The key differentiator here is the storage requirements (2-8c ‘normal refrigerator’).
That’s much more accessible to developing / low GDP countries as opposed the cumbersome and expensive storage requirements of the other two.
That’s much more accessible to developing / low GDP countries as opposed the cumbersome and expensive storage requirements of the other two.
The fact that we have three highly effective vaccines in such a short period is amazing and between them we might stand a chance of making and distributing them at the scale necessary to get things under some kind of control by August.
Pandemrix, a flu vaccine, caused a notable uptick in narcolepsy in Sweden, Finland and likely the UK. This was not (and could not) be seen in smaller trial populations.
It is not a given that any of the covid vaccines is safe enough. Historically, two cases of rushed vaccines (cutter polio and Gullah barre) were worse than the disease - and these were for diseases worse than covid. Those were 50-60 years ago. Pandemrix was 10-20. I’m not sure we’re that much better on safety now to rush vaccines.
https://www.who.int/vaccine_safety/committee/topics/influenz...
“Even at this stage, it does not appear that narcolepsy following vaccination against pandemic influenza is a general worldwide phenomenon, as no excess of narcolepsy has been reported from several other European states where Pandemrix was used, or from Canada where a pandemic vaccine similar to pandemrix was used. This complicates interpretation of the findings in Finland and Sweden. It seems likely that some as yet unidentified additional factor was operating in Sweden and Finland. The findings from the VAESCO project and further investigations in Finland and Sweden, may help clarify the determinants of any increased risk of narcolepsy, which currently appears to be restricted to the months following vaccination and by age group and country.”
What’s certainly true that for some effects to be observable, millions have to be vaccinated first.
2013:
https://www.reuters.com/article/us-narcolepsy-vaccine-pandem...
“In total, the GSK shot was given to more than 30 million people in 47 countries during the 2009-2010 H1N1 swine flu pandemic.”
“Independent teams of scientists have published peer-reviewed studies from Sweden, Finland and Ireland showing the risk of developing narcolepsy after the 2009-2010 immunization campaign was between seven and 13 times higher for children who had Pandemrix than for their unvaccinated peers.”
“Europe’s drugs regulator has ruled Pandemrix should no longer be used in people aged under 20.”
So if you give the entire US population a vaccine like that, less than twenty thousand of them develop narcolepsy. As a reminder a quarter million of them already died from COVID-19 and more are dying every day - not to mention the tens of thousands whose cause of death isn't listed as COVID-19 but would not be dead if not for an ongoing pandemic.
Cutter screwed up. No amount of prior safety testing can fix that. Their Polio vaccine had Polio virus in it (to be clear: The traditional Oral Polio Vaccine is supposed to have a "live" virus in it, but the injected vaccine Cutter were selling is not). Obviously nobody is going to test "What happens if we inject children with the Polio virus" because the answer is "Some of them get Polio. Duh" and so no test could have prevented Cutter from screwing up.
I have no idea what you meant by "Gullah barre" the Google results I get are all about Guillain-Barré syndrome, which I mentioned above. Guillain-Barré is not a vaccine, it's a weird auto-immune disorder, and arguably even where it's listed as very rare side effect of a vaccine, that's misleading because it's also a side effect from getting viral infection, so if you avoid vaccination but do get the virus you may get GBS as a result anyway. The human immune system is pretty inscrutable.
I assume the concern is that an unknown unknown means it could cause/trigger/amplify some other disease/condition that may be comparable/worse than the problem it solves.
Cause/effect and morals are hard. Add to the mix a general statistical innumeracy, and some general suspicion about authorities, and it makes it really hard for the general populace to actually weigh the two different options.
I don't think we should dismiss these concerns as just stuff for nutjobs. I've seen otherwise reasonable people having trouble making up their minds about that.
And yes, the mechanism is likely that Pandemrix activated a predisposition. But it was not activated in statistically equivalent kids who did not get Pandemrix.
Why is it so hard to acknowledge that not all vaccines are perfect, and that there’s a risk involved? I am not avtivax. I am pro vaccination. I am anti religious “a vaccine can never be bad” thinking which seem to be prevalent among otherwise rational scientific people.
This is just patently untrue.
The Cutter Incidence gave patients Polio due to an improperly activated virus. While this is bad, it could not be worse than the disease itself - since it is the disease itself, no worse, no less.
Regarding risk of Gullain-Barre syndrome due to vaccination, Wikipedia has this to say: "In fact, natural influenza infection is a stronger risk factor for the development of GBS than is influenza vaccination and getting the vaccination does reduce the risk of GBS overall by lowering the risk of catching influenza." So here I also find it hard to believe the vaccine would be worse than the disease,
I'm also sceptical of the claim that Polio or the 1976 Swine Flu would unambiguously be worse than Covid19. 70% of Polio case have no symptoms, and less than 0.5% cause permanent injury, according to Wikipedia. The 1976 Swine Flu outbreak seems to have caused a few hundred cases and only one death.
On the other, a cursory search says the current record for fastest developed vaccine was mumps at 4 years. So this is a vaccine setting new milestones, and there is a risk that not all of them will be positive. I'd rather be a little late to be vaccinated than a little early, especially being in a lower risk demographic.
At the 1-year mark, everything looked perfect. At the towo years mark (original endpoint) the conclusion was that while it was safe, it offered statistically insignificant protection.
Properly designed tests need those 2 years, at the very least. The “SAFE” confidence axis was compromised. Whether or nit it is justified is what we’re discussing here.
Cutter was, most definitely, much worse than the disease if you look at it from a population perspective.
The 1976 Guilian barre was at least comparable to the flu it was supposed to stop, if not worse. According to https://en.m.wikipedia.org/wiki/1976_swine_flu_outbreak, the disease caused one death and 13 hospitalizations, and an uptick of Giullan barre reports - a disease that more often than not requires hospitalization and sometimes death. I can assure you it caused more than 13 hospitalizations, and - having known two GBS people who made a full recovery - a very long and painful months long process. So, at 50,000,000 immunized - a 1 in 1,000,000 would still be worse than the flu.
I am not anti vax even if HN constantly seems to interpret my comments as such.
I am vaccinated, so are my kids. But whenever I mention that immunizations have risks, I’m treated like a heretic.
Everyone is assuming something like cutter cannot happen again. This is a religious assumption, not a scientific one.
This is a more reasonable assessment, but it is still patently false. According to Wikipedia, 0.04% vaccinations resulted in paralysis in the Cutter Incident, compared to 0.1-0.5% of wild type polio. So the vaccine was 2-10x safer than wild polio. Without vaccinations, virtually all children were infected with polio virus early in life [1], so being administered the defective vaccine was still a lot better than taking a chance with the real disease.
Of course, you are correct regarding the 1976 flu outbreak. If you administer something to a large segment of the healthy population, even a small risk of side-effects will add upp to a large number of cases. If the disease itself turns out to be very rare, as was the case with the flu outbreak, the vaccine itself could cause more damage than the disease even if the disease is much worse.
However, this is clearly not applicable Covid-19, which we already know is spreading very fast and will need to infect a large number of the population before herd immunity is achieved. The situations are simply not comparable at all – even the vaccine from the 1976 flu outbreak would be less risky than the odds of being infected with a serious case of Covid 19 (of which the long term effects are also unknown, to be clear).
> But whenever I mention that immunizations have risks, I’m treated like a heretic.
Mainstream media, healthcare professionals and social media are all worried about the risks of a rushed vaccine. I literally see articles and hear conversations about this several times a month. Nobody is denying that large scale vaccinations have risks.
I'm not criticizing you because I'm against being cautious of vaccination risks. The criticism is that you are spreading false facts and misleading analysis that grossly mischaracterise what the risks of vaccinations really are, both presently and historically.
"Some vaccines can have rare but serious side effects" is a perfectly alright statement. But "Historically, two cases of rushed vaccines (cutter polio and Gullah barre) were worse than the disease - and these were for diseases worse than covid" is just not. Some of it is false and the comparison to Covid19 is misleading.
From https://en.wikipedia.org/wiki/Polio_vaccine#1950%E2%80%93195... : "The Cutter vaccine had been used in vaccinating 200,000 children in the western and midwestern United States.[76] Later investigations showed that the Cutter vaccine had caused 40,000 cases of polio, killing 10.[76]". So, 20% incidence; mentions 250 "paralytic illness", so 0.125% paralysis (no idea where you took the 0.04% - it does not appear in the Wikipedia text).
From https://en.wikipedia.org/wiki/Polio#Paralytic_polio : "In children, nonparalytic meningitis is the most likely consequence of CNS involvement, and paralysis occurs in only one in 1000 cases." ; So, for children, the incidence of paralysis is 0.1%
Who got the cutter vaccine? Mostly children. See e.g. from https://www.washingtonpost.com/history/2020/04/14/cutter-pol... "By April 30, within forty-eight hours of the recall,” Offit wrote. “Cutter’s vaccine had paralyzed or killed twenty-five children: fourteen in California, seven in Idaho, two in Washington, one in Illinois, and one in Colorado."
So, I just tried to check your numbers, and I couldn't; Could you post references?
But I also wanted to check my memory, and Wikpedia seems to agree with me, Go on, please do check my quotes.
still patently false. pfft. Perhaps false under some assumptions, definitely not "patently false".
You would also have to include further transmissions caused by wild polio if you would like to make such a comparison.
> still patently false. pfft. Perhaps false under some assumptions, definitely not "patently false".
Even with your own calculation, which is inflated by also including transmission within the community for the vaccine but not for wild polio, the vaccine was very much comparable to wild polio (0.125% versus approx. 0.1%). Without vaccination, polio would usually infect virtually all children. So even with your own inflated assumptions it's false that the vaccine was worse than polio.
So under which assumptions would it not be false?
Take them with wikipedia, not me. I will note, that Wikipedia talks about both Cutter and Wyeth having problems, so it is possible the numbers are a sum of wyeth+cutter which would be compatible with your numbers being cutter only, but in the context of safety vs. polio wouldn't matter.
> You would also have to include further transmissions caused by wild polio if you would like to make such a comparison.
All wild polio numbers include those numbers by default - there actually is no way to get them otherwise, I guess you are saying "you should probably debase by more than 200,000 because of secondary infections". I don't know how to do that, exactly, but it will likely still be similar.
> Even with your own calculation, which is inflated by also including transmission within the community for the vaccine but not for wild polio, the vaccine was very much comparable to wild polio (0.125% versus approx. 0.1%).
With this calculation, the vaccine was 25% worse than the wild type. No error bars, but, that's easily worse, even much worse.
> So under which assumptions would it not be false?
How kind of you to drop "patently". If you didn't mean "patently" false earlier, why did you use that word? twice?
From[0]: "Patently: in a way that is so obvious that no one could disagree.". It's nice of you to finally bring sources, but even these sources don't make it "patently" false, given that they disagree with the sources I gave (which, I concede, reference more than just the safety of the Cutter incident which I originally mentioned, but which are definitely the subject matter under discussion)
[0] https://www.macmillandictionary.com/dictionary/british/paten...
Wikipedia is not wrong, but you are using their numbers wrong. Your source is talking about the total number paralysis cases that occurred as a result of the vaccine ("250 cases of paralytic illness had occurred"). This includes secondary infections. If you follow the sources listed on Wikipedia page you reference, you will find two sources: my source [1], and [2] (via [3]), both which declare around 60 cases of paralysis in vaccinated persons, and then a larger number (in the order of 200) of total cases. The numbers you reference are referring to only the Cutter polio vaccine, by the way.
And you cannot use the total number of cases in the comparison that you did.
> All wild polio numbers include those numbers by default - there actually is no way to get them otherwise, I guess you are saying "you should probably debase by more than 200,000 because of secondary infections". I don't know how to do that, exactly, but it will likely still be similar.
If by debase you mean divide, then yes: you would need to divide by more than 200,000.
Your number is {how likely am I to get paralysed by the vaccine polio + how likely am I to cause further paralysis via secondary infection chain}, and you are comparing it to simply {how likely am I to get paralysed by the wild polio}. The first number is inflated a lot by the addition of secondary infections.
The numbers are not at all likely to be similar. As you can see in my (and your) sources, secondary infections accounted for more than double the number of paralysis cases, and therefore there it is likely a lot more people got sick via the secondary infections than the number people who was vaccinated. This causes the big discrepancy between our numbers.
Wild polio causes secondary infections as well, but this is not included in the number you are using for comparison, since it only includes the individual risk.
> With this calculation, the vaccine was 25% worse than the wild type. No error bars, but, that's easily worse, even much worse.
But the lack of error bars means that the calculation is meaningless.
You are assuming that "one in 1000 cases" means exactly one case per 1000 cases, and translate this to 0.100% with three decimals of accuracy.
It is clear from context that "one in 1000" is a rounded number for convenience, and they could very well have runded up from 0.8 or down from 1.4. You simply cannot conclude that the vaccine was 25% worse from your data. But we can conclude that they were in some way similar under your false assumptions, as they both would round to 1.
If you want to conclude anything else except "they are both around 0.1%", you would have to find a source that specifies at least 1 decimal of accuracy in the number incidents per 1000 cases.
Of course, this does not really matter, since you would still be comparing the wrong numbers.
Your argument here is "It's ambiguous and inconclusive when using clearly wrong assumptions that inflate the difference". Taking that argument into consideration, I'm still willing to confidently call it patently false.
Although I agree that I should not have said "Even with your own inflated assumptions it's false that the vaccine was worse than polio." What I meant was "Even your own inflated assumptions does not support that the vaccine was worse than polio", but I clearly worded it badly.
> How kind of you to drop "patently". If you didn't mean "patently" false earlier, why did you use that word? twice?
I meant it when I used it, and my question had a purpose. If you cannot give any reasonable assumptions where it wouldn't be false (which you haven't been able to do), then it would be patently false to me. The reason it does not seem patently false to you is because you have several misunderstandings in your reasoning and your reading of the sources. But I'm not really interested in discussing this terminology further.
> given that they disagree with the sources I gave
They don't. As I said, you are simply misreading your sources.
But seriously, even if you would manage to find some source which would refute my sources and back up your original claims, I have a bigger point to make now:
During this discussion, you have made numerous mistakes in many posts, beyond my criticism of your faulty reasoning:
(1) Mathematical mistakes
(2) Misreadings of the sources
(3) Inability to clear up ambiguities by looking at the referenced source or secondary sources
Even if by some happenstance you would happen to be right (even a broken clock, etc), you clearly are not confident enough doing this kind of analysis to be lecturing people about the specifics of vaccination risks. You are just as likely to mislead yourself and others as you are to educate.
Of course, this probably won't stop you, since you are not likely to respect my opinion. But hopefully it will still be in the back of your mind next time you approach this topic.
[1] https://www.nejm.org/doi/full/10.1056/NEJMp048180 [2] https://www.cabdirect.org/cabdirect/abstract/19642705083 [3] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2928990
And I may agree with your analysis - on phone now, can’t really do the reading.
However, we have two sources you claim are only for the cutter incident, whee one quotes 200,000 doses and another 120,000; as you note, the 1/1000 might well be 0.8 or 1.3 in 1000; it may be false but it is definitely bot “patently false”.
On the same note, it’s the internet, and for all you know I am a dog, but I have saved a family members from years of agony and wrong treatments due to wrong diagnosis after being told “it is patently obvious” that my analysis was wrong. And I have apology letters from department heads at two of the world’s highest ranked hospitals after it turned out I was right and they were wrong.
And you know what? I’m quite sure I probably had a few mathematical errors along the way back then as well. But what they thought was two orders of magnitude more probable evidence towards one direction, turned out to be higher probability in the other (by less than an order of magnitude) and turned out to be what the thought was improbable beyond consideration. (And, I found a few mathematical errors in a three peer reviewed papers they were relying on)
I take issue with people who claim “patently obvious” about things which have about factor of 2 or so (if I take your numbers) without error bars (120000-200000 is a large difference) and without supplying sources, which you didn’t bother until I did.
(And I may not have time to delve into this further - this is merely of historical interest to me, not life and death like that other event).
Also, you may notice this sub thread is basically the only one that actually discusses numbers, others use arbitrary determinations like “most people’s living memory” to discard concerns. Despite advocating vaccines myself, I have a problem with religious zealotry around vaccines, which is what most pro-vaccine people practice - I have a child who could not get vaccines for medical reasons for many years, and I have to explain that, no, vaccines are not perfectly safe on an individual basis, and have not historically been perfectly safe on a population basis (Swedish Pandemrix), even though on a net population basis they are a net positive.
I thank you again for your thoughtful discussion.
Sure, having Guillain-Barre is scary, but it is something that you can make a full recovery from.
It is never an excuse NOT to get a vaccine, unless you actually know that you got Guillain-Barre Syndrome from a vaccine. That is a discussion between that particular patient and their neuromuscular neurologist. In that case, you do not get the flu vaccine any longer because it can cause you to experience Guillain-Barre Syndrome again.
But, this really is an isolated situation that can be categorized as very rare and the general public should always get their vaccines.
If you catch the flu, it can absolutely trigger Guillain-Barre Syndrome, and would be far more likely to trigger Guillain-Barre Syndrome than the flu vaccine itself. If you get the flu and had the flu vaccination, it typically makes the flu illness less worse, making you less likely to get something like Guillain-Barre Syndrome.
There are lots of infectious agents that can trigger Guillain-Barre Syndrome, so it is wise to get your vaccines to prevent them as much as possible. They prevent serious infections, at minimum, which would help prevent Guillain-Barre Syndrome.
I also have the long term variant of Guillain-Barre Syndrome, known as Chronic Inflammatory Demyelinating Polyneuropathy, which is in pharmaceutical remission due to me taking subcutaneous immunoglobulin twice a week for 3 hours each time.
What I am saying is that while all of this sounds rare and devastating, it’s treatable. Not only that, you’re more likely to get Guillain-Barre Syndrome from a bad case of the flu than from a flu shot.
"The increased risk of narcolepsy due to vaccination was 1 in 18400 or 0.005%."[1] Considering the fatality and long term disability rate of Covid, and the way testing and safety protocols are done for vaccines, I don't really see how there could be an unknown and unseen risk that would outweigh the risk of contracting Covid.
It might be, but it’s not open and shut.
Additionally, it's not as if the average vaccine has a 0.005% chance of giving you narcolepsy. That figure was for the one vaccine in one country which appears to be the only example in most people's living memory of a vaccine possibly causing long-term side effects (it's not even proven the vaccine was the cause). There have been tens of billions of vaccines given during this time period and this is the only example where there may have been long term side effects.
> There have been tens of billions of vaccines given during this time period and this is the only example where there may have been long term side effects.
No, there are other examples, the other two I just mentioned are from memory, I suspect if I go research I will find more (I don't have the time). You know what else is common to those other two cases? They were rushed (pandemrix wasn't AFAIK).
SARS-Cov-2 vaccines were all rushed, and the safety protocols used to confidently ascertain those billions of vaccines were NOT followed - The standard is to wait 2-4 years to see that there's no ADE or other issues.
I am pro-vaccination. I don't understand why it is hard to acknowledge and discuss the risk profile of vaccines - they re not risk free. Excuse me if I don't automatically think a rushed vaccine is perfectly safe.
That Polio vaccine wasn't a side effect of the vaccine though, it was an issue with people accidently getting injected with a live virus. Since no live virus is even remotely involved in any COVID19 vaccines it has zero relevance here. Even if they were, we have 60+ years of history with no similar incidents since then.
> I suspect if I go research I will find more
You really won't. I've been reading about this extensively during this period and those are the only examples where there may have been long term effects that anyone can point to.
I qualified my original comment with "in most people's living memory" and didn't include the '76 swine flu vaccine because, frankly, I don't think pointing to an issue that happened 44 years ago in a field that has seen pretty significant technological advancement in knowledge, methods, and manufacturing processes really makes sense.
> why it is hard to acknowledge and discuss the risk profile of vaccines
My issue is not that there's isn't some theoretical risk, it's that it just isn't put in context of how minute it is. In all likelihood your risk of facing long term effects from a car accident happening on your way to get vaccinated are higher than anything that could happen from the vaccine. And both those risks are, of course, many orders of magnitude less than your chance of suffering long-term effects from catching COVID19.
Your omnipotent knowledge is inspiring. We have absolutely zero years of experience with RNA based vaccines. We had incidents with vaccines, not of the same kind. Ergo, there's a non zero probability we will have incidents in the future, by any reasonable inference.
> I qualified my original comment with "in most people's living memory" and didn't include the '76 swine flu vaccine because, frankly, I don't think pointing to an issue that happened 44 years ago in a field that has seen pretty significant technological advancement in knowledge, methods, and manufacturing processes really makes sense.
That's really painting a target where your arrow landed. Most people's living memory does not include e.g. the 1918 pandemic or the bubonic plague, or atomic bombs, or thousands of other things we're proactively defending against and of which we have better understanding but are still an issue. If "living memory" is your criterion ... well, I wouldn't describe it as anything but completely arbitrary.
Within living memory you have totally understandable and preventable things like Fukushima, the nestle mother milk fiasco in Africa, and others. We had enough understanding to stop all of them, and yet they happened. Every single SARS-COV-2 vaccine manufacturer has gotten government immunity from future claims, which aligns their incentive differently compared to vaccines they have produced in the past. They have become too big/important to sue - much like e.g. the fukushima reactor operator. Given this distinctly different incentive structure, rushed schedule, novel RNA delivery system - your belief that the past is a good predictor of the future is unscientific (at the very least, unbayesian without a ton of nontrivial priors you don't bother stating).
> And both those risks are, of course, many orders of magnitude less than your chance of suffering long-term effects from catching COVID19.
Ah, about that. Do you have any actual data about that? Because the best summary of "long covid" evidence I found was written by an MD, is summarized here[0], and can further be summarized by the word "lacking". I spent a lot of time looking for actual data about long covid (not anecdotes), and this summary is better than what I was able to find myself (but I do urge you to read it - do introduce it to your "living memory").
[0] https://sebastianrushworth.com/2020/11/17/what-is-long-covid...
Apparently the pfizer and Moderna vaccines will keep for 30 days at refrigerator temps after thawing out. You can ship in dry ice and then I can't imagine the vaccine sitting around in any doctors office or pharmacy for longer than 30 days.
Additionally, lots of countries have already preordered all the major candidates, so in those cases its already spent money.
It isn't a new thing for what it's worth. Going back to earlier this year it has been looked at, but we don't really have a clear picture on what will shake out.
We need the vaccine to remove the virus from circulation, not just keep us safe from it as individuals.
This vaccine is cheap, 90% efficient and easy to get people vaccinated. The other ones are expensive, 95% efficient and difficult to get people vaccinated.
The Oxford is best only if you either live in a very remote place, or are a very poor place. If you rely on the oxford vaccine it will be a little longer to get herd immunity, but overall your costs will be cheaper.
But I must reemphasize, the above is only about logistics. Because most people live in cities, all vaccines will be distributed in big cities just to get the numbers they need. What ever vaccine you are offered first is the one to take. You personally are unlikely to be offered a choice other than take it or leave it.
Regretfully, it would be not the first example of major economies using the current reality as an excuse/cover to conveniently push political policies/agendas that would otherwise have been impossible to implement (at least not without violating laws/treaties and maybe even basic human rights). I have no intention to fear monger, but I believe way too many are too naive about some of the things that are currently happening. That is, mostly people within those major economies, for people in less fortunate countries already learned the hard way how double-faced those major economies turned out.
How all this will eventually turn out ... anyone's guess is as good as mine. I guess we will all learn, when the immediate emergency of the current situation is over. I would prefer to be/remain optimistic, but thus far there appear to be more reasons for caution and skepticism (at best).
I've read this 3 times and can't figure out what you're trying to say.
Are you saying that rich countries are going to intentionally choose more expensive vaccines, with the intention of suppressing the lower classes?
That's so rediculous. In rich countries (other than the usa) the gov pays for these things not the citizens. Even then, the expensive vaccine is only $40, that's within the means of most poor people.
Not to mention that would screw over the rich people who want to benefit from (vaccine induced) heard immunity.
> .. the gov pays for these things not the citizens .. You do know that the only money governments have, is the money they got from its citizens, right? That is, aside from what they may have earned (though plundered or extorted might be more fitting) from other nations.
> .. the expensive vaccine is only $40, that's within the means of most poor people .. You may want to reevaluate your knowledge about the rest of the world. That is, outside the USA and some the more affluent parts of Europe. Also, that vaccine probably won't cost "just" $40 equally for everyone.
However, believe whatever you want. Time will no doubt teach us all a lessen. Personally, I hope it will teach me that I was wrong with my skepticism.
> Time will no doubt teach us all a lessen.
I doubt it. You need to actually have a position that can be shown to be true or false with the passage of time before you can learn something from the passage of time. You have a bizare, logically disconnected, rant that does not make any predictions. I don't think any course of events would prove you right (or wrong).
> You may want to reevaluate your knowledge about the rest of the world
In context, we were discussing afluent countries, canada europe, etc.
> Also, that vaccine probably won't cost "just" $40 equally for everyone.
They will cost $0 directly. As you say there will be indirect costs based on taxes. However that will be true regardless of if you get the vaccine and be scaled based on your income, so im not sure how you think that applies to your argument sbout class divide.
The price difference will likely remain substantial, but in case anyone is unaware, the difference is currently greater due to AstraZeneca pledging to the sell the vaccine at cost "during the pandemic", while Pfizer and Moderna have indicated that they fully intend to profit. [1]
Once AstraZeneca deem the pandemic to be over, the price will likely rise.
It was reported a few months ago that internal AstraZeneca documents showed them projecting the "Pandemic Period" to end on 1 July 2021. [2]
[1] https://www.nytimes.com/2020/07/21/health/covid-19-vaccine-c...
[2] https://thehill.com/policy/healthcare/520202-astrazenecas-no...
Also, all 3 have made various noises about not making a profit etc, it's quite hard to sort out the marketing from what will actually happen at this point. Oxford/Astra have committed to supplying at least 100M doses to low-income countries for under $3 though.
Edit: just found a source here confirming what you said: https://www.bbc.com/news/health-55040635
India's Serum Institute has already partnered to mass produce this vaccine. https://www.ndtv.com/world-news/oxford-says-covid-19-vaccine...
-80C is really close to dry-ice temperatures. So I wonder if its actually -80C or if the researchers were just saying "Dry Ice".
Realistically, every major population can be reached in 24 hours by modern transport, and the Pfizer 5000-dose transport package keeps the temperature for 5 days.
Of course we now have reason to believe that vaccines that don't need dry ice will be approved, so logistics will direct the easier to ship ones to remote places.
Most of the producers have had their entire capacity bought out in prep for distribution of the vaccine.
Eventually you are right. If the Pfizer vaccine is to be used in remote places the people getting the vaccine will need to schedule it in advance (and probably pay for it) to ensure that once it arrives it is used.
You might want to update the comment to avoid confusion.
The other two current candidates are mRNA vaccines, an approach which hasn't been used in humans before -- looks like the harbinger of a revolution but we have no past experience.
This O/AZ uses the actual spike protein embedded in a simian virus (that does not affect humans and has its own DNA removed). It's possible to generate antibodies to the vehicle (virus) which is why a simian virus is used (humans won't already have encountered it) but also means your own immune system could target the vaccine itself. Loewe speculates that this is why the higher dose was less effective.
On the other hand we still have no idea how well these vaccines will work. First, we have (as I discussed) two different approaches in the three current candidates, one of which is fairly new and one which is completely novel. We have had only limited time to see how well they work and have only limited experience in broad efficacy, duration of effect, and, crucially, how long they last (it takes a long time to learn if you'll need a 10 year booster!). We don't know how fast the virus mutates away from the vaccine's target (though we do currently think we have a good idea). And we simply haven't tried enough people to get a good handle on side effects.
One of the difficulties in solving these is that new approaches contain unknown unknown. Look at CRISPR-CAS: got a (deserved) Nobel this year yet may already have been discovered to be ineffective or worse in the real world. That takes time to learn.
Now it's not that the people doing the work are idiots -- they know all these problems better than I do. But I am appalled that this is treated by the press as a distinction between, say, a pair of beta implementations of something, one in Python and one in Ruby.
Going back to systems issues: when we don't know these factors we take a calculated risk (really an estimated risk). The social aspects of vaccination (close to ubiquitous use, the risk of any side effects increasing the anti-vaxx rate for other immunizations, which itself could become a public health disaster etc) mean these factors are upmost in public health officials, not whether they have adequate refrigeration.
Vaccines are particularly difficult for reasons like these above -- there's a reason why they have their own special laws and government-assumed liability insurance. I haven't worked on vaccines, so take this as you will, but I have worked in anti-invectives, have designed preclinical and clinical protocols (including first-in-human) which were submitted and approved by the FDA, run clinical trials, have presented to the FDA and defended protocol design, so I have some idea what's involved and how to read the presented endpoints and findings.
Sorry I’m a total noob in this area.
I answer your question in a parallel comment; click "parent" on your comment and look at my response to jeromegv
Honestly I feel like this vaccine is going to leave the mRNA-based vaccines trailing in its wake in terms of global government adoption.
However for developing world the prices becomes the issue, so you are probably right, this vaccine is cheaper and thus more available.
[1]: https://www.nationalgeographic.com/science/2020/11/moderna-e...