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Comment by ketamine__ | Hacker News Reader

If one has access to the Pfizer vaccine why bother with AZ's vaccine?

A billion doses or so have already been manufactured around the world or are very close to. It's also substantially cheaper and as others said, way easier to store and transport. It will make a huge difference in the non-rich countries.

Leaked prices from the EU:

-Oxford/AstraZeneca: €1.78

-Johnson & Johnson: $8.50

-Sanofi/GSK: €7.56

-BioNTech/Pfizer: €12

-CureVac: €10

-Moderna: $18

Where are you getting that information about a billion doses already manufactured? Would be great if true!

There is a company called Serum Institute they have been doing production for sometime now.

https://www.businesstoday.in/current/corporate/serum-institu...

Is the price a result of the cost to produce it, or is it price adjusted, reflecting the relative demand? Perhaps there's limited demand for a vaccine if the mixed results undermines confidence.

Also, it would be interesting to understand the global pricing. Due to market segmentation, there could be inconsistent local pricing among the manufacturers.

This is a bit confused with different currencies being used with implied ordering...

USD 0.82 -> €1.00

Oxford/AstraZeneca: €1.78

-Johnson & Johnson: US$8.50 €6.97

-Sanofi/GSK: €7.56

-CureVac: €10

-BioNTech/Pfizer: €12

-Moderna: US$18 €14.76

I'd go one step further and point out that J&J also requires only one shot (assuming they can reach high effectiveness ~90% without significant side effects <100ppm).

Not only is there reduced logistical challenge which is easily >$10, but the others are only listed at half the effective price since they have to be given twice 3-4 weeks apart!

Although there is significant consideration being given to giving only one dose of Pfizer/Moderna, i.e. a health system operated stage 4 trial. At least I hope they do the effort to make it a proper trial, it might be a shambolic politically driven cluster fuck.

(Do you get an 'immunity passport' with only one shot? Which vaccines do countries recognize? The Russian and Chinese ones with NO clinical trial data?)

Nobody needs an immunity passport once a location is back below community spread.

Once a location has a low local positivity rate, testing and contact tracing are effective again.

This should start occurring naturally once essential workers are vaccinated; then any partial lockdown or additional vaccination should destroy community spread.

Practically speaking, countries will likely require proof of immunisation for international travel. Maybe not the US, though I wouldn't go there without it.

I'd also expect it would become expensive to get travel insurance without immunisation.

Your points don't address my question.

It does not have the same strict criteria in terms of keeping it at a very cold temperature which makes it interesting for developing countries.

That's great but irrelevant to my question.

The mRNA vaccines aren't currently being produced at a high enough volume. Having more types of vaccines available means more vaccinations are possible in a shorter period of time.

Right. Where I live, there are enough orders for the three main vaccines to vaccinate all adults. But half of that is for the AZ option. Just like vaccines in general are going to be prioritized for at-risk demographics and essential workers, I'd sure hope they're also prioritizing the more effective vaccines for them.

Given the current data, of course I'd personally prefer of the mRNA vaccines. But that's unlikely to be something I have any agency over. It's either nothing for an indefinite amount of time, or accept whatever they have even if it is one of the less effective options.

Except my question was based on having access to an mRNA vaccine...

I'm not confident I have a full understanding of the tradeoffs / I will be doing more research once I can actually access either / availability will probably be the deciding factor anyways, but with that said:

As I understand the state of things I'd be more comfortable getting the AZ/oxford vaccine than the Pfizer/BioNTech vaccine because the underlying technology is less novel, and therefore there is less potential for unknown long term side effects (of the unknown unknowns variety).

The nice thing about the mRNA vaccines is that while that tech hasn't been used in an approved vaccine before, it has been used in other treatments, and there's no real mechanism for there to be long term side effects. The vaccine and the proteins it causes to be produced are only in your system for a limited time period. Long term side effects are more of a concern for medications that are taken on an ongoing basis.

Currently if I had the choice I'd go for the Pfizer vaccine hands down, given the superior efficacy in testing. (That said, beggars can't be choosers, so I'd take any approved vaccine I could get...)

I'm the exact opposite - given how the technology works (and I think mRNA vaccines are truly ingenious and amazing), it seems the potential for negative side effects would be much greater (but, to emphasize, still not that high) with a modified-adenovirus-vector vaccine than an mRNA vaccine. I mean, the pathway for the AZ vaccine is to get a modified chimp adenovirus to infect your cells where they will generate spike proteins. The mRNA vaccines really are just snippets of RNA wrapped in lipids - they're about as simple and direct a mechanism as you can get.

There was an HIV vaccine trial a few years ago that was adenovirus based, where patients who got the vaccine ended up with a _higher_ rate of infection than those in the control group. It was a major disaster. The mechanism was believed to be those who'd had the adenovirus previously were at increased risk. The AZ vaccine uses a modified chimp adenovirus people have not been exposed to in order to reduce this kind of risk, but the Russian vaccine uses the same adenovirus as the failed HIV vaccine trial.

You should include your sources to distinguish your comment from the anti-vax noise:

HIV original vaccine: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2585831/

As relates to Covid: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7571904/

AZ's vaccine is, I believe, easier to transport due to being storable at higher temperatures.

Because it would actually help.

As of currently there is a huge production backlog for Moderna and Pfizer, but not the simpler AZ and Sputnik vector vaccines. Mass vaccinations need to happen last month, not in May to be effective. In May/June when our batches will be ready, the wave would already be over and you would be protected for the next 6 months with almost no risk. The next useful vaccination period would be fall 2021.

With the two simpler vector vaccines you could start now for everybody, as did Russia, Hungary and Argentina weeks ago. Well, with Sputnik not the elderly.

> If one has access to the Pfizer vaccine why bother with AZ's vaccine?

You wouldn’t. Poorer people in poorer countries will get the less effective vaccines. Richer people in richer countries will get the better ones. There is a difference therein. But nothing compared to the vaccinated-unvaccinated gulf.

It's going to be used by rich Western economies too. Britain and Australia will use it. Dont believe this is only an inferior treatment compared to others, wait for better stats to emerge. This stuff is 5x cheaper and easier to ship and store. It will be used by every economy be it rich or poor.

> It's going to be used by rich Western economies too

Agreed. But more AZ will go to e.g. Rochester over Manhattan.

I'm from the UK, and would expect that in our country the split of AZ vs Pfizer would not be determined by wealth but by need.

I don't see why it would (or at least should!) be any different in America - but aware there are way more corporate interests at play.

Manhattan isn't homogeneous and the tiny number of urbanites who care enough to flash the label of their vaccine source don't matter at scale. The 1m doses of pfizer given out so far haven't gone to socialites and rich, they've gone to states for sub distribution in a hospital and semi-public regulated health system. They might be private providers, they're subject to policy.

When AZ arrives in bulk it will be used in Manhattan's hospitals unless some politics about IPR intrude, which is not impossible but it has nothing to to with real efficacy or scientific reasoning. It's politics and lobbying.

Less effective is perhaps a misleading word choice, remember the Phase 3 trials are measuring efficacy in preventing any cases (as defined in the study endpoint).

Despite the efficacy being lower the Oxford vaccine is extremely effective, not a single vaccinated recipient was hospitalised once 21 days had passed from the first dose.

αἴκα.

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