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Comment by Throwawayaerlei | Hacker News Reader

The Russian Gam-COVID-Vac/Sputnik V vaccine looks very good, but for the US or to much of the West, there's a price to be paid for being in an effective state of war with another country. Although Gamaleya is now working with AZ/Oxford to see if substituting one of their doses for one of Oxford's will produce much better results, which I never would have expected.

This is based on the theory that the immune system response to Oxford's virus vector is mostly negating the benefit of the second dose taken 21 days after the first. Gam-COVID-Vac gets around this by using different viruses for each dose, and has 90% efficacy results from their Phase III trial. Unfortunately, no one can yet manufacture it in anything like bulk quantities, but they have set up manufacturing partnerships with a whole bunch of countries from India to South Korea.

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The use of Russian and Chinese vaccine is much about trust. No one trusts that the Russians have done proper trials or that the reported data is accurate and no outside party has a means to verify their claims. Time will tell - I very much hope it works, but wouldn't be surprised if it didn't.

France allowed the Pasteur institute to fail - a much desired vaccine was stopped because it wasn't effective enough. Impossible to imagine the same happening in Russia, as Putin needs to project power.

> the theory that the immune system response to Oxford's virus vector is mostly negating the benefit of the second dose taken 21 days after the first

Do you know if there are more trials underway to verify this? I'm guessing it ties in to AZ's encouragement for delaying the second dose i.e. wait until the immune response has died down. I think UK medical consensus is currently recommending 12 weeks rather than the original 3-4.

Non-sequitur, but true: this is a political hatchet job from delivered by a center-left newspaper to a center-right politician. The key to this crisis and article can be found in the middle of the article: "...von der Leyen's press department has been energetic in its defense of the Commissions actions. After all, the EU has secured rights to 2.3 billion doses of vaccine, they have pointed out, with 760 million of them from BioNTech/Pfizer and Moderna.

But what use is that when the availability of the vaccine will remain so limited for the foreseeable future? When the producers are unable to deliver what they have agreed to – or can only deliver much later?"

Von der Leyen deserves all the hatchet jobs she can get... She is the child of a political dynasty and hasn't done anything well for citizens in her life.

Besides her parentage, you forgot to mention that she's a German woman and mother in a position of power, to fully "justify" your ad hominem attack.

It's not an ad hominem when you're talking about someone's competence. Has she done anything good or not?

As a French I'm still extremely bitter about the insane manoeuvering by the EPP to put her in place. Then again, finding anyone even remotely competent in the EPP is probably quite hard.

It's not a hatchet job. The EU's handling of the vaccine has turned into an incredible disaster. Given the stakes, and the magnitude of the disaster, it's only natural the architect of that disaster get evaluated critically.

It is both. And especially the Spiegel has an issue with her. Also has a history of pushing agendas.

Personally, I blame part of the availability issues, caused by the Pfizer plant "shutdown" in Belgium, on that hatchet job. The Spiegel was among the first to use the unsatisfactory vaccine availability against von der Leyen. Fair enough, but as solution they called for increased ordering. Pressure built, frustration kicked in and then every news outlet demanded the same thing. Local politicians supported that narrative, they avoided discussions about their own fuck ups. Then the EU ordered more, demand exceeded capacity, and Pfizer reworks its plant. That resulted in even worse short term availability issues. So great job, I guess.

The 12 weeks is not about maximizing protection for an individual recipient, but was a decision made solely to get the first dose to more people faster.

In terms of effect on effectiveness per person it is purely speculative.

That's not correct for the AZ vaccine, the longer interval is supported by the trial data, and we simply lack that data for other vaccines, though for most other vaccines historically a longer interval than 3 weeks is better for a second dose.

Exploratory analyses showed that increased immunogenicity was associated with a longer dose interval (see Immunogenicity Table 3). Efficacy is currently demonstrated with more certainty for dose intervals from 8 to 12 weeks. Data for intervals longer than 12 weeks are limited.

https://www.gov.uk/government/publications/regulatory-approv...

If the AZ vaccine actually better with longer delays, that's great, but it does not change the fact that the political decision to increase the interval was made at a point where the UK was starting to give second jabs of the Pfizer vaccine, and second round vaccinations with the Pfizer vaccine were cancelled for a lot of people as a result, prompting Pfizer to warn they didn't have data on what that would do.

As such the decision was very clearly made on the basis of getting more people some protection, whether or not they could be confident of the effect of the long term protection across the various vaccines.0

It's a reasonable gamble to take given the amount of spread, and is not a criticism (though the way the change was communicated was absolutely awful), but if it had been a decision taken based on available data one would expect the schedules actually tested by the manufacturers to be adhered to, even if different between the vaccine.

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