UK going against Pfizer recommendation for vaccination

[TimisaMonster 31,073]

29 minutes ago, Reality said:

2021 will be a worse year.

It'll be 2020s mean big sister...we aren't ready 

[djparky 267]

Ultimately it will be like the annual flu injection  which protects people as  much as possible from flu ( and the many various versions of it)- it didn't stop me getting swine flu 10 years ago. Nothing will be 100%.

That said given the amount of money this bunch of f***wits have spent on this, it shouldn't be beyond the wit of even this lot that as medical professionals are suggesting they start 24/7 vaccination centres in all those empty stadiums, town halls, etc the government has forced to close over the last year. 

[jezze0410 395]

4 minutes ago, Chromatography said:

wow, people being stupid? shocker there. 

this is a very illogical way of thinking. these vaccines are not the same, as you said. and the absence of data is NEVER a conclusion. just because we haven’t seen the other vaccine decrease in efficacy due to longer periods of time between dosing due to lack of data, doesn’t mean that the efficacy remains unchanged. that is the BIGGEST scientific sin. 

I’m not saying I endorse without hesitation the MHRA’s decision making, but I do trust without hesitation the people in MHRA, who are better informed and have access to more data than you or I. 

Where I think you miss the point is that MHRA has never claimed that the Pfizer vaccine will definitely not be less effective after a longer gap; but given what MHRA knows about how vaccines work in general, how that vaccine works in particular and the data from clinical trials from that vaccine, it is more than possible for them to construct a confidence interval for that claim’s veracity (that efficacy will not decrease). It’s like any risk management exercise: they’ve come to the conclusion that the benefit that the greater number of vaccinations this strategy will enable is greater than the risk of the Pfizer being less effective as a result. This strategy has also been backed by many other vaccine and medical institutions not associated in any way with the government, and as I mentioned most criticism is directed at the logistics of rebooking.

[spector 1,919]

9 minutes ago, jezze0410 said:

Well, it is still unknown how responsive various vaccines are to future mutations of the virus (we might end up having to do yearly shots like for influenza), so the booster might not give long-term immunity. 

my understanding is that changes ("mutations") in the spike protein do not affect the efficacy of the vaccine because the strains ("mutations") of sars cov-2 do not make it a new virus; once infected, the symptom profile seems to be the same.

14 minutes ago, jezze0410 said:

But yes, the booster does improve the immune response to the antigen considerably. 

precisely.

15 minutes ago, jezze0410 said:

The trade-off here is between conferring 52% effective immunity to as many people as possible as quickly as possible and conferring 95% effective immunity to half that number.

 i understand that; i just do not think, given the available data and information on the virus and the vaccines, that it's scientifically sound to make that trade-off.

[Chromatography 10,186]

1 minute ago, jezze0410 said:

I’m not saying I endorse without hesitation the MHRA’s decision making, but I do trust without hesitation the people in MHRA, who are better informed and have access to more data than you or I. 

Where I think you miss the point is that MHRA has never claimed that the Pfizer vaccine will definitely not be less effective after a longer gap; but given what MHRA knows about how vaccines work in general, how that vaccine works in particular and the data from clinical trials from that vaccine, it is more than possible for them to construct a confidence interval for that claim’s veracity (that efficacy will not decrease). It’s like any risk management exercise: they’ve come to the conclusion that the benefit that the greater number of vaccinations this strategy will enable is greater than the risk of the Pfizer being less effective as a result. This strategy has also been backed by many other vaccine and medical institutions not associated in any way with the government, and as I mentioned most criticism is directed at the logistics of rebooking.

the MHRA cannot make this claim without scientific evidence, which they do not have. it is a highly egregious error to assume that it’ll be okay based on data from a different vaccine. these are also “new” vaccines in the sense that they are mRNA vaccines, something we haven’t used before and we don’t know a lot about. this even further justifies that we cannot make a gross generalization of this vaccine with such little data to go on, and CERTAINLY not data from an entirely different vaccine. this is an incredibly inappropriate way to handle this situation. if i have learned anything about my career in the sciences is that you cannot conclude or justify something without the data to back it.

[jezze0410 395]

Just now, spector said:

my understanding is that changes ("mutations") in the spike protein do not affect the efficacy of the vaccine because the strains ("mutations") of sars cov-2 do not make it a new virus; once infected, the symptom profile seems to be the same.

precisely.

 i understand that; i just do not think, given the available data and information on the virus and the vaccines, that it's scientifically sound to make that trade-off.

I was not referring to the UK or South African strains (though I think I have read somewhere that some of the mutations in the SA strain are not just with the S protein, hence its increased severity and why it is far more concerning; might be wrong though); I’m referring to future variants that will inevitably arise. 

Regarding whether the trade-off is worth it, I don’t think either of us have access to all the data to make a full judgment on this. Giving as many people a first dose as possible also enables the economy to open up sooner and reduce stress on hospitals. I do trust the MHRA to have done their due diligence and risk assessment, albeit in a highly accelerated rate. The MHRA are among the most respected medical agencies in the world, and they know full well what a knock to their reputation it would be if this decision ends up being a terrible one.

[Leblanc 2,494]

46 minutes ago, jezze0410 said:

I understand that it is in vogue to disparage anything the UK does at the moment, but this decision was not made by the government—it’s made by the MHRA, the UK’s equivalent of the FDA. So whatever your thoughts on the Tories’ handling of the pandemic or the Tories in general, don’t be so quick to judge this. Furthermore, most of the uproar among GPs and medical experts is not that this approach will not work, but that it causes vast logistical difficulties (having to cancel and rebook thousands of appointments)—but if you look at the official recommendation, clinics delivering vaccines have a great deal of flexibility in deciding when to start implementing the longer gap.

Basically speaking, the AstraZeneca vaccine’s clinical data shows that the lower the level of antibodies remaining after the first vaccine, the more effective the booster dose is, with 12 weeks being an optimal period. While the Pfizer vaccine is of a completely different type, it differs from the AZ only in how the vaccine teaches the body to produce antibodies in response to the virus. So while there is no evidence that the Pfizer will also perform better with a longer gap between doses, there is no significant evidence that it does not perform better with a longer gap between doses, nor that it it will perform worse with a longer gap. 

The MHRA seems to be banking on the longer gap either not affecting the efficacy too negatively or even improving the efficacy. The Pfizer vaccine is 52% effective after the first dose, and that for the AZ vaccine is similar too. The initial policy when just the Pfizer was approved for use was to retain half of all the vaccines procured to ensure that everyone who has received a first dose can receive a booster 21 days layer; now with the AZ vaccine in play too, which can be produced and delivered far more rapidly and will be by far the dominant vaccine in the UK, MHRA has decided to change course and vaccinate basically at the rate at which the vaccines can be delivered; the long gap between doses gives time for more vaccines to be made, improves the efficacy of the AZ, and likely does not significantly negatively impact the efficacy of the Pfizer. 

You’ll likely see news stories about the MHRA allowing mixing and matching different vaccines for the first and second doses soon too, possibly against the will/intention of all the vaccine manufacturers, but I have confidence that the MHRA would never recommend anything that it knows will have a negative impact. As someone who works in the diagnostics industry, I generally criticise the MHRA for too much bureaucracy and being unnecessary stringent with data or document requirements; this is a refreshing change.

Thank you for the clarity and use of reason 

[Morphine Prince 109,724]

20 minutes ago, Chromatography said:

wow, people being stupid? shocker there. 

this is a very illogical way of thinking. these vaccines are not the same, as you said. and the absence of data is NEVER a conclusion. just because we haven’t seen the other vaccine decrease in efficacy due to longer periods of time between dosing due to lack of data, doesn’t mean that the efficacy remains unchanged. that is the BIGGEST scientific sin. 

This. 

If the FDA were to do this in the US I would be livid. I consented to TWO doses, not one. 

I have adhered to all public health measures and I work exposed to the virus. I WILL get my two doses. PERIOD. 

I feel sorry for these people in the UK. 

[spector 1,919]

3 minutes ago, jezze0410 said:

I was not referring to the UK or South African strains (though I think I have read somewhere that some of the mutations in the SA strain are not just with the S protein, hence its increased severity and why it is far more concerning; might be wrong though); I’m referring to future variants that will inevitably arise. 

Regarding whether the trade-off is worth it, I don’t think either of us have access to all the data to make a full judgment on this. Giving as many people a first dose as possible also enables the economy to open up sooner and reduce stress on hospitals. I do trust the MHRA to have done their due diligence and risk assessment, albeit in a highly accelerated rate. The MHRA are among the most respected medical agencies in the world, and they know full well what a knock to their reputation it would be if this decision ends up being a terrible one.

idk, i just wanted to flex my little knowledge to impress you and go on a date 

[jezze0410 395]

1 minute ago, Chromatography said:

the MHRA cannot make this claim without scientific evidence, which they do not have. it is a highly egregious error to assume that it’ll be okay based on data from a different vaccine. these are also “new” vaccines in the sense that they are mRNA vaccines, something we haven’t used before and we don’t know a lot about. this even further justifies that we cannot make a gross generalization of this vaccine with such little data to go on, and CERTAINLY not data from an entirely different vaccine. this is an incredibly inappropriate way to handle this situation. if i have learned anything about my career in the sciences is that you cannot conclude or justify something without the data to back it.

I agree with you entirely regarding the need for evidence-based science. And I do have a history in physics and economics, so I do share your respect for scientific rigour. But the simple fact of the matter is that you don’t need to know 100% about the vaccine or booster timings’ effects of its efficacy to be able to construct a model based on the information you do have, from which you can draw conclusions with a known degree of uncertainty.

I can’t really reply anymore, since it’s really late in HK where I am (happy new year, by the way!), but please know that I share your legitimate concerns about the lack of publicly available data supporting this decision. I believe a paper of some sort has been published to support the decision, but I simply can’t stay up any longer to find it...

[March34th 1,973]

i live in Ontario and our provincial government has been considering doing something in this vein. Their excuse is it would help more people get vaccinated faster as doses intended for person A as a second dose could go to person B as their first does and so on. But there isn't enough evidence to show only the first dose of the vaccine will be substantial. Regardless I'll get the vaccine but hopefully the government here thinks twice because it could be a shot in the foot. 

[emig09 24,701]

We have the Russian one 

[Guest]

Wouldn't follow Pfizer either...

[jezze0410 395]

https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/948338/jcvi-advice-on-priority-groups-for-covid-19-vaccination-30-dec-2020.pdf

Here’s a link to a very thorough paper on the MHRA-approved JCVI (Joint Committee on Vaccination and Immunisation, in charge of all vaccination advice and strategy in the UK) strategy. The immediate, most pressing goal (Phase 1) is to prevent death (rather than to reduce the number of cases); given that the clinical trials have shown that there were no instances of severe disease after even just one dose (from what I recall; there might have been an insignificant (statistically-speaking) number of severe illnesses), the decision to prioritise the number of vaccination seems quite clear to me...

[bionic 50,111]

58 minutes ago, TimisaMonster said:

It'll be 2020s mean big sister...we aren't ready 

2021 walking in like "I heard you've been talking smack about my sister"

while 2020 stands in corner like