5 ms·

The current recommendation is yes, you should get vaccinated. (If we continue at the incredibly slow pace of vaccinations we're going, though, I wouldn't be su

by SamBam 6y ago

The current recommendation is yes, you should get vaccinated. (If we continue at the incredibly slow pace of vaccinations we're going, though, I wouldn't be surprised if experts start recommending people who have had Covid get lower priority. An expert recently shared that, at this rate, it will take ten years to get to herd immunity in the US. [1]) 1. https://twitter.com/DrLeanaWen/status/1343920976854196225 https://twitter.com/DrLeanaWen/status/1343920976854196225

Ericson2314 6y ago
Well hopefully they approve the Oxford-AstraZeneca vaccine too, which should be much easier to roll out are greater scale.
- grawprog 6y ago
  I'm probably going to be downvoted for this...pointing out any issues in any measures towards covid seems to have this effect. But how is astrazeneca's methodology reasonable? https://www.astrazeneca.com/media-centre/press-releases/2020/azd1222hlr.html https://www.astrazeneca.com/media-centre/press-releases/2020... >Over 23,000 participants are being assessed following two doses of either a half-dose/full-dose regimen or a regimen of two full doses of AZD1222 or a comparator, meningococcal conjugate vaccine called MenACWY. The placebo in the study was a meningitis vaccine that actually caused issues that halted the study and because astrazeneca's vaccine was deemed more effective than that, the vaccine was deemed a success. In what way is that anywhere near a reasonable clinical study?
  - cmrdporcupine 6y ago
    Their process was not reasonable. Which is why it was considered a failure and I believe they had to go back to the drawing board. They will have to do a proper job, if they haven't already. With the other two vaccines already approved, national health boards will be in no rush to fast track it.
    - Exmoor 6y ago
      Not sure where you're getting your data, but it's incorrect. It was not considered a failure. There have been some questions about what the best dosage and timing might be for the highest effectiveness, but I've heard the UK may approve it as early as tomorrow. The USA may wait until the trial being run inside the USA is completed, but that has more to do with ensuring the vaccine is safe and works on their wide demographics than any concerns with how the UK and Brazil studies were done.
      - respinal 6y ago
        >the UK may approve it as early as tomorrow. https://news.ycombinator.com/item?id=25549454 https://news.ycombinator.com/item?id=25549454
        respinal 6y ago
        Update: They did https://news.ycombinator.com/item?id=25579391 https://news.ycombinator.com/item?id=25579391
  - mlyle 6y ago
    Having a placebo which has some degree of side effects is not insane, even though it caused problems here. The vaccines have lots of side effects. If you give something with lots of side effects and compare it to a placebo with none, people have a good guess of what group they're in and behave differently. This is often considered more reasonable than comparing to a saline injection, and it's a reason why lots of drugs now are compared to e.g. ritalin-- something relatively benign with some side effect that feels like it is "doing something". The half-dose/full-dose regimen was a mistake in a clinic administering the trial, though. A mistake that happened to look more effective than the overall vaccine population, which is a bit troublesome and a primary reason why AstraZeneca has problems now. Now that we have effective COVID vaccines, we can run noninferiority trials-- e.g. comparing Moderna's vaccine to a potential new vaccine-- which get around a lot of the problems here.
    - respinal 6y ago
      > The half-dose/full-dose regimen was a mistake in a clinic administering the trial, though. More on that here: https://news.ycombinator.com/item?id=25548342 https://news.ycombinator.com/item?id=25548342
  - deleted 6y ago
    [deleted]
  - ashtonkem 6y ago
    The placebo has to be something that feels like a vaccine, otherwise the double-blind aspect will be broken. But since we know the precise risks associated with meningitis vaccines, we can trivially determine the relative risk of the covid vaccine compared to something else of a known risk level. Oh, and it's not like the meningitis vaccine will confer any protection from covid.
- prh8 6y ago
  The problems so far are not related to the particular vaccines, but rather the lack of planning and money for said management. 10m doses have been distributed but only 2m given so far. States are really struggling due to lack of federal assistance in $$ and planning.
  - mlyle 6y ago
    It's hard to know how much of the lag is A) holidays, B) reporting delays, C) logistics delays (allocation to the state isn't delivery to the point of care), vs D) ramping/administration delays. I suspect many more doses have been given but not reported (B), and a lot more of the shortfall can be explained by A & C. If that's true, we're going to be production limited very soon... though the decision to hold back more than half of the doses doesn't help. Reaching phase 1B will help, too, because it will mean the opening of mass vaccination clinics, which can run in parallel to the remaining portion of 1A which is more targeted and logistically complicated. E.g. Santa Clara County Fairgrounds are set up for high throughput drive-through COVID testing and plans are to use the same infrastructure that can host massive numbers of cars and lanes to have massive numbers vaccinated and waiting out their 20 minute observation time. This site will be able to do thousands of doses per day-- >0.3% of the County's population per day-- alone, which exceeds the number of doses we can be expected to be allocated for quite some time. Johnson and Johnson is the best hope for another near-term EUA, which could significantly improve vaccine supply in February.
  - ashtonkem 6y ago
    The vaccine matters, as they have different storage requirements and dosing requirements. One of the vaccines requires that it be kept in a deep freeze, thawed before use, and everyone needs two doses. This is a logistically complicated process that takes much more time to deliver, and will therefore be slower. The Oxford vaccine can be stored in a regular refrigerator, which drastically reduces infrastructure cost and makes it speedier to administer, since it doesn’t need to be carefully warmed to room temperature from subzero. Oh, and it’s cheaper. That matters.
  - maxerickson 6y ago
    Wider availability means you can not worry about prioritization. There's no guarantee things would be going any faster, but if anyone can walk into a pharmacy and get a shot it seems like it would speed up a bit.
jtsiskin 6y ago
I would be very surprised if the vaccination rate didn’t increase at least 10x from what it is now. This actually seems like pretty positive news

by SamBam 6y ago

Ericson2314 6y ago

Well hopefully they approve the Oxford-AstraZeneca vaccine too, which should be much easier to roll out are greater scale.

grawprog 6y ago
I'm probably going to be downvoted for this...pointing out any issues in any measures towards covid seems to have this effect. But how is astrazeneca's methodology reasonable? https://www.astrazeneca.com/media-centre/press-releases/2020/azd1222hlr.html https://www.astrazeneca.com/media-centre/press-releases/2020... >Over 23,000 participants are being assessed following two doses of either a half-dose/full-dose regimen or a regimen of two full doses of AZD1222 or a comparator, meningococcal conjugate vaccine called MenACWY. The placebo in the study was a meningitis vaccine that actually caused issues that halted the study and because astrazeneca's vaccine was deemed more effective than that, the vaccine was deemed a success. In what way is that anywhere near a reasonable clinical study?
- cmrdporcupine 6y ago
  Their process was not reasonable. Which is why it was considered a failure and I believe they had to go back to the drawing board. They will have to do a proper job, if they haven't already. With the other two vaccines already approved, national health boards will be in no rush to fast track it.
  - Exmoor 6y ago
    Not sure where you're getting your data, but it's incorrect. It was not considered a failure. There have been some questions about what the best dosage and timing might be for the highest effectiveness, but I've heard the UK may approve it as early as tomorrow. The USA may wait until the trial being run inside the USA is completed, but that has more to do with ensuring the vaccine is safe and works on their wide demographics than any concerns with how the UK and Brazil studies were done.
    - respinal 6y ago
      >the UK may approve it as early as tomorrow. https://news.ycombinator.com/item?id=25549454 https://news.ycombinator.com/item?id=25549454
      - respinal 6y ago
        Update: They did https://news.ycombinator.com/item?id=25579391 https://news.ycombinator.com/item?id=25579391
- mlyle 6y ago
  Having a placebo which has some degree of side effects is not insane, even though it caused problems here. The vaccines have lots of side effects. If you give something with lots of side effects and compare it to a placebo with none, people have a good guess of what group they're in and behave differently. This is often considered more reasonable than comparing to a saline injection, and it's a reason why lots of drugs now are compared to e.g. ritalin-- something relatively benign with some side effect that feels like it is "doing something". The half-dose/full-dose regimen was a mistake in a clinic administering the trial, though. A mistake that happened to look more effective than the overall vaccine population, which is a bit troublesome and a primary reason why AstraZeneca has problems now. Now that we have effective COVID vaccines, we can run noninferiority trials-- e.g. comparing Moderna's vaccine to a potential new vaccine-- which get around a lot of the problems here.
  - respinal 6y ago
    > The half-dose/full-dose regimen was a mistake in a clinic administering the trial, though. More on that here: https://news.ycombinator.com/item?id=25548342 https://news.ycombinator.com/item?id=25548342
- deleted 6y ago
  [deleted]
- ashtonkem 6y ago
  The placebo has to be something that feels like a vaccine, otherwise the double-blind aspect will be broken. But since we know the precise risks associated with meningitis vaccines, we can trivially determine the relative risk of the covid vaccine compared to something else of a known risk level. Oh, and it's not like the meningitis vaccine will confer any protection from covid.
prh8 6y ago
The problems so far are not related to the particular vaccines, but rather the lack of planning and money for said management. 10m doses have been distributed but only 2m given so far. States are really struggling due to lack of federal assistance in $$ and planning.
- mlyle 6y ago
  It's hard to know how much of the lag is A) holidays, B) reporting delays, C) logistics delays (allocation to the state isn't delivery to the point of care), vs D) ramping/administration delays. I suspect many more doses have been given but not reported (B), and a lot more of the shortfall can be explained by A & C. If that's true, we're going to be production limited very soon... though the decision to hold back more than half of the doses doesn't help. Reaching phase 1B will help, too, because it will mean the opening of mass vaccination clinics, which can run in parallel to the remaining portion of 1A which is more targeted and logistically complicated. E.g. Santa Clara County Fairgrounds are set up for high throughput drive-through COVID testing and plans are to use the same infrastructure that can host massive numbers of cars and lanes to have massive numbers vaccinated and waiting out their 20 minute observation time. This site will be able to do thousands of doses per day-- >0.3% of the County's population per day-- alone, which exceeds the number of doses we can be expected to be allocated for quite some time. Johnson and Johnson is the best hope for another near-term EUA, which could significantly improve vaccine supply in February.
- ashtonkem 6y ago
  The vaccine matters, as they have different storage requirements and dosing requirements. One of the vaccines requires that it be kept in a deep freeze, thawed before use, and everyone needs two doses. This is a logistically complicated process that takes much more time to deliver, and will therefore be slower. The Oxford vaccine can be stored in a regular refrigerator, which drastically reduces infrastructure cost and makes it speedier to administer, since it doesn’t need to be carefully warmed to room temperature from subzero. Oh, and it’s cheaper. That matters.
- maxerickson 6y ago
  Wider availability means you can not worry about prioritization. There's no guarantee things would be going any faster, but if anyone can walk into a pharmacy and get a shot it seems like it would speed up a bit.

jtsiskin 6y ago

I would be very surprised if the vaccination rate didn’t increase at least 10x from what it is now. This actually seems like pretty positive news