Coronavirus

[Simon B]

Yes. Can’t remember where I read it, but how the vaccine affects transmission is still unclear.

It's currently a general truth. It's not possible to know at this stage. The studies conducted so far were neither designed for nor capable of discerning this.

It's hard to see how you could construct a trial which would answer the question. It's impractical as it requires monitoring the entire real lives of the participants, and then enrolling everyone they come into contact with and so-on in yet another example of an exponentially growing problem. You end up defaulting to the trial into which we have now all implicitly been enrolled and which will eventually yield an a-posteriori (empirical) answer of sorts.

[Anastasius]

Yes. Can’t remember where I read it, but how the vaccine affects transmission is still unclear. I guess somewhere there is a calculation that, ( making this up but you get the idea) if transmission is substantially reduced, then it might make more sense in terms of ordering, to do 11-25 YOs before” not at high risk” 30/50s. Or something. You can see how this might make sense. But I doubt in fact that they will stray from the roadmap. You can’t expect them to walk and talk at the same time........

What do you mean 'might' make sense ? We KNOW that the NHS is on its knees. We know that the predominant age group being hospitalised due to Covid is in that senior age range cohort. We do know that vaccinating that cohort will minimise their chances of catching Covid. We DON'T know how being vaccinated affects transmission. So it DOES make sense to vaccinate that age cohort.

[Simon B]

But TS's example is about trading the priority of 11-25 vs 30-40/40-50 or whatever. Hypothetically this might turn out to give the most overall benefit fastest - depending on how you define benefit and to whom. That would depend on things we don't know and have no way of knowing yet.

Nobody sensible* is suggesting that it makes sense to deprioritise the 75+ cohort at this stage.

*Lots of not sensible people seem to be suggesting it with some notion that said 75+ cohort can be "protected" by other means - while completely ignoring the screamingly obvious deluge of evidence for how well that hasn't been going so far. An impressively asinine feat of mental gymnastics IMV, but there's a lot of it about.

[teamsaint]

What do you mean 'might' make sense ? We KNOW that the NHS is on its knees. We know that the predominant age group being hospitalised due to Covid is in that senior age range cohort. We do know that vaccinating that cohort will minimise their chances of catching Covid. We DON'T know how being vaccinated affects transmission. So it DOES make sense to vaccinate that age cohort.

It MIGHT make sense IF it is shown that the vaccine has enough effect on transmission to make it more effective to vaccinate some younger groups first ( because they can cause spread to older groups) rather than vaccinate some older groups, eg “not at high risk” 30-50 s .
Just saying what I read, in any case.

Seems logical enough to me do do what is most effective most quickly at reducing the numbers getting tye worst illness.But clearly the most at risk of serious illness are getting the jabs first.

The kind of arguments presented in this paper, though this isn’t the one I read.

https://academic.oup.com/jlb/article/7/1/lsaa050/5860822

And

https://theconversation.com/which-age-group-old-or-young-should-get-the-covid-19-vaccine-first-may-depend-on-timing-150412

But in any case, it is pretty academic , as the road map is set.

[johnb]

I think that in the current circumstances there is little alternative to concentrating on vaccinating those at most risk of severe illness, hospitalisation and death.

Sure there are interesting hypotheses about the effectiveness of vaccinating the younger age groups and it is absolutely right that academics research various scenarios. However we have to deal with the crisis as it presents itself now and to do so with our current level of knowledge about the vaccines.

[Serial_Apologist]

I think that in the current circumstances there is little alternative to concentrating on vaccinating those at most risk of severe illness, hospitalisation and death.

Sure there are interesting hypotheses about the effectiveness of vaccinating the younger age groups and it is absolutely right that academics research various scenarios. However we have to deal with the crisis as it presents itself now and to do so with our current level of knowledge about the vaccines.

I have to say, I was most impressed at the service laid on at my local surgery yesterday.

As someone not yet in the 80+ range I had not expected to be seen to this early. One turned up, as requested, not more than five minutes before time of appointment, was asked by one of two young people in hi-res waistcoats "on guard" outside the premises to give name and address and be offered hand cleanser, then immediately checked inside for time of appointment and directed down a corridor to the furthermost of a number of small waiting areas. The operation was being conducted like a military operation, yet everyone was smiling and friendly. The two others already there were seen to within a minute and myself in two. The doctor administering the injection asked a few straightforward questions about existing health conditions before delivering the jab, explaining that I might experience some soreness for a day or two (I have), and giving me a card to carrry on me stating when, where and by whom I had been given the Pfizer Bion Tech (with batch number), together with notice to keep two weeks in April free for my second dose, and a pamphlet stating as much as one needed to know about the vaccine, do's and don'ts, which took less than the 15 minutes one was asked to remain seated in the main reception area to make sure of no side effects. Three staff members were quick to make sure seats were given the once over the moment people rose to leave. I was home in ten minutes, and, apart from the tenderness mentioned above, and a degree of fatigue which in any case is pretty normal for me these days, I have experienced no adverse after-effects, thus far.

Perhaps people might like to re-count their own experiences with the service.

[oddoneout]

I have to say, I was most impressed at the service laid on at my local surgery yesterday.

As someone not yet in the 80+ range I had not expected to be seen to this early. One turned up, as requested, not more than five minutes before time of appointment, was asked by one of two young people in hi-res waistcoats "on guard" outside the premises to give name and address and be offered hand cleanser, then immediately checked inside for time of appointment and directed down a corridor to the furthermost of a number of small waiting areas. The operation was being conducted like a military operation, yet everyone was smiling and friendly. The two others already there were seen to within a minute and myself in two. The doctor administering the injection asked a few straightforward questions about existing health conditions before delivering the jab, explaining that I might experience some soreness for a day or two (I have), and giving me a card to carrry on me stating when, where and by whom I had been given the Pfizer Bion Tech (with batch number), together with notice to keep two weeks in April free for my second dose, and a pamphlet stating as much as one needed to know about the vaccine, do's and don'ts, which took less than the 15 minutes one was asked to remain seated in the main reception area to make sure of no side effects. Three staff members were quick to make sure seats were given the once over the moment people rose to leave. I was home in ten minutes, and, apart from the tenderness mentioned above, and a degree of fatigue which in any case is pretty normal for me these days, I have experienced no adverse after-effects, thus far.

Perhaps people might like to re-count their own experiences with the service.

Good to hear your positive experience SA. The lack of 'shambles' stories in the local rag suggests that the actual jabbing is going OK - the difficulties are with supply, and the patchy coverage of sites. The speed with which the age groups are worked through will depend on numbers to be done - perhaps in your area there are not so many ahead of you age-wise? I've been looking at the situation for my home town as the demographic in this county is heavily weighted towards older. One of the town surgeries(not mine which is posting no info other than standard NHS bulletins) says it has 2500 80+ patients to get through, the population of the ward I live in is close to 30% 65+ age group, with 1700 to be done ahead of my age group, so it could take a while.

[Dave2002]

This page from the NY Times attempts to explain how some (9 - nine) of the available vaccines work - https://www.nytimes.com/interactive/...ines-work.html

There is another page which gives limited information about some of the other vaccines being developed - https://www.nytimes.com/interactive/...e-tracker.html

[Dave2002]

This page - reported by the BBC - comments on the notion that it might be a good thing to spread out the first and second jabs of the incoming vaccines - https://www.bbc.com/future/article/2...e-vaccine-dose

Actualy it's also interesting to look at the evaluation methods used for the different vaccines, also explained in the article, as this does partly explain the different results for vaccines using different regimes.

Let's hope that there is an ongoing effort to check this and other variations to protocols, and that political and societal forces are not driving us into bad science.

The article is also interesting because it seeks to explain the mechanisms by which immunity is built up after vaccination - something about which I expect many of us who are not biologists or cell scientists have much inkling.

[french frank]

Perhaps people might like to re-count their own experiences with the service.

Mine almost identical to yours, S-A, particularly "The operation was being conducted like a military operation, yet everyone was smiling and friendly." As I said before, mine was at a neighbouring, larger practice, but I had to go to my own for a blood test this morning, it was extremely quiet and had a slightly confusing way of exiting (I attempted to go out through the adjoining pharmacy but was shoo'd back and pointed to the tradesmens' entrance, now exit). Like you, I have no date for the 2nd, but it will be after approx. 12 weeks, so in April some time. Re Dave2002's, I think there was an earlier link to an article which suggested that a delayed second jab was more beneficial than feared at first.

It's the hospitals that will be bearing the brunt of all this, and suffering the strains in the system.

As for priorities, in the US there are calls for BAME communities to be treated as a priority group.

[Dave2002]

Mine almost identical to yours, S-A, particularly "The operation was being conducted like a military operation, yet everyone was smiling and friendly."

Was there any evidence of backup? I know that mostly there are no problems, but there can sometimes be, and then rather quick medical intervention is needed. We haven't had any experience yet, but others I know round here seem to be going to car parks in some of the local GP premises. Hopefully most people will be able to drive in, and drive out without any problems.

I might be less concerned about the smiles, and more keen on obvious efficiency and effectiveness - though smiles are nice too!

[french frank]

Was there any evidence of backup? I know that mostly there are no problems, but there can sometimes be, and then rather quick medical intervention is needed. We haven't had any experience yet, but others I know round here seem to be going to car parks in some of the local GP premises. Hopefully most people will be able to drive in, and drive out without any problems.

I might be less concerned about the smiles, and more keen on obvious efficiency and effectiveness - though smiles are nice too!

I presume that the statutory 15-minute wait before we were allowed to leave took into account the speed with which a reaction would occur? As for the smiles, I felt it was just a sign that there was no sign of stress among the professionals - which was reassuring - rather than it being pleasant to see a smiling face.

[Dave2002]

I have heard of an adverse reaction occurring within a few seconds - severe enough to require immediate attention - which was available in the location where that occurred.
I'm not so sure that would be available in a car park in the middle of nowhere. However if there is an on site team - perhaps not just one person, presumably there's less to worry about.

You are right that the normal protocol is to wait 15 minutes - but that by itself is pointless unless there is help available for cases which trigger a strong anaphylactic reaction.

[french frank]

You are right that the normal protocol is to wait 15 minutes - but that by itself is pointless unless there is help available for cases which trigger a strong anaphylactic reaction.

Well, there would be the doctors who were administering the vaccine who were only a few steps away from the waiting room. And there were people in the waiting room overseeing the handing out of the timers and taking them in again.

[Dave2002]

Well, there would be the doctors who were administering the vaccine who were only a few steps away from the waiting room. And there were people in the waiting room overseeing the handing out of the timers and taking them in again.

Waiting room....??
Up here most doctors and dentists don't let anyone into their waiting rooms these days. Some communication is by tapping on windows and maybe passing in notes.
One waits in one's car, and people come out and get you or maybe treat you in the car park, if necessary.