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Diddling with the vaccine
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Has Achieved Nirvana
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posted
So the Brits are going to be delaying the second dose of the two-dose vaccines, in an attempt to get as many people as possible at least partially protected.

They're talking about mixing and matching, that is not requiring that both doses that an individual gets be the same vaccine.

And in the US, the head of Warp Speed is floating the concept of half doses for people in the 18 to 55 year old age group. I guess there's some study data to support that concept.

You need a scorecard to keep track of the players...


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Outrage is warranted. But outrage unaccompanied by analysis is a danger in itself.

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Posts: 30450 | Location: Somewhere in the middle | Registered: 19 January 2010Reply With QuoteReport This Post
knitterati
Beatification Candidate
Picture of AdagioM
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There is a lot of vaccine out there; it seems like the shortage is in the personnel to administer it. Waiting impatiently for my non-priority turn. Oregon is ninth from the bottom of the list of states in terms of getting people vaccinated. And there’s no waiting list/sign up option. Grrrr.


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http://pdxknitterati.com

 
Posts: 8594 | Location: Oregon | Registered: 06 June 2005Reply With QuoteReport This Post
Has Achieved Nirvana
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Did you check your county? In Illinois it seems like registrations are happening at the county level.


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Outrage is warranted. But outrage unaccompanied by analysis is a danger in itself.

Bazootiehead-in-training



 
Posts: 30450 | Location: Somewhere in the middle | Registered: 19 January 2010Reply With QuoteReport This Post
(self-titled) semi-posting lurker
Minor Deity
Picture of ShiroKuro
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quote:
And in the US, the head of Warp Speed is floating the concept of half doses for people in the 18 to 55 year old age group.


jesus christ.

I really hope that doesn't happen to me. Well, or anyone else, really. (p.s. I'm just under 55 y/o)

Ok, there's some data...

I went to campus today for the first time in ages, checked out the classroom where I'll be teaching, set up all the tech.

I'm f2f starting Wednesday. Unless I have a heart attack first.


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Posts: 15128 | Location: not in Japan any more | Registered: 20 April 2005Reply With QuoteReport This Post
knitterati
Beatification Candidate
Picture of AdagioM
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quote:
Originally posted by wtg:
Did you check your county? In Illinois it seems like registrations are happening at the county level.


Here’s the oh-so-helpful (not) information on the county page:

“ It will take time to distribute vaccines
It will be months before a COVID-19 vaccine is available to everyone. It will take time to make enough vaccines and distribute them in our communities.

Until they are widely available and enough people have been vaccinated, continue to take everyday measures to protect yourself and others.”


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http://pdxknitterati.com

 
Posts: 8594 | Location: Oregon | Registered: 06 June 2005Reply With QuoteReport This Post
Has Achieved Nirvana
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Some thoughts about the implications of going to a one dose, delayed second dose regimen for the various COVID vaccines.

quote:
For the Pfizer vaccine, the two-dose schedule is 95% effective, but studies have shown that from 12 days after the first shot (so allowing time for it to generate protection) to the timing of the second shot, a single dose is about 85-90% effective.

For the Oxford/AstraZeneca vaccine, the full efficacy is about 70% after two standard doses. But with the data currently available, I cannot calculate the efficacy of a single dose of the Oxford/AstraZeneca vaccine. However, it seems that a single injection can reduce the risk of hospitalisation.


quote:
Will delaying the second dose make the vaccine less effective overall?
Almost certainly not. During the Oxford/AstraZeneca trials there were logistical problems that meant some people had to wait longer for their second shots than expected. The efficacy of the vaccine was actually a bit better in those people who had to wait longer for their second dose, though these results were not statistically significant.

No similar data exists for the Pfizer vaccine, so we cannot be certain what the effects of delaying the second dose will be for it, but it is likely that a delayed two-shot regimen will still be effective. We know from immunisations against other infectious diseases that the first, priming doses tend to produce immunological memory that is well maintained in healthy individuals, meaning that the second, top-up jab is still effective even if given late. That’s why vaccine schedules are flexible: if jabs are missed or delayed, we usually only require the schedule to be finished, not restarted.


https://theconversation.com/de...key-questions-152771


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Outrage is warranted. But outrage unaccompanied by analysis is a danger in itself.

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Posts: 30450 | Location: Somewhere in the middle | Registered: 19 January 2010Reply With QuoteReport This Post
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WTG, that's somewhat comforting.

Nothing about the half doses though?


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Posts: 15128 | Location: not in Japan any more | Registered: 20 April 2005Reply With QuoteReport This Post
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A few random thoughts...

The gold standard is to test out hypotheses/different approaches and evaluate the results to determine the "best" approach.

We have COVID vaccines that have been tested using a certain set of parameters.

We're in the middle of a pandemic.

We have other experience with vaccines.

The virus has demonstrated it can spread more readily. That will kill more people than if the virus were to become more virulent.

If the piece in The Conversation is accurate about , then I think it's reasonable to strongly consider the single dose/delayed second dose strategy the UK is implementing. You don't have perfect data, but in medicine and science you rarely do. There's always uncertainty and risk.

I'm trying to locate more information that tells us what happened in the studies. I've heard some doctors asking for full access to that info, but apparently the vaccine manufacturers are not releasing it except to the various national health authorities in charge of approving use. I'm not optimistic I'll find what I'm looking for, but I'll keep digging.

quote:
Nothing about the half doses though?


Not sure what you mean about half-doses.

The AstraZeneca Oxford trial had a problem with manufacturing, and for a segment of the trial participants, they received a half dose followed by a full dose. The protection rate for that group was in the 90 percent range, I believe. Much higher than the blended number of 70 percent for the whole trial. But then the people in that funky "mistake" group may also have been younger, which may be why their rate was higher.

We want more data. The clock is ticking. It all comes down to "you do the best you can with the information you have".

Speaking for myself, at this point in time I'm much more worried about getting the virus and having to deal with both the immediate and possible long term issues than I am choosing the "wrong" vaccine regimen.

That's my thinking for now.


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Outrage is warranted. But outrage unaccompanied by analysis is a danger in itself.

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Posts: 30450 | Location: Somewhere in the middle | Registered: 19 January 2010Reply With QuoteReport This Post
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WTG, earlier, you wrote, and I commented as follows:

quote:
Originally posted by ShiroKuro:
quote:
And in the US, the head of Warp Speed is floating the concept of half doses for people in the 18 to 55 year old age group.


jesus christ.

I really hope that doesn't happen to me. Well, or anyone else, really. (p.s. I'm just under 55 y/o)


I think now I misunderstood your comment?

I thought you meant "half a dose" as in, half of the amount normally expected in one shot, but perhaps you meant "half a dose" as in, one shot, since "a dose" is actually two shots?

Re your most recent comment:

quote:
Speaking for myself, at this point in time I'm much more worried about getting the virus and having to deal with both the immediate and possible long term issues than I am choosing the "wrong" vaccine regimen.


If by that you mean, getting only one shot instead of two, or having the second shot pushed back farther, I can agree with that.

In any case, since I am back in the classroom, my main concern right now is to get the vaccine as soon as I can. If one shot (instead of two) is 85-90% effective, that's pretty good!


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Posts: 15128 | Location: not in Japan any more | Registered: 20 April 2005Reply With QuoteReport This Post
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Ah, I see now what you mean about half-doses. I didn't remember your previous post.

No, I haven't seen anything about that beyond the manufacturing snafu that happened in the AstraZeneca trial.


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Outrage is warranted. But outrage unaccompanied by analysis is a danger in itself.

Bazootiehead-in-training



 
Posts: 30450 | Location: Somewhere in the middle | Registered: 19 January 2010Reply With QuoteReport This Post
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BTW my mother is getting her first shot tomorrow (I think I posted this somewhere, but she lives in IL now)


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Posts: 15128 | Location: not in Japan any more | Registered: 20 April 2005Reply With QuoteReport This Post
Has Achieved Nirvana
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I am scheduled to get the shot Friday evening.
Was waiting to grab a spot with the county process when I got a text from my provider, Centura.


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Posts: 22999 | Location: Still living at 9000 feet in the High Rockies of Colorado | Registered: 20 April 2005Reply With QuoteReport This Post
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That's great, Chas. Let us know how it goes.

My friend who got her shot a week ago Sunday hasn't grown any scales yet....


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Outrage is warranted. But outrage unaccompanied by analysis is a danger in itself.

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Posts: 30450 | Location: Somewhere in the middle | Registered: 19 January 2010Reply With QuoteReport This Post
Has Achieved Nirvana
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SK, something occurred to me this morning that I thought I'd throw out there regarding half-doses and how sometimes medicine gets kinda creative....

I've mentioned before that mr wtg is getting an immunotherapy treatment for his bladder cancer. It's the BCG vaccine, which is normally used to prevent TB and leprosy in countries where those diseases are a problem. It's also used to treat bladder cancer, though instead of being administered in the arm like a regular vaccine, it is infused directly into the bladder via catheter. The patient holds it in the bladder for two hours and then just voids normally.

There is a dosing protocol that is based on how the cancer is graded. That protocol is based on studies done over the years and it outlines how much BCG is administered, at what intervals, and over what period of time.

The original protocol had him getting BCG treatments for a total of three years, with the intervals between treatments getting longer.

There is a worldwide shortage of BCG, so the protocols have been modified because of that shortage. They've told him that because he is responding so well (good news), he won't be receiving BCG treatments after the one year mark because of the vaccine shortage (bad news). They've also greatly reduced the dose being administered. He went from a full dose to half dose to one-third dose over the course of the last year.

Recently they've asked him to change his appointment day and time because they have to be sure they have enough people available to give the BCG to once they've reconstituted a vial's worth before it goes south and they have to throw it out; it's only good for a couple of hours.

I might add that mr wtg's doctor is one of the top people in the country and was instrumental in developing the protocol based on studies that have been done over the years. He literally wrote the book that pretty much everyone else is following and is one of the people trying to figure out how to deal with the BCG shortage.

bottom line, ya do the best you can and hope for the best. There is no perfect solution.


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Outrage is warranted. But outrage unaccompanied by analysis is a danger in itself.

Bazootiehead-in-training



 
Posts: 30450 | Location: Somewhere in the middle | Registered: 19 January 2010Reply With QuoteReport This Post
(self-titled) semi-posting lurker
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quote:
ya do the best you can and hope for the best. There is no perfect solution.


Indeed. The hope is that the solution that gets settled on is as good as it can be given the circumstances. Usually, whether this worked or not can only be known when it's all over.

Re your husband, I'm sorry you and he are having to deal with all of that.

It sounds like he's doing really well -- may that be a trend which continues!!


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My piano recordings at Box.Net: https://app.box.com/s/j4rgyhn72uvluemg1m6u

 
Posts: 15128 | Location: not in Japan any more | Registered: 20 April 2005Reply With QuoteReport This Post
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