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Here [1] it says the vaccine was designed mostly over the weekend of 11th Jan 2020. Here we are 10 months later and we know it works. If our knowledge of vaccin

Here [1] it says the vaccine was designed mostly over the weekend of 11th Jan 2020. Here we are 10 months later and we know it works. If our knowledge of vaccine design is so good experts can design a vaccine that works over a weekend, what new breakthroughs are required to reduce the time between then and now substantially? A lot of benefit could have been had if we'd been able to get along this path more quickly. [1]: https://www.theguardian.com/world/2020/nov/23/coronavirus-scientists-developed-oxford-vaccine-at-breakneck-speed https://www.theguardian.com/world/2020/nov/23/coronavirus-sc...

jimbokun 6y ago
It would require forgoing any kind of serious trials to determine the efficacy and safety of the vaccine. It is the classic "make a baby in 9 months with 9 women" dilemma. There is no way around conducting a trial and waiting long enough until you see what happens to the participants.
DennisP 6y ago
The main bottleneck is getting a bunch of volunteers, vaccinating them, and seeing how many get the disease over the next few months. Kinda hard to speed that up, unless you're confident/desperate enough to just skip testing. Maybe if the disease were 10X more dangerous and you had a vaccine that was just a minor variation of a previous one, it'd be worth it. A little time could maybe be shaved off by speeding up production. The mRNA vaccines have an advantage here, you can basically use an RNA printer to churn out whatever RNA sequence you need.
- triangleman 6y ago
  Wait isn't that exactly what they did?
mrtksn 6y ago
Definitely. It’s a similar situation with the aviation too. Unfortunately, rules in fields like medicine and aviation are written with blood. Someone gets too greedy or too comfortable and you have large numbers of people death or incapacitated. We already have large numbers of charlatans preying on the hopes of desperate people, must be very careful not to lower the barrier too much or these might jump too. Even worse, people might be targeted by slick psychopaths and coerced into extremely dangerous things, destroying communities when anything goes wrong. Hopefully though, some mountains might have been moved and some things might have gotten faster from now on.
- tinus_hn 6y ago
  Yeah, too bad for these millions of people who died from the disease! At least we followed the procedure!
  - mrtksn 6y ago
    It's not about following arbitrary rules for the sake of following rules. There are people out there that won't hesitate to kill any number of people for the hard cash or fame, some did it before and that's how the rules were born. I am sure that some of rules could be revisited thanks to the new tech but portraying it as "rules kill people" is intellectually dishonest or naive. Look what happened with Boeing 737-MAX. Some businessmen, scientists and engineers will cut corners to get their job "done" and every now and then it will be catastrophic.
    - tinus_hn 6y ago
      There is an argument to be made about which odds are better though. Take the risks with a vaccine or don’t and suffer the disease? It’s just that using the vaccine is an active choice so you run into trouble with ethics.
moultano 6y ago
Challenge trials. https://www.1daysooner.org/ https://www.1daysooner.org/ If it were considered ethical to do them, we could have known in a few weeks. "Medical ethics" claims another million lives.
- tantalor 6y ago
  Good summary of problems with challenge trials for Covid: https://www.statnews.com/2020/06/23/challenge-trials-live-coronavirus-speedy-covid-19-vaccine/ https://www.statnews.com/2020/06/23/challenge-trials-live-co...
  - moultano 6y ago
    The point that challenge trials don't determine safety is accurate, but most of the article is again arguing about the ethics rather than the efficacy. Imagine if volunteers were not permitted by ethicists to storm the beaches of Normandy because their safety could not be guaranteed. Our current testing protocol requires letting the virus rampage through the population before the trials will achieve statistical significance, which is surely more unethical than deliberately exposing a small number of people.
    - tantalor 6y ago
      I tend to agree in the case of Covid, but I'll play devil's advocate... Suppose we replace Covid with "car crashes" and vaccine with "seatbelts". This is a good analogy because crashes are rare and we can't cure trauma (like on Star Trek). It would be absurd to deliberately cause car crashes in order to study the effect of seatbelts. For the experimental group, there will still be some minor injuries. For the control group, many will die.
      - moultano 6y ago
        That sounds more like doing challenge trials for an ebola vaccine, for which I'd expect you'd get very few volunteers. Still though, if there are people willing to risk sacrificing themselves, and the information would definitely save lives, we should let people do that for the greater good. The world's militaries throw away far more lives for far less benefit.
nabla9 6y ago
Nothing. Timelines for Covid-19 vaccine are already compressed. Even this data is just preliminary from Phase III. Limiting factor is safety and testing for safety. They started trials with two people, one gets vaccine one gets placebo. They look for side effects then add more and more people while constantly observing those vaccinated for side effects. Vaccines are not inherently safe, they are safe because they have gone trough huge amount of volunteer testing. If there are unwanted side-effects, vaccine is withdrawn. Since vaccines work with the immune system, you must look for autoimmune reactions, neurological symptoms etc. Some of them can emerge weeks or months later. With new mRNA vaccines there are even more unknowns. Emergency authorization they seek means taking calculated risk. With covid-19 epidemic taking that risk is acceptable.
- mchusma 6y ago
  I strongly disagree with this. I cannot think of a valid utilitarian argument allowing willing people from getting a vaccine. First, vaccines have an extremely high success rate, 33% of vaccines make it through all trials to approval. 50% after phase 1 is complete. The worst vaccine side effect ever is widely considered to be the swine flu vaccine from 60 years ago, where 1 in 100,000 got GBS (a bad disease). If we knew with 100% confidence that this vaccine was tied for the worst, then if you are over 65 it would be about 1,000x better for you to take this "bad vaccine" versus not. Each successive trial lost us a lot of time, and very little confidence gain. The reality is we had many groups all independently find a vaccine that worked in Q12020. It's only the government ban on their use that allowed the pandemic to proceed like it has. Right now in the US, the FDA has said it is not even planning to MEET on the Pfizer candidate's approval for 3 weeks. Just insane. Then, the CDC says it needs 24-48 hours after FDA approval to authorize it's release. Why can't the meet right now? Why can't the CDC pre approve release? Or be in the meeting and give simultaneous approval? Or be on a phone alert to give approval within 1 hour? The most likely answer is that in a nationally declared pandemic, any vaccine produced by someone who has gotten a vaccine approved in the last 10 years can sell and distribute (cash only no insurance) vaccines without approval. Require them to collect data on its usage and efficacy. Wait until normal process to require people to be vaccinated.
  - 6y ago
wbl 6y ago
None. We could have run a 400 person challenge trial in March and gotten the effqcoty data then deployed to Healthcare workers and surveillance for safety. This would entirely change the situation we're seeing now.
Wintamute 6y ago
None. Longitudinal trails are required to assess safety - literally waiting and seeing what happens. There's no other way to assess long term effects on the human system. For the avoidance of any doubt none of the new vaccines have had anything like the proper amount of time for a bare minimum longitudinal trial. Whether you decide to take a vaccine nobody in the world is more than 6 months out on will hopefully be left to personal choice.

jimbokun 6y ago

It would require forgoing any kind of serious trials to determine the efficacy and safety of the vaccine. It is the classic "make a baby in 9 months with 9 women" dilemma. There is no way around conducting a trial and waiting long enough until you see what happens to the participants.

DennisP 6y ago

The main bottleneck is getting a bunch of volunteers, vaccinating them, and seeing how many get the disease over the next few months. Kinda hard to speed that up, unless you're confident/desperate enough to just skip testing. Maybe if the disease were 10X more dangerous and you had a vaccine that was just a minor variation of a previous one, it'd be worth it. A little time could maybe be shaved off by speeding up production. The mRNA vaccines have an advantage here, you can basically use an RNA printer to churn out whatever RNA sequence you need.

triangleman 6y ago
Wait isn't that exactly what they did?

mrtksn 6y ago

Definitely. It’s a similar situation with the aviation too. Unfortunately, rules in fields like medicine and aviation are written with blood. Someone gets too greedy or too comfortable and you have large numbers of people death or incapacitated. We already have large numbers of charlatans preying on the hopes of desperate people, must be very careful not to lower the barrier too much or these might jump too. Even worse, people might be targeted by slick psychopaths and coerced into extremely dangerous things, destroying communities when anything goes wrong. Hopefully though, some mountains might have been moved and some things might have gotten faster from now on.

tinus_hn 6y ago
Yeah, too bad for these millions of people who died from the disease! At least we followed the procedure!
- mrtksn 6y ago
  It's not about following arbitrary rules for the sake of following rules. There are people out there that won't hesitate to kill any number of people for the hard cash or fame, some did it before and that's how the rules were born. I am sure that some of rules could be revisited thanks to the new tech but portraying it as "rules kill people" is intellectually dishonest or naive. Look what happened with Boeing 737-MAX. Some businessmen, scientists and engineers will cut corners to get their job "done" and every now and then it will be catastrophic.
  - tinus_hn 6y ago
    There is an argument to be made about which odds are better though. Take the risks with a vaccine or don’t and suffer the disease? It’s just that using the vaccine is an active choice so you run into trouble with ethics.

moultano 6y ago

Challenge trials. https://www.1daysooner.org/ https://www.1daysooner.org/ If it were considered ethical to do them, we could have known in a few weeks. "Medical ethics" claims another million lives.

tantalor 6y ago
Good summary of problems with challenge trials for Covid: https://www.statnews.com/2020/06/23/challenge-trials-live-coronavirus-speedy-covid-19-vaccine/ https://www.statnews.com/2020/06/23/challenge-trials-live-co...
- moultano 6y ago
  The point that challenge trials don't determine safety is accurate, but most of the article is again arguing about the ethics rather than the efficacy. Imagine if volunteers were not permitted by ethicists to storm the beaches of Normandy because their safety could not be guaranteed. Our current testing protocol requires letting the virus rampage through the population before the trials will achieve statistical significance, which is surely more unethical than deliberately exposing a small number of people.
  - tantalor 6y ago
    I tend to agree in the case of Covid, but I'll play devil's advocate... Suppose we replace Covid with "car crashes" and vaccine with "seatbelts". This is a good analogy because crashes are rare and we can't cure trauma (like on Star Trek). It would be absurd to deliberately cause car crashes in order to study the effect of seatbelts. For the experimental group, there will still be some minor injuries. For the control group, many will die.
    - moultano 6y ago
      That sounds more like doing challenge trials for an ebola vaccine, for which I'd expect you'd get very few volunteers. Still though, if there are people willing to risk sacrificing themselves, and the information would definitely save lives, we should let people do that for the greater good. The world's militaries throw away far more lives for far less benefit.

nabla9 6y ago

Nothing. Timelines for Covid-19 vaccine are already compressed. Even this data is just preliminary from Phase III. Limiting factor is safety and testing for safety. They started trials with two people, one gets vaccine one gets placebo. They look for side effects then add more and more people while constantly observing those vaccinated for side effects. Vaccines are not inherently safe, they are safe because they have gone trough huge amount of volunteer testing. If there are unwanted side-effects, vaccine is withdrawn. Since vaccines work with the immune system, you must look for autoimmune reactions, neurological symptoms etc. Some of them can emerge weeks or months later. With new mRNA vaccines there are even more unknowns. Emergency authorization they seek means taking calculated risk. With covid-19 epidemic taking that risk is acceptable.

mchusma 6y ago
I strongly disagree with this. I cannot think of a valid utilitarian argument allowing willing people from getting a vaccine. First, vaccines have an extremely high success rate, 33% of vaccines make it through all trials to approval. 50% after phase 1 is complete. The worst vaccine side effect ever is widely considered to be the swine flu vaccine from 60 years ago, where 1 in 100,000 got GBS (a bad disease). If we knew with 100% confidence that this vaccine was tied for the worst, then if you are over 65 it would be about 1,000x better for you to take this "bad vaccine" versus not. Each successive trial lost us a lot of time, and very little confidence gain. The reality is we had many groups all independently find a vaccine that worked in Q12020. It's only the government ban on their use that allowed the pandemic to proceed like it has. Right now in the US, the FDA has said it is not even planning to MEET on the Pfizer candidate's approval for 3 weeks. Just insane. Then, the CDC says it needs 24-48 hours after FDA approval to authorize it's release. Why can't the meet right now? Why can't the CDC pre approve release? Or be in the meeting and give simultaneous approval? Or be on a phone alert to give approval within 1 hour? The most likely answer is that in a nationally declared pandemic, any vaccine produced by someone who has gotten a vaccine approved in the last 10 years can sell and distribute (cash only no insurance) vaccines without approval. Require them to collect data on its usage and efficacy. Wait until normal process to require people to be vaccinated.
- 6y ago

wbl 6y ago

None. We could have run a 400 person challenge trial in March and gotten the effqcoty data then deployed to Healthcare workers and surveillance for safety. This would entirely change the situation we're seeing now.

Wintamute 6y ago

None. Longitudinal trails are required to assess safety - literally waiting and seeing what happens. There's no other way to assess long term effects on the human system. For the avoidance of any doubt none of the new vaccines have had anything like the proper amount of time for a bare minimum longitudinal trial. Whether you decide to take a vaccine nobody in the world is more than 6 months out on will hopefully be left to personal choice.