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Coronavirus
- Thread starter Wenche
- Start date
AlanSubie4Life
Efficiency Obsessed Member
Yeah the Moderna dose (100µg) is about 3x Pfizer . I believe that Moderna calibrated the dose to make sure a sufficient response was elicited in elderly patients: https://www.nejm.org/doi/full/10.1056/NEJMoa2028436
You can see there was some benefit to going to 100µg vs. 25µg. Don't just look at the median levels in the box plots - look at the outliers and spread. Also note the logarithmic y-axis.
I think I would have gone with 100ug as well. They unfortunately didn't explore 50mg extensively (though they did test it in another (small) trial).
It would be nice to be able to have data showing that 50ug would work nearly as well as 100ug and be able to double the number of doses! So there is an advantage to lower dosing! Unfortunately the dose-response is not quite linear - it looks like maybe 100ug is less than 4x better than 25ug (very hard to tell). So 50ug could be nearly as good as 100ug - or it might be somewhere in the middle. It's very hard to tell with just two points!
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That 95% effectiveness was from a trial conducted last year. The 72% J&J vaccine efficacy is against any symptom in the US during a more recent study and 85% effective in preventing severe disease. Trials conducted at a different time, in different places, and different variants in the wild. It's not fair to compare those two numbers against each other.
The effectiveness of the Pfizer vaccine against severe disease is more comparable to the J&J number, which leads to the thinking that the effectiveness of Pfizer would be similar to that of J&J if tested head-to-head right now.
There is a 2-dose J&J trial (2nd dose at day 57) underway with results expected in May. I wonder whether FDA/CDC would recommend a 2nd dose to anyone receiving the J&J right now if/when a 2-dose vaccination schedule is approved and suggested.
(Are any people who have received either the Pfizer or Moderna getting a second dose much later than one month after the first shot?)
Me. Moderna. First dose Jan 26, second dose--still waiting.
But wait, I thought COVID is already over in Texas and everything is opening back up and no masks already. So why do you even need a booster now?
Oh wait, maybe you are planning to travel outside of Texas where COVID is still active...
scottf200
Well-Known Member
Perhaps more than groups than elderly patients. I know of folks with Lupus that take immunity system-type suppression drugs. So is "more spike proteins" better for those types of cases too I'm (we're) wondering. Their doctor (rheumatologist) indicated the vaccines would be more effective for others due to the suppression drugs.
Maybe I'm not understanding all this tho.
Just received the ticket for the second dose--next Friday.
MXLRplus
Active Member
So what are thoughts about England's plan to get as many single dosed residents as possible before doing the full 2-shot? While not peer reviewed, an Israel study is backing up that plan.
Not an immunologist, but my impression is that immunity formed against the viral vector is not a significant problem in practice. I’m not sure exactly why this is. Perhaps it attracts less attention from the immune system because the vector virus does not reproduce. Whatever antibodies that are created against the vector virus are not prevalent enough when the 2nd booster shot is given to successfully interfere with the vaccine.
As for potential causes for AZ being a less effective vaccine, one reason that stands out in my mind is that it apparently does not use the pre-fusion stabilization modifications to the spike protein that most other vaccines used. That means it’s spike proteins can sometimes deform from their pre-fusion configuration thus hiding some of the more important epitopes for antibodies.
This isn’t quite what you are asking for, but this table shows reactions to the Pfizer vaccine taken from the phase 3 trial and compared to reaction rates of placebo as well as other non-COVID vaccines like the new one for shingles and the flu. As the data shows, temporary vaccine side-effect reactions are actually somewhat more common for Shingrix than for the Pfizer COVID shot.
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The data was just updated today and Florida is now up at ~40% B.1.1.7.
Discussion and more charts:
https://twitter.com/alexbolze/status/1367997024746971138?s=21
AlanSubie4Life
Efficiency Obsessed Member
Yeah, I had forgotten that. Other than possible variants, etc., I do wonder about the clearly reduced efficacy curves for J&J though. Really they need to do side-by-side comparisons now!
These appear to be the first dose numbers, strangely. Of course, second dose reactions are much more common. Fever goes up to 16%. Muscle and bone pain double in rate. The aggregate numbers (set which is the union of all reactions) are not given for Pfizer (they are for Moderna).
bkp_duke
Well-Known Member
Source for this please.
I practiced in Texas, and death reporting, especially by infectious disease causes, was always completed within days of the coroner completing an autopsy, or if no autopsy, just a few days after the death.
My wife told me today that there are now 3 older folks in her hospital after getting really ill from the second dose. She mentioned bleeding as one of the issues. She didn't notice which vaccine. The above data is only 18-55. Most people being vaccinated now are 65+ (though I heard today that Connecticut was doing 55+). Is anyone hearing of severe reactions requiring hospitalization in 65+?
bkp_duke
Well-Known Member
I've said many times, MANY times. This is the fastest way to get the pandemic behind us.
uujjj2
Member
It was widely reported in the summer. On July 27 and again on January 8, Texas officials reported huge one-day spikes in deaths, which were clearing a portion of the backlog. Not to single out Texas, though; many states report deaths pretty slowly, especially during big spikes in COVID.
I don’t know much about Steve Kirsch or Fluvoxamine, his new favorite drug. I do know that Kirsch was just on Dr. Drew Pinsky’s podcast a few days ago. My impression is that Pinsky has a reputation for flogging fringe right-wing opinions including medical (mis)information but I don’t follow him closely. So that’s a mark against Kirsch in my mind, but he seems to be generating a lot of attention for himself and his COVID treatment ideas recently in mainstream media as well.
I see that his recommended drug list includes ivermectin. Ivermectin is trendy among the right-wing radio talk show set as a COVID treatment. Like hydroxychloroquine, it worked in early lab “test tube” experiments but my impression is that there isn’t any compelling evidence that it works in real people. Although I haven’t read much about it, my impression is that the lab testing implied that people would need a dangerously high dose (far in excess of what is actually being prescribed) in order for it to be effective against the COVID-causing virus. So, that’s another mark against him. In his favor: he helped fund a study which showed hydroxychloroquine was an ineffective treatment.
Kirsch’s document and its list of drugs is interesting as an indication of what is trendy among some non-mainstream medical folks.
Anyway, that’s my tentative impression.
There was a story on Fluvoxamine on 60 Minutes yesterday. Apparently it is in a phase 2 trial after a remarkably good phase one trial where none of those COVID positive taking Fluvoxamine ended up needing hospitalization versus something like 10% in the placebo group. As a side effect it might decrease some of the violent tendencies of a large segment of folks in the world.
bkp_duke
Well-Known Member
Source please. "Widely reported" is being lazy. Find it to support your arguments, because my own personal experience as a physician says this is a BS claim.
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