Probably every drug has risks, many higher than the 1:1,000,000 reported for AZ/J&J. It's always a balance between the risk untreated vs. treated - many cancer drugs will kill you, but slower than they kill the cancer. Contraceptives have various issues, but their "social good" is deemed worthwhile.
I've read that they are doing gene analysis to try and determine why these cases appear - is it gender, age, cross-reactions with other meds, ...? And recall that some of these conditions appear without obvious causes. If they're due to an overly aggressive immune response, recall that the cytokine storm caused by covid in such cases is what attacks the lungs (why immunosuppressants are used as treatments).
This might just be the straw that broke the camels back. As far as I remember the contracts the EU signed turned out to be incredibly one sided, with deliveries getting cut down when someone found out that more dosages could be extracted, no hard delivery requirements leading to constant shortages, etc. . Not getting out of that mess when alternatives exist seems like a bad idea.
There were no hard delivery requirements in any of AstraZeneca's contracts because they didn't have any way to guarantee how much they could deliver - the contract was literally to build the full-scale production lines, and they had no idea of the yield until those lines were actually built because messy biological processes are involved.
The big problems with the EU's AZ purchase is that they bought less of it relative to their population than the UK (so had a commensurately reduced amount of production capacity allocated to them), signed the contract later (meaning less time to fix yield issues), and completely failed to grasp that signing a "best effort" contract for X units of a never-mass-produced vaccine on timescale Y didn't guarantee they'd be delivered on time. Like, the UK apparently only got something like a third the amount of AZ vaccine as expected by now in the initial contract and is more dependent on it than the EU, but you wouldn't even know there was a problem because the publicly-announced schedule was based on actual production numbers - and the UK contract had clauses with teeth to make sure AZ provided the information needed to make that possible. Not only that, the initial plans were ambitious enough that even after the main vaccine supplier underperformed hugely, the UK still ended up ahead of the EU despite most of their vaccines coming from suppliers who did perform as expected.
What kind of "best effort" is signing five more delivery contracts when you aren't even sure that you can get the first few done?
> Like, the UK apparently only got something like a third the amount of AZ vaccine as expected
So just how far behind the expected production is AZ? The UK only got a third, the EU is months behind schedule and half a dozen other countries are just around the corner waiting to have their contracts fulfilled.
> and the UK contract had clauses with teeth
Yeah, that would require halfway competent politicians, not something you find in the EU.
This is very likely a political decision. AZ has not honoured their "best effort" contract obligations, the company priortized UK deliveries to honour their other contract and Western Europeans are reluctant to take it because it's less well tolerated than mRNA vaccines and now the very rare blood clot issues. It's too bad, because vaccination rollouts are well behind schedule with less than 10% or so of the EU population vaccinated, while the UK has vaccinated almost everyone under 50 and at risk groups and are out of lockdown. Germany by contrast is imposing additional lockdown measures.
I got my first AZ shot it and I'm thankful it exists and really hope it works against the new variants. Maybe this is a chance for poorer countries like Ukraine, Moldova, the former Yugoslav republics and Albania to get their citizens vaccinated. Western Europe should probably donate part of their stocks to these countries through the Covax mechanism instead of letting it go to waste.
The publication to follow is the CDC Advisory Committee on Immunization Practices (ACIP) monthly reports. There's a report from January and one latest is from March 1.
So far no statistically significant adverse events have occured for either pfizer or moderna vaccines. I follow them closely.
although we do not have data yet to show if there are any side effects 1+ years after vaccination, it would be very unlikely that there would be. Serious side effects from vaccines are almost always immediate and seen within a few weeks after administration, not months or years later.
Except this particular vaccination mechanism (mRNA) has never been licensed for use in humans. Yes, there has been research, but never any sort of trial on the scale of what is happening right now. So, we really don't know what the long term effects of this particular type of vaccine are.
I'm not trying to cast doubt on the efficacy of the vaccines that have been approved. Rather, I'm simply pointing out we don't have much data on the long term effects on humans.
mRNA is rapidly degraded once in the body (really anywhere that isnt cold storage), existing for hours to days at most after injection. There isnt a really plausible reason why there would be no serious short term side effects reported after hundreds of millions of shots, but a hidden risk of long term serious side effects.
yes you are correct that we don't really know until we know, but there is good reason to believe that mRNA vaccines are actually safer than traditional methods
The conversation is about the respective merits of one vaccine over another. The fact that one is a new approach with no long term data on humans whether the other is a traditional approach is relevant.
J&J and AZ adenovirus-vector covid vaccines are highly novel vaccines that are very similar to mRNA vaccines, just with a different delivery mechanism.
I was under the impression that adenovirus vaccines have only been been approved in the past year or two - a few for Ebola and the new ones for Covid. Are there others that have been around before that?
It doesn't seem like it really matters if adenovirus vector vaccines is an "old idea" - after all, the idea of using MRNA has also been around for a long time. But if we've only started actually using them recently, how different is our knowledge of long-term effects?
The fact that it is an "old idea" is indeed unimportant, but what is very, very important is that large scale study over long periods has already been performed on that vaccination platform so we really do know a lot about it.
That means that the similarity to mRNA is a good thing in terms of any worries about unexpected consequences. Of course it also means that we know that the risk of any unexpected consequences for adenovirus vaccines is also very low.
They’re saying “we don’t have any data on long term studies of such vaccines”, which is an important point. There is a risk there, and there’s no obvious way to manage it.
Also I'm not really sure what saying "we don't know the long term effect are" accomplishes. It's not really adding much to the conversation.
You are making the claim that there may not be any long term effects to the vaccine, but the information you cite has nothing to do with mRNA-based vaccines. I'm simply suggesting we don't have the data yet to make such claims.
the link I posted was to provide a list of known vaccine adverse reaction events throughout history to show that none of them occurred months after vaccination. Adverse events are almost always acute so the fact that we haven't seen widespread serious side effects after 6+ months means they are very likely incredibly safe.
Your supposition about likelihood bears no resemblance to reality. It's almost as if you're misleading people on purpose. I certainly hope that's not the case.
Fully 1/3 of all medications approved by the FDA turn out to have serious, and some life-threatening, side effects YEARS after the medication was approved.
______
You realize that this new 'vaccine' bears no resemblance whatsoever to any prior vaccinations?
This new Covid Vaccine is not a true vaccine. This is a drug that modifies the inner workings of cells.
That is not a vaccine but a 'new drug'.
I repeat: 1/3 of all new drugs have serious, and sometimes life threatening, reactions attributed to them between 1-5 years after the drug's approval and release to the public.
1/3...
That is not an insignificant number, and it is HIGHLY LIKELY that this new drug will have similar issues.
Well, except that these serious adverse effects are often so rare to not have any way of reaching statistical significance. Especially when you consider that you're looking for associations between medication and any indication. Just by random chance you'd get a many associations between serious diseases and any medication.
The very rare and very serious side effects are tracked closely, and it's likely that for a vast number of medications, even though the very rare side effects are written on the packaging, there actually is no causal connection with the medication whatsoever.
Every vaccine uses body cells to a certain extent. Sure, mRNA vaccines are new, but the underlying mechanism is not.
Vaccines are behaving differently from drugs. Once they took effect, and your immune system reacted, it is over. And with millions of people vaccinated by now, for months, any adverse effects would have shown. That's why we discuss blood clots, under normal circumstances these rare cases would have gone unnoticed for quite a while.
The effect seen with these two adenovirus platform vaccines seems to be exactly what this would suggest we should expect too.
Roughly the immune system says "OK, let's attack things this shape" - which is why it's so useful for defending us against a wide variety of viruses - but alas, the shape it's picking in some patients happens to also match Platelet Factor 4, so now they are mounting an immune defence against their own blood clotting mechanism which is bad.
I don't know (perhaps if I read more papers about this I'd find out) whether it is suspected that the immune system makes this bad matching choice based on the spike protein (which we want it to match because of this coronavirus killing millions of people) or the adenovirus (which even if it could replicate in humans, which it can't, basically gives you the common cold so who cares) which is delivering it. If it's the latter, that's showing an advantage to the mRNA vaccines, since they don't need a viral delivery mechanism at all.
As I understand, the required teratogenicity study in rats with Pfizer is ongoing as of two weeks ago [1]. It’s rather optimistic to claim we’ve seen everything when even animal studies haven’t completed. Vaccine science itself is rapidly developing. Now I don’t think there will be issues with this drug, but surprises may lurk still.
You can't compare vaccines to the overall universe of drugs like that. The main difference is that drugs that are intended to be taken over the long term can develop long term side effects. Vaccines are taken once or a few times, and then they're done. The parent is correct that complications arising from vaccines years after they're taken just isn't something that should be expected to happen.
No, because again, you take the vaccine, it causes an immune response, and then it leaves your system. Even if you then take it again a year later. It's not like a drug that you're regularly taking, which remains in your system. What would change my mind is if I saw vaccinologists explaining a mechanism by which a vaccine could cause long-term side effects, rather than the opposite.
we are not talking about new drugs in general - we are talking specifically about vaccines. Here is an opportunity to easily prove your point: show me significant examples of serious side effects from vaccines 6+ months after they were administered.
It's clear with statements like "This new Covid Vaccine is not a true vaccine" that you are just parroting anti-vax talking points. Nobody changed the definition of vaccines and mRNA vaccines fit the definition no matter how you describe them
I think the big issue is that people are afraid of the active risk of the vaccine (more so than the passive risk of not getting the shot). I think that even rational people have this fear to some degree. We need to help people deal with that fear. Something I see very little of.
I know that kind of fear personally, I’m on meds with risks orders of magnitude worse than that vaccines and that have been (and still is) a struggle for me. I can do the math, and I understand the risks, but taking an active risk is just hard.
This is probably the most underrated comment. Very few people think twice about e.g. driving a car, but a lot of people are scared of flying. It can also be as simple as being afraid of needles; when I get vaccinated I barely feel it but even knowing that I'm still apprehensive beforehand.
Hopefully, as more people get vaccinated, it will become somewhat normalised (in communities that aren't actively against it). If all your mates did it, it's probably fine. (no sarcasm)
These are both Adenovirus vectored vaccines. My theory is that plain Adenovirus also causes clots, but likewise at percentages so low you would never see them in data. Unless you infected millions of people with the same strain, like these vaccines do.
There's studies dating back many years showing that adenoviruses can cause clots and thrombocytopenia in rodents.
The lesson might end up being, surprisingly, that mRNA vaccines are both safer and more effective than traditional vaccines
Viral vector vaccines have a bit more real-world testing than mRNA vaccines, but they certainly aren't "traditional": there are only a few vaccines developed with this technology--for Dengue fever and Ebola--that have ever been authorized for use, and most within the last couple years; the classic notion of a vaccine--and all of our "traditional" vaccines--are either inactive or attenuated strains.
Denmark reports AZ's serious blood clotting issue as up to 1:40'000.
I will still get vaccinated with it if it's available in our country for me as I think the risk is worth it in my case. But if I was a woman under 60 and especially under 40 I would be hesitant to get vaccinated with AZ and probably wait for other vaccine.
"The Danish Health Authority said studies had shown a higher than expected frequency of blood clots following doses, affecting about one in 40,000 people."
It's a weird one isn't it - 1/40,000 but they only gave 150,000 doses out. This seems like the error bars on this would be huge - we've seen in the UK very few of these events with millions vaccinated which is pretty strange. Is there something different about Denmark and Britain at this time of year?
I've had the AZ vaccine 1st dose 3 weeks ago now and I keep getting very concerned by the ever changing picture; is it 1 in a million or 1 in 40000, or did these people have conditions that made this situation more likely... will we see an increase in the rate as we get more data too over the coming weeks a lot like we did with COVID.
All very unclear right now. I wish the case reports of all the people with blood clots were made available so everyone could review if they match the groups who have had the problems.
As to the difference, maybe they first vaccinated health professionals with AZ and UK mostly vaccinated older people with it, so different issues became apparent? It affects mostly younger women, so it would manifest pretty clearly with female nurses.
One thing I haven't seen discussed is that staff nurses, instrument nurses, etc. spend much more time standing up in a stationary position (not walking or sitting) compared with other healthcare workers in a hospital setting.
Everyone is jumping to focus on young females/genetics but it could really just be occupation related, most of these nurses will have their vacine shot on-site and continue their daily shift afterwards (where they stand orthostatic for several hours).
I can only speculate since I know next to nothing about that but AFAIK those thromboses are not in leg veins but in different parts of the body - in the brain (Cerebral venous sinus thrombosis), lungs (embolism) etc.
"Vaccination with ChAdOx1 nCov-19 can result in the rare development of immune thrombotic thrombocytopenia mediated by platelet-activating antibodies against PF4, which clinically mimics autoimmune heparin-induced thrombocytopenia."
I think I read 10 somewhere but as I’ve said in the sibling comment it’s hard to know if these were all weird cases like the one who died or if they fit a pattern at all.
I don't think it's different based directly on that, but rather based on something which is strongly related to that.
If you're giving a chemotherapy drug to patients with advanced cancer, 1 in 10⁶ is perfectly acceptable. But it's acceptable because the do-nothing course is probably worse. Even serious, chronic pain relief I'd consider 1 in 10⁶ to be a good tradeoff.
With vaccines, you're taking healthy people with no acute condition and exposing them so the do-nothing course is much better than the cancer case.
Those differences of course drive the "do we give it to 3 people or 2 Billion people?" decision, but it's not directly the breadth but the underlying reason for the breadth that make me think differently about the acceptable risk level. If 2 Billion people had cancer or serious, chronic pain, I'd be in favor of giving them a drug which would cure 999,999 of them for every 1 that it killed.
I didn't expect to find this level of, frankly, absolute nonsense on HN. Please don't write fabricated statistics which have no basis in reality. It's dangerous to present such misinformation.
If the data are so good, why hasn't the vaccine been approved. Mainly because it's not clear that you could replicate these results, partly because of how the data was analyzed, partly because of how the experiment was run, partly because AZ has (and openly admitted) been p-hacking their results.
If you are looking for 95% significance and you test something ineffective 20 times, you should expect to get one significant result.
AZ and the Oxford team openly did this this prior to this trial and actually admitted to it in a press conference. In fact they not only released data only from some trials but they only released some of the data from some of the trials.
In the real world, where you look at results from any trial in the context of other trials and available data, these results are not credible.
The AZ, PFE and MRNA vaccines were designed to combat the original virus. PFE and MRNA were over 95% effective in trials where they were tested against only the original strain but only about 90% effective against a mix of the new strains and the old strain that exists now. PFE and MRNA and all vaccines in general are somewhat less effective in over 65s. AZ was only 65% effective against the original strain in a population which included no over 65s in the original trials and the data from these trials were p-hacked and so almost certainly overstated effectiveness. AZ would have you believe that their vaccine is now magically 10% more effective in an environment where the variants are circulating and the 20% of the tested population is over 65. This when, real-world large scale population level data in populations where it's been widely used shows an effectiveness nowhere near that.
Also remember, this is in a context where they have openly, in a press conference admitted to p-hacking. The head of the Oxford team actually, for real, insisted that if the vaccine efficacy is seems significant in a sub-sample of the tested population at any point before the trial endpoint, it's effective even if it's not significant in the entire population at any point or not significant at the endpoint. There is something like a 70% chance that if you used his criteria, a saline injection would seem to be effective.
Long Covid is mostly self reported vague symptoms, namely fatigue and brain fog. It's what happens when you stay at home too much and don't get enough exercise and have a poor diet. Isolation? The Covid 15* that many of us packed on? You will feel worse and especially more fatigued, no doubt.
Not to mention being constantly immersed in an environment of fear. It's a misattribution to associate side effects of weight gain, isolation, depression with the Covid illness.
That's some pretty impressive remote diagnostic capability you have there, have you thought about a career in telemedicine? (Update: This snarky comment is in response to a much more hostile parent comment that has since been changed.)
> It's what happens when you stay at home too much and don't get enough exercise and have a poor diet
While both are risk factors for a wide range of illnesses, last time I checked, neither of those cause lung damage visible on a chest x-ray.
Yesterday I met a woman whose husband has lost his sense of smell for 4+ months and still has not regained it. My lungs still hurt sometimes on deep breaths 6 months later.
We'd have to distinguish between physical symptoms that are well-known long-term effects of viral infections and psychosomatic disorders that may be triggered without any infection whatsoever.
Losing your sense of smell, even permanently, is a known side-effect of Influenza infection:
The same is true for many inflammatory conditions, such as myocarditis.
As for diffuse symptoms that are most likely psychosomatic: Look into ME/CFS. These are patients which may have a very real perception of debilitating symptoms that have no tangible underlying physical cause. There's a lot of misguided activism surrounding the topic, because people don't want to be perceived as having a mental disorder, due to the associated stigma.
Covid isn't influenza and these were verified cases. You seem to be working from a position of motivated reasoning, so I'm going to opt out of trying to convince you.
Indeed, Sars-CoV2 isn't Influenza, but its symptoms are anything but unique to respiratory illnesses and viral infections.
A popular media narrative has arisen, claiming that COVID poses some unique health risks that weren't already facts of life to some degree. This is then used for justifying endless interventions, re-arranging our whole lives around this one new illness.
This can cause panic among the psychologically vulnerable population, causing the very symptoms that are now attributed to "long COVID". I wouldn't phrase it quite as polemically as my flagged cousin, but there is truth to what they are saying.
> You seem to be working from a position of motivated reasoning, so I'm going to opt out of trying to convince you.
I don't even know what you would want convince me of. We probably agree for the most part. Sars-CoV2 isn't Influenza and (in aggregate) it is more dangerous than Influenza. It made everyday life riskier.
We may or may not agree on what an appropriate response to this new risk is. Either way, we both are susceptible to motivated reasoning. That shouldn't prevent us from having a conversation.
It is my understanding that many doctors have found "long covid" to 1. be a thing and 2. have specific, unexpected symptoms. Now it is possible that they are all wrong, but could you perhaps give a few arguments why you are right and all those doctors are wrong?
As for ME/CFS being psychosomatic, that's a bit more controversial, with doctors on either side. Nothing is proven either way. Still, symptoms such as fatigue and brain fog are consistent with ME/CFS.
We like to dismiss such symptoms when it is convenient, e.g. when it occurs as a side-effect of a vaccine, while taking it rather serious when it occurs after some hyped-up new illness such as COVID. In either cases, it could simply be the Nocebo effect at work.
> It's what happens when you stay at home too much and don't get enough exercise and have a poor diet.
Surely this means that "long covid" is not caused by the coronavirus infection itself, but by staying at home too much and a poor diet and not enough exercise. Is that not what this meant?
It is true that many "long covid" symptoms are vague symptoms like fatigue, it also true that many who self-report "long covid" never had a positive COVID test.
It is also true that staying at home and listening to media dramatizations causes stress, which can cause the aforementioned symptoms.
So, if you put two and two together, you may come to the conclusion that many or even most "long covid" cases are psychosomatic and not caused by the virus itself, even in those people who actually were infected.
Like I said, this needs to be differentiated from symptoms that are clinically verifiable long-term effects of respiratory illness and viral infection.
These are the same doctors that we now doubt their competence in when it comes to pausing vaccination with J&J and AZ, or are these doctors somehow more credible?
One of my best friends and his wife have long covid and it has completely wrecked their lives. They had covid 6 months ago and are still incapable of going back to work. My friend was an avid cyclist and his wife was also pretty physically fit.
My friend described to me how hard it was for him to make a grilled chese sandwich and how it required him to take breaks in between taking the things out of the fridge and beginning the grilling. He also described to me how he couldn't even listen to music until recently because he couldn't focus on it.
It is only recently that he can talk to me on the phone for 30 minutes without getting completely exhausted from the mental energy of it.
I have lc. It is borderline crippling. I can barely climb the stairs and terms like "brain fog" are comically inaccurate. Its like being drugged or having something like dementia. I've only somehow managed to barely keep my job by hiding this from my employer. I'm also usually unable to stay away the entire daya and have hard crashes in the afternoon where I must lie down and crash into a weird deep sleep or I might faint standing up. Before this I was active, fit, and generally a high energy person. This also isn't "stress." I won't tell you my life story but I have more mileage on me than most and I've handled serious stress without my entire body falling apart on me.
Secondly, the only thing that has helped was my first dose of pfizer, which made me very sick for a week but since then helped with my symptoms significantly. Its very, very clearly linked to the actual virus and how our immune system reacts to it and I'm guessing things like the vaccine may help our immune system recalibrate itself or help our bodies fight off resident infections we just can't beat.
Thirdly, post-viral effects are well studied. We see them in all sorts of infections like Lyme, SARS, or EBV. This isn't necessarily new, its just different per virus family. Doctors usually can't help because there's no real treatment, and write people up like me as CFS/ME and hope it goes away (which so far thankfully there are a lot of reports of lc going away after a 2nd dose of the vaccine). Lesser so, people without lc still have chronic issues with their lungs, heart, sense of smell, tinitus, etc. Its really all a matter of degree. This isn't the common cold where you just beat it and go back to normal. For many people normal doesnt come back for a long time and how bad it is in the meantime is the big question.
Lastly, I think calling people hysterical from your comfy armchair where you're enjoying good health is tasteless, rude, and ignorant. I hope you never get lc or have to help a loved one with it. I hope you also stay out of the medical field if you have such an ungenerous and anti-compassionate attitude towards sick people.
The fact that you feel like the vaccine helped you makes me suspect your symptoms are not due to covid. Getting covoid will provide the same type of lasting immunity as a vaccine. Moreover, the existence of chronic lyme disease is very dubious.
Again, do you have any data to back this significant claim?
To paraphrase, your thesis is "there is no significant difference in physical and mental health between covid patients and people that have only been suffering the social/economic effects of a quarantine but not contracted covid".
This thesis seems highly verifiable/falsifiable in an empirical way.
Seems short sighted to me given we don't know efficacy against the variants. If I were in the contractual chair I'd keep all my options on the table, we aren't out of this yet.
assuming this is true, as opposed to some kind of way to leverage better terms out of a deal
If I were the chair I'd be looking at how can I subsidize more mRNA production (the whole supply chain, lipids might be a better focus than mRNA itself) so that if variants are a problem we can get more vaccine fast. This will also scale to the net pandemic. This seems to be something close to what they are doing.
Right now adenovirus based vaccines as a rule seem like they need to go back to the lab for a few years.
I would keep options open to other vaccine technologies. There are others out there with some promise. I wouldn't expand on them yet - they haven't delivered, but I'd keep options open and would be ready to change if the real world conditions change.
The EU have options to buy 100 million doses of AZ vaccine for 2022, but they need to make up their minds now if they want them or not.
With AZ's history of not delivering on time I think this is a no-brainer, especially since we don't know if the AZ vaccine will work on the new Covid variants. Why pour more money down the AZ drain when we have better alternatives?
Because it’s a very small amount of money relative to the impact of the pandemic. Even if these vaccines only added 1% to the fight against the pandemic they’d be worth it. This is another expression of the “penny wise, pound foolish” decision-making process that led to the EU being last in lines for the vaccines in the first place.
Someone in the world is going to have a use for these vaccines, buy them and then give them away if you don't need them in the end but in the meantime just book more supply. 18 months from now if the world is flushing COVID-19 vaccines down toilets due to surpluses every dollar will have been worth spending, the downsides are too great.
The problem is that this option is to buy AZ's current vaccine that have a high probability of being ineffective in 18 months. EU is not saying that it won't buy from AZ, but as of now it's not well spent money to buy their current one to be delivered in 18 months. By then all companies will have new better vaccines and the EU would have to fork up a shitload of money on the new AZ vaccine and just write the old of as another loss while the AZ execs get another fat bonus paid by the EU citizens.
> The problem is that this option is to buy AZ's current vaccine that have a high probability of being ineffective in 18 months.
I doubt that is a "high probability" occurrence.
If it does occur and AZ makes a lot of money, I don't care. The EU has many shitloads of money to spend, spread out your bets, go to town, reward every vaccine producer with huge profits, that's what we want, we want all of the companies that bet big on developing products - successful or unsuccessful - to make money off this thing. That way if it happens again they won't be shy about giving it another go!
Isn't AZ selling the vaccine at cost? Won't AZ also have the opportunity to improve their vaccine (or delivery protocol)? Won't more data be available in one year with which to make these decisions?
Regardless of the margins involved, I think it is improbable that AZ would want to produce an obsolete vaccine when those facilities could be producing a better one if they have something ready to go. Its not like everyone involved here is a sociopath, they can put the money down now and renegotiate for a mutually beneficial change to the contract.
The EU was slow off the mark when it came to ordering vaccines and as a result it did not get priority for deliveries. The EU can't change that now, but it can send the manufacturers a message warning of the dangers of not showing fealty.
Perhaps I'm cynical, but I do wonder if this decision is more politics than science.
I think people are possibly reading a bit more into this than necessary. Stripped of context "supplier A delivers ~33% of contracted quantity of thing, other suppliers deliver 100% or more of contracted quantity of thing, supplier A's contract not renewed" is not even a vaguely surprising narrative, even if 'thing' is entirely generic.
In my understanding, the mRNA platform can be used for any application where you want to temporarily express a protein in the body. In the case of these COVID vaccines, it's being used to express the coronavirus spike protein, but Moderna is already using this technology for HIV, flu and others[0]. I believe the applications beyond vaccines are many, too.
It’s pretty much the holy grail for vaccines. It delivers the spike protein via mRNA and the hardest part is the delivery which they’re ironing out with nanolipids (also Moderna biggest IP) during this COVID run. Though I’m an engineer so take everything at face value.
The vaccine only contains the (mRNA) blueprints for the spike protein that cells of the body will then produce themselves. The immune system then reacts to those.
mRNA is a decade in the making, which is why they were able to target/isolate a COVID-19 vaccine is a very short time. Two weeks I believe, someone please correct me.
Even if true (and apparently some German officials are saying it isn't), the contracts go through the end of 2021 is my understanding, so that makes these announcements a bit less significant than the headlines suggests.
To be honest, it seems like there is an argument to be made that the rich countries _should_ stop buying the J&J and AZ vaccines, except perhaps to donate to poorer countries, because the mRNA vaccines are much more challenging for poorer countries to use (multiple doses, refrigeration more challenging). I wonder if the focus on (very rare) side effects is part of an effort to lay the groundwork for doing that without a huge backlash from rich country citizens.
The rich countries shouldn't stop buying they should buy and give away for sure. Not some strings-attached bullshit but just straight-up dropping refrigerated containers of them at airports.
Politics is unfortunately going to get in the way of that.
COVAX is a thing, so there's hope. But even the usual politics aside, it's going to be a hard sell if you can't even get your own population vaccinated quickly and safely.
Also, let's be realistic here - there's more to vaccine distribution than just dropping refrigerated containers of perishable vaccines off. I get the intention of the sentence, but just giving away doses is not in itself a recipe for success or helping people. Helping implementing/building medical infrastructure and expertise out is a gift that will keep on giving.
Giving away vaccines is a necessary if not sufficient condition for success, we can pile on additional conditions to the point of paralysis if we want.. but bottom-line, there are hundreds of millions if not billions of people who want vaccines that can't get them... roll those shots out!
"Never let a good crisis go to waste" as they say - political concessions would be squeezed out of nations needing the vaccine but not able to pay for it. China is doing it, the Eurozone and US are doing it. Everybody is doing it.
> I wonder if the focus on (very rare) side effects is part of an effort to lay the groundwork for doing that without a huge backlash from rich country citizens.
But that focus also undermines the use of these vaccines in poorer countries. Who will want the thing that the rich countries rejected as substandard?
Seems like mRNA vaccines is winning the the race against other emerging technology like viral vector. If we manage to figure out the nanolipids to live in better temperature conditions, mRNA will change our generation.
As I see it, the issue isn't with the University of Pennsylvania but with academia. Publish or perish. Get consistent grants or find a new job. The system isn't geared to promoting long term risky endeavors.
> The system isn't geared to promoting long term risky endeavors.
They made a mistake by trying to follow the obvious path towards progress, and the result proves how wrong they were. The path was deceptive and the straight direction was leading to detours.
This problem appears also in AI. Optimization only works when you can point to the solution. Evolution on the other hand can find these hidden stepping stones that initially don't appear useful, but it takes time.
In my opinion lots of the scientific research is just following the trends instead of finding these hidden stepping stones. Only very few are committed to searching so far from the beaten road.
Im not sure what exactly the criticism of UPenn is here.
Is the criticism that the university mistreated Karikó or set unrealistic expectations?
IS the criticism that the university lacked the foresight to know how valuable her contributions would be 30 years later and didn't adequately support or compensate her?
I don’t know where this idea that untenured university faculty should should not be expected to meet the objectives and and milestones of the university comes from. They took the risk and employed her for 16 years (1989-2005) before she published a groundbreaking study, then another 8 years, before leaving to be a VP at BioNTech. 7 years later, the technology was demonstrated to be incredibly valuable.
Does U Penn deserve no credit for the 24 years of work done by university faculty and researchers in university labs?
We know it's hard to predict the future, and how research might be useful - lasers are a famous example. So yeah, research institutions tying research to the value of the contributions, instead of rewarding quality research is maybe worthy of criticism (but sadly common).
Personally, I'd guess it's the two-faced-ness of it all is a bigger one. Not being supportive, i.e. demoting/blocking tenure for Karikó, while at the same time being happy to patent the research, trying to use it as PR 7 years later (once it was shown to be useful), and potentially strategically omitting details. Just leaves a bad taste behind when you find out about the background. Probably without the PR, there'd be less criticism.
I don't think it was common sense 30 years ago that this technology would eventually pay off.
I imagine things looked pretty grim for the first 24 years the university employed her to work on it with little commercial traction, and the technology was only finally demonstrated due to a freak global pandemic 7 years after that.
The mRNA tech feels like a glimpse of the future, let’s hope they can iron out some of the teething problems (e.g. anaphylactic shock, absurd storage requirements).
> Seems like mRNA vaccines is winning the the race against other emerging technology like viral vector.
But it could very well have failed.
The fact that we have a surfeit of vaccines is something NO ONE predicted. Everybody was just hoping that one of them would work.
In addition, the A/Z and J&J vaccines don't need the same level of cold chain refrigeration that the Moderna and Pfizer ones do.
While in the US and the EU we have the infrastructure to choose between any of the major vaccines, in many places of the world this is not true. It's the A/Z and J&J vaccines or nothing.
From reading local news, the reason seems to be unrelated to clotting complications. Instead it seems to be based on the expected long-term efficacy of non mRNA vaccines.
Seems rather short sighted in my opinion given that the current scientific consensus is that Covid will become a seasonal thing as it mutates which means that booster shots will probably be needed. Given that amount of R&D funds that the two companies have put in I would imagine they would be reluctant to join in efforts to produce a vaccination for future variations.
That doesn't appear to be the case, even if you limit it to "enough for rich countries".
Pfizer is predicting that they will be able to produce 250 million doses month by the end of the year, so I guess they are getting there (depending on how long a period is acceptable).
Just search for Pfizer 3 billion (that's the annual rate they expect to be at by the end of the year).
The population you want to cover and how long it is allowed to take are both factors in whether production is a limit, so there isn't really one answer as to whether production rate is a factor.
If Covid becomes a seasonal thing (very possible), we will need more efficient treatments, too. For everyone who cannot either get the vaccine at all or didn't manage to get the booster shot on time.
Fortunately it seems lately that some treatments do provide relief to people who are already sick:
Long-term availability of mRNA vaccines is looking great (short-term is bad to middling but delivery promises were kept and even over-fulfilled and there were no relevant hiccups – everything is scaling up as quickly or more quickly than promised) and they seem to be the gold standard. Plus, as a bonus, maybe they are easier to modify.
Price and logistics aren’t really a concern that’s relevant for the EU and mRNA vaccines. It’s cheap enough and easy enough to handle.
It's not reserved to German politicians but the EU democracy apparatus as a whole is broken to the core without any better alternative.
Politicians aren't incentivized to optimize for doing what's right for their constituencies or the greater good but instead they say whatever gets them (re)elected then do whatever their lobby friends who contribute to the party's fund tell them to do, while putting a positive spin on this for the great unwashed.
We have no system in place that holds politicians accountable for the damage they do throughout their careers.
Even when they are forced to resign due to various scandals, they often end up as "consultants" at the businesses they helped get rich with tax-payer money.
That statement can be applied to a lot of countries outside of the EU, it is not an EU specific problem. It represents a challenge for western democracies that appeared with the recent waves of populist movements (Trump, Brexit, 5 Stars, etc.)
Uninformed cynicism, however, is the exclusive mantra of online commentating.
The EU is disputing the report in question. And even if it were true, they'd probably have some reason than what you're coming up with in the absence of all information, which is basically "let's kill some people".
The point of this decision is that they think mRNA technology is the future, so they're investing in that. While I don't dispute that lots of EU politics is short sighted, this seems to be the direct opposite.
We don't yet have a clear picture of how necessary booster shots will be.
Each mutation that impacts antibody reactivity also has a chance to impact infectiousness, and the proteins targeted by the vaccines are large enough that it isn't trivial to predict the outcome.
So we might need to do boosters, or we might be fine with the vaccines we have now.
It works, but has inferior efficacy compared to mRNA vaccines.
Same for J&J.
If you have a choice, why get AZ? More over second shot is 3 months away, for mRNA it is at most 42 days away.
J&J has one shot, that has efficacy lower event than AZ.
US is vaccinated mostly using mRNA (because AZ took long to approve and J&J came at that time, but is now blocked).
In my country we have the most amount of Pfizer vaccine, AZ screwed us and didn't deliver so why bother with almost non-existent vaccine that has lower efficacy?
J&J delivered todays some vaccines, but I assume it won't do it anymore as it waits to see what happens with clothing.
It's my understanding that efficacy cannot be directly compared like this, as it's a function of what variants were around during the trial, amongst other things. I believe Vice produced a good video on this recently.
Importantly, don't all vaccines currently authorised have 100% protection against death from COVID-19?
Why not? Funding vaccine research seems a worthy endeavor even if some of the research doesn’t pan out. The end result doesn’t need to be an immediately usable vaccine in order for the time & money spent to be worthwhile. Even a completely failed vaccine project could yield a piece of information that helps ensure the next project doesn’t fail.
Because money is finite? Not every research grant gets funded. So let's start with the most promising ones?
Funding vaccines that are not meeting standards should be dropped so that standards can be met. These companies don't need money for R&D, they have enough and can recoup it if they create a product that the market wants.
There are different levels of research. Right not Adrenovirus vaccines need to go back to the lab and figure out this clotting issue. Maybe they can, maybe they can't, either way this is a basic research question that needs only a tiny amount of research money. More importantly, that money needs to be spread over a few years.
Most of the vast amounts of research funding given isn't really research, it is scaling up production - a much harder problem that needs much more money. Since we now know of some issues (that would be very hard to find before a large scale roll out - lets not put undeserved fault on anyone here) the labs can focus on them.
Both AZ and J&J have been proven effective. They clearly work. It might not be politically expedient for the EU Commission to emphasize that fact, but it is true nevertheless.
They work, but at least AZ is working hard to NOT deliver vaccines to EU. (and sending those manufactured in EU to the UK).
Remember when Italians found 15M vaccines at the factory?
I don't know why AZ representatives aren't prosecuted for such behavior of the company.
So I think it is a good call to wait for the contract to end.
BTW. Work at ~72%, mRNAs are at ~91%. What would you choose if you had both at the table? And what would you choose if you have the 91% at the table and 72% one in the other room?
The 15 million vaccines which the EU and Italy claimed were some secret shipment to the UK without any basis, and actually turned out to be part of their already publicly announced deliveries to the EU and South America (with the latter being vaccines of non-EU origin which they were just packaging)? Those 15 million vaccines? There's been some astoundingly dodgy political narrative-pushing against AZ.
I didn't write it was a secret shipment to the UK.
Just that they have hidden 15M doses, that could be used to protect lives. And considering that they were obligated to provide few M of vaccines to EU countries makes it a good case against AZ.
Is reducing the total amount of vaccines to EU from 500M to 200M in the whole 2021 also a dodgy political narrative against AZ?
Good. But at the same time it should be possible to buy through private channels. So we can circumvent and get rid of the terribly inefficient bureaucrats.
The EU could've issued an export ban for Covid vaccines like the US and UK did but did not want to. There would have been 34 million more doses available until the end of March if they had done it.
But even in these times, the EU rather supports their allies than revert to nationalism. It could pay dividends in the future.
The UK does not formally restrict exports but it didn't export a single dose to the EU despite AZ telling the EU that they would. This lead to the export controls the EU put in place where the EU can forbid exports into countries that don't export themselves. AZ exported 9 million doses into the UK, the UK didn't export a single dose back.
The UK most likely sent them to Australia because Italy blocked AZ exports to Australia.
The AZ doses that the EU did not receive were from plants based in the EU run by European companies fulfilling AZ production. The UK government even invested £55m over a year ago in one such EU-based plant to bring its capacity up after the Dutch government didn't.
I completely agree. USA has been hoarding millions of doses of then unapproved AstraZeneca (in USA) while central Europe was hit so hard my home city was thinking about changing Hockey stadium to giant morgue since they run out of capacity.
UK received millions of dozes of AZ from European factory, it was never the case other way around.
I may be biased, and I would like to be wrong here. Please tell me how USA and UK helped Europe with vaccines, how they did not succumb into deepest nationalism.
I never witness somebody from USA or UK acknowledge this. Only some comment from Canadians being grateful that they receive vaccines from Europe while USA is not exporting any. (I know this changed later and they started export to Mexico)
Well, dugs like vaccines are not sold to private parties. At least in country I know.
EDIT: To clarify, vaccines are not sold without a prescription. At least not that I am aware of and where I life. So for me, a sale to a private party was understood as "you walk in and order it". Obviously you can do that with a prescription. That being said, doctors practices are already administering the Covid shots in the EU. Not as unbeaurocratic as the US so.
They are in Europe. You can go to your family doctor and ask for a flu shot even if you are young and don't get it recommended by default. Same as you can go to your doctor and ask for lots of other vaccines because you want to travel abroad for instance. I paid for many vaccines in private in Austria in order to travel to certain countries. Don't see why I shouldn't be able to pay for a COVID-19 vaccine the same way.
Ah, sure. But the produceris selling to the doctor who is then administering the shot to you. Quite different from you buying the shot for yourself. Without an ordonance from a doctor you wont get a vaccine.
> Without an ordonance from a doctor you wont get a vaccine.
Like many people are trying to explain to you, you're just talking nonsense. You can get many vaccinations commercially without any kind of prescription in most western countries.
Many countries even have commercial chains of shops that do this - for example example here's a price list of a company in the UK.
And you can walk in there and buy it like, say, a bottle of oke? Not without going through a doctor before hand, the same doctor who administers the shot after you picked it up at the pharmacy.
It doesn't have to be the same doctor, but anyway a doctor is not a bureaucrat and buying medicine with a prescription is something that only involves private parties (unless you want to be reimbursed by social security when it exists of course, then social security is obviously involved and it might be public).
If you're advocating for the end of mandatory doctor's prescription for all medicine that's your right, but it's rather doubtful that it would be an improvement over the current system.
Here in the US my doctor is a “private party”. They don’t work for the government, they work at a private business. Nor do I need their involvement to get a vaccine.
The pharmacist at my local grocery store can legally prescribe me a vaccine on the spot at my request, and an assistant can administer it. The pharmacy in my local grocery store is also a private business. For all intents and purposes, yes, I walk into a pharmacy and buy a vaccine.
Here I walk into a pharmacy and say I want a vaccine. They do some paperwork and give it to me. No doctor visit required.
My doctor can give me a vaccine, but it has been a long time since I got mine there. I generally the pharmacy because they give me a discount on some sort of item I'd buy anyway.
Yes, especially for vaccines that are not on a schedule, but given in specific travel circumstances, in many places in Europe you can buy the dose, store it for a few days in your home fridge and then go to a nurse to have it administered (and logged if you need proof).
For many of the vaccines you can just go and buy them and store them yourself without any special permission or prescription. Usually you do not want to do it, simply because it is easier for the immunization clinic to take care of it.
Well yes, that is how you can buy influenenza and many other shots in many many EU countries. I once drove to another country (yo Portugal) to buy a specific vaccine for my sisters kid. Their region had ran out. After getting it from pharma I drove straight to the nurse where they were waiting to get the shot but the kind pharmacist also told me I can store it ik my fridge.
I didn't say anything about the rich. A vaccine costs pounds, everyone can afford it. Only thing preventing you from being covid protected is a random lazy bureaucrat in Brussels.
Bureaucracy, and scarcity. Personal freedom to buy it would be great if there were more than plenty for everyone, but right now they should be given to those who have a much higher risk of severe complications and/or death. Not even the US allows private selling right now.
When dealing with complex dynamical systems (such as markets), you don't get exact answers. You get general phenomena which require intelligence to understand.
But in this case, the answer's very simple, and in my opinion, very obvious: High-risk people value the vaccine more, and allocating a proportion to the open market gives them the option of paying for one instead of having to wait for government permission. This is a first-order effect, not even a second-order effect.
The second-order effect would have been that more people might have been incentivized to create a vaccine if you opened the door for more profits. Right now there are lots of individuals throughout the world who don't have access to a vaccine.
So the fact that the EU will not renew a contract at expiration in favour of other providers is impacting your freedom?
The underlying truth is that a lot of Brits have identified with AZ, and any "attack" to the vaccine feels like a personal attack to their country and their identity to them... You seem to be in that category.
You must be delusional. What's preventing you from being vaccinated is the scarcity of vaccines, and those being allocated to the people that need them most, instead of those that pay the most. If they were sold on the free market the price would rise rapidly above the current price, as demand outnumbers supply by at least an order of magnitude.
Western 'Free markets' are not free at all, and the sale of these vaccines could be regulated to a fixed price.
In the meantime, the state has taken a monopoly on the distribution of these vaccines and has even stopped administering them, so while they are available, they are locked away.
I predict for later this year, we will see news reports of batches of vaccines being safely disposed of ( destroyed ).
I've read that they are doing gene analysis to try and determine why these cases appear - is it gender, age, cross-reactions with other meds, ...? And recall that some of these conditions appear without obvious causes. If they're due to an overly aggressive immune response, recall that the cytokine storm caused by covid in such cases is what attacks the lungs (why immunosuppressants are used as treatments).
And nobody understands Long Covid.