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Will another variant take over?

  • 23-03-2021 1:22pm
    #1
    Registered Users Posts: 114 ✭✭ MegamanBoo


    I'm posting this in the hope that I'll be corrected on some false assumption I've made.

    As I understand things, the majority of Irish people will be getting the AstraZeneca vaccine.

    At present, until AZ release a booster shot which is due later in the year, this is very ineffective against at least the South African variant, and possibly more.

    So when we all get the AZ vaccine, the UK variant will no spread, but one of these other variants will.

    While the elderly who have received the other (Moderna, Pfizer) vaccines should be covered, we'll be dealing with another variant of Covid, through lockdowns or some other approach, until we can get the AZ booster.


Comments

  • Registered Users Posts: 13,396 ✭✭✭✭ CIARAN_BOYLE


    MegamanBoo wrote: »
    I'm posting this in the hope that I'll be corrected on some false assumption I've made.

    As I understand things, the majority of Irish people will be getting the AstraZeneca vaccine.

    At present, until AZ release a booster shot which is due later in the year, this is very ineffective against at least the South African variant, and possibly more.

    So when we all get the AZ vaccine, the UK variant will no spread, but one of these other variants will.

    While the elderly who have received the other (Moderna, Pfizer) vaccines should be covered, we'll be dealing with another variant of Covid, through lockdowns or some other approach, until we can get the AZ booster.

    There is not sufficient to say this.

    There's a study but any review of the study would have concluded it was a bad study.

    I would hope that the AZ vaccine would offer a reasonable level of protection against the sa variant.

    Once we get a sufficient bulk vaccinated I would expect us to move to low level restrictions only (mask wearing, cough etiquette, hand washing and a minimal amount of social distancing).

    We do t know what the situation is re boosters. The UK is talking. Boosters for all before Christmas but who knows.


  • Registered Users Posts: 4,958 ✭✭✭ Allinall


    I would also question the statement that the majority of Irish people will be getting the AZ vaccine.

    Has this been stated anywhere?


  • Registered Users Posts: 13,396 ✭✭✭✭ CIARAN_BOYLE


    Allinall wrote: »
    I would also question the statement that the majority of Irish people will be getting the AZ vaccine.

    Has this been stated anywhere?

    Thats also a correction question to raise.

    The hope would have been for the majority to be vaccinated with the AZ vaccine when AZ was promising more than they are delivering by a massive amount.

    I'd now put money on more people being vaccinated with both BioNtech (Pfizer) and J&J than AZ.


  • Registered Users Posts: 114 ✭✭ MegamanBoo


    There is not sufficient to say this.

    There's a study but any review of the study would have concluded it was a bad study.

    Who reviewed the study?

    Didn't South Africa stop giving the AZ vaccine because it was ineffective.

    I'm not saying it is or isn't, to me it just look extremely risky that expectations are getting raised that we'll all be back to near-normal soon.

    Am I right that we're pretty much just hoping this AZ vaccine will work for the variants.


  • Registered Users Posts: 4,332 ✭✭✭ Charles Babbage


    MegamanBoo wrote: »

    As I understand things, the majority of Irish people will be getting the AstraZeneca vaccine.


    This is not correct straight off. As AZ have fulfilled a fraction of the EU order only a minority of people will have the AZ vaccine in the ROI.

    So far only about 20% of vaccines have been AZ
    https://covid19ireland-geohive.hub.arcgis.com/pages/vaccinations

    this proportion is not going to change hugely, AZ will provide a few more, but there will also the the J&J vaccine and over half of the vaccines will be Pfizer.
    The J&J vaccine is only slightly less effective against the South African variant than the British one.


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  • Registered Users Posts: 114 ✭✭ MegamanBoo


    Allinall wrote: »
    I would also question the statement that the majority of Irish people will be getting the AZ vaccine.

    Has this been stated anywhere?

    Fair point and based on what I see I hope that's wrong.

    I'm basing that on how coupled the EU rollout seems to be with AZ availability.

    But I would love to see some data on that if anyone has it?


  • Registered Users Posts: 114 ✭✭ MegamanBoo


    This is not correct straight off. As AZ have fulfilled a fraction of the EU order only a minority of people will have the AZ vaccine in the ROI.

    Again I'd love to have that confirmed.

    Weren't we giving pretty much no vaccines when AZ was paused?

    Also, do we have the ultra-cold storage facilities in place for the other vaccines.

    Wasn't a lot of our plan that gp's, pharmacists etc would give the AZ vaccine as it's easier to distribute.


  • Registered Users Posts: 13,396 ✭✭✭✭ CIARAN_BOYLE


    MegamanBoo wrote: »
    Who reviewed the study?

    Didn't South Africa stop giving the AZ vaccine because it was ineffective.

    I'm not saying it is or isn't, to me it just look extremely risky that expectations are getting raised that we'll all be back to near-normal soon.

    Am I right that we're pretty much just hoping this AZ vaccine will work for the variants.

    Read an article on the study rather than a headline.

    95% CI that the efficacy is between - 74% and 60%.

    Too few people taking part to draw any conclusions.


  • Registered Users Posts: 114 ✭✭ MegamanBoo


    So far only about 20% of vaccines have been AZ
    https://covid19ireland-geohive.hub.arcgis.com/pages/vaccinations

    Cheers for that, I find that very reassuring in one sense.

    Maybe less so that we'll be able to rapidly get out the other vaccines.


  • Registered Users Posts: 1,226 ✭✭✭ Valhallapt


    Pfizer will be the single biggest provider of vaccine in Ireland. Already is and will continue to be. Takes almost no effort to check this data before posting.


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  • Registered Users Posts: 13,396 ✭✭✭✭ CIARAN_BOYLE


    MegamanBoo wrote: »
    Cheers for that, I find that very reassuring in one sense.

    Maybe less so that we'll be able to rapidly get out the other vaccines.

    If Astra Zenaca didn't have their problems we would have more Astra Zenaca given out than Pfizer but they had their problems and we are behind.


  • Registered Users Posts: 114 ✭✭ MegamanBoo


    Read an article on the study rather than a headline.

    95% CI that the efficacy is between - 74% and 60%.

    Too few people taking part to draw any conclusions.

    We must be looking at different studies.

    https://www.nejm.org/doi/full/10.1056/NEJMoa2102214?query=featured_home

    I appreciate that this hasn't been fully studied yet.

    As you've pointed out it's too early to draw conclusions, my fear is that a lot of people (including our government) appear to have drawn the conclusion that this will be effective.


  • Registered Users Posts: 114 ✭✭ MegamanBoo


    Valhallapt wrote: »
    Pfizer will be the single biggest provider of vaccine in Ireland. Already is and will continue to be. Takes almost no effort to check this data before posting.

    Those figures are what's already been given, is that not skewed because we've really only vaccinated the elderly so far and they can't get AZ.

    Great if it is a reliable figure.


  • Registered Users Posts: 695 ✭✭✭ DaSilva


    My personal non expert take on this is that yes, a variant will take over, just as they have continually done since the beginning of the pandemic, and that it also won't matter.

    Before last year scientists knew that the other endemic coronaviruses continually infected us throughout our lifetime, it was thought that this occurred due to waning immunity, but a paper from 2020 suggests its because of variants, every few years they have changed enough to re-infect certain individuals and that is how they continue to exist.

    Some studies also suggest that although the S.African variant may still be able to infect people who have gotten the Oxford vaccine (and I imagine it will do the same to a lesser extent to those who got the Pfizer vaccine) they do not get seriously ill.

    I think its going to turn out that there is a dramatic difference in severity of illness when you first exposed to sars-cov-2 than when you are exposed for a second time to a variant.

    So in summary, I think in 5 years time regardless of what vaccine you get you are likely to become infected with some variant of sars-cov-2 again, and it might even make you cough or even feel sick enough to be bed ridden and thats about it.

    Since we will have vaccines though for these variants, I imagine the medical advice will be to get a booster if you can, especially if you are in some medically vulnerable category.

    So, yes, variants will take over, they will reinfect you, but what really will matter from a disease point of view is if your body has experience with fighting this virus, variant or not.


  • Registered Users Posts: 1,226 ✭✭✭ Valhallapt


    MegamanBoo wrote: »
    Those figures are what's already been given, is that not skewed because we've really only vaccinated the elderly so far and they can't get AZ.

    Great if it is a reliable figure.
    AZ was never planned to be the main vaccine. We ordered more of everything than we needed, at one stage it looked like AZ would be first, but no chance of that happening now.

    Here is the Swedish delivery timetable, we are getting the same on a pro rata basis

    https://www.folkhalsomyndigheten.se/smittskydd-beredskap/utbrott/aktuella-utbrott/covid-19/statistik-och-analyser/prognos-av-vaccinleveranser/

    The HSE are reluctant to publish as they don’t want to be accused of missing time lines


  • Banned (with Prison Access) Posts: 1,714 ✭✭✭ ThewhiteJesus


    I have heard alot of stories of serious reactions to the asraz vaccine, i'm very concerned about it new variant or not !


  • Banned (with Prison Access) Posts: 1,714 ✭✭✭ ThewhiteJesus


    Valhallapt wrote: »
    AZ was never planned to be the main vaccine. We ordered more of everything than we needed, at one stage it looked like AZ would be first, but no chance of that happening now.

    Here is the Swedish delivery timetable, we are getting the same on a pro rata basis

    https://www.folkhalsomyndigheten.se/smittskydd-beredskap/utbrott/aktuella-utbrott/covid-19/statistik-och-analyser/prognos-av-vaccinleveranser/

    The HSE are reluctant to publish as they don’t want to be accused of missing time lines

    Wasn't it the cheapest vaccine ?


  • Registered Users Posts: 13,396 ✭✭✭✭ CIARAN_BOYLE


    MegamanBoo wrote: »
    We must be looking at different studies.

    https://www.nejm.org/doi/full/10.1056/NEJMoa2102214?query=featured_home

    I appreciate that this hasn't been fully studied yet.

    As you've pointed out it's too early to draw conclusions, my fear is that a lot of people (including our government) appear to have drawn the conclusion that this will be effective.

    vaccine efficacy against this variant, analyzed as a secondary end point, was 10.4% (95% CI, −76.8 to 54.8).

    95% confidence that efficacy is between - 76.8% and 54.8%

    Slightly different numbers but effectively the same point. Too small a study to guarantee accuracy.


  • Registered Users Posts: 13,396 ✭✭✭✭ CIARAN_BOYLE


    mfaislife wrote: »
    What does all that mean?

    76.8% - 54.8% had no symptoms, 23.2% - 45.2% did have 1 or more symptoms?

    It means they are 95% confident that the efficacy is between - 76% and 54%.

    Thats too wide an interval and means that the study sample is too small.


  • Registered Users Posts: 114 ✭✭ MegamanBoo


    vaccine efficacy against this variant, analyzed as a secondary end point, was 10.4% (95% CI, −76.8 to 54.8).

    95% confidence that efficacy is between - 76.8% and 54.8%

    Slightly different numbers but effectively the same point. Too small a study to guarantee accuracy.

    You'll have to explain your take on that a bit better. Is it 10.4% efficacy or between 76 and 54?

    The (small) study concludes:

    "A two-dose regimen of the ChAdOx1 nCoV-19 (AZ) vaccine did not show protection against mild-to-moderate Covid-19 due to the B.1.351 variant."


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  • Registered Users Posts: 13,396 ✭✭✭✭ CIARAN_BOYLE


    MegamanBoo wrote: »
    You'll have to explain your take on that a bit better. Is it 10.4% efficacy or between 76 and 54?

    The (small) study concludes:

    "A two-dose regimen of the ChAdOx1 nCoV-19 (AZ) vaccine did not show protection against mild-to-moderate Covid-19 due to the B.1.351 variant."

    Sorry for the delay answering. Work was a potent distractions from boards.ie.



    A confidence interval is a statistical tool when a study is too small to draw conclusive results. If I studied the hair colour of people in my office and said 80% of people have brown hair. Therefore 80% of Irish have brown hair. My sample size (of 10) would be tiny and I’d have to put an insane confidence interval on it. So my result would be expressed as 80%(95% CI, 0% - 100%). My study would be worthless as it doesn’t narrow the results at all.



    In this case the result from the study was 10% but all that means is that when they reference their ztables and do their maths they are 95% sure the real result is somewhere between -76.8% and 54.8%.



    So what does that mean? Well it means that the study isn’t worth much at all.



    So I feel happy to ignore it and move on. I mean 125% range in the confidence interval is pointless.



    Another failing of the study is that it doesn’t (and I don’t expect it as it is so small already) reference partial defence at all. With a lot of strains of influenza (which constantly mutates) having antibodies to a similar strain gives partial protection. You may still have symptoms but are unlikely to have serious symptoms. If I have antibodies to a swineflu its likely to do something against a new swineflu. This isn’t mentioned at all in this study but that’s because you need a much bigger study to show the effect on serious covid. It’s always going be a bigger effect than there is on minor covid.



    At the end of the day all the vaccines work in a similar way. They expose the body to something that will make them make antibodies that are effective against Covid 19. The antibodies made from exposure to one vaccine or another aren’t going to be wildly different. If antibodies from Pfizer and Moderna work against South African variant (and they do even if efficacy is reduced) antibodies from Astra Zenaca will too to some extent.



    So in conclusion its ok to have doubts about Astra Zenaca effectiveness against variants but its not going to be that bad and that study isn't worth the paper its written on as a judgement of the effectiveness of the az vaccine.


  • Registered Users Posts: 114 ✭✭ MegamanBoo


    Thanks for that Ciaran, that's very interesting. I think what threw me there was that it's been a while since I studied stats and I was confusing a hyphen and a minus. I was reading it as being between 76 and 54 but it's actually negative 76 to 54.

    Makes a lot more sense.

    So in lay mans terms, based on a very small study, it's still far more likely than not ineffective against the South African variant.

    But I do understand the point that it should give some increased protection, which raises some hope if you allow that future variants aren't themselves more dangerous. Or that the likelihood of long covid isn't tied to the severity of initial symptoms. (Anyone got any info on that?)

    Still scary times in my opinion and a bit soon to be getting peoples hopes up again.


  • Registered Users Posts: 142 ✭✭ purplefields


    It means they are 95% confident that the efficacy is between - 76% and 54%

    The 95% refers to the reliability of the experiment. Once we have our interval, either the efficacy is in the range (between 76% and 54%) or it isn't.


    Interestingly, you'd be very surprised at how small a sample size is required for many experiments. Even with polls on boards, you may notice that after a few votes, the proportions do not change that much for the final result.


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