One of many links provided below:

https://abcnews.go.com/Health/early-tri ... d=71564008

In an interview conducted last month, Pfizer's CEO Albert Bourla stated that if all goes well with these vaccine trials and testing, a vaccine could start to be distributed as early as October of this year.

This is coming just weeks after AstraZeneca's ChAdOx1 nCoV-19 entered phase 2/3 trials. Many analysts have claimed that the AstraZeneca/Oxford candidate is so far the leader in the race to start vaccine distribution by the end of the year if luck is on our side.

However, the main drawback of this is that AstraZeneca's CEO stated that protection from COVID-19 may last for only a year.

Yep, being from STL, where they (pfizer) are making the vaccine, there is a lot of buzz going around regarding the potential success. And while I can't elaborate due to breaking the site's rules regarding internal information, all I'm going to say is that there is even better news than what is being reported to the press

This is great news.
From the article

"While the manufacturer has not given a specific release date, Dormitzer assured ABC News Pfizer is "currently on track" to meet the goal of producing 100 million doses by the end of the year and another 1.2 billion doses in 2021.

"The goal that we've set is to distribute millions of vaccine doses in 2020 and executing on that, of course, means everything has to go well," he said. "We need the regulatory approval to do so. But that is our plan."

The vaccine should go to the elderly and most susceptible first and foremost. Then we can start to work towards full re openings. The bad news is that we still have 4-6 months of social distancing to get through.

Yesterday morning, Pfizer and BioNTech announced that their BNT162b2 COVID-19 Candidate has at least a 90% efficacy at preventing COVID-19.(1) I want to talk for a moment about what we know, what we don't know, and where this takes us.

1) What we know
Pfizer/BNT (which I'll call "Pfizer" from now on) had at first planned an aggressive schedule. In any vaccine trial, the investigators and the patients are "blinded" to who got the vaccine candidate and who got the placebo. At certain milestones during the trial, the plan was to assemble a Data Monitoring Board (DMB) who would lock the doors and unblind the data to see who got COVID-19 and who didn't. Pfizer's plan was quite aggressive: they were going to unblind at 32, 64, and then 164 cases. However, on discussion with the FDA, they decided to dispense with the 32 case endpoint and go with 64 as their first interim data analysis.

While they were negotiating this with the FDA, they went past 64 cases of COVID. In fact, 94 people in the trial were infected. When they looked at the data, they found that the vast majority of those cases (we don't know the exact number yet; it might have been all of them, but no less than 83) were in the placebo group.
From this, Pfizer has concluded that the vaccine reduces the risk of contracting COVID-19 in *at least* 90% of patients who receive both doses (21 days apart) starting 7 days after the second dose.

In addition, there have been no serious safety concerns during the trial. Two competing candidates, both Adenovirus-vectored vaccines (one from J&J and the other from AstraZenica/Oxford) were briefly halted when patients had significant adverse events occur. Both of those products were found to not be responsible for those events and their trials are again underway.

2) Implications for other COVID-19 Vaccines
The big news here is that this proves that COVID-19 vaccines can work!. This Isn't an enormous surprise; I had expected this all along. After all, these vaccines didn't fall out of a clear blue sky. Coronavirus vaccine candidates have been in the works since SARS In 2002. But this means that the doomsayer's prediction of: "there will be no vaccine and no protective immunity" has been eliminated.

The bigger surprise for me is just how well it works. COVID-19 starts as a mucosal infection and proceeds into the blood in some portion of patients. Injected vaccines are really good at stopping viral infections that have to get into the blood, but for flu shots, injected vaccines only prevent infection in a middling 30-60% when the viruses are matched (although they prevent severe disease in about 80-90%). Then again, should I have been so surprised? Measles, mumps, rubella, and chickenpox are all viruses that start in the mucosa and then get into the blood. Those vaccines, which are injected, all work very well. And HPV is a purely mucosal virus, but an injected vaccine offers essentially 100% protection against infection.
The four leading Western COVID-19 vaccines (not from Asia) are all "expression-based," meaning that they introduce into the patient's cells the genetic code for a modified spike protein that can't trigger into the post-fusion form (After the virus enters the cell). These are Pfizer (an mRNA vaccine) AstraZenica (the ChAdOx1-vectored vaccine), Moderna (another mRNA vaccine), and Johnson and Johnson (an Adenovirus 26-vectored vaccine). All of them had similar pre-clinical results as far as antibody production and protection in nonhuman primates. A fifth candidate by Novovax, is based on a nanoparticle "bouquet" of spikes, which also seems to be promising in preclinical trials, is about to enter Phase III trials in the USA.

So because at least the first four are all based on similar principles, then we can expect that ALL OF THEM WILL WORK. They might work a little better or worse than Pfizer's, but I expect that they will all work.

This means that we won't just be dependent on Pfizer to produce and distribute a vaccine (more on that in a minute). This means that we might be able to vaccinate a good portion of the USA by the end of next year.

3) The efficacy is stunning!
I'd been expecting the vaccine to work. The FDA put a "floor" of 50% efficacy on these vaccines in order to get approval. But I had been hoping for 70-80% efficacy at best. To get >90% isn't something I dared hope.

Not only that, but Pfizer thinks that the vaccines will maintain protection for at least a year (and given how the immune system works against viruses, it might be good for decades, like the measles vaccine). For now, a year is good enough. We can get boosters if need be, but by then we can all be back to going to sports games, the gym, restaurants, and laughing and having a meal wth friends.

The other thing about a high efficacy rate is that it means that uptake is less important; meaning that even if you don't get vaccinated, I can still be pretty safe if I do. Sure, if we want to eradicate the virus, then we need high population coverage, but even if we don't get that high coverage, people who have had the vaccine can live with much less fear.

4) There are still hurdles.
Pfizer won't reach their safety endpoint for another three weeks. At that point, they will file an application for an Emergency Use Authorization (EUA). The trials will go on and hopefully this won't impact other trials. If that's the case, then we might see the first doses go into the highest-risk deltoid muscles (healthcare workers, residents of long-term care facilities) sometime around the Holidays.

Even then, this particular candidate has some issues. It requires a -80C freezer for storage. Most hospitals and pharmacies only have -20C freezers. -80C freezers are mostly used in research labs, but some cancer centers and other specialized medical facilities have them. Even a basic unit is US$10K+. Pfizer is working on studying higher storage temperatures and other methods of distributing these vaccines. It isn't a show-stopper, but it most certainly is a major difficulty.

The good news is that the other candidates can be stored at a much more conventional -20C or even +4C (the temperature of a typical refrigerator).

5) So when does COVID-19 go away?
I started my residency in Pediatrics in 2005. Back then, every winter was dominated by a virus called rotavirus. Rotavirus was responsible for 70% of hospitalizations in infants for vomiting, diarrhea, and dehydration. I was hospitalized for rotavirus when I was 20 months old.

In the winter of 2006-2007 a new vaccine, ROTATEQ, came along. This vaccine could only be given to children who were under 2mo when it was developed (it requires three doses at 2, 4, and 6mo and if you miss one dose you can't finish the series). This vaccine offered about 90% efficacy against rotavirus.

A year later, I was rounding in the hospital as a senior resident in February 2008 when we realized something: "Where are all of our rotavirus cases?" We'd only seen a handful all winter.

The disease had all but vanished. I last saw a case in 2010. This new vaccine has similar efficacy (at least) to the rotavirus vaccine and it doesn't have the limitation of only being available to a novel cohort of the population.

Folks, there is an end in sight. The pandemic is going to end. It's going to end soon because we put together a massive effort and we used science to create a vaccine. The vaccine is going to work.

We are going to win.

"We will succeed, and that success will belong to every one of us. We should take comfort that while we may have more still to endure, better days will return. We will be with our friends again. We will be with our families again. We will meet again."
-Her Majesty Queen Elizabeth II, 5 April 2020

(1)https://www.pfizer.com/news/press-release/press-release-detail/pfizer-and-biontech-announce-vaccine-candidate-against

Good write up Doc!

The next challenge will be convincing the Anti-Vaxers and Covid-19 deniers to get the vaxine.

To see someone of Docs’ credentials write “we are going to win” is enormously uplifting in a year that’s been challenging at best.

So this is why all the Pfizer people I knew had been so bubbly and talking about a return to normal for the past few days. LOL and I was like no way not for a long time and showing them all of the "official" press stuff about Pfizer from CNN/FOX and they were like ummhmm yep.

bill142 wrote:

The next challenge will be convincing the Anti-Vaxers and Covid-19 deniers to get the vaxine.

Luckily, as doc alluded to, with such a high level of effectivity, what the anti-vaxers do doesn't even matter to us rationals. If they want to keep getting it and dying from it, let them knock themselves out

stl07 wrote:

bill142 wrote:

The next challenge will be convincing the Anti-Vaxers and Covid-19 deniers to get the vaxine.

Luckily, as doc alluded to, with such a high level of effectivity, what the anti-vaxers do doesn't even matter to us rationals. If they want to keep getting it and dying from it, let them knock themselves out

i really don´t mind shorter lines to get the vaccine because of them.

best regards
Thomas

I ll wait some months before getting the vaccine, just to check the unknowns with theses rushed out vaccines.

stl07 wrote:

bill142 wrote:

The next challenge will be convincing the Anti-Vaxers and Covid-19 deniers to get the vaxine.

Luckily, as doc alluded to, with such a high level of effectivity, what the anti-vaxers do doesn't even matter to us rationals. If they want to keep getting it and dying from it, let them knock themselves out

Don't forget that antivaxxers not getting it can also harm others. Some people can't be vaccinated for medical reasons. They depend on the herd immunity created by all the people who do get vaccinated. However, if there are too many people who don't want to be vaccinated, there will be no herd immunity, and those who can't be vaccinated will still be at risk, together with about 10% of the people who are vaccinated.

this looks like a game changer, I just hope it gets here real quick. Especially since the virus is NOW totally out of control.
On a personal note, I did get Cov19 and unfortunately gave it to my husband. It took me 3 weeks to get over it, I had no problem breathing, I just had problems keeping anything down and being very weak and tired. It was doing weird things to my feet. I couldn't stand on my feet, it's like i couldn't put pressure on my feet. I am fine now, I finally shed it. However, my husband is still struggling after three weeks, he is now having breathing issues. If he doesn't get better by Thur his Dr. going to have him check into a hospital.
It's really kicking his butt. I don't get how some people, are over it in three days, and people like my husband and I had it drag on for weeks with it doing very weird things to us both.

stl07 wrote:

bill142 wrote:

The next challenge will be convincing the Anti-Vaxers and Covid-19 deniers to get the vaxine.

Luckily, as doc alluded to, with such a high level of effectivity, what the anti-vaxers do doesn't even matter to us rationals. If they want to keep getting it and dying from it, let them knock themselves out

The problem it will still be groups that cannot take the vaccine..

I see a future where in order to travel or visit nursery homes for older and weak people you will need to show certificate that you have taken the vaccine. That might be extended to some other vaccines for sicknesses mentioned in the thread.

bill142 wrote:

The next challenge will be convincing the Anti-Vaxers and Covid-19 deniers to get the vaxine.

Can we skip them?

DLFREEBIRD wrote:

Especially since the virus is NOW totally out of control.

Exhibit A, influenza. That one is *totally* "under control".
Give me a break.

Hey Doc, the mask will have to come off right? To properly judge the effectiveness of this vaccine against the "herd"?

Thank you very much for the very interesting summary!

DocLightning wrote:

Pfizer/BNT (which I'll call "Pfizer" from now on)

How is the task sharing between these two companies? The German press just mentions and praises Biontech (by the way, located in my former home town, the City of Mainz )

Thanks for the explanatory info, DocLightning. It certainly seems that there is a new dawn on the horizon,

May I pose a question? Do you see the anti-vaccination faction in the US sabotaging the chances of herd immunity being achieved, say, sometime next year and the epidemic continuing to darkeni life in the US?

A question to all: how many people in the US would refuse vaccination for themselves and their children if given the choice of being vaccinated or not being vaccinated? Are there any data sources giving some idea of the size of the anti-vaccination movement?

DocLightning wrote:

Folks, there is an end in sight. The pandemic is going to end. It's going to end soon because we put together a massive effort and we used science to create a vaccine. The vaccine is going to work.

We are going to win.

As usual, high information density. Keep posting, we follow with interest.

What humans can't do if they put their mind to it?
And still there are so many technologies that need developing and we just don't want to make the needed resources available.

I always wonder how genius and stupid mankind is.

You are describing exponential growth of the virus (a "case"), not the disease caused by it.
Doc, correct me if I'm wrong, but the vaccine would be to prevent the *disease*, not the virus itself from spreading?

DocLightning wrote:

Folks, there is an end in sight. The pandemic is going to end. It's going to end soon because we put together a massive effort and we used science to create a vaccine. The vaccine is going to work.

We are going to win.

Amen. Science (and fighting for the Common Good) always win. Thank you for this write up!

DLFREEBIRD wrote:

I am fine now, I finally shed it. However, my husband is still struggling after three weeks, he is now having breathing issues. If he doesn't get better by Thur his Dr. going to have him check into a hospital.
It's really kicking his butt. I don't get how some people, are over it in three days, and people like my husband and I had it drag on for weeks with it doing very weird things to us both.

Hang in there. Glad you're better. I hope he gets back to 100% ASAP.

ArcticSEA wrote:

You are describing exponential growth of the virus (a "case"), not the disease caused by it.

Yes, exponential growth in cases of detected infection. Since it can make people ill it follows that a growth in the number of cases leads to a growth in the number of people showing symptoms of illness due to COVID-19 infection.

Olddog wrote:

I ll wait some months before getting the vaccine, just to check the unknowns with theses rushed out vaccines.

I doubt you'll "have to wait" as you'll be waiting whether you want to or not. The first to receive any vaccine when it arrives will be healthcare personnel and workers in essential and critical industries.

Production ramps will come into play and global supply and commitments will need to be accommodated for those first two. That will likely take those "some months" you want to wait to see how good it is.

After that it will move to people at high risk for severe COVID-19 illness due to underlying medical conditions and people 65 years and older that request it. Then it will move on from there.

I will say that I will take a successful vaccine as soon as I can.

Tugg

ArcticSEA wrote:

Doc, correct me if I'm wrong, but the vaccine would be to prevent the *disease*, not the virus itself from spreading?

Not Doc, but I believe you are wrong in that the vaccine will allow the body to defeat and eradicate the virus. Thus removing/reducing its ability to spread to another person. Viruses needs to grow and multiply to then create "viral load" that can be spread effectively.

To my knowledge a vaccine is NOT a "symptom treatment" like aspirin, antihistamines and decongestants, that just reduce effects of whatever is affecting the person.

Tugg

Doc, can too cold of temp destroy this mRNA vaccine? I ask because most hospitals do have some cryo ability now...LOX and Nitrogen thos big tanks outside....if there was some way to use the gasses they have on site to keep the vaccine frozen, it may mitigate the issues of having to ship specially designed boxes all over the planet...

Doc, thanks for your write up. I think a lot of people are so bent up about COVID/Trump that they will not admit the efficacy of vaccines. They will focus on anecdotes of people getting COVID and dying anyway.

We previously saw this. A person is anti-science if they say COVID is harmless to people under 18, because a young person with leukemia who was immune-suppressed (and possibly dying anyway) caught COVID and it went on their death certificate. So that means all schools in our country need to remain closed until 2025. Etc.

I know people including a whole group of elderly MDs who are remaining to be indoors or wear masks for years to come, because Trump has destroyed our world. No one can offer certainty that COVID won't mutate, come back and hurt someone (this is true for all vaccine-related topics).

COVID was a scientific and medical topic (which I don't comment on besides body counts). But COVID was also a cultural and political topic, about Trump, about educated/uneducated, about taking back power from the working classes. People wearing masks to to signify their identity outdoors or at home. I don't think that part will go away for a long time. A lot of people will stick to their narrative.

I did predict this cultural narrative would change on or around Election Day. Sure enough, the first trading day after the election was completed, (yeah it's a coincidence), cultural sentiment shifted on COVID. I hope it does shift. If Trump had won, we have to think how the narrative on the threat of COVID would be different. How the threat continues, or if anything, is accentuated and continues to build, by virtue of Trump.

My little take is COVID was going to do exactly what it did, and this was known with accuracy in March. The financial equivalent of millions of human lives was spent and lost trying to contain COVID, which was already out of containment on April 1. Meanwhile, vaccine development continued. I guess now we can just move on, thank god.

Thanks for the update, Doc. This is indeed very encouraging! Certainly some optimism (along with other events) that 2021 will better.

Doc, thank you very much for this write up and the previous thread that detailed more of the science. All excellent information.

This is exciting stuff and I didn’t realize this also meant good news for the other prospects, which means there will be some price competition, too.

Thanks again!

stl07 wrote:

bill142 wrote:

The next challenge will be convincing the Anti-Vaxers and Covid-19 deniers to get the vaxine.

Luckily, as doc alluded to, with such a high level of effectivity, what the anti-vaxers do doesn't even matter to us rationals. If they want to keep getting it and dying from it, let them knock themselves out

Check out Exhibit 1 in the following article:

https://www.mckinsey.com/industries/hea ... ndemic-end

The anti-vaxxers may not matter indeed.

Quick anecdote on Covid and some of its more surprising effects... I contracted it after attending a wedding just over a month ago (I know, dumb choice). It hit me hard in terms of general lethargy, muscle aches, and overall weakness/shortness of breath when doing any sort of exertion. I had a fever and would soak through my sheets each night with sweat. That lasted for about 4 days, and then it started to improve rapidly.

For context, I'm extremely active. I'm 34 and I spend about 8 hours a week training on my bike for races that I do in non-covid times. For the first few days that I was able to get back on the bike, I felt as if I just wasn't getting enough oxygen when pushing myself. I had a mild cough and I could feel tightness in my chest that felt like lung congestion. I figured this would gradually improve, and it did. About a week after my worst symptoms left me, I was on the bike and felt what seemed to be a charlie horse in one of my calves. I tried to ride through the pain, but the leg became swollen and increasingly painful. I did some googling and became concerned it was DVT (a blood clot in a vein). I went in the next day for diagnostics and lo and behold, I have a clot from above my knee all the way to my foot in my leg. It was excruciatingly painful to do just about anything other than lay down with the leg elevated for a few days, but it's starting to improve as I treat it with anticoagulants and compression sleeves.

I have no family history of clotting disorders, I'm extremely active and not anywhere close to overweight, I eat a healthy diet, no smoking etc etc, so really I had no risk factors for DVT other than having recently had Covid. After talking with my doctor, it seems as if Covid can and does increase the risk of clotting in otherwise healthy individuals which of course could potentially be fatal if the clot breaks off and travels to the lungs/heart. I should be fine and my activity level is returning to normal about 2 weeks after the diagnosis, but I'll be on anticoagulants for months and cannot do any outdoor activity including cycling that could result in an accident, as I could bleed to death.

Point of sharing this is... Covid isn't well understood yet, and people say for young and healthy folks like myself it's just a walk in the park. It can be, but it can also be much worse. I hope this vaccine is widely distributed and that others don't have to go through the same.

On a side note, I find it quite symbolic that this epic achievement (I hope it truly is that) comes from a transatlantic partnership between two companies led by highly talented immigrants to their respective countries. Greeks and Turks to boot, go figure.

casinterest wrote:

This is great news.
From the article

"While the manufacturer has not given a specific release date, Dormitzer assured ABC News Pfizer is "currently on track" to meet the goal of producing 100 million doses by the end of the year and another 1.2 billion doses in 2021.

"The goal that we've set is to distribute millions of vaccine doses in 2020 and executing on that, of course, means everything has to go well," he said. "We need the regulatory approval to do so. But that is our plan."

The vaccine should go to the elderly and most susceptible first and foremost. Then we can start to work towards full re openings. The bad news is that we still have 4-6 months of social distancing to get through.

Nope, Medical Triage dictates that those caring for the populace get it first, otherwise, there will be fewer caregivers to care for the patients..

Sounds promising as I said in the Covid mega-thread, however from what I have been told at work (hospital) the European Union
has not purchased/signed contract for this vaccine but the one developed by AstraZeneca.

*edit

Old news it seems. https://ec.europa.eu/commission/pressco ... ip_20_2081

Today, the European Commission approved a fourth contract with pharmaceutical companies BioNTech and Pfizer, which provides for the initial purchase of 200 million doses on behalf of all EU Member States, plus an option to request up to a further 100 million doses, to be supplied once a vaccine has proven to be safe and effective against COVID-19. Member States can decide to donate the vaccine to lower and middle-income countries or to re-direct it to other European countries.

wingman wrote:

On a side note, I find it quite symbolic that this epic achievement (I hope it truly is that) comes from a transatlantic partnership between two companies led by highly talented immigrants to their respective countries. Greeks and Turks to boot, go figure.

Yes, that’s remarkable, especially in these days when people are very critical about immigrants. The man behind Biontech is the son of Turkish immigrants and came to Germany when he was five years old.

@waterpolodan:
Thanks for sharing.
My 79 year old diabetic mother in law went in and out of ICU. But a second blood clot and probably also kidney failure finally killed her.
I didn't know blood clots are also an issue for the young and healthy.
Do you have a family history of heart attacks? My mother in law had.

An interesting note is that neither Pfizer nor BioNTech received any funding from the US "Operation Warp Speed" for development or clinical trial or manufacturing of the vaccine. Pfizer self-funded and BioNTech SE received German government funding support. (Operation Warp Speed has secured orders with Pfizer for 100 MIL doses and options on 500 MIL more)
https://www.bloomberg.com/news/articles ... washington

Tugg

DocLightning wrote:

Pfizer/BNT (which I'll call "Pfizer" from now on)

IMU BNT is the inventor/designer, Pfizer is the partner/producer.

BioNTech actually is a very interesting setup ( persons involved, core research they were active in before):
https://en.wikipedia.org/wiki/BioNTech
https://de.wikipedia.org/wiki/BioNTech

N14AZ wrote:

Thank you very much for the very interesting summary!

DocLightning wrote:

Pfizer/BNT (which I'll call "Pfizer" from now on)

How is the task sharing between these two companies? The German press just mentions and praises Biontech (by the way, located in my former home town, the City of Mainz )

I think I can answer this one. BNT is in a way the research lab, and Pfizer the company which handles production/certification/finance. The structure where research labs partner with big pharma is quite common. Looking at the 4 current frontrunners:

Pfizer (Big pharma, US) + BioNTech (German)
Johnson & Johson (Big pharma, US) + Jansen (Belgium/Dutch owned by J&J, but not the same company)
AstraZenica (UK) + Oxford (UK) + additional manufacturing partners

I think only Moderna really did everything "in house".

olle wrote:

stl07 wrote:

bill142 wrote:

The next challenge will be convincing the Anti-Vaxers and Covid-19 deniers to get the vaxine.

Luckily, as doc alluded to, with such a high level of effectivity, what the anti-vaxers do doesn't even matter to us rationals. If they want to keep getting it and dying from it, let them knock themselves out

The problem it will still be groups that cannot take the vaccine..

The good news is that the list of people who cannot take the vaccine is pretty short. That would be: 1) Children (any approval will be for adults 18+ and then at some point later children 12+) 2) Anyone with allergies to the vaccine's components. The major components of the vaccine are RNA, and you can't be allergic to RNA, and lipids, and you can't be allergic to lipids. However, without a complete list of the other ingredients, there might be an odd ingredient to which a small number of people are allergic.

The vaccine will be safe for people with immunocompromising conditions (although it may not work as well). It also probably won't be approved for pregnant women, mostly out of an abundance of caution and not because this kind of vaccine would propose any specific risk to pregnant women or their pregnancy.

So children won't be able to get it, but they are at much lower risk for severe outcomes.

Sokes wrote:

My 79 year old diabetic mother in law went in and out of ICU. But a second blood clot and probably also kidney failure finally killed her.
I didn't know blood clots are also an issue for the young and healthy.

They are. It turns out that the virus can directly interact with an activate platelets.

ArcticSEA wrote:

You are describing exponential growth of the virus (a "case"), not the disease caused by it.
Doc, correct me if I'm wrong, but the vaccine would be to prevent the *disease*, not the virus itself from spreading?

The exact molecular nature of the infection kinetics in vaccinated subjects are not known, nor are they known for other highly-effective vaccines (measles, for example). Presumably, even if you are vaccinated and have very high levels of humoral and cellular immunity, the virus will still be able to infect a few cells in your nose. However, the instant that starts, the immune system will come down on it like a ton of bricks and stopping the infection within just a few cycles. That would mean that the virus would never rise to a level where it could be detected by diagnostic tests or be transmitted.

So the vaccine would prevent both meaningful infection *and* disease, which is the point.

art wrote:

May I pose a question? Do you see the anti-vaccination faction in the US sabotaging the chances of herd immunity being achieved, say, sometime next year and the epidemic continuing to darkeni life in the US?

Given vaccines with >90% efficacy, I think probably not. At present, only half of US adults say that they would get the vaccine. However, I suspect that number will go up once the vaccine is available and they have seen their friends, family, and favorite celebrities get it. In addition, I think that there will be some incentives to get it. Already, countries require certain vaccinations in order to enter the country. It would be a pretty trivial process for a country to require proof of COVID-19 vaccination to enter. I could also see airlines and cruise lines requiring proof of vaccination to board. So as time goes on, I think that we will get high enough coverage to suppress the virus. I don't think we'll eliminate it any time in the forseeable future. After all, measles vaccination is 97% effective and we haven't gotten rid of that and polio vaccination is almost 100% effective and we still haven't gotten rid of that. But it will be a minor issue in the background while we go back to flying on planes, attending sporting events, and laughing with friends.

bill142 wrote:

Good write up Doc!

The next challenge will be convincing the Anti-Vaxers and Covid-19 deniers to get the vaxine.

+1 on that.

Despite the glowing talk, I'll still wait a bit just out of caution and let others get the vaccine first. I'm also keeping well away from any large gatherings as much as I can.

waterpolodan wrote:

For context, I'm extremely active. I'm 34 and I spend about 8 hours a week training on my bike for races that I do in non-covid times. For the first few days that I was able to get back on the bike, I felt as if I just wasn't getting enough oxygen when pushing myself. I had a mild cough and I could feel tightness in my chest that felt like lung congestion. I figured this would gradually improve, and it did. About a week after my worst symptoms left me, I was on the bike and felt what seemed to be a charlie horse in one of my calves. I tried to ride through the pain, but the leg became swollen and increasingly painful. I did some googling and became concerned it was DVT (a blood clot in a vein). I went in the next day for diagnostics and lo and behold, I have a clot from above my knee all the way to my foot in my leg. It was excruciatingly painful to do just about anything other than lay down with the leg elevated for a few days, but it's starting to improve as I treat it with anticoagulants and compression sleeves.

Crap - that's not nice. Get a smart trainer and use Zwift while you are still on the medications for that, it's safer.

cpd wrote:

bill142 wrote:

Good write up Doc!

The next challenge will be convincing the Anti-Vaxers and Covid-19 deniers to get the vaxine.

+1 on that.

Despite the glowing talk, I'll still wait a bit just out of caution and let others get the vaccine first. I'm also keeping well away from any large gatherings as much as I can.

waterpolodan wrote:

For context, I'm extremely active. I'm 34 and I spend about 8 hours a week training on my bike for races that I do in non-covid times. For the first few days that I was able to get back on the bike, I felt as if I just wasn't getting enough oxygen when pushing myself. I had a mild cough and I could feel tightness in my chest that felt like lung congestion. I figured this would gradually improve, and it did. About a week after my worst symptoms left me, I was on the bike and felt what seemed to be a charlie horse in one of my calves. I tried to ride through the pain, but the leg became swollen and increasingly painful. I did some googling and became concerned it was DVT (a blood clot in a vein). I went in the next day for diagnostics and lo and behold, I have a clot from above my knee all the way to my foot in my leg. It was excruciatingly painful to do just about anything other than lay down with the leg elevated for a few days, but it's starting to improve as I treat it with anticoagulants and compression sleeves.

Crap - that's not nice. Get a smart trainer and use Zwift while you are still on the medications for that, it's safer.

Zwift + smart trainer is exactly what I’ve been doing! The day I can hang in a zwift race again is the day I’ll feel mostly recovered. For context, before the virus I was holding 290-300 watts as my ftp, around 3.8 w/Kg. Post covid and pre clot, I was struggling to hold 200 watts for any length of time. With the clot initially I was doing 90 watt rides for 15 minutes at a time and it was excruciating. Now I’m back to around 210 for an hour if I’m just trying to hold a steady pace. Getting better.

waterpolodan wrote:

cpd wrote:

bill142 wrote:

Good write up Doc!

The next challenge will be convincing the Anti-Vaxers and Covid-19 deniers to get the vaxine.

+1 on that.

Despite the glowing talk, I'll still wait a bit just out of caution and let others get the vaccine first. I'm also keeping well away from any large gatherings as much as I can.

waterpolodan wrote:

For context, I'm extremely active. I'm 34 and I spend about 8 hours a week training on my bike for races that I do in non-covid times. For the first few days that I was able to get back on the bike, I felt as if I just wasn't getting enough oxygen when pushing myself. I had a mild cough and I could feel tightness in my chest that felt like lung congestion. I figured this would gradually improve, and it did. About a week after my worst symptoms left me, I was on the bike and felt what seemed to be a charlie horse in one of my calves. I tried to ride through the pain, but the leg became swollen and increasingly painful. I did some googling and became concerned it was DVT (a blood clot in a vein). I went in the next day for diagnostics and lo and behold, I have a clot from above my knee all the way to my foot in my leg. It was excruciatingly painful to do just about anything other than lay down with the leg elevated for a few days, but it's starting to improve as I treat it with anticoagulants and compression sleeves.

Crap - that's not nice. Get a smart trainer and use Zwift while you are still on the medications for that, it's safer.

Zwift + smart trainer is exactly what I’ve been doing! The day I can hang in a zwift race again is the day I’ll feel mostly recovered. For context, before the virus I was holding 290-300 watts as my ftp, around 3.8 w/Kg. Post covid and pre clot, I was struggling to hold 200 watts for any length of time. With the clot initially I was doing 90 watt rides for 15 minutes at a time and it was excruciating. Now I’m back to around 210 for an hour if I’m just trying to hold a steady pace. Getting better.

I spoke to someone else on Zwift who got the virus too, he's struggling to get back to previous fitness. Reckons hard efforts feel like his lungs are burning. He didn't get blood clots though. Best of luck getting full fitness back.

Tugger wrote:

An interesting note is that neither Pfizer nor BioNTech received any funding from the US "Operation Warp Speed" for development or clinical trial or manufacturing of the vaccine. Pfizer self-funded and BioNTech SE received German government funding support. (Operation Warp Speed has secured orders with Pfizer for 100 MIL doses and options on 500 MIL more)
https://www.bloomberg.com/news/articles ... washington

Tugg

Then why was Trump patting himself on the back?

proest wrote:

N14AZ wrote:

Thank you very much for the very interesting summary!

DocLightning wrote:

Pfizer/BNT (which I'll call "Pfizer" from now on)

How is the task sharing between these two companies? The German press just mentions and praises Biontech (by the way, located in my former home town, the City of Mainz )

I think I can answer this one. BNT is in a way the research lab, and Pfizer the company which handles production/certification/finance. The structure where research labs partner with big pharma is quite common. Looking at the 4 current frontrunners:

Pfizer (Big pharma, US) + BioNTech (German)
Johnson & Johson (Big pharma, US) + Jansen (Belgium/Dutch owned by J&J, but not the same company)
AstraZenica (UK) + Oxford (UK) + additional manufacturing partners

I think only Moderna really did everything "in house".

Is this another advantage with national health care services while EU countries has been putting a huge amounts of funding and in practice taken the risk for the vaccine project going forward? Is it possible for a private owned insurance company to risk the same way?

olle wrote:

Is this another advantage with national health care services while EU countries has been putting a huge amounts of funding and in practice taken the risk for the vaccine project going forward? Is it possible for a private owned insurance company to risk the same way?

I'm not sure sure I'd go as far as making a connection like that. There are many, many successful medicines and medical innovations made in the US. It's the partnership and cooperation here that promises the highest level of achievement, which is getting billions of people vaccinated as quickly and effectively as possible. That's no small thing.

olle wrote:

Is this another advantage with national health care services while EU countries has been putting a huge amounts of funding and in practice taken the risk for the vaccine project going forward? Is it possible for a private owned insurance company to risk the same way?

Well.... the vaccines are being developed by private owned companies. And Pfizer has put up its own money for its part in their effort. And lastly, insurance companies almost always cover the full cost of vaccines (there is sometimes a co-pay though those are also often waived) as the cost of a vaccination is much lower than having to cover an ill person. And in particular with COVID... vaccine cost versus hospital cost of one patient? That's what insurance companies are all about, "how do we pay the least amount?".....

Tugg

DLFREEBIRD wrote:

Tugger wrote:

An interesting note is that neither Pfizer nor BioNTech received any funding from the US "Operation Warp Speed" for development or clinical trial or manufacturing of the vaccine. Pfizer self-funded and BioNTech SE received German government funding support. (Operation Warp Speed has secured orders with Pfizer for 100 MIL doses and options on 500 MIL more)
https://www.bloomberg.com/news/articles ... washington

Tugg

Then why was Trump patting himself on the back?

It's Trump, that's why

stl07 wrote:

DLFREEBIRD wrote:

Tugger wrote:

An interesting note is that neither Pfizer nor BioNTech received any funding from the US "Operation Warp Speed" for development or clinical trial or manufacturing of the vaccine. Pfizer self-funded and BioNTech SE received German government funding support. (Operation Warp Speed has secured orders with Pfizer for 100 MIL doses and options on 500 MIL more)
https://www.bloomberg.com/news/articles ... washington

Tugg

Then why was Trump patting himself on the back?

It's Trump, that's why

It's the only thing he's good at.

Article in Nature, with some commentary from top immunologists in the field:

https://www.nature.com/articles/d41586- ... y-20201110

Basically, questions still remain about how much protection it offers, to whom and for how long. But it bodes well for the rest of the vaccine candidates as well.

Did anyone catch his presser this afternoon where he actually said that The vaccine will be available to the entire general population with the exception of places like New York state for political reason. I am so glad he will not be around when it is time to distribute the vaccine!