UK warns people with serious allergies to avoid Pfizer vaccine | Hacker News Reader

UK warns people with serious allergies to avoid Pfizer vaccine

reuters.com

124 pointspseudolus151 comments

Not in this article, but in the BBC article[0]: "Both NHS workers have a history of serious allergies and carry adrenaline pens around with them."

[0] https://www.bbc.co.uk/news/health-55244122

It's in this article, too:

> As is common with new vaccines the MHRA (regulator) have advised on a precautionary basis that people with a significant history of allergic reactions do not receive this vaccination, after two people with a history of significant allergic reactions responded adversely yesterday,

It's kind of understated, tho

Got to get them clicks though

Weird that they say adrenaline and not epinephrine

See https://en.wikipedia.org/wiki/Adrenaline#Terminology

Adrenaline is the commonly used term in the UK

> They are understood to have had an anaphylactoid reaction, which tends to involve a skin rash, breathlessness and sometimes a drop in blood pressure. This is not the same as anaphylaxis which can be fatal.

From the BBC article: https://www.bbc.co.uk/news/health-55244122

As someone who carries an epi-pen after experiencing anaphylaxis that distinction makes a big difference to what we're talking about here.

Good bet that it's treatable with just antihistamines, going by my experience with systemic (non-anaphylactic) food allergy reactions, which display similar symptoms.

Thank you, doctor.

To give us context, where did you study medicine?

Anaphylactoid reactions can kill you just as well as anaphylaxis.

"Anaphylactoid reactions are defined as those reactions that produce the same clinical picture with anaphylaxis but are not IgE mediated, occur through a direct nonimmune-mediated release of mediators from mast cells and/or basophils or result from direct complement activation"

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3209676/

This is interesting, I have never heard of this. I thought all food/drug allergies (as opposed to environmental allergies) were IgE-mediated.

The Pfizer vaccine - and the Moderna one - both use a polyethylene glycol (PEG) copolymer in them as a nanocarrier. PEG in injections is a known allergen, and these very serious effects are known. Whether or not it showed up in the trials is irrelevant, it didn't have to.

How hard would it be to mass test people if they are allergic?

Because current polls show you probably won't reach heard immunity with voluntarily vaccination. But can you do mandatory vaccination, when you know some people may face serious problems?

Those two people seem to recover, but who knows with other people?

I think a lot of the vaccination plan relies on voluntary vaccination in the form of “business xyz voluntarily declares that all its employees must vaccinate unless they have medical reason not to.”

Hospitals are already informing doctors, nurses, and staff that they will be required to vaccinate as soon as a vaccine becomes available and airlines have already gone on the record saying they will require proof of vaccination to allow travel.

It’s not as voluntary as you think for a great segment of the population, it’s just that no one will go to jail for refusing.

> business xyz voluntarily declares that all its employees must vaccinate unless they have medical reason not to

Isn't this illegal in pretty much any first word country? I know it is in Germany and France

Not in the USA, no. Except if it clashes with religious freedoms.

It's funny that religious freedom > personal (non-religious) beliefs/moral

Or outraging.

But even if it is your formal religion, here in germany one guy tried to claim marijuhana as part of his religion (rastafari). Which you could argue it is.

But the judge declared something the line of, "who cares, this does only affect a few people, case dismissed". As in bavaria official religion is the catholic church and beer. (sadly not really exagerated as the current bavarian ministerpresident declared that every official building has to have a cross in every room)

Note that the Pfizer trial at least (and IIRC Moderna as well) excluded people with a history of severe allergies. Which IMO makes sense: why put those people at risk of a relatively common complication when you don't even know yet if the vaccine is effective? Testing for allergy safety in that small population is something you can do later.

If a vaccine contains a known allergen, is giving it to people with severe allergies even a test of anything? Is it possible for allergens to not cause allergies despite being present?

By "at risk of a relatively common complication", I'm not trying to say that the vaccines contain any known allergens. I'm not enough of an expert to know if those specific ones do or don't. I'm just saying that people with severe allergies often have allergic reactions to vaccines.

It is entirely possible for an allergen to not cause sensibilisation ans a consequent allergy.

It is extremely rare for an allergen you are sensibilized ("allergic") to, not to cause some reaction. But the reaction may vary in strength and symptoms, especially with age and presence of irritants to the immune system. Unfortunately, some vaccines do contain those irritants as active ingredients to improve the function of the vaccine.

What are the real world cross allergies?

I'm very interested to see how this sort of situation will align with the increasing number of countries/airlines/music venues/hotels/theme parks that are stating they will only admit people who have been vaccinated.

It will probably take careful legislation to prevent those who can't be vaccinated from being relegated to second class citizens alongside those who won't get vaccinated. At the end of the day both groups still pose an infection risk.

there are like 5 vaccines so just use another

People with serious allergies often have severe reactions to vaccines period, existing ones and all these new ones too. I wouldn't bet on any of the others doing much better.

My understanding is that with the exception of the Oxford vaccine, all the front runners use the same technology. This limitation could well apply to all of them.

How will they verify that individuals have been vaccinated if the government doesn't supply that information?

Also, you raise an interesting dichotomy between those who can't VS those who won't that I hadn't considered.

The NHS is providing a certificate to show vaccination has taken place. I imagine other countries will follow suit. I could even see it ending up as an official stamp in your passport or similar.

I have certificates lying around somewhere for the vaccinations I received as a kid. Pretty sure school required them baring some waiver. I’m not making predictions about how the Covid vaccine will be handled, but rather just putting it into a little context.

if you travel a lot it's common to carry a vaccination card (I have one for all those tropical disease vaccinations I've had) - I expect many countries will require you to carry such covid status documentation before they let you in (or board the plane to their country

There's already a process and standard, internationally-recognized certificate for Yellow Fever vaccination, overseen by the WHO. Some countries check this book at the border.

The certificate booklet has space for other vaccinations.

Booklet: https://tourseastafrica.files.wordpress.com/2014/05/yellowca...

This has not been announced, unless I've missed it in the last 36 hours, only speculated about.

There are NHS vaccination reminder cards which you'll be given at your first appointment and recommended to keep in your wallet - with sticker(s) of what dates you had / will have jabs, and a little info about how to find out more info.

This is standard NHS practise for vaccinations that require multiple spaced out injections - I've had two cards pretty much identical to the photo I've seen of the covid ones in the last few years, for other vaccines from the NHS.

The UK's Health Minister confirmed to Sky News yesterday morning that they are not for providing proof you've been vaccinated, and that they do not need to be kept after your final injection.

> How will they verify that individuals have been vaccinated if the government doesn't supply that information?

Should public authorities keep a record of whether or not you've been vaccinated?

Vaccination is a medical procedure. As such, whether someone is or isn't vaccinated could be considered a private matter (patient-doctor confidentiality), just like any other medical treatment.

If vaccination became mandatory, we'd have a different discussion. But if it's not, a public government has little argument to keep a record about your medical history, and, even less so, divulge that information to private actors.

Can private actors - venues, hotels, restaurants,... - force someone to divulge medical information?

No. They can't. They could ask, but you're not obliged to answer anything related to your medical history.

Could they refuse entrance if you refuse to provide medical information?

I'm curious when the first legal cases will pop up where someone decides to take a venue to court because they were actively refused entrance over being unwilling to divulge medical information.

Those claims are bullshit. The people most likely to travel are last in line to receive the vaccine and supply is limited so you cannot just go to your GP and get the shots.

I mean obviously not yet? But it seems pretty clear that within a few months that situation is going to change.

I would assume that within the next six months most airlines, at any rate, will require either proof of vaccine or a reasonable excuse for not having it. Some airlines are already talking about this.

I think the problem is this is not government controlled, but will be individually implemented by each private org. Without central administration, they're likely to rely on the vaccination card they give patients to track when their next shot/brand of shot will be. If you're excluded for valid medical reasons, you might not get a card... but as of now, an exclusion card doesn't seem to exist.

This is why I mention legislation. I think we could see it becoming illegal to exclude people based on their vaccine status. Or maybe we have some sort of exemption card.

Vaccination is medical procedure. It's not different from other medical procedures. As such, it's part of patient-doctor confidentiality.

Put differently, when asked, you are not obliged to answer any questions about whether or not you are vaccinated. For instance, if I ask you whether you had a flu shot last year, you do not have to answer me.

What about public authorities? Same thing applies, unless vaccination is legally mandatory. Then we'd have a different discussion.

Finally, how many private businesses are willing to risk a court case over refusal of service because a patron isn't willing to divulge medical information? Not to mention potential violations of discrimination laws.

There's plenty of precedent for this. For example many countries require evidence of yellow fever immunisation upon entry, if coming from a high risk region.

But that's a third party entity (country) and not the country where one is living in.

That is the difference between a county and a business. Countries have the legal authority to deny passage through their borders with limited exception. Businesses have the right to reserve service in some cases but not others.

Exactly. It's the last past I was getting at as a rebuke to the grandparent comment.

Reserving service isn't straightforward. Especially not when it comes to sharing private medical information e.g. when someone wasn't vaccinated because of an autoimmune disease.

Your exact medical condition is no concern of that business, and one shouldn't be forced to give up that information lest risking to be barred from service.

It's for this reason why many businesses have terms and conditions pointing out to customers the role of personal responsibility, and asking them to waive their right to legal action. Moreover, let's not forget the existence of business insurance that protects from calamities.

If vaccination can't be mandated through public action because there's not enough support, then that comes with consequences for the general public. One of them would be that the relationship between owner and patron gets burdened by a new liability. The question then is whether or not the harm of publicly mandated vaccination outstrips the harm caused by that liability in everyday life.

Public schools in every US state already require vaccination, by law [0]. The regulations are without exception written in such a way that anyone who wants to make a fuss about it will find it easier to claim a religious exemption than to test it in court, but there's a lot of legal precedent for mandating vaccines.

[0] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2553651/

Re: public schoools, and, by extension, any public entity. This is why I stated:

> What about public authorities? Same thing applies, unless vaccination is legally mandatory. Then we'd have a different discussion.

Everything you mention is the "different discussion" in that statement.

My comment was a rebuke against what is mentioned in the grandparent comment:

> but will be individually implemented by each private org

Private organisations - restaurants, shops, music venues, malls, theatres,... - may try and ask for personal medical information, but you are not obliged to divulge anything to them.

Private organisations barring entrance because you are unwilling to disclose personal medical information: I'm wondering how well that would hold up in a legal case.

For instance, you have an autoimmune disease and you can't get vaccinated. You present at a restaurant. You are asked "are you vaccinated?". If you answer the question truthfully with "no" but you don't want to disclose your medical condition, you likely risk getting barred anyway. So, now you are in a position where you need to make a trade off: divulge your medical condition - which isn't any of the restaurant's business - in hopes of gaining access (no guarantee) or keep silent.

See where this is going? The problem isn't people who are against vaccination, it's the potential of creating legal hurdles for people who can't get vaccinated due to a medical condition which may bar them from participating in society. That's just not okay.

Moreover, if private venues are afraid of being the butt of an infection cluster (e.g. as a result of contact tracing) then they ought to insure themselves. That would be not much different from insuring oneself from other liabilities such as a patron tripping and breaking their arm in theme park. This is also the very reason why many venues have warnings and provide waivers to patrons giving up the right to take legal action against the venue.

Lastly, the article you quote specifically focusses on choosing to not get vaccinated based on philosophical or religious arguments within a public context: getting educated at a public school. Which is a different category of legal challenges. Moreover, the conclusion of the article is that tort law is only a second best approach to publicly mandated vaccination within that category.

This is highly unlikely. These companies need the income. The last thing they'd want to do is add on further restrictions to their struggling industries.

Yeah, but they might not need the income from the few who cannot get vaccination for medical and not mental reasons. And rather focus on the paying majority.

Which would be somewhat discriminating against those people. But if the vaccination works as promised (95%), it should allow some nonvaccinated people without problems?

It's important to note that the 95% refers to the reduction of mild COVID-19. There is very little data on how well the vaccines actually prevent the spread of illness - often called sterilizing immunity(1) - most of the trials simply weren't doing the extensive PCR testing required to measure that.

There's a good chance they do in fact reduce the spread of COVID-19 too in a significant way, as many vaccines achieve that. But some don't.

The second issue, is that we don't have enough data yet to know if the vaccines prevent severe COVID-19, let alone deaths, in the people most at risk. That at least we'll probably find out soon from the UK.

1) https://thehill.com/changing-america/well-being/prevention-c...

In theory, people who can’t be vaccinated and people who can buy choose not to be will both need to be excluded from large crowds until the virus is no longer a significant risk factor.

In practice, given all that has happened since the last election, I expect the current UK government solution to show all the skill of a bored teenager mimicking Jackson Pollock in a school art class.

This is also something I'm watching carefully.

My expectation is that most businesses will have some official policy of "you must be vaccinated to enter" but they won't actually enforce it. This decreases their liability on both sides (Don't want to be seen inviting outbreaks, but don't want to deal with HIPAA / privacy laws).

I was surprised to learn that the US already has a list of required vaccines for legal immigration[1]. I think its very likely the Covid-19 vaccine makes the list, considering even the flu vaccine is required.

[1] https://www.uscis.gov/policy-manual/volume-8-part-b-chapter-...

It's fairly common for countries to require vaccinations simply to enter them as well. For example, I've personally gotten the yellow fever vaccine, which is required to enter Kenya.

That vaccine is actually relatively risky. Yellow fever is a serious disease, and the vaccine from weakened - but not killed - yellow fever virus. Thus very occasionally it causes what's basically yellow fever. That's still much safer than the risk of getting yellow fever if you are visiting a place like Kenya. But at least where I live, doctors won't give it to you without confirming where exactly you are travelling, because the otherwise the risk/benefit tradeoff isn't worth it.

A while back, when outbreaks of measles were occurring in the US (IIRC), they were sometimes blamed on immigrants. I wasn't surprised that vaccination was required for immigration, but it took a surprising amount of searching to find it.

Many countries already mandate some vaccinations before permitting entry (yellow fever comes to mind). Which requires a certificate as proof. I don't know how those countries handle people who can't get vaccinated, but I suspect that there are lessons to be learnt there.

Anecdote: I needed to get a yellow fever vaccination for last-minute travel to Kenya. So last minute in fact that medically speaking, the vaccine was useless as the immunity wouldn't have kicked in yet. Immigration did in fact notice this, and had no problem with letting me in when I explained why.

That certificate at least has zero security features, and could easily be faked.

It could be easily faked. But if you come down with yellow fever in a place where you claimed immunity, all they have to do is contact the doctor that stamped it. They are regulated by the WHO and won’t lie for you.

Suddenly you have a case of international fraud while bedridden in a country that takes yellow fever very seriously.

The difference between yellow fever and covid is the mortality rate. Covid is below 1% (hard to find data as everyone stopped talking about mortality rates when the number of cases skyrocketed without an increase in deaths). Yellow fever is around 3-7%.

People traveling to Kenya will want to vaccine for their health and largely won't try to fake it.

>they will only admit people who have been vaccinated

Is any country issuing a proof of vaccination document? If they don't have a system already in place to issue these, I think it's unlikely they will be able to roll it out at this point.

Basically, I'll believe it when I see it. To me it seems like a very hard thing to enforce and implement. I suspect the companies are more interested in "security theater" to facilitate normal business operations as soon as possible than actually excluding people who haven't been vaccinated.

Most healthy young people won't be vaccinated in the long run, I suspect. Those most at risk, the health workers and those who are most likely to spread it will get it, but everyone else will be kind of optional.

That companies are advocating for "passports" is more than likely an expression against anti vaccination sentiments and a desire to open for business whatever the costs.

That's weird they didn't notice this when doing trials.

> Pfizer has said people with a history of severe adverse allergic reactions to vaccines or the candidate’s ingredients were excluded from their late stage trials, which is reflected in the MHRA’s emergency approval protocol.

Smells a little bit like what some of us (developers) occasionally do when under pressure. As in, trying to save some crucial time in a rush, by focusing on testing just the things that were specifically worked on, instead of running it through the entire test suite (or QA dept) before deploying. If something comes up, user feedback will certainly bubble through quickly enough and can be worked on. Which, to be perfectly frank, often does work out just fine.

I'm pretty certain this has nothing to do with pressure.

The risks profile is very different, and for the same reason my trials aren't run on pregnant women. It hardly makes sense (and would be immoral) to include people in a clinical trail who you know are more likely to get adverse affects (up to death) from the drug/vaccine.

Especially for vaccines you know there will be certain subgroups that can't be vaccinated anyway, and because of herd immunity that doesn't matter too much.

Why let those subgroups participate in the first vaccinations though? If they were clearly aware of this, why go ahead in one of the most-watched "deployments" (in my life-time), and invite the potential risk (and it's a huge risk) in only after it's gone "live" with the real population? I mean, if I knew those subgroups would be problematic, I sure as hell would make sure the first week of those vaccinations would go as smooth as possible (with all the media and the rest of humanity carefully watching), and give it to people I am most certain will be fine with it. Everything else, the trials should've caught, or should catch in the near future? Why play the risk on day one?!

While they haven't said yet, it's fairly clear this was an error; either the people with a history of allergies ignored the warnings (every vaccine I've had as an adult has come with allergy warnings) or the warnings weren't given (which would be bad and must be fixed).

> which is reflected in the MHRA’s emergency approval protocol

Makes me think this is an acknowledged limitation and a closer metaphor would be removing some use cases and cutting scope.

I'm not sure I follow why this is news and a changed in protocol if it was known since the approval

This is entirely normal for drug development. AIUI they also didn't test on pregnant people. Given that the aim here is to produce herd immunity, rather than sterilising immunity in 100% of the population, this should all broadly be fine.

Sure, yet, I wonder why this seems to trickle out the day AFTER the first run, when, if it's true what you say (and I have no idea, so you certainly know more about it) they would have been able to avoid this entire report / potential fiasco (think of the anti-vaxxers) by announcing it a bit more boldly beforehand, no? Why let that bit of negative information overshadow the second day?

It's more or less standard. _Any_ new drug is highly likely to exclude certain classes of people. This is particularly the case with vaccines where the risks of excluding a small number of people are generally low, as you're relying on herd immunity anyway.

I'm not sure if this was talked about before, but the fact that (like basically every vaccine ever) it won't initially be available to pregnant women was certainly talked about ahead of time. This isn't a fiasco; it's normal.

I think you miss the point entirely. The broader public's perception of the drug is instrumental to its adoption. If the public are led to believe that the medicine is unsafe, the result will be a reduced level of herd immunity as fewer people will take the vaccine.

Medical institutions (CDC, BMJ, Public Health England), the Government, and the broader media (newspapers, TV stations, companies like Facebook) are responsible for encouraging safe and efficacious use of medicine for the good of society, but they can't do that when the narrative is co-opted by anti-vaxxers, the right, and other shameless opportunists.

Nope. You learn nothing by testing on people with known allergies to the ingredients.

Could we get to herd immunity by not immunizing those people who are part of groups excluded from the trials?

Quite likely - I would expect "severe" allergies to be less than 1% of the population.

I think most vaccines right now have not been proven to have sterilizing immunity, so ppl who have gotten the vaccine can still transmit it to others who haven't been vaccinated. That's in the 1 or 2 week widow after getting infected themselves.

Even if it doesn't produce sterilizing immunity it will reduce the spread by stopping the virus from causing coughing and sneezing. So it's possible that it will allow reaching herd immunity anyway.

That's how normal vaccines for things like measles work. Not everyone can take them, or they have other issues, so they depend on the rest of us to do our part for herd immunity.

Yes. Almost no vaccines can be given to _everyone_, and the portion of the population with severe allergies of the epipen-carrying-around variety is fairly small.

Yes this is news, so clearly there has been some mismatch in expectations.

That's a much smaller group than the people who have just been advised not to take it though, and I assume that people in that group would already have been advised not to take it. We don't know what allergies the affected people had AFAIK, but the advice goes far beyond people with a history of severe reactions to vaccines/its ingredients:

> “Any person with a history of a significant allergic reaction to a vaccine, medicine or food (such as previous history of anaphylactoid reaction or those who have been advised to carry an adrenaline autoinjector) should not receive the Pfizer BioNtech vaccine,” it said.

I've never had a reaction to vaccines, I'm unaware of having a reaction to any medicine, so from what Pfizer said I could have been in the trial. But I'd be excluded by this new advice because I carry an epi-pen for a food allergy.

I wouldn't read too much into that warning, at least in terms of overall safety. The fact is, they're releasing these vaccines on a broad scale much faster, and with less safety testing completed, than usual. So there's plenty of things that we normally wouldn't know yet at this stage of development; in this case just leads to authorities being extra cautious, because this is an experiment. It's just that with other vaccines the general public would never become aware of issues like that, because the vaccines wouldn't have been released so early to so many people.

FWIW, looks like the HPV vaccine also had problems with occasional severe allergic reactions: https://www.reuters.com/article/us-vaccine-reaction-idUSN314...

That article is from 2008, so I don't know if that issue has been fixed or not. Regardless, it obviously wasn't a deal breaker, as Gardasil is still being used.

They excluded people in this group from the trials.

And really old people. The first person was ironically in that group.

The BioNTech/Pfizer trial included 1712 people age 75 and over. The mean age in that group was 78 and the maximum 91.

The Queen (94) and Prince Phillip (99) will be having their jabs soon, to "inspire the naton" :/

Did they have blue blooded individuals in the trial? /s

I guess the question is whether there is any sort of screening done prior to a patient receiving the vaccine. A simple question ("do you carry an adrenaline autoinjector") would have prevented this.

I would doubt that inject into people with known allergies will ever pass the ethics committee. It sounds like `let's do a thing that is known harmful to people in experiment`. Should a normal people allow that experiment to proceed?

This is why it's so critical that multiple vaccines were and are being developed. So that whatever subset of people can't get vaccine X, well they can get vaccine Y and Z. And hopefully, this means everyone has at least one vaccine they can take.

It also highlights the need for everyone to get vaccinated as quickly as possible. Don't procrastinate when the opportunity arises, because there are people around you who can't be vaccinated or can't be vaccinated with vaccines available to them. You being vaccinated cuts off one more path the virus can take to them.

No thanks, the pre alpha test can do other people. On top of it you still have to wear the mask it doesn't stop you spreading the virus. It just reduces the severity for the people vaccinated.

I second this sentiment. I'd wager a few bucks that all the people pressuring others to hurry and get the vaccine will conveniently be in no rush to follow up and check whether the vaccine had any health consequences or offer to help.

I'd take it today with zero qualms.

Don't worry though, what is likely the "average" HN reader (30, male), is pretty much last on the list, so by the time we get it there will be tens or hundreds of millions of people who have received all of the various types of vaccines.

What? Why? You are say "those who want others to become healthy won't want to ensure they stay healthy". That sounds illogical.

Have you never heard about the word "Virtue Signaling"?

That's not their job. Government departments with Public Health functions do that (e.g. https://vaers.hhs.gov/)

> On top of it you still have to wear the mask

This is the most nonsensical part to me. If the vaccine does what they say it does (reduce severe cases) then the justification for mask wearing and social distancing is gone.

When herd immunity is reached, then the need will be gone.

As more people become vaccinated the transmission rate will drop rapidly and people will stop complying with masks and distancing, etc. Same thing that happened in the Northeast and West when the transmission rare was suppressed, people started acting more and more normal and things reopened. Except this time, they'll have good reason to.

Only if everybody you come into contact with has been vaccinated. In the meantime, the vaccine might just be turning you into an asymptomatic carrier.

> Pre-Alpha test

THIS IS NOT SOFTWARE! I cannot believe I continue to see this complete ignorance smugly repeated on HN. The vaccine has undergone three phases of testing including large scale release. It's been "baked" since January, the only things fine tuned have been the exact dose of the mRNA. Given the effectiveness, it's highly unlikely we'll see a v1.1 anytime soon, if ever, but if we do it would likely have to go through similar levels of testing and would be just as "pre-alpha" as this.

> On top of it you still have to wear the mask it doesn't stop you spreading the virus.

Other comments have already dealt with why we'll still need to use masks.

> it doesn't stop you spreading the virus. It just reduces the severity for the people vaccinated.

We're still waiting on final data on how much vaccinated people will decrease the spread, but everything we've seen so far indicates that eventual severity of illness correlates very closely with how likely you are to infect others. Even if this wasn't true, reducing severity is huge since universal vaccination would then allow the virus to spread with reduced health effects savings hundreds of thousands of lives.

This sentiment is one among many reasons why there will be no return to 'normalcy' any time soon after the introduction of vaccines.

> It also highlights the need for everyone to get vaccinated as quickly as possible. Don't procrastinate when the opportunity arises, because there are people around you who can't be vaccinated or can't be vaccinated with vaccines available to them. You being vaccinated cuts off one more path the virus can take to them.

I would consider this faulty logic. I'm going to avoid taking a coronavirus vaccine until we have some actual data on the effects. Why would you rush to risk unknown consequences to your own health, and thus your ability to care for your loved ones if they get sick?

We have plenty of data. There were several rounds of trials for each vaccine involving tens of thousands of people over many months. What extra special data are you holding out for that the scientists and various national regulating agencies don't require?

>There were several rounds of trials for each vaccine involving tens of thousands of people over many months.

>over many months

Long-term effects have not been investigated. In fact, Pfizer has requested immunity from governments (https://www.independent.co.uk/news/health/coronavirus-pfizer...).

>Asked about when the full data on the vaccine’s clinical trial would be published, the company said this was still being worked on.

Not being able to review this yourself also removes some credibility from that vaccine.

I'm not against fast-forwarding the vaccine to protect the vulnerable, but it's irresponsible to claim this vaccine has insane amounts of data showing its lack of side effects. A better argument would be "it probably is better than getting Covid."

You being vaccinated only cuts off the path that the virus can take to somebody if the vaccine gives you sterilising immunity - otherwise, it may just prevent you experiencing disease symptoms, but not stop you being infectious.

There isn't enough evidence yet to understand whether the leading vaccines induce sterilising immunity yet. As such, we can't rely on these vaccines to give us herd immunity.

Reinfection rates are 0.01% per a recent study out of Qatar. So even if we all "get" the infection after being vaccinated, our own immune response should prevent reinfection for at least 6 months in 99.9% of cases.

Can you explain what you think this means?

Get COVID don't get COVID again.

I have one question regarding the current Pfizer data (it would be great if anyone with experience in statistics could help out):

UK healthcare professionals received this information called "REG 174 INFORMATION FOR UK HEALTHCARE PROFESSIONALS" [1] It states that the "efficacy of COVID-19 mRNA Vaccine BNT162b2 [for 75 years of age and older] was [...] 100% (two-sided 95% confidence interval of -13.1% to 100.0%)"

What does this mean? With my very minimal university statistics knowledge I would say that they are 95% sure that the efficacy lies between -13.1% and 100.0% for age >=75. And that means: We simply do not know (probably due to lack of data in this cohort). Where am I making an error?

Thank you in advance!

[1] https://assets.publishing.service.gov.uk/government/uploads/...

If you look at the formula for determining vaccine efficacy, you'll see it's determined by comparing the risk of being infected while unvaccinated vs the risk of being infected while vaccinated. If the risk of being infected while vaccinated is higher than the risk while unvaccinated then you will get a negative efficacy.

I believe you are right in saying we simply don't know what the efficacy is for those over 75 as a result of this study. Given that the range extends to 100% that tells us that no one over 75 who received the vaccine also tested positive for the virus. However the lower bound tells us that even if the vaccine had increased the chance of being infected by 13% we still would have expected 0 over 75 to be infected by the time they were tested simply because the probability of being infected is already so low.

https://en.m.wikipedia.org/wiki/Vaccine_efficacy

Thank you for your explanation!

Isn't this kind of normal for a vaccine?

Any time i have gotten the flu shot they ask all sorts of questions about allegeries, and even though i answer no to all of them, they still make me sit there for 15 minutes after "just in case".

Yes, it's non news dressed up as news because it feeds into fear. Ideally people would read the story, come to the same logical conclusion you did, and disregard if they aren't in the small group of people who know they have this issue.

Expect similar scary headlines when news outlets realize that they're not recommending it for pregnant or nursing mothers or children (because they haven't had chance to study the effects and effectiveness).

It makes complete sense to exclude people with severe allergies from the trials if you believe severe allergies are likely to affect the health and safety of the vaccine. This is fairly common for vaccines. It's not cutting corners either. If you expect severe allergies to adversely affect outcomes, you don't gain anything from having them in your general trial population, because unless you make sure your data gather and trial protocols are designed to test for the difference, you're unlikely to be able to form a robust opinion on the safety of the drug for allergy sensitive people, but are highly likely to taint your understanding of how it affects "normal" people. (that is, you could probably observe risk fairly easily, but you wouldn't be sure to confirm its safe for them if nothing showed up)

There might be something about being conservative to avoid what happened to these people without notice, but in the scheme of things its a pretty small pain point.

1 in 1,000 people in the UK have died after contracting COVID (this number is rising).

2 people out of thousands vaccinated yesterday had an allergic reaction that they recovered from (both people carry EpiPens and have a history of allergic reactions).

Monitoring systems mean we know about this, so bottom line is everything is going well so far. We will obviously want to continue to monitor.

1 in 1000 deaths is of the entire U.K. population, not just of those who have contracted the virus. The death rate is roughly 1 in 28 for those who caught it.

https://en.wikipedia.org/wiki/Template:COVID-19_pandemic_dat...

Which uses as a reference:

* https://coronavirus.data.gov.uk/details/cases

* https://coronavirus.data.gov.uk/details/deaths

> The death rate is roughly 1 in 28 for those who caught it.

You are confusing IFR and CFR.

Thanks for pointing that out, I had indeed forgotten to account for that.

Yes, because one day is enough time to conclude about outcomes.

> We know from the very extensive clinical trials that this wasn't a feature...

Not a feature, no kidding!?! The latter portion of that read like something for devs to understand...I had never heard of language like that in the medical/pharma world...then again, I've been removed from that industry for almost 14 years now. My dark sense of humor wants to really laugh at this, if it didn't deal with such somber subject matter.

It's really hard to tell from the wording of all of this what exactly this applies to. It talks about medicine and food allergies, but also says those who carry an an adrenaline autoinjector. Does that mean those that carry the adrenaline autoinjector for medicine and food allergies? Or anyone who carries one AT ALL? For example, someone who has one for bee stings - should they avoid the vaccine?

Moreover my sister reacted badly to one specific vaccine... Should she skip this based on that or assume it's fine based on the lack of reaction to most vaccines.

The guidance here is really lacking.

The guidance is intentionally lacking. She should talk to her doctor.

And the doctor is going to have better information about this vaccine than is available to the general public? That seems highly unlikely - there is not some secret doctor only channel for information on drugs. Hence why the guidance is lacking (I would not be complaining if instead the guidance was "overly technical" or something).

No, a doctor is going to have better information about the specifics for her situation and whether or not the risk of a reaction is worth the benefit of the vaccine.

Her doctor is likely not going to know any better than she does. The manufacturer, and the scientists involved, are in the best position to answer this question.

Unless your sister is in one of the groups currently being vaccinated (health care workers and over-80), the question is moot. By the time it's available to her, they'll hopefully have more information and can give more concrete guidance.

If the vaccine is available to her, then the guidance is reasonably clear that no, she should not take it yet.

I mean, the country we are in also currently makes it moot, but that doesn't make the guidance any more adequate...

Don't worry, the decision will be made for her by governments and/or venues banning the unvaccinated from public places. All will be well again!

This is dangerous guidance because it ignores the risk of COVID. Both of these people turned out fine, so if anything this seems like an endorsement of this vaccine for people with severe allergies. There is no guarantee any of the vaccines won't have issues. Its much better to say: "If you commonly get allergic reactions to medicines, you might get one here. Use your judgement or speak to your doctor about the risks of remaining unvaccinated versus taking this particular vaccine."

Let people make their own risk decisions. Banning the vaccine is how we got into this mess to begin with.

How many people were vaccinated, and how many would have this kind of reaction to any other vaccine (like flu)?

My son is severely allergic to peanuts. Wonder how this will play out.

Allergies to what?

it's in the article: "Any person with a history of a significant allergic reaction to a vaccine, medicine or food (such as previous history of anaphylactoid reaction or those who have been advised to carry an adrenaline autoinjector) should not receive the Pfizer BioNtech vaccine"

...or any other similar vaccine?

Well... that's one way to find out if I have a vaccine allergy, I guess. If the first shot goes bad I'm definitely not getting the second.

I really wonder if and how badly this will affect the already on-edge population on "just how soon they'll ring up to get in line" for testing, once they see this plastered all over the news this evening. And, I mean, even worse: pure gold for the antivaxxers, which is going to be a problem, too. I just hope people will understand this is part of the process and not let go of their motivation to get vaccinated.

n=1 anecdote follows:

I'm somewhat in the camp of "Of course I'll take the vaccine, but I don't necessarily want to be at the front of the line" and this - to me - is irrelevant. So far it's two people out of thousands, and those two had a known history of severe allergic reactions. So this doesn't make me any more reluctant to take the vaccine.

And, I mean, pure gold for the antivaxxers, which is going to be a problem, too.

Yeah, I am worried about that as well. The last thing we need is anything to encourage the anti-vaxxer crowd and fuel their ridiculous conspiracy theories. sigh

> The last thing we need is anything to encourage the anti-vaxxer crowd and fuel their ridiculous conspiracy theories. sigh

A good start would be to stop proving them right... again, and again, and again...

Reply on news.ycombinator.com