COVID-19 Vaccine News and Discussion Thread

stl07 · Tue Apr 20, 2021 2:16 am

panamair wrote:
stl07 wrote:
proest wrote:
Wondering when the US will start exporting vaccines, already 62 shots per 100, and 40% have had the first shot. Roughly 24% under the age of 18, so (max 152 shots/100 needed total, little less due to J&J). There is a case to be made to control vaccine export very hard till at least everybody has the first shot, after that the case starts to get weaker very fast.

Roughly 36% of Americans above 18 still need a first vaccination, this includes all vaccine hesitate people (which I guess at 20%), so speed will likely drop in 3/4 weeks time. It's time for the US to start exporting (at a slow pace), beginning with AZ which Canada/India/UK could directly put to good use, but soon also Pfizer and Moderna.

I think the US is already exporting AZ

It’s technically a loan to Canada and Mexico at this point...exports are still officially forbidden.

Ok that is just stupid. Why do we need AZ vaccine in the US when it isn't even approved?

panamair · Tue Apr 20, 2021 5:19 am

stl07 wrote:
panamair wrote:
stl07 wrote:
I think the US is already exporting AZ

It’s technically a loan to Canada and Mexico at this point...exports are still officially forbidden.

Ok that is just stupid. Why do we need AZ vaccine in the US when it isn't even approved?

Well, AZ has submitted theirs for FDA emergency use approval and the FDA is currently reviewing. The administration probably is still keeping its AZ stockpile in case there is any faltering in Pfizer/Moderna/J&J production/delivery while many Americans still need to be vaccinated, and AZ gets approved in the interim.

lightsaber · Tue Apr 20, 2021 11:18 am

panamair wrote:
stl07 wrote:
panamair wrote:

It’s technically a loan to Canada and Mexico at this point...exports are still officially forbidden.

Ok that is just stupid. Why do we need AZ vaccine in the US when it isn't even approved?

Well, AZ has submitted theirs for FDA emergency use approval and the FDA is currently reviewing. The administration probably is still keeping its AZ stockpile in case there is any faltering in Pfizer/Moderna/J&J production/delivery while many Americans still need to be vaccinated, and AZ gets approved in the interim.

A while ago, I wanted AZ so the younger had an option. With the possible interaction with birth control,that isn't so much of an option.

We (USA) need more vaccinations, we have a high steady burn rate:
https://ourworldindata.org/explorers/co ... rmed+cases

We've had a high burn rate in New York and New Jersey. Yes Florida is climbing up to New York's rate (about the same population) and Michigan has issues... that tells us we needed more vaccinated.
https://www.worldometers.info/coronavirus/country/us/

Everywhere in the Western world seems to be slowing vaccination. In the EU, AZ hesitancy certainly plays a role. In the USA, lack of J&J. I don't know why Chile slowed...
https://ourworldindata.org/grapher/dail ... pean+Union

We (USA) would have been doing much better if we could have used the AZ. Hopefully reasonable guidelines are arrived at.

Lightsaber

DocLightning · Tue Apr 20, 2021 3:26 pm

panamair wrote:
Well, AZ has submitted theirs for FDA emergency use approval and the FDA is currently reviewing. The administration probably is still keeping its AZ stockpile in case there is any faltering in Pfizer/Moderna/J&J production/delivery while many Americans still need to be vaccinated, and AZ gets approved in the interim.

For the US, I just don't see how AZ's advantages are worth the drawbacks. It takes two doses and has markedly lower efficacy than the mRNA products, especially against the B.1.135 variant. It also has the thrombocytopenia issue. OK, so it has easier storage requirements and is less expensive, but these are not really major issues in the US. So I don't think we should be approving a product that is fully inferior to the existing products. At least with J&J the single-dose administration is a major advantage that makes up for a lot of its drawbacks.

I would vote against EUA if I were on the committee.

Dupli · Tue Apr 20, 2021 4:19 pm

lightsaber wrote:

Everywhere in the Western world seems to be slowing vaccination. In the EU, AZ hesitancy certainly plays a role. In the USA, lack of J&J. I don't know why Chile slowed...
https://ourworldindata.org/grapher/dail ... pean+Union

Lightsaber

In EU, at least where I live, speed of vaccinations closely follows delivery, with some delay for planning. We are slowing down now because az made a big delivery end of march (administered last week) and after that almost nothing.
There is a big delivery planned next week, Pfizer/biontec, so expect a large jump the week after that.
So for now there are no vaccines in storage because of hesitance. If somebody doesn't show up, somebody else is being called. I didn't get called yet, and, for now, have no access to any vaccine.

aerolimani · Tue Apr 20, 2021 5:10 pm

stl07 wrote:
panamair wrote:
stl07 wrote:
I think the US is already exporting AZ

It’s technically a loan to Canada and Mexico at this point...exports are still officially forbidden.

Ok that is just stupid. Why do we need AZ vaccine in the US when it isn't even approved?

Sorry, but I thought it legitimate to point out that restricting exports of vaccines is protectionism. It’s the USA putting their needs first. That is, IMHO, regrettable, if understandable. What is unfortunate is that the level of protectionism extends to the point that the US won’t sell doses of a vaccine they haven’t even approved, and which they’ve stated they probably won’t even need.

Also, I thought that non-av was the one forum where political commentary was permitted. Is it not?

dtw2hyd · Tue Apr 20, 2021 5:24 pm

aerolimani wrote:
Sorry, but I thought it legitimate to point out that restricting exports of vaccines is protectionism. It’s the USA putting their needs first. That is, IMHO, regrettable, if understandable. What is unfortunate is that the level of protectionism extends to the point that the US won’t sell doses of a vaccine they haven’t even approved, and which they’ve stated they probably won’t even need.

Also, I thought that non-av was the one forum where political commentary was permitted. Is it not?

That protectionism started because some country pillaged our entire N95 strategic stockpile when our healthcare workers needed them.

Yes, putting restrictions on surplus medical supplies is draconian, but there is a reason. I believe Biden administration is looking into different ways to bypass those restrictions, including calling it a loan.

AirbusCheerlead · Tue Apr 20, 2021 5:43 pm

EMA just finished live stream about J&J vaccine.
They say thrombocytopenia is likely linked to vaccine and product information will be updated accordingly. (The signal or as I understand the occurrence is higher than one would expect in normal population).

A NYT journalist asked why EMA informed before FDA. The answer was basically: we have experience with AZ and look at similar ocurance since early March.
I personally believe the reason is different. The covid situation is different in EU and US and J&J more urgently needed in Europe. More importantly, the FDA/CDC has to make a decision that is binding for all states (or can states go against FDA recommendations? ). On the other hand the EMA just put out an assessment while the health agencies of each member state makes there own decision based on there own risk assessment. And while it might not be the best process to reduce vaccine hesitancy, it make sense that based on the risk assessment different countries arrive to different conclusions.

They also gave number of known cases of CVST with thrombocytopenia for the different vaccine in use in Europe (numbers worldwide): Moderna 5 cases, Pfizer 25 cases, AZ over 250 cases and J&J 8 cases.
(I hope I didn't mix up my numbers but they should be published in many newspapers in the next hours)
For Moderna and Pfizer the signal is below expected number in population while for AZ and J&J it is higher.

Also of note: saying out of 7 Mio jabs for J&J isn't fully correct, the occurrence of CVST with thrombocytopenia can happen several days after vaccination, hence when the US stopped J&J it was based on less jabs.

Best regards and stay safe,
Jonas

aerolimani · Tue Apr 20, 2021 5:45 pm

dtw2hyd wrote:
aerolimani wrote:
Sorry, but I thought it legitimate to point out that restricting exports of vaccines is protectionism. It’s the USA putting their needs first. That is, IMHO, regrettable, if understandable. What is unfortunate is that the level of protectionism extends to the point that the US won’t sell doses of a vaccine they haven’t even approved, and which they’ve stated they probably won’t even need.

Also, I thought that non-av was the one forum where political commentary was permitted. Is it not?

That protectionism started because some country pillaged our entire N95 strategic stockpile when our healthcare workers needed them.

Yes, putting restrictions on surplus medical supplies is draconian, but there is a reason. I believe Biden administration is looking into different ways to bypass those restrictions, including calling it a loan.

Quite frankly, such policies lack the bigger vision. As long as large parts of the world remain unvaccinated, fertile breeding grounds for new variants exist. We are entering into a cat-and-mouse game. As long as new variants keep cropping up with such regularity, we will be constantly behind the curve.

Perhaps the island nations of the world can exist in their little vaccinated bubbles, but for all the countries of the Americas, Europe, Asia, and the Asian sun-continent, we need to think more internationally. All our borders are porous, and mostly by choice. How many trucks and trains cross every day, without quarantine, between Canada, Mexico, and the USA?

casinterest · Tue Apr 20, 2021 6:03 pm

proest wrote:
Wondering when the US will start exporting vaccines, already 62 shots per 100, and 40% have had the first shot. Roughly 24% under the age of 18, so (max 152 shots/100 needed total, little less due to J&J). There is a case to be made to control vaccine export very hard till at least everybody has the first shot, after that the case starts to get weaker very fast.

Roughly 36% of Americans above 18 still need a first vaccination, this includes all vaccine hesitate people (which I guess at 20%), so speed will likely drop in 3/4 weeks time. It's time for the US to start exporting (at a slow pace), beginning with AZ which Canada/India/UK could directly put to good use, but soon also Pfizer and Moderna.

I think it will start to happen in Mid to late May. Currently clinics are now open to anyone 16 and older. Everyone is making their appointments, but I expect Demand is going to run well short of production by mid may.

There are some strongly opinionated folks against getting the vaccine, that we are covering in another thread, and even though I expect most will eventually get it, it is not seen as important due to mixed messaging from religious and conservative sources. There is also the "invincible" young age demographic that has no kids that do no see it as imperative.

As for me, I am now a double dose Pfizer recipient.

ThePointblank · Tue Apr 20, 2021 6:35 pm

The Canadian province of Manitoba and the US state of North Dakota have struck an agreement where North Dakota will vaccinate about 4,000 Canadian truckers within a period of 8 weeks, free of charge:

https://twitter.com/Gray_Mackenzie/stat ... 60932?s=19

aerolimani · Tue Apr 20, 2021 6:54 pm

[twoid][/twoid]

ThePointblank wrote:
The Canadian province of Manitoba and the US state of North Dakota have struck an agreement where North Dakota will vaccinate about 4,000 Canadian truckers within a period of 8 weeks, free of charge:

https://twitter.com/Gray_Mackenzie/stat ... 60932?s=19

Fantastic news! The Canadian government has made international air travel extremely onerous, and it was responsible for only 0.5% of cases in Canada. Meanwhile, thousands of truckers cross the border every day, without quarantine or testing. And, you can bet that lots of them are stopping in at Tim Hortons for an unmasked double double and a sandwich. I am happy to hear that something real is finally being done about the real problem.

The US has the vaccines, but the problem is everyone’s. It’s great to see this kind of cooperation, and true understanding of the problem, and how to get us all out of it.

Link in tweet is broken. Link to functional news article here: https://www.cbc.ca/news/canada/manitoba ... -1.5994519

lightsaber · Tue Apr 20, 2021 7:29 pm

DocLightning wrote:
panamair wrote:
Well, AZ has submitted theirs for FDA emergency use approval and the FDA is currently reviewing. The administration probably is still keeping its AZ stockpile in case there is any faltering in Pfizer/Moderna/J&J production/delivery while many Americans still need to be vaccinated, and AZ gets approved in the interim.

For the US, I just don't see how AZ's advantages are worth the drawbacks. It takes two doses and has markedly lower efficacy than the mRNA products, especially against the B.1.135 variant. It also has the thrombocytopenia issue. OK, so it has easier storage requirements and is less expensive, but these are not really major issues in the US. So I don't think we should be approving a product that is fully inferior to the existing products. At least with J&J the single-dose administration is a major advantage that makes up for a lot of its drawbacks.

I would vote against EUA if I were on the committee.

The advantage is for the rest of the world. In my opinion, if the FDA rejects than many others will reject AZ. Factories cannot be converted quickly. India's issue shows just staying out of the hospital is a bonus and AZ has done that, even with B.1.351.

https://www.msn.com/en-gb/news/world/in ... NewsSearch

frmrCapCadet · Tue Apr 20, 2021 8:03 pm

Individual human, vocational preferences, national reactions both political and scientific have always experienced peculiar sensitivities to perceived and actual risks. Behavioral scientists as much as physical scientists are needed to address this.

Chemist · Tue Apr 20, 2021 9:47 pm

aerolimani wrote:
dtw2hyd wrote:
aerolimani wrote:
Sorry, but I thought it legitimate to point out that restricting exports of vaccines is protectionism. It’s the USA putting their needs first. That is, IMHO, regrettable, if understandable. What is unfortunate is that the level of protectionism extends to the point that the US won’t sell doses of a vaccine they haven’t even approved, and which they’ve stated they probably won’t even need.

Also, I thought that non-av was the one forum where political commentary was permitted. Is it not?

That protectionism started because some country pillaged our entire N95 strategic stockpile when our healthcare workers needed them.

Yes, putting restrictions on surplus medical supplies is draconian, but there is a reason. I believe Biden administration is looking into different ways to bypass those restrictions, including calling it a loan.

Quite frankly, such policies lack the bigger vision. As long as large parts of the world remain unvaccinated, fertile breeding grounds for new variants exist. We are entering into a cat-and-mouse game. As long as new variants keep cropping up with such regularity, we will be constantly behind the curve.

Perhaps the island nations of the world can exist in their little vaccinated bubbles, but for all the countries of the Americas, Europe, Asia, and the Asian sun-continent, we need to think more internationally. All our borders are porous, and mostly by choice. How many trucks and trains cross every day, without quarantine, between Canada, Mexico, and the USA?

The pandemic risk isn't over for anybody until it's over for everybody.

aerolimani · Tue Apr 20, 2021 9:51 pm

Chemist wrote:
aerolimani wrote:
dtw2hyd wrote:

That protectionism started because some country pillaged our entire N95 strategic stockpile when our healthcare workers needed them.

Yes, putting restrictions on surplus medical supplies is draconian, but there is a reason. I believe Biden administration is looking into different ways to bypass those restrictions, including calling it a loan.

Quite frankly, such policies lack the bigger vision. As long as large parts of the world remain unvaccinated, fertile breeding grounds for new variants exist. We are entering into a cat-and-mouse game. As long as new variants keep cropping up with such regularity, we will be constantly behind the curve.

Perhaps the island nations of the world can exist in their little vaccinated bubbles, but for all the countries of the Americas, Europe, Asia, and the Asian sun-continent, we need to think more internationally. All our borders are porous, and mostly by choice. How many trucks and trains cross every day, without quarantine, between Canada, Mexico, and the USA?

The pandemic risk isn't over for anybody until it's over for everybody.

Well put.

dtw2hyd · Tue Apr 20, 2021 10:23 pm

aerolimani wrote:
dtw2hyd wrote:
aerolimani wrote:
Sorry, but I thought it legitimate to point out that restricting exports of vaccines is protectionism. It’s the USA putting their needs first. That is, IMHO, regrettable, if understandable. What is unfortunate is that the level of protectionism extends to the point that the US won’t sell doses of a vaccine they haven’t even approved, and which they’ve stated they probably won’t even need.

Also, I thought that non-av was the one forum where political commentary was permitted. Is it not?

That protectionism started because some country pillaged our entire N95 strategic stockpile when our healthcare workers needed them.

Yes, putting restrictions on surplus medical supplies is draconian, but there is a reason. I believe Biden administration is looking into different ways to bypass those restrictions, including calling it a loan.

Quite frankly, such policies lack the bigger vision. As long as large parts of the world remain unvaccinated, fertile breeding grounds for new variants exist. We are entering into a cat-and-mouse game. As long as new variants keep cropping up with such regularity, we will be constantly behind the curve.

Perhaps the island nations of the world can exist in their little vaccinated bubbles, but for all the countries of the Americas, Europe, Asia, and the Asian sun-continent, we need to think more internationally. All our borders are porous, and mostly by choice. How many trucks and trains cross every day, without quarantine, between Canada, Mexico, and the USA?

What are the most populous nations doing? After developing multiple vaccines China now says, ours are slightly effective than saline (rhetoric).

India is charging every person for the vaccine, but giving an advance to two manufacturers who are ready to ramp up production. Serum Institute is asking for $428 Million and Bharat Biotech is asking for $215 Million. Exhibiting capitalist principles at the wrong time or coffers are empty.

And you are complaining about USA hoarding less than one days supply for couple of countries in the world.

Only half of US adults got one dose. Only yesterday everyone became qualified.

Like I said multiple times, no country can hoard these because these vaccines have short expiration.

DocLightning · Tue Apr 20, 2021 11:43 pm

lightsaber wrote:
The advantage is for the rest of the world.

I'm not sure that the use of this vaccine in other nations is the concern of the FDA. Moreover, there are plenty of drugs and vaccines that are approved and even in wide use around the world that are not used in the USA.

lightsaber · Wed Apr 21, 2021 1:00 am

dtw2hyd wrote:
aerolimani wrote:
dtw2hyd wrote:

That protectionism started because some country pillaged our entire N95 strategic stockpile when our healthcare workers needed them.

Yes, putting restrictions on surplus medical supplies is draconian, but there is a reason. I believe Biden administration is looking into different ways to bypass those restrictions, including calling it a loan.

Quite frankly, such policies lack the bigger vision. As long as large parts of the world remain unvaccinated, fertile breeding grounds for new variants exist. We are entering into a cat-and-mouse game. As long as new variants keep cropping up with such regularity, we will be constantly behind the curve.

Perhaps the island nations of the world can exist in their little vaccinated bubbles, but for all the countries of the Americas, Europe, Asia, and the Asian sun-continent, we need to think more internationally. All our borders are porous, and mostly by choice. How many trucks and trains cross every day, without quarantine, between Canada, Mexico, and the USA?

What are the most populous nations doing? After developing multiple vaccines China now says, ours are slightly effective than saline (rhetoric).

India is charging every person for the vaccine, but giving an advance to two manufacturers who are ready to ramp up production. Serum Institute is asking for $428 Million and Bharat Biotech is asking for $215 Million. Exhibiting capitalist principles at the wrong time or coffers are empty.

And you are complaining about USA hoarding less than one days supply for couple of countries in the world.

Only half of US adults got one dose. Only yesterday everyone became qualified.

Like I said multiple times, no country can hoard these because these vaccines have short expiration.

To others, to explain the issue of supplies. Let's take a walk back in time, but first the current situation.
USA currently ships out only 28 million doses per week, an increase from 3 weeks ago of 25 million doses per week for the USA. If we spread that out among everyone, it quickly wouldn't matter.
https://www.freep.com/story/news/health ... 200812002/

It wasn't long ago we were celebrating 13.5 million doses per week:
https://nypost.com/2021/02/23/covid-19- ... ion-doses/

Two months ago there was a perception vaccine production wouldn't ramp up in time. A good read on all the stuff needed.
https://www.popsci.com/story/health/mrn ... roduction/

One shortage is the glass vials the vaccine goes into, but way back in 2020, the USA paid over $200 million to expand production:
https://www.reuters.com/article/us-heal ... SKBN23G1YY

Well, still tight supplies, more recently they received another $57 million to increase production 50%. Those little vials are apparently previous:
https://www.wsj.com/articles/cornings-c ... 1616756400

We know we impacted international production:
https://www.marketplace.org/2021/03/09/ ... gredients/

“There are a lot of bags and filters and critical items that manufacturers need,” Poonawalla said at the event, sponsored by the World Bank. “Now I’ll give you an example: the Novavax vaccine needs these items from the U.S.”

The issue is, politically, until each nation can supply enough to its own population, doing less than is possible to produce that vaccine is not acceptable.

Hoarding really cannot occur as everything has shorter shelf lives. Everyone needs bags, filters, valves, reagents, and many items I just don't know about.
That requires building new factories.

https://indianexpress.com/article/expla ... e-7280711/
Exports of critical raw materials used in the production of some Covid-19 vaccines have been blocked as a result of Biden’s decision to invoke the US Defense Production Act earlier this year.
Plastic bags, filters and cell culture media, especially, are relevant to most vaccines being made to tackle the Covid-19 pandemic. This includes vaccines like Covishield and Covovax, of which SII was expected to supply over a billion doses each this year.

Poonawalla has reportedly said the restrictions have halved the number of doses of Covovax that SII can stockpile.

That last link is actually the most informative (I recommend reading it). The issue is the USA needed to surge production and the easiest way to surge production is divert existing production. According to that link, the USA is the volume supplier for many of the (unspecified) needed ingredients/items.

As already noted, the US has a long way to go. Only half adults had first dose, we are only at 39.56% because we need to vaccinate kids (I know a few with bad side effects personally).
https://ourworldindata.org/covid-vaccinations

We need to vaccinate everyone. That I can agree with. We need to "loan out" the 20 million doses in the stockpile of AZ.
https://www.bloomberg.com/news/articles ... lion-doses

Everyone is frustrated with slow vaccine production. I wish there was an easy answer. Unfortunately, this current wave will go through before the world has enough vaccine to slow it.

Lightsaber

LCDFlight · Wed Apr 21, 2021 1:19 am

Chemist wrote:
aerolimani wrote:
dtw2hyd wrote:

That protectionism started because some country pillaged our entire N95 strategic stockpile when our healthcare workers needed them.

Yes, putting restrictions on surplus medical supplies is draconian, but there is a reason. I believe Biden administration is looking into different ways to bypass those restrictions, including calling it a loan.

Quite frankly, such policies lack the bigger vision. As long as large parts of the world remain unvaccinated, fertile breeding grounds for new variants exist. We are entering into a cat-and-mouse game. As long as new variants keep cropping up with such regularity, we will be constantly behind the curve.

Perhaps the island nations of the world can exist in their little vaccinated bubbles, but for all the countries of the Americas, Europe, Asia, and the Asian sun-continent, we need to think more internationally. All our borders are porous, and mostly by choice. How many trucks and trains cross every day, without quarantine, between Canada, Mexico, and the USA?

The pandemic risk isn't over for anybody until it's over for everybody.

Who said the "risk" has to be over? Who said anything is risk-free? Nothing in life (or medicine?) is risk-free.

Chances are that COVID will be with us the rest of our natural lives. I was never impressed that we are going to "control" COVID or "win against" COVID. That's presumptuous and setting ourselves up for disappointment. Should we be sad the rest of our lives over this? There are plenty of diseases to be sad about, this is one. But we should try to be happy.

lightsaber · Wed Apr 21, 2021 1:22 am

DocLightning wrote:
lightsaber wrote:
The advantage is for the rest of the world.

I'm not sure that the use of this vaccine in other nations is the concern of the FDA. Moreover, there are plenty of drugs and vaccines that are approved and even in wide use around the world that are not used in the USA.

The FDA has no grounds for denying AZ that I know of. Something better isn't enough. Does the AZ vaccine meet the minimum requirement, yes or no? If yes, it should be approved. If no, no one should have it (which data from the UK shows is clearly not the case). We are debating if this sets a global standard or not. Many countries automatically approve medicines the FDA approves. The fact the FDA doesn't have reciprocity in approvals is quite silly, in my opinion.
https://www.outsidethebeltway.com/drug- ... ciprocity/

But if we reject, it will be interpreted as having a reason other than "well, we don't really need it." I see this as making a difference in controlling Covid19. I'm reading the paper Wall Street Journal and it notes that in Africa they are having trouble with AZ (sorry no link, off today's paper, page A7): 'One reason for low demand for vaccines in some countries, health officials said, is the decision by some European countries to restrict the use of the AstraZeneca vaccine for younger people amid reports of a rare but severe blood-clotting disorder. " I believe if the US rejects the vaccine, that will result in more vaccine resistance and thus more variants.

"There is a lot of misinformation out there and thsi negaitve messaging especially in Europe and America is the main reason our vaccinations took off to a slow start," said Diana Atwine, the permanent secretary of Uganda's health ministry.

In my opinion, "do as I say, not as I do" doesn't work in parenting, international relations, or vaccines.

Lightsaber

54678264582 · Wed Apr 21, 2021 7:48 am

ThePointblank wrote:
The Canadian province of Manitoba and the US state of North Dakota have struck an agreement where North Dakota will vaccinate about 4,000 Canadian truckers within a period of 8 weeks, free of charge:

https://twitter.com/Gray_Mackenzie/stat ... 60932?s=19

Yet we are two months behind the US. In Manitoba adults my age won't start getting their vaccines until end of May, beginning of June............

Challenger007 · Wed Apr 21, 2021 8:40 am

panamair wrote:
stl07 wrote:
panamair wrote:

It’s technically a loan to Canada and Mexico at this point...exports are still officially forbidden.

Ok that is just stupid. Why do we need AZ vaccine in the US when it isn't even approved?

Well, AZ has submitted theirs for FDA emergency use approval and the FDA is currently reviewing. The administration probably is still keeping its AZ stockpile in case there is any faltering in Pfizer/Moderna/J&J production/delivery while many Americans still need to be vaccinated, and AZ gets approved in the interim.

I don't know why such a panic arose against the AZ vaccine, because it is no worse than other drugs, and in a sense even better because it does not require any super-cool storage conditions. Possible complications can be foreseen if, before vaccination, a clinical blood test and a coagulogram are taken and, based on these tests, a course of therapy is taken (for example, if blood clotting is increased, anticoagulants must be taken to prevent blood clots, all depending on the vaccination schedule).

dtw2hyd · Wed Apr 21, 2021 10:45 am

India increased Covishield(AZ's India brand name) from INR 250 to INR 600. Rates to government(150,400) are irrelevant because they won't be available.

Interesting because it is now $9.5 vs Pfizer/Moderna $13. Not so cheap anymore.

Serum Institute borrowed money from banks, because government advance still in the pipeline.

https://www.ndtv.com/india-news/coronav ... _topscroll

KFTG · Wed Apr 21, 2021 10:52 am

Looks like Sputnik will receive EUA in India
India is a ticking timebomb; all int'l travel to/from India should cease immediately, with mandatory quarantines for all travelers ex-India
https://www.youtube.com/watch?v=qyMrYRWgzy0

c933103 · Wed Apr 21, 2021 12:16 pm

lightsaber wrote:
DocLightning wrote:
lightsaber wrote:
The advantage is for the rest of the world.

I'm not sure that the use of this vaccine in other nations is the concern of the FDA. Moreover, there are plenty of drugs and vaccines that are approved and even in wide use around the world that are not used in the USA.

The FDA has no grounds for denying AZ that I know of. Something better isn't enough. Does the AZ vaccine meet the minimum requirement, yes or no? If yes, it should be approved. If no, no one should have it (which data from the UK shows is clearly not the case). We are debating if this sets a global standard or not. Many countries automatically approve medicines the FDA approves. The fact the FDA doesn't have reciprocity in approvals is quite silly, in my opinion.
https://www.outsidethebeltway.com/drug- ... ciprocity/

But if we reject, it will be interpreted as having a reason other than "well, we don't really need it." I see this as making a difference in controlling Covid19. I'm reading the paper Wall Street Journal and it notes that in Africa they are having trouble with AZ (sorry no link, off today's paper, page A7): 'One reason for low demand for vaccines in some countries, health officials said, is the decision by some European countries to restrict the use of the AstraZeneca vaccine for younger people amid reports of a rare but severe blood-clotting disorder. " I believe if the US rejects the vaccine, that will result in more vaccine resistance and thus more variants.

"There is a lot of misinformation out there and thsi negaitve messaging especially in Europe and America is the main reason our vaccinations took off to a slow start," said Diana Atwine, the permanent secretary of Uganda's health ministry.

In my opinion, "do as I say, not as I do" doesn't work in parenting, international relations, or vaccines.

Lightsaber

One thing with some of those countries not using AZ vaccines following EU countries decision is that, some of them have much lower case count thàn EU/US. So while the risk parity with death from vaccine against infection might be at 30 or 50 years old in those US/EU countries, it might be essentially everyone in some other countries

lightsaber · Wed Apr 21, 2021 12:25 pm

c933103 wrote:
lightsaber wrote:
DocLightning wrote:

I'm not sure that the use of this vaccine in other nations is the concern of the FDA. Moreover, there are plenty of drugs and vaccines that are approved and even in wide use around the world that are not used in the USA.

The FDA has no grounds for denying AZ that I know of. Something better isn't enough. Does the AZ vaccine meet the minimum requirement, yes or no? If yes, it should be approved. If no, no one should have it (which data from the UK shows is clearly not the case). We are debating if this sets a global standard or not. Many countries automatically approve medicines the FDA approves. The fact the FDA doesn't have reciprocity in approvals is quite silly, in my opinion.
https://www.outsidethebeltway.com/drug- ... ciprocity/

But if we reject, it will be interpreted as having a reason other than "well, we don't really need it." I see this as making a difference in controlling Covid19. I'm reading the paper Wall Street Journal and it notes that in Africa they are having trouble with AZ (sorry no link, off today's paper, page A7): 'One reason for low demand for vaccines in some countries, health officials said, is the decision by some European countries to restrict the use of the AstraZeneca vaccine for younger people amid reports of a rare but severe blood-clotting disorder. " I believe if the US rejects the vaccine, that will result in more vaccine resistance and thus more variants.

"There is a lot of misinformation out there and thsi negaitve messaging especially in Europe and America is the main reason our vaccinations took off to a slow start," said Diana Atwine, the permanent secretary of Uganda's health ministry.

In my opinion, "do as I say, not as I do" doesn't work in parenting, international relations, or vaccines.

Lightsaber

One thing with some of those countries not using AZ vaccines following EU countries decision is that, some of them have much lower case count thàn EU/US. So while the risk parity with death from vaccine against infection might be at 30 or 50 years old in those US/EU countries, it might be essentially everyone in some other countries

I agree the risk case does shift with the fraction of the population vaccinated. That is an excellent point.
I consider the FDA decision mostly a global health decision. I hope they realize the consequences.

Lightsaber

par13del · Wed Apr 21, 2021 12:59 pm

lightsaber wrote:
I agree the risk case does shift with the fraction of the population vaccinated. That is an excellent point.
I consider the FDA decision mostly a global health decision. I hope they realize the consequences.

Lightsaber

Since the EU and the USA are the big drivers of what other countries do, that ship already sailed when the EU made their pronouncements over the last few months, just look at countries in Africa who have abandoned AZ and others elsewhere are following, imagine the people who are also on social media, it is not just official government announcements to be considered. The FDA decision if positive will not have much effect on hesitancy unless followed by something tangible like free vaccines (the Biden invocation of the Defense Act kills that) and even that may not work, the world is already split between the USA and EU, so whether we like it or not, politics will play a role, it can be ignored at the worlds peril as the virus does not care.

aerolimani · Wed Apr 21, 2021 1:07 pm

On the other hand, for countries that choose to continue with AZ, it’s a boost to their programs when availability is increased, due to others discontinuing use of AZ.

Right now, studies are being done to determine if the second shot could be a different vaccine, after the first shot was AZ. So, some of us could end up with a blend. Shot 1, AZ, and shot 2, Pfizer or Moderna.

lightsaber · Wed Apr 21, 2021 1:50 pm

I agree the EU situation has hurt AZ acceptance. :cry2:

The number who will be crippled is sad.

For whatever reason, myself and my cousins seem to be more likely to have nerve related long haul symptoms (lack of taste, smell, tinnitus, stomach "feelings"), but we all seem to start healing with mRNA vaccine (many theories, pockets of virus, virus shards, auto-immune reset).

I want the greatest quantity vacvinated so others do not have long haul symptoms or they recover earlier. Note, symptoms that only last 60 days are not long haul symptoms. :faint:

So technically, I only became a long hauler this week. :boggled:

https://www.axiomllc.com/blog/top-7-cov ... -alarming/

https://health.ucdavis.edu/coronavirus/ ... ulers.html

aerolimani wrote:
On the other hand, for countries that choose to continue with AZ, it’s a boost to their programs when availability is increased, due to others discontinuing use of AZ.

Right now, studies are being done to determine if the second shot could be a different vaccine, after the first shot was AZ. So, some of us could end up with a blend. Shot 1, AZ, and shot 2, Pfizer or Moderna.

The issue is AZ is easy to move in volume. That is why it is cheap (fewer resources per dose).

I continue to advocate AZ + mRNA, but only after research, as that stretches out the mRNA supply.

As I suspect factories will switch over to other vaccines, this will, in my opinion, reduce supply. I do not know the ratio of production of other vaccines.

I suspect far fewer will be vaccinated in 2021 than previously thought.

Lightsaber

art · Wed Apr 21, 2021 2:47 pm

I don't like what the UK is doing with first and second doses.

In England there has been a dramatic fall in the number of first doses given this month and a dramatic rise in the the number of second doses given.

March
9.2 million first doses given
2.6 million second doses given

April (to 21st)
1.5 million first doses given
5.5 million second doses given

UK decided to use an interval of 12 weeks (84 days) between first and second doses.

ie if 1,000,000 first doses had been given 84 days ago, one would expect 1,000,000 second doses to have been given today.

6.2 million first doses had been given 84 days ago
9.0 million second doses have been given today

In other words, second doses are way, way ahead of schedule. Does that matter?

I think it does:
(a) the UK is reducing the % of the population with some protection against COVID (first dose) by giving people full protection (second dose) prematurely. I think that means more people will become ill with COVID.
(b) by delaying first doses, the time at which all can be fully protected will move to the right - if we do not complete the first dose programme until August, we will not be able to get the second dose programme finished until September onwards (even if we reduce the interval between doses to 28 days).

I hope the UK goes back to giving more weight to first doses.

dtw2hyd · Wed Apr 21, 2021 2:48 pm

Few more details are emerging on India's vaccination progress, there lack of.

According to SII CEO, Indian government ordered only 110 Million doses, that is for 1.4 Billion people needing two doses. As that contract about to expire SII is setting new price.

https://twitter.com/CNBCTV18Live/status ... 51/photo/1

Don't have Covaxin contract details. I am sure that order wouldn't be any close to 2.8 Billion.
Sputnik V got EUA. Others are invited to apply for approval.

Canada has orders for 6x their population, suppliers are struggling, but India expects to vaccinate everyone without even placing order with its own vaccine makers.

par13del · Wed Apr 21, 2021 3:08 pm

art wrote:
I don't like what the UK is doing with first and second doses.

In England there has been a dramatic fall in the number of first doses given this month and a dramatic rise in the the number of second doses given.

The UK has two issues, (1) they are no longer receiving vaccines as imports have dried up (2) Their increased local production is ramping, there will be a lag and the local product supplies may or may not have sufficient quantity to meet the deadlines for second doses, in addition, the type vaccine may be different - local versus import, AZ versus Pfizer, Novo. etc.
So my take is that they are using up their existing supplies of vaccine in to ensure those who started with Pfizer or Az get their second, while they delay first doses until their local production ramps up.
Note that this is the second time they have had to make adjustments, they initially increased the length of time between doses because of supply issues, now they are also looking at having some folks have dissimilar vaccines, also due to supply issues.

BaconButty · Wed Apr 21, 2021 3:15 pm

lightsaber wrote:
Unfortunately Moderna production in EU behind schedule. EU will get their vaccines, UK and Canada will be shorted.

https://www.msn.com/en-us/news/world/mo ... NewsSearch

Lightsaber

Shouldn't affect the UK too much - in any case, we were late signing up with Moderna, so can't complain. Maybe it is like a butchers shop, when it suits.

This is how I saw UK vaccine rollout going now the bad news is all (hopefully) in, and a drop in Moderna deliveries won't affect it too much:

                At 11 April                     At 31 July         
                1st dose        2nd dose        Ist Dose        2nd Dose    Uncommited
AZ              21              2               24              24          52
Pfizer          11              6               20              13          0
Moderna         0               0               2               1           13
Novavax         0               0               3               0           54
Jannsen         0               0               0               0           30
Total           32              8               49              38          149

Based on

The governments central planning assumption of 3.2m/week (last 7 days was 3.35m)
A split of 2m/1m/0.2m between AZ/Pfizer/Moderna included in above
No AZ after mid-late June. AZ will hit a crunch of second doses from mid May to mid June due to the March surge - after that we will be largely vaccinating the youngsters.
No Janssen for the same reason
1m Novavax in June, 2m in July. Figures pulled from my backside (though they will have to eventually hit 2m/week, so assuming a slow ramp-up)

The target is around 47m first doses (90% of 52m). So little room for manoeuvre.

Perhaps more interesting is what's left and how things progress after July. No Pfizer - or at least all committed to second doses. Unless we've got some crafty options with decent delivery positions. The trade-offs won't favour AZ for boosters. Likewise J&J (possibly). For Curevac we've invested in the V2 of the vaccine - early 2022. Valneva not here until early Q4 (allowing 5 months for Phase 3 trials and approvals and assuming they go well). So the post "adults fully vaccinated" vaccine plan becomes clear: Moderna down the age range - enough for 6.5m kids - there's approximately 15m of them. And Novavax for the boosters, perhaps joined by Valneva later.

I focus on the UK, since the newspapers I read do, but I'd be interested how others see their vaccine programs developing after all adults have been offered one.

Few other snippets I though were interesting:

Moderna and Novavax are being added to the combination trials
https://www.bmj.com/content/373/bmj.n971
So it's trialling them following AZ or Pfizer.

Vaccine maker Valneva less hopeful of Europe-wide deal
https://medicalxpress.com/news/2021-04- ... -wide.html
"It's not you, it's me".

AZ has better T-Cell response than Pfizer
https://www.ft.com/content/4492746e-6a1 ... 9c9f37eca4
It's nothing new, just more data. But I thought it's interesting in view of @DocLightning 's opinion. You can't can't fault his conclusion - the US won't use AZ. You have relatively low rates of infection, you're into vaccinating younger people and alternatives are close at hand. All this say's it's not a good fit. However, in terms of efficacy, I'm not sure. The strength of AZ has been in it's T-Cell response - it tends to do better the worse the potential outcome. As it stands, MRNA vaccines may be superior, particularly at preventing any kind of infection, hence spread. And as of now their strong antibody response has held up, even to the SA variant. However, the SA variant apparently cuts the antibody response after Pfizer by two thirds - seeming still enough. After AZ it's apparently cut to 1/7th (no link, sorry), seemingly not enough. But what if we get a variant that escapes the MRNA antibody response? We fall back on the cellular response that AZ excels in. Which is why, for resilience, I suspect there's value in having diverse vaccines at play in the population. Though we're too dependent on AZ, which is why I hope they do go ahead with Novavax boosters starting with those vaccinated in December.

Professor Paul Moss, who leads UK CIC, said the cellular responses could help protect against severe disease and may help the body recognise variants of the virus.

“They [T-cells] are somewhat less susceptible to loss of immune recognition against viral variants than antibody response,” he added. “I think people are confident that the variants will only lose 10 to 20 per cent of the cellular response, whereas they can lose a lot more of the antibody response.”

DocLightning · Wed Apr 21, 2021 3:24 pm

lightsaber wrote:
The FDA has no grounds for denying AZ that I know of.

Couple of things:
1) The FDA does not assume a default position of "all drugs will be approved unless there is a reason not to." They set the bar high for any applicant drugs.

2) There is a concept in pharmaceutical approval/license of "non-inferiority." If you are going to license or approve a new candidate drug, then the manufacturer needs to prove that their product is non-inferior to already approved/licensed products. If we compare AZ to the mRNA vaccines, we see an inferior product. It has lower efficacy and a worse safety profile while requiring the same number of doses.

If AZ would like to tweak their product (I would recommend changing to 10^11 particles, improved purification to remove any extraparticle nucleic acids, a change to a prefusion-stabilized spike, and the use of a heterologous prime-boost vector regimen), then I think they could get to the high level of efficacy that I would want to see to ensure good protection against emergent variants and robust reduction in transmission. At that point the 1:10^6 ratio of thrombocytopenia would probably be balanced by the substantially easier manufacture and lower cost of the AZ product.

The trouble is that at this point, it will be difficult to do the Phase I-III trials in time.

BaconButty · Wed Apr 21, 2021 3:36 pm

art wrote:
UK decided to use an interval of 12 weeks (84 days) between first and second doses.

ie if 1,000,000 first doses had been given 84 days ago, one would expect 1,000,000 second doses to have been given today.

6.2 million first doses had been given 84 days ago
9.0 million second doses have been given today

In other words, second doses are way, way ahead of schedule. Does that matter?

Art,

As of today there have been just under 10.8m second jabs.
On 3rd February we had 10.5m first jabs - the closest date.

Which is 11 weeks. The same as the SAGE assumption when doing it's projections.

You're right - the second doses were way ahead, but they've been closing toward the expected value for a while. What I suspect has happened is that the high priority vulnerable people we're vaccinated "on label" which caused second doses to run ahead which has since corrected.

5427247845 · Wed Apr 21, 2021 3:49 pm

par13del wrote:
art wrote:
I don't like what the UK is doing with first and second doses.

In England there has been a dramatic fall in the number of first doses given this month and a dramatic rise in the the number of second doses given.

The UK has two issues, (1) they are no longer receiving vaccines as imports have dried up (2) Their increased local production is ramping, there will be a lag and the local product supplies may or may not have sufficient quantity to meet the deadlines for second doses, in addition, the type vaccine may be different - local versus import, AZ versus Pfizer, Novo. etc.
So my take is that they are using up their existing supplies of vaccine in to ensure those who started with Pfizer or Az get their second, while they delay first doses until their local production ramps up.
Note that this is the second time they have had to make adjustments, they initially increased the length of time between doses because of supply issues, now they are also looking at having some folks have dissimilar vaccines, also due to supply issues.

Imports from where have been dried up?

par13del · Wed Apr 21, 2021 4:29 pm

marcelh wrote:
par13del wrote:
art wrote:
I don't like what the UK is doing with first and second doses.

In England there has been a dramatic fall in the number of first doses given this month and a dramatic rise in the the number of second doses given.

The UK has two issues, (1) they are no longer receiving vaccines as imports have dried up (2) Their increased local production is ramping, there will be a lag and the local product supplies may or may not have sufficient quantity to meet the deadlines for second doses, in addition, the type vaccine may be different - local versus import, AZ versus Pfizer, Novo. etc.
So my take is that they are using up their existing supplies of vaccine in to ensure those who started with Pfizer or Az get their second, while they delay first doses until their local production ramps up.
Note that this is the second time they have had to make adjustments, they initially increased the length of time between doses because of supply issues, now they are also looking at having some folks have dissimilar vaccines, also due to supply issues.

Imports from where have been dried up?

India has delayed their exports, not just to the UK but to COVAX as well.
The European vaccination thread is available to discuss whether you think folks are taking shots at the EU.

lightsaber · Wed Apr 21, 2021 5:09 pm

marcelh wrote:
par13del wrote:
art wrote:
I don't like what the UK is doing with first and second doses.

In England there has been a dramatic fall in the number of first doses given this month and a dramatic rise in the the number of second doses given.

The UK has two issues, (1) they are no longer receiving vaccines as imports have dried up (2) Their increased local production is ramping, there will be a lag and the local product supplies may or may not have sufficient quantity to meet the deadlines for second doses, in addition, the type vaccine may be different - local versus import, AZ versus Pfizer, Novo. etc.
So my take is that they are using up their existing supplies of vaccine in to ensure those who started with Pfizer or Az get their second, while they delay first doses until their local production ramps up.
Note that this is the second time they have had to make adjustments, they initially increased the length of time between doses because of supply issues, now they are also looking at having some folks have dissimilar vaccines, also due to supply issues.

Imports from where have been dried up?

India shipped 5 million, withheld (understandably) 5 million to use domestically:
https://www.hindustantimes.com/india-ne ... 71137.html

EU stopped exporting AZ to UK:
https://www.hindustantimes.com/india-ne ... 71137.html

Europe has priority on Moderna made in EU, cutting shipments to UK:
https://www.bing.com/amp/s/news.yahoo.c ... 04226.html

Including Dutch made (big row over UK funding):
https://www.msn.com/en-gb/news/world/al ... NewsSearch

I agree with the assessment that the UK is cutting 1st doses to give 2nd doses. i also agree the ramp up is taking time. I speculate the UK is concerned with a cut in ingredients for NovaVax, so is delaying approval, perhaps to prevent competition for ingredients? (pure speculation on my part).

NovaVax is ready for fill/finish, late moved to UK:
https://www.bbc.com/news/uk-england-tees-56570168

GSK said it hoped the "fill and finish" process can begin as early as May.
...
The original plan was for this to be done in Europe once the vaccine product was manufactured by plants in the north east.

I suspect that having paid for vaccine blocked by the EU meant the UK couldn't risk UK made but EU made vaccine wouldn't be commandeered, but that is my speculation.

Pfizer, which still depends on UK ingredients, still seems to be exported to the UK.

I couldn't find the latest AZ production data in the UK.
It was scaling up to 2 million per week:
https://www.manchestereveningnews.co.uk ... e-19616605

So the UK made a mistake of funding vaccine production outside of the UK. That lesson has been learned. The money is now being spent to increase UK production of AZ, NovaVax, and Valneva:

Valneva still needs phase 3 trials, but in production.
https://www.sortiraparis.com/news/coron ... ry/lang/en

Made in Scotland:
https://inews.co.uk/news/health/covid-v ... als-945999

The reality is, we will have vaccine shortage until we have a surplus. When depends on vaccine hesitancy. Production won't be sufficient for 2021 much less 2Q2021...

Lightsaber

lightsaber · Wed Apr 21, 2021 6:52 pm

More good news on vaccines:
Only 32 people have been admitted to hospital with covid-19 more than three weeks after receiving at least one dose of either the Pfizer/BioNTech or Oxford/AstraZeneca jabs, a study has found.

From: https://www.newscientist.com/article/22 ... z6shDPRjIq

We've posted numerous links on how vaccines slow transmission. If one dose keeps people out of the hospital, that is a benefit! e.g., the article points out to the oxygen shortage in India. :cry2:

I remain a huge advocate of vaccinating as many as early as possible.

This article notes the USA is about to run out of adults who want the vaccine:
https://www.msn.com/en-us/health/medica ... NewsSearch

On Tuesday, an analysis from the Kaiser Family Foundation concluded that the U.S. will reach a tipping point in enthusiasm for covid-19 vaccination within the next two to four weeks.
I think it is already happening. Anyone really trying for appointments has one of the people I know. The only person I know who qualifies for a vaccine without an appointment who wants one hasn't logged in yet, so that doesn't count. This is in greater Los Angeles, a high demand area.

Next is allow children to sign up (Pfizer with 12 to 15 year olds is the only one I know about ready). IMHO, the only way we will reach herd immunity is by vaccinating a good chunk of the 73 to 75 million children. Link above noted 61% very willing to get the vaccine, we are close to that.
https://www.childstats.gov/AMERICASCHIL ... s/pop1.asp

I personally know dozens of people who just need more information to get the vaccine, but the amount of information keeps increasing. In other words, they are avoiding the vaccination, but not willing to be labeled as anything. So if 61% of adults are willing to be vaccinated and I'd bet 60 million or so of the kids.. That means about 220 million of 330 million. Is 2/3rds enough?

Unfortunately, unless we open up to children soon, I think we'll lose our vaccine momentum. And the *vast* majority of those not willing to vaccinate, that I know personally, are not who the media is pointing a finger at. :scratchchin:

Sigh, as children cannot (yet) get the vaccine, I cannot yet party. (I'm waiting until everyone has an opportunity and then 6 weeks.)

Lightsaber

ThePointblank · Wed Apr 21, 2021 6:56 pm

Biden is apparently open to providing further assistance to Canada in procuring additional vaccines, and has spoken to Justin Trudeau on the matter:

https://www.citynews1130.com/2021/04/21 ... u-vaccine/

Probably more of the AstraZeneca or even the Janssen vaccines currently sitting in storage in the US will be released to Canada...

5427247845 · Wed Apr 21, 2021 7:19 pm

lightsaber wrote:
marcelh wrote:
par13del wrote:
The UK has two issues, (1) they are no longer receiving vaccines as imports have dried up......

Imports from where have been dried up?

India shipped 5 million, withheld (understandably) 5 million to use domestically:
https://www.hindustantimes.com/india-ne ... 71137.html

EU stopped exporting AZ to UK:
https://www.hindustantimes.com/india-ne ... 71137.html

Europe has priority on Moderna made in EU, cutting shipments to UK:
https://www.bing.com/amp/s/news.yahoo.c ... 04226.html

Including Dutch made (big row over UK funding):
https://www.msn.com/en-gb/news/world/al ... NewsSearch

Lightsaber

According to the links you provided, the EU didn't stop the export to the UK completely. For instance, the infamous Halix factory in the Netherlands will deliver about 20% of the production to the UK.

But those additional doses won't help a lot in the EU. AZ has only delivered about quarter of the doses in Q1 and Q2 won't be much better with just over a third. Instead of 300 million doses in Q1 and Q2 it will only be 100 million.
The Netherlands has ordered 11,7 million doses of AZ and has only received up and untill today some 1,5 million doses. Despite AZ is only administered to people of 60 years and older, we still need all the doses to be delivered in May to fully vaccinate them.

So AZ will help to stop the spread of the virus, but I don't consider it as a game changer. Too little and too late to make the difference.

AirbusCheerlead · Wed Apr 21, 2021 7:39 pm

lightsaber wrote:
marcelh wrote:
par13del wrote:
The UK has two issues, (1) they are no longer receiving vaccines as imports have dried up (2) Their increased local production is ramping, there will be a lag and the local product supplies may or may not have sufficient quantity to meet the deadlines for second doses, in addition, the type vaccine may be different - local versus import, AZ versus Pfizer, Novo. etc.
So my take is that they are using up their existing supplies of vaccine in to ensure those who started with Pfizer or Az get their second, while they delay first doses until their local production ramps up.
Note that this is the second time they have had to make adjustments, they initially increased the length of time between doses because of supply issues, now they are also looking at having some folks have dissimilar vaccines, also due to supply issues.

Imports from where have been dried up?

India shipped 5 million, withheld (understandably) 5 million to use domestically:
https://www.hindustantimes.com/india-news/uk-blames-sii-for-delay-vaccines-priority-in-india-as-cases-surge-officials-101616438571137.html

EU stopped exporting AZ to UK:
https://www.hindustantimes.com/india-news/uk-blames-sii-for-delay-vaccines-priority-in-india-as-cases-surge-officials-101616438571137.html

Europe has priority on Moderna made in EU, cutting shipments to UK:
https://www.bing.com/amp/s/news.yahoo.com/amphtml/coronavirus-moderna-uk-vaccine-delivery-pregnant-women-pfizer-biontech-astrazeneca-122304226.html

Including Dutch made (big row over UK funding):
https://www.msn.com/en-gb/news/world/almost-all-dutch-made-astrazeneca-doses-will-stay-in-eu-says-brussels/ar-BB1frXka?ocid=BingNewsSearch

I agree with the assessment that the UK is cutting 1st doses to give 2nd doses. i also agree the ramp up is taking time. I speculate the UK is concerned with a cut in ingredients for NovaVax, so is delaying approval, perhaps to prevent competition for ingredients? (pure speculation on my part).

NovaVax is ready for fill/finish, late moved to UK:
https://www.bbc.com/news/uk-england-tees-56570168

GSK said it hoped the "fill and finish" process can begin as early as May.
...
The original plan was for this to be done in Europe once the vaccine product was manufactured by plants in the north east.

I suspect that having paid for vaccine blocked by the EU meant the UK couldn't risk UK made but EU made vaccine wouldn't be commandeered, but that is my speculation.

Pfizer, which still depends on UK ingredients, still seems to be exported to the UK.

I couldn't find the latest AZ production data in the UK.
It was scaling up to 2 million per week:
https://www.manchestereveningnews.co.uk/news/uk-news/astrazeneca-imminently-scaling-up-vaccine-19616605

So the UK made a mistake of funding vaccine production outside of the UK. That lesson has been learned. The money is now being spent to increase UK production of AZ, NovaVax, and Valneva:

Valneva still needs phase 3 trials, but in production.
https://www.sortiraparis.com/news/coronavirus/articles/242217-covid-vaccine-without-a-deal-with-the-eu-valneva-will-turn-to-each-eu-country/lang/en

Made in Scotland:
https://inews.co.uk/news/health/covid-vaccine-manufactured-scotland-90-percent-immune-response-early-trials-945999

The reality is, we will have vaccine shortage until we have a surplus. When depends on vaccine hesitancy. Production won't be sufficient for 2021 much less 2Q2021...

Lightsaber

Dear Lightsaber, sorry for answering here since it would probably be better in the EU thread...

I believe your opinion is strongly influenced by the US and British press, that in generally does seem to have much comptent for the EU. I believe many American and British fail to understand how instrumental Europe was in developing the different Covid vaccines on the market (Moderna/Pfizer/J&J/AZ). I'm not diminishing the tremendous work done in the US and UK. But while the huge involvement of US and UK is fully a knowledge in Europe, the reverse doesn't seem the case.

About your link to Moderna:
The journalist seem simply wrong. Being Swiss, I can tell you that Switzerland is very much impacted by the Moderna shortfall. Will I'm not certain about the EU, seeing the German Moderna deliveries over the last weeks, I assume EU deliveries are also affected by the shortfall. How Moderna will catch up, and if differance there will be seem between EU, Switzerland, UK, and Canada, I can't say.
In a wjs article they say: "[Moderna] but didn’t specify others beyond Canada an UK". I assume the journalist in our article interpreted that as EU not affected.

https://www.wsj.com/amp/articles/vaccine-manufacturing-issues-force-moderna-to-cut-supplies-to-canada-u-k-11618600046

What I found more than worring than the shortfalls, is the communication from both Moderna and AZ. Indeed both seem to inform on the day of deliveries (if they even inform) despite them knowing well in advance.
In the Bloomberg article the journalist infers the problem being in Switzerland: "Moderna, which is working with Swiss partner Lonza Group AG to make the shots in Europe, attributed the reduction in deliveries to a slower-than-expected ramp-up of production capacity."

https://www.bloomberg.com/news/articles/2021-04-16/moderna-cuts-covid-vaccine-supply-forecast-to-u-k-canada

But we know that the "fill & finish" and delivery takes several weeks. Hence not being able the doses must have been well known before. Or did the try to ask the White House to allow them to ship some active ingredient to Spain from the US and were denied? But even in that case the shortfall should have been known earlier.

In Switzerland the federal health department informed the Cantons on Thursday that since Moderna was going to ship more over the next weeks, they should stop keeping the second dose in reserve. But on Friday only an handfull vaccines arrived. That a big shipment was expected on Friday only makes it worse. Over the weekend there was a spat in the media with some officials from cantons blaming the federal government of incompetence...

About NovaVax:
I personally don't think the deal with GSK making the "fill and finish" has anything to due with the spat over AZ and worries about EU export ban. I think it was just a chance for the UK to strengthen its pharma sector (not a critic on my part). For the NovaVax supply the UK is still dependant on EU or US supply chain (I belive for example the Matrix-M adjuvant is not produced in the UK).

About Pfizer:
The story about Croda International and the lipid nanoparticles was in my opinion massively oversold by the British tabloids. Well Croda certainly plays a role in the vaccine production, I found on the Internet that Pfizer/BioNTech have several suppliers of the lipid nanoparticles...
Interestingly some IP for lipid nanoparticles used by Pfizer/BioNTech belongs to Canadian based Acuitas Therapeutics. Avanti Polar Lipids has a licence from Aquitas to produce those lipids. Avanti Polar Lipids was bought by Croda in summer 20 and signed a deal with Pfizer in November 20...

About Valneva:
You know that I too have big hope for that vaccine, and see it as a possible solution for people hesitant about vaccination. The EU seems to have gone full mRNA, hence Valneva doesn't seem to fit the portfolio anymore. I think it is a good strategy of them to speak directly with member states and I can see France for example buy a few doses...

About AZ:
I personally belive this hole thing about EU export ban was solely about AZ. I don't think people will agree here if the steps taken by the EU were right or wrong.
Just a few remarks:
In your Guardian link, Breton says the UK didn't pay for the Dutch plant (he says this was confirmed to him by the plant manager). This seem rather logical to me. I assume the UK government paid AZ to develop manufacturing and not individual plants...
So while British and US media likes to point out that UK invested in AZ production, they seem to overlook that the EU also paid upfront (I believe 400 Mio Euro)...

Also I don't know if you have seen this politico article, but if not it should be anoted interesting read. One of the main point of the article is that AZ actif ingredients (aka the vaccine before fill and finish) was sent to Europe from the US...

https://www.politico.eu/article/astrazeneca-vaccine-shortfall-production-woes-documents/amp/

Best regards and stay safe,
Jonas

5427247845 · Wed Apr 21, 2021 8:20 pm

Also important is a steady and predicable flow of deliveries to optimize the vaccination proces.

I found an interesting overview on the Dutch Corona dashboard (https://coronadashboard.rijksoverheid.nl/landelijk/vaccinaties about the weekly deliveries.

I've extracted some interesting numbers:

Deliveries (P = Pfizer A= AstraZenica):
week 08 - P: 200,000 A: 148,000
week 09 - P: 208,000 A: 216,000
week 10 - P: 219,000 A: 95,000
week 11 - P: 219,000 A: 45,000
week 12 - P: 326,000 A: 45,000
week 13 - P: 326,000 A: 430,000 (last week of Q1)
week 14 - P: 488,000 A: 55,000
week 15 - P: 488,000 A: 143,000

To be delivered:
week 16 - P: 488,000 A: 42,000 (this week)
week 17 - P: 681,000 A: 491,000
week 18 - P: 652,000 A: 205,000
week 19 - P: 652,000 A: 205,000

dtw2hyd · Wed Apr 21, 2021 10:37 pm

I think there are myriad issues with vaccine supply chain, it is very difficult to pin blame on one country, region or manufacturer.

1) Who developed - Irrelevant because everyone is being very cooperative.
2) Who is the active ingredient supplier and any export restrictions?
3) Where is the vaccine produced and any export restrictions?
4) Did the country really signed the contract with vendors?
5) Did vendor live up to the contracts?
6) Who is hoarding surplus?

I would say show stoppers are #4 and #5, rest are temporary.

lightsaber · Thu Apr 22, 2021 2:36 am

I'm just amazed only 32 in Britain were vaccinated after having both doses (either Pfizer or Astrazenica) and waiting 3 weeks (after 2nd jab):
https://www.mirror.co.uk/news/uk-news/e ... t-23952839

All the discussion on risks is orders of magnitude off.

marcelh wrote:
Also important is a steady and predicable flow of deliveries to optimize the vaccination proces.

I found an interesting overview on the Dutch Corona dashboard (https://coronadashboard.rijksoverheid.nl/landelijk/vaccinaties about the weekly deliveries.

I've extracted some interesting numbers:

Deliveries (P = Pfizer A= AstraZenica):
week 08 - P: 200,000 A: 148,000
week 09 - P: 208,000 A: 216,000
week 10 - P: 219,000 A: 95,000
week 11 - P: 219,000 A: 45,000
week 12 - P: 326,000 A: 45,000
week 13 - P: 326,000 A: 430,000 (last week of Q1)
week 14 - P: 488,000 A: 55,000
week 15 - P: 488,000 A: 143,000

To be delivered:
week 16 - P: 488,000 A: 42,000 (this week)
week 17 - P: 681,000 A: 491,000
week 18 - P: 652,000 A: 205,000
week 19 - P: 652,000 A: 205,000

First, thank you for the numbers and link.
I assume ratio is similar to Germany (also getting limited Moderna): https://ourworldindata.org/grapher/covi ... untry=~DEU

That week 13 for AZ is eye opening. However, that is 489,500 (week 13 is 215,000) people who could be kept out of the hospital by week 21 or 22.

We can agree if production had been better, more would be saved. I'm sure India or Brazil right now would be happy for any surplus AZ.

Don't get me wrong, I'm even more excited to see those 652k Pfizer numbers and hope the 491k AZ delivery holds up.

There isn't enough vaccine anywhere right now. Soon there will be some surplus from the USA (not Pfizer as that will go to children soon), but we'll be able to share AZ,J&J, and probably Moderna (although I hope that is certified for children soon too). Now, I personally know tons of people who don't want to deal with 2-doses (why, I cannot explain... I just don't understand, but I accept them at their word). So I hope that is approved to surge the US vaccination rate.

e.g., Moderna has a 6 month old through 11 underway. As the father of a child in that age range, I hope for sooner rather than later.
https://www.cbsnews.com/news/covid-19-v ... n-moderna/

I find it amazing the *really* hard to make vaccines are in numbers (Pfizer, Moderna), the adrenovirus, per articles I read last year, should have been the really mass produced.

As I type this, 928 million doses of vaccine have been administered.
https://www.nytimes.com/interactive/202 ... acker.html
Looking at the maps, Moderna has been for US, Canada, Europe, and just a bit of Central America.

I need a translator card for the Chinese vaccines:
https://www.dw.com/en/coronavirus-how-e ... a-56370802

I have read how SinoVac (in this thread) was effective, I'm just not seeing it in the case data:
Vaccines administered: https://ourworldindata.org/grapher/covi ... untry=~CHL (11.54 million Sinovac, 1.81 million Pfizer which isn't enough to matter in Chile)
While Chile's cases are better than some, not like UK or Israel, I was expecting cases to be about 20% lower by now. It appears the vaccine is working, just taking some time.

https://ourworldindata.org/explorers/co ... HL~BRA~ISR

I'd rather have AZ than the majority of the vaccines out there. That is just my opinion and holds no weight as full disclosure, I had Pfizer, but if I was still waiting, AZ would be on my list to get.

SII will produce 100 million doses per month of AZ by July. Aparently making AZ is hard (old goal was that by May) from 60 million now (I'm sorry, when they say 60 to 70 million, I take the low number). When you have 1300 million to vaccinate, 50 million per month means everyone is vaccinated by the end of the year.
https://www.usnews.com/news/world/artic ... ot-end-may

Lightsaber

KFTG · Thu Apr 22, 2021 7:59 am

Some good news out of India (they need it)
COVAXIN 100% effective against severe COVID, 78% effective overall
https://www.reddit.com/r/Coronavirus/co ... icacy_100/

AirbusCheerlead · Thu Apr 22, 2021 9:06 am

lightsaber wrote:
I'm just amazed only 32 in Britain were vaccinated after having both doses (either Pfizer or Astrazenica) and waiting 3 weeks (after 2nd jab):
https://www.mirror.co.uk/news/uk-news/e ... t-23952839

All the discussion on risks is orders of magnitude off.

Hi Lightsaber,

Interesting article from the Guardian about the same topic (the article also has a link to the published paper).
https://www.theguardian.com/world/2021/ ... y-positive

While the numbers are still very good, reality is a little worse. And that exactly is the problem with newspapers like Telegraph, Mirror and the like. While the numbers are correct, they put them out of context and make it harder for the reader to see the full picture. Nevertheless the core message of those articles is still true: the study is really encouraging and shows the massive impact of vaccines.

The study has data has for 74'405 hospitalisation but those happend between September and March (2nd wave). If one considers only data from 8 December (first jab) the number is reduced to 42'788 hospitalisations. Of those 1802 had a vaccine and only 32 were admitted three weeks or more after having a first shot (my numbers are not fully exact either since some are from the Guardian article and others from the study)

Between 8 December and 28 February 208'145 were hospitalised or about 5 times more than the data available for the study.

Best regards and stay safe,
Jonas

lightsaber · Thu Apr 22, 2021 12:10 pm

marcelh wrote:
lightsaber wrote:
marcelh wrote:
Imports from where have been dried up?

India shipped 5 million, withheld (understandably) 5 million to use domestically:
https://www.hindustantimes.com/india-ne ... 71137.html

EU stopped exporting AZ to UK:
https://www.hindustantimes.com/india-ne ... 71137.html

Europe has priority on Moderna made in EU, cutting shipments to UK:
https://www.bing.com/amp/s/news.yahoo.c ... 04226.html

Including Dutch made (big row over UK funding):
https://www.msn.com/en-gb/news/world/al ... NewsSearch

Lightsaber

According to the links you provided, the EU didn't stop the export to the UK completely. For instance, the infamous Halix factory in the Netherlands will deliver about 20% of the production to the UK.

But those additional doses won't help a lot in the EU. AZ has only delivered about quarter of the doses in Q1 and Q2 won't be much better with just over a third. Instead of 300 million doses in Q1 and Q2 it will only be 100 million.
The Netherlands has ordered 11,7 million doses of AZ and has only received up and untill today some 1,5 million doses. Despite AZ is only administered to people of 60 years and older, we still need all the doses to be delivered in May to fully vaccinate them.

So AZ will help to stop the spread of the virus, but I don't consider it as a game changer. Too little and too late to make the difference.

I missed 20% to UK, thank you.

I believe the shear quantity matters. My prior link had SII making 60 million doses a month. Perhaps not a game changer, but really needed. When SII gets up to 100 million doses per month, that will really help.

The Covax scheme is way behind schedule. It direly needs more vaccine, in particular easy to store and transport vaccine.

https://www.theguardian.com/world/2021/ ... ing-scheme

So while short on quantity, I will focus on the positive. AZ will be a major tool in vaccinating the world. This isn't the EU vaccine strategy thread, but the vaccine discussion thread. So I will focus not on my province, but the world.

I fully admit the USA has the luxury of a vaccine drive far enough along to have more hope. But new varriants are hitting children hard (1300 dead in Brazil, India just notes some anecdotes on hospitizations). So until not only my children, but children in general are offered a vaccine, I will temper my enthusiasm.

https://www.bing.com/amp/s/www.nbcnews. ... cna1264231

https://www.msn.com/en-in/health/medica ... NewsSearch

On a side note, my long haul symptom of tinnitus went away yesterday for the first time in months. While it is back this morning, this gives me hope I will shake it. Me and my cousins seem to have been hit hard by the nerve damage. However, we also seem to heal post vaccine (at least post mRNA).

I want the minimum to have this illness.

Lightsaber

BaconButty · Thu Apr 22, 2021 12:17 pm

AirbusCheerlead wrote:
lightsaber wrote:
I'm just amazed only 32 in Britain were vaccinated after having both doses (either Pfizer or Astrazenica) and waiting 3 weeks (after 2nd jab):
https://www.mirror.co.uk/news/uk-news/e ... t-23952839

All the discussion on risks is orders of magnitude off.

Hi Lightsaber,

Interesting article from the Guardian about the same topic (the article also has a link to the published paper).
https://www.theguardian.com/world/2021/ ... y-positive

While the numbers are still very good, reality is a little worse. And that exactly is the problem with newspapers like Telegraph, Mirror and the like. While the numbers are correct, they put them out of context and make it harder for the reader to see the full picture. Nevertheless the core message of those articles is still true: the study is really encouraging and shows the massive impact of vaccines.

The study has data has for 74'405 hospitalisation but those happend between September and March (2nd wave). If one considers only data from 8 December (first jab) the number is reduced to 42'788 hospitalisations. Of those 1802 had a vaccine and only 32 were admitted three weeks or more after having a first shot (my numbers are not fully exact either since some are from the Guardian article and others from the study)

Between 8 December and 28 February 208'145 were hospitalised or about 5 times more than the data available for the study.

Best regards and stay safe,
Jonas

I read that, and I thought it was pretty churlish by the Guardian. They could have pointed out that as of 12 Feb (3 weeks earlier, the latest someone could contribute to the "32") there were 14.5m first doses given and only half a million second doses. And it covers our 3rd wave which is really December through February - by 5th March hospitalizations were down to early October levels.

So even 150 out of 200,000 hospitalizations is fantastic, considering the large number of partially vaccinated people. That's 21% of the whole population, not just adults. So the expected figure would have been 40,000 or so! It also vindicates the long gap between doses.

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