29 ms·

Good: + ~90% of individuals achieve immunity. + no significant side-effects. Not so good: - two doses needed, 3 weeks apart, immunity after one month from f

Good: + ~90% of individuals achieve immunity. + no significant side-effects. Not so good: - two doses needed, 3 weeks apart, immunity after one month from first dose. Slow rollout. - -80C storage and transport needed. Challenging, but doable in developed countries, but still may slow down mass rollout. Not feasible in many developing countries. I still wonder about long-term immunity. Anyone can share any insight?

selectodude 6y ago
The Ebola vaccine required -80 C storage as well and they got it into literal war zones. It’s a difficult problem, but a solved one.
- FiReaNG3L 6y ago
  Depends on the scale - we are talking mass vaccination of the whole planet here.
  - foolmeonce 6y ago
    Not really, if every airport runs a vaccination program that takes 2 months before someone can fly there's very little need for more global infrastructure. The problem with lockdowns, etc is reinfection mostly by air travellers.
    - rocgf 6y ago
      How could that possibly be the problem? This maybe _was_ the problem in the beginning of the pandemic. Now, it's in the general population and will spread even if you ban all airplanes and repurpose airports into petting zoos.
      - foolmeonce 6y ago
        We already know how to drop the R value in a given place. It is pointlessly expensive to do so for long enough to eliminate the virus in any place that is going to be reconnected to the air network until travellers have a very low chance of infection. Sure some places will find total vaccination the best option, but places with out the infrastructure and money can simply do one lockdown that isn't compromised again by air travel. China is an example that would have left the pandemic if not for the need to resume Air travel.
- danesparza 6y ago
  My understanding is that -80c cold storage isn't widely available. The Ebola outbreak might have shown how to get small numbers of doses into a warzone, but scaling this up might prove to be a logistical difficulty. "Once a provider receives that vaccine, it really starts the clock that the vaccine needs to be administered within five days of when it's put in the refrigerator" Source: https://www.cbsnews.com/news/coronavirus-vaccine-distribution-storage-financial-needs/ https://www.cbsnews.com/news/coronavirus-vaccine-distributio...
  - bluGill 6y ago
    Sure it is. Any small city (> 50,000 people) has someone who can get you liquid nitrogen in far larger quantities than will ever be needed (thus stuff is used for a lot of industrial processes). Put it in a cooler from wal-mart and you have a week. Any you get a week after thawing it to use is anyway, so you don't need the cold storage where the end user is. I don't know what the thawing protocols are of course.
    - chasd00 6y ago
      i'm involved in some state government COVID vaccine projects. The issue is you can't just knock together cold storage like this, there's (naturally) a long process to get "approved" and "certified" for vaccine administration. Storage is one of these criteria, they're not going to hand over a batch of vaccine to some doc with a cooler of dry ice.
      - bluGill 6y ago
        Of course not. they need to ensure the cooler is packed correctly - those standards exist. Those I don't think the doc even needs a fancy cooler, if I understand correctly they need to thaw this first, by the time the individual doc gets it they need to be thawing it and then using it quick. (I don't know what thaw procedures are though)
        deleted 6y ago
        [deleted]
- studius 6y ago
  Ebola was localized. COVID-19 is not. I like your optimism, and what you said isn't incorrect about Ebola at the time, but I don't think it's correct about our current situation. How many locations globally have this level of refrigeration? Given that there would be high demand for it, wouldn't prices on any available refrigerators exceed what even the most altruistic companies and organizations could pay? This still needs to be solved. We have a lot of entrepreneurs, investors, and engineers reading this, so let's not be hasty in hand-waving over something serious.
  - sekai 6y ago
    > Ebola was localized. COVID-19 is not You could easily localize COVID-19, just make a vaccination passport. No entry to a country if you're not vaccinated. > How many locations globally have this level of refrigeration Almost all developer countries, urban centres, where majority of people live anyway.
    - chinathrow 6y ago
      > Almost all developer countries, urban centres, where majority of people live anyway. At -80C? Edit: There are hardly storage places right now for these temperatures. https://www.youtube.com/watch?v=byW1GExQB84 https://www.youtube.com/watch?v=byW1GExQB84
      - bluGill 6y ago
        You can buy dry ice at your local grocery store. You can probably buy a cooler to put it in. And you get a week to use it after thawing, so if there is a break in the supply chain you only need to detect it and announce a vaccination clinic to that area. There might be some small town that gets 100% vaccination early on just because the truck broke down nearby and so local doctors were suddenly called upon to vaccinate their whole town just to use doses that couldn't be shipped any farther.
        nemothekid 6y ago
        The linked video claims Pfizer has a similar solution and the currently tested parameters limit the cooler can only be opened 2x per day, and not more than 1 minute at a time, and the box only lasts 10 days, and carries doses in multiple of 1000s. A breakdown scenario in a rural area could mean 1000s of wasted doses
- ksk 6y ago
  While you may call it a 'solved' problem, in reality, its a problem that every single pharma company in the world wants to avoid, due to the high costs and other challenges. Source: I work in vaccines, and our company works on thermostable formulations, among other things.
lbeltrame 6y ago
The latest data (preprint, not peer reviewed etc etc) mention memory B and T cells up to 8 months after recovery from the illness. This means that an immunity of one year is probably likely. This would be probably enough to quench the spread, but not to eradicate the virus.
- deleted 6y ago
  [deleted]
- bufferoverflow 6y ago
  I think we can eradicate it by contact tracing. With 90% efficiency it will be extremely tough for the virus to spread. For any new cases you simply test everyone in the vicinity of the infected person. But I don't think even that will be necessary. 90% efficiency reduces R so much, it will probably die out on its own. The real problem is mutations that are not covered by the vaccine. If it mutates as efficiently as flu, it will be a challenge.
  - garethrowlands 6y ago
    Corona viruses cannot mutate as efficiently as flu. They are very different beasts.
    - thelittleone 6y ago
      17 million mink culled in Denmark for mutated Covid which was passed on to humans. https://www.reuters.com/article/us-health-coronavirus-denmark-mink-factb-idUSKBN27M2L4 https://www.reuters.com/article/us-health-coronavirus-denmar...
      - dboreham 6y ago
        "as efficiently"
      - lbeltrame 6y ago
        This vaccine targets the entire spike protein. It is very difficult, from an evolutionary point of view (very high affinity for the ACE2 receptor), that the spike protein would change so much that the vaccine would be completely ineffective.
sambeau 6y ago
+ ~90% of individuals achieve immunity It could also refer to 90% reduced severity. A 60% vaccine can reduce the severity of the illness by 40% so only 40% of the expected number end up in hospital.
- MichaelApproved 6y ago
  I thought it was that 90% show production of antibodies.
  - comicjk 6y ago
    No, they showed an antibody response in the spring. That's the easy part. This is the real-deal clinical trial: they gave tens of thousands of people the vaccine candidate, tens of thousands a placebo, and then counted the resulting cases for months, as well as watching for side effects. The 90% reduction is in actual cases.
- pmachinery 6y ago
  The first line of the article states: "The first effective coronavirus vaccine can prevent more than 90% of people from getting Covid-19, a preliminary analysis shows."
  - bluGill 6y ago
    Problem is it is all from a press release. They can mangle words to be correct but very misleading. We will have to wait for the scientific paper which will take some time.
  - sambeau 6y ago
    They say that every time they talk about vaccines but if you look at articles like this: https://www.cdc.gov/flu/prevent/misconceptions.htm https://www.cdc.gov/flu/prevent/misconceptions.htm and this https://www.cdc.gov/flu/prevent/vaccine-benefits.htm https://www.cdc.gov/flu/prevent/vaccine-benefits.htm you'll see that that's not how it always works. > Flu vaccination can reduce the risk of flu-associated hospitalization for children, working age adults, and older adults.
hairytrog 6y ago
Developing countries have youth immunity. When you convolve covid hospitalization / IFR as function of age with age distribution, developing countries have no risk whatsoever from COVID. that's why Brazil and India are nearing herd immunity with basically no serious medical infrastructure saturation. Median age in Africa is 19... No fks given. Covid vaccine is just for old people/developing countries.
- AQXt 6y ago
  > that's why Brazil and India are nearing herd immunity with basically no serious medical infrastructure saturation. [citation needed]
- ciceryadam 6y ago
  Coronavirus: Overwhelmed India hospitals turn Covid patients away. Hospitals in the country are struggling to cope with the number of patients they’re getting. Many are dying without getting the treatment they need. https://www.bbc.com/news/av/world-asia-india-53014213 https://www.bbc.com/news/av/world-asia-india-53014213
gen220 6y ago
I believe that temperature is achievable with fairly simply-insulated dry ice containers, in situations where mechanical cooling is not feasible. https://www.nytimes.com/2020/09/18/business/coronavirus-covid-vaccine-cold-frozen-logistics.html https://www.nytimes.com/2020/09/18/business/coronavirus-covi... I guess you should invest in dry ice manufacturing companies!
- jp555 6y ago
  dry ice manufacturing companies? Do You mean the Co2 supply chain? We make a lot of carbonated beverages; there will likely be no shortage.
  - bluGill 6y ago
    There is a glut in the CO2 supply - it is a byproduct of several industrial processes. (even before carbon capture for environmental reasons.)
- andylynch 6y ago
  Yes. Pfizer have published info on their logistics, there are details in the wall st journal. Basic idea is a little box of ~1000 doses goes in a big box filled with enough dry ice for up to ten days. Average delivery time will be around 3. edit: See https://www.wsj.com/articles/pfizer-sets-up-its-biggest-ever-vaccination-distribution-campaign-11603272614 https://www.wsj.com/articles/pfizer-sets-up-its-biggest-ever...
snarf21 6y ago
This is good news but I'm worried about the mutation already showing up in minks in Denmark. Minks apparently have a near identical respiratory system. https://www.nbcnews.com/news/world/denmark-plans-kill-15-million-minks-after-coronavirus-mutation-spreads-n1246445 https://www.nbcnews.com/news/world/denmark-plans-kill-15-mil...
- procinct 6y ago
  Fortunately it sounds very contained. All cases (fewer than 15) were confined to a single location and there haven’t been any more detected since September. So most likely the mutation is now extinct.
  - plutonorm 6y ago
    Let's see how this comment ages. I give it 50-50
    - procinct 6y ago
      I’m not saying anything with certainty. However, a lot of work has been expended in trying to contain this cluster and currently this is how it looks with the data we currently have.
      - sideshowb 6y ago
        It's not just this cluster though. If it happens once it could happen again and we may not notice the next until it's too late. So here's hoping the vaccine catches all likely mutations too...
  - deleted 6y ago
    [deleted]
- DataGata 6y ago
  Hence the genociding.
DanBC 6y ago
Also not so good: this is a corporate press release. The data will come later.
- alisonkisk 6y ago
  That seems wrong. The data probably came first, but in less popular publications.
  - deleted 6y ago
    [deleted]
- corobo 6y ago
  At least this one has a decent looking 'n' value. The BBC also address this in part > There are still questions - how long does immunity last, does the vaccine work as well in high-risk elderly people, does it stop you spreading the virus or just from developing symptoms? I'd rate the news as "vibing" on a scale of clickbait to party for the world
  - sologoub 6y ago
    The current n=94. The real n=43.5k data apparently will come later. Article doesn’t specify when, but “hopes” to have enough of the larger n analyzed to submit to regulators by 3rd week of November.
    - peter422 6y ago
      No, 43.5k is the number of people in the trial and 94 is the number of confirmed COVID cases within the entire population. The trial will be complete from an effectiveness perspective once there are ~150-200 cases. Safety is a different story and may take more time to wait for side effects.
      - sologoub 6y ago
        > However, the data presented is not the final analysis as it is based on only the first 94 volunteers to develop Covid so the precise effectiveness of the vaccine may change when the full results are analysed. Thanks! Misread the 94, but the n=43.5k is also misleading since they have not analyzed all of the results and duration of the study vs exposure risk is still tbd. If the 94 participants that got COVID also abided by all the other precautions, such as masks, etc, then it stands to reason that the actual infection rate in the population approximating pre-covid behaviors may also be higher.
berdario 6y ago
How does this compare to the chinese vaccine? It's already in use around the world[1], but I haven't heard of how many people gain immunity thanks to it in percentage, nor if that one also requires multiple jabs. 1. https://www.aljazeera.com/news/2020/11/3/uae-pm-and-dubai-ruler-receives-coronavirus-vaccine https://www.aljazeera.com/news/2020/11/3/uae-pm-and-dubai-ru...
- tasogare 6y ago
  > chinese vaccine Yeah sure, let’s trust the scientists that let the virus leaked in the first place... Russian vaccine is also one I wouldn’t touch with a pole.
- bluGill 6y ago
  Who knows. This is the first to track and announce scientific results. It may be better or worse, we don't know. Maybe numbers are being kept and we can figure out in a few years. Maybe the Chinese are not keeping track in any way and we will never know.
  - berdario 6y ago
    I looked a bit further, and they shared data on their vaccine already in August, but there are gaps: https://www.fiercebiotech.com/biotech/sinopharm-shares-phase-2-data-inactivated-covid-19-vaccine https://www.fiercebiotech.com/biotech/sinopharm-shares-phase... "unlike other COVID-19 vaccine trials, the study lacked a comparison arm featuring serum samples from patients previously infected with the coronavirus, complicating the task of interpreting whether the response is likely to confer immunity." It seems that a vaccine needing a 2nd booster jab is also something that is quite common. Anyhow, good news all around... The more viable vaccines we have, the more likely that the pandemic will be controlled sooner.
- dehrmann 6y ago
  Or the Russian one /s
deleted 6y ago
[deleted]
m3kw9 6y ago
Not so good: Safety data is for 2 months only
- asdfman123 6y ago
  One point they made on NPR is that it's hard to imagine any sort of vaccine that would be as harmful as the virus itself, which is killing 1000 people per day.
  - greenburger 6y ago
    The issue is that a vaccine would be given to billions of people, whereas the virus is only infecting hundreds of thousands per day. Because vaccines are given to healthy people that may never be exposed to the disease the bar for safety is different.
_ph_ 6y ago
Fortunately, it isn't the only vaccine in the pipeline. Curevac, another German company located pretty close to BioNTech, is also working on a similar vaccine which can be cooled in normal fridges, so is easier to roll out. They supposedly are only a few months behind. The -80c storage should be no showstopper for all densely populated regions and these are where the vaccine is most urgently needed. Over time, there will be easier to handle alternatives or we just build more deep-freezers.
- tachyonbeam 6y ago
  There's many vaccines in development, even some to be available as nasal sprays and oral vaccines. I'm hopeful that by the end of this year, we'll get 1 or 2 more vaccines successfully completing Phase 3, and then several more in 2021.
tzs 6y ago
Another good point: not developed using fetal stem cells. That makes no scientific difference, but there are a fair number of people in the US who will not use a vaccine if it is developed that way.
asperous 6y ago
Given the unbelievably aggressive timeframe that this vaccine was developed under, it'a still a huge achievement
bmmayer1 6y ago
Long term protection will be achieved by a significant % of the population being vaccinated at any given time, yielding herd immunity. Exciting news for the world!
cashsterling 6y ago
-80C storage is an issue, you are definitely right, but it is a common requirement for many biological samples and protein-based drug therapies. -80C lab freezers are not that expensive and all over the place. I used to work in biotech and, at one company, all of our intermediate drug substance storage was -80C. we had freezers big enough to drive a forklift into; one such a freezer could store millions of doses... and we had several. There are numerous companies which specialize in -80C transport and shipping. These containers can be used as temporary (3-7 day) storage at destinations where they do not have infrastructure. So this vaccine can be distributed to regions with the infrastructure to store it and we can preserve vaccines with less stringent requirement for developing countries, etc.
- TearsInTheRain 6y ago
  > There are numerous companies which specialize in -80C transport and shipping. These containers can be used as temporary (3-7 day) storage at destinations where they do not have infrastructure. But what kind of capacity can they handle? I imagine the scale of a Covid vaccine rollout would overhelm prior existing infrastructure
  - bluGill 6y ago
    There are a lot of other things that need this treatment. There is also limited ability to make doses. If you don't already have the infrastructure in place, then you will get notified when you shipment is arriving, and you get a few days to administer it. You schedule everyone who will get a dose for their shot and they are in and out quickly. If it takes more than half a day to use up their entire shipment it is because some dosages are reserved for 3rd shift and will be administered 12 hours later. Then repeat 3 weeks latter. Of course larger institutions already have everything in place and will get shipments with less warning (but they will also get smaller shipments since they don't have to get everyone done at once)
- Negitivefrags 6y ago
  Could you name some of the companies? Are any of them public?
hedora 6y ago
Also bad: What did they use to stabilize the mRNA? If they’re managing to do it with just temperature and maybe glycerol, that’s great. If it’s RNAlater, then that’s going to have safety issues. If it’s something else, how was the additive tested for long term safety? (Vaccines like this have been in the works for a long time. There has been time for safety studies.) Edit: RNAlater MSDS sheet: https://tools.thermofisher.com/content/sfs/msds/2012/AM7020_MTR-APLT_BE.pdf https://tools.thermofisher.com/content/sfs/msds/2012/AM7020_...
- JohnJamesRambo 6y ago
  What is wrong with RNAlater? Seems like it is just EDTA and Sodium Citrate and Ammonium Sulfate. https://www.protocols.io/view/RNAlater-Recipe-c56y9d https://www.protocols.io/view/RNAlater-Recipe-c56y9d
- hundchenkatze 6y ago
  I don't read safety sheets often so I'm likely off base here, so please correct me if I'm wrong. My interpretation is that when used correctly it's safe. Section 2 states it is non-hazardous. Section 4 states it is not expected to present a significant ingestion/inhalation hazard under anticipated conditions of normal use. Finally, Section 11 indicates that the Ammonium compounds present in RNALater may be harmful, but only when they are administered at LD50 concentrations.
- IAmGraydon 6y ago
  If you’re trying to spread misinformation, the HN crowd is going to be a difficult target. You might want to check in over at Reddit instead. Critical thinking isn’t really their forte.
justanotherme 6y ago
In my opinion this sounds extremely good. They say that 94 people got covid. We do not know how many of them were from the placebo group and how many were from the vaccinated group. But the wording "was found to be more than 90% effective" probably means that much more than 85 of the covid-patients came from the placebo group. The reason is that they need to be a few standard deviations away from the mean to make such assumptions with high probability. I think probably at most 2 patients of the 94 covid-patients came from the vaccinated group (only then you could make such a statement with high certainty). And that means that probably the vaccine is more than 97% effective. This would be extremely good news. But let's wait for the data.
DCKing 6y ago
The complexity of the distribution of such a vaccine on such a large scale will be a major bottleneck in a return to a society without imposed pandemic measures. A much less sexy and more human bottleneck, which permits of far more classes of failure of getting the virus to people well. The distribution is important work which we will see being the subject of much criticism. I hope everybody can keep their expectations in check. Getting working vaccines is incredibly important, but this is just the first step. There are no easy fixes - we'll be in this situation for the foreseeable future.
scottlamb 6y ago
> - two doses needed, 3 weeks apart, immunity after one month from first dose. Slow rollout. Yeah, this alone is bad news. Last year my parents got a two-dose shingles vaccine. The two doses are supposed to be separated by two to six months. My parents struggled to find their second doses in the window. Apparently there was limited supply and no one had the foresight to reserve second doses when people received their first, or even to prioritize second doses over first. The covid vaccine will have much more demand and apparently a tighter window, and our health system isn't exactly well-coordinated right now, so I anticipate a lot of people will be unable to get the second dose with the proper timing.
- DrBazza 6y ago
  I'm curious, which country is this? In the UK, the NHS are generally on top of things like this, so it should not happen in most cases.
  - scottlamb 6y ago
    US. I believe they got these vaccines through pharmacy chains like Walgreens or CVS. This is one of several ways people get vaccines here—it's common for seasonal flu shots especially to be available at employers (medical staff travel from one employer to the next) and pharmacies (sometimes even grocery stores with in-store pharmacies) in addition to the general practitioners' regular clinics. I think for the first dose they got it wherever was convenient—probably the pharmacy where/when they were picking up a prescription—and for the second they looked everywhere for months.
- yreg 6y ago
  It will be an incredible challenge, but there is at least some economy of scale on our side. Wendover did a nice video[0] on this topic month ago, explaining how UPS/FedEx/DHL/… are already massively upscaling their cold chain infrastructure. Retrofitting planes, building giant freezers in transport hubs. [0] The Greatest Logistics Challenge Ever - https://www.youtube.com/watch?v=byW1GExQB84 https://www.youtube.com/watch?v=byW1GExQB84
topbanana 6y ago
My understanding is that the -80C storage is most likely simply because they haven't tested at higher temperatures yet.
- alexfromapex 6y ago
  Probably due to DNA storage because I used to work with genomics and we had the same temps
  - asdff 6y ago
    RNA* You can leave DNA out on your bench for a month and it will be fine.
- refurb 6y ago
  I'm highly skeptical. Needing -80C is a major disadvantage. Pfizer would have collected stability data at higher temperatures if they could get it. The fact it's -80C means they can't prove it stable at higher temperatures.
3327 6y ago
The study is suspect end points. I cannot elaborate - too long. I will let the virologist PHDs weigh in here to take this point forward. Tldr: i have a team in a top institution. There are gaps and the news is TGTBT.
- tempestn 6y ago
  What's the point of even commenting if you're too busy to so much as string together a few coherent sentences?
MichaelMoser123 6y ago
For how long do the vaccines remain effective? I couldn't get any predictions on that. Some links that might be relevant: https://edition.cnn.com/2020/10/27/health/russia-coronavirus-vaccine-sputnik-v-reality-check/index.html https://edition.cnn.com/2020/10/27/health/russia-coronavirus... Moderna vaccine requires storage at -20 °C Sputnik V at -18 °C; so that would be easier to handle. https://www.ndtv.com/world-news/after-pfizer-russia-says-its-covid-vaccine-sputnik-v-over-90-effective-2322904 https://www.ndtv.com/world-news/after-pfizer-russia-says-its... 90% effectiveness says the Russian vaccine Sputnik V https://www.globaltimes.cn/content/1206008.shtml https://www.globaltimes.cn/content/1206008.shtml "No infections among 56,000 people who traveled abroad after receiving Sinopharm-developed COVID-19 vaccine" https://www.jpost.com/health-science/hadassah-bringing-15-million-doses-of-russian-covid-19-vaccine-to-israel-648093 https://www.jpost.com/health-science/hadassah-bringing-15-mi... Israel is bying Russian vaccine shots, the head of Hadassah hospital says there is quite a lot of power politics involved in the discourse (Hadassah is one of the major hospitals in Israel) https://www.berliner-zeitung.de/wirtschaft-verantwortung/corona-impfung-wer-zahlt-fuer-moegliche-schaeden-li.101215 https://www.berliner-zeitung.de/wirtschaft-verantwortung/cor... (in German) for the EU some producers of COVID vaccines got an exemption clause for liabilities, they say because of very tight development schedules (says an unnamed speaker of the European Comission)
- RobertDeNiro 6y ago
  These are the most difficult numbers to have because the vaccine and trials are still only a few months old.
robot 6y ago
no significant side-effects _for now_.
- tempestn 6y ago
  The mechanism of action is known, so potential side effects are largely predictable. I'm not an expert, but I don't see any reason to think there would be unexpected long term side effects from this sort of vaccination. Is there reason to think otherwise?
  - ksk 6y ago
    There is always some effect whenever any foreign molecule is injected in your blood. Simply knowing ONE 'mechanism of action' doesn't tell you the 'mechanism of reaction' or all the other cross reactions that happen. It also doesn't tell you what will happen when some one is already on medication for other health issues. The body is simply too complex to many any definitive statement like that. So there are many reasons to think otherwise, but the simplest one is - Every single medication and vaccine that we've ever made has known side-effects. Not all side-effects are known right off the bat, and many take years to detect.
    - tempestn 6y ago
      Do you have any examples of a vaccine that's had side effects not show up for years after it went into use? I'm not saying there hasn't been—I really don't know.
      - ksk 6y ago
        Aside - I re-read my earlier comment and I don't mean to come off as a crazy anti-vax person! I work in vaccines, but I can't think of a vaccine that was completely recalled due to long-term safety issues of the top of my head. Most recalls happen because one lot or the other had some production issues. Certainly, vaccines are extremely safe by the time they get approved - because the approval process is careful, methodical and takes years. However, in this case, if a COVID vaccine is approved by the end of this year or in the near-term, we won't have any long-term data, and so I do worry about those aspects, about the compounds used in the final formulation as well as the untested nature of RNA/DNA based vaccines. A few places to do research for those interested: https://vaers.hhs.gov/data/datasets.html https://vaers.hhs.gov/data/datasets.html? https://www.fda.gov/vaccines-blood-biologics/safety-availability-biologics/recalls-biologics https://www.fda.gov/vaccines-blood-biologics/safety-availabi...
tboyd47 6y ago
Incomplete: - Trial is only halfway complete. - Preliminary results have not been peer-reviewed.
devy 6y ago
> I still wonder about long-term immunity. The current understanding is that there will be likely no long-term immunity, just like the flu virus (as it mutates). > -80 Degree Celsius storage and transport needed. This is actually typical for vaccines storage/transportation needs. Unfortunately this will also means that it cannot be easily distributed into developing countries where supply chain requirements are largely unmet.
yurlungur 6y ago
One other factor to consider is that this is an mRNA vaccine, which is of a newer generation of technology in vaccine production. From what I've read it is the first large scale adoption of mRNA vaccines so the really long term risks are less known. That said, theoretically mRNA vaccines should have a lot of advantages. Later in 2021 there may be a few other options for vaccines to take as well, so I'd do some research at least.
zamalek 6y ago
> Good: ~90% of individuals achieve immunity. As far as I recall, the high R0 of COVID-19 meant that >90% was needed for herd immunity. You then also have to factor anti-vaxxers into the equation. It's a good stop-gap for the 90% who develop immunity, but we need a better vaccine even in developed countries.
- anoncake 6y ago
  Estimates for herd immunity are between 20-80%.
  - zamalek 6y ago
    Thanks for the correction.
Animats 6y ago
-80C is dry ice (frozen CO2) temperature. So you can carry vaccine vials around in a cooler with a block of dry ice. Pfizer has a dry ice shipping container good for 10 days. FedEx can ship that. Then the vaccine can be stored at refrigerator temperature for maybe 5 days. Dry Ice costs maybe $3/Kg. The SF bay area has dry ice delivery.[1] Lagos, Nigeria has dry ice delivery.[2] Bismark, North Dakota has a dry ice plant.[3] It's not hard to get. Coolers for holding items in dry ice are about $100 on Alibaba.[4] This doesn't look like a big problem. [1] https://bensdryice.com/ https://bensdryice.com/ [2] https://www.businesslist.com.ng/company/256889/greatsmith-resources-ltd https://www.businesslist.com.ng/company/256889/greatsmith-re... [3] http://www.dryiceweb.com/Praxair/Bismarck_ND.htm http://www.dryiceweb.com/Praxair/Bismarck_ND.htm [4] https://www.alibaba.com/product-detail/Vaccine-Carrier-Biomedical-Cooler-Box-For_1600052419210.html https://www.alibaba.com/product-detail/Vaccine-Carrier-Biome...
- rrrrrrrrrrrryan 6y ago
  It's still more difficult and expensive than the alternative. It's not a big deal for the first world, but poorer nations may hold out for future vaccines that remain stable at higher temperatures and only require a single dose.
  - Animats 6y ago
    Base technology first, then convenience features. Merck is working on a one-dose pill, but that's not expected before mid-2021. There's micro encapsulation for vaccines.[1][2] The vulnerable active molecule can be put inside a coating that is stable in storage but dissolves after injection. [1] https://www.academia.edu/33376119/Microencapsulation_of_Vaccine_Antigens_and_Adjuvants_for_Mucosal_Targeting https://www.academia.edu/33376119/Microencapsulation_of_Vacc... [2] https://www.sciencedirect.com/topics/immunology-and-microbiology/microencapsulation https://www.sciencedirect.com/topics/immunology-and-microbio...
  - abhiminator 6y ago
    >but poorer nations may hold out for future vaccines that remain stable at higher temperatures and only require a single dose. Valid point, but I feel there's never been a better time for massively pushing this vaccine (after proper testing and regulatory approval, of course) to medium/low income countries. Winter should make it much easier in managing the temperature range stability required for storing/shipping the vaccine, especially in countries around the equatorial region. Doing it in late spring/summer will not be a good idea (assuming a better vaccine doesn't come out by then).
fspeech 6y ago
Note it is at least 90%. Case number is likely too low to give a tighter estimate with high enough confidence. That is, even if no one vaccinated is infected they still can't claim a much higher effectiveness with confidence as there are only 94 cases. So they are giving just a lower bound.
johnisgood 6y ago
How do we know that there are no significant long-term side-effects? These vaccines seem to be developed so quickly while others take years or even decades... I do not know if this is irrational fear, but I fear that this is rushed and there might be potentially serious side-effects that are missed. Why am I being down-voted? Is it really of no concern?
- deleted 6y ago
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- apostacy 6y ago
  I for one agree with you. There is no rush to get vaccinated. Personally, I doubt I will get it at all. The authorities have a very long way to go to win back my trust, after the chain of screwups over the last year. We've seen that they will lie to us, we've seen that they apply rules to us that they themselves don't follow, and we've seen them take advantage of the situation for their own benefit. It is a huge shame that so many people are not going to take it solely because they've betrayed our trust so many times that now that they might be doing something good, we won't cooperate.
  - johnisgood 6y ago
    You are getting down-voted too by people who do not even bother replying, probably some blind followers, government-loving NPCs. You know how you could turn this against them to make them think twice about it? Get the Russian vaccines, or the Chinese. Yeah, do it! Suddenly they are not so keen... Now imagine if their beloved State made it mandatory to get Russian vaccines inside them. They would most likely be against it, and our votes would not be down... It is not even the votes I give a damn about, but the fact that we do not know THAT much of COVID-19 but people seem to believe the claims that we have extremely safe vaccines ready just within a few months. Yeah, they say that of the Russian vaccines, too, are you going to take it, down-voter? Would you like the State to make it mandatory for your kid to get vaccinated? I am curious. My entire family tested positive for COVID-19, and my grandma most likely has it. None of us has/had symptoms. I do not want to get vaccinated. If you (not you, the down-voters) really care, go get vaccinated by the Russian vaccines. My country plans to vaccinate the elderly, kids, and people with chronic diseases first, then the rest of the population. I really, really wonder how many people are going to have FORESEEABLE side-effects. I think they are also planning to make it mandatory. P.S. I am not an anti-vaxxer, but these claims by pharmaceutical companies sound shady as heck. If they said they found the vaccine after 5 days and they claim it is super safe because 5 people did not die from it within 10 days, would it make you OK the vaccine? Come on. My problem is that. It is too quick, and too many promises of lack of side-effects, and lots of financial interest. For that I do not believe them. We (medical workers) even have to lie about people dying from COVID-19 so we (the hospital) get more funding. How about that? Governments put price control on the tests, which resulted in zero competition as it was not worth it for private businesses to continue testing. How about that?
m1aw 6y ago
About the logistical part. Wendover did on Youtube a really great video explaining the cold chain in international shipping and what companies are already doing to be ready for it. https://www.youtube.com/watch?v=byW1GExQB84 https://www.youtube.com/watch?v=byW1GExQB84
throwaway9d0291 6y ago
> -80C storage and transport needed. Challenging, but doable in developed countries, but still may slow down mass rollout. Not feasible in many developing countries. True but it's also a bit more complicated than that. The YouTube channel Wendover Productions has a great video on the subject: https://www.youtube.com/watch?v=byW1GExQB84 https://www.youtube.com/watch?v=byW1GExQB84 (skip to 5:01 for the talk about the cold chain). TL;DW, there are other factors: - Whether the hospital is able to maintain the vaccine at the required temperature (many, especially the smaller ones, don't have the equipment) - This is medical technology and unproven options (like buying a random box off Alibaba like someone suggested) are unlikely to be used - Pfizer (vaccine in TFA) has developed a shipment container that uses dry ice and lasts 10 days but it can only be opened twice a day, for less than a minute at a time, so facilities administering vaccines need to be able to accurately predict how many they'll administer in a given day - Pfizer's box is only built for multiples of a thousand doses and only lasts 10 days so isn't well-suited to smaller areas that can't administer 1000 vaccines in 10 days
- Kliment 6y ago
  This is all true but is missing some important detail - the box (shipment container suggests shipping container sized things, it's more of a flight case size thing) is meant for long distance transport, rather than local distribution. It holds the vaccines at -80C for ten days, and can be refilled with dry ice (which is widely available anywhere that has a carbonated drinks industry) to extend that period. The ten days is how long it's expected to be in continuous transit, worst-case. The vaccine must be thawed before use, and can be stored in a regular freezer for a few days, just not indefinitely. Since the transport cases are reusable, and don't need to be completely populated, what will likely happen in rural areas is that they'll have a case for shipment, refill it with dry ice on site, and use a second case to transport a small number of doses to the point of use. Repeat until used up, refilling with dry ice every few days at a central location (less than a week's travel from administration sites). I don't think it's going to be a major problem in practice.
bayesian_horse 6y ago
Only time will tell. But usually, vaccines will induce longer immunity than the real diseases themselves because they have been optimized for immunogenicity. There will be no eradication of the virus, certainly not world-wide, short of multiple waves of vaccinations. Not even with one type of vaccine, but more likely more than one. Some of the developing world might get vaccinated with a cheaper, more traditional vaccine, but later. But there is no good vreason why you can't have huge vaccination campaigns with cooling trucks at least in their bigger cities.
azerf 6y ago
ttest

selectodude 6y ago

The Ebola vaccine required -80 C storage as well and they got it into literal war zones. It’s a difficult problem, but a solved one.

FiReaNG3L 6y ago
Depends on the scale - we are talking mass vaccination of the whole planet here.
- foolmeonce 6y ago
  Not really, if every airport runs a vaccination program that takes 2 months before someone can fly there's very little need for more global infrastructure. The problem with lockdowns, etc is reinfection mostly by air travellers.
  - rocgf 6y ago
    How could that possibly be the problem? This maybe _was_ the problem in the beginning of the pandemic. Now, it's in the general population and will spread even if you ban all airplanes and repurpose airports into petting zoos.
    - foolmeonce 6y ago
      We already know how to drop the R value in a given place. It is pointlessly expensive to do so for long enough to eliminate the virus in any place that is going to be reconnected to the air network until travellers have a very low chance of infection. Sure some places will find total vaccination the best option, but places with out the infrastructure and money can simply do one lockdown that isn't compromised again by air travel. China is an example that would have left the pandemic if not for the need to resume Air travel.
danesparza 6y ago
My understanding is that -80c cold storage isn't widely available. The Ebola outbreak might have shown how to get small numbers of doses into a warzone, but scaling this up might prove to be a logistical difficulty. "Once a provider receives that vaccine, it really starts the clock that the vaccine needs to be administered within five days of when it's put in the refrigerator" Source: https://www.cbsnews.com/news/coronavirus-vaccine-distribution-storage-financial-needs/ https://www.cbsnews.com/news/coronavirus-vaccine-distributio...
- bluGill 6y ago
  Sure it is. Any small city (> 50,000 people) has someone who can get you liquid nitrogen in far larger quantities than will ever be needed (thus stuff is used for a lot of industrial processes). Put it in a cooler from wal-mart and you have a week. Any you get a week after thawing it to use is anyway, so you don't need the cold storage where the end user is. I don't know what the thawing protocols are of course.
  - chasd00 6y ago
    i'm involved in some state government COVID vaccine projects. The issue is you can't just knock together cold storage like this, there's (naturally) a long process to get "approved" and "certified" for vaccine administration. Storage is one of these criteria, they're not going to hand over a batch of vaccine to some doc with a cooler of dry ice.
    - bluGill 6y ago
      Of course not. they need to ensure the cooler is packed correctly - those standards exist. Those I don't think the doc even needs a fancy cooler, if I understand correctly they need to thaw this first, by the time the individual doc gets it they need to be thawing it and then using it quick. (I don't know what thaw procedures are though)
      - deleted 6y ago
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studius 6y ago
Ebola was localized. COVID-19 is not. I like your optimism, and what you said isn't incorrect about Ebola at the time, but I don't think it's correct about our current situation. How many locations globally have this level of refrigeration? Given that there would be high demand for it, wouldn't prices on any available refrigerators exceed what even the most altruistic companies and organizations could pay? This still needs to be solved. We have a lot of entrepreneurs, investors, and engineers reading this, so let's not be hasty in hand-waving over something serious.
- sekai 6y ago
  > Ebola was localized. COVID-19 is not You could easily localize COVID-19, just make a vaccination passport. No entry to a country if you're not vaccinated. > How many locations globally have this level of refrigeration Almost all developer countries, urban centres, where majority of people live anyway.
  - chinathrow 6y ago
    > Almost all developer countries, urban centres, where majority of people live anyway. At -80C? Edit: There are hardly storage places right now for these temperatures. https://www.youtube.com/watch?v=byW1GExQB84 https://www.youtube.com/watch?v=byW1GExQB84
    - bluGill 6y ago
      You can buy dry ice at your local grocery store. You can probably buy a cooler to put it in. And you get a week to use it after thawing, so if there is a break in the supply chain you only need to detect it and announce a vaccination clinic to that area. There might be some small town that gets 100% vaccination early on just because the truck broke down nearby and so local doctors were suddenly called upon to vaccinate their whole town just to use doses that couldn't be shipped any farther.
      - nemothekid 6y ago
        The linked video claims Pfizer has a similar solution and the currently tested parameters limit the cooler can only be opened 2x per day, and not more than 1 minute at a time, and the box only lasts 10 days, and carries doses in multiple of 1000s. A breakdown scenario in a rural area could mean 1000s of wasted doses
ksk 6y ago
While you may call it a 'solved' problem, in reality, its a problem that every single pharma company in the world wants to avoid, due to the high costs and other challenges. Source: I work in vaccines, and our company works on thermostable formulations, among other things.

lbeltrame 6y ago

The latest data (preprint, not peer reviewed etc etc) mention memory B and T cells up to 8 months after recovery from the illness. This means that an immunity of one year is probably likely. This would be probably enough to quench the spread, but not to eradicate the virus.

deleted 6y ago
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bufferoverflow 6y ago
I think we can eradicate it by contact tracing. With 90% efficiency it will be extremely tough for the virus to spread. For any new cases you simply test everyone in the vicinity of the infected person. But I don't think even that will be necessary. 90% efficiency reduces R so much, it will probably die out on its own. The real problem is mutations that are not covered by the vaccine. If it mutates as efficiently as flu, it will be a challenge.
- garethrowlands 6y ago
  Corona viruses cannot mutate as efficiently as flu. They are very different beasts.
  - thelittleone 6y ago
    17 million mink culled in Denmark for mutated Covid which was passed on to humans. https://www.reuters.com/article/us-health-coronavirus-denmark-mink-factb-idUSKBN27M2L4 https://www.reuters.com/article/us-health-coronavirus-denmar...
    - dboreham 6y ago
      "as efficiently"
    - lbeltrame 6y ago
      This vaccine targets the entire spike protein. It is very difficult, from an evolutionary point of view (very high affinity for the ACE2 receptor), that the spike protein would change so much that the vaccine would be completely ineffective.

sambeau 6y ago

+ ~90% of individuals achieve immunity It could also refer to 90% reduced severity. A 60% vaccine can reduce the severity of the illness by 40% so only 40% of the expected number end up in hospital.

MichaelApproved 6y ago
I thought it was that 90% show production of antibodies.
- comicjk 6y ago
  No, they showed an antibody response in the spring. That's the easy part. This is the real-deal clinical trial: they gave tens of thousands of people the vaccine candidate, tens of thousands a placebo, and then counted the resulting cases for months, as well as watching for side effects. The 90% reduction is in actual cases.
pmachinery 6y ago
The first line of the article states: "The first effective coronavirus vaccine can prevent more than 90% of people from getting Covid-19, a preliminary analysis shows."
- bluGill 6y ago
  Problem is it is all from a press release. They can mangle words to be correct but very misleading. We will have to wait for the scientific paper which will take some time.
- sambeau 6y ago
  They say that every time they talk about vaccines but if you look at articles like this: https://www.cdc.gov/flu/prevent/misconceptions.htm https://www.cdc.gov/flu/prevent/misconceptions.htm and this https://www.cdc.gov/flu/prevent/vaccine-benefits.htm https://www.cdc.gov/flu/prevent/vaccine-benefits.htm you'll see that that's not how it always works. > Flu vaccination can reduce the risk of flu-associated hospitalization for children, working age adults, and older adults.

hairytrog 6y ago

Developing countries have youth immunity. When you convolve covid hospitalization / IFR as function of age with age distribution, developing countries have no risk whatsoever from COVID. that's why Brazil and India are nearing herd immunity with basically no serious medical infrastructure saturation. Median age in Africa is 19... No fks given. Covid vaccine is just for old people/developing countries.

AQXt 6y ago
> that's why Brazil and India are nearing herd immunity with basically no serious medical infrastructure saturation. [citation needed]
ciceryadam 6y ago
Coronavirus: Overwhelmed India hospitals turn Covid patients away. Hospitals in the country are struggling to cope with the number of patients they’re getting. Many are dying without getting the treatment they need. https://www.bbc.com/news/av/world-asia-india-53014213 https://www.bbc.com/news/av/world-asia-india-53014213

gen220 6y ago

I believe that temperature is achievable with fairly simply-insulated dry ice containers, in situations where mechanical cooling is not feasible. https://www.nytimes.com/2020/09/18/business/coronavirus-covid-vaccine-cold-frozen-logistics.html https://www.nytimes.com/2020/09/18/business/coronavirus-covi... I guess you should invest in dry ice manufacturing companies!

jp555 6y ago
dry ice manufacturing companies? Do You mean the Co2 supply chain? We make a lot of carbonated beverages; there will likely be no shortage.
- bluGill 6y ago
  There is a glut in the CO2 supply - it is a byproduct of several industrial processes. (even before carbon capture for environmental reasons.)
andylynch 6y ago
Yes. Pfizer have published info on their logistics, there are details in the wall st journal. Basic idea is a little box of ~1000 doses goes in a big box filled with enough dry ice for up to ten days. Average delivery time will be around 3. edit: See https://www.wsj.com/articles/pfizer-sets-up-its-biggest-ever-vaccination-distribution-campaign-11603272614 https://www.wsj.com/articles/pfizer-sets-up-its-biggest-ever...

snarf21 6y ago

This is good news but I'm worried about the mutation already showing up in minks in Denmark. Minks apparently have a near identical respiratory system. https://www.nbcnews.com/news/world/denmark-plans-kill-15-million-minks-after-coronavirus-mutation-spreads-n1246445 https://www.nbcnews.com/news/world/denmark-plans-kill-15-mil...

procinct 6y ago
Fortunately it sounds very contained. All cases (fewer than 15) were confined to a single location and there haven’t been any more detected since September. So most likely the mutation is now extinct.
- plutonorm 6y ago
  Let's see how this comment ages. I give it 50-50
  - procinct 6y ago
    I’m not saying anything with certainty. However, a lot of work has been expended in trying to contain this cluster and currently this is how it looks with the data we currently have.
    - sideshowb 6y ago
      It's not just this cluster though. If it happens once it could happen again and we may not notice the next until it's too late. So here's hoping the vaccine catches all likely mutations too...
- deleted 6y ago
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DataGata 6y ago
Hence the genociding.

DanBC 6y ago

Also not so good: this is a corporate press release. The data will come later.

alisonkisk 6y ago
That seems wrong. The data probably came first, but in less popular publications.
- deleted 6y ago
  [deleted]
corobo 6y ago
At least this one has a decent looking 'n' value. The BBC also address this in part > There are still questions - how long does immunity last, does the vaccine work as well in high-risk elderly people, does it stop you spreading the virus or just from developing symptoms? I'd rate the news as "vibing" on a scale of clickbait to party for the world
- sologoub 6y ago
  The current n=94. The real n=43.5k data apparently will come later. Article doesn’t specify when, but “hopes” to have enough of the larger n analyzed to submit to regulators by 3rd week of November.
  - peter422 6y ago
    No, 43.5k is the number of people in the trial and 94 is the number of confirmed COVID cases within the entire population. The trial will be complete from an effectiveness perspective once there are ~150-200 cases. Safety is a different story and may take more time to wait for side effects.
    - sologoub 6y ago
      > However, the data presented is not the final analysis as it is based on only the first 94 volunteers to develop Covid so the precise effectiveness of the vaccine may change when the full results are analysed. Thanks! Misread the 94, but the n=43.5k is also misleading since they have not analyzed all of the results and duration of the study vs exposure risk is still tbd. If the 94 participants that got COVID also abided by all the other precautions, such as masks, etc, then it stands to reason that the actual infection rate in the population approximating pre-covid behaviors may also be higher.

berdario 6y ago

How does this compare to the chinese vaccine? It's already in use around the world[1], but I haven't heard of how many people gain immunity thanks to it in percentage, nor if that one also requires multiple jabs. 1. https://www.aljazeera.com/news/2020/11/3/uae-pm-and-dubai-ruler-receives-coronavirus-vaccine https://www.aljazeera.com/news/2020/11/3/uae-pm-and-dubai-ru...

tasogare 6y ago
> chinese vaccine Yeah sure, let’s trust the scientists that let the virus leaked in the first place... Russian vaccine is also one I wouldn’t touch with a pole.
bluGill 6y ago
Who knows. This is the first to track and announce scientific results. It may be better or worse, we don't know. Maybe numbers are being kept and we can figure out in a few years. Maybe the Chinese are not keeping track in any way and we will never know.
- berdario 6y ago
  I looked a bit further, and they shared data on their vaccine already in August, but there are gaps: https://www.fiercebiotech.com/biotech/sinopharm-shares-phase-2-data-inactivated-covid-19-vaccine https://www.fiercebiotech.com/biotech/sinopharm-shares-phase... "unlike other COVID-19 vaccine trials, the study lacked a comparison arm featuring serum samples from patients previously infected with the coronavirus, complicating the task of interpreting whether the response is likely to confer immunity." It seems that a vaccine needing a 2nd booster jab is also something that is quite common. Anyhow, good news all around... The more viable vaccines we have, the more likely that the pandemic will be controlled sooner.
dehrmann 6y ago
Or the Russian one /s

deleted 6y ago

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m3kw9 6y ago

Not so good: Safety data is for 2 months only

asdfman123 6y ago
One point they made on NPR is that it's hard to imagine any sort of vaccine that would be as harmful as the virus itself, which is killing 1000 people per day.
- greenburger 6y ago
  The issue is that a vaccine would be given to billions of people, whereas the virus is only infecting hundreds of thousands per day. Because vaccines are given to healthy people that may never be exposed to the disease the bar for safety is different.

_ph_ 6y ago

Fortunately, it isn't the only vaccine in the pipeline. Curevac, another German company located pretty close to BioNTech, is also working on a similar vaccine which can be cooled in normal fridges, so is easier to roll out. They supposedly are only a few months behind. The -80c storage should be no showstopper for all densely populated regions and these are where the vaccine is most urgently needed. Over time, there will be easier to handle alternatives or we just build more deep-freezers.

tachyonbeam 6y ago
There's many vaccines in development, even some to be available as nasal sprays and oral vaccines. I'm hopeful that by the end of this year, we'll get 1 or 2 more vaccines successfully completing Phase 3, and then several more in 2021.

tzs 6y ago

Another good point: not developed using fetal stem cells. That makes no scientific difference, but there are a fair number of people in the US who will not use a vaccine if it is developed that way.

asperous 6y ago

Given the unbelievably aggressive timeframe that this vaccine was developed under, it'a still a huge achievement

bmmayer1 6y ago

Long term protection will be achieved by a significant % of the population being vaccinated at any given time, yielding herd immunity. Exciting news for the world!

cashsterling 6y ago

-80C storage is an issue, you are definitely right, but it is a common requirement for many biological samples and protein-based drug therapies. -80C lab freezers are not that expensive and all over the place. I used to work in biotech and, at one company, all of our intermediate drug substance storage was -80C. we had freezers big enough to drive a forklift into; one such a freezer could store millions of doses... and we had several. There are numerous companies which specialize in -80C transport and shipping. These containers can be used as temporary (3-7 day) storage at destinations where they do not have infrastructure. So this vaccine can be distributed to regions with the infrastructure to store it and we can preserve vaccines with less stringent requirement for developing countries, etc.

TearsInTheRain 6y ago
> There are numerous companies which specialize in -80C transport and shipping. These containers can be used as temporary (3-7 day) storage at destinations where they do not have infrastructure. But what kind of capacity can they handle? I imagine the scale of a Covid vaccine rollout would overhelm prior existing infrastructure
- bluGill 6y ago
  There are a lot of other things that need this treatment. There is also limited ability to make doses. If you don't already have the infrastructure in place, then you will get notified when you shipment is arriving, and you get a few days to administer it. You schedule everyone who will get a dose for their shot and they are in and out quickly. If it takes more than half a day to use up their entire shipment it is because some dosages are reserved for 3rd shift and will be administered 12 hours later. Then repeat 3 weeks latter. Of course larger institutions already have everything in place and will get shipments with less warning (but they will also get smaller shipments since they don't have to get everyone done at once)
Negitivefrags 6y ago
Could you name some of the companies? Are any of them public?

hedora 6y ago

Also bad: What did they use to stabilize the mRNA? If they’re managing to do it with just temperature and maybe glycerol, that’s great. If it’s RNAlater, then that’s going to have safety issues. If it’s something else, how was the additive tested for long term safety? (Vaccines like this have been in the works for a long time. There has been time for safety studies.) Edit: RNAlater MSDS sheet: https://tools.thermofisher.com/content/sfs/msds/2012/AM7020_MTR-APLT_BE.pdf https://tools.thermofisher.com/content/sfs/msds/2012/AM7020_...

JohnJamesRambo 6y ago
What is wrong with RNAlater? Seems like it is just EDTA and Sodium Citrate and Ammonium Sulfate. https://www.protocols.io/view/RNAlater-Recipe-c56y9d https://www.protocols.io/view/RNAlater-Recipe-c56y9d
hundchenkatze 6y ago
I don't read safety sheets often so I'm likely off base here, so please correct me if I'm wrong. My interpretation is that when used correctly it's safe. Section 2 states it is non-hazardous. Section 4 states it is not expected to present a significant ingestion/inhalation hazard under anticipated conditions of normal use. Finally, Section 11 indicates that the Ammonium compounds present in RNALater may be harmful, but only when they are administered at LD50 concentrations.
IAmGraydon 6y ago
If you’re trying to spread misinformation, the HN crowd is going to be a difficult target. You might want to check in over at Reddit instead. Critical thinking isn’t really their forte.

justanotherme 6y ago

In my opinion this sounds extremely good. They say that 94 people got covid. We do not know how many of them were from the placebo group and how many were from the vaccinated group. But the wording "was found to be more than 90% effective" probably means that much more than 85 of the covid-patients came from the placebo group. The reason is that they need to be a few standard deviations away from the mean to make such assumptions with high probability. I think probably at most 2 patients of the 94 covid-patients came from the vaccinated group (only then you could make such a statement with high certainty). And that means that probably the vaccine is more than 97% effective. This would be extremely good news. But let's wait for the data.

DCKing 6y ago

The complexity of the distribution of such a vaccine on such a large scale will be a major bottleneck in a return to a society without imposed pandemic measures. A much less sexy and more human bottleneck, which permits of far more classes of failure of getting the virus to people well. The distribution is important work which we will see being the subject of much criticism. I hope everybody can keep their expectations in check. Getting working vaccines is incredibly important, but this is just the first step. There are no easy fixes - we'll be in this situation for the foreseeable future.

scottlamb 6y ago

> - two doses needed, 3 weeks apart, immunity after one month from first dose. Slow rollout. Yeah, this alone is bad news. Last year my parents got a two-dose shingles vaccine. The two doses are supposed to be separated by two to six months. My parents struggled to find their second doses in the window. Apparently there was limited supply and no one had the foresight to reserve second doses when people received their first, or even to prioritize second doses over first. The covid vaccine will have much more demand and apparently a tighter window, and our health system isn't exactly well-coordinated right now, so I anticipate a lot of people will be unable to get the second dose with the proper timing.

DrBazza 6y ago
I'm curious, which country is this? In the UK, the NHS are generally on top of things like this, so it should not happen in most cases.
- scottlamb 6y ago
  US. I believe they got these vaccines through pharmacy chains like Walgreens or CVS. This is one of several ways people get vaccines here—it's common for seasonal flu shots especially to be available at employers (medical staff travel from one employer to the next) and pharmacies (sometimes even grocery stores with in-store pharmacies) in addition to the general practitioners' regular clinics. I think for the first dose they got it wherever was convenient—probably the pharmacy where/when they were picking up a prescription—and for the second they looked everywhere for months.
yreg 6y ago
It will be an incredible challenge, but there is at least some economy of scale on our side. Wendover did a nice video[0] on this topic month ago, explaining how UPS/FedEx/DHL/… are already massively upscaling their cold chain infrastructure. Retrofitting planes, building giant freezers in transport hubs. [0] The Greatest Logistics Challenge Ever - https://www.youtube.com/watch?v=byW1GExQB84 https://www.youtube.com/watch?v=byW1GExQB84

topbanana 6y ago

My understanding is that the -80C storage is most likely simply because they haven't tested at higher temperatures yet.

alexfromapex 6y ago
Probably due to DNA storage because I used to work with genomics and we had the same temps
- asdff 6y ago
  RNA* You can leave DNA out on your bench for a month and it will be fine.
refurb 6y ago
I'm highly skeptical. Needing -80C is a major disadvantage. Pfizer would have collected stability data at higher temperatures if they could get it. The fact it's -80C means they can't prove it stable at higher temperatures.

3327 6y ago

The study is suspect end points. I cannot elaborate - too long. I will let the virologist PHDs weigh in here to take this point forward. Tldr: i have a team in a top institution. There are gaps and the news is TGTBT.

tempestn 6y ago
What's the point of even commenting if you're too busy to so much as string together a few coherent sentences?

MichaelMoser123 6y ago

For how long do the vaccines remain effective? I couldn't get any predictions on that. Some links that might be relevant: https://edition.cnn.com/2020/10/27/health/russia-coronavirus-vaccine-sputnik-v-reality-check/index.html https://edition.cnn.com/2020/10/27/health/russia-coronavirus... Moderna vaccine requires storage at -20 °C Sputnik V at -18 °C; so that would be easier to handle. https://www.ndtv.com/world-news/after-pfizer-russia-says-its-covid-vaccine-sputnik-v-over-90-effective-2322904 https://www.ndtv.com/world-news/after-pfizer-russia-says-its... 90% effectiveness says the Russian vaccine Sputnik V https://www.globaltimes.cn/content/1206008.shtml https://www.globaltimes.cn/content/1206008.shtml "No infections among 56,000 people who traveled abroad after receiving Sinopharm-developed COVID-19 vaccine" https://www.jpost.com/health-science/hadassah-bringing-15-million-doses-of-russian-covid-19-vaccine-to-israel-648093 https://www.jpost.com/health-science/hadassah-bringing-15-mi... Israel is bying Russian vaccine shots, the head of Hadassah hospital says there is quite a lot of power politics involved in the discourse (Hadassah is one of the major hospitals in Israel) https://www.berliner-zeitung.de/wirtschaft-verantwortung/corona-impfung-wer-zahlt-fuer-moegliche-schaeden-li.101215 https://www.berliner-zeitung.de/wirtschaft-verantwortung/cor... (in German) for the EU some producers of COVID vaccines got an exemption clause for liabilities, they say because of very tight development schedules (says an unnamed speaker of the European Comission)

RobertDeNiro 6y ago
These are the most difficult numbers to have because the vaccine and trials are still only a few months old.

robot 6y ago

no significant side-effects _for now_.

tempestn 6y ago
The mechanism of action is known, so potential side effects are largely predictable. I'm not an expert, but I don't see any reason to think there would be unexpected long term side effects from this sort of vaccination. Is there reason to think otherwise?
- ksk 6y ago
  There is always some effect whenever any foreign molecule is injected in your blood. Simply knowing ONE 'mechanism of action' doesn't tell you the 'mechanism of reaction' or all the other cross reactions that happen. It also doesn't tell you what will happen when some one is already on medication for other health issues. The body is simply too complex to many any definitive statement like that. So there are many reasons to think otherwise, but the simplest one is - Every single medication and vaccine that we've ever made has known side-effects. Not all side-effects are known right off the bat, and many take years to detect.
  - tempestn 6y ago
    Do you have any examples of a vaccine that's had side effects not show up for years after it went into use? I'm not saying there hasn't been—I really don't know.
    - ksk 6y ago
      Aside - I re-read my earlier comment and I don't mean to come off as a crazy anti-vax person! I work in vaccines, but I can't think of a vaccine that was completely recalled due to long-term safety issues of the top of my head. Most recalls happen because one lot or the other had some production issues. Certainly, vaccines are extremely safe by the time they get approved - because the approval process is careful, methodical and takes years. However, in this case, if a COVID vaccine is approved by the end of this year or in the near-term, we won't have any long-term data, and so I do worry about those aspects, about the compounds used in the final formulation as well as the untested nature of RNA/DNA based vaccines. A few places to do research for those interested: https://vaers.hhs.gov/data/datasets.html https://vaers.hhs.gov/data/datasets.html? https://www.fda.gov/vaccines-blood-biologics/safety-availability-biologics/recalls-biologics https://www.fda.gov/vaccines-blood-biologics/safety-availabi...

tboyd47 6y ago

Incomplete: - Trial is only halfway complete. - Preliminary results have not been peer-reviewed.

devy 6y ago

> I still wonder about long-term immunity. The current understanding is that there will be likely no long-term immunity, just like the flu virus (as it mutates). > -80 Degree Celsius storage and transport needed. This is actually typical for vaccines storage/transportation needs. Unfortunately this will also means that it cannot be easily distributed into developing countries where supply chain requirements are largely unmet.

yurlungur 6y ago

One other factor to consider is that this is an mRNA vaccine, which is of a newer generation of technology in vaccine production. From what I've read it is the first large scale adoption of mRNA vaccines so the really long term risks are less known. That said, theoretically mRNA vaccines should have a lot of advantages. Later in 2021 there may be a few other options for vaccines to take as well, so I'd do some research at least.

zamalek 6y ago

> Good: ~90% of individuals achieve immunity. As far as I recall, the high R0 of COVID-19 meant that >90% was needed for herd immunity. You then also have to factor anti-vaxxers into the equation. It's a good stop-gap for the 90% who develop immunity, but we need a better vaccine even in developed countries.

anoncake 6y ago
Estimates for herd immunity are between 20-80%.
- zamalek 6y ago
  Thanks for the correction.

Animats 6y ago

-80C is dry ice (frozen CO2) temperature. So you can carry vaccine vials around in a cooler with a block of dry ice. Pfizer has a dry ice shipping container good for 10 days. FedEx can ship that. Then the vaccine can be stored at refrigerator temperature for maybe 5 days. Dry Ice costs maybe $3/Kg. The SF bay area has dry ice delivery.[1] Lagos, Nigeria has dry ice delivery.[2] Bismark, North Dakota has a dry ice plant.[3] It's not hard to get. Coolers for holding items in dry ice are about $100 on Alibaba.[4] This doesn't look like a big problem. [1] https://bensdryice.com/ https://bensdryice.com/ [2] https://www.businesslist.com.ng/company/256889/greatsmith-resources-ltd https://www.businesslist.com.ng/company/256889/greatsmith-re... [3] http://www.dryiceweb.com/Praxair/Bismarck_ND.htm http://www.dryiceweb.com/Praxair/Bismarck_ND.htm [4] https://www.alibaba.com/product-detail/Vaccine-Carrier-Biomedical-Cooler-Box-For_1600052419210.html https://www.alibaba.com/product-detail/Vaccine-Carrier-Biome...

rrrrrrrrrrrryan 6y ago
It's still more difficult and expensive than the alternative. It's not a big deal for the first world, but poorer nations may hold out for future vaccines that remain stable at higher temperatures and only require a single dose.
- Animats 6y ago
  Base technology first, then convenience features. Merck is working on a one-dose pill, but that's not expected before mid-2021. There's micro encapsulation for vaccines.[1][2] The vulnerable active molecule can be put inside a coating that is stable in storage but dissolves after injection. [1] https://www.academia.edu/33376119/Microencapsulation_of_Vaccine_Antigens_and_Adjuvants_for_Mucosal_Targeting https://www.academia.edu/33376119/Microencapsulation_of_Vacc... [2] https://www.sciencedirect.com/topics/immunology-and-microbiology/microencapsulation https://www.sciencedirect.com/topics/immunology-and-microbio...
- abhiminator 6y ago
  >but poorer nations may hold out for future vaccines that remain stable at higher temperatures and only require a single dose. Valid point, but I feel there's never been a better time for massively pushing this vaccine (after proper testing and regulatory approval, of course) to medium/low income countries. Winter should make it much easier in managing the temperature range stability required for storing/shipping the vaccine, especially in countries around the equatorial region. Doing it in late spring/summer will not be a good idea (assuming a better vaccine doesn't come out by then).

fspeech 6y ago

Note it is at least 90%. Case number is likely too low to give a tighter estimate with high enough confidence. That is, even if no one vaccinated is infected they still can't claim a much higher effectiveness with confidence as there are only 94 cases. So they are giving just a lower bound.

johnisgood 6y ago

How do we know that there are no significant long-term side-effects? These vaccines seem to be developed so quickly while others take years or even decades... I do not know if this is irrational fear, but I fear that this is rushed and there might be potentially serious side-effects that are missed. Why am I being down-voted? Is it really of no concern?

deleted 6y ago
[deleted]
apostacy 6y ago
I for one agree with you. There is no rush to get vaccinated. Personally, I doubt I will get it at all. The authorities have a very long way to go to win back my trust, after the chain of screwups over the last year. We've seen that they will lie to us, we've seen that they apply rules to us that they themselves don't follow, and we've seen them take advantage of the situation for their own benefit. It is a huge shame that so many people are not going to take it solely because they've betrayed our trust so many times that now that they might be doing something good, we won't cooperate.
- johnisgood 6y ago
  You are getting down-voted too by people who do not even bother replying, probably some blind followers, government-loving NPCs. You know how you could turn this against them to make them think twice about it? Get the Russian vaccines, or the Chinese. Yeah, do it! Suddenly they are not so keen... Now imagine if their beloved State made it mandatory to get Russian vaccines inside them. They would most likely be against it, and our votes would not be down... It is not even the votes I give a damn about, but the fact that we do not know THAT much of COVID-19 but people seem to believe the claims that we have extremely safe vaccines ready just within a few months. Yeah, they say that of the Russian vaccines, too, are you going to take it, down-voter? Would you like the State to make it mandatory for your kid to get vaccinated? I am curious. My entire family tested positive for COVID-19, and my grandma most likely has it. None of us has/had symptoms. I do not want to get vaccinated. If you (not you, the down-voters) really care, go get vaccinated by the Russian vaccines. My country plans to vaccinate the elderly, kids, and people with chronic diseases first, then the rest of the population. I really, really wonder how many people are going to have FORESEEABLE side-effects. I think they are also planning to make it mandatory. P.S. I am not an anti-vaxxer, but these claims by pharmaceutical companies sound shady as heck. If they said they found the vaccine after 5 days and they claim it is super safe because 5 people did not die from it within 10 days, would it make you OK the vaccine? Come on. My problem is that. It is too quick, and too many promises of lack of side-effects, and lots of financial interest. For that I do not believe them. We (medical workers) even have to lie about people dying from COVID-19 so we (the hospital) get more funding. How about that? Governments put price control on the tests, which resulted in zero competition as it was not worth it for private businesses to continue testing. How about that?

m1aw 6y ago

About the logistical part. Wendover did on Youtube a really great video explaining the cold chain in international shipping and what companies are already doing to be ready for it. https://www.youtube.com/watch?v=byW1GExQB84 https://www.youtube.com/watch?v=byW1GExQB84

throwaway9d0291 6y ago

> -80C storage and transport needed. Challenging, but doable in developed countries, but still may slow down mass rollout. Not feasible in many developing countries. True but it's also a bit more complicated than that. The YouTube channel Wendover Productions has a great video on the subject: https://www.youtube.com/watch?v=byW1GExQB84 https://www.youtube.com/watch?v=byW1GExQB84 (skip to 5:01 for the talk about the cold chain). TL;DW, there are other factors: - Whether the hospital is able to maintain the vaccine at the required temperature (many, especially the smaller ones, don't have the equipment) - This is medical technology and unproven options (like buying a random box off Alibaba like someone suggested) are unlikely to be used - Pfizer (vaccine in TFA) has developed a shipment container that uses dry ice and lasts 10 days but it can only be opened twice a day, for less than a minute at a time, so facilities administering vaccines need to be able to accurately predict how many they'll administer in a given day - Pfizer's box is only built for multiples of a thousand doses and only lasts 10 days so isn't well-suited to smaller areas that can't administer 1000 vaccines in 10 days

Kliment 6y ago
This is all true but is missing some important detail - the box (shipment container suggests shipping container sized things, it's more of a flight case size thing) is meant for long distance transport, rather than local distribution. It holds the vaccines at -80C for ten days, and can be refilled with dry ice (which is widely available anywhere that has a carbonated drinks industry) to extend that period. The ten days is how long it's expected to be in continuous transit, worst-case. The vaccine must be thawed before use, and can be stored in a regular freezer for a few days, just not indefinitely. Since the transport cases are reusable, and don't need to be completely populated, what will likely happen in rural areas is that they'll have a case for shipment, refill it with dry ice on site, and use a second case to transport a small number of doses to the point of use. Repeat until used up, refilling with dry ice every few days at a central location (less than a week's travel from administration sites). I don't think it's going to be a major problem in practice.

bayesian_horse 6y ago

Only time will tell. But usually, vaccines will induce longer immunity than the real diseases themselves because they have been optimized for immunogenicity. There will be no eradication of the virus, certainly not world-wide, short of multiple waves of vaccinations. Not even with one type of vaccine, but more likely more than one. Some of the developing world might get vaccinated with a cheaper, more traditional vaccine, but later. But there is no good vreason why you can't have huge vaccination campaigns with cooling trucks at least in their bigger cities.

azerf 6y ago

ttest