The vaccines | vaxxed boosted unvaxxed? New poll

How's your immunity looking? Had covid - vote twice - vax status and then again for infection status

  • Vaxxed but no booster

  • Boostered

  • Still waiting in queue for first vaccine dose

  • Won't get vaxxed (unless I have to for travel/work etc)

  • Past infection with covid + I've been vaccinated

  • Past infection with covid - I've not been vaccinated


Results are only viewable after voting.

Zlatan 7

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If a vaccine was given to NHS workers and carers that stops you becoming really ill from the virus but you can still become infected and transmit , even to a much lesser degree than being unvaccinated then surely masks , ppe, social distancing and other measures would have to remain in place . Whereas if a vaccine is developed that prevents transmission as well as preventing serious illness we will see the end of such measures.
This is what I was trying to get at but was told it’s a vaccine not a paracetamol so I guess people will be dropping their guard a lot with regards to social distancing and other measures
 

djembatheking

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Absolutely. The only time a vaccine can cause us to change our behaviour will be after the elderly have been vaccinated. Assuming the vaccine is as effective as hoped, that could bring the overall mortality down to a level that is not far off flu. Which would kick off some very interesting public health discussions.
As much as I want to see care workers and NHS protected I also want to see them vaccinated so they can`t transmit so hospitals and care homes become easier environments to control . I hope that they aren`t vaccinated with an unproven, rushed vaccine then unable to be then given a far more efficient one that may be only months away . It could be just the way the UK have bumbled through this that makes me wary of us being the first and only ones to approve so far. Fingers crossed we get it right, time will tell.
 

djembatheking

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This is what I was trying to get at but was told it’s a vaccine not a paracetamol so I guess people will be dropping their guard a lot with regards to social distancing and other measures
I know where you are coming from and I am in agreement . I am all for vaccination and getting life back on track but I am also wary of our leaders decisions. Don`t trust Hancock one bit.
 

Pogue Mahone

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As much as I want to see care workers and NHS protected I also want to see them vaccinated so they can`t transmit so hospitals and care homes become easier environments to control . I hope that they aren`t vaccinated with an unproven, rushed vaccine then unable to be then given a far more efficient one that may be only months away . It could be just the way the UK have bumbled through this that makes me wary of us being the first and only ones to approve so far. Fingers crossed we get it right, time will tell.
Whatever they get won’t be “unproven “. Even allowing for the way this has been fast-tracked I would be 100% confident that the MHRA made certain that the vaccine has been proven to be safe and effective.
 

djembatheking

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Whatever they get won’t be “unproven “. Even allowing for the way this has been fast-tracked I would be 100% confident that the MHRA made certain that the vaccine has been proven to be safe and effective.
Sorry, badly worded, I don`t doubt for a minute it will be proven but meant to try and say not the best it could be.
 

pocco

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It's not strange to have more than one version of a vaccine but it is strange to have so many. Part of the reason we have so many is there was a big pot of gold at the end of the rainbow, but mostly it's because it's a novel virus that needed to be responded to in rapid time. There was no reason to believe that Novavax would work any better than AstraZeneca's vaccine before anyone started the trials, and by the time we had results from human trials there were already over a hundred vaccine candidates in the pipeline.

Right now there's 41 vaccines in phase 1, 17 in phase 2, 13 in phase 3 and 7 in the same stage as Pfizer. There will be a question for some the vaccines in phase 1 whether it's worth moving ahead with the more expensive human trials, now that we know highly effective vaccines arlready exist. All 30 of the companies that are currently in phase 2 and 3 currently didn't know that and until the results were collected and published, there was no reason to believe anyone else's vaccine was better than theirs.

So then it gets onto the question of what does it mean to be better? The main thing they're being judged upon is their efficacy in preventing severe symptoms. That's what the regulators instructed them to focus on and that's what the headline figures have been reporting. We know Pfizer and Moderna are really good at that, Astra Zeneca are also good but it's not clear how good just yet.

Next they're being judged upon their ability to prevent all symptoms, and ideally prevent infection. All companies have tested people if they report symptoms, so we should capture the majority of that first part, but few companies (Astra Zeneca being one) have tested people irrespective of symptoms. Doing regular PCR tests is resource-intensive and as it wasn't required by the regulators to secure approval, most companies have went with the approach of testing for antibodies a few months down the line to check how much it prevents infection.

Somewhere in between those two aspects is the most important remaining practical question: how much does it prevent transmission of the virus? If you aren't infected you can't transmit it, but even if you are infected it is known that some people are less infectious than others. Generally it's thought that asymptomatic transmission is lower than symptomatic transmission, so if these vaccines are highly effective at limiting the symptoms then they will limit transmission. But I don't think anyone has reported any figures on that. Just vague, generally positive statements.

Then the final medical assessment is about its safety profile. What side effects do they have, do they particularly effect some groups more than others, etc. Then you move onto practical considerations like: how much does it cost, how easily is it manufactured, what is the current production capacity, what are the storage and distribution requirements, how many doses are required.

In some senses we know more about those practical considerations than the medical ones. Even after huge trials we still don't know which is the "best" vaccine because it depends on how much weight you apply to each of those medical factors, and because we don't have data for some of those medical factors. That's mostly due to the pace of development but generally it's completely normal to have multiple treatments for a particular disease. If you want to avoid getting malaria for example, you're given a few choices and advised on how effective they are, how suitable they are for someone with your demographic and medical profile, what side effects come with them and how much they cost. You can get the doctor to recommend one but ultimately you can choose one of them.

All of that isn't because pharma companies are greedy but because developing medicine is hard. It's very rare you find something that not only prevents disease but prevents infection, comes with no notable side effects, is equally safe for all people, is easily and cheaply manufactured and stored, and can be done in a single dose.

Vaccines are the best method we've ever invented that do fit most of those medical criteria: they're much safer than most medical treatments, and they're much more effective. Primarily that's because they're forced to go through these massive trials to ensure both of those things. However many vaccines that we develop don't do so well on the practical side of things, at least on the first iteration. They can be hard to manufacture, difficult to transport and store, or impossible to do in just one dose. Which is why even for diseases that we have highly effective vaccines for, decade after decade some companies try to develop new ones that are more practical, while some aim for fewer side effects or increased efficacy.

That's the stage that Novavax and others are at right now. Just because one exists already that does exceptionally well on at least one of those dimensions doesn't mean that it will be better than theirs on all dimensions, and on at least one dimension Novavax is theoretically better: it is adminstered as a single dose. Other vaccines coming down the pipeline might be far better at reducing transmission than any of the current ones. Some existing manufacturing plants are able to create some kinds of vaccines and not others, so even if we re-focused all of our efforts on just Pfizer, we wouldn't be using the maximum production capacity overall and the growth in Pfizer production wouldn't balance that out. Lots of other reasons too.

So essentially no, it's not all driven by greed. They've worked exceptionally quickly and effectively so far and criticising them for how they've gone about things is a bit unfair at this point. Profit motivated them to develop the vaccines but there are many legitimate reasons to continue developing the vaccines.
Ok thanks for the explanation. So, theoretically, if one vaccine turns out to be everything we need it to be, but we needed far quicker production, would rival companies ditch their vaccine to help develop greater quantities of the better vaccine to meet demand? Or are you effectively saying that they are so far down the line in their vaccine that they simply need to recoup money now?

I understand what you're saying that they all acted in everybody's best interest in developing a vaccine quickly. But would they/ could they help develop a better vaccine if it was practically the perfect vaccine and greater quantities were needed? In such an instance, would the company that created the vaccine give others access to help out?

Another question is, say five years down the line it is shown that this will need and annual vaccine like the flu, is it likely by that point we would then only be using the vaccine that proves to be the best and the others will then be redundant?

I don't have any strong feeling either way, I'm just asking this more out of interest and I'm just relieved there are vaccines on the way.
 

Pogue Mahone

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Ok thanks for the explanation. So, theoretically, if one vaccine turns out to be everything we need it to be, but we needed far quicker production, would rival companies ditch their vaccine to help develop greater quantities of the better vaccine to meet demand? Or are you effectively saying that they are so far down the line in their vaccine that they simply need to recoup money now?

I understand what you're saying that they all acted in everybody's best interest in developing a vaccine quickly. But would they/ could they help develop a better vaccine if it was practically the perfect vaccine and greater quantities were needed? In such an instance, would the company that created the vaccine give others access to help out?

Another question is, say five years down the line it is shown that this will need and annual vaccine like the flu, is it likely by that point we would then only be using the vaccine that proves to be the best and the others will then be redundant?

I don't have any strong feeling either way, I'm just asking this more out of interest and I'm just relieved there are vaccines on the way.
The companies won’t “ditch” vaccines but the buyers (i.e. health services) will stop buying them. That’s the way this has always worked. Newer and better medicines come along and the old ones stop being prescribed.

And to answering your other question about pooling resources to develop the “perfect” vaccine, every company thought/hoped that their vaccine would turn out perfect but we needed loads of different vaccines to go into development as nobody knew for certain how any of them would turn out. We’re actually incredibly lucky to have so many getting good results.
 

jojojo

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Ok thanks for the explanation. So, theoretically, if one vaccine turns out to be everything we need it to be, but we needed far quicker production, would rival companies ditch their vaccine to help develop greater quantities of the better vaccine to meet demand? Or are you effectively saying that they are so far down the line in their vaccine that they simply need to recoup money now?

I understand what you're saying that they all acted in everybody's best interest in developing a vaccine quickly. But would they/ could they help develop a better vaccine if it was practically the perfect vaccine and greater quantities were needed? In such an instance, would the company that created the vaccine give others access to help out?

Another question is, say five years down the line it is shown that this will need and annual vaccine like the flu, is it likely by that point we would then only be using the vaccine that proves to be the best and the others will then be redundant?

I don't have any strong feeling either way, I'm just asking this more out of interest and I'm just relieved there are vaccines on the way.
In effect that's what happens in the industry anyway. BioNTech had a core R&D knowledge about mRNA vaccine development but not the manufacturing or trial management capacity, Pfizer had some of the R&D knowledge - enough to know they wanted to partner up with BioNTech, which is what they did. In a year or two, they may be able to produce a version that doesn't rely on -70c cold storage - but some nations want it now, despite the logistical/cost implications.

Novavax again has R&D skills but to get from Phase1/2 even to Phase 3 trials would have been too big a leap without government funding and sales guarantees. Having got that far though they immediately started partnering up with manufacturing sites in Czechoslovakia, Spain, India etc. It's not easy though, the FDA won't even allow them to start their Phase3 trial in the US using vaccine produced in their own (small) factory - they want to see how they're going to make it/test it when it's produced at the Fuji pharmaceutical site in the US, who Novavax plan to use as their US supplier. Because the management of that will become the template for mass production by all contractors.

What there isn't (yet) is a vaccine patent that's been gifted to the WHO so they can offer it to any manufacturer who can make it. The closest we get to that are groups like AstraZeneca promising to offer theirs at cost price to poorer countries and the Bill Gates foundation funding some trials in Africa in return for similar offers of cheap franchises.
 

jojojo

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In other good news from a BBC Radio5 phone-in this morning:

Mum-of-three Jennifer, from St Albans, asks whether Father Christmas will be front of the queue to get the vaccine.

“Oh, absolutely,” Prof Van-Tam replies.

“The JCVI (Joint Committee on Vaccination and Immunisation) made a very special case for Father Christmas and he is absolutely going to be the top of our list.”
 

Tony Babangida

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In other good news from a BBC Radio5 phone-in this morning:

Mum-of-three Jennifer, from St Albans, asks whether Father Christmas will be front of the queue to get the vaccine.

“Oh, absolutely,” Prof Van-Tam replies.

“The JCVI (Joint Committee on Vaccination and Immunisation) made a very special case for Father Christmas and he is absolutely going to be the top of our list.”
He’s pretty old to be fair and looks like a candidate for some comorbidities.
 

Brwned

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Just to correct the detail there. Novavax is a two dose 3-weeks-apart vaccine. I think the only single shot vaccine in Phase 3 is the Johnson and Johnson.

Novavax currently has excellent Phase 1/2 data - better than the mRNA vaccines at producing antibodies. It also has the best animal "challenge test" data, with a test in macaque monkeys that showed it blocked transmission as well as disease. It's a fridge stored vaccine.

Phase 3 is underway, but until it reports no one will know how good it is. Anecdotally, the people running Phase 3 in the UK are pleased with how few side-effects and issues they're seeing, despite it including lots of 60+ and people on other medications. If it works, they may be able to convert it into a combined flu/covid jab - and they're trialling it in some people, with both being given in the same session at the moment.
Appreciate the correction - too many vaccines to remember is good problem to have!

Ok thanks for the explanation. So, theoretically, if one vaccine turns out to be everything we need it to be, but we needed far quicker production, would rival companies ditch their vaccine to help develop greater quantities of the better vaccine to meet demand? Or are you effectively saying that they are so far down the line in their vaccine that they simply need to recoup money now?

I understand what you're saying that they all acted in everybody's best interest in developing a vaccine quickly. But would they/ could they help develop a better vaccine if it was practically the perfect vaccine and greater quantities were needed? In such an instance, would the company that created the vaccine give others access to help out?

Another question is, say five years down the line it is shown that this will need and annual vaccine like the flu, is it likely by that point we would then only be using the vaccine that proves to be the best and the others will then be redundant?

I don't have any strong feeling either way, I'm just asking this more out of interest and I'm just relieved there are vaccines on the way.
Generally speaking yeah there does tend to be one vaccine that just displaces the others. Some are still better for certain subgroups than others (e.g. pregnant women) and some are still more appropriate in some places (e.g. Pfizer might be best but least appropriate in arid, rural areas without the storage capacity). But yeah generally there is a standout one that gets used ahead of all others for most healthy individuals.

Much less common in treatments because they are often trying to prevent very sick people from getting critically ill, so side effects are a much smaller trade off than in healthy populations, in which means they have accelerated development procedures, and because in many ways they are trickier problems there are more new treatments competing at different times.

The various malaria tabs really are a case of choose your poison, if I want to scuba dive I shouldn't take this one as I'm more likely to get nauseous, if I have sleep trouble I don't want this one as it causes weird dream effects, if I want the least side effects I pay the most for this one. That's not uncommon and not an excess of big pharma but just an indication of the struggles to find something that prevents our bodies from doing this crazy things. We've come along way in a few centuries but the viruses and bacteria have a big head start.

And yeah it's possible you could refocus resources and scale up some capacity, but not that easily and it's not a no brainer given the stage of development we're at now, I gather.
 

Salt Bailly

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In other good news from a BBC Radio5 phone-in this morning:

Mum-of-three Jennifer, from St Albans, asks whether Father Christmas will be front of the queue to get the vaccine.

“Oh, absolutely,” Prof Van-Tam replies.

“The JCVI (Joint Committee on Vaccination and Immunisation) made a very special case for Father Christmas and he is absolutely going to be the top of our list.”
White privilege rears its ugly head once again.
 
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In other good news from a BBC Radio5 phone-in this morning:

Mum-of-three Jennifer, from St Albans, asks whether Father Christmas will be front of the queue to get the vaccine.

“Oh, absolutely,” Prof Van-Tam replies.

“The JCVI (Joint Committee on Vaccination and Immunisation) made a very special case for Father Christmas and he is absolutely going to be the top of our list.”
He's elderly, overweight and his diet is awful so would've been near the top anyway
 

Zlatan 7

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Don't let perfection be the enemy of good.
That’s not what he was getting at I don’t think. It was more a question of could you take a ‘better’ vaccine at a later date if you’ve already taken one of the ‘not so good’ earlier vaccines
 

Pexbo

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In other good news from a BBC Radio5 phone-in this morning:

Mum-of-three Jennifer, from St Albans, asks whether Father Christmas will be front of the queue to get the vaccine.

“Oh, absolutely,” Prof Van-Tam replies.

“The JCVI (Joint Committee on Vaccination and Immunisation) made a very special case for Father Christmas and he is absolutely going to be the top of our list.”
Fantastic news. Absolutely no excuse for there not to be presents under the tree this year then.
 

krautrøck

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In other good news from a BBC Radio5 phone-in this morning:

Mum-of-three Jennifer, from St Albans, asks whether Father Christmas will be front of the queue to get the vaccine.

“Oh, absolutely,” Prof Van-Tam replies.

“The JCVI (Joint Committee on Vaccination and Immunisation) made a very special case for Father Christmas and he is absolutely going to be the top of our list.”
Talk about a potential superspreader.
 

prateik

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RoadTrip

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I don’t think there’s any point in reading too much into Fauci’s comments. Is there a risk that the UK rushed the process? Potentially. But there are large consequences of doing so longer term so I can’t imagine they’ve taken a huge risk like that. I’d hope no corners were cut but at the same time, there may well have been but if so, you’d think a balanced risk-reward approach at the very least. Also Fauci can’t really say anything else as that would then question the FDA’s approval process.

I guess the proof will be in the pudding if other countries ultimately approve the drug for use or not.
 

prateik

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When is the UK planning to start vaccinating people? Sometime next week?
The FDA will have their meeting on the 10th.. there is a good chance it is approved in the US as well before people start getting jabs in the UK..
 

Pogue Mahone

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When is the UK planning to start vaccinating people? Sometime next week?
The FDA will have their meeting on the 10th.. there is a good chance it is approved in the US as well before people start getting jabs in the UK..
I know some docs in the UK who are booked in to get injected next week.

On a side note, I’ve heard a rumour about a GP offering vaccine shots to private patients for several thousand quid a go.
 

Sparky Rhiwabon

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What difference will it really make when the FDA approve it next week?
It’s just not the type of thing you want corners cutting on. The UK's boast that we got there quickest because “we're better than other countries” is a bit pathetic to be honest.
 

Bosws87

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Did they get to the bottom of if it stops transmission, because in theory if it does the best group to vaccinate first would be the healthy work force who are out and about travelling day in day out.

The vulnerable (elderly) in particular are at the end of the chain of transmission.
 

Pogue Mahone

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It’s just not the type of thing you want corners cutting on. The UK's boast that we got there quickest because “we're better than other countries” is a bit pathetic to be honest.
But they will be injecting people with the exact same thing that the FDA will approve shortly. Different story entirely if the FDA reject it. I suspect they won’t.
 

carpy

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It’s just not the type of thing you want corners cutting on. The UK's boast that we got there quickest because “we're better than other countries” is a bit pathetic to be honest.
Yes it is but unless the vaccine isn't approved by other countries then I'd imagine the only people who would be put off would be the people who were never going to get vaccinated anyway.
 

Wolverine

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Pfizer vaccine SmPC has been released. Goes by the catchy name of BNT162b2.

Section 5.1 gives the most detail yet on efficacy. Will be all we have until peer reviewed publication.
That's useful.
Dilution process is a bit fiddly. Annoyingly also that not recommended for breast feeders, pregnant patients and requirement to rule out pregnancy in women of child-bearing age.
And the fact that it comes in a batch. But undiluted storable for at 2-8 celcius for 5 days is good for the clinics and up to 2 hours at room temp gives a tight but doable window for home visits/care home jabs.

Still think though that the next UK covid scandal will be how the roll out of these things are fudged up. Not vaccine hesitancy. Too much can go wrong and not enough reassurance or planning for how some very real practical obstacles will be overcome.
 

Pogue Mahone

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That's useful.
Dilution process is a bit fiddly. Annoyingly also that not recommended for breast feeders, pregnant patients and requirement to rule out pregnancy in women of child-bearing age.
And the fact that it comes in a batch. But undiluted storable for at 2-8 celcius for 5 days is good for the clinics and up to 2 hours at room temp gives a tight but doable window for home visits/care home jabs.

Still think though that the next UK covid scandal will be how the roll out of these things are fudged up. Not vaccine hesitancy. Too much can go wrong and not enough reassurance or planning for how some very real practical obstacles will be overcome.
Having to dilute a five dose vial will be a faff too. Will take some coordination to avoid wastage. Especially in GP land.