Pfizer Covid vaccine approved for use next week in UK
bbc.com
bbc.com
1. Heavily impacted by Covid-19.
2. Centralised health care system makes it easier to compare results and efficiency. E.g. it's UK which figured out that dexamethasone is efficient against Covid https://www.who.int/news/item/16-06-2020-who-welcomes-prelim...
3. Developed country with great logistics.
That will take until February or so to complete.
1. Long-term care residents/staff
2. Hospital workers
3. Anyone 85+ years old.
Priority ranking is here: https://www.gov.uk/government/publications/priority-groups-f...
Though this is generic and should change depending on the results on vaccine trials (should there be evidence of differential effectiveness).
* older adults’ resident in a care home and care home workers
* all those 80 years of age and over and health and social care workers
* all those 75 years of age and over
* all those 70 years of age and over
* all those 65 years of age and over
* high-risk adults under 65 years of age
* moderate-risk adults under 65 years of age
* all those 60 years of age and over
* all those 55 years of age and over
* all those 50 years of age and over
* rest of the population (priority to be determined)
[1] https://www.gov.uk/government/publications/priority-groups-f...
That is:
1. Immunize the age group that is dominating in the hospitalization statistics, then 2. Immunize the age group is accounting for the majority of transmission, then 3. Immunize the rest.
There's a good chance that situation will create a black market both for vaccines (real and fake) and forged proof of vaccination.
The UK government has ruled out having a vacination passport (for good reason in my opinion).
The UK government changed their mind about a second lockdown given new evidence. The virus got much worse and they responded. What new evidence is there that the UK government is going to start vaccination passports? Has something changed?
That's the wrong question. The right one is "may something change in the future?" And an answer on this: "maybe, we don't know, nobody knows the future".
That being said, extrapolation of the exponential curve a month forward is one of relatively simple ways to predict the future. And yet, it was _completely_ unexpected for the UK government. Think about that.
Strong opinions, loosely held.
At first glance forgery seems like a very real threat considering how hard it is to tell vaccine from sodium chloride (entire testing procedures are based on this), but the same difficulty is also working against a black market: why pay if the seller can't give event the slightest indication that it's not a fake and the fake has no intrinsic value at all? You'd have to fake the distribution structures and not the product and an elaborate fake structure isn't something that suddenly pops up from some dark market investment, it could only evolve from simpler black market schemes. But those won't happen, at least not in time (except maybe in places with a truly corrupt regular distribution system, where it would start with "redistributed" real vaccine and then slowly shift over to fakes)
I have no doubt there are some pretty interesting models being developed to determine the best course of action.
So we don't know how beneficial your 2 above would be.
https://www.medscape.com/viewarticle/941030?src=soc_tw_20111...
The results announced up to now just showed that the vaccines reduce chance of a vaccinated person becoming sick.
Where do I sign up?!
If the goal is to slow down the pandemic, then the "irresponsible spreaders" should be vaccinated first.
On the other side, if the goal is to punish "irresponsible spreaders", then they should be vaccinated last. But that also means that pandemics would not be slowed down, and the ones taking that decision will be responsible for further spreading.
Or you could go by demographics. The hardest hit groups in the worst spreading areas. Etc.
You're right that it's not a trivial thing, but if you wanted to do it, reasonable approximations could be found.
HN-ians like to model stuff, and i get that. To do it properly we need to know how many "young"(active ppl) there are, how many old with lung problems, the rates of propagation in and between those, and probably other stuff. But the goal is to keep the deaths down, and my opinion is that by far the smartest way is to first vaccinate the vulnerable people and those who deal with them directly (nurses, etc.). There's also a lot of points about practicality. For example; If i get infected not much happens (i'd just have to isolate myself, even with heavier symptoms). But if my mother gets those severe symptoms she would need to go to the hospital, if she would live at all.
Even if the math says it's better to vaccinate the young ones first, i'd still argue that it's overall safer to vaccinate the vulnerable ones first.
I believe that most experts are expecting it won't.
> The final decision on the prioritisation for health and social care workers will be dependent on vaccine characteristics and the epidemiology at the start of any programme.
Which hospital / trust are you with? I had mine done at Royal Free.
Care homes are all mostly small, with a handful of employees.
EDIT: Wales has just said it's going to be really hard getting the Pfizer vaccine out to care homes: https://www.pulsetoday.co.uk/news/clinical-areas/immunology-...
Selfishly, I guess we should be happy that there is an anti-vaxxer sentiment; it means the rest of us will get our vaccines faster.
I find this ridiculous considering the massive challenge we have ahead of us just to get the vaccine to the millions of people who desperately want it.
Sure, if we get to the point where everyone who wants the vaccine has had it, and there are still people dying from COVID, then we can discuss illiberal measures to increase vaccine take-up. (I'd still be opposed to them).
Getting worked up about this stuff when not a single person (outside of the trial groups) has been vaccinated yet just demonstrates our politicians' (on all sides) tendency towards authoritarianism.
https://www.itv.com/news/2020-11-10/covid-vaccine-will-enoug...
...to no longer be a threat to an unvaccinated person.
This isn't like the childhood vaccines, where we need herd immunity to protect the children who are too young to be vaccinated.
Provided that everyone who wants the vaccine can get it, I don't see the problem with letting everyone else make their own decision.
The current priority list of people is nowhere near 70% of the population anyway. Most people under 50 won't have the opportunity to be vaccinated for months. So this absolutely is a theoretical problem, at least for now.
Given that Covid is such a mild disease for most young people, I predict that by the time the elderly and vulnerable have been vaccinated, this will be a non-issue anyway.
This whole thing becomes moot once the vulnerable are vaccinated, no need for creepy immunity passports.
It wasn't healing and it turned out he had an undetected issue processing folic acid I believe, which has an effect on how your body heals from neurological damage. He's recovering now after 3 months but has to take folic acid and other supplements 5 times a day.
Other friends have had persistent diminished lung capacity for months on end; these are folks who had no co-morbidities and in their 20s.
However, through my partner I am friends with many classical singers. They are absolutely worried about damaging their instrument.
It's not only too young children who might not be legitimately unvaccinated...some people who are immunocompromised or otherwise medically unable to take certain vaccines must also rely on herd immunity for protection.
https://immunizebc.ca/sites/default/files/graphics/vaccine-s...
Pandemics have, since time immemorial, been an exception to the "I can do what I want" rule.
Much like allowing parents to fall into conspiracy theory traps and refuse to allow their children to be vaccinated against measles, resulting in that disease suddenly becoming a threat again, if we're going to get back to normalcy we can't let half the population ignore the vaccine.
But, since we are going to let half the population ignore the vaccine, prepare for a long, drawn-out period of time during which the disease will flare up, lockdowns will be imposed, more people will needlessly die, and conspiracy theories will continue to make a mockery of civilization.
People who do take the vaccine are likely still able to spread the virus.
The pandemic is not going to go quietly any time soon.
Restricting social interaction and business is a crushing approach to solving the problem, with severe consequences to health and economics. It's brute force, like securing a computer using an air gap. The only reason lockdowns have been used in 2020 is because we have no other options available, but a free and readily-available vaccine changes the calculus.
Having worked in the pharmaceutical industry, if I ever said my FDA approved drug was "safe and effective" I'd have the FDA dropping the hammer on me.
The FDA does not prove a drug is safe. No drug is 100% safe. The FDA determines whether the risks of the treatment are outweighed by the benefit.
I have no doubt that additional safety signals will pop up from Covid vaccines as the treated population expands by 100x. Most likely they will not be severe and the risk will still outweight the benefit.
But to say "we've tested the vaccine on a 15,000 people so we know it's safe to vaccinate 1B+ people" is not something the FDA would agree with.
To me a chainsaw is a safe tool to use. Dangerous, but safe. To others it is not. Is a chainsaw a "safe" tool?
No drug is safe, but in this case, not taking a drug is not safe. If it's safe enough to vaccinate 15,000 people, when 300 of them are expected to die without vaccination, it's incredibly unlikely that side effects discovered on 1 billion people will not make the vaccine the safe choice.
Happens extremely rarely though.
And the FDA itself talks about approved drugs being safe and effective: https://www.fda.gov/drugs/drug-information-consumers/fdas-dr...
The FDA is incredibly strict when it comes to advertising. I remember reading about one violation where the ad had a tagline for an ADHD medication "So you can concentrate on the important things" and showed a picture of a child studying. The FDA said "the image implies that your medication will improve the ability of a child to study and you have submitted no data to the FDA to support this claim".
The more people that get vaccinated, I think the easier it'll be to start vaccinating more and start getting back to normal fingers crossed
Support dropped by 20%. Surprisingly, it dropped by about the same amount for both the political right & left, although support on the left started at a higher level. This may indicate that even people on the right were influenced by the perception of a too-rapid approval process.
[0] https://www.pewresearch.org/science/2020/09/17/u-s-public-no...
Plus, any given vaccinated individual would have to rely less on others being vaccinated as well.
But I am grateful that vaccines got developed and tested so quickly anyway.
The Oxford vaccine is far cheaper (15x) and easier to store so long term it has a lot of competitive advantages.
After a bit of push-back the laboratory acknowledged that this 90% efficacy was comparing a much younger vaccinated population than the one that got placebo.
That has put some doubts on the entire procedure (with countries forcing them to publish details), but it doesn't look like a real problem right now. Anyway that one high efficacy result is very likely flawed.
Anyway, what I get is that the important part is this: "Nobody getting the actual vaccine developed severe-Covid or needed hospital treatment."
1. https://www.theguardian.com/uk-news/2020/nov/23/oxford-covid...
I don't know what the regulator will do about this situation; it's clear that the vaccine is effective in at least one of the dosing regimes administered, but being entirely certain as to which is better is probably impossible to determine from the data available.
https://www.bbc.co.uk/sounds/play/p08ztv8h (starts around 7:30)
Professor Jennifer Rogers (clinical trial statistician):
> "There was some planned dosing differences anyway but this one happened by accident. Now that doesn't mean these results are completely invalid - doesn't mean that at all. You can make changes to your protocol and you can make changes to what you're gonna analyse all the way up until you actually see your data.... If you haven't seen what the data looks like, you are allowed to make changes to your protocols and it is quite common, it does happen that people make changes as to what they're going to analyse.
> "So this change was carried out with discussion with the regulators so it was all fine..."
Now I tried to find the same information reported online and I found this from the same Professor:
https://spectator.com.au/2020/11/what-we-know-so-far-about-t...
> It is perfectly acceptable to make changes to the protocol prior to database lock, so the protocol could have been updated to include this additional analysis (the point of closing a database is to ensure a trial can remain blind, meaning researchers can’t carry out ad-hoc analysis or potentially selectively report results before proper analysis takes place). However, according to version 14 of the protocol, dated 9 November 2020, the primary analysis was set to be the efficacy of two doses of vaccine (across both half and full dose), with secondary analyses being the efficacy of at least one full dose and efficacy of two full doses of vaccine. Efficacy of half dose with a full dose booster was not considered as a secondary analysis in the protocol and so could be an ad-hoc analysis post database lock.
So I'm not actually sure whether AstraZeneca announced the change to their analysis before or after they started looking at their results. If they announced they were going to include the half-doses before database lock then they can use them as valid results.
[1] https://clinicaltrials.gov/ct2/show/NCT04516746 [2] https://www.reuters.com/article/uk-health-coronavirus-astraz...
Maybe there are extraordinary arrangements being made for the vaccine, but it won't be because of a good prevailing open-market logistics situation.
Edit: here's the Road Haulage Association warning of severe supply chain disruption https://www.bbc.co.uk/news/uk-54021421
Edit 2, since responses are unexpected:
> HMRC's assumption is that there'll be 11 million new customs declarations a year on goods going from GB to NI as of January 1
Negotiations are ongoing to secure a trade deal with the EU once the transition period is over. The UK are also securing trade deals with other countries, including Canada and Japan.
Both sides recognise failure to reach a deal, or to extend the transition period, would be damaging for both sides.
Which is precisely why both sides are negotiating a deal to ensure that doesn’t happen...
Am I missing something here?
"3. Developed country with great logistics."
Which I now realise I misread as "Developed in a country" (i.e. Belgium, where it's manufactured). An entirely different, erroneous, reading of the sentence.
Therefore my comment addressed the nature of cross-channel shipping which authorities I respect have repeatedly warned about.
It's too late to edit to add that clarification about the misreading. But that's what was missed.
If the army steps in to provide logistics at a time of national crisis, that's great. But it's not what I would expect this government to do based on the recent historical evidence: We've been in a national crisis for a while and the government has routinely preferred to neglect public-sector expertise and go private in a vast array of public procurement. Much of it has been highly questionable judgment (ministers awarding contracts to friends with penalty clauses).
Please don't under-estimate our ability to fuck this up, probably by giving the distribution contracts to a crony.
Where we fuck up is in the competency of the people in charge of awarding contracts.
Be it Grayling giving millions of pounds to a ferry company with no ferries owned or leased, or indeed any experience at all with ferries (and, wonderfully, with a T&Cs on their website copy-pasted from a pizza delivery site). As a wonderful finale, the government was sued by EuroTunnel because they awarded the contract without going through the proper process (which, of course, would have meant that the drawbacks of a pizza delivery business offering ferries might have been identified); we gave millions to a Ferry company incapable of delivering anything, and then millions to an actual transport company in compensation for breaking the rules on tendering.
Or be it KFC awarding their chicken distribution (despite warnings from people who knew) to a company with no experience in or facilities for cold food distribution, leading to KFC going literally out of business for a couple of weeks because they had no chicken in the stores.
We Brits have a competent infrastructure and the ability for the people in charge to award contracts to entirely the wrong parts of it.
Large PPE contracts were given to companies with no experience in making nor providing PPE, while companies with some experience were ignored. (Sometimes these contracts were awarded to personal contacts of ministers -- one was given to a bloke in the pub who happened to have the minister's contacts in WhatsApp.
[0] I don't actually mean "thanks". That's childish and passive-aggressive of me, and I shouldn't do it. What I really mean is to suggest that I think you've added nothing to this and that you're addressing a point that nobody made, for reasons only you know. I would guess that it's some kind of hyperbole, and that what you kind of mean is "oh, for something as important as this, someone will do a proper job" which is at least a meaningful statement (if perhaps something of a triumph of hope over experience), but if I have to pick apart your snark to get the actual meaning, I'm doing your job for you. Can you not just write clearly, and state what you mean?
Both of the massive fuckups I listed were highly unlikely, but they still happened.
No, I didn't actually interpret your comment as a claim that KFC will be in charge of the rollout. There's no need to be aggressive.
I haven't seen the word used outside the UK so a definition might be useful: a quango, or quasi non-governmental organisation is the platypus of the British government world. As the name implies it's neither a part of the government nor the private sector. Instead, quangos are paid for by taxpayers but are completely unaccountable to them, as they can't be directly controlled by ministers or the civil service.
The theory behind this is that governments are crap at things because elected politicians interfere with the expert work of technocrats. So by setting up artificial blockades to political interference, power is transferred to technocrats and things should work better.
In practice what happens is that the government ends up hiring people who aren't very good at what they claim to be expert in, and who get corrupted by whatever unaccountable powers have been delegated to them. But they aren't easily fixable because they're "independent".
The Electoral Commission is a good example of a completely broken quango. Its only goal in life is to organise elections and referendums in ways that everyone agrees is completely fair and trustworthy. It is a staggering failure: the board of directors is full of people who publicly state very strong political opinions. It engaged in a legal vendetta against people who campaigned for Brexit. It has constantly prosecuted pro-Leave campaigners and got its ass kicked in court, where judges have repeatedly dismissed cases on the grounds that they have no evidence and/or are engaged in malicious legal behaviour. They've referred cases to the police that were then dropped for lack of evidence. Senior staff have posted on Facebook that they cried when the Tories won the election. Nobody who has followed these sagas can possibly believe these people are neutral, independent or even possess basic competence, but as they're a "quango" there isn't much of a framework to fix it beyond changing the law to totally abolish them.
tl;dr quango = power without accountability.
Still, there has not been the same hit from the disease, which only underlines that the differences in effect that are seen worldwide are about differences in population and geography - being overweight, having a very low friction of movement (e.g. excellent transport links, many borders), and not being low in vitamin D etc - far more than they are about government response.
I'm not saying the UK government has done well but it's striking to me that, from a distance, the criticisms of the UK and US I see coming from my friends are very similar, very parochial, and seem driven by media headlines rather than anything objectively sound.
In short, I'd give it another few years before you judge them more harshly than the government that brought us the Iraq war, for one.
While governments change and might or might not be incompetent, those structures largely remain the same.
I'm not saying that the government shouldn't be kept in check, but the fact that the UK government appears to move with all the speed of a striking slug appears to be the fault of the system they are required to follow, not the government itself.
they're pushing for more cycling, more climate measures, more taxes on IT giants etc
and these are Conservatives, the opposite of left-leaning.
on the other hand, their Covid response was the same as Spain, Italy, France etc i.e. pretty bad. but they also approved the vaccine really quick, and we're getting that next week.
so overall, a meh, like most other countries where I lived.
as a point of reference, from the countries I lived in, I consider Singapore and Tokyo to be a notch above the rest of the world when it comes to governance.
but most government of the countries i've lived in were the same as the UKs: they only react, they're politicians, they're detached from the real world etc etc
was this always so? i've noticed this while living in London and, coming from a literal 3rd world country, I do not understand it. i'm trying to find when this started... i don't it started anytime in the recent past. seems to have been going on for a while.
Being self deprecating is very common in a large number of countries, among all those who are reasonably intelligent or educated, to be able to notice how many bad things exist around them.
As others have already mentioned, this is caused by the fact that people can see directly the many bad things that exist in their neighborhood, but they have very little information about how things are bad elsewhere, and they hope that at least in other distant places the same mistakes are not being made.
And I saw what happened to NHS Logistics, which was one bit of the NHS that wasn't losing money. It was running well. It was privatised to DHL in 2006 for purely ideological reasons, and then for several years was terrible. Ten years later, after Lord Carter's report into efficiency and productivity, we set up a new org called NHS Supply Chain and in effect re-nationalised it by giving the responsibility to a company which is owned by the Secretary of State for the Department for Health and Social Care. I don't think anyone has really learned any lessons from that.
So to put it another way, It is not that NHS is good, it is just the others are worse. Although this conclusion or opinion also makes me rather sad.
How does this relate to your point about a culture of self-criticism?
That's like beating your children but comforting them that they atleast have food on the table and clothes on their back.
This has been made worse by terrible political decisions, such as Brexit [0]. Specifically, austerity and political decisions (not limited to corruption) is linked to 130,000 preventable deaths [1]. Those same "budget cuts" for austerity exist while money is sent to "consultants" to "help fix things".
Not everyone in the UK has it well. The government, quite frankly, is fairly shit. And corrupt.
[0] - https://www.ifs.org.uk/publications/14901
[1] - https://www.theguardian.com/politics/2019/jun/01/perfect-sto...
The UK has one of the first (Oxford/AstraZenica), but this news about the first approved is not a vaccine developed in the UK. But I'm still happy to celebrate the Turkish couple's German company that's owned by Pfizer, as I will be when Oxford hopefully release more good news on top of their initial press release.
And our culture is far from perfect in the UK. Criticising a country's problems doesn't prevent also celebrating its positives.
I can't find the original quote but I 100% agree with you that it is pretty odd to take pride in something you have an extremely tangential relationship with
Once you've interacted with a corrupt bureaucracy or wondered whether the medicine you bought is counterfeit or realized the only thing stopping the cops from shaking you down is luck, you get a new found appreciation for stability, reliability and fairness (yes not always) of developed countries.
The UK national infrastructure does have a history of dubious at best procurement, outsourcing and "consultancy" decisions in supplying it's services - those public services often then coming under extreme criticism from the same quarters as your attack - who are often the same private sector blowhards who cause many of the problems in the first place.
Far more public sector hating and damage comes from there than from the virtue signallers you (rightly) criticise.
That is a very tactful way of describing what has gone on in this country for a while
To take the example of the NHS - it is constantly under attack by budget cuts, fragmentation and privatisation. Would it still be something to be proud of in a few decades if everyone stopped holding leaders to account?
I think you are arguing that some people are not genuine. If the price of progress is hearing people you don't care for virtue signalling, that's fine by me. I'd much rather have too much, and risk some of it not being genuine or warranted, than too little.
And I would argue that the people who genuinely want better demonstrate more national pride and a better understanding of their own culture than those sitting back and patting themselves on the back.
NHS Logistics didn't run well. As is consistently true of government run organisations it was run so badly that most of the NHS didn't even try to use its services. At the time of the privatisation the NHS sourced around half a million products but only acquired 50,000 of them via NHS Logistics. The entire purpose of privatising it was to try and make it work better and thus to encourage the NHS to buy more centrally to get bulk discounts, something that wasn't going to happen for as long as doing so required them to work with a small, sclerotic socialised bureaucracy.
Why would anyone think that an organisation which had no economies of scale, nor any demonstrated expertise in logistics in a competitive environment, be better at delivering things than DHL, a world famous delivery and logistics company that the NHS frequently chose to use anyway in preference to its own operation? That's ideology.
How much did NHS Logistics workers care about the health of the citizens who paid their salaries? Not at all: even though many of them were going to keep their jobs anyway they reacted to privatisation by going on strike and picketing trucks to stop them delivering supplies to hospitals. That's ideology. Fortunately it didn't kill anyone, but only because hospitals were already mostly bypassing the striking workers already due to aforementioned poor performance.
The NHS had its limits thrown into sharp focus this year. Mass testing is a bad idea, but putting that to one side for a moment, Germany and indeed most other places were able to ramp up test volumes far faster than the UK did, because Germany used private labs from the start when the NHS insisted on only using NHS labs, despite being given direct commands to scale up testing as fast as possible. That's ideology.
Finally, the supply chain hasn't been effectively renationalised. The contract changed from DHL to Unipart:
https://spendmatters.com/uk/dhl-challenges-loss-of-nhs-logis...
Supply Chain Coordination Ltd is what the name suggests: a relatively small coordinating body that manages contracts for various services, including contracts for logistics provisioning.
The brutal reality about the NHS is that not a single country in the world has copied this model. If it was good we'd see other countries adopt it but they don't. They don't adopt it because it's not good: this model is a relic of a time when the British public had just won a world war and as such had been exposed to years of war propaganda that made the government look artificially competent. In countries where that didn't happen the idea you'd want a single, centralised government agency to run every aspect of something as vital as healthcare was seen as insane: after all, if you go down that route why not have the government supply all food too? All entertainment? Why not run a fully USSR-style economy? Well because we know it doesn't work, that's why. There's nothing magical about the NHS that renders all those experiences irrelevant.
My own experience of the NHS (as a non-Brit who lived in the UK for more than a decade) is that it is inefficient at the small things (sitting in a waiting room for an hour - but being shamed if I show up 10 minutes late for my appointment) but brutally effective at big important things (treatment for life threatening diseases - worked well, but the biscuits were rubbish). I know this isn't data, but I also know that British people love to carp about the NHS, and having lived with health services in two other industrialised countries, I quite liked it.
The NHS is not healthcare. The NHS is not doctors or nurses or life saving operations. The NHS is not hospitals. All first world countries have these things, but none have an NHS except Britain.
The NHS is a bureaucracy that manages resource allocation. That's it. That's all it boils down to.
When you saw life saving operations working as hoped, that isn't happening because of the NHS. You'd see the same in France, Germany, Sweden, the USA, Japan or many other places. We don't judge the skill of a bureaucracy or institution based on the skill of individual employees, we judge it based on factors like:
1. How much overhead does it impose?
2. How competent is it at organising its operations?
3. How agile is it, how able is it to react to new circumstances and continually improve itself?
4. How many people can access its services, who might want to use them?
5. If it fails at any of those criteria, how easy is it to switch to a competitor?
The NHS varies from average to poor when evaluated by these criteria, with the exception of (4) where it gets the best possible score because it even happily treats people who flew in to the UK specifically for free treatment! But if we exclude that edge case then it becomes pretty average again, because universal access is solved in other societies using insurance schemes of various kinds (sometimes mandatory and subsidised). The exception is the USA where for cultural reasons a lot of people don't like being forced to buy health insurance.
Although its overhead is reasonable when evaluated in pure GDP terms, this is achieved partly through building up large maintenance backlogs which is hardly sustainable: true cost of the NHS to the UK should probably be higher than is actually reported. The government has tried several times to force the NHS to spend money on maintenance and upgrades but usually fails: the NHS takes whatever money was granted to it for this purpose and immediately spends it on daily operations in violation of their agreements. Nothing happens because to Brits the NHS is a holy religion, so NHS management don't really feel accountable.
The biggest problem with government run industries is not that they can't carry out their mission at all. Soviet factories successfully made steel and rockets, after all. Their problem is lack of agility and lack of quality. Agility: see the NHS testing ramp-up problems discussed in sibling threads. Quality: see how slowly the NHS ramped treatment back up after the April shutdown. Other countries did much better in that regard, because private hospitals desperately want to treat people in ways that the NHS just doesn't. How could it be otherwise: if private hospitals don't treat people then they run out of money and go bust, like any other business. If the NHS doesn't treat people, its staff basically get a paid holiday with no negative consequences. Of course that affects people's behaviour.
I said average to poor, that's true except for (5) where the impact is catastrophic. Its tax funded status means the private health sector is seriously throttled in the UK. So only the rich can work around NHS failures, and even then not always (private hospitals don't do the full range of treatments in the UK).
> tax funded status means the private health sector is seriously throttled in the UK
This doesn't make sense? Bupa exists?
Private health insurance is quite cheap in the UK compared to America because anything complicated or expensive can and will be dumped back on the public sector.
> this is achieved partly through building up large maintenance backlogs which is hardly sustainable: true cost of the NHS to the UK should probably be higher than is actually reported. The government has tried several times to force the NHS to spend money on maintenance and upgrades but usually fails: the NHS takes whatever money was granted to it for this purpose and immediately spends it on daily operations in violation of their agreements. Nothing happens because to Brits the NHS is a holy religion, so NHS management don't really feel accountable.
Unsourced Tory propaganda.
How do you know? Nobody talks about alternatives to the NHS in the UK, even though it's an obvious topic that should be talked about all the time (the UK's a highly visible exception to the consensus of other rich countries and that would normally provoke debate). You don't actually know what the alternatives to the NHS are because any attempt to be honest about the system's problems are immediately met with a horde of leftists yelling things like "Tory propaganda", and insisting that anyone who criticises the NHS inexplicably hates nurses/babies/life saving operations, etc. They successfully shut down political debate every time.
It's entirely plausible that if there was a serious, honest and rational debate in the UK about healthcare then the country would move towards a European system. Why not? The UK aligns with European neighbours far more often than it does with the USA and that will likely continue even after Brexit.
Re: Bupa. Aren't you agreeing with me here, then? The private healthcare sector in the UK is anaemic compared to other countries because it's so hard to compete against "free". They end up trying to offer slightly better quality around the edges. They can offer complicated or expensive operations too, but people are already being forced to pay the government for them regardless of their own personal evaluation of quality or need, so hardly any market exists. Bupa is a minnow compared to its equivalents in the rest of the world, and how many competitors to Bupa can you name? The British healthcare market exists forgotten in the shadows because the NHS drowns it.
[Unpleasant facts] Unsourced Tory propaganda.
This is what I mean. It's not propaganda, it's actual reality that Labour and leftists live in denial of. Literally the first result for [nhs maintenance backlogs] is this:
https://www.kingsfund.org.uk/blog/2019/10/ERIC-data-nhs-esta....
"In 2018/19, the total cost of tackling the backlog of maintenance issues in NHS trusts rose by 8.4 per cent to £6.5 billion. And of this over half, £3.4 billion, was for issues that present a high or significant risk to patients and staff (see Figure 1). Now, if these numbers don’t quicken the pulse, a little more context is needed. High-risk issues are identified where repairing or replacing NHS facilities or equipment ‘must be addressed with urgent priority in order to prevent catastrophic failure, major disruption to clinical services or deficiencies in safety liable to cause serious injury and/or prosecution’"
Or you can read about it direct from Parliament (see section 2):
https://committees.parliament.uk/publications/1779/documents...
Note that this backlog is just to restore physical objects to an "acceptable state" (quoting the Parliament document here). It's not to actually make the NHS better than it used to be, just the cost to stop it being so degraded it's actually dangerous: "One director of an NHS trust told me that broken gutters in his hospital lead to water seeping through the walls when it rains heavily. This happens so frequently that nurses now give ‘water updates’ in their shift handovers, so incoming team members know when they will have to start unplugging electrical equipment".
That was the backlog before an epidemic of bad data and advice from government run bureaucracies destroyed the economy that has to pay for it. The government no longer has any financial strength left to tackle this issue, and risks triggering serious inflation by trying to print its way out.
There are many other places you can read about this. The NHS is decaying away because its managers are terminally incapable of making the difficult decisions management requires. Given a choice between paying down their maintenance backlog or giving nurses a pay rise, they do the latter every single time even when commanded by ministers not to. Sometimes they even fail to spend the money they were given and end up with a "surplus", just through managerial incompetence.
That's not "Tory propaganda". It's reality, and exactly how the Soviet union looked at the end of its days.
> Any whiff of ineligibility by payment is completely unacceptable, and rightly so, or we'd end up with the US disaster
Lots of European systems require e.g. payment for GP appointments and aren't anything like the US system. Likewise, the UK makes people pay for dentistry, spectacles.
> From a political point of view, we have to defend the existing system because otherwise the US one will be forced on us
This sounds like unsourced propaganda...
> Private health insurance is quite cheap in the UK compared to America because anything complicated or expensive can and will be dumped back on the public sector.
Most private healthcare in the UK covers complicated and expensive cancer treatments, including ones not covered by the NHS, so this doesn't hold water. (There are a few cheaper, less common insurance plans that don't cover cancer and are designed to complement the NHS coverage, AFAIK)
Tiny firms and shell companies are "an organisation which had no economies of scale, nor any demonstrated expertise in logistics in a competitive environment". DHL at least has a track record of large scale delivery.
> NHS insisted on only using NHS labs, despite being given direct commands to scale up testing as fast as possible
Unsourced, never heard this.
https://theconversation.com/coronavirus-four-issues-that-hav...
"Part of the reason the UK has had difficulty in meeting the 100,000 tests daily goal was because of its focus on centralised testing centres. In contrast to the robust and wide-reaching testing programmes in Germany and South Korea, the UK government initially decided to centralise all of its laboratory testing in a few large hubs"
And yes of course there's corruption and incompetence in government - in procurement as well as everything else. The fact that governments routinely fail to even write proper contracts to buy things should give pause for thought when considering how well they'd handle running the entire operation.
So, not an NHS decision but a political decision by the relevant cabinet minister? That changes the answer. It's important to distinguish between decisions made by "the NHS" (to the extent that this isn't just individual trusts, or NICE, or whatever) and political decisions made by the government which are ideological.
Are you sure about that? The median income in the US is less than $33k.
The UK has universal healthcare so the infrastructure and public understanding are in place to actually do the vaccination programme per se. I have every confidence that the NHS medics will do their part efficiently as they do every year for the Flu shot I get, but getting frozen vaccine delivered to local NHS clinics is a logistics problem and an opportunity for somebody's wife's best friend's ex-boyfriend to be given a £100M contract even though he has no relevant experience and is obviously the wrong choice.
Six months later, with headlines about vaccine shipments defrosting abandoned in carparks miles from their intended destination and tens of thousands more dead the government will announce it had a brain wave, the Army (always the people drafted in when policy has failed) will now deliver vaccines. Don't worry about the money which has meanwhile mysteriously increased to £250M due to "performance payments" which somehow didn't involve performance but did involve payments - that's water under the bridge, can't be helped ...
Remember when we were going to do a snap Brexit, no transition, just drop dead one day suddenly? Basically the same group of fools paid people with no relevant experience and no ships to provide last minute ferry services. How do you provide ferry services with no ships? You don't, you just pocket the cash.
Some perspective would be nice.
When you tell your buyers to go grab every last bit of PPE they can and cut them a blank cheque to do it of course you're not going to get the best price, especially when every other country in the world is doing the same things.
Do you focus on the 10s of millions of pieces delivered successfully? Absolutely not, get the tinfoil and red yarn out, we'll dig up something questionable. I've seen some other countries equipping medical staff in bin liners and gaffer tape, on reflection we have it pretty good.
>In the months following the emergence of the COVID-19 pandemic in March 2020 in the UK, government awarded around £18 billion of contracts using emergency procurement regulations to buy goods, services and works to support its response to the pandemic. Government was having to work at pace, with no experience of using emergency procurement on such a scale before and was developing its approach at the same time as procuring large quantities of goods and services quickly, frequently from suppliers it had not previously worked with, in a highly competitive international market. This procurement activity secured unprecedented volumes of essential supplies necessary to protect front-line workers. Our separate report on the supply of PPE looks in detail at the extent to which demand for that equipment was met and the value-for-money achieved.
While government had the necessary legal framework in place to award contracts directly, it had to balance the need to procure large volumes of goods and services quickly, with the increased commercial and propriety risks associated with emergency procurement. We looked in detail at a sample of contracts selected on a risk basis. Although we found sufficient documentation for a number of procurements in our sample, we also found specific examples where there is insufficient documentation on key decisions, or how risks such as perceived or actual conflicts of interest have been identified or managed. In addition, a number of contracts were awarded retrospectively, or have not been published in a timely manner. This has diminished public transparency, and the lack of adequate documentation means we cannot give assurance that government has adequately mitigated the increased risks arising from emergency procurement or applied appropriate commercial practices in all cases. While we recognise that these were exceptional circumstances, there are standards that the public sector will always need to apply if it is to maintain public trust.
From: https://www.nao.org.uk/report/government-procurement-during-...
And remember everyone, when reading reports like this one should replace any soft seeming rebukes with phrases such as "these muppets had no idea what they were doing" and "this looks incredibly corrupt, but if we say that this report will never be released".
A huge part of the perception that the UK is failing at dealing with Covid-19 due to awarding contracts to cronies comes from exactly this comparison with a South Korean success story that is a complete and utter media illusion. (They're also testing at something like a twentieth the rate of the UK - not enough to offer free testing to everyone with potential symptoms like we do, let alone do regular testing of all medical staff or any of the other things our press says our government is incompetent for not achieving - but you wouldn't know that from the UK media coverage either. Judging from their media reporting on the number of people awaiting results, they're probably not even doing any better at returning the results to people fast either.)
Sometimes they even just outright lie. When the UK hit 100,000 Covid tests in a day, the BBC ran a completely false claim that Germany reached that level of testing a month before the UK when in reality they didn't until several months after us. The BBC kept that claim in an article that was prominently featured on their news front page for a month after they were aware it was false meaning a substantial proportion of the entire UK population probably saw it. I still see it popping up everywhere. (They also claimed that meeting the 100,000 a day goal was faked by counting tests when they were sent out rather than when they were completed. In reality, it was met either way, and one of the minsters involved even pointed this out in a BBC interview - but people who followed the BBC coverage wouldn't know about it.)
https://www.thetimes.co.uk/article/coronavirus-in-scotland-a...
"One country that has achieved an unparalleled level of efficiency and responsiveness in its logistics and sustainment activities is the United Kingdom (UK). The British Ministry of Defense (MOD) has wholeheartedly embraced outsourcing many of these functions to the private sector."
Also of interest: "One of the primary reasons why the MOD is willing and able to enter into long-term PBL-based service and support contracts with private companies, not just British firms but global providers, is because of its attitude towards the private sector. The MOD views the private sector as a positive contributor to their mission. It works hard to establish a collaborative relationship. MOD officials are demanding and insist on adherence to contracting requirements. But they treat the private companies as partners, not adversaries."
[1] https://nationalinterest.org/blog/the-buzz/britains-innovati...
The whole article is a fascinating read, especially when I noticed that it was written in 2016 :-O
If the private company does a good job does it matter that they are mates with a tory? Seems little short-sighted of you if I must say.
[1] https://nationalinterest.org/blog/the-buzz/britains-innovati...
https://www.occrp.org/en/daily/13239-court-to-look-into-uk-g...
https://www.dailyrecord.co.uk/news/politics/record-view-cron...
Again, for clarity: using the private sector isn't a problem. Corruption is. Failing to get results is.
I'm all up for chucking money at a big problem and sorting out the mess later, but this is a depressingly predictable mess, and chucking money at the problem bought us a demonstrably worse outcome than we should have had.
Ok, apart from that, the ideal guinea-pigs would have been the House of Commons and The House of Lords. The former are ultimately replaceable by the electoral process, and the latter are equivalent to a Care Home, albeit taxpayer-funded and all the residents wear ermine-collared red gowns.
Given how short of a time it took to actually develop this thing, could we have drastically sped up this process by maybe being a bit more risky with the trials? At this point ~1.5 million people have died from the virus.
I've really struggled with this knowledge that we've had a vaccine which it turns out is 95% effective for practically the entire course of the pandemic at at this point... and our conservative "moral" process was to let 1.5 million people die while we vet it.
Also, we'd still have had to wait for production ramp up which I believe has been done in parallel to the testing, so it may not have saved that much tie.
My question was more where is there room to speed this stuff up?
But that does presume your methods of exposure are equivalent to what's happening in the real world, both in terms of method and dose. And those are both open questions here and could have bearing on efficacy.
So not even a mild case of the zombs?
https://metro.co.uk/2020/11/25/zombie-mink-rise-from-grave-a...
If I carried the decimal correctly, 5 thousand out of 58 million is less than 1% of 1%.
Hard to walk or smile when you're dead.
1. More than 5,000 people under 50 in a population of 66 million will have serious side effects from COVID.
2. In fact, nearly 3,000 people under 50 have already died from COVID in the UK.
3. This is despite only a small percentage of the population (3-10%) having been infected by COVID.
4. Even if you are under 50, and don't die to COVID, you are going to kill other people, by spreading it to them.
It's like driving drunk. It's personal risk AND risk to every other person around you.
When you do not vaccinate, and then go out and about, you are inflicting risk on immuno-compromised persons, for whom the vaccine doesn't work well.
Unless we lock anti-vaxxers in their homes, or unless we hold them criminally liable for infecting someone else, it's not a question of their personal risk.
Choosing to not get a vaccination primarily endangers you personally, but definitely also raises the danger level to those who have no choice in the matter.
> and make those decision individually
if you can somehow ensure people who get sick can't spread it, sure it's down to the individual, but it's a society-level problem. That's what "infectious" means.
The worst year of the Polio epidemic in the United States was 1952 where 3145 people died and about 21,000 had some level of lasting (but not necessarily permanent) health impact.
I personally don't think the state should mandate vaccinations by the way, even though such a mandate would almost definitely be a net good to society.
1976 was potentially problematic because there was a massive immunization program because of fears of a pandemic, but H1N1 was not actually spreading.
2020 is obviously a different story. The pandemic is here.
This approach is incredibly selfish. Would you pursue it if you were held responsible for consequences of that behaviour, as drunk drivers are?
The government forcing you to take an injection is literally not your choice. Not to mention, we know drunk driving impairs people and increases risk. There are tons of studies that show that (they also show sleep deprivation is worse than alcohol for driving, but that's not illegal ... probably because it's not measurable, or it's hard to gauge intent).
This vaccine has been rushed through the process with zero long-term Longitudinal studies. A drug company can yell 95% effective all they want, but the fact is, this is a HUGE unknown. The vast majority of normal scientists in other fields cannot do this research themselves and there aren't even any published papers yet we can look at.
This is a bad argument. You want some more bad arguments? Look at the Buck SCOTUS decision which lead to forced serialization, or the SCOUTS decision that lead to Japanese internment camps. You know what those two decisions were dependent on? Jacobson. The vaccine case.
Not taking a vaccine and interacting with other people is also a choice.
> they also show sleep deprivation is worse than alcohol for driving, but that's not illegal
Drowsy driving is difficult to prove, but generally held to be within the coverage of reckless driving laws. Some jurisdictions have expressly included coverage of it, as well, at least in the context of establishing the necessary illegality in vehicular homicide statutes (NJ and Arkansas.)
> Apr 2, 2020: Asymptomatic transmission refers to transmission of the virus from a person, who does not develop symptoms. There are few reports of laboratory-confirmed cases who are truly asymptomatic, and to date, there has been no documented asymptomatic transmission.
Any news on this?
Down-voter: I literally quoted https://www.who.int/docs/default-source/coronaviruse/situati....
If you have news on it, say so instead of down-voting. I want to know how likely it is for asymptomatic people to spread the virus. I swear, I will keep checking the responses because I am curious how likely it is that people will catch it from me, excluding the fact that I do not leave the house for weeks (I work remotely).
Most people who play one round of Russian Roulette don't die, either.
You are doing a fantastic job of proving my point.
Show me evidence it stops transmission, and show me evidence it is safe for people with autoimmune diseases. If they come back good, I might take that particular vaccine. If not, then get off my back. If it does not stop transmission, it should be my choice, and you are just giving me a selfish opinion. I am NOT going to risk my health, period. Risk yours if you wish.
You accuse them of playing Russian roulette while you justify not taking the vaccine with "the majority of COVID cases aren't lethal"?
> I think this is way too overblown.
1.5 million people have died.
> I want to know how likely it is for asymptomatic people to spread the virus. I swear, I will keep checking the responses because I am curious how likely it is that people will catch it from me
If you're trying to determine the risk of someone catching it from you (and assuming that you'd immediately self-isolate when you start experiencing symptoms) you should be looking at pre-symptomatic transmission rather than just asymptomatic transmission.
Here's a study that finds that around 44% of infections happened in the presymptomatic stage: https://www.nature.com/articles/s41591-020-0869-5?fbclid=IwA...
But did they die FROM or WITH covid? That's the million dollar question. Here's CDC data that says 94% of Covid-19 deaths involved one or more comorbid conditions... i.e. these are not healthy people struck down in their prime... https://www.cdc.gov/nchs/nvss/vsrr/covid_weekly/index.htm#Co...
Point is, just a raw number doesn't actually make a great argument.
Even worse, it's a number without context. The most recent annual death stat I could find was for 2017 which saw about 54,750,000 deaths. So '1.5m dying from covid' is less than 3% of this year's deaths.
In my opinion, and the opinion of many others, those numbers seem a fair argument for the "overblown" POV.
But might universities and workplaces make it a requirement once a vaccine becomes readily available? That wouldn't surprise me in the slightest. And that may force some tough decisions on skeptics who would have liked to see more time. (Which doesn't include myself.)
How is that different from not vaccinating against a dangerous, contagious disease. It increases risk, and it kills people around you.
> This vaccine has been rushed through the process with zero long-term Longitudinal studies.
There are zero long-term longitudinal studies for the dangers of COVID, too (Or of odds and dangers of losing immunity years after an infection.) Do you get to just assume that there aren't any, without extending the same latitude for vaccination?
Look at the comments in this subthread. Look at the arguments made against vaccination. They aren't data-driven. Not a single number is listed in them. No number of studies are going to convince people whose argument for not getting vaccinated is 'I don't think it's a big deal, and I don't want to, and I will only talk about personal responsibility, because I don't care about my impact on anyone else.'
The fact is that the COVID vaccines, as with any medicine, will have side effects, and some of those side effects may be life-altering. There are valid concerns about the vaccines and these effects that cannot simply be brushed off as anti-vax nonsense.
Some other HN-er said this. If this is true, then it should be my decision. Since I have been through it without symptoms, I am supposedly immune for 6 months, but even after that, I do not really care. I care about it personally as much as I care about the flu. I have not vaccinated myself against the flu in years. Let it be my decision, please. I am not an anti-vaxxer, but when it comes to the COVID-19 vaccine, I am a bit wary. I do not mind tested vaccines that have been around for decades and have been extensively researched and are pretty known to be safe.
You're probably thinking of Great Britain by itself, which is the island containing the main parts of the countries of Scotland, England, and Wales.
> In Ireland, the term "British Isles" is controversial, and there are objections to its usage. The Government of Ireland does not officially recognise the term, and its embassy in London discourages its use. Britain and Ireland is used as an alternative description, and Atlantic Archipelago has also seen limited use in academia.
Amusingly (but perhaps not surprisingly), British imperialism briefly waded into this dispute as well:
> Following British attempts to control the seaway in the late 1830s, the Times Journal, published in London in 1840, referred to the Persian Gulf as the "Britain Sea", but this name was never used in any other context.
[1] https://en.wikipedia.org/wiki/Persian_Gulf_naming_dispute
Has anyone proposed a viable alternative?
Great Britain may have been named after one of the isles, but the controversy arises because the UK spans (part of, but not all of) the two main isles.
> Has anyone proposed a viable alternative?
I don't know what would count as "viable" if you reject "Britain and Ireland" and "Atlantic Archipelago".
> Great Britain may have been named after one of the isles
Great Britain is the largest island of the isles. The UK's full name is The United Kingdom of Great Britain and Northern Ireland; ie there's no political entity of Great Britain (and never has been).
Indeed. I suppose if Ireland's full name were "The Republic of Little Britain" there wouldn't be a controversy about the term "British Isles".
> there's no political entity of Great Britain (and never has been).
Unless you include the Kingdom of Great Britain (1707–1801):
https://www.forbes.com/sites/barrycollins/2020/11/15/amazon-...
> Please don't post comments saying that HN is turning into Reddit. It's a semi-noob illusion, as old as the hills.
While the healthcare is centralised, the data is not, and often poorly federated between a multitude of organisations. Scotland has unified this much more and is far better placed to monitor for efficacy and side effects.
Wait post Brexit to see if you change your mind about that one.
The assessment of a marketing authorisation application for a new medicine takes up to 210 ‘active’ days. This active evaluation time is the time spent by EMA experts to evaluate the evidence provided by the applicant in support of a marketing authorisation application.
This time is interrupted by one or two ‘clock-stops’ during which the applicant prepares the answers to any questions raised by the CHMP. The maximum duration of a clock-stop depend on how long the applicant thinks it will take to respond, but must be agreed by the CHMP. The first clock-stop usually lasts 3 to 6 months and the second one 1 to 3 months.
Overall, the assessment of a new medicine usually lasts around a year.
https://www.ema.europa.eu/en/human-regulatory/marketing-auth...
I think it's been mandatory since thalidomide.
Without a doubt. The closest competitors would be imatinib (3 years) and several other chemotherapy drugs (~5 years) meant to treat malignant tumors. The vast majority of the drugs approved this quickly, with the exception of the HepC treatment, treated diseases with a life expectancy of less than the time it took to approve the drugs so long term side effects was less of a concern.
Not that I have a problem with your asking the question, I just don't think an opinion poll on a tech board is going to yield an accurate prediction of what to expect.
I'm pretty sure they were hoping to be answered by someone heavily schooled in mRNA vaccines and/or a practitioner involved in the trials for this particular vaccine. On this particular "tech board", there's a reasonable chance of getting a response from those kinds of experts.
Part of your answer, which I'm paraphrasing to "I don't know, talk to the experts", is already a good answer. But I was hoping that there was an expert lurking around that might be able to explain the risks or link to some evidence.
The US set a meeting date of 12/10 to decide on EUA so scientists had time to review the data.
The FDA itself closely inspects data throughout the phase 3 trials so this review should just consist of looking at the details to see if something was missed, (ideally) not some brand new information come to light.
For example, the EU is going to review the Pfizer vaccine on December 29, and they have requested further information.
It's mind boggling to Engineers to hear this, but Medicine is older than the scientific method and physicians used Regulatory capture to prevent competition.
I'd love a science based healthcare alternative.
She couldn't find a study to backup the claims that the medical team wanted to make in the document, but the lead doctor said that if this wasn't included, the patients would suffer and ultimately die.
So she said "you need to prove this in a study so it can be included, otherwise you put the company at risk". To which the doctor said "We could do that, but it would take 3-4 years, and in the mean time, the patients we're caring for would go back home, the doctors would be missing the one key piece of advice, and then they'll all suffer and die".
Science is slow. People are dying now.
Formal Peer review is good, but not necessary in science. Replication is necessary.
And as a note, we can still have Authority based healthcare, but a science based healthcare system would be cheaper and more reliable.
But not a lot. That's what's fascinating. At least in the US, over 95% of fatalities are people over 55. We're at 200k ~ 300k deaths for the year in the US (and I think there is reason to believe this is an overestimate, not an underestimate). That's lower than heart disease and cancer (500~600k yearly). I doubt we'll even approach those numbers by March.
Science is slow because it needs to be right. We're no longer in a time 185 years ago when Jenner could just stab people with puss he pulled off of a Horsepox infected cow. Remember that 500 years ago, the Chinese were blowing smallbox puss into people's noses (infections in the nose were typically not bad and people recovered faster) and isolated them. Many of them survived fine, but some died.
Do you want to return to that world where we just experiment on humans without regards to what that means?
This vaccine should be a choice. I'm under 40 and not in a high risk group. I'm fine with people volunteering to take this vaccine. Maybe I'll take it in 5 years. But I don't want to see this become mandatory for going to work or being able to enter a music venue.
You can quote the Jacobson decision all you want, but that SCOTUS decision only said Jacobson had to pay the $5 fine, he never was forced to take the vaccine. Furthermore Jacobson lead to the Buck decision (forced sterilization) and the SCOTUS decision that led to the WW2 Japanese internment camps. It's bad law that's bread a poisoned well of bad law.
I'll never understand people who say this, thinking it somehow proves their point or something. My parents are nearly 60, and easily have 20 more years of time with me and their grandkids. Why are we okay with that?
We can provide support specifically to those at risk, while also respecting the liberty and freedom of everyone else. Someone with an autoimmune disease or who is 65 can choose not to go to a pub and simply not interact with the rest of the world using technology. At the same time, the pub owner should be allowed to make a damn living.
I don't understand why this is so complicated.
There are people who are competent enough to do so. Those people carry the actual responsibility.
Your thoughts have answers readily available.
[1] https://en.m.wikipedia.org/wiki/Antibody-dependent_enhanceme...
I'm sure this has all been thought about by relevant experts but I'd like to see the published research.
It is still risky, and I hope it will not be mandatory.
Personally since I belong to a low-risk group, there will be quite some time before the line reaches me where I need to make a decision, in which more data will be available from high-risk groups. It will also take time for my country currently pressured health care system to allocate resources for vaccinations without causing even more problems. My current estimate is many months from now.
Outside of long term side-effects I am concerned about how long the protection last. It is difficult to calculate risk without knowing that data point.
But I think SARS died out before the vaccine was ready/needed.
While we cannot totally disregard ADE, I assume we should have seen it by now (and the Oxford trial was stopped exactly because they thought they might have observed something like it). Whether it appears again on a population scale level, nobody knows.
100% of the 100ug treatment group had at least one symptom, 80% of those classified as moderate. The vaccine is going to make you feel sick for a little while.
Lucky children can't vote, lets start vaccinations!
I somewhat kid, but COVID is a real life example where a tiny minority has ruled over the overwhelming majority.
However, if they do not screw something up in production (which I regard a larger potential source of error than the vaccine itself) there won't be long term side-effects for most people. There were some side effects from swine-flu in Sweden around 2010 that were certainly major and those affected 1/12.000 people. I would guess that is an upper bound for side effect, but as I said, guessing probabilities of an unknown with sample size one is hard.
BioNtech has been developing mRNA vaccines for cancer patients for some time, so I would not expect any really large long term (in the range of 2-4 years) side-effects for fractions of the population larger than 20% based on that alone.
Vaccine is good but my biggest worry is if the same kind of virus happen again, it will become justification for lockdown until the vaccine exist.
E.g. I believe it was the swine flu vaccine that caused narcolepsy in a small percentage of people receiving it. But that was apparent immediately.
To my knowledge no one has identified any slow acting consequences of a vaccine that would not have been obvious from the first rollout of a vaccine.
So this question is mostly academic. Unless you’re someone in the UK slated to get the first dose, you probably won’t even have an opportunity to get the vaccine before the effects in early groups become known. And for those in high risk early groups, the risk of covid surely outweighs the risk of vaccine.
Nothing has shown up in trials so far so I’m not expecting side effects beyond the known effect of short term flu like symptoms for a couple days.
The mechanism for the narcolepsy was a protein present in the virus itself. So actually getting the flu would have been much worse for those with the genes that made them susceptible.
It doesn’t sound like mRNA vaccines would have this vulnerability. Though I do take your point that it’s possible something like the swine flu narcolepsy event would only be found after the fact. However that would be a pretty small consequence since in this case the flu also would have caused worse narcolepsy.
https://www.youtube.com/watch?v=4bOHYZhL0WQ
Vaccines are also very young. We've had them for 185 years, and there were probably a lot of side effects from people getting stabbed with Horse Pox, but a lot of them probably just died and we didn't collect data back then they way we do today.
It's not comparable.
0: https://sebastianrushworth.com/2020/11/17/what-is-long-covid...
We don't know what "permanent damage" is actually happening. I remember having pneumonia in the 90s and it took my lungs over 3 months to recover, and that's from a normal known infection.
I think there is a strong case to be made, that a lot of these "long covid" cases might be a combination of normal pneumonia recovery, nocebo effect and fear/hysteria over this disease.
It seems very likely at this point that COVID is a disease of the blood vessels, which has the potential to do some really nasty damage to your organs. The numbers are hard to estimate but I've seen experts say that they think about 5 times the number of people who die will have enough problems to be considered having a long term disability. With estimates of case fatality being about .5% - 1.5% that would mean about 5% of the people who get it will have enough long term damage to be disabled.
https://www.nature.com/articles/d41586-020-02598-6
"Evidence from people infected with other coronaviruses suggests that the damage will linger for some. A study published in February recorded long-term lung harm from SARS, which is caused by SARS-CoV-1. Between 2003 and 2018, Peixun Zhang at Peking University People’s Hospital in Beijing and his colleagues tracked the health of 71 people who had been hospitalized with SARS. Even after 15 years, 4.6% still had visible lesions on their lungs, and 38% had reduced diffusion capacity, meaning that their lungs were poor at transferring oxygen into the blood and removing carbon dioxide from it."
We know this much and SARS is poorly studied because it faded away so we generally lost interest in it. This virus is both similar and different enough to be very, very wide spread so even minor negative effects over the total population that gets moderate to mild cases will have the potential to have very large impacts on worldwide health.
As time goes on we are going to better document the consequences of mild and moderate cases and understand these things better, caution seems advisable until we do.
We didn't really shut SARS down so much as it seemed to have shut itself down, conventional epidemic control measures were enough to contain it and it was not quite easily transmissible enough to sustain itself in the wider population without being allowed to gain a real foothold undetected first.
That last point would be why you would not expect (and I would think it is impossible) to find that at the end of the day COVID-19 will be anywhere near as deadly as SARS. We have strong evidence that it takes truly extraordinary measures to suppress this new virus at a rate that will in fact eliminate it from a population when compared to SARS. SARS simply didn't spread that widely because if it did that would directly contradict the relative ease of its containment.
Likewise influenza was well known before the 1917 pandemic, or H1N1.. and?
For example, if one happens in your brain, that's a stroke. Which is known to happen with COVID-19 patients[2].
---
[1] https://www.hopkinsmedicine.org/health/conditions-and-diseas...)
[2] https://www.thelancet.com/article/S1474-4422(20)30272-6/full...
How bad are people expecting the vaccine to be?
> A possible concern could be that some mRNA-based vaccine platforms 54,166 induce potent type I interferon responses, which have been associated not only with inflammation but also potentially with autoimmunity 167,168 . Thus, identification of individuals at an increased risk of autoimmune reactions before mRNA vaccination may allow reasonable precautions to be taken. Another potential safety issue could derive from the presence of extracellular RNA during mRNA vaccination. Extracellular naked RNA has been shown to increase the permeability of tightly packed endothelial cells and may thus contribute to oedema 169. Another study showed that extracellular RNA promoted blood coagulation and pathological thrombus formation 170. Safety will therefore need continued evaluation as different mRNA modalities and delivery systems are utilized for the first time in humans and are tested in larger patient populations.
- most adverse events were due to manufacturing issues (e.g. contamination with some live virus). In this respect, I don't think the Covid vaccines are likely to be any more or less risky than other vaccines, such as the annual flu vaccine
- two vaccines had an association with the Guillain-Barré Syndrome (GBS). Even nowadays, if you take the annual flu vaccine they advise caution if you've had GBS before.
- one Rotavirus vaccine was quickly discontinued after they saw it can cause a serious condition called intussusception
- finally, a case that you'll hear lots of people talking about, a possible link between a flu vaccine adjuvant (AS03) and narcolepsy. The CDC page directs you to the actual study [2]. My summary is that this link was observed only in Sweden and Taiwan, but in no other countries. The Pfizer and Moderna vaccines do not have adjuvants (but Novavax and others will have).
[1] https://www.cdc.gov/vaccinesafety/concerns/concerns-history....
If you offered me a vaccine tomorrow vs a 100% certain mild case of COVID-19 that would guarantee me immunity for a year so I could get the vaccine in 12 months when there was /even more/ confidence about the safety of the vaccine I would take the vaccine.
I haven't been able to come up with a theory as to why public health departments and the media haven't been making the long term effects a key part of their messaging.
0: https://sebastianrushworth.com/2020/11/17/what-is-long-covid...
"Second, covid is not some magical entity, it’s a coronavirus, and it behaves like other coronaviruses, and other respiratory viruses more generally. It would be strange for covid to cause symptoms that other respiratory viruses don’t. And since I’ve never heard of “long rhinovirus” or “long influenza”, I’m inherently doubtful of claims that there’s such a thing as “long covid”."
This is just getting caught up in silly semantics, people are experiencing longer term health effects, they are calling it "long covid" for lack of a better name not because it is an affirmative diagnosis.
"On MedRxiv, there is a pre-print awaiting peer review of a prospective cohort study that followed 4,182 people with positive PCR tests... if we assume that this study was reasonably accurate, then one in 50 people who get covid still have symptoms at the twelve week point..."
This is supposed to be an argument that inclines me to think that whatever "Long Covid" is I am not supposed to be worried about it? If 1 in 50 people that get a positive test are still feeling after effects of having what the author believes "behaves just like other coronaviruses" then I think we should be very concerned! Even if truly long term effects only develop in 1 in 500 COVID-19 cases.. that's a lot of people who are going to be sick for a really long time! It would be 400 Americans a day right now. Yikes! That's bad!
I'll take my chances with a vaccine!
(And I know the standard response to this is.. "well, those people are mostly old or sick with something else so you can't really count it that way" but a certain, maybe large, proportion of those people would probably never get a serious respiratory virus in the near or medium term in the absence of COVID-19. It is a really large number of extra sick people, and all at once.)
Also the 4 other coronaviruses circulating thing is silly, obviously the long term effects of the common cold viruses are not going to be comparable if the short term effects are clearly not comparable, it is reductionism of the worst kind.
> Also the 4 other coronaviruses circulating thing is silly, obviously the long term effects of the common cold viruses are not going to be comparable if the short term effects are clearly not comparable, it is reductionism of the worst kind.
What you are saying is "obvious" is not at all obvious, and is not the assessment of the experts who have looked at the data and weighed in.
In terms of obviousness: why do you think that the long term effects are unlikely to be comparable (if not strikingly similar), since the long term (adverse) effects of each of these four (and also several of the influenza A) viruses seem to be clinically identical, despite each having distinguishable acute characteristics?
> This is just getting caught up in silly semantics, people are experiencing longer term health effects, they are calling it "long covid" for lack of a better name not because it is an affirmative diagnosis.
I agree that the terminology becomes tricky. But I think the question is better stated as: is "long COVID19" any different from other "long covid" (ie, the rare but well known post-viral syndrome that is observed with all coronaviruses).
> Even if truly long term effects only develop in 1 in 500 COVID-19 cases.. that's a lot of people who are going to be sick for a really long time! It would be 400 Americans a day right now.
...but a relatively small cohort in the bigger picture of post-viral syndrome, if indeed it occurs with approximately equal frequency with the other coronaviruses (and some influenza A viruses).
I think we need to be careful about measuring potential adverse outcomes against one another, and try our best to use numbers that reflect the likely lived experience of people (to wit, nearly everyone contracts the "garden variety" coronaviruses a few times in their life).
If the current slate of vaccines don't prevent this effect, then I'm having trouble putting any math together that suggests that it will generally reduce population-level instances of "long covid" (again, defined broadly as long effects from any covid, not just COVID19).
Asserting that all coronaviruses are similar and must have very similar effects in the short and long term seems like a very bad assumption to make, before the original SARS outbreak the scientific consensus was that coronaviruses were not capable of causing sevre illness in humans - despite their long history of being known killers of animals! Asserting we absolutely know things about this virus based on things that we didn't think the whole category of viruses was capable of doing less than 20 years ago without citations is bad!
So asserting that the long term effects of this virus are likely to be similar to the long term effects of other coronaviruses is not credible given the available evidence, and saying that it is likely to be similar to influenza (an unrelated virus that is very different) is even less credible. (And if the hospitals were this overloaded with flu patients every year we'd be worried about the long term effects on the survivors, but they are not!)
"I think we need to be careful about measuring potential adverse outcomes against one another, and try our best to use numbers that reflect the likely lived experience of people (to wit, nearly everyone contracts the "garden variety" coronaviruses a few times in their life)."
I don't know what this is supposed to mean, but if is contingent on believing that "garden variety" coronaviruses are similar in their effect to SARS-COV2.. I mean we can see just by looking at the ICU tallies in nearly every jurisdiction in the world that this is not the case so I don't know what conclusions you expect anyone to draw.
At the end of the day that is what this always comes down to with these COVID-19 debates it seems, the jurisdictions that haven't taken the virus seriously have been absolutely devastated by it, there is no secret knowledge to uncover. One should draw from that the inference that assuming that there is some secret formula of logic that will arrive at the conclusion that we already know the long terms effects of this virus seems less than credible. It might turn out to be correct! But that still won't vindicate the flawed logic of drawing the conclusion now.
If having one's virus research repeatedly published in the world's top journals, and securing a patent for a novel influenza vaccine, does not make one an expert, I think maybe we're casting too narrow a net. Not only in Sunetra Gupta an expert on viruses in my book, but one of the world's best.
> Asserting that all coronaviruses are similar and must have very similar effects in the short and long term seems like a very bad assumption to make
But I didn't do that. This brings us back to my original question: is there evidence that "long COVID19" is different than other long covids? If I'm understanding you correctly, you seem wont to presume that the answer is "yes", simply because the acute affects are different. But, as I pointed out, viruses with a wide-range of acute effects all produce clinically similar "post-viral syndrome". To my knowledge, there is no convincing evidence that SARS-CoV-2 is an outlier in this specific respect. Or am I wrong?
You're just goalpost moving here, the argument in the article you are citing clearly says the viruses are similar and presumes that their effects are similar on that basis. If YOU don't accept that then you don't accept your own cited authority, you're wasting your own time here on that basis.
How is this a credible person to listen to? It boggles the mind, she is an epidemiologist! After making a professional error on that scale I would crawl in a hole and not come out for a year!
I wouldn't be surprised if the leaders of the vaccine firms weren't using their own vaccines on themselves and their families for a couple more years, until they have sufficient data.
I have read enough research papers about the replication crises in many fields to know how much these long term studies are needed to properly assess a risk-benefit analysis for vaccination. I will, personally, stay the fuck away for the next couple years. My life didn't change much anyway, I've been working from home for years now. Less social life, but I can weather that.
As a note, we got COVID with the wife, I was without symptoms while she lost taste for a couple days and was tired for a week. That was all.
Source (german):
"Bund und Länder stellen sich darauf ein, dass "bei bestmöglichem Verlauf" noch im Dezember mit ersten Impfstoff-Lieferungen gerechnet werden kann. Gesundheitsminister Jens Spahn sagte heute im Deutschlandfunk, dass Anfang Januar die Ersten aus den Risikogruppen und auch schon Pflegebeschäftigte geimpft sein könnten.", https://www.tagesschau.de/inland/faq-corona-impfstoff-105.ht... , 1. Dezember 2020, 11:00 Uhr
Having said that, I believe the EMA (EU) also carried out a rolling evaluation, so I'm not sure what the differences are there.
There is absolutely 0% chance at the end the vaccine will not be approved. But 100% chance 20 days will have been wasted.
That's not true, I think it's foolish to 100% trust a company to not make any rushed mistakes, lie, or hide some facts, when there are massive amounts of money involved.
How are they going to check if the manufacturer fudged the report? Run the experiment themselves again in 20 days?
Edit: by the way in the UK they were prepared properly and the vaccine is approved today. Or would you say they are acting irresponsibly?
Site and document inspections.
"Why worry about something that isn't going to happen?"
So looking at it for 20 days isn’t going to help with that. It’s just going to cost 100000 lives.
In reality life is full of gray and often the correct answer is found "in between".
Let’s look at how it turns out in the UK. Mr. Fauci already ate his words of critique and apologized.
The report is about 15000 people who got the vaccine and didn’t get seriously ill. There’s nothing to judge on that you can seriously do in 20 days, in that time frame you can only look at the basics and these are clear: 15000 people got the vaccine, didn’t get seriously ill and mostly became immune.
It’s a waste of time and time is lives.
Delaying vaccines is not ‘just the reality of things’. It’s a political decision with grave consequences. One country makes one choice, another makes another choice. The reality of things is that choice decides wether people live or die. There is no way to shift the blame away from that.
In any case, it's still somewhat unclear why the UK has done so badly with Covid. There are some obvious things the government should have done better - and unless Brexit turns out to be a "titanic success", I can't see how Boris Johnson will remain PM until the next election. But even compared to countries that have implemented weaker measures, slower than we have, or have had their healthcare systems overwhelmed, or struggled with testing - we've suffered much worse. And the reason why is, at this point, unknown.
One argument is we have a less healthy population, either due to lifestyle factors or due to having relatively mild previous flu seasons. Another is our dense, poor housing and service economy. Another is travel and weather. Will be interesting to see what falls out over the analyses over the next few years, and if anything is done to act on the problems (I doubt..).
The factor that these preparedness plans can't account for who is in charge at the time the disaster hits. We might have technically had the best plans, best scientists, best civil service, best procedures - and then the person in charge refused to listen to them. Like Trump and the CDC. Maybe people will vote for competence over bluster next time around? (I doubt..)
The only danger sign I would foresee that would indicate a rush is if some regulator declines to approve emergency use - but given the data that seems highly unlikely.
They've had some of the data for a while. Pfizer didn't finish their analysis of the Phase 3 data until close to their EUA submission on Nov 20th.
But yes, you are correct, the EMA has specific requirements for it's submission and if they haven't received it until Monday, it's going to take a while to review it, even on an expedited basis.
My mnemonic: the two Ls are like parallel lines.
I'm actually rather wondering what's taking the EU so long.
If interested, the FDA release all documentation - search for Drugs@FDA and find a recent medicine, and see just how much review it gets. You'll be surprised!
What's ridiculous about this situation is that the regulatory authorities are not willing to weigh against the benefit which would come from an early emergency-use authorization (which could have happened as early as August). It's like CPU branch prediction: approve the vaccine for early distribution as fast as it can be made--which would only have been a few hundred million doses globally so far--while the phase 3 studies are going on. The early distribution would be watched as observational studies, of course. If it fails Phase 3, stop distribution and move on to the next vaccine.
If the vaccine works, this strategy would have directly saved tens or hundreds of thousands of lives, and potentially millions from getting sick and whatever long-term complications come from COVID-19. Indirectly, early vaccination of essential workers would work to decrease R0 and therefore cause fewer people to get sick through normal means.
If the vaccine doesn't work, there isn't much money wasted since the manufacturing is already being done pre-approval anyway.
In the worst case if the vaccine primes and adverse immune reaction, that is bad and an argument against early approval. However you have to weigh the added risk (that early vaccinated people have a higher CFR) vs the probability of that happening, which is low.
High likelihood of highly beneficial outcome if it works. Lower possibility of a relatively moderate bad outcome to a smaller population if it doesn't. Certainty of many added deaths if you wait. I don't have the data the regulators have that is necessary to quantify this and make the call.
But for dumb political reasons, this option is off the table. Only Russia and China went ahead with early vaccination; all the other national agencies decided not to even think about early distribution. It was not even an option on the table.
This disease has over a 98% survival rate, and even higher if you're under 40. Many of the "long COVID" studies I've read have been in high risk or elderly people, they were limited case studies and I think a case can be made that most "long COVID" could be nocebo or mass hysteria at this point (or the fact that it could just take the body months to heal from a bad infection).
We've never approved a drug, much less a vaccine, at this speed before. Unless you go back to the days of Jenner where he just stabbed people with Horsepox and there was no real regulation or long term data collection.
I don't know about China, but mass vaccination have not started in Russia yet. It will begin only from the next week starting with medical personnel and teachers. Effectively the Russian vaccine has only finished phase 3 trials (based on 40k volunteers) relatively recently.
The UK government is in dire need to demonstrate positive aspects of leaving the EU, and being able to independently greenlight this vaccine first is one particularly well suited for PR. The Brits love their NHS system and healthcare in general, so hitting it home on that turf resonates with them.
Ceasing this opportunity is especially important because all the other aspects of Brexit are just about to hurt the Brits big time next year, with the EU transitional period running out at the end of this year, with effectively no trade deal whatsoever in place to replace it, and Trump having been thrown out of office and most of the British prime ministers' hopes for an advantageous and quick trade deal with the US being dumped together with him.
Money Quote: "...because of Brexit we’ve been able to make a decision to do this based on the UK regulator, a world-class regulator, and not go at the pace of the Europeans, who are moving a little bit more slowly."
Other agencies do not feel that need, realise approval is currently not on the critical path (manufacturing is), and allow themselves two weeks more.
People are already rewriting Christmas carols: "wipe the halls with sanitizer, falalalala lalalala 'Til we get the cure from Pfizer falalalala lalalala"
https://etcanada.com/news/712874/chris-stapleton-wants-every...
It's not an anti-vaccine attitude, just healthy skepticism considering how much pressure there is to get this out and into distribution.
It's a difficult problem, because inevitably there will be harm initially if you allow free discussion. But over time the harm will be less in comparison to complete shutdown of any public conversation about the vaccines.
If the anti-vaxxers don't want the COVID vaccine, so be it. Let them pay with their health. That'll be the best course of action for beating down the quacks who will oppose any vaccinations.
1) It is much easier to spread misinformation than to collect facts and spread real data
2) Mistrust is insidious and spreads, allowing anti-vaxers then goes into other forms of anti institutional ideologies.
3) Herd immunity. If some kid has leukimia and cannot get vaccinated, he survives thanks to everyone else being vaccinated. Some 30 year old reactionary being an anti-vaxxer and getting covid and surviving it would be ok if he was not a vector of infection to the most vulnerable in society.
So in my opinion teaching people basic scientific literacy (so they can check primary sources like published research), and fostering scientific respect and trust would do us wonders as a society. We put a man on the moon, and reduced child mortality by 90% by trusting science, why allow people who think the theory of gravity is "just a theory" spread their thoughts.
100% true, I was not thinking far enough on this.
> You can develop resistance naturally. When your body is exposed to a virus or bacteria, it makes antibodies to fight off the infection. When you recover, your body keeps these antibodies. Your body will defend against another infection. This is what stopped the Zika virus outbreak in Brazil. Two years after the outbreak began, 63% of the population had had exposure to the virus. Researchers think the community reached the right level for herd immunity.
And if you do talk to a person like that, no press release is a problem for them, they see right through it.
Individual instances can be found, and errors do happen. However the idea that the biggest pharma companies, integrated by incredibly talented and hardworking people, and every safety institution (The american FDA, the EU security council etc) are all so compromised as to miss real problems and purposefully endanger the population is in my humble opinion absurd.
What is the societal advantage on letting a baker share his uninformed opinion on epidemiology? Why let software engineers discuss the safety standards of the medical field? A ton of the situations and problems are heavily skewed to high technical knowledge of narrow field.
I have no idea about how many volunteers are a good number to run a vaccine experiment, I have no idea what a good control group vaccine looks like or why use HepB and not measles. Me sharing my opinions on this topic only pollutes the conversation when I do not have the background knowledge to form an opinion on it.
If you look for information on this topics it would be much better for society if my blog is not there and there is information from actual doctors and epidemiologists talking about it.
Second, as any right free speech comes with certain responsibilities. My point is education people in using their right appropriately.
Lets get all Spiderman, great power comes great responsability. The right to free speech comes with the responsability to know when to shut up. Letting professionals speak and have the floor during events that concern their domain knowledge is a basic pre-requisite for the good ideas to flourish.
^ That's what you sound like.
Edit: it's funny that the comment above gets downvoted just for asking a question. Great world we live in. We didn't learn anything from the past. Blaming and shaming gay people in the AIDS epidemic, some previous hastily released vaccines that caused the anti vaccine current to gain momentum (just look in the nordics at the current willingness to get a COVID vaccine, something like 1 in 4 maybe)
I honestly hate anti-vaxxers with incredible intensity now. Before they were an annoyance, now they have destroyed all intelligent discourse on this current topic.
For logical concerns, another example is an earlier, mouse brain derived Japanese encephalitis vaccine. Pulled, due to suspected prions causing brain swelling, and death. It should be noted that these effects were not seen until years after a peron received vaccination.
It does not matter that current vaccine $x does not "work that way", instead, it is well known that some vaccines will be troublesome.
This is not anti-vaxxer, I have all standard vaccinations, for they are tested, years of use behind them, safer than the alterative.
Yet it is so hard to find accurate info, everything is filled with crazy, emotionally based screaming and decision making, it's infuriating.
Source: https://www.svt.se/nyheter/snabbkollen/novus-fler-vill-ta-co...
[1] survey done on November 19 by Novus
I think a comment on HN from about a week or so maybe?
>In our paper, we show that the risk appears to be limited to only one vaccine (Pandemrix®). During the first year after vaccination, the relative risk of narcolepsy was increased 5 to 14-fold in children and adolescents and 2 to 7-fold in adults. The vaccine attributable risk in children and adolescents was around 1 per 18,400 vaccine doses. Studies from Finland and Sweden also appear to demonstrate an extended risk of narcolepsy into the second year following vaccination, but such conclusions should be interpreted with a word of caution due to possible biases.
https://en.wikipedia.org/wiki/Pandemrix
> The increased risk of narcolepsy due to vaccination was 1 in 18400 or 0.005%
https://www.nhs.uk/news/cancer/swine-flu-deaths-examined/
seems to state an infection fatality rate of the 2009 H1N1 of 0.026%
So anyone under 30 has a dramatically lower chance of dying due to covid, and therefore would likely have a higher risk of a serious side effect when compared to the risks of contracting covid.
It's an interesting dilemma, for the good of public health you have to have certain populations actually increase their own personal risk, at the benefit of the majority overall.
The fatality rate of COVID-19 and the rate of serious complications is high enough that it easily dwarfs the chance of any potential rare side effects of the vaccines.
We know quite a bit about their short term safety. It's impossible to know for sure if there is any long term side effect. But that is probably a risk we have to take to get past the immediate threat of covid-19.
If this is indeed the point of contention - balancing the risk of adverse outcomes from a rushed vaccine vs those from a virus, I think it's inaccurate to say that the risks from this virus, understood generally across the population, are "very high". The likelihood of contracting it is of course very high, but the risk of adverse effects are only high for a relatively small stratum of the population.
It makes sense to reserve "very high" for pathogens like HIV or Ebola, not SARS-CoV-2. For a very large majority of the population, SARS-CoV-2 has approximately equal risk to the four seasonally circulating coronaviruses, so even a small risk from an overlooked data point might be significant.
We need to reach herd immunity one way or another, so I'm not sure the discussion of individual risk is the right one. With no data being available for patients to examine ourselves, it's hard to even know how to make these decisions.
IMO the risks of an rushed new vaccine are much higher
Do you have an actual source for that? People keep repeating it over and over but I've seen no evidence that COVID-19 carries particularly high risk compared to other infectious diseases.
In other words those who got narcolepsy were nonetheless better off with the vaccine than if they had caught the flu.
1. I expect that there will be a lot of people who think that once they get the shot, they can immediately stop wearing masks and practicing social distancing.
The rollout to the general public will need to be combined with extensive efforts to make sure people know that it takes time for a vaccine to actually provide protection.
In the case of this one, it is about a week after the second shot, which is three weeks after the first shot, so you should keep up all your pre-vaccination measures for a month after getting the first shot.
2. In a fair number of people, the first shot is accompanied by strong symptoms similar to a severe flu, which lasts for about a day. (I haven't read anything about whether or not this can also happen with the second shot).
The people who get that strong reaction might be reluctant to get their second shot.
The education efforts accompanying the rollout to the general public should make sure people know that there is a decent chance of such a reaction, but they will get over it in a day, and it will be worth it for the protection from COVID.
Moderna was testing for SARS-COV-2 protection efficiency, while Pfitzer was testing for COVID protection efficiency, but they have similar targets as far as I know.
I’d love to know an experts’ answer because the difference between the two is huge, I would hate myself to kill my parents by catching SARS-COV-2 after getting vaccinated.
You can still get the flu even if you had a flu shot for example. Some of that may be due to the flu shot being the wrong strain but some of it is definitely due to infection post vaccination. The main reason that they recommend a flu shot is that you usually have a milder course of illness.
Covid will probably be the same way. You could have mild symptoms or be asymptomatic despite being vaccinated and infect someone else.
We do not know that if you get covid, despite vaccination, that you are not infectious.
What I don't think is realistic at all is expecting the population as a whole to continue to wear masks until everyone is vaccinated, and then just everyone goes back to normal at once. Like it or not, this just isn't how it will play with most regular people. People are itching to be done with 2020 and the pandemic, they just gave up their Thanksgiving, they're about to give up their Christmas gatherings, it won't take much to push people over the edge into throwing up their hands and saying "all done!"
Why a Covid vaccine doesn't mean the end of face masks yet
The Guardian, 20th Nov
https://www.theguardian.com/commentisfree/2020/nov/12/covid-...
I would really like to know whether I should get the vaccine or not? All the info that's out there says that immunity to C19 is temporary, so a vaccine after having gone through it doesn't seem redundant.
Does anyone know if there's been any research on effects of the vaccine on the people who got C19 and recovered? I'm especially worried about possibility of a cytokine storm possibility as a reaction to vaccine.
Your fears about "cytokine storm possibility as a reaction to vaccine" are unfounded. These vaccines have been tested on tens of thousands of trial participants.
[If I'm understanding what you're saying correctly] Not necessarily. There are vaccines, such as those for HPV and Tetanus that provide better immunity than the natural immunity provided by having and surviving the illness [1].
I don't recall reading any research on the immunity provided between a vaccine and the illness on COVID-19, so I don't know whether this could be such a case.
[1]: https://www.chop.edu/centers-programs/vaccine-education-cent...
I find it hard to believe they haven't covered this with their phrase 3 trials, where the intent is to ensure that there is no risk at broad scale (in addition to effectiveness), and they pause the trial if anyone dies for unknown reason (etc) -- I definitely remember the trials pausing briefly while they investigated[1], and then continuing once resolved.
I also saw a study a few weeks ago where they found people with antibodies 6-8 months later[2][3]. Suggesting longer term immunity.
[1]: https://www.nytimes.com/2020/10/14/health/covid-clinical-tri... [2}: https://www.sciencealert.com/evidence-grows-favouring-corona... [3]: https://www.businessinsider.com/long-term-coronavirus-immuni...
"People who have gotten sick with COVID-19 may still benefit from getting vaccinated. Due to the severe health risks associated with COVID-19 and the fact that re-infection with COVID-19 is possible, people may be advised to get a COVID-19 vaccine even if they have been sick with COVID-19 before."
https://www.cdc.gov/coronavirus/2019-ncov/vaccines/vaccine-b....
Doesn't the evidence so far suggest the exact opposite?
https://www.mcclatchydc.com/news/politics-government/white-h...
I would also wager (but this is a weaker probability) that the majority of healthy young people on HN won't be getting a vaccine at all.
This isn't quite true. What is true is that there is no information out there to conclusively support long term retention of antibodies, in large part because we've only got 6 months of data.
As to the latter point, I wonder about the trial design. If they didn't give all participants a Covid antibody test before starting, it is very likely that several participants were previously infected. Smaller sample size though.
Doesn't comparing to a control group account for that?
Age 20-65, BMI below 2, with no long term medical conditions
You find enough people that fit that group and then randomly divide them into two groups, one of which is the test group and one the control. It is possible but unlikely that the criteria includes "has not previously had Covid 19". Assuming the criteria didn't include that, then some of the participants and some of the control group will have previously had Covid, and so we now have some evidence as to whether a cytokine storm occurs.
[1] https://www.redcrossblood.org/donate-blood/dlp/covid-19-anti...
https://bnonews.com/index.php/2020/08/covid-19-reinfection-t...
Duration of immunity? I've heard a minimum of 3-4 months reported, possibly longer, but do we know more now?
Am I right that we don't yet know if they reduce transmission or simply prevent the disease?
If the duration of immunity turns out to only be a few months, I wonder how this is going to play out. Will we periodically vaccinate 25-60% of the population, indefinitely? (I've seen varying estimates on what kind of coverage is needed to keep the pandemic in check.)
Short of eradication, if immunity is not permanent, what options do we have apart from a perpetual vaccination program or just accepting an increased rate of mortality going forward?
The only way to know for sure is to wait and see. But patients vaccinated for SARS in ~2004 still show immune responses now and people who received the various SARS-COV-2 trial vaccines in April of this year still show immunity. There's also studies showing many people who recovered from COVID on their own have demonstrated 9 months (and counting) of immunity. The truth is that the immune system is super complex and there isn't a single simple blood test they can do to tell if a person will resist a virus or not, so a lot of the conflicting numbers you will have seen depend on what exactly was tested and the media reporting has been pretty poor at contextualizing those study results.
So there's reason to hope vaccine-derived immunity could be long lasting (say 1-10+ years), but we'll just have to see. But talk of 3-4 months of immunity seems to be media hype.
> Am I right that we don't yet know if they reduce transmission or simply prevent the disease?
Correct, we don't know yet. Pfizer unfortunately only tested people with symptoms for COVID in their trial, so we have no idea if it reduced asymptomatic cases or reduced transmission. Oxford did test thousands of people weekly in the UK to find asymptomatic cases and they have said they have "evidence" their vaccine reduces transmission, but they haven't published their peer-reviewed Phase 3 results yet so we don't know by how much. The scientific consensus seems to be that all the vaccines will probably reduce transmission by some amount, but by how much is unknown. But it stands to reason that the quicker someone clears the virus from their body, the less time they will be shedding infectious levels of virus.
> Short of eradication, if immunity is not permanent, what options do we have apart from a perpetual vaccination program or just accepting an increased rate of mortality going forward?
Luckily, this probably won't be the case. In any case, viruses tend to mutate and become less virulent over time since killing your host is a bad way to transmit yourself. So the general guess is that the virus will eventually mutate to be less lethal, similar to the how the 1918 flu virus still circulates but doesn't cause that level of mortality anymore.
Probably the latter, with decreasing mortality "waves" until covid basically becomes just another flu-strain.
Considering the common side effects from this vaccine (most people get severe flu-like symptoms for about a day after each shot), it's pretty unlikely people would be willing to be re-vaccinated every few months.
Is there any evidence of whether these vaccines prevent transmission of the virus yet? Or so far do we just know that they protect the person who is vaccinated?
I'm not aware of a disease for which this isn't true, that vaccinated people can be carriers.
At least in the US, the explicit target endpoint for FDA approval was just prevention of disease, not prevention of infection, and the phase III trials for both the Moderna and Pfizer/BioNTech trials were only designed to assess this criterion: they only tested symptomatic people, so it's entirely possible (though not that likely given animal model observations, etc.), that infections were just as common in the treatment groups as control groups, but they just never developed symptoms and so were never tested. More research will be needed to ascertain which kind of immunity is being conferred.
https://www.medscape.com/viewarticle/941030?src=soc_tw_20111...
"In an ideal world, a vaccine would prevent infection entirely and, it follows, also prevent disease and severe disease. But this may be hard to achieve for a respiratory virus vaccine. Animal challenge data suggest that vaccinated animals may still be infected even if they don't experience symptoms. A vaccine that is able to reduce the severity of disease, even if it cannot prevent infection entirely, would obviously still have enormous public health value. Therefore, this is what trials target as their primary aim."
I suggest everybody to read carefully the whole article, as it is written by an indisputable expert, and what is presented in the article isn't based only on the animal models but on much broader knowledge. Nobody at this moment should expect that the vaccines guarantee that somebody who is vaccinated won't be able to infect somebody who hasn't received a vaccine. That, for example, means that even if the health workers do get a vaccine they will still have to wear protective equipment.
The mutation rate among coronaviruses is so slow that it's much more probable that whenever we see some new significant change among them it is due to the recombination, not due to the mutation. Coronaviruses have a specific mechanism of "error correction" in them which lowers the mutation rate, compared to most RNA viruses.
The "selection pressures" are also less likely in this case then most would estimate. We as humans are much more "pressured" by this virus in its current form than the virus by anything we'd do. The viruses themselves don't even "need" to come "around" anything, and there are enough unknown viruses in the world which aren't less potential threat than this one which understandably got the spotlight.
It's surely good to be aware of all the processes involved but the probabilities of different events and outcomes should also direct our responses.
The question is whether the vaccine against covid prevents people from getting infected with the virus or whether the vaccine protects against the effects of the Covid disease. This is not the same.
* 99.96% of the placebo group did not have a serious case of covid
* 99.25% of the placebo group did not get covid
* No one in the trial was deliberately inoculated - participants just lived their lives as normal.
* Only symptomatic participants were tested - this seems unbelievable to me - we have no idea what the actual incidence rate is because not everyone was tested
* Vaccines might just mask symptoms - since not everyone is getting tested, vaccine makers just have to make sure there are no symptoms. No symptoms equals no test.
* No trials done with two placebos - we need trials where both groups are in a placebo group. One gets a shot that gives a mild side effect and the other gives no side effect
* No trials done with unrelated immune boosters - we need to see how well this vaccine performs against other immune boosters. This could be a drugs or even supplements (vitamin D & C and exercise).
* Two shots were given in a trial lasting just 4 months - 4 months is an incredibly short amount of time to know whether it will be effective long term. It also gives Pfizer two chances to boost immune
* Long term health consequences of vaccine - we only have 4 months of data, which is way too short of time to see any longer term consequences
* There is a huge incentive to provide something that masks symptoms - billions of dollars are at stake. Big pharma is one of the very last companies I would trust with a novel vaccine
* No coronavirus vaccine in history - many coronaviruses currently circulate, but no vaccine has even been produced for them. It seems quite coincidental that humans finally put the pieces together for our current novel strand
The answer is still yes for both cases, long term covid damage is bad at any age and so is taking out a grandparent, co-worker you like.
But there is a limited supply. At least in the short-term, if I get a dose, that means someone else doesn't get one.
If someone around me is at risk, then they should get vaccinated and I should defer if my risk is low.
Personally, I will take the vaccine as soon as it's made available to me. Even if my risk is perhaps low (which may or may not be true), taking the vaccine reduces the chance that I would spread COVID to someone else. It's a collective effort to reduce the spread, not an individual or selfish one.
https://www.thelancet.com/journals/lancet/article/PIIS0140-6...
This is from September, though, so maybe more is known about that now. I haven't seen news about that, however.
Also as a society we need to encourage everyone to get the vaccine and do whatever possible to suppress anti-vaccine hysteria, you know the conspiracy theories are already going to go crazy over this I'm sure.
That's a lot lower than the risk for older people, but it's still a somewhat high absolute risk.
Personally, I'd get vaccinated. The risk even for young people is still there, and it's not that low.
The source for these numbers is the following paper, specifically figure 2a:
From the Scottish Government figures.The hospitalization to confirmed cases breaks down like this for age:
Age Cases Hospitilizations
0-4 1417 77 (5.4%)
5-14 3933 44 (1.1%)
15-19 7766 46 (0.5%)
20-24 9035 79 (0.8%)
25-44 28690 867 (3.0%)
EDIT: Here are the stats for the seasonal flu: https://www.cdc.gov/flu/about/burden/past-seasons.html tldr: 1-2% hospitalization average
So get advise from your doctor. Perhaps it depends on your "health issues". And, don't look for an answer from the internet anytime soon.
I assume it depends on your condition. If you are lucky, they have tested it on people with similar conditions and there is data for it. Otherwise, they may still be able to measure the risk. If your doctor suggests that there is a risk because of your condition, then you have to calculate the risk of not taking it as well. How much risk is there for you with the vaccine? How long can you keep yourself safe from COVID19. That depends on your interactions with other people, your job, and people around you etc.
Also importantly and slightly paradoxically, if you are a young person who would eagerly volunteer to get a vaccine, it's likely that you are diligently compliant with all the other necessary rules like hand washing, masks, social distancing, and so the need for a vaccine would be even lower!
Identifying those who would most benefit is hard. Those who would most benefit is not the same group as those who would jump at the chance of a vaccine.
There are loads of young people with the weirdest post covid complications.
https://www.cbsnews.com/video/covid-long-haulers-60-minutes-...
If you're young you will get natural immunity from it sooner or later.
No young person had any issues.
More young people will be hurt by the vaccine than COVID.
This isn't true. In my country we've had 25-35 deaths in people under 45 from Covid-19. So the death rate is very very small, but its not zero.
Including deaths of people under 25. These people may have had existing co-morbidities of course, but not all of them might have known they had those co-morbidities.
A lot of hospitalizations of people under 45 too.
Most everyone is going to know Pfizer and Oxford respectively. Internationally Mainz isn't exactly a famous city, nor is AstraZeneca a well-known pharmaceutical company.
Hell, we let Trump present the Mainz vaccine as if it was his personal achievement.
Germany has got to do better here.
It might not be famous but it played a key role in the development of the Renaissance, Reformation, Age of Enlightenment, and Scientific Revolution, as well as laying the material basis for the modern knowledge-based economy and the spread of learning to the masses.
At the end of the day, a Smallpox pandemic in 10-20 years might end up killing more people than a premature covid vaccine saves ... No idea how you could quantify this risk though -- but seems unfortunate that medical science has no way to realistically factor in this kind of third order effect into their risk modeling ...
There seems to be a surge in anti-anti-vaxxer sentiment (any skepticism being met with strong resistance). If the vaccine were to fail after that much hype I believe it'd be a concern for worry. (Not that I think it's likely to "fail" in obvious way, just defending OP)
I didn't mean they were on the increase, I was saying the people against them have been more outspoken because of the pendemic, to the detriment of people that are skeptic (but not anti-vaxxer). The issue isn't about the anti-vaxxers, it'd be more about radicalizing more center people.
But this is false for anyone not super anti vaxxer
>Why worry about it? We've got bigger fish to fry right now.
It's important to weigh all the effects of our policies as a nation. If we can accomplish 99% of the result without some side effects it's better than trying for 100% with possible future problems. I think it's fair to see how policies will affect the population/its divide (i.e. it's not a small enough fish to disregard).
There's already going to be a big PR campaign to encourage people to have the vaccine.
Do you want to delay it and do more trials?
Actually I did hear one good idea which was to pay people $1000 to get vaccinated. In economic terms, its a bargain.
https://www.forbes.com/sites/shaharziv/2020/12/01/proposal-p...
I think just deploying the vaccine and encouraging people to take it would work fine imo. It's a strategy that is not controversial and would fix 99% of the problem.
In one way paying for giving the vaccine makes sense, on the other I'm not sure it's needed or that it'd be seen in a favoritable light (there's already a lot of controversy about how the pandemic was handled economically).
EDIT: to backup why I don't think it's needed; I haven't found the study from the article you linked, but according to https://www.nature.com/articles/s41577-020-00451-5 about 70% of people need to be immune. I don't think that's a hard number to get (but I may be wrong), but assuming there is some immunity when you get the virus (which seems supported), you don't need to vaccinate 70%, you need 70% either vacicnated or having already gotten the virus (which is 10% of the population as of now). I understand it's not insanely supported take, but that's why from curosry look I don't think it's needed. Not a firm belief though.
All the while, claiming that this new mRNA technology, is the panacea to all our ailments and diseases.
I feel humanity might be at an inflection point here, where we divide into the world of the Morlocks and the Eloi.
While I’m no anti vaccination idiot I’d like to understand the risks to some degree.
Are there any notable helpers or adjuvants or preservatives?
I know what you mean is "not dormant and doing something for months/years", but at the same time, if it can initiate a modification of immune response, it can do "other things".
I believe we must take the utmost of care at this juncture, and make sure assurances are not construed as in a poor light.
So, even if producing the proteins turns out to be somewhat harmful long term, it cannot possibly be as harmful as the whole virus.
Assuming that covid infection is inevtable without a vaccine, we really have a choice between getting a little bit of mRNA injected into our cells, and a ton of mRNA injected.
https://www.sciencedaily.com/releases/2016/03/160322100714.h...
The extent to which a molecule is active in your body is only slightly correlated with toxicity. There is zero reason why a fragile molecule can't cause damage before it breaks down.
This is how ended up with thalidomide. They tested it in pregnant lab rats, but the window for birth defects is incredibly short in rats. So everything checked out.
In drug development you can't assume anything without data to back it up.
The FDA at this point certainly doesn't have the ability to analyze that either, so the best we have is a theoretical understanding.
With a disease such as Covid it might be 100000x safer to get vaccinated than not.
All national vaccination programs must calculate and assess such relative risk and find so much advantage in favor of vaccination.
I've kind of OD'ed on COVID-19 news myself, so haven't listened to them for a while and don't know if they've commented on this vaccine yet, but they probably will, and for a thorough, educated, hype-free analysis, there's no better place I can think of to go to than TWiV.
[1] https://en.wikipedia.org/wiki/RNA_vaccine [2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5906799/
If you wish to pretend otherwise, I'd love for you to state your case.
Wait... This doesn't scare anybody?
Why has this not been approved before?
Would an mRNA vaccine be approved under less pressing circumstances...?
The approval processes are still the same, just without the years-long idle cycles that usually slow things down. The end result will be good as any other vaccine you might get.
Not really. mRNA starts to degrade within minutes of injection, and lasts maybe at most a few days in your body. It cant turn back into DNA, so once its gone, it can no longer have any effect on you.
> Why has this not been approved before?
Its a relatively new technology that took a lot of work and money to make a stable, effective vaccine with. Its also relatively expensive to manufacture.
> Would an mRNA vaccine be approved under less pressing circumstances...?
Yes, though these almost certainly were approved faster than other vaccines would be because of the pressing nature of things.
If this is true, then how does it provide protection against COVID19 for more than a few days?
The general principle is the same as for most vaccines: make the body generate its own antibodies (and/or T cells) for the virus in question. So in that sense of course its effect is long term, just like when you get sick with some virus and your body develops antibodies for it - the virus itself is gone, but the effect on the immune system is long-lasting.
From an FT article:
> Conventional vaccines administer an inactivated virus, or proteins from that virus, into the body to trigger an immune response, which can prevent subsequent infection.
> In contrast, mRNA technology — originally developed as a cancer therapy — injects genetic instructions into the body that tell cells to make viral proteins that prime the immune system. Although mRNA vaccines had been under development for several years for viruses including influenza, cytomegalovirus, HIV, rabies and Zika, the arrival of Covid-19 turbocharged the process.
- https://www.ft.com/content/74e41528-80c3-4b0f-b343-be43d90f0...
So yes, but no. And it's reassuring compared to say DNA tweaking which would permanently change the instructions in some cell lines in your body, or more extremely germ line DNA tweaking which would alter your cells and those of any subsequent offspring you have.
According to the data I've seen on kinetics (these vaccines have been in development since 20 years ago, so there's plenty of basic and animal test data) there's production of the antigen at the site of injection for approximately ten days. There's some systemic production in the liver for 2-4 days, but that's it.
The mRNA can last this long (normally, as you correctly say, it would get broken up in minutes) due to the lipid nanoparticles it is bound to, which are the "secret sauce" of this vaccine.
Not particularly, the UK has just concluded their approval of this vaccine and the EU and US are also reviewing it, so if there is something wrong they will most likely find it. There are enough different vaccines in development that there isn't much incentive to ignore faults if they show up.
>Why has this not been approved before?
I think it is new technology, which arrival has been accelerated by the enormous investments in vaccine technology over the past year.
>Would an mRNA vaccine be approved under less pressing circumstances...?
Can't really comment on this because I don't know much about it, but I would guess that they would have never reached the approval state without the pandemic and the huge need for parallel development of vaccines. I think that at all times there are a bunch of technological developments that are on the cusp of being ready for broad adoption that are just waiting for some boost in funding that propels them to maturity. Progress happens very quick when the whole world has a need for the development of something.
https://www.economist.com/science-and-technology/2020/12/01/...
I guess something's gotta be first and in the absence of any prevailing pandemic there's not as much incentive to develop vaccines as opposed to say cancer treatments.
I believe Pfizer and Moderna are mRNA based vaccines. The Oxford and Russia's Sputnik V are adenovirus vector vaccine.
https://www.vox.com/2020/8/13/21359025/coronavirus-vaccine-c...
Beyond all that, these drugs are being rolled out to the most at risk group, those that have a mortality rate higher than any risk rate that was not captured by a smaller sample size of the test. Unless you're elderly or a medical worker, you won't have the option to take the vaccine until millions of other do. I'm getting pretty sick of you people whining about nonsense.
We just spent 9 months trying to lift the ban on this vaccine. We have the technology to beat pandemics, we only lack the regulatory structure.
Vaccines are typically so safe and effective that for high risk populations taking a completely untested vaccine would be expected to (a) be effective and (b) safer than covid. So approving this was maybe the easiest call in medical history, and from first principles could have taken 1 day to approve for high risk groups.
We need a regulatory framework for fast approval anyway, if we ever want to have personalized medicine. With mRNA vaccines now in play, we can beat so many things if the regulatory environment lets us.
https://en.wikipedia.org/wiki/COVID-19_vaccine#Vaccine_candi...
1) BioNTech/Pfizer haven't "just" tested for safety (I'm implying that's what you meant with your "trying to lift the ban" hyperbole), they have also used the clinical trials to single out one particular candidate out of at least four initial candidates for best expected efficacy. And they have used the trials to evaluate the best dosage. Medical trials are about much more than just the safety aspect.
2) It's easy to say "we could simply have broadly distributed this vaccine back in March" now in hindsight. However, in March, there were serious doubts about whether it would even work, considering the entire technology hadn't ever yielded a fully approved commercial vaccine.
3) I don't want to highlight this once more, but COVID-19 wouldn't be so deadly if the US hadn't fucked up its response in every possible way, and some that were thought to be impossible. A good part of those "over a thousand people dying per day" are self-inflicted and have nothing to do with any vaccine tests or vaccine approval timelines.
Lol.
I wouldn't be so quick to trust anything British right now. We're in a bit of a state.
The only reason we're not the laughing stock of the world right now is because the Americans managed to fuck up even more than us.
Swiss cheese model. Each agency is going to have holes, and many previously unknown ones could be exposed given the unusual time and societal pressures they’re working under.
If the UK approves something and everyone goes “eh, good enough” that’s significantly riskier than if we wait the extra week or two and get consensus from the UK, EU, US, etc. The chances of large holes showing up in the processes of all of those agencies that align to miss something is much less.
We’re talking about things we’re going to be injecting into literally hundreds of millions of people very quickly. The risks of a fuckup here are pretty severe and it’s quite likely a severe mistake would cause more harm than delaying another week or two.
https://www.pharmamanufacturing.com/industrynews/2020/uk-reg...
Edit: Actually FDA Fast Track was approved in July. There should be no surprises for the FDA in this submission. https://www.pfizer.com/news/press-release/press-release-deta...
I imagine the expedited process also means summaries and overviews that would normally be presented were skipped--detailed documentation if we're continuing the source code metaphor.
Plus, how the FDA approves it (including the speed) will create an impression on people's minds of how safe the vaccine is. Fast is good. "Too fast" is bad.