Are vaccines the light at the end of the tunnel?

[cangelmd]

1 hour ago, Dylandude said:

Fantastic news from Pfizer.

In the UK the BMA (British Medical Association) wrote to all GP’s last week to outline the start of the vaccination process which will be lead by GP’s, initially during December. At the outset Healthcare workers and the over 85’s will be offered the vaccine.

 

There is however a logistical problem ahead. It is outlined in the BBC report that the vaccine needs stored at -80C

I spoke today with a division of a huge US Pharmaceutical Wholesale & Distribution company, and they have no facility for that type of storage or distribution via vans and lorries in the UK. The lowest temperature currently available in the UK is -12C

I have also spoken with two doctors today, and no doctors surgery will have the equipment to store at that temperature either.

 

I highlighted the potential of logistical problems earlier in this thread. Having spent a career working in the Pharmaceutical Industry there are multitude of factors to allow for beyond drug discovery. My input was ridiculed by Fouremco and I stopped posting as a result. Subsequently TeeRick kept the beacon burning for sense and sensibility.

 

We have breakthrough, however, we have to find a way of getting this vaccine to everyone in as fast and as safe a way as possible.

We were contacted by someone in the federal govt - HHS likely, possibly through our national hospital network - several months ago about availability of -70 freezers. We have 2 at our mid sized community hospital, but neither would be usable for drugs under current guidelines. I think then the pharmacy was either shipped a freezer or told that we were on the list to get a freezer.

My point is that in the US, vaccine distribution will be over seen by state health departments and will not be through the normal routes for the general population at first. It will likely be state health for older adults, possibly partnering with hospitals to provide clinics and other types of outreach to nursing homes (and vaccinating people on acute care visits if possible) and hospital-based for healthcare worker. That's the way that hospital nurses and many physicians get their flu vaccines now. My state is known for not being at the fore front of anything, but ADPH has already published their initial guidelines for vaccine distribution in the state. Nothing earth shattering from what has been published on a national level, but somewhat simplified, and included reaching out to rural pops and persons who might refuse vaccine on first wave. Someone is thinking and doing their homework, so I wouldn't stress about this, "they" are working on it.

[Fouremco]

1 hour ago, Dylandude said:

I highlighted the potential of logistical problems earlier in this thread. Having spent a career working in the Pharmaceutical Industry there are multitude of factors to allow for beyond drug discovery. My input was ridiculed by Fouremco and I stopped posting as a result. Subsequently TeeRick kept the beacon burning for sense and sensibility.

I have never ridiculed any of your posts, and I'm sorry that you feel that way. I have pointed out, however, that at times the valid points that you are trying to make are undermined by your use of the term "everyone". For example, in one of your earlier posts, you stated "What everyone over looks is you to have to have capacity to manufacture sterile glass vaccine syringes". I simply pointed out that your comment was at odds with the action already taken by one government, as Canadian authorities had "begun procuring the supplies that will be essential for 'mass vaccinations' in the event that a vaccine is found for COVID-19, starting with signing a contract for 37 million syringes."  https://www.ctvnews.ca/health/coronavirus/anticipating-mass-vaccinations-canada-ordering-millions-of-syringes-1.4965078"

 

[TeeRick]

2 hours ago, Dylandude said:

Fantastic news from Pfizer.

In the UK the BMA (British Medical Association) wrote to all GP’s last week to outline the start of the vaccination process which will be lead by GP’s, initially during December. At the outset Healthcare workers and the over 85’s will be offered the vaccine.

 

There is however a logistical problem ahead. It is outlined in the BBC report that the vaccine needs stored at -80C

I spoke today with a division of a huge US Pharmaceutical Wholesale & Distribution company, and they have no facility for that type of storage or distribution via vans and lorries in the UK. The lowest temperature currently available in the UK is -12C

I have also spoken with two doctors today, and no doctors surgery will have the equipment to store at that temperature either.

 

I highlighted the potential of logistical problems earlier in this thread. Having spent a career working in the Pharmaceutical Industry there are multitude of factors to allow for beyond drug discovery. My input was ridiculed by Fouremco and I stopped posting as a result. Subsequently TeeRick kept the beacon burning for sense and sensibility.

 

We have breakthrough, however, we have to find a way of getting this vaccine to everyone in as fast and as safe a way as possible.

Dylandude I might be wishful thinking today since I am so completely happy with this vaccine readout.  Perhaps the -80C will be a problem for some common distribution and storage channels.  But if it is a highly effective vaccine that will be eventually solved.  A lot of thought and effort has already been applied to this so the solution might be challenging but not impossible.  Furthermore I think the Moderna Vaccine using the exact same mRNA technology only requires -20C freezer temperatures.  I have never understood the difference between the two.  Perhaps Pfizer is running further temperature stability studies as necessary to maybe use -20C?

[terrydtx]

6 hours ago, K.T.B. said:

The vaccine is released in January.  Essential workers (healthcare workers, etc.) are inoculated first, along with nursing home/senior living facilities.  My February seniors and people with underlying conditions.  February/March will be essential workers (teachers, etc.).

Since both of us are over 70, we can wait until February. Our first cruise next year is in late May.

[Arizona Wildcat]

8 hours ago, Dylandude said:

Fantastic news from Pfizer.

In the UK the BMA (British Medical Association) wrote to all GP’s last week to outline the start of the vaccination process which will be lead by GP’s, initially during December. At the outset Healthcare workers and the over 85’s will be offered the vaccine.

 

There is however a logistical problem ahead. It is outlined in the BBC report that the vaccine needs stored at -80C

I spoke today with a division of a huge US Pharmaceutical Wholesale & Distribution company, and they have no facility for that type of storage or distribution via vans and lorries in the UK. The lowest temperature currently available in the UK is -12C

I have also spoken with two doctors today, and no doctors surgery will have the equipment to store at that temperature either.

 

I highlighted the potential of logistical problems earlier in this thread. Having spent a career working in the Pharmaceutical Industry there are multitude of factors to allow for beyond drug discovery. My input was ridiculed by Fouremco and I stopped posting as a result. Subsequently TeeRick kept the beacon burning for sense and sensibility.

 

We have breakthrough, however, we have to find a way of getting this vaccine to everyone in as fast and as safe a way as possible.

Pfizer developed shipping containers than can hold the vaccine at the required temperature.  Pfizer said PFIZER will coordinate distribution.

[Sam.Seattle]

I can see the light at the end of the tunnel!!!!

🛳️

[LGW59]

5 minutes ago, Sam.Seattle said:

I can see the light at the end of the tunnel!!!!

🛳️

2022 is oh so close

[TeeRick]

Here is a short general summary article on the Pfizer vaccine results published yesterday in Nature which is a highly respected journal.

 

https://www.nature.com/articles/d41586-020-03166-8

[cangelmd]

41 minutes ago, TeeRick said:

Here is a short general summary article on the Pfizer vaccine results published yesterday in Nature which is a highly respected journal.

 

https://www.nature.com/articles/d41586-020-03166-8

Reading that brings up a question for me.

If we need to know the vaccine prevents transmission, how many people need to be followed to determine that? The fewer people, the easier to do repeat testing, but the fewer people, the fewer infections, especially if people begin to get vaccinated and social distancing, etc continue.

I don’t see how a challenge trial could possibly be ethical at that point... could some sort of retrospective study be done of say college students, get them vaccinated, then say go off and live life and follow them?

 

It seems to me that we have reached a high enough state of paranoia with this virus, that we (society) may not accept much uncertainty. 
Herd immunity by definition will block transmission, but will that be enough to stop paranoia? 

[mimbecky]

38 minutes ago, cangelmd said:

Reading that brings up a question for me.

If we need to know the vaccine prevents transmission, how many people need

This was the basis of my question on Nov 2nd (obviously not well articulated).  I understood that the vaccines being studied are not addressing if they stop transmission. Thus my concern with more people being asymptomatic and yet still transmitting to others not fortunate enough to qualify yet for vaccination.

[grandgeezer]

1 hour ago, cangelmd said:

Reading that brings up a question for me.

If we need to know the vaccine prevents transmission, how many people need to be followed to determine that? The fewer people, the easier to do repeat testing, but the fewer people, the fewer infections, especially if people begin to get vaccinated and social distancing, etc continue.

I don’t see how a challenge trial could possibly be ethical at that point... could some sort of retrospective study be done of say college students, get them vaccinated, then say go off and live life and follow them?

 

It seems to me that we have reached a high enough state of paranoia with this virus, that we (society) may not accept much uncertainty. 
Herd immunity by definition will block transmission, but will that be enough to stop paranoia? 

 

Check with the real experts and see what it takes to reach heard immunity. Sometimes the cure is worse than the disease. According to the Mayo Clinic, and D.A. Anderson, there is only once sensible option, a vaccine. Herd immunity occurs eventually, when 60-90% of the population have the antibodies, depending on seriousness of the disease. To get to that level with Covid, you are probably closer to the 90%.

I'm sure you can find "experts" to say otherwise, they are probably the same experts that think the earth is flat.

[UnorigionalName]

6 minutes ago, grandgeezer said:

 

Check with the real experts and see what it takes to reach heard immunity. Sometimes the cure is worse than the disease. According to the Mayo Clinic, and D.A. Anderson, there is only once sensible option, a vaccine. Herd immunity occurs eventually, when 60-90% of the population have the antibodies, depending on seriousness of the disease. To get to that level with Covid, you are probably closer to the 90%.

I'm sure you can find "experts" to say otherwise, they are probably the same experts that think the earth is flat.

 

Herd immunity is mostly a phenomenon of vaccination.  It doesn't really work that way for the natural course.  Yes, there is some herd immunity effect in that if everyone gets it, next time around less people will get it and hospitals won't get overcrowded, but the virus will never go away. 

 

22 hours ago, TeeRick said:

Dylandude I might be wishful thinking today since I am so completely happy with this vaccine readout.  Perhaps the -80C will be a problem for some common distribution and storage channels.  But if it is a highly effective vaccine that will be eventually solved.  A lot of thought and effort has already been applied to this so the solution might be challenging but not impossible.  Furthermore I think the Moderna Vaccine using the exact same mRNA technology only requires -20C freezer temperatures.  I have never understood the difference between the two.  Perhaps Pfizer is running further temperature stability studies as necessary to maybe use -20C?

 

Maybe because they use different (proprietary) formulations for their lipid nanoparticle? Maybe there are some tradeoffs one way or another.

 

[TeeRick]

Herd Immunity can be natural (by infection/exposure) or can be acquired (through vaccinations).  Both methods require a lot of time and patience.

[BP99]

23 hours ago, Fouremco said:

I have never ridiculed any of your posts, and I'm sorry that you feel that way. I have pointed out, however, that at times the valid points that you are trying to make are undermined by your use of the term "everyone". For example, in one of your earlier posts, you stated "What everyone over looks is you to have to have capacity to manufacture sterile glass vaccine syringes". I simply pointed out that your comment was at odds with the action already taken by one government, as Canadian authorities had "begun procuring the supplies that will be essential for 'mass vaccinations' in the event that a vaccine is found for COVID-19, starting with signing a contract for 37 million syringes."  https://www.ctvnews.ca/health/coronavirus/anticipating-mass-vaccinations-canada-ordering-millions-of-syringes-1.4965078"

 

Hi,

Could you please tell me your source for you statement:

"manufacture sterile glass vaccine syringes". This is interesting

since most vaccines use plastic syringes.

Thanks!

 

[BP99]

22 hours ago, TeeRick said:

Dylandude I might be wishful thinking today since I am so completely happy with this vaccine readout.  Perhaps the -80C will be a problem for some common distribution and storage channels.  But if it is a highly effective vaccine that will be eventually solved.  A lot of thought and effort has already been applied to this so the solution might be challenging but not impossible.  Furthermore I think the Moderna Vaccine using the exact same mRNA technology only requires -20C freezer temperatures.  I have never understood the difference between the two.  Perhaps Pfizer is running further temperature stability studies as necessary to maybe use -20C?

Hi,

As far as I remember (which isn't great lately) the vaccine storage issues

(-80C) is for long term storage while it's shelf life for short term 

storage is -20C. I think this was for the Moderna RNA vaccine but

may?? be the same or different for Pfizer as mentioned on earlier posts.

[markeb]

35 minutes ago, grandgeezer said:

 

Check with the real experts and see what it takes to reach heard immunity. Sometimes the cure is worse than the disease. According to the Mayo Clinic, and D.A. Anderson, there is only once sensible option, a vaccine. Herd immunity occurs eventually, when 60-90% of the population have the antibodies, depending on seriousness of the disease. To get to that level with Covid, you are probably closer to the 90%.

I'm sure you can find "experts" to say otherwise, they are probably the same experts that think the earth is flat.

 

Vaccines induce herd immunity. No one argues that's the most reasonable way to stop transmission, if the vaccines are ultimately shown to stop transmission and not just disease (which I think they will be)?

 

Who is D.A. Anderson? I don't find anyone by that name on staff at the Mayo Clinic.

[TeeRick]

1 hour ago, cangelmd said:

Reading that brings up a question for me.

If we need to know the vaccine prevents transmission, how many people need to be followed to determine that? The fewer people, the easier to do repeat testing, but the fewer people, the fewer infections, especially if people begin to get vaccinated and social distancing, etc continue.

I don’t see how a challenge trial could possibly be ethical at that point... could some sort of retrospective study be done of say college students, get them vaccinated, then say go off and live life and follow them?

 

It seems to me that we have reached a high enough state of paranoia with this virus, that we (society) may not accept much uncertainty. 
Herd immunity by definition will block transmission, but will that be enough to stop paranoia? 

We have always required a vaccine against paranoia😀.  Very tough target!

Seriously though, I think the arguments that you and mimbecky and UnoriginalName bring up on transmission from asymptomatic carriers or non-vaccinated infected individuals are going to be with us for years.  No good way around this except perhaps one- Get as many people vaccinated as possible and hope to impact transmission.  That's all you can really do.  We know this from influenza which has been with us forever even though we have vaccines yearly.  We can only really protect ourselves and might just have to live with that.  But if there is a highly effective vaccine and hundreds of millions of people get vaccinated we might get back to some version of normal within 1-2 years.  If the virus changes then vaccines might need to be made yearly (or possibly less frequently) like influenza vaccines.  The good news is that the technologies like mRNA are easy to change sequences and match mutations pretty quickly.  Or even eventually mix different mRNA's in the same formulation.  I am being optimistic and I hope multiple vaccines work (they all share the antigen SPIKE in their design).  And the planet accepts that everybody that lives on it needs to be vaccinated.  Hey it worked with Smallpox campaigns and Polio campaigns on a worldwide basis.  It took decades but it worked.  So why not a worldwide vaccine effort for COVID (SARS)?  Am I dreaming?

Edited November 10, 2020 by TeeRick

[Fouremco]

23 minutes ago, BP99 said:

Hi,

Could you please tell me your source for you statement:

"manufacture sterile glass vaccine syringes". This is interesting

since most vaccines use plastic syringes.

Thanks!

 

That is a direct quote from the post by Dylandude that I questioned for his use of the term "everyone".

 

 

[markeb]

11 minutes ago, TeeRick said:

Am I dreaming?

 

Maybe. I hope not.

 

Remember that smallpox was "easy" to eradicate, and it still took over 200 years. Variola only causes disease in humans.  The infectious period for smallpox generally coincided with the most visible indicator of disease, the pox rash. The scarring from either natural disease or vaccination gave a clear indication of immunity.  And, there was essentially no asymptomatic carrier state. When the last cases were ultimately chased down on the African continent, ring vaccination worked in part due to the relative lack of societal movement, and global travel was still somewhat in its infancy to childhood.

 

With SARS-CoV-2, we're already seeing non-human infections (mink), which isn't surprising for a recently emerging zoonosis. The infectious period seems to pre-date the disease. There's no visible indicator of immunity, and there's a significant asymptomatic transmission/carrier state. And if reassortment of some sort is occurring in non-human hosts, you're going to need a global surveillance program to stay ahead of any disease competent change (and possibly ultimately to try to protect wildlife from us!). Finally, as witnessed by having this conversation on a cruise forum, everyone wants to, and much of the global population can, move freely and quickly almost anywhere around the world.

 

Sorry...

 

 

[ECCruise]

On 11/9/2020 at 12:19 PM, K.T.B. said:

 

This my assumption.  The vaccine is released in January.  Essential workers (healthcare workers, etc.) are inoculated first, along with nursing home/senior living facilities.  My February seniors and people with underlying conditions.  February/March will be essential workers (teachers, etc.).  End of March everyone else.

 

I truly think by the time summer hits, the people who need it will have it and the people who want it will be most inoculated.  I suspect about 40% of the population will ignore it and assume they're "invulnerable" to the virus.

I admire your optimism but the dates seem far too optimistic with "end of March, everyone else."

The very best estimate, from Pfizer is 1.3 billion doses through the entire 2021 timeframe.  Meaning that only 650 million worldwide can be vaccinated.  With a worldwide population of 7.8 billion that would mean inoculations for less than 10% worldwide, for the entire year.

[Porky55]

46 minutes ago, ECCruise said:

I admire your optimism but the dates seem far too optimistic with "end of March, everyone else."

The very best estimate, from Pfizer is 1.3 billion doses through the entire 2021 timeframe.  Meaning that only 650 million worldwide can be vaccinated.  With a worldwide population of 7.8 billion that would mean inoculations for less than 10% worldwide, for the entire year.

This is if you assume that Pfizer is the only provider - but we know that Astrazeneca, Novavax, J&J, Moderna to mention a few, will also provide vaccines, which will reach 90% efficacy too. If one maker has managed 90% - the others shall quickly follow.
These 9 companies have signed a pledge to manufacture a safe viable vaccine for Covid19.

https://www.healthline.com/health-news/9-pharma-companies-join-to-release-open-letter-promising-covid-19-vaccine-safety

 

 

 

Edited November 10, 2020 by Porky55

[zap99]

17 hours ago, LGW59 said:

2022 is oh so close

Let's hope that the light at the end of the tunnel is not just a train coming 😁

[ECCruise]

1 hour ago, Porky55 said:

This is if you assume that Pfizer is the only provider - but we know that Astrazeneca, Novavax, J&J, Moderna to mention a few, will also provide vaccines, which will reach 90% efficacy too. If one maker has managed 90% - the others shall quickly follow.
These 9 companies have signed a pledge to manufacture a safe viable vaccine for Covid19.

https://www.healthline.com/health-news/9-pharma-companies-join-to-release-open-letter-promising-covid-19-vaccine-safety

 

 

 

OK.  There will be other providers.

But they are all exactly the same formula?  Exactly the same approach?  And all will reach 90%?

I hope so but I don't think so.  That would mean every one of these providers would be knocking on the door of the most effective vaccines in the history of medicine.  Maybe.

[grandgeezer]

2 hours ago, markeb said:

 

Vaccines induce herd immunity. No one argues that's the most reasonable way to stop transmission, if the vaccines are ultimately shown to stop transmission and not just disease (which I think they will be)?

 

Who is D.A. Anderson? I don't find anyone by that name on staff at the Mayo Clinic.

D.A. Anderson is a world renowned Clinic that came up when I Googled heard immunity. The results from both places were basically the same but weren’t attributed to just one person.  

[markeb]

2 minutes ago, grandgeezer said:

D.A. Anderson is a world renowned Clinic that came up when I Googled heard immunity. The results from both places were basically the same but weren’t attributed to just one person.  

 

M. D. Anderson? That's the major cancer center of the University of Texas (although they've now lined through the word "cancer" on their web page, interesting), and they do show up close to the top of a Google search for herd immunity. May sound like it, but not being a jerk here. All the Google hits on D.A. Anderson were going to M. D. Anderson. And there is a reasonably good but short article there on herd immunity. I thought at first you meant D. A. Henderson (the primary architect of the eradication of smallpox), but he passed away in 2016.

 

The physician they interviewed for some reason equates herd immunity to natural infection, but that may well be because that's how the term is being used out there. Reality is recovered and immune natural infections + vaccine induced immunity will both contribute to herd immunity.