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The risks of partial immunisation
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By *oo hot OP Couple
over a year ago
North West |
Very little has been made of the great risk that the UK is taking by adopting unauthorised and unlicensed medical trials by ignoring the manufacturers' vaccine recommendations about the time between jabs.
Solitary voices in the wind have tried to point out the biggest risk of all - that of unintentionally creating immunisation resistant strains through the exposure of partially immune people to the virus in society.
Finally though, the voices are being heard and the UK response is weak. From the BMJ...
The US news site STAT referred to the move as “effectively turning [the UK] into a living laboratory.” It accused the UK of basing its new vaccination schedule “on small slices of evidence mined from ‘subsets of subsets’ of participants in clinical trials . . . and on general principles of vaccinology rather than on actual research into the specific vaccines being used.”
Paul Bieniasz, a retrovirologist from Rockefeller University who is studying how the virus can acquire mutations, has warned that the UK was taking a gamble that risked fostering vaccine resistant forms of the virus. He told the news site STAT, “My concern, as a virologist, is that if you wanted to make a vaccine-resistant strain, what you would do is to build a cohort of partially immunized individuals in the teeth of a highly prevalent viral infection.”
When asked about this concern, a Department of Health and Social Care spokesperson did not directly answer the question, saying rather that it was “vital we do everything we can to quickly and safely protect as many vulnerable people as possible from this virus” |
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Pascal Soriot from AstraZeneca in a interview in the Politico today advised leaving a greater distance between jabs for their vaccine as it gives greater protection, we are all in one big vaccine trial and results will change daily between protection and efficiency rates |
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"Pascal Soriot from AstraZeneca in a interview in the Politico today advised leaving a greater distance between jabs for their vaccine as it gives greater protection, we are all in one big vaccine trial and results will change daily between protection and efficiency rates "
Astra Zeneca do have some data to support the dosing schedule, although it's very minimal.
There's zero data to support delaying the Pfizer-BioNTech vaccine and I've said that ever since that decision was made. |
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"Pascal Soriot from AstraZeneca in a interview in the Politico today advised leaving a greater distance between jabs for their vaccine as it gives greater protection, we are all in one big vaccine trial and results will change daily between protection and efficiency rates
Astra Zeneca do have some data to support the dosing schedule, although it's very minimal.
There's zero data to support delaying the Pfizer-BioNTech vaccine and I've said that ever since that decision was made. "
You are right. They said no trials have gone past 21 days in between doses, so we can only hope that adequate protection can be provided with pushing the boundaries on the pfizer BioNtech vaccine |
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And if the UK experiment does happen to create a Pfizer vaccine resisting variant of covid, that spreads worldwide and negates the entire vaccination effort so far, who in government is going to stand up and say "oops, that didn't go well, sorry everyone"? |
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By (user no longer on site)
over a year ago
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"Pascal Soriot from AstraZeneca in a interview in the Politico today advised leaving a greater distance between jabs for their vaccine as it gives greater protection, we are all in one big vaccine trial and results will change daily between protection and efficiency rates
Astra Zeneca do have some data to support the dosing schedule, although it's very minimal.
There's zero data to support delaying the Pfizer-BioNTech vaccine and I've said that ever since that decision was made.
You are right. They said no trials have gone past 21 days in between doses, so we can only hope that adequate protection can be provided with pushing the boundaries on the pfizer BioNtech vaccine"
This is true. The trials also show that immunity is only good for up to 5 months but how many of you would take the vaccine if you took the same logic.
I find the irony is list with so many of these arguments.
Also someone raised the issue that we're all guinea pigs in trials. Indeed we are being exposed every day to trials and tests that we aren't even aware exist.
I find it interesting that Both Germany and Denmark suggested over two weeks ago that they are considering doing the same thing with a wider spread between the vaccine. Maybe the UK has got it right and many other follow.
Israel have publically come out and said the first Pfizer vaccine is not as effective as the company states. So have we just been suckered in by this high figure of immunity because it's what we wanted to hear or are we able to step back and read and assess critically instead of quickly jumping into something with little forethought?
The latter seems to be the forum norm and it's this kind of response that is just feeding the uncertainty and fear amongst people.
People need to think more responsibly and critically instead of #instareplies with clear agendas. |
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By (user no longer on site)
over a year ago
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its long been known that taking antibiotics when not required can cause bacterial infections to become resistant to the antibiotics but i’m not sure the same logic applies to vaccinations does it? (the rest is just me running through some logic in my head so if i am talking garbage will gladly take someone educating me)
a vaccine is not an “anti viral” in the way that we have anti biotics ... both of those are drugs designed to fight and kill the bacteria or virus whereas a vaccines purpose is to introduce a small amount of the virus (synthetic or otherwise) into your system to allow your body to build up its own natural response
second doses of other vaccines are boosters - where the first vaccine gave you some protection but this will increase that level (sometimes to lifetime immunity like the case of mmr, sometimes more of a refresher course for you body - i think they advise a tetnus top up if its been more than 10 years and you might be at risk)
so surely the biggest risk with the increased delay is that we wont get the level of protection we thought we originally would
different vaccines all have different gaps between them ... japanese encephalitis (definitely spelled wrong) i had to come back for dose 2 a week later , mmr we get as a baby and then again at pre school so about 4 years apart , it was either my typhoid or hep A (i had them combined) where i was told if i came back for another dose within a year it would give me lifetime immunity ... so it is possible that the vaccines will still work with a longer delay between them ... it just seems stupid to have taken the approach without testing
i assume there will be monitoring of study groups afterward to see what difference to the original test groups we see and perhaps additional boosters will be required now to achieve the results we were first aiming for |
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"Pascal Soriot from AstraZeneca in a interview in the Politico today advised leaving a greater distance between jabs for their vaccine as it gives greater protection, we are all in one big vaccine trial and results will change daily between protection and efficiency rates
Astra Zeneca do have some data to support the dosing schedule, although it's very minimal.
There's zero data to support delaying the Pfizer-BioNTech vaccine and I've said that ever since that decision was made.
You are right. They said no trials have gone past 21 days in between doses, so we can only hope that adequate protection can be provided with pushing the boundaries on the pfizer BioNtech vaccine
This is true. The trials also show that immunity is only good for up to 5 months but how many of you would take the vaccine if you took the same logic.
I find the irony is list with so many of these arguments.
Also someone raised the issue that we're all guinea pigs in trials. Indeed we are being exposed every day to trials and tests that we aren't even aware exist.
I find it interesting that Both Germany and Denmark suggested over two weeks ago that they are considering doing the same thing with a wider spread between the vaccine. Maybe the UK has got it right and many other follow.
Israel have publically come out and said the first Pfizer vaccine is not as effective as the company states. So have we just been suckered in by this high figure of immunity because it's what we wanted to hear or are we able to step back and read and assess critically instead of quickly jumping into something with little forethought?
The latter seems to be the forum norm and it's this kind of response that is just feeding the uncertainty and fear amongst people.
People need to think more responsibly and critically instead of #instareplies with clear agendas."
I'm not sure you entirely understand how studies work, and the difference between them and the government making stuff up.
Further, I find it quite amusing that you say this to one of the most qualified people on the forum to speak about such matters. |
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"Pascal Soriot from AstraZeneca in a interview in the Politico today advised leaving a greater distance between jabs for their vaccine as it gives greater protection, we are all in one big vaccine trial and results will change daily between protection and efficiency rates
Astra Zeneca do have some data to support the dosing schedule, although it's very minimal.
There's zero data to support delaying the Pfizer-BioNTech vaccine and I've said that ever since that decision was made.
You are right. They said no trials have gone past 21 days in between doses, so we can only hope that adequate protection can be provided with pushing the boundaries on the pfizer BioNtech vaccine
This is true. The trials also show that immunity is only good for up to 5 months but how many of you would take the vaccine if you took the same logic.
I find the irony is list with so many of these arguments.
Also someone raised the issue that we're all guinea pigs in trials. Indeed we are being exposed every day to trials and tests that we aren't even aware exist.
I find it interesting that Both Germany and Denmark suggested over two weeks ago that they are considering doing the same thing with a wider spread between the vaccine. Maybe the UK has got it right and many other follow.
Israel have publically come out and said the first Pfizer vaccine is not as effective as the company states. So have we just been suckered in by this high figure of immunity because it's what we wanted to hear or are we able to step back and read and assess critically instead of quickly jumping into something with little forethought?
The latter seems to be the forum norm and it's this kind of response that is just feeding the uncertainty and fear amongst people.
People need to think more responsibly and critically instead of #instareplies with clear agendas."
FYI The trials were unable to evaluate the durations of immunity any longer than their own durations. Research has continued since, in order to get further data. We know the likely duration of naturally acquired immunity coming from infected people, which is a useful benchmark but could we'd hope be shorter than that derived from the vaccines |
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By *obka3Couple
over a year ago
bournemouth |
"Very little has been made of the great risk that the UK is taking by adopting unauthorised and unlicensed medical trials by ignoring the manufacturers' vaccine recommendations about the time between jabs.
Solitary voices in the wind have tried to point out the biggest risk of all - that of unintentionally creating immunisation resistant strains through the exposure of partially immune people to the virus in society.
Finally though, the voices are being heard and the UK response is weak. From the BMJ...
The US news site STAT referred to the move as “effectively turning [the UK] into a living laboratory.” It accused the UK of basing its new vaccination schedule “on small slices of evidence mined from ‘subsets of subsets’ of participants in clinical trials . . . and on general principles of vaccinology rather than on actual research into the specific vaccines being used.”
Paul Bieniasz, a retrovirologist from Rockefeller University who is studying how the virus can acquire mutations, has warned that the UK was taking a gamble that risked fostering vaccine resistant forms of the virus. He told the news site STAT, “My concern, as a virologist, is that if you wanted to make a vaccine-resistant strain, what you would do is to build a cohort of partially immunized individuals in the teeth of a highly prevalent viral infection.”
When asked about this concern, a Department of Health and Social Care spokesperson did not directly answer the question, saying rather that it was “vital we do everything we can to quickly and safely protect as many vulnerable people as possible from this virus”"
It has been explained before that viruses are not subject to "resistance " like bacteria. A vaccine either stimulates a response in the body or it doesnt as we get older or have an immune deficiency illness we produce a lower response, this is why most vaccines are given as boosters most many months later, sometimes even years later, whether people get the second dose after four or twelve weeks later will have no effect on the ability of the virus to mutate, each time a virus replicates it has between a 1 in a 10000 to 1 in several million chance of mutating, most are unviable and die, the odd one has a big enough change to make it noticeable such as the one first found in Kent. AZ have stated that their studies have shown a better immune response at 12 wks, I heard an ex chief medical officer yesterday that it is far more likely for the Pfizer one to be the same than for it to be less effective, there is far too much fake news going on without you spreading reports from some crank. |
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" Israel have publically come out and said the first Pfizer vaccine is not as effective as the company states. So have we just been suckered in by this high figure of immunity because it's what we wanted to hear or are we able to step back and read and assess critically instead of quickly jumping into something with little forethought? "
It's to be expected, because the trials were skewed heavily to the 18-55 age group in terms of participants, so these age groups make stronger immune responses. There were only about 760 people over 75, out of cohorts of 20,000 in each of the Pfizer-BioNTech vaccine and the placebo groups. So, the weaker immune response of elderly people was largely diluted in the data. Israel vaccinated mainly over 75s so they've generated realistic data on how people with weaker immune systems respond. The Pfizer-BioNTech vaccine does not contain any additional adjuvant (substances to boost immune response) as the lipid "bubble" components are thought to have a slight adjuvant effect. The fact older people make weaker immune responses is why the seasonal influenza vaccine is formulated differently for the over 65s vs other adult age groups and the children's nasal vaccine.
Re: the idea of vaccine "resistance" raised by Girlinlingerie, there won't be resistance in the same way as bacteria can be resistant to antibiotics, no. But any time an organism is put under what we call a selection pressure, then you generate circumstances where those organisms best adapted will thrive and proliferate. Having low levels of immunity to a certain strain or version of a virus will mean that any variants which are capable of evading this immunity will become predominant. This means any mutations in the spike protein of SARS-CoV-2 that means it evades the immune system could actually become the more common strain. This is what is meant by vaccine "resistance". There's already some evidence that some variant mutations in SARS-CoV-2 could enable the virus to "hide" from the immune system.
The way infectious organisms "hide" is by influencing the normal signalling mechanisms of cells. Infected cells will display certain proteins on the surface that act as "distress signals" and this is what the immune cells recognise (this is called antigen presentation). If this antigen presentation process can be suppressed or stopped, then you have a situation where the intracellular pathogen (the virus) can be within cells, actively replicating but without the immune system "seeing". Our T-cells cannot "see" free viral particles (or most types of pathogen) in the blood stream or lymphatic system very easily. That's why sepsis (whole body infection due to pathogens in the bloodstream) is so serious and so hard to treat once established.
Basically, we don't want to create a selection pressure that favours variants that can evade the immune system, because no matter how many antibodies you might generate from vaccination, antigen presentation is still needed to enact this immunity upon exposure to the pathogen. No antigen presentation = no targeted immune response. |
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"Pascal Soriot from AstraZeneca in a interview in the Politico today advised leaving a greater distance between jabs for their vaccine as it gives greater protection, we are all in one big vaccine trial and results will change daily between protection and efficiency rates "
The amount of people willing to play guinea pig like this is crazy. How it’s not been fully challenged is unbelievable |
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"Pascal Soriot from AstraZeneca in a interview in the Politico today advised leaving a greater distance between jabs for their vaccine as it gives greater protection, we are all in one big vaccine trial and results will change daily between protection and efficiency rates
The amount of people willing to play guinea pig like this is crazy. How it’s not been fully challenged is unbelievable "
I think people were just desperate for something to cling into.
Some hope |
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By *ostafunMan
over a year ago
near ipswich |
"Pascal Soriot from AstraZeneca in a interview in the Politico today advised leaving a greater distance between jabs for their vaccine as it gives greater protection, we are all in one big vaccine trial and results will change daily between protection and efficiency rates
The amount of people willing to play guinea pig like this is crazy. How it’s not been fully challenged is unbelievable "
I love reading all the experts on here im surprised fab didn't get involved from the start we would all have had both jabs by now. |
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By (user no longer on site)
over a year ago
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" Israel have publically come out and said the first Pfizer vaccine is not as effective as the company states. So have we just been suckered in by this high figure of immunity because it's what we wanted to hear or are we able to step back and read and assess critically instead of quickly jumping into something with little forethought?
It's to be expected, because the trials were skewed heavily to the 18-55 age group in terms of participants, so these age groups make stronger immune responses. There were only about 760 people over 75, out of cohorts of 20,000 in each of the Pfizer-BioNTech vaccine and the placebo groups. So, the weaker immune response of elderly people was largely diluted in the data. Israel vaccinated mainly over 75s so they've generated realistic data on how people with weaker immune systems respond. The Pfizer-BioNTech vaccine does not contain any additional adjuvant (substances to boost immune response) as the lipid "bubble" components are thought to have a slight adjuvant effect. The fact older people make weaker immune responses is why the seasonal influenza vaccine is formulated differently for the over 65s vs other adult age groups and the children's nasal vaccine.
Re: the idea of vaccine "resistance" raised by Girlinlingerie, there won't be resistance in the same way as bacteria can be resistant to antibiotics, no. But any time an organism is put under what we call a selection pressure, then you generate circumstances where those organisms best adapted will thrive and proliferate. Having low levels of immunity to a certain strain or version of a virus will mean that any variants which are capable of evading this immunity will become predominant. This means any mutations in the spike protein of SARS-CoV-2 that means it evades the immune system could actually become the more common strain. This is what is meant by vaccine "resistance". There's already some evidence that some variant mutations in SARS-CoV-2 could enable the virus to "hide" from the immune system.
The way infectious organisms "hide" is by influencing the normal signalling mechanisms of cells. Infected cells will display certain proteins on the surface that act as "distress signals" and this is what the immune cells recognise (this is called antigen presentation). If this antigen presentation process can be suppressed or stopped, then you have a situation where the intracellular pathogen (the virus) can be within cells, actively replicating but without the immune system "seeing". Our T-cells cannot "see" free viral particles (or most types of pathogen) in the blood stream or lymphatic system very easily. That's why sepsis (whole body infection due to pathogens in the bloodstream) is so serious and so hard to treat once established.
Basically, we don't want to create a selection pressure that favours variants that can evade the immune system, because no matter how many antibodies you might generate from vaccination, antigen presentation is still needed to enact this immunity upon exposure to the pathogen. No antigen presentation = no targeted immune response."
thanks for such a detailed response
next question (sorry) if this mutation potential exists every time the virus passes from ine person to the next and the vaccine resistance described is nothing to do with being able to fight off a weak vaccine like bacteria and antibiotics , does that not mean the same risk exists at zero, 1 or 2 doses of the vaccine and this delay hasnt increased the risk at all as some suggest? (or my brain might now just be clicking that lower immunity means higher chance of contracting the virus and if you do thats another chance for it to mutate but this risk level would still be equal to someone with no jab yet and the 2nd jab delay still isnt the problem ) |
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"
thanks for such a detailed response
next question (sorry) if this mutation potential exists every time the virus passes from ine person to the next and the vaccine resistance described is nothing to do with being able to fight off a weak vaccine like bacteria and antibiotics , does that not mean the same risk exists at zero, 1 or 2 doses of the vaccine and this delay hasnt increased the risk at all as some suggest? (or my brain might now just be clicking that lower immunity means higher chance of contracting the virus and if you do thats another chance for it to mutate but this risk level would still be equal to someone with no jab yet and the 2nd jab delay still isnt the problem ) "
Better immunity to the virus almost certainly results in a lower viral load (if any), should a person encounter SARS-CoV-2 after the two full doses of the vaccine. This means far fewer replicating virions and therefore lower potential for mutation. If there is widespread partial or low immunity and a moderate viral load is possible in such individuals, there's a higher chance of mutations favouring immune system evasion becoming common.
As we have no data about spacing the Pfizer-BioNTech vaccine out by three months AND little data about the strength of the immune response in elderly people, we cannot say whether allowing such a dosing regime is going to place us in that position of widespread low/little immunity. The view of many is that now isn't the time for an unplanned population wide experiment, but is the time to, in the words of our illustrious leader "follow the science."
Once we have this situation under control through complete vaccination, controlled trials or retrospective analysis could be done to quantify the effectiveness of different dosing schedules etc. For example, it might become apparent that in younger people with robust immune systems, three months is okay, but in older people, it is not. We may need a differential strategy for different groups. |
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By *ogloomMan
over a year ago
Levens |
"
thanks for such a detailed response
next question (sorry) if this mutation potential exists every time the virus passes from ine person to the next and the vaccine resistance described is nothing to do with being able to fight off a weak vaccine like bacteria and antibiotics , does that not mean the same risk exists at zero, 1 or 2 doses of the vaccine and this delay hasnt increased the risk at all as some suggest? (or my brain might now just be clicking that lower immunity means higher chance of contracting the virus and if you do thats another chance for it to mutate but this risk level would still be equal to someone with no jab yet and the 2nd jab delay still isnt the problem )
Better immunity to the virus almost certainly results in a lower viral load (if any), should a person encounter SARS-CoV-2 after the two full doses of the vaccine. This means far fewer replicating virions and therefore lower potential for mutation. If there is widespread partial or low immunity and a moderate viral load is possible in such individuals, there's a higher chance of mutations favouring immune system evasion becoming common.
As we have no data about spacing the Pfizer-BioNTech vaccine out by three months AND little data about the strength of the immune response in elderly people, we cannot say whether allowing such a dosing regime is going to place us in that position of widespread low/little immunity. The view of many is that now isn't the time for an unplanned population wide experiment, but is the time to, in the words of our illustrious leader "follow the science."
Once we have this situation under control through complete vaccination, controlled trials or retrospective analysis could be done to quantify the effectiveness of different dosing schedules etc. For example, it might become apparent that in younger people with robust immune systems, three months is okay, but in older people, it is not. We may need a differential strategy for different groups."
We can say that the dosing regime in the short term will provide high levels of immunity in most people vaccinated, just with one dose.
Worrying about selection pressure is a mute point if we dont vaccinate as many as possible as quickly as possible. By not taking the risk balances equation and pushing out the second dose ,(which hasnt been fully explored with the pfizer vaccine but has several reasons why it shouldnt be an issue) we leave a large portion of the population in a position to mutate more virus more quickly and havent got the medical system capable of supporting.
The more patients and mutations in sufficient numbers becomes a greater issue. Particularly when many of the immunocompromised are good reading grounds for mutating more virus.
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" .
We can say that the dosing regime in the short term will provide high levels of immunity in most people vaccinated, just with one dose.
Worrying about selection pressure is a mute point if we dont vaccinate as many as possible as quickly as possible. By not taking the risk balances equation and pushing out the second dose ,(which hasnt been fully explored with the pfizer vaccine but has several reasons why it shouldnt be an issue) we leave a large portion of the population in a position to mutate more virus more quickly and havent got the medical system capable of supporting.
The more patients and mutations in sufficient numbers becomes a greater issue. Particularly when many of the immunocompromised are good reading grounds for mutating more virus.
"
A very interesting article on the vaccine resistance concept here:
Kennedy DA, Read AF (2020) Monitor for COVID-19 vaccine resistance evolution during clinical trials. PLOS Biology 18(11): e3001000. https://doi.org/10.1371/journal.pbio.3001000
And also here:
COVID-19 Evolution in the Post-Vaccination Phase: Endemic or Extinct?
Ariel Fernández
ACS Pharmacology & Translational Science Article ASAP
DOI: 10.1021/acsptsci.0c00220
We have already applied strong selection pressures to the virus, which have probably resulted in the more transmissible strains becoming predominant. |
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By *ogloomMan
over a year ago
Levens |
With amateur media led modelling there are a variety of factors left out.
One of which is the fact that the virus is still circulating in the community. So the vaccinated arent 'cured' they are purely given a chance of developing a level of immunity over and above what they may or may not of had and this taking 2 to 3 weeks to develop in general.
Many of the vaccinated may see the virus again and this will act in a way that triggers their immune system. These people will be likely to have a greater level of immunity for longer as they have effectively had a natural reminder to their systems. A bit similar to having had a second dose of one of the currently approved vaccines. |
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By *ogloomMan
over a year ago
Levens |
"With amateur media led modelling there are a variety of factors left out.
One of which is the fact that the virus is still circulating in the community. So the vaccinated arent 'cured' they are purely given a chance of developing a level of immunity over and above what they may or may not of had and this taking 2 to 3 weeks to develop in general.
Many of the vaccinated may see the virus again and this will act in a way that triggers their immune system. These people will be likely to have a greater level of immunity for longer as they have effectively had a natural reminder to their systems. A bit similar to having had a second dose of one of the currently approved vaccines."
Please excuse my generalization or simplifications |
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By (user no longer on site)
over a year ago
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The country that has published clinical results is Israel there they've found that in the over 60s the Pfizer vaccine gives a min of 33% efficacy with one dose the astra zeneca vaccine data for single dose hasn't been released. Clearly data does show that on the whole its better to give the whole elderly population a 33% boost than half of them a maximum of 60% with 2 doses of the Pfizer vaccine. The astra zeneca vaccine could actually benefit with upto 12 weeks between doses as it appears efficacy increases if the delay is increased from 2 to 12 weeks but again data hasn't been fully released that is just preliminary findings |
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