If there is some reason that our rates will fall more quickly, I'd love to hear it.)
The argument for our lifestyle changes was always to "slow the spread" or "bend the curve". It seems we've done that about as well as we can.
Its definitely getting into the same order of magnitude at that point, though. It'd be hard to argue for stringent lockdowns, IMO.
http://91-divoc.com/pages/covid-visualization/?chart=countri...
[1] https://www.cnbc.com/2021/02/24/moderna-covid-vaccine-booste... [2] https://www.statnews.com/2021/02/25/is-more-simply-better-wh...
* The 0.15% number is absurd when larger percentages of the US and UK population have died from Corona. Even if 100% were infected, IFR would have to be larger.
The fewer the infections, the fewer the mutations.
The fewer the mutations, the fewer the vaccine resistant variants.
The fewer the vaccine resistant variants, the fewer the need for new vaccines.
The fewer the need for new vaccines, the fewer the need for people to get vaccinated.
Repeat.
It's hard to predict when it will happen, but infections will collapse the same way they spread, but only if people get vaccinated and retain some discipline until the collapse.
Aren’t you committing a logical error here? There will need to be new vaccines as long as there is at least one escape variant. The “fewer the need” is really a binary 0 or 1, and you haven’t done anything to show that your “getting vaccinated and retaining some discipline until the collapse” gets us from a 1 to a 0. There’s a time component as well.
But yeah, it’s a neat story that gets shots in arms.
That's not exactly how the flu shot works. They make an educated guess as to which strain will become most widespread, then develop the corresponding vaccine. Years that the flu shot isn't as effective is when they guess the wrong strain.
My guess is that next year's flu season is going to be a lot worse than more recent ones because of this.
Do we have any sign yet on whether the COVID-season would be expected to run on a similar schedule?
Doing anything like this systematically should be though out carefully.
Doing my first 10 vaccines felt like buying software licence in the 90'. I fear that the new ones will be like those sucky Saas subscriptions.
Anecdotal but for my 2 appointments, the immunization centers clearly had a lot more capacity than customers. Lots of unused space and not-busy workers. I would guess because people that should be in line chose not to be.
But he also said shipments are improving and I also got a message from one of the mass vaccination sites.
To be clear, these were places where an appointment was needed, so they should have had a clear picture of demand.
But, we can probably reduce the number of cases per year to near 0 in the US, if all eligible people get vaccinated. Wiki told me there were under 500 confirmed cases in the US in 2018, and Google told me that r_0 for measles is between 12 and 18. COVID is nowhere near that transmissible.
I don't see that ever happening, at least for another generation or two.
There's also natural immunity for the ones who'd rather have that than the scary scientist-designed shot. The most irresponsible ones have the best chance of getting nature's vaccine. Depending on how long immunity lasts, that might drive it very low.
And as far as I know, the vaccines are highly effective and very few people are actually medically unable to get this vaccine. Honestly, if only people who chose not to be protected from it die... too bad for them.
Like if it's "therefore, past May 15 we should all just act as we did pre-COVID", that's different than "therefore, that's overall very good news for society".
There's a quantitative/qualitative thing going on here. We could be mostly "back to normal" in a broad numbers sense, while immuno-compromised people are left with a much more dangerous reality than they faced pre-COVID. They're left hoping for test/trace/eradication.
Personally, I'll feel pretty safe hanging out, even in closed-in areas, with other vaccinated people. But out and about, the decision to wear a mask will be more predicated on the actual disease prevalence numbers in that area. And we'll all continue to wait on data of how long the vaccines last.
I expect the emergence of new variants that spread in the unvaccinated either in places without masks (and resistant to vaccinations) like the US south, or (more probably) in the 96% of human beings that aren't Americans (and have much less access to covid vaccines), and the vaccine pressure selecting for the spread of variants that are different enough for the current set of vaccines to be less effective.
I am not an expert, this is just an educated guess by a layperson.
I also anticipate a major backlash against those who would refuse vaccines, as well as an impending necessary overhaul of the process and timeline for bringing slightly modified vaccines to market (as a clear need to quickly protect against new variants or even new strains emerges).
There is clearly a surge, but it's not yet worse than the previous one, and hopefully vaccination reduces the impact.
(I'm looking at the daily cases tab on https://www.michigan.gov/coronavirus/0,9753,7-406-98163_9817... )
Anecdotes about the variants spreading much more rapidly are going around though.
Cases up, but hospitalizations and deaths down. Giant nothingburger.
50% of Republicans are wary of taking the vaccine. (Edit: that was Sep. 20' data. The partisan imbalance is now less with 56% of Republicans more or less opting in, notably, African Americans, theoretically 'most at risk' (we don' know exactly why) have the most hesitancy by race with only 61% planning to take it. [1])
Surprising number of elderly are not taking the vaccine, for a variety of reasons - access to information, travel, knowledge, language.
(Edit: more than 25% of age >80 in Ontario have been eligible and have not taken the vaccine. That's a 'very high number' for those most at risk. Toronto is now having mobile vans go door to door, esp. where there are high concentrations of elderly) [2]
For the same reason not everyone votes - a lot of people won't end up taking it.
I think the risk is that if there are 'no protocols' in place and we have the new more aggressive versions and lower rates of vaccination than we think ...
And we could definitely have another wave during the summer.
I believe the next few months will be fickle we should keep our guard up until 'done is done'.
[1] https://www.pewresearch.org/science/2021/03/05/growing-share...
[2] https://www.cbc.ca/news/canada/toronto/covid-19-vaccine-onta...
In Europe each country has their own definition of the above, making it nearly impossible to compare.
But judging from how things are going in Texas and Mississippi right now, there is a high chance of things being normal there on the May 15.
Mind you it does require around 25-30% vaccinated before you can say that.
https://apps.texastribune.org/features/2020/texas-coronaviru...
I got dose 1 of Moderna yesterday (first day i was eligible).
"Organic immunity"? You mean that thing that the public health authorities are pretending doesn't exist, therefore requiring me, a person who caught, tested positive, and recovered from COVID in February to get vaccinated? Yeah, let me know when they stop pretending. I'm willing to get a vaccine, but annoyed because it has no benefit for me and only risk (albeit low).
Edit:
Downvote all you want, but I was a teen in the 90s when the public health authorities pretended like heterosexuals engaging in standard sexual activities were at equal risk of catching HIV compared to IV drug users and gay men. They weren't remotely at the same risk, by orders of magnitude. They wanted to promote safe sex and abstinence in teens and young people, which is a good thing, but they didn't hesitate to use the fear of HIV as a tool to (dishonestly) achieve that goal.
We don't know how the vaccine would improve things for people without visible long covid symptoms, but it is likely to help.
Also immune response improves after a vaccine just as it improves after a second shot.
There are risks, there might not be benefits for you, but there are definitely benefits to taking the vaccine for people who recovered.
I think a lot of sufferers of it are psychosomatic. The demographic for long covid doesn't match the demographic of those who are most at risk of the virus or get the worst symptoms. Instead, it matches the demographic most likely to complain about symptoms from other diseases that have attracted large numbers of sufferers, only to have most of them disappear when the disease became less trendy: Fibromyalgia and gluten intolerance, who had massive spikes in patients claiming to have the diseases, and suddenly big drop offs, for lifelong illnesses that don't go away. These patients tended to be affluent, white, middle-age women, who are not remotely the most at risk from covid, but are disproportionate in claiming long covid.
The vaccine probably has a placebo effect on these kinds of folks. Underestimating the full power of psychosomatic driven symptoms is a big problem. The mind can really make the body sick, and there's a lot of science backing this up.
I should specify that i don't think this is voluntary, or humans wanting attention. I think it's induced by excessive fear-based media and the subconscious, combined with the huge evolutionary advantage of the mind having the ability to induce vomiting if other tribe members who have eaten contaminated food begin getting sick.
https://www.newscientist.com/article/dn23851-what-if-your-gl...
Can you provide links to any peer reviewed scientific literature on the benefits of the vaccine for recovered individuals? I don't trust any of the journalism on this, considering that they are universally scientifically and statistically illiterate clickbait producers these days.
But I would advise you to take it.
Yes, there are people who have caught it twice. They are rare, and the paper highlighted that a likely explanation was false positives in the original testing.
I'll take the vaccine, but shouldn't be required to.
First, it seems that natural immunity is a bit inferior to the mRNA vaccines ('only' 80% protection for people at your age[0]). Second, a single shot offers better protection against the SA variant which can apparently escape the immune reaction of some people who were previously ill[1]. A second shot is apparently unnecessary[2].
Local guideline is to wait a few months following recovery (there are concerns a too early vaccination will lead to immune overreaction) and then get a single shot.
[0] https://www.thelancet.com/journals/lancet/article/PIIS0140-6...
[1] https://www.iol.co.za/lifestyle/health/new-sa-covid-19-varia...
[2] https://www.businessinsider.com/people-who-had-covid-19-need...
Effectiveness doesn’t really mean much between approved vaccines in the US. Please watch this video: https://youtu.be/K3odScka55A
From what we know so far, any of the approved vaccines are excellent and no one knows for sure if one is better than the other. The only logical thing to do is get what is offered to you as soon as possible.
That being said, this is excellent news that Pfizer is protective against the SA Variant. Not trying to minimize that news, just point out that it still is better to just get whatever approved vaccine you can.
I'm sure if we polled all the bio-phd's with option between the vaccines, they will all choose mRNA based ones because they have higher protection %'s, and significantly lower side effect risks.
Most countries don't have the luxury of giving their citizens the choice, so they resort to making up a lie to calm people from "bank run" on mRNA vaccines.
https://old.reddit.com/r/COVID19/comments/mh7wtw/astrazeneca...
"It was mentioned by Emer Cooke during the press conference.
"For the AZ vaccine based on spontaneous reporting in the EEA it's 4.8 cases per million, for the Biontech vaccine, based on the same criteria it was 0.2 cases per million and for the Moderna vaccine, based on the same criteria, 0 cases per million"
So ~25 fold compared to the BioNTech/Pfizer vaccine. 0.2 cases per million is in line with the expected number of cases in the general population. The Moderna vaccine probably hasn't been used enough in the EEA for such rare events to occur.
It's also worth keeping in mind that these numbers are based on older data. It is based on 62 reported cases (of which 44 are in the EEA). Germany alone has reported 31 cases and they aren't all included here. So expect these numbers for the AZ vaccine to go up a bit when they announce their updated recommendations at the plenary meeting next week."
This Pfizer data, plus the results in Israel suggest that the mRNA vaccines really are just objectively better.
They all prevent death and hospitalizations though so get the one you can get, but it seems likely the mRNA shots are better.
The main thing I'm wondering is if the people that got covid post J&J had really mild disease (like a tiny cold or something) or "mild" disease like absolutely miserable but just didn't have to go to ICU. Is that information known?
Basically the video confuses some of what the control group actually does and then says "well they all prevent death anyway" - no shit. The question is if one is better than the other and the answer seems like yes. The main counter would be the presence of variants, but the Israeli population faced variants and the mRNA efficacy rate held. This new Pfizer data suggests mRNA is just better.
Of course. It's right there in the FDA report, starting on page 51:
https://www.fda.gov/media/146219/download
7.1.1.5.3 Case Definition for Mild COVID-19
• A SARS-CoV-2 positive RT-PCR or molecular test result from any available respiratory tract sample (eg, nasal swab sample, sputum sample, throat swab sample, saliva sample) or other sample;
AND at any time during the course of observation:
• One of the following symptoms: fever (≥38.0°C or ≥100.4°F), sore throat, malaise (loss of appetite, generally unwell, fatigue, physical weakness), headache, muscle pain (myalgia), gastrointestinal symptoms, cough, chest congestion, runny nose, wheezing, skin rash, eye irritation or discharge, chills, new or changing olfactory or taste disorders, red or bruised looking feet or toes, or shaking chills or rigors.
You will find equivalently precise definitions of moderate and severe disease, as well. And if you care to look, you can find the same thing for all of the other FDA-approved vaccines. They're similar, but not identical. In general, "mild disease" is what most reasonable people would consider to be mild disease, but there are minor differences in terms of which specific symptoms/thresholds are used. For this vaccine specifically, you can see that having two or more of the above symptoms will bump you into the "moderate disease" category. So they're pretty strict.
> The question is if one is better than the other and the answer seems like yes.
Given that you clearly haven't read the data, I don't know how you can possibly make such a speculation.
I don't mean to pick on you specifically, but this entire affair has been defined by people who are way too willing to speculate after reading a few news articles.
> “I don't know how you can possibly make such a speculation.”
I don’t mean to come across as overconfident, is my understanding of efficacy wrong? Or the purpose of control groups? I’m happy to be wrong or corrected.
The speculation comes from the efficacy numbers and the results in Israel - is there a reason to dismiss those?
Edit: Reading the Pfizer results from here (https://www.fda.gov/media/144245/download) it seems like fewer moderate/severe cases of covid in the vaccinated population when compared to J&J (taking into account both of their placebo groups)? I’m not sure if I’m reading these correctly, but the docs don’t seem to contradict my impression that the mRNA vaccines are better.
J&J's excuse for 66% effectiveness is that they were tested when there was more Covid going around? That's exactly when the vaccine is supposed to protect you. Not when there isn't an opportunity to catch the disease.
And if we then take this claim on its face, then Pfizer and Moderna vaccine stated effectiveness is pointless, since it wasn't tested during the worst times.
Finally, the claim that no one in the study group that did catch the virus ended up in the hospital is also based on self-selective bias. I am assuming people in the study were younger people who needed the money and not older folks who are at a higher risk. I am not saying that it's not true - just that the biases need to be taken into account in any study.
That may be true in the earlier phases, when you are just trying to show that the vaccine isn't too harmful and works in at least some cases.
It's not true for the large phase 3 trials. For those you try for a study group that matches the demographics of the people who will be getting the vaccine in the wild.
For the J&J phase 3 trial, 34% of the participants were over 60. 41% had comorbidities associated with an increased risk for progression to severe COVID. Race was 74% white, 13% black, 6% Asian, and 1% Native American. Ethnicity was 15% Hispanic.
Pfizer was 45% age 56-85, Moderna was 16% over 65. Race for both was about 80% white, 10% black, 4-5% Asian, 1% Native. Ethnicity was 26% Hispanic for Pfizer, 20% for Moderna. I don't know what percent had comorbidities.
1) There were more of the variants going around, not more of the original strain going around when JNJ was tested and all the vaccines are less effective against the variants. PFE and MRNA were tested when only the original strain was going around. All the vaccines were designed to combat the original strain.
2) JNJ doesn’t protect as well against mild Covid. But the symptoms from this mild Covid are comparable to the side effects from the second dose of PFE/MRNA which affect 30-40% of people and based on anecdata from people I know nearly everyone.
Additionally JNJ has side effects as well.
I'm a participant in one of the J&J Ensemble trials. There is no payment associated with my participation.
Are they saying the other vaccines were tested when you had lower chance of multiple exposures, and they were tested when there was higher chance, and it isn't controlled for in coming up with that number?
> The only logical thing to do is get what is offered to you as soon as possible.
Is there any reason to be skeptical of the vaccine? Long term effects, etc. I don't normally get a flu shot or go to the doctor or anything like that. I'm pretty nervous. I used to date an anti-vaxxer who swore some kind of shot gave her brother autism... Obviously that's material to get downvoted and laughed at here on HackerNews but... just thought I'd bring my "atypical" perspective to the table.
Generally you should assume they are measuring symptoms of infections that go beyond the upper respiratory tract. This is because the vaccines provide little protection against an upper respiratory tract infection but instead are very effective at preventing it from progressing further into a more severe infection. This is referred to as non-sterilizing immunity: it is probably the most important concept for everyone to understand about the vaccines.
I am seeing a lot of comments here claim that vaccines are 100% effective at preventing death or severe infection where severe is generally defined as hospitalization. Nothing is 100% effective, and particularly not vaccines for those whose immune system does not respond properly. Death in particular is generally not an endpoint that can be compared in a statistically significant way in these studies. [1]
I will still be getting the first imperfect vaccine I am allowed to at the first chance I get. When I needed to get an appointment for my Mom I started writing a user script to help with that. [2]
[1] https://dalewharrison.substack.com/p/vaccine-boosterism
[2] https://gist.github.com/gregwebs/265e0ef6b1a3051377cfc4d66ac...
They prevent symptomatic covid infection which includes respiratory symptoms.
- Take two identical[1] populations of people
- Wait for some people (100 for easy math here) in the unvaccinated group to get the disease. Probably measured by a PCR test indicating presence of the virus and ignoring symptoms since they say "preventing disease" and not severe symptoms, hospitalization, death etc.
- Count how many folks have the disease in the vaccinated group[2]. In the "91%" case we would expect 9 people to test positive, meaning 91 of 100 people we would expected to get the disease did not.
I like to think of it as I am ~1/10th as likely to get the disease as I would be if i had not been vaccinated.Is this what they mean in this?
[1] Doing your best to create identical groups by controlling for population differences such as gender, age, and other known risk factors,
[2] We need also to control for time in the study etc.
[Lots of editing for formatting etc]> Is this what they mean in this?
Yes, that's what they mean. And even for the vaccines that are ~60-70% effective, all of them have so far been 100% effective in preventing hospitalization and death. It's not binary, the vaccines don't make you completely immune to this virus but greatly reduce the impact it has.
I thought this video explained it well: https://www.youtube.com/watch?v=K3odScka55A
I suspect most of the public doesn't even know what 91% means. Combine that with being bad at evaluating risk in general. It mostly represents a 10x improvement in cases per capita per time, but I think telling folks that their risk went from 1 in 10,000 to 1 in 100,000 (or whatever) probably doesn't mean a lot. Folks just want "safe" or "not-safe" :(
Same, and it gets less likely if you are in a group of vaccinated people since the chances of being exposed to someone who is sick goes down. Herd immunity at that point.
That might make the vaccine even more effective than the study shows if the stats don’t back out risk adjustment (which they probably cannot do).
But note that wearing a mask is still required. At a technical level, you may still be able to spread the disease, even if you're fully vaccinated. And the vaccines aren't 100% effective, so even the minimal self protection you get from a mask is better than nothing.
More importantly, I believe, is sociological: once there are a lot of people in public without masks, even if it were safe, a lot of people would take it as an excuse not to wear one. That leaves both them and others open to getting sick. The mask is a minimal inconvenience, and should be continued.
If you want want to skip the mask among people you know to be vaccinated, in private, that's about as safe as anything ever gets in life. Even small, private gatherings with a cluster of unvaccinated people (i.e. people who all live together) are reasonably safe without masks for those who are vaccinated.
You'll need to read the actual trial protocol for a specific vaccine to find out just what they were measuring, and how they defined e.g. "serious" vs. "non-serious" cases.
They basically split people at a certain area into two groups, give one the real thing, another one placebo, track infections, compare the results.
Comparing vaccines by effectiveness is meaningless because they're not all tested at the same place at the same time. So J&J has lower effectiveness, but it was calculated at the peak of the outbreak, when each participant interacted with Covid more frequently in their everyday lives.
For the comparisons to become meaningful, it'd need to be re-done at the same place at the same urban area, with 10s of thousands of participants for each vaccine. You'd also need to have approximately similar age spread, plus similar population distribution within an urban area. Since it's all volunteer-based, this kind of study won't happen.
In conclusion: take any that's available to you.
Obviously if you can get any vaccine, do so! But to claim that we can't possibly compare vaccines is silly. Yes the trials have differences, but they're not so different as to make us totally ignorant. We can use the trial data plus knowledge of the mechanism of action to make solid bets on relative effectiveness.
I'm not sure I can envision a reasonable way to embargo the numbers.
Especially important since we have kids.
The whole point of a vaccine is to prime your immune system, it does not provide a magical shield to your body. If you get exposed to COVID-19 after being vaxxed, you will still have COVID-19 in your system for some amount of time. It will just (hopefully) get killed very quickly when the memory B/T cells (that were created by your body when you had an immune response to the vaccine) ramp up production.
I was paid to work specifically on COVID, so was monitoring the vaccine data very closely. It was *very* promising, but there were a few things that puzzled me in where comparing results in placebo/control group vs vaccine groups, for both Pfizer and Moderna.
So I would check near daily for new results.
And then after Christmas break, when I went to check, found out both control groups had been effectively destroyed. (https://www.wsj.com/livecoverage/covid-2020-12-17/card/Pc6LV...)
I'm not kidding, there are no longer any control/placebo groups for these vaccines. These were studies that were approved to run for 2 years!
I had to sit through hours of boring mandatory training from NIH on importance of control groups. In these cases they just threw that away.
It reaks to high heaven to me.
(Note: I've seen nothing to indicate these vaccines are dangerous. Effective? Looks very likely, at least in the short run. Long run effective? HIGHLY skeptical. Total contribution to ending the pandemic from the vaccines? I'm highly skeptical that it will actually be high, when an honest accounting comes out). Would I personally take the vaccine had I not had COVID already? Yes. Though not if I were a kid or teenager (very little risk from COVID).
If you are in medical research, please don't look to these people as role models. Please do things openly, on git, and don't sweep uncomfortable truths under the rug.
Is it? I don't remember reading about that in NIH training on control groups. I'm pretty sure when your plan is to distribute 1 billion vaccines, holding out 0.000015 for a placebo control group is a sensible "ethical" tradeoff. Especially if, I don't know, everyone *volunteered* and agreed to those terms when signing up! And especially if, I don't know, all the data they had to date showed no increase in death rate?
For Covid, there's an additional problem with antibody tests being relatively abundant, and would allow the participants to unblind themselves anyway.
Actual Study Start Date: July 27, 2020
Estimated Primary Completion Date: October 27, 2022
[0] https://clinicaltrials.gov/ct2/show/NCT04470427I thought there was going to be a two year control group because that was the plan published on ClinicalTrials.gov run by NIH.
> The moment somebody in a trial could get vaccinated via some other channel, they'd drop out and get unblinded
If this is such obvious common knowledge why wasn't it in the plan? Why isn't it in the training?
I am 100% open to fundamentally and drastically changing the way we test medicines and vaccines et cetera, but that's very different than just making decisions willy nilly that just so happen to align 100% with shareholder interests.
The numbers do not come close to supporting any ethical reason for doing this.
Also HN may shadow ban you.
I don't think HN shadow bans me. My goal on these sites is high variance. High upvotes or high downvotes. In my experience that's the goal—either create a lot of value for people or learn something.
I also have accounts on not my real names for more pleasant, positive, uplifting content, but I save the controversial stuff for my real name accounts.
All the vaccines so far are 100% effective against "preventing severe disease"
The last one (non-symptomatic), we don't really know, I don't think any studies have been done which regularly test everyone, at scale. Someone correct me if I'm wrong.
https://www.nejm.org/doi/full/10.1056/NEJMc2102153
https://www.nejm.org/doi/full/10.1056/NEJMc2101927
2 weeks after the second Pfizer dose, one of the medical centers had a positive test rate of 0.05% (not a typo, 0.05 percent).
I'm a little confused by the percentage though. Looking at the 2nd study, and ignoring 1-7 days after the second dose, there's still 8+7 people who got infected a week after the 2nd dose, out of ~5000 tested. How do they get to the 0.05% number? Also, if I understand correctly, the table says there's around 16,000 eligible, but only 4000-5000 were tested? Am I missing something?
I believe Pfizer has even started doing 3rd shot boosters for very early phase 1-2 people from last year.
Efficacy in vaccines == people who were prevented from being confirmed COVID positive (symptoms sufficient to prompt a test, leading to a positive result)
Therefore, a 91% effective metric for vaccines means that 91% of those who receive that vaccine are expected to NOT contract COVID 'at all'. Thing is though, many vaccines broadly do not prevent disease but shift the severity upon contraction.
The metric that is actually useful for informing the public and policy is the answer to the question of 'does this prevent hospitalization, severe disease and death?'. Broadly speaking most approved vaccines globally have near 100% effectiveness in this.
The efficacy is the 1-relative risk of the primary endpoint.
But I was just reading about another study of medical personnel who were taking periodic COVID tests so as to catch asymptomatic transmission, and I believe this study (or maybe merely the media about it) also used "effectiveness".
It does not mean 10% of people end up with no protection at all, as was my first thought.
There seems to be a very strong urge not to compare any of them as better, which puts users in a position of information asymmetry where they might not make the best health choices for themselves.
Is there any realistic way to compare which of the vaccine selections available in the USA is better given certain conditions? For example, if someone has a history of reacting to vaccines (GBS), is the attenuated adenovirus from J&J a better choice compared to the mRNA alternatives?
It's a rational answer.
Humans are notoriously irrational in their decision making, and focusing on which is better in order to make the best health decision may lead to making a decision that is far worse.
At the same time, this is a country where 45% of people believe ghosts are real and 35% have been in contact with someone after the've died. You absolutely do not want people at the margin holding out for a longer time to get the vaccine they think is best when they could have been vaccinated a month ago.
counterpoint: if a person believes themselves to be "smart enough to make this decision", they should also be smart enough to read the research and make that conclusion for themselves which one is better for their specific situation, no?
AFAIK, the research is publically available, so it's not a problem of a lack of information, rather it's a lack of anyone with significant enough credentials willing to speak up and endorse a particular solution over the others.
All the vaccine information that is available is fully available, and the only decision that is available is:
Get the vaccine, or don't get the vaccine. Picking which vaccine is not an option at this time.
This doesn’t matter on an individual level. There are public health reasons to try and get as many people as vaccinated as possible, no matter the vaccine. But aggregate math means little to the individual person. The difference between. 70% and 90% is fairly profound, profound enough to weigh against individual people making a decision on which vaccine to get.
It’s not irrational at all for an individual to prefer the vaccine with the highest efficacy. It’s hubris, or insanity, on the part of public health officials to expect an entire nation of people to put individualism aside for the sake of greater good.
Clearly I disagree with the rationality--you're comparing the efficacy rates of being vaccinated among Moderna, Pfizer, or J&J. That's irrational--instead a person should compare the efficacy rate of being vaccinated by any of the available vaccines vs the efficacy rate of not being vaccinated due to holding out for personal preference of a vaccine.
It is absolutely not hubris to encourage people to take the vaccine available to them now, rather than wait a month for the one with 90%.
It's a prisoners dilemna and the government should encourage people to choose the cooperate approach by imposing incentives and manipulating the informational landscape.
It's the same reason why I support government recycling initiatives or the general idea of taxation.
Is this your situation? I hadn't heard of this happening for anyone.
Calling the standard answer infantile was where I took issue.
Assuming your question wasn't rhetorical--in the hypothetical scenario you described based on today's info, I would opt for J&J,
1) as a matter of convenience
2) The technology behind J&J is more mature
If the 90% effective one is supply constrained and has this complicated 2 dose thing, and the 60-some % is simple and available, you're still doing your part to make a serious dent in the spread of the disease overall. And if the death rate of covid is some low number x, making it 0.3x is a pretty good deal.
You may think people should get whatever vaccine is available to them. That is fine. But to actively discourage discussion and information comparing the vaccines is downright Orwellian.
It's Loserthink to believe every person has the medical background and qualified to weigh the medical information on vaccines to make an informed decision to wait for their choice of vaccines.
I'd take any approved vaccine without hesitation if it'd be offered to me right now. But if I am free to choose: It'd be Biontech or Moderna.
But I wasn't given a choice, and I'd happily get J&J if it was "this or nothin." So I ended up with Pfizer anyway.
There are error bars on those point estimates, and they're wide, because the trials didn't have a huge number of hospitalizations or deaths. You also can't compare them across trials, because they were tested on different populations, at different times, under different conditions (i.e. dominant variants, but also temperature, disease prevlance, etc.)
Based on everything I've seen so far, the approved vaccines are all essentially statistically indistinguishable, with the caveat that the J&J vaccine is one dose, the mRNA vaccines are two, and the AZ trial was kind of a mess. But the choice of dosing strategy was always somewhat arbitrary, based on the inherent sloppiness of a combined phase 1/2 trial. Had Pfizer and Moderna decided to go with a one-shot regimen, the trial would have reported a very similar effectiveness profile to J&J.
I strongly suspect we'll see better data on all three that will put them within a margin of error of each other, and suggest better dosing strategies.
Also AstraZeneca keeps getting suspended due to blood clots. I think we're up to 7 or 8 countries now? Canada was the most recent I remember, but I think most have resumed now.
https://www.sciencemag.org/news/2021/03/rare-clotting-disord...
The running theory appears to be that in rare cases, that vaccine results in antibodies that attack platelets, causing a weird reaction that results in clotting.
From what we know so far, any of the approved vaccines are excellent and no one knows for sure if one is better than the other. The only logical thing to do is get what is offered to you as soon as possible.
The effectiveness is measured as 1-(Nnotinfected / (Ninfected + Nnotinfected)).
The video claims that when the study was done during the surge or in "other countries", the effectiveness might be different because Ninfected is higher, which makes no sense at all, since the probability of the vaccine protecting you shouldn't change based on how the virus is spreading in the general population. For a set of 100 placebo and 100 vaccinated, even if all 100 are infected, the vaccinated segment should be as protected as possible. 95% efficacy means only 5 in the vaccinated are infected. 66% efficacy means 50 in the vaccinated are infected.
Worth paying for a subscription during this pandemic.
For me, the list in order of preference is:
Pzifer
Moderna
Sputnik V
Sinopharm
JnJ (steep bell curve to get to this point)
I think its helped me, who was already sold on the mRNA ones. But most important to me is how it undermines most of the “plandemic” theories, not that they were ever convincing, only how they never factored in geopolitical realities.
If you are in the USA you should be able to easily choose between the three approved vaccines, so it is relevant to gather good information, just as you would with any medical decision.
https://cen.acs.org/pharmaceuticals/vaccines/tiny-tweak-behi...
J&J appears to be slightly less effective with its one dose, but would probably be just as effective as Moderna and Pfizer (if not more) if a second dose were given. J&J simply doesn't need the second dose because 75+% is still considered extremely good.
Even though J&J isn't considered one of the "mRNA vaccines", it still functions similarly to the mRNA vaccines. Their adenovirus carries the mRNA, allowing it to be remain stable in your body for longer, building strong immunity from 1 dose.
https://www.cnbc.com/2021/03/29/cdc-study-shows-single-dose-...
Edit: Looks like the earlier results I was thinking of say 52% effectiveness from 1 dose, but that included people who were infected very shortly after the first dose.
> Using the data from the published study of the Pfizer vaccine, Public Health England determined that vaccine efficacy was 89% for 15-21 days after dose 1 – and before dose 2 on day 21. The range was between 52% and 97%.
Source: https://globalbiodefense.com/2021/03/20/how-effective-is-the...
No. Because the trails were structured differently and measured different things and there is little interest in doing studies comparing the options rather than just administering them to as many people as possible.
AstraZeneca seems to be lagging behind, and what little data I've seen on J&J seems to suggest that it's better than AstraZeneca but still not as effective as Pfizer or Moderna.
I think the short answer is that we simply don't know yet which one is "better", especially since there are so many dimensions for what can make one vaccine better than the others:
- dosing schedule
- logistical constraints like refrigeration, shelf life
- rate of severe side effects (like allergic reactions)
- rate of mild side effects (like the severe cold symptoms I got from the J&J shot)
- duration of immunity
- effectiveness against emerging variants
- effectiveness at preventing hospitalization vs severe disease vs transmission vs infection altogether
We just don't have data to fairly compare the vaccines on all these dimensions.
The answer from a public health perspective is to get as many shots in as many arms as fast as possible, as long as they have low rates of severe side effects and are reasonably effective. However I agree that it sows distrust to not be honest & upfront about the fact that it's highly unlikely that all vaccines are actually equal, and that we simply don't have the data to know exactly how they differ. That could easily be followed up with a "once we figure out which ones are actually better we'll give additional vaccines and/or booster shots to those that drew the short straw".
Pretending they are all equal is only going to further erode trust when we inevitably figure out how they're not actually equal.
This pandemic has really shined a light on their lack of trust in institutions, and while they both got the J&J vax, they are proactively sending me and my partner literature about why mRNA is dangerous / should be avoided / how it's all a big plot to... X/Y/Z.
They're not crazy, I swear. In fact if you sat and had a conversation with either of them, you'd think they were some intelligent / kind people. But for some reason, I have to spend way more time than I care to combating misinformation they send us to the point where we had a harsh talk recently that we need them to stop bringing it up or we'll cut off communication for a bit.
If I had to take a guess... they got to retirement with too much free time on their hands, so they spend all day on their phones reading crap they see on the internet. They might have had their initial biases, but when they see a headline that strengthens the bias they can't get enough.
> I have to spend way more time than I care to combating misinformation
I find these statements at odds with each other. FWIW, my in laws and my extended family all believe in various vaccine conspiracy theories and that makes them all literally, truly crazy.
I cannot choose, though, and will probably get AstraZeneca once it's my turn.
Also, let's say you get vaccine A today. And in 6 months, it turns out you really wanted vaccine B since it's way more effective it turns out. Why can't you just get vaccine B in 6 months? I imagine if vaccine B is the clear winner, they are going to crank up production on that one as much as they can?
It's not enough of a difference to wait for one of the others, but it would drive my choice if I had an option.
When I made my appointment, the clerk warned me that they only had 2 dose vaccines, apparently enough people wanted the 1 dose that it was worth mentioning it.
So it can be pretty situational which one is 'better'.
The dosage also matters. J&J for example decided to study one dose first, but are now doing a phase trial to see how good the immunity is for a 2-dose program. So potentially if you get a second dose (maybe down the line), you will also get a stronger immunity closer to the other 2 dose vaccines.
But we're talking 91% vs. 76%.
This is a bad analysis. Disease management is simply not a case where "best health choices for themselves" has any meaning whatsoever. The best choice, the UNAMBIGUOUSLY best choice, for everyone, everywhere, is to get the vaccine that is available first as soon as you possibly can. Period. That's the "best" choice.
Imagining that you can do better individually relies on an intuition that everyone else will be following the rules while you cheat. And that's why no one wants to give you answers as to which the "best" vaccine is.
It includes data on the variants and how the differing vaccines are impacted by those variants. Disclaimer: this is just preliminary data and obviously needs way more research.
I've also been following the Israeli studies for Pfizer and that's what lead me to choosing the Pfizer vaccine over the Moderna one.
One follow-up question I had is this: is it dangerous to have more than one type of vaccine? Provided it's spaced out long enough (2-6 weeks apart) and there's an abundance in supply of course.
From what I understand, mixing vaccines is not a new strategy for vaccinations in general (it's called heterologous prime-boost) and can provide enhanced immunity.
https://www.advisory.com/daily-briefing/2021/04/01/vaccine-m...
Your questions would need to be answered by scientific medical research... which hasn't been done.
The "strong urge not to compare any of them" is good because there isn't a good basis for doing sound comparisons.
Also, even if you somehow knew, for example, that Pfizer was X% more effective or X% safer for you than J&J, but J&J was available now while Pfizer would be available in 4 weeks, you would still need to add the risk of four additional weeks of unprotected exposure to the equation for Pfizer to understand the relative risks.
Putting it together: (A) there isn't a sound way to compare the relative efficacy of J&J, Pfizer, and Moderna (especially on an individual basis) (B) waiting will increase your risk of serious problems from covid means "whichever one is available to you" is the right answer (not an "infantile" one -- careful there; you're throwing around a pejoritive, but I'm pretty sure you're the one who has a superficial grasp of the situation.)
As more data is collected it may be possible to break things down, e.g., by age group or region (if a particular variant is dominant in a region a particular vaccine is especially effective against that variant), but we'll have to see.
The way this sentence is worded negatively affects the way the rest of your comment is read. You would have created a better foundation for discussion (I believe/hope) if you had removed all the snark:
"I know the answer is 'whichever one is available to you', but lets put that aside for a moment."
People can grow thicker skin and not let a slighly snarky argument undermine a valid discussion. This isn't reddit, there's no reason for the hivemind mentality here. I come here to see discussions around the substance of the content and not ridiculous semantic disputes or someone flexing their "iamverysmart" muscle
'Pfizer/Biontech' or 'Biontech/Pfizer' is just too long!
I haven’t even heard people discuss the ‘where’ when getting the vaccine they just want one of the more effective vaccines (be it Moderna or Pfizer- Johnson and Johnson and AstraZeneca are possibly just as effective but that’s hard to communicate and still being studied).
I think either way is probably fine, both companies are sharing the costs and profits equally.
X - vaccine - 25 people get it Y - no vaccine - 250 people get it
That would mean it's 1 - 25/250 * 100 = 90% effective.
What gives? You'd think it'd be the other way around if anything.
In the very beginning of the South African variant there was a report that it wouldn't protect against it and other variants. They're the most expensive vaccine and they want to keep selling their product.
I just lost faith in anything. When politicians make a profit from a prolonged emergency situation they have no reason to shorten the pandemic period. I'm talking about German politicians getting a commission on masks, and them being the ones who decide which kinds of masks are required. It's all so corrupt.
I'm waiting for the Russian and/or Chinese vaccine, maybe travel to Serbia to get my Sputnik V shots, since the EU is playing it political. About a month ago they were even suggesting that "Can we trust the Russian vaccine or is it a Trojan Horse" I mean, suggesting that the Russians would knowingly kill the population of the EU. How through and through Nazified is Germany?
Why would I pick the Sputnik V one over all others? Because they have prior knowledge and are doing 2 vectors (I'm not an expert but I read something about them doing ... well 2 vectors so the virus can't develop a resistence against the vaccine). I trust the Russian government more than my own, who has time and against lied and deceived me, even denounced what we were demonstrating against the new copyright laws and upload filters. The EU is corrupt through and through and they walk over dead bodies. Especially this new EU council lead by Ursula von der Leyen.
Who even elected her? No one that's who. She has a past where she was involved in a corruption scandal and the phone with evidence on it, a state owned phone, was magically erased just when the evidence was to be secured.
So yeah I don't trust anything that's developed in the EU and much less GB who voted pro those harmful "copyright" laws so they could have an advantage when they brexitted.
Astazenica kills people. A Vaccine that kills people. WTF. And politicians are debating that it should now be used on the elderly, because hey fuck the elderly right, they're old and almost dead anyway...
I can't eat how much I could puke.
> In the very beginning of the South African variant there was a report that it wouldn't protect against it and other variants. They're the most expensive vaccine and they want to keep selling their product.
> I just lost faith in anything. When politicians make a profit from a prolonged emergency situation they have no reason to shorten the pandemic period [. . .]
These two arguments you’re making contradict each other - the vaccine protection from the variant without an update shortens the pandemic period. An announcement that everyone needs to shelter in place while a new vaccine is developed is actually what would prolong it.
Also, you seem to be placing more trust in an early “news report” than a scientific study, which makes no sense.
[Edit] To elaborate since there is so much negativity to my original comment. There is no absolute proof that the variant originated in South Africa, so calling it by a country’s name is an insult to human intelligence. We refer to the virus as the Coronavirus and not the Chinese virus. Why should the variant be any different? (This variant being actually called 501.V2)
The actual name for the variant in question is 501.V2.
The other problem with naming a variant after a country or state is what happens when the locale identifies a subsequent variant?
However, I wouldn't be interested personally. If after long term use these vaccines prove to be everything they are promised to be _and_ coronvirus remains an issue, I would gladly take it. As it is I am relatively healthy and not at risk.
Reasonable people can disagree on the trustworthiness of media, government and technocrats.
Ultimately, trust is earned. It is up to the individual to decide for himself. Attempts to scare people into vaccination or mandate use don't help the sale. Trust has been lost. Until this has been addressed, the optics surrounding the promotion of these vaccines can appear as hard sell, urgency, "act now while supplies last" scare techniques.
I know many here are convinced. Hopefully this gives some insight into the skeptical view. Tinfoil or microchip implants don't play a role.
if you get the coronavirus you put other people at risk. Risk of death, in fact. shrugging off covid as not your problem is actually unethical.
Without knowing anything about my situation, you jump to the furthest extreme. Please understand how this speaks exactly to my point.
But that's exactly what not getting a vaccine for a very contagious disease does. In a population there will be people who can't take the vaccine for medical reasons or it was ineffective for some reason. But, if the whole population takes the vaccine that can, herd immunity is still achieved and those people end up protected. By not taking the vaccine when you medically can, you're putting others in the community at risk.
Much like prior to covid, we were seeing an uptick in measles outbreaks because of antivaxers. Not only did the antivaxers put their kids at risk, but also kids in the groups I mentioned earlier.
> https://www.cbsnews.com/news/measles-outbreak-anti-vaccinati...
Besides, there are ways of mitigating that risk. He could just prep at home and wait out the two weeks. It won't be the end of the world.
For example, what if 90% of people on a flight would prefer for the 10% of unvaccinated-by-choice people not to be present on the flight at all? They would presumably be fine if the airline put on special "unvaccinated" flights for unvaccinated-by-choice people - except that probably wouldn't be viable as a business model. Since there isn't reciprocation, why should the vaccinated people be forced to be put at risk by you?
What if, instead of flights, we were talking about access to your local grocery store?
Last I checked, car wrecks aren't self-replicating, mutating, exponential-growth deadly diseases.
It's a very strange position not predicated on the available science. People who are wary of the vaccine are likely reacting to the obvious anti-scientific message.
https://www.reuters.com/article/us-health-coronavirus-eu-vac...
"The European Union aims to increase the region’s COVID-19 vaccine production capacity to 2-3 billion doses per year by the end of 2021"
Hint: The EU has about 400 Million people
3 bn PER year. Trust me. You may have to get vaccinated every year. Don't get me wrong, the strategy makes sense. Still not very encouraging.
The real reason the EU needs this kind of capacity is that the current EU vaccination campaign is going very poorly. Most of the population will only get vaccinated late in summer and autumn, so the yearly capacity needs to be appropriate to at least get it done this year and before the next flu season.
Oh, and the EU produces vaccines for a lot of others like UK, Israel and the US, as well as most third-world-countries. Imports into the EU are neglegible.
Hint 2: ""Quite often vaccines are more effective than natural immunity but we might need to vaccinate everybody every year, or two or three, for quite some time and maybe forever."
https://news.sky.com/story/covid-19-will-we-need-an-annual-v...
Sorry to break the news to you but it is unlikely the world will be what it was.