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What if more than one vaccine is proven to work?

Thu May 14, 2020 1:57 pm

As we know, multiple companies have been racing to develop COVID-19 vaccines. Hopefully, it is just a matter of a few months until we have an idea of what works and what doesn't. But what happens if more than one vaccine is proven to immunize people against the virus?

Will different regions of the world be given different vaccines? Or can there only be one specific universal vaccine for protection?
 
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casinterest
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Re: What if more than one vaccine is proven to work?

Thu May 14, 2020 2:03 pm

We will get the vaccines that work and can be produced quickly in each region . Right now there is a wide definition for "works"
The item that the scientists are working on is to make sure that the cure is
A. Effective
B. Not worse than the virus itself.

Look at the Flu Vaccine.
It is estimated to reduce infections by a certain percentage in the at risk group.

https://www.cdc.gov/flu/vaccines-work/vaccineeffect.htm

And look at the different manufacturers just in the US.

https://www.cdc.gov/flu/professionals/vaccines.htm
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rfields5421
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Re: What if more than one vaccine is proven to work?

Thu May 14, 2020 3:29 pm

Within a couple years the ONE best vaccine will be identified, but it will be beyond the capacity of any company to produce all the vaccine doses needed.

The number of doses needed is huge. The next BIG NEWS STORY will be the people wanting/ needing the vaccine and unable to get the shot/ pills/ ?? because production has not ramped up enough to provide vaccine to everyone. Duh. The US still has not been able to produce and supply enough testing kits to test even one percent of the US population. Vaccine is going to be sought by EVERYONE.

If this is a one-time shot - too large a production facility will bankrupt the company who builds up to produce the most vaccine when those production facilities are no longer needed.

If it turns out to be yearly like the flu, then three or four manufacturers will establish regular yearly production capacity.
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Pellegrine
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Re: What if more than one vaccine is proven to work?

Thu May 14, 2020 4:00 pm

Actually, some people get multiple flu vaccines every year. One by manufacturer A and one by manufacturer B. Something like this could be requested by the patient, but probably wouldn't be initiated by a doctor.
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StarAC17
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Re: What if more than one vaccine is proven to work?

Thu May 14, 2020 6:17 pm

rfields5421 wrote:
Within a couple years the ONE best vaccine will be identified, but it will be beyond the capacity of any company to produce all the vaccine doses needed.

The number of doses needed is huge. The next BIG NEWS STORY will be the people wanting/ needing the vaccine and unable to get the shot/ pills/ ?? because production has not ramped up enough to provide vaccine to everyone. Duh. The US still has not been able to produce and supply enough testing kits to test even one percent of the US population. Vaccine is going to be sought by EVERYONE.

If this is a one-time shot - too large a production facility will bankrupt the company who builds up to produce the most vaccine when those production facilities are no longer needed.

If it turns out to be yearly like the flu, then three or four manufacturers will establish regular yearly production capacity.


I believe to counter this any vaccine has a way to be mass produced when it goes to human trials. Therefore if the vaccine is successful there is a supply to be manufactured or already mass produced.
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rfields5421
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Re: What if more than one vaccine is proven to work?

Thu May 14, 2020 6:38 pm

StarAC17 wrote:
I believe to counter this any vaccine has a way to be mass produced when it goes to human trials. Therefore if the vaccine is successful there is a supply to be manufactured or already mass produced.


The flu vaccine is probably (I could be wrong) the single most widely given vaccine every year - as far as number of doses.

The research, manufacture and distribution timeline/ supply chain is over a year long. Even then, at the time of change over from the 'old' vaccine to the 'new' vaccine often means short supplies, or no supply for many retail outlets. The CDC says 169.1 million doses of flu vaccine were given in the 2018-19 flu season in the US.
https://www.cdc.gov/flu/prevent/vaccine-supply-historical.htm

That was approximately 37.1% of the US population for the 2016-17 flu season..

What percentage of the population do you think are going to WANT the COVID-19 vaccine?

What limitations will be set upon people in the US (similar to current limits upon who can get a COVID-19 test) to define who can get the vaccine?

The US has still only been able to test some 10-12 million people for COVID-19 despite mass production ramp ups which have occured.

Do you think vaccines are going to be available faster/ more readily?

I'm not saying it cannot be done. I'm just saying it is a HUGE logistics problem to solve. Not only production of vaccine, but distribution of the vaccine. The socio-political factors in deciding who gets the vaccine first?

At risk elderly - age 60 and over?

Or our precious children before they got back to large crowded schools?

Our President suggested that giving the vaccine to the elderly is a possibly better usage of limited availability. Some have suggested to him that children don't need the vaccine because 'they are not likely to get a bad case'.

Not meaning to pick on the man for his thoughts. It is a VERY DIFFICULT decision what will ultimately be on his desk to make a decision. Despite recommendations from medical professionals (1) the professionals will have differing opinions, (2) the pressure from different groups will be incredible.

Personally, I'm 67 + years old, my wife is 81. We would both prefer kids get vaccinated FIRST. There is no future is we make a mistake and the young become the most negatively impacted group.
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einsteinboricua
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Re: What if more than one vaccine is proven to work?

Thu May 14, 2020 8:12 pm

rfields5421 wrote:
We would both prefer kids get vaccinated FIRST. There is no future is we make a mistake and the young become the most negatively impacted group.

I believe children (and teachers) should be the first to be vaccinated, but not because it will impact the future generation but because children are:
1. Less affected by the virus which means the can become carriers
2. Spend most of the school day in close proximity to people

Having them be immune to the virus means parents can still hunker down until it's their turn for a vaccine. Elderly folks, especially those in nursing homes or those who live with family, should be the second group to get the vaccine, and work their way down until you get to the younger generations.
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winginit
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Re: What if more than one vaccine is proven to work?

Thu May 14, 2020 8:50 pm

einsteinboricua wrote:
rfields5421 wrote:
We would both prefer kids get vaccinated FIRST. There is no future is we make a mistake and the young become the most negatively impacted group.

I believe children (and teachers) should be the first to be vaccinated


Surely after medical professionals though no?
 
StarAC17
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Re: What if more than one vaccine is proven to work?

Thu May 14, 2020 8:54 pm

rfields5421 wrote:
StarAC17 wrote:
I believe to counter this any vaccine has a way to be mass produced when it goes to human trials. Therefore if the vaccine is successful there is a supply to be manufactured or already mass produced.


The flu vaccine is probably (I could be wrong) the single most widely given vaccine every year - as far as number of doses.

The research, manufacture and distribution timeline/ supply chain is over a year long. Even then, at the time of change over from the 'old' vaccine to the 'new' vaccine often means short supplies, or no supply for many retail outlets. The CDC says 169.1 million doses of flu vaccine were given in the 2018-19 flu season in the US.
https://www.cdc.gov/flu/prevent/vaccine-supply-historical.htm

That was approximately 37.1% of the US population for the 2016-17 flu season..

What percentage of the population do you think are going to WANT the COVID-19 vaccine?

What limitations will be set upon people in the US (similar to current limits upon who can get a COVID-19 test) to define who can get the vaccine?

The US has still only been able to test some 10-12 million people for COVID-19 despite mass production ramp ups which have occured.

Do you think vaccines are going to be available faster/ more readily?

I'm not saying it cannot be done. I'm just saying it is a HUGE logistics problem to solve. Not only production of vaccine, but distribution of the vaccine. The socio-political factors in deciding who gets the vaccine first?

At risk elderly - age 60 and over?

Or our precious children before they got back to large crowded schools?

Our President suggested that giving the vaccine to the elderly is a possibly better usage of limited availability. Some have suggested to him that children don't need the vaccine because 'they are not likely to get a bad case'.

Not meaning to pick on the man for his thoughts. It is a VERY DIFFICULT decision what will ultimately be on his desk to make a decision. Despite recommendations from medical professionals (1) the professionals will have differing opinions, (2) the pressure from different groups will be incredible.

Personally, I'm 67 + years old, my wife is 81. We would both prefer kids get vaccinated FIRST. There is no future is we make a mistake and the young become the most negatively impacted group.


I'm not saying the production would be ready on day 1 to fulfill global demand but they would already have a reasonable amount of the vaccine produced given the trials are successful and it is approved by the FDA and other international governing bodies to start immediate doses.

I personally like what they did in Contagion and drew it by a birthday lottery. In theory that is fair and this would produce an pretty even amount of people able to get it on a given day. With each given day the risk to the public is less.
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DocLightning
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Re: What if more than one vaccine is proven to work?

Thu May 14, 2020 11:21 pm

That's the case now. The Hepatitis B vaccine used in China is different from the one used in the USA. In India and parts of Europe they use a vaccine for measles, mumps, rubella, and varicella called PRIORIX-TETRA, which is made by GlaxoSmithKline, while the PROQUAD product in the USA is made by MERCK and there are some minor differences in the strains used.

In the USA there are two brands of hepatitis A vaccine (VAQTA by Merck and HAVRIX by GSK). There are two different pentavalent pediatric immunizations, one being PEDIARIX by GSK (GSK vaccines end in "-RIX"), which combines HBV, IPV (polio), and DTaP and the other being PENTACEL by Sanofi, which combines IPV, DTaP, and HiB. Moreover, in the USA there are multiple different brands of influenza vaccination each year, some of which are produced using different techniques, and some of which are administered in different ways. For example, there is an intradermal flu vaccine for the needle-shy that I have had and I barely felt. There is also a nasal version, but only certain patients are eligible for that one (ages 2-49, no history of severe asthma, no immunosuppression). Generally, the CDC/ACIP recommendation is to get one of any of these per season. Interestingly, this year the one produced using recombinant technology will use a slightly different strain than the ones grown on chicken eggs for reasons that I have yet to have anyone explain adequately to me.

And there are two different meningitis B vaccines that use very different technologies but have similar efficacy.

In order to get a competing vaccine to market, a manufacturer must demonstrate that its product is non-inferior to the already marketed vaccine. In some cases, the new vaccine is demonstrably superior to the existing product. In the last year or so, GSK introduced SHINGRIX, a singles vaccine that reduces the risk of shingles in older adults by a stunning 98%, far superior to the pre-existing ZOSTAVAX (Merck), which only caused a 70% reduction in risk. The CDC recommended it for the entire population, even those who had already had ZOSTAVAX.

As the first vaccines hit the market, there will probably be limited head-to-head data and the recommendation will be to get whichever one you can. As time goes on, it is likely that one or a few will be demonstrated to be superior to the others and then we'll see whether the CDC/ACIP recommends reimmunization.
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DocLightning
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Re: What if more than one vaccine is proven to work?

Thu May 14, 2020 11:23 pm

einsteinboricua wrote:
I believe children (and teachers) should be the first to be vaccinated, but not because it will impact the future generation but because children are:
1. Less affected by the virus which means the can become carriers
2. Spend most of the school day in close proximity to people


I am going to disagree. The recent reports of a Kawasaki-like syndrome in children who are convalescing from COVID-19 make me think that we should delay administration to children until we have a better idea of whether the vaccine is likely to set off the same syndrome.
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frmrCapCadet
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Re: What if more than one vaccine is proven to work?

Fri May 15, 2020 12:43 am

Epidemiologists and other scientists will likely make a recommendation as to who should receive early immunizations. Factors could include vulnerability, medical workers, outbreaks in particular areas, travelers. Most of us should simply follow the recommendations.
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Sokes
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Re: What if more than one vaccine is proven to work?

Fri May 15, 2020 9:23 am

frmrCapCadet wrote:
Epidemiologists and other scientists will likely make a recommendation as to who should receive early immunizations. Factors could include vulnerability, medical workers, outbreaks in particular areas, travelers. Most of us should simply follow the recommendations.


In a perfect world that's the sensible thing to do.
I go off topic. This post is about distribution.

Strange that nobody considers money. A lot of vaccine manufacturing capacity is in India. I doubt early vaccines will go to Indian nurses if a rich man is willing to pay 100.000 $ for it.

Should a 60 year old Indian farmer get priority with an Indian manufactured vaccine over a 45 year old American engineer that works in R+D? That 60 year old farmer is quite satisfied to stay in lockdown in his village if he gets 100 $ / month for himself and his family. Most Indians are used to a very boring life. Rich countries aren't.

The world does not appreciate India enough. If India had not to be so radical, the demand for tests, incubators ... in the world would be much worse. A friend from Bombay told she didn't leave the flat since lockdown (25. March). And flat in Bombay means matchbox. A watchman brings food to the door. Of course most places are not so bad, but the economy is on life support.

The world would do well to give financial help to India as the government is under enormous pressure to restart the economy.
So if the world wants to enjoy the manufacturing capacity of India in medicaments, vaccines and other stuff, now would be a good time to help the Indian government.
I believe 30$/ (Indian and month) would do to increase lockdown indefinitely = till the developed world is vaccinated.
Let's say for 40 billion $/ month help from the international community lockdown could probably be extended. That's 500 billion $/ year.

India's GDP was 2,6 trillion $ in 2017. 500 billion $/ year is not great for India. But it will take care that India can satisfy it's foreign payment obligation and that those not in farming can pay for food and medicines and those in farming for medicines. The other 80% of GDP is gone. But what does one need while sitting at home?
I agree for so much money it's cheaper for the West to build up own capacity. But if India can't serve it's foreign debt global financial markets won't have a fun time.

People from the Netherlands born in 1945/ 46 had an increased risk to develop diabetes early. That's because German occupiers removed food. Malnourishment in uterus leads to increased risk of diabetes in later life. It's not like everybody has it in India, but it's quite common even among people in their 40s who aren't overweight.

"One in six people with diabetes in the world is from India. The numbers place the country among the top 10 countries for people with diabetes, coming in at number two with an estimated 77 million diabetics. China leads the list with over 116 million diabetics."
https://www.thehindu.com/sci-tech/healt ... 975027.ece

Probably one in six people in the world is Indian, but then India is a young society.

Let's say lockdown till the rich of the world are vaccinated would require 700 billion $ for 1,5 years. I guess auctioning of the first ten million vaccines can pay that money back. India is greatly helped and the rich countries complete vaccinations a few months early.

1% of 7 billion people is 70 million. How much would an auction of the first 1% vaccines bring?
Should distribution really be according to need? If yes a 40 year old US citizen will have to wait a long time till everybody with higher priority in the world is vaccinated. If it's according to need, but restricted to own country, India's vaccination manufacturing capacity won't be available to rich countries for a long time.
I suggest India and industrialized countries help each other.

Within each country I think that the top 10% of income tax payers should be in a priority class. Not top priority, but the government has to show some appreciation.

In Germany those who have a private health insurance enjoy marginal better healthcare, but pay much higher. They basically subsidize those in the government obligatory insurance. I don't say a 30 year old in the private insurance should get priority over a 60 year old in the government insurance. But some appreciation for their subsidy has to be shown.
I wouldn't profit from these suggestions. Anyway I'm stuck in India.
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frmrCapCadet
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Re: What if more than one vaccine is proven to work?

Fri May 15, 2020 2:07 pm

I suspect that the US, China, India, EU, Japan et alia will cooperate at some level to ensure adequate supplies. But it will be up to each country to ensure the best use of those supplies. The Gates foundation most basic mission is to ensure that all people benefit from our world wide public health, and especially poorer people and especially vaccines. The foundation is spending a lot of money on this virus, as are national government agencies. I am not familiar with research facilities on vaccines in China and India. Perhaps someone knowledgeable could give us a summary of what those two countries (filled with talent obviously) are doing.
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EstherLouise
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Re: What if more than one vaccine is proven to work?

Sat May 16, 2020 8:34 pm

Remember polio? Remember that two doctors came up with different vaccines that worked within a short period of time? Remember the names Dr. Sabin and Dr. Sauk?

I don't feel like typing a two page reply about their discoveries and how the world adopted them. You can research it just as good as me.
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Aesma
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Re: What if more than one vaccine is proven to work?

Sat May 16, 2020 11:13 pm

There was already a controversy here in France with Sanofi's CEO saying the US would get the vaccine first. Sanofi's president had to clarify that this was for vaccines manufactured in the US. Sanofi has much more capacity to make vaccines in France, and those would go to France/Europe first...
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