COVID-19: Vaccine/antidote and testing procedures Megathread [Mod Warning - Post #1]

Tenzor07

dominatinMC wrote: »

A bit dismayed by the news this evening and the reporting of Paul Reid's assessment that "Covid will be with us for a very long time - irrespective of a vaccine". He is insisting that behavioural changes across society will be needed for a long time (didn't quantify this) even with a vaccine. To which it begs the question, why the hell do we need a vaccine if things can't go back to normal? I know the vaccine isn't a "silver bullet" but my understanding was that it would suppress the virus to such an extent that things could, indeed, go back to normal. We get it, the virus will always be with us, but if it's not rampaging through society, I fail to see why we can't go back to normal.

Well of course, the flu vaccine has been out for decades and people still get the flu.
With the first vaccines being rushed along in places like China and Russia without all the usual testing and precaution how effective are they really? 30%?
Countries start spending billions from their health budgets to buy enough of the vaccines for their countries, start distributing it out then things go back to pre-covid times yet the numbers of cases are still there every day... The we go back to Covid measures.... So if the 2nd or 3rd vaccine is say 50% effective do people think Governments will be able to gear up yet again and spend further billions on distributing yet another vaccine?

CIARAN_BOYLE

dominatinMC wrote: »

A bit dismayed by the news this evening and the reporting of Paul Reid's assessment that "Covid will be with us for a very long time - irrespective of a vaccine". He is insisting that behavioural changes across society will be needed for a long time (didn't quantify this) even with a vaccine. To which it begs the question, why the hell do we need a vaccine if things can't go back to normal? I know the vaccine isn't a "silver bullet" but my understanding was that it would suppress the virus to such an extent that things could, indeed, go back to normal. We get it, the virus will always be with us, but if it's not rampaging through society, I fail to see why we can't go back to normal.

Last I heard they were talking about mid 2021 for vaccines exiting trials. I see talk about it taking upto a year to ramp up production so that everyone gets vaccinated.

I also see mention that that a vaccine won't work on everyone (flu vaccine is 67% effective for comparison, ie it doesn't help 1 in 3 who get it) so risks will remain until a sufficient quantity have been vaccinated for there to be herd immunity. If herd immunity occurs at 60% and the vaccine is 50% effective 100% vaccination will not achieve herd immunity.

There's also a lot of discussion about how long lasting any immunity received by vaccine will be. There are sources showing that antibody levels are low 3 months after receipt of vaccine. If it turns out that booster vaccines (ie revaccination) are necessary it could take upto 2 years to ramp up production sufficiently to ensure sufficient supply.

I would hope that once a vaccine is available in small numbers (to protect our most vulnerable people) we will only need small scale behavioural changes (social distancing, cough etiquette and regular hand sanitisation) but we may need to do something til at least mid 2023.

Santy2015

CIARAN_BOYLE wrote: »

Last I heard they were talking about mid 2021 for vaccines exiting trials. I see talk about it taking upto a year to ramp up production so that everyone gets vaccinated.

I also see mention that that a vaccine won't work on everyone (flu vaccine is 67% effective for comparison, ie it doesn't help 1 in 3 who get it) so risks will remain until a sufficient quantity have been vaccinated for there to be herd immunity. If herd immunity occurs at 60% and the vaccine is 50% effective 100% vaccination will not achieve herd immunity.

There's also a lot of discussion about how long lasting any immunity received by vaccine will be. There are sources showing that antibody levels are low 3 months after receipt of vaccine. If it turns out that booster vaccines (ie revaccination) are necessary it could take upto 2 years to ramp up production sufficiently to ensure sufficient supply.

I would hope that once a vaccine is available in small numbers (to protect our most vulnerable people) we will only need small scale behavioural changes (social distancing, cough etiquette and regular hand sanitisation) but we may need to do something til at least mid 2023.

Agree with most of what your saying but society isn’t going to stick any sort of restrictions until 2023. Business can’t keep going on like this also our city and town centres will be destroyed!

CIARAN_BOYLE

Santy2015 wrote: »

Agree with most of what your saying but society isn’t going to stick any sort of restrictions until 2023. Business can’t keep going on like this also our city and town centres will be destroyed!

Well I'm hoping that by 2023 some social distancing (not the current level), decent cough etiquette and hand sanitisation will be enough.

If it's normal to socially distance in workplaces the workplaces people can stay socially distanced in workplaces. I remember some discussion about 1 metre vs 2 metre social distancing. I can't remember the specific numbers but I believe that you get 3/4 of the benefit of social distancing at the lower distance. If the background risk factors fall sufficiently we can revisit the how much social distancing debate.

I actually hope that cough etiquette and occasional washing hands become a permanent part of life.

I do agree the question of how much restrictions society will take will determine how long they are kept.

Charles Babbage

dominatinMC wrote: »

A bit dismayed by the news this evening and the reporting of Paul Reid's assessment that "Covid will be with us for a very long time - irrespective of a vaccine". He is insisting that behavioural changes across society will be needed for a long time (didn't quantify this) even with a vaccine. To which it begs the question, why the hell do we need a vaccine if things can't go back to normal? I know the vaccine isn't a "silver bullet" but my understanding was that it would suppress the virus to such an extent that things could, indeed, go back to normal. We get it, the virus will always be with us, but if it's not rampaging through society, I fail to see why we can't go back to normal.

Well if flu currently has a material effect on demand for the HSE and causes capacity to be exceeded, although flu has a vaccine, then the addition of Covid may means additional demand for health care, even if better treatments mean that most people recover well.

We can't go back to normal now because most people haven't had it and there is no vaccine and so if you let it rip a shed load of people would get it, which would overwhelm the health service and would still wreck the economy.

stephenjmcd

CIARAN_BOYLE wrote: »

Last I heard they were talking about mid 2021 for vaccines exiting trials. I see talk about it taking upto a year to ramp up production so that everyone gets vaccinated.

I also see mention that that a vaccine won't work on everyone (flu vaccine is 67% effective for comparison, ie it doesn't help 1 in 3 who get it) so risks will remain until a sufficient quantity have been vaccinated for there to be herd immunity. If herd immunity occurs at 60% and the vaccine is 50% effective 100% vaccination will not achieve herd immunity.

There's also a lot of discussion about how long lasting any immunity received by vaccine will be. There are sources showing that antibody levels are low 3 months after receipt of vaccine. If it turns out that booster vaccines (ie revaccination) are necessary it could take upto 2 years to ramp up production sufficiently to ensure sufficient supply.

I would hope that once a vaccine is available in small numbers (to protect our most vulnerable people) we will only need small scale behavioural changes (social distancing, cough etiquette and regular hand sanitisation) but we may need to do something til at least mid 2023.

Mid 2021 for exiting trials? The leading candidates are hoping for approval late 2020 or early 2021 pending favourable data from phase 3 trials.

Mass production of said candidates started a while ago, doses to be available as soon as approval is gained. For most of us though we won't be first in line so will have to wait a bit longer.

From reading the trial data and just reading up on vaccine in general I'd be hoping for mid 2021 fingers crossed that we see some sort of vaccination programme roll out, there'll obviously be priority for certain groups of the public

Sconsey

I think the comparisons with the flu vaccine are pointless as they are for two very different things. The flu vaccine is based each year on the known strains of flu that are expected to be in circulation, the vaccine changes annually to cover different strains and it doesn't always cover all strains in circulation. It's hit-and-miss based on the strains in circulation in any given year.

There is only one strain of Covid 19, the covid vaccines are all only targeting one strain of the virus.

Assuming covid vaccine effictivness based on past flu vaccine effictveness is not valid at all.

Le Bruise

CIARAN_BOYLE wrote: »

Well I'm hoping that by 2023 some social distancing (not the current level), decent cough etiquette and hand sanitisation will be enough.

If it's normal to socially distance in workplaces the workplaces people can stay socially distanced in workplaces. I remember some discussion about 1 metre vs 2 metre social distancing. I can't remember the specific numbers but I believe that you get 3/4 of the benefit of social distancing at the lower distance. If the background risk factors fall sufficiently we can revisit the how much social distancing debate.

I actually hope that cough etiquette and occasional washing hands become a permanent part of life.

I do agree the question of how much restrictions society will take will determine how long they are kept.

If we’re still social distancing in 2023 we can say goodbye to professional sport, along with the music industry and hospitality trade. Even mid 2021 will put them all to the wall!

I agree that hand hygiene and cough etiquette should stay with us forever....as that’s just good manners!

theguzman

Le Bruise wrote: »

If we’re still social distancing in 2023 we can say goodbye to professional sport, along with the music industry and hospitality trade. Even mid 2021 will put them all to the wall!

I agree that hand hygiene and cough etiquette should stay with us forever....as that’s just good manners!

Ending professionalism in sport would be a very good thing to emerge, sport should be played for the love of the game and not mercenaries, look at the Premier League which has destroyed English football, Man City able to bridbe and buy their way to the top, in GAA Dublin with tens of millions able to field a professional team aided and abetted by the corrupt GAA and corrupt referees. I'd have more respect for a bunch of amateur guys any day of the week over the likes of the Ronaldos and the Dean Rock's of this world. 1 billion on Premier league when there is starvation and the GAA getting €45m when we have homelessness, hospital mayhem and road infrastructure like the congo basin, I have zero sympathy for the sporting sector and the less they get the better.

Le Bruise

theguzman wrote: »

Ending professionalism in sport would be a very good thing to emerge, sport should be played for the love of the game and not mercenaries, look at the Premier League which has destroyed English football, Man City able to bridbe and buy their way to the top, in GAA Dublin with tens of millions able to field a professional team aided and abetted by the corrupt GAA and corrupt referees. I'd have more respect for a bunch of amateur guys any day of the week over the likes of the Ronaldos and the Dean Rock's of this world. 1 billion on Premier league when there is starvation and the GAA getting €45m when we have homelessness, hospital mayhem and road infrastructure like the congo basin, I have zero sympathy for the sporting sector and the less they get the better.

Don’t sit on the fence there!!

We won’t get into a pros/cons of professional sport debate on the vaccines thread (I’d lose said debate anyway, as I don’t know enough about it). I simply want to be able to see sport (rugby mainly) on the telly in the future....and I think crowds will be needed at some point to fund that! Gigs and festivals are also a love of mine, so them too.

hynesie08

Lads!! Trump just said we'll have a vaccine in weeks......... New years piss up....

CIARAN_BOYLE

Le Bruise wrote: »

If we’re still social distancing in 2023 we can say goodbye to professional sport, along with the music industry and hospitality trade. Even mid 2021 will put them all to the wall!

I agree that hand hygiene and cough etiquette should stay with us forever....as that’s just good manners!

There will be big changes to professional sport.

When the risks profile is appropriate see socially distanced crowds at sporting venues. Every second or third seat full.

Im not saying it will be the current social distancing till 2023 but some form may exist.

Wanderer78

CIARAN_BOYLE wrote:

Im not saying it will be the current social distancing till 2023 but some form may exist.

Ah this virus will eventually move on, these sectors will eventually return, all involved just need to be protected, particularly financially

patnor1011

Sconsey wrote: »

I think the comparisons with the flu vaccine are pointless as they are for two very different things. The flu vaccine is based each year on the known strains of flu that are expected to be in circulation, the vaccine changes annually to cover different strains and it doesn't always cover all strains in circulation. It's hit-and-miss based on the strains in circulation in any given year.

There is only one strain of Covid 19, the covid vaccines are all only targeting one strain of the virus.

Assuming covid vaccine effictivness based on past flu vaccine effictveness is not valid at all.

Do you seriously think that there is only one strain of covid 19?

is_that_so

This seems a good place to drop this in. A summary of 5 still unanswered questions, including strains of COVID-19. As the article says we've only been at this six months.

From immunity to the role of genetics, Nature looks at five pressing questions about COVID-19 that researchers are tackling.

https://www.nature.com/articles/d41586-020-01989-z

hmmm

The big trial news yesterday was Regeneron's first release of data
https://www.statnews.com/2020/09/29/regenerons-covid-19-antibody-may-help-non-hospitalized-patients-recover-faster-early-data-show/

Mixed bag I would say.

The biggest disappointment for me was that their production capacity in 2021 would be in the order of hundreds of thousands a month, which sounds a lot lower than what is needed.

Hmmzis

hmmm wrote: »

The big trial news yesterday was Regeneron's first release of data
https://www.statnews.com/2020/09/29/regenerons-covid-19-antibody-may-help-non-hospitalized-patients-recover-faster-early-data-show/

Mixed bag I would say.

The biggest disappointment for me was that their production capacity in 2021 would be in the order of hundreds of thousands a month, which sounds a lot lower than what is needed.

You have to keep in mind this is a synthetic protein treatment. The mABs have to be grown by cell cultures or plants, then extracted, purified etc. The doses are quite high as well. It never was meant to be deployed on the scale of vaccines or even antivirals.

Overall the data in the press release seems to line up with what most were expecting after Lilly's results. Post exposure prophylaxis works well, but once the patient has developed their own ABs, it's of very limited utility.

This could be very useful for high risk groups on the medical frontlines and long term care facilities.

But what's up with that bizarre dose response, why is the higher dose not having a stronger effect?

I'd be very willing to hang my hat and say there isn't a hope in hell of any sort of social distancing in 2023.

Sconsey

patnor1011 wrote: »

Do you seriously think that there is only one strain of covid 19?

Not anymore, looks like there are up to six known strains, not that that directly impacts the vaccine development.
https://www.sciencedaily.com/releases/2020/08/200803105246.htm

So I still think comparing the effectiveness of the flu vaccine (for a virus with so many strains) to a covid 19 vaccine is pointless.

Hmmzis

Sconsey wrote: »

Not anymore, looks like there are up to six known strains, not that that directly impacts the vaccine development.
https://www.sciencedaily.com/releases/2020/08/200803105246.htm

So I still think comparing the effectiveness of the flu vaccine (for a virus with so many strains) to a covid 19 vaccine is pointless.

Depends how you define a strain, it can be a very fuzzy term to get an agreement on.

It will be interesting to see how the G clades behave once there are sufficient convalescent people, vaccinations have started and mABs used. So far the G clades have been observed to be more infectious and to be spreading faster while at the same time being more sensitive to neutralization (https://www.biorxiv.org/content/10.1101/2020.09.28.317685v1).

Sconsey

Hmmzis wrote: »

Depends how you define a strain, it can be a very fuzzy term to get an agreement on.

It will be interesting to see how the G clades behave once there are sufficient convalescent people, vaccinations have started and mABs used. So far the G clades have been observed to be more infectious and to be spreading faster while at the same time being more sensitive to neutralization (https://www.biorxiv.org/content/10.1101/2020.09.28.317685v1).

Fixed the link! https://www.biorxiv.org/content/10.1101/2020.09.28.317685v1

smurfjed

This would have a dramatic impact on aviation.

Becton Dickinson & Co’s Covid-19 test that returns results in 15 minutes has been cleared for use in countries that accept Europe’s CE marking, the diagnostics maker said Wednesday.

The test is part of a new class of quicker screening tools named for the identifying proteins called antigens they detect on the surface of SARS-CoV-2. Becton Dickinson expects to begin selling the test, which runs on the company’s cellphone-sized BD Veritor Plus System, in European markets at the end of October. It will likely be used by emergency departments, general practitioners and pediatricians.

“It is really a game-changing introduction here in Europe,” said Fernand Goldblat, BD’s head of diagnostics for Europe. Europe was really at the epicenter of the pandemic in April and May, “and unfortunately I think we’re headed back in that direction. So the need will be extremely high,” he said.

Antigen tests have emerged as a valuable tool because they produce results much more quickly than gold-standard PCR diagnostic assays. However, they are generally less accurate. In the U.S., for instance, instructions for BD’s system recommend that negative results be confirmed by a molecular testing method.

Becton Dickinson said its antigen assay is 93.5% sensitive, a measure of how often it correctly identifies infections, and 99.3% specific, the rate of correct negative tests. The data, which differ from the U.S. label’s 84% sensitivity and 100% specificity, come from a new clinical study that was recently submitted to the U.S. Food and Drug Administration, spokesman Troy Kirkpatrick said.

In the U.S., where regulators cleared the assay in July, the Veritor Plus System has an average selling price of $250 to $300, and the tests themselves are about $20 each.

https://www.bloomberg.com/news/articles/2020-09-30/becton-dickinson-15-minute-virus-test-cleared-in-europe?cmpid=socialflow-twitter-business&utm_content=business&utm_campaign=socialflow-organic&utm_medium=social&utm_source=twitter

funnydoggy

I'm assuming any side effects from a vaccine would've been spotted within the last 3 phases of human trials, and longer term ones would be much rarer?

I'm still trying to wrap my head around that part but I trust the science

scooby77

Some good news from Moderna:
"Results from an early safety study of Moderna Inc’s coronavirus vaccine candidate in older adults showed that it produced virus-neutralizing antibodies at levels similar to those seen in younger adults, with side effects roughly on par with high-dose flu shots, researchers said on Tuesday"
Some mild side effects also mentioned.

https://www.reuters.com/article/reutersComService_2_MOLT/idUSKBN26K3KE

Hmmzis

funnydoggy wrote: »

I'm assuming any side effects from a vaccine would've been spotted within the last 3 phases of human trials, and longer term ones would be much rarer?

I'm still trying to wrap my head around that part but I trust the science

Given the size of the trials anything not detected in phase 3 would be very rare. The long term ones can still be detected early if the monitoring of participants is thorough.
There are two critical time periods after vaccination where things can go bad:

1. Right after injection (1 sec - 4 days) - that's the allergies, fevers, pains, fainting, dizziness, etc.

2. At seroconversion (2 weeks - 3 months) - that's the auto-immune attacks in case there are self-antigens expressed in the vaccine (the self antigen would be present on the virus as well in any case) and the immune system wasn't able to recognize it as such. These are the side effects everyone means when they talk about long term adverse reactions. It's not that the reaction happens years down the line, it's that it will last a long time after seroconversion. So far from what I've gathered this particular issue has been only observed in a few versions of whole virus inactivated vaccines (flu in particular). I haven't come across any other types being impacted by this issue.

After phase 3 the rollout of any vaccine is still monitored and anything that looks out of line is investigated. That's to detect those really rare and difficult to see side effects. For example, if a side effect happens only in 1 out of 100,000 recipients then it's unlikely that even in a 60k phase 3 trial it will be seen, but once 100,000,000 people have had it it might be possible to see the effect above background levels.

funnydoggy

Lovely answer thanks Hmmzis!

iguana

Out of curiosity what sorts of trials were done on H1N1 vaccine? The turn around from notification of a novel flu strain to the beginning of mass vaccination was incredibly fast, under 5 months. Were full phase 3 trials conducted?

Mark1916

https://www.bloomberg.com/news/articles/2020-09-30/oxford-astra-covid-vaccine-review-said-to-start-in-europe

Looks like the EU are starting the ball rolling!

ACitizenErased

Mark1916 wrote: »

https://www.bloomberg.com/news/articles/2020-09-30/oxford-astra-covid-vaccine-review-said-to-start-in-europe

Looks like the EU are starting the ball rolling!

Interesting that Oxford could jump ahead again. Was expecting Pfizer to lead the way.

ACitizenErased

ACitizenErased wrote: »

Interesting that Oxford could jump ahead again. Was expecting Pfizer to lead the way.

They may have been helped by the recent infection surge in the UK. That's where the first volunteers were recruited.