There are about 200 vaccines currently in development for the SARS-Cov2 virus. Credit: Juan Carlos Lucas/NurPhoto/Getty
If there’s a finish line in sight for the grim marathon that has been Covid-19, it’s a vaccine. It will be – we all hope – the thing that signals a return to some sort of normality, eventually. And there have been some promising headlines recently: notably, the Oxford-AstraZeneca vaccine has started production, with the UK deputy chief medical officer saying a rollout could start before Christmas, while Pfizer says that it hopes to file for FDA emergency use approval for its own vaccine within the next few weeks.
I don’t want to downplay these developments. They’re important, and if one or both of those is authorised, then we could start seeing people being vaccinated relatively soon. But I did want to talk about some of the difficulties and complexities involved. It is perfectly possible that one vaccine is already in production, and that another will soon be approved for emergency use, and that still, you, ordinary British person1 will not see either for over a year; and that most of the world will not see one for another year after that.
First, let’s talk about the different kinds of vaccine. All vaccines work on one basic principle, which is presenting the immune system with something (an “antigen”) that looks like the thing you’re vaccinating against, usually a virus. But there are different ways to make that antigen.
There are, depending on how you want to break it down, essentially four different kinds. The traditional method – which goes back to Louis Pasteur – involves getting hold of the actual virus you’re vaccinating against, killing or weakening it somehow, and using that as an antigen. These are known as “killed virus vaccine” and “live attenuated virus vaccines”, but I’ll refer to them both as traditional vaccines.
The second involves using a part of the virus, a “subunit”, as the antigen. In the case of coronaviruses, the part involved is the spike protein, the lumpy bits outside the body of the virus. In modern subunit vaccines, you can use a genetically modified virus to infect yeast cells and get them to produce the protein, so it is faster.
The third and fourth, viral vector vaccines and RNA vaccines, also both use the protein spike as the antigen, but instead of producing it in a factory, they recruit the body to do that for them. Viral vector vaccines use a genetically modified virus to infect the body’s cells and make them produce the spike protein, just as the actual virus co-opts the body’s cells to force them to make copies of itself.
RNA vaccines do much the same, except instead of using a genetically modified virus, they simply use tiny lengths of RNA, which – once snuck inside a cell membrane, in a tiny blob of fat called a lipid nanoparticle – commandeers the cell’s machinery and starts it making the spike protein.
All of these have different strengths and weaknesses. Traditional vaccines are reliable; they’re a mature technology and tend to give good immune responses. But they are slow to make – they need to be grown in insect cells or hens’ eggs, so a batch can take a couple of weeks. The exact process for each one is subtly different, so you can’t easily repurpose a factory. And it takes a lot of infrastructure – a lot of steel in the ground – to make a factory.
Subunit vaccines are pretty well field-tested now; they’ve been around for a few decades. They’re somewhat faster than the traditional ones to make, and the factory hardware is more interchangeable because you can get your yeast to produce any protein you like, but they still need large vats.
Viral vector vaccines, like traditional ones, require the growth of actual virus particles in some biological substrate, such as hens’ eggs or mammalian cells. But unlike traditional vaccines, you don’t need to make a different virus each time – you can just grow the same virus (in the case of the Oxford-AstraZeneca vaccine, a member of a family of viruses called adenoviruses) for each vaccine, and paste in the genetic code for the particular protein you want it to build. They are, however, very much untried – as far as I know, only one has been used in humans before, for protection against Ebola.
RNA vaccines are much faster to produce – it’s “a chemical rather than a biological process”, according to Al Edwards, a professor in biomedical technology at the University of Reading. They also require far smaller doses, so you can get many more out of, say, a 200-litre bioreactor, and, like viral vector vaccines, you can paste in the RNA sequence for whatever protein you need: you can use the same equipment for a vaccine for any given virus. It can also be very small scale, with relatively low-tech equipment; Imperial College is planning to make a small demonstration plant in rural Uganda. But RNA vaccines have literally never been used before, and, inconveniently, while all the other kinds of vaccine can happily be kept at normal fridge temperature (2°C to 8°C), the lipid nanoparticles that are used to get RNA vaccines into the machinery of the cell are very unstable, and need to be kept at -80°C.
There are about 200 vaccines currently in development for the SARS-Cov2 virus. All of the above kinds of vaccines are represented. However, the two we mentioned at the top, the Pfizer and Oxford/AstraZeneca vaccines, are the two most advanced – both are in Phase III trials (that is, large trials to show that they are not merely safe in humans, but actually work). They are an RNA vaccine and a viral vector vaccine, respectively. Moderna, Johnson & Johnson, and Novavax also have vaccines in Phase III trials, but are not, I think, quite so far along.
As a bit of an aside, something strange has happened with the Oxford/AstraZeneca vaccine. Two patients got ill. The first was with MS, and the vaccine study declared on its consent form that it was unrelated, so the trial continued after a brief pause. The second was transverse myelitis, an inflammation of the sheath around the spinal column; again, the trial paused, and, while it restarted in the UK, Brazil and South Africa, in the US, it did not.
Will a vaccine stop Covid?
That is extremely unusual, according to Stephen Evans, a professor of pharmacoepidemiology at the London School of Hygiene and Tropical Medicine. Usually, drug trials are monitored by independent groups called Data and Safety Monitoring Boards (DSMBs). If a patient gets ill, these boards look at the situation – often, as in the AstraZeneca case, pausing the trial to do so – and decide whether the illness was caused by the vaccine, and, if so, whether the risk outweighs the benefit. If it does, they might recommend to the regulator that they end the trial.
But normally you only have one DSMB for the whole trial. In this case, there are apparently two – one for the UK, Brazil and South African parts of the trial, and one for the US. And while the UK one decided it was safe to carry on with the trial after a brief pause, the US one has not. The US Food and Drug Administration (FDA) is now investigating it and not allowing it to restart. “It’s a very strange thing to have two different DSMBs for the same vaccine,” says Evans. “I’ve not known it to happen before.”
Andrey Zarur, the CEO of the RNA biotech company GreenLight – who have their own RNA vaccine in animal trials, and for whom, full disclosure, I’ve been doing some writing over the past few weeks – thinks that the UK regulators have been very lenient. “AstraZeneca have had very favourable treatment in the UK,” he says. “They say the myelitis is unrelated, but the FDA says BS.” It’s a fairly rare condition, and he thinks it’s likely that it’s connected; he thinks “you may get partial approval” in the UK, but it won’t be approved in the US, at least not soon. Evans is more hopeful, and thinks that the FDA is being “super-cautious”. He notes that a previous vaccine candidate developed by the Oxford team for the MERS virus also saw a serious adverse event. That one was also declared unrelated, but Evans speculates that the coincidence might be enough to make the FDA more wary.
Either way, AstraZeneca are confident enough that they’ll get approval – in the UK, at least – to start production; the UK government has ordered 30 million, with an option for 70 million more. And if Pfizer does get enough data to apply for emergency use approval, they’ll start manufacturing too, at least at small scale.
So let’s talk about manufacturing. All the vaccines currently under development look like they’ll need two doses each. It’s one thing making 10,000 or 20,000 doses for a clinical trial – in order to get the world to herd immunity, even assuming that the vaccines all bestow complete immunity after the booster shot, we are going to need to vaccinate more than four billion people, twice each. Eight billion doses is an awful lot. A normal bioreactor for traditional vaccines might be 200 litres and able to make a million or so doses in a period of weeks; you’ll need a lot of them.
You can’t simply use a bigger vat, says Edwards. It’s like making a cake: if you can make a cake 20cm across and 10cm deep in your oven, that doesn’t mean you can make a cake 20 metres across and 10 metres deep in a much bigger oven. “It would be burnt on the outside and soggy in the middle.” Making live viral vaccines is a biological process, with lots of steps that depend on precise temperatures and chemistries. “The bigger your batch, the more you have to change your system of production,” he says, “so if you’re making it in a big batch, you have to check you’re still making the same thing. One disaster is that if you make it a different way, it can have a different effectiveness or even not work.” You can make lots of smaller reactors, but obviously that is expensive and difficult.
That’s true for traditional virus vaccines, but it’s also true for the modern viral vector ones, which similarly have to brew up a virus. “Making an adenovirus particle has never been scaled,” says Zarur. The only medical treatments which use similar technologies, gene therapies, have only been used on “single-digit thousands” of patients, he says. AstraZeneca says that it can create two billion doses by the end of next year, but Zarur is sceptical: “there just aren’t enough reactors in the world” as it stands.
RNA vaccines can be made more easily, and because they need much smaller doses, you can get more doses out of the same-size reactor. But Zarur points out other problems. Moderna and Pfizer, both developing RNA vaccines, have each said they can produce around a billion doses by the end of next year. But, Zarur says, that’s an estimate based on how much of their raw materials they can get hold of. “When Moderna says they’re going to make a billion doses by the end of 2021,” he says, “it’s about calling on suppliers and saying how much nucleotide can you make.” And the suppliers of nucleotides might say, we can build enough to make a billion doses. “But those are the same suppliers that Pfizer is calling! Those materials, the nucleotides and the enzymes, are in very short supply.” RNA vaccines, he says, have enormous upsides, but there just isn’t a supply chain in place for them yet.
It is, Zarur says, “a twist of fate” that “the vaccines that are in the lead are also the ones with the least developed supply chain”. The Coalition for Epidemic Preparedness Initiatives (CEPI), the global body established to prepare vaccines for new viruses, estimates that even putting all the pharma companies together, globally there is only capacity to make between two and four billion doses by the end of 2021; even in the most optimistic scenario, we will only have about half of what we need.
(It’s worth noting here that the Oxford-AstraZeneca vaccine trial will be declared a success if there are half as many infections among people given the real vaccine as among those given the control — so if there were 100 in the control arm and 50 in the vaccine, that would be enough. This means it may be that “successful” vaccines only prevent 50% of infections. If that were the case, we’d need to vaccinate a lot more than half the world.)
Manufacturing the vaccine isn’t the end of the problem. “After you’ve made billions of doses,” says Edwards, “you have the opposite problem: we’ve got factories making tonnes of these vaccines, now you’ve got to get them into little tubes, stick them in a fridge, get them all around the world and put them in needles and stick them in someone’s arm.”
It is a huge logistical challenge. Recently, I spoke to Toby Peters, a professor of cold-chain economy at the University of Birmingham, and Nilay Shah, the head of the chemical engineering department at Imperial College London, about the difficulties of mass rollout of vaccines. At the moment, we vaccinate only a subset of the population at a time: small children, vulnerable people, pregnant women. Now, though, we need to vaccinate everyone, fast. To get a sense of how much the system needs to be scaled up, at the moment, about 50 million vaccine doses – for measles, polio, things like that – are distributed every month in India. There are nine different vaccines, so that’s about 6 million people. But, he reckons, we’d need to get that up to about 200 million people a month. The vaccines need to get from the factory to the clinic to the patient without spending more than a day or so at room temperature.
This “cold chain” delivery is a significant enough challenge if you’re working in a city, but to get to people living in rural parts of India, or sub-Saharan Africa, you will need infrastructure. You’ll need trained people to deliver it, especially if you’re putting several doses in a single vial, which will save money but will mean the healthcare workers need to know how to safely take the right dose out while keeping the remainder sterile and secure. And the vaccine needs to reach a majority of the population. So, Shah points out, you need to get it to them – it needs to be walking distance at most for everyone. We can’t expect billions of people to travel long distances; in underdeveloped areas, that might mean mobile vaccination stations in trucks.
Peters points out that millions of tonnes of food are transported chilled around the world, and that that cold chain is extremely effective and has huge capacity, so it’s not impossible; but it will require a major effort, not least to find out how many fridges and things are available in the developing world, and second to design a cold-chain system, separate from the existing vaccine cold chain. Even in the UK, this is going to be a non-trivial problem. “One thing that bothers me slightly,” says Edwards, “is that a mass vaccination programme is as difficult as a mass testing program, and that” – this last with admirable understatement – “hasn’t always run as smoothly as we hoped.”
Again, RNA vaccines can be made at a smaller scale, so more locally. But then if you want to keep them for more than 24 hours or so, you need to keep them at -80°C. “You can do that in London or New York,” says Zarur, “but how are you going to get it to Laos or Sao Paolo? And unless you vaccinate those populations, you’re wasting your time.” He is hopeful that the second generation of RNA vaccines, including GreenLight’s, will be made in small, almost popup factories anywhere you can get some cheap chemical ingredients and an electrical supply, and then in the 24 hours you have before it degrades, you can get it to where it needs to be. “You couldn’t get it from Cambridge, Massachusetts to France,” he says. “But you could get it from Mexico City to Chiapas.” But that won’t be true of the first-generation ones, which will require more complex and expensive ingredients.
None of this is to say that it’s not important that vaccines are starting to roll off the shelf. It is. Even if only a few million doses are built at first – even if, as Zarur says, “it’s enough for the football players, the Trumps, and the healthcare workers” – that’s a big deal. As he points out, in the first wave, “healthcare workers were dying in the hallways”, and the shortage of medical professionals caused by illness was part of the reason it killed so many others – people weren’t getting treated properly. And as we vaccinate the most at-risk populations, the susceptible population will be reduced, so the virus will find it harder to infect people, and the death toll will come down, and slowly the situation will improve for all of us.
But it absolutely will not be: we get a vaccine in December and we’re out of this by February. The light is real, but the tunnel it’s at the end of is still pretty long.
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SubscribeI’m fairly sure that the 50% success rate of the vaccine isn’t spread evenly across the population. Older and more frail people are less likely to gain immunity from it.
This puts us in a difficult situation because if we’re going to gain herd immunity (yes even vaccines protect people that way too Matt Hancock) then we will have to inject a lot of healthy young people with the rushed vaccine.
We will have locked young people up for 2 years, made them vastly poorer, removed their liberties and now we’ll inject them with an experimental vaccine for the benefit of others. Btw I’ve read enough comments from older people to know that many think this is disgusting too.
One small remark: herd immunity is not a choice or a strategy, it’s a scientific fact, it is happening right now, you will become immune or you already are immune. Source?: the 9000 scientists behind the Great Barrington Declaration.
I’m surprised at how toxic those two words have become. It’s how epidemics end. I would tentatively suggest that the south west and south east and areas along the south coast will deteriorate no further and will need no restrictions. Why do I say that? Look at what happened in the summer in those areas. flooded with people cheek by jowl. London may also deteriorate no further but they may have pain heaped upon the by the hapless Sadiq Khan. The ONS serology study suggests 7% have been infected and have antibodies and SAGE are using this. This is criminally inept. A truer number seems to be 28-33% based on natural immunity and T cell responses. Karl Friston uses 33% in his latest model and Mike Yeadon thinks 28% and suggests SAGE should be disbanded for incompetence!
Agreed – the T-cell thing seems so important…. has anyone seen anything written by the WHO or Sage members to rebut the idea that we have T-cell immunity? They seem to be just brushing the idea under the carpet at the moment
A one sentence extract from a paper by Prof Ioannidis that is peer reviewed and supported by the WHO. I’ve attached the link if you want to read it all.
“Moreover, multiple studies have identified pre-existing cellular immunity that may be effective against SARS-CoV-2 in 20-50% of participant samples.” It’s at the bottom of page 7.
https://onlinelibrary.wiley…
Because there’s no direct evidence for it. Prof Shane Crotty’s work is often cited as evidence, but he does not agree with the way it’s interpreted (from (@profshanecrotty on Twitter, in August):
There’s been a proper trial done on masks and the outcome was no discernible benefit as per the original science. When asked when they were going to publish the reply was “when we can find someone willing to!” Wish I could find it again but I can’t. Mike Yeadon is confident on T cells and cross coronavirus immunity.
I’ve replied twice to this..where have they gone? Here’s the link again and for the 3rd time
https://onlinelibrary.wiley…
https://onlinelibrary.wiley…
For thr 4th time! Come on unherd!
Reference is a peer reviewed study by Prof J Ioannidis which unherd won’t let me post the link
The title is “Global perspective of COVID”19 epidemiology for a full”cycle pandemic” and can be found on The European Journal of Clinical Investigation. See pages 7&8 for the one sentence reference.
Wonder if they will let me post a link to this letter in the British Medical Journal ” T-cells really are the superstars in fighting CoVID – but why are some of us so poor in making them?” https://www.bmj.com/content…
It makes a number of points relevant to this discussion
Thanks for posting that link. Fascinating in depth info on the T-cells question ““ though not an easy read for a layman (such as me).
I am no expert at all in any of this…other than maybe presentation, and I would have thought changing the phrase to *community immunity* would probably work.
It’s meant to be a non-trivial suggestion, but I can see how it may well get picked up as trivial…..
Hi Ted, thanks for replying..I think the “correct” term nowadays is population immunity.
Classic newspeak.
Yup, hence the speech marks around correct.
> herd immunity is not a choice or a strategy, it’s a scientific fact, it is happening right now, you will become immune or you already are immune.
The debate is about how to attain it, of course. Conventionally, that’d be via vaccine.
> the 9000 scientists behind the Great Barrington Declaration
I’m not sure I should trust Drs Bananas and Shipman, though, never mind Dr Person Fakename.
Trolling some of the worlds foremost epidemiologists who have put their careers at risk for what they beleive is the right approach isn’t very constructive.
Quite surprised to see today that there seems to be some acceptance from SAGE that London appears to have some level of herd immunity. I would suggest other areas of the south will prove to have it as well. Despite what is being said about the South West they will probably have it as well.
One small remark, some people won’t become immune for various reasons, hopefully this will be a small %. According to the Matt “basic maths is beyond me” Hancock the handful of documented reinfections out of 40 million infections is proof that immunity doesn’t occur.
The fact some people don’t aquire immunity naturally or otherwise is where the herd kicks in, because the virus won’t be able to spread easily. I know this is basic logic, but it seems beyond the Health Secretary.
Funny how many on here and other ‘right of centre media’ have clamoured to support and endorse the “Barrington declaration” supported, by I think 2500 ‘respected scientists’, not all of whom are actively in the field of medicine and virus related science.
Yet spend endless time and effort ridiculing AGW, endorsed by 99% of scientists actually involved in that area of research?
Funny old world.
For the record, I think the former have got a point, the second are indisputably correct.
AGW, eh? Well, okay, then. And – yeah, 99% of scientists endorse (handwavy climate thingy scary scary.)
http://www.populartechnolog…
is a list of peer reviewed refutations of ALL 97% consensus studies.
IPCC experts dissenting from IPCC conclusions
Shellenberger letter.
Richard Tol on Cook’s Consensus – brief, strong refutation by an IPCC fellow and a highly credentialed scientist.
It is not reasonable to go against consensus. It was not reasonable of Einstein to advance the theory of relativity against the consensus.
It was not reasonable of Ignaz Semmelweis to promote his ‘unscientific’ theory of medical handwashing. If the consensus of learned (and apparently infallible scientific experts – they were all doctors) had listened, probably 100,000+ mothers / infants would have lived through childbirth. But, hey”¦ consensus is always correct.
It was unreasonable of Galileo to question the Aristotelean consensus of a geocentric universe.
It was unreasonable of dozens of geneticists to object to Lysenkoism, and they were executed for it.
It was unreasonable Alfred Wegener to insist on Plate tectonics against the consensus that attacked him.
It’s unreasonable of Richard Lindzen, Richard Tol, John Christy, Judith Curry, and more than 2 dozen others who worked for the IPCC, then left citing strenuous objections to flawed scientific process.
No matter how unreasonable it was for these great scientists, and many others, to buck the almighty consensus, they did so. And they were right. Science gets stuck in consensus, it advances by breaking with the consensus.
The consensus view of science and of the majority of people – Vitamin C prevents colds. No evidence has been found, but since 2X Nobel Laureate Linus Pauling made the claim, it became consensus truth. Only – it’s not true. It’s never been proved and many have tried.
You are correct that the adulterated models show that man’s CO2 will increase warming. Data does not agree with the modeled results. 99% of scientists do understand that plants sequester CO2 (and they are relatively starved for it.)
The modeling calibration issue goes double for COVID.
Tom also forgets another massive key factor, you’ve got to persuade enough of your population to have it for it to be effective. I’m no anti vaxer, my family have had every recommended jab to date and I have a fly jab every year now im middle aged, but I have serious concerns about someone injecting me with something that appears to be rushed through every regulatory check because the world’s politicians are in a panic.
At the moment it feels safer to take my chances with the virus
The herd immunity required for it to be effective is now a dirty term, its apparently unscientific according to Matt Hancock. He wisely notes that we don’t control Aids with herd immunity. He does forget to mention that Aids has a near zero recovery rate (I’ve heard of 1 or 2 possibles) vs > 99% for Covid 19.
With people like Matt Hancock in charge it doesn’t matter if we have full lockdown, tiered lockdowns, focused protection or no lockdown – we are doomed.
As I have said for some time, we have achieved ‘herd insanity’ across almost the entire political class, most of the media, and the vast majority of the population. No hope. Just let the Chinese take over. At least they are competent in some respects.
Great term ” herd insanity” – so apt !
Herd insanity driven by herd stupidity. Increasingly, I also see no hope.
He does seem particularly ignorant on anything to do with immunity and health – but then just look at who is advising him! He stands no chance
I’ll happily have the vaccine. Just maybe not in the first wave of vaccine roll-out.
Anyone have any more news on the death of the Brazilian in the Astra trial ? They were refusing to release any information and the trial is continuing.
We must also accept that in any large trial x number of people will get ill and some will die by coincidence.
I worry with the Covid vaccines that the political pressure to get it quickly may result in corners cut and a small chance of long term negative effects – not least putting people off proven vaccines.
Lots of people develop life changing conditions (migraines, tiredness etc) , that take months or years to diagnose if they ever are. I wonder how many of these will be attributed to either ‘long covid’ or the vaccine in the future.
Die by coincidence??? I don’t want this rushed vaccine. I will take my chances with the virus that has a very good recovery rate.
If you take a group of 100,000 people, then over a few months a small number will die. This is with or without drug trials.
To test the vaccine they could give it to the terminally ill, and then show scary graphs of “died with 28 days of vaccine”. But that would be a crazy misleading way of doing things.
I understand the Brazilian doctor was in the control group that was not given the vaccine being tested, to compare against the group that was actually given the vaccine? In that sense (if my info is true and correct) then his death is a co-incidence, and if he died from Covid-19 it’s a co-incidence that tends to strengthen the case for getting a vaccine sorted.
The participant was in the control group that had been given a dose of a currently used meningitis vaccine.
so much for inert placebos.
Depends on your risk factors I guess
I remain staggered at the way so many of those in power seem to be hanging their hat on a vaccine to the exclusion of all else. There is a possibility that the destruction will be complete before it arrives (if it ever does – I wonder what will happen if the trials fail?). As to the logistics we have never in history vaccinated whole populations, we vaccinate those at risk.
A quick word on local lockdowns if I may…..
This is a doomed and expensive strategy. The correct way of dealing with this would be to spend the money on supporting people to do nothing on actually supporting them to continue to do something. So in Manchester’s case forget locking down and spent the £60m on helping people to live with the situation by keeping businesses open and not paying them to close. We have much better medical responses and the NHS is nowhere near overwhelmed. As for Manchester hospitals being full of possibly full the last time I looked it was a NATIONAL health service, they aren’t the only hospitals in the country.
Well, Smallpox was given to pretty much most people on the planet, although there was a degree of acquired immunity among many already. However, it did take 15 years of concerted effort, and an awful lot of money, to bring down reported cases to zero. Furthermore, although it was significantly more deadly (30% is the usual estimate) than CV-19, whole populations were not shut down if an outbreak happened, although some kind of group isolation was implemented. The Powers That Be don’t seem to be learning much from Smallpox; from test & trace, to protecting vulnerable people, through to keeping economies running, it’s all just a tad shambolic.
Thanks for the reply and yes you are correct. On test and trace…..I’m gobsmacked that the govt can base its whole strategy on a test that is woefully inaccurate. Based on false positives and incidence the possibility of your test being a correct positive is roughly 1 in 3. This is further reduced by it picking up old virus and positive tests where the presence of virus in below the transmittable level. It is very possible the true rate is 10-20%. Apparently a couple of weeks ago the govt instructed borderline tests to be automatically retested. Not reported, I wonder why?
There are real time indicators available now and the reliance on positive tests should be reduced if not dispensed with.
Kary Mullis stated many many times throughout his career, the PCR is not capable of being a diagnostic tool! It is not a test.
Much more than a tad.
From https://www.ncbi.nlm.nih.go…
In the 1960s, serious adverse events associated with smallpox vaccination in the United States included death (1/million vaccinations), progressive vaccinia (1.5/million vaccinations), eczema vaccinatum (39/million vaccinations), postvaccinial encephalitis (12/million vaccinations), and generalized vaccinia (241/million vaccinations).20 Adverse events were approximately ten times more common among those vaccinated for the first time compared to revaccinees.20 Fatality rates were also four times higher for primary vaccinees compared to revaccinees.
Post-vaccinial encephalitis is a rare adverse event that frequently leads to death, especially in infants and young children. Reported case fatality rates range from 9% to 40%.25,28 Ten to twenty-five percent of surviving patients have permanent neurologic sequelae.25,28 No predisposing conditions have been identified for this condition, and treatment with VIG has little to no effect.
From https://bmcpublichealth.bio…
Post-vaccinial encephalitis
The risk of post-vaccinial encephalitis (complication risk, CR), the risk of a post-vaccinial encephalitis death (mortality risk, MR), and the individual risk of dying of post-vaccinial encephalitis (case fatality risk, CFR) by age group are displayed in Table 2. The highest risk for developing post-vaccinial encephalitis was among infants aged <1 year old (risk ratio, 2.80, compared to vaccinees aged 1 year or older). Although the summary risk in this age group was 6.8 cases per million vaccinations, the 1970 Lane et al. study [25] that prospectively surveyed physicians estimated a much higher risk (CR, 176.5 cases per million; 95% CI, 36.4″“515). The risk in vaccinees aged >1 year was much lower and did not change with age.
Smallpox has characteristics that made its elimination easier. The main one was that people became ill with it before they became infectious. I think it took about 12 days. This enabled people to be isolated.
Finally an article in which Tom asks the right questions, but he still has to apologize to John Ioannidis from Stanford University. And about the vaccine-madness: Johan Giesecke, now reinstated by the WHO as an advisor, already said in april that waiting for a vaccine is not the right strategy…so let’s stop waiting for it, it will not do much more than the vaccine against seasonal influenza: which is close to nothing.
He’s asking some of the the right questions, the other question is “even with a viable vaccine after 1-2 years of lockdown will the absolute destruction of lockdown in health and quality of life have been worth it?”
Compared with dying, yes, the costs (hardly “the absolute destruction of lockdown in health and quality of life”) will have been worthwhile.
I am not a great one for trying to balance up things like this in this way…I mean , for example, if we have all got into a kind of *better* mindset in respect of distancing (espeiclaly very vulnerable people) the importance of washing and sanitising things like supermarket trolley handles and so forth… then we might say fewer deaths on a long term trend from all sorts of other things (like say Flu or pneumonia etc) as well as Covid-19 because of the panic that nailed some fairly simple mitigation measures into people’s minds?
So, say a Flu pandemic, which this isn’t, could be mitaigated in part far more effciently and effectively in 2029 because of the way this one was handled?
Chopping off stats at any time point will be arbitrary.
The only question to ask is why, when 19 fewer people died in the UK last week relative to the same week last year, we are destroying the economy and millions of lives.
Because we are ruled by a bunch of ill-educated morons, without an iota of common sense between them.
If they had a scintilla of rationality we would not be facing mass civil disobedience or worse by Easter, if not sooner.
Mr Bailey, the question you ask is a good one, but one answer might be that the death toll last week was statistically the same as last year precisely because we had taken draconian measures to contain the epidemic, and that if they hadn’t been taken, it would be far higher. Of course, what we lack is any real control group – i.e., there is no country (and certainly no first-world country) that has taken no measures at all.
In any case, even if we had taken no measures, many people would surely have modified their behaviour out of fear. The economy would have taken a drastic hit because people simply wouldn’t be doing so many of their normal activities.
Just as an example, in normal times I am a regular operagoer. I’m in my early forties and not too worried about this virus for my own part. If the Royal Opera House was still open, I’d probably be there almost as often as normal. But the 80% of its clientele who are over 70 might not be willing to take the risk; so an organisation whose business model depends on 95% occupancy would sink anyway. Then, think that most of the 2000 people who would have been in the audience would have dined out in Covent Garden before the show. But since many of them chose not to go to the opera they had no reason to come into London, so bars and restaurants couldn’t make ends meet either… I think there would have been a major recession whatever we did.
I’m not, I should say, on board with all the measures that have been taken. But I just don’t believe that the choice was ever between lockdown and “business as usual”.
Nanny state or freedom of choice to take a calculated risk – or not! But the Government would have spent less on compensation for shutting business down, therefore less for our children to pay back in future
It actually begs the question why didn’t the virus return when the restrictions were lifted? Pubs etc opened on 4th July. Throughout the summer we were all able to mix much more freely……BUT….no resurgence of the virus until we get to the traditional beginning of the autumn respiratory season. I would also add that compulsory mask wearing was introduced in July when the incidence was low. I wonder what the exit strategy was for mask wearing?
We know, with near scientific certainty, that selenium, zinc, D3, and Vitamin C boosts our immune system and resistance to all disease, to include viruses (Wait! No one was supposed to tell you that!) and D3 is especially helpful when lower autumn/winter sun exposure reduces natural D3 production, but these effective and affordable solutions are NOT promoted by the CDC (America’s failed Center for DISEASE Control). Instead, they want you to wear that filthy, bacteria-infested, oxygen-depriving, speech-impeding piece of underwear on your face. Why is that? It couldn’t be a money-making scam… could it? Or a govt growth scheme? Or both???
Don’t be silly.
Great question.
Because the hospitals are filling up and our national healthcare system is already failing.
Not to say you are wrong.
Tom, you quote Andrey Zarur, the CEO of the RNA biotech company GreenLight as saying, in the first wave, “healthcare workers were dying in the hallways”. That is not true and smacks of scare mongering to push a vaccine, so unless you can categorically provide evidence of this event may I suggest you edit your piece to remove this quote.
I think with vaccines, ventilators, PPe and everything else we would be foolish, or at least naive, to totally discount the *share price boosting* effect than any even slightly sunny-side up news from a company can provide to a share price…whether that price has previously been *ill* or not.
This is what absolutely kills me when I hear people who fancy themselves as “educated” pompously going on about “following the science”. They talk about “science” as tough it were an independent entity moving through society separate and apart from the people who “do” science.
Perhaps a good way to think of it would be to resurrect a term used by the medieval Catholic Schoolmen philosophers. In their terminology, a “universal” (here used as a noun) was any substance which had no existence except as a facet or aspect of another entity. The classic example was colour. There are any number of things which are green, but you cannot go into a hardware shop and buy a bucket of “green”. It does not exist apart from things which are green. In the same manner, is science a universal? Does it exist other than in the flawed and fallible humans who practice science?
What did Lord Percy create then?
I stand corrected.
We are being told, quite frequently, by the Covid scare machine, that there may not be a long lasting immunity to the virus. In which case, why are we still looking forward to a vaccine (which confers immunity) as the crock of gold at the end of the rainbow? Hopefully it will not turn out to be a very expensive crock of something else.
They think that, even if there is no long lasting immunity, it will be the sort of thing that you vaccinate for yearly, like the flu.
Please see my response above. It’s a bit long but I did try to post a link to BMJ with a previous comment but that hasn’t come through so had to elaborate. They probably either don’t allow links or they need to check them?
I had the same problem with a link. I asked for advice and was told by another member of the forum that unherd and disqus doesn’t like links. When reposted without the link no problem. Henceforth I won’t be posting links but where appropriate I’ll try to describe the path to the article. Hope this helps.
I cannot post links either. I don’t know of any instances where something that is ‘referred for moderation’ ever gets approved and shows up here. So I think it is just an algorithm that rejects links. But *some people* are being allowed to post links, so I don’t know what it is that they are doing that we are not.
I agree with everything you said about needing to treat with great care and caution, but I don’t think that this is what is going to happen. And I think that most immunologists think that long lasting immunity is more likely than not if you get infected with covid. But how good will the vaccines be at producing T-cell responses? Everything I have read so far seems to indicate that they aren’t very good at this. It is entirely possible to produce a vaccine that protects for a much shorter time than actually getting sick would have protected you. Have we done this? Around here, at any rate, discussion about this always leads to somebody saying, “well, if we have, then in the worst case, we will need yearly corona vaccines in the same way we need yearly flu vaccines”, which is all I really meant by my short post above.
My understanding is that there are some instances where a vaccine confers more durable immunity than naturally acquired immunity. Pretty sure that Professor Francois Balloux has mentioned hepatitis as an example, though he’s also emphasized that such instances are outliers and not the norm.
That said, I agree with your overall point that it’s bizarre and contradictory that some people ignore the likelihood that SARS-CoV-2 is broadly similar to most other viruses but then assume that a vaccine will work like vaccines for most other viruses. The rebuttable presumption should be that the vast majority of people who fight off a SARS-CoV-2 infection have robust immunity for at least 1-2 years – like with other coronaviruses that infect humans – and very likely experience less severe symptoms if subsequently infected with SARS-CoV-2.
Evidence to date supports the above point. There’s a telling “dog that didn’t bark” in that we’ve seen only a handful of confirmed reinfections with SARS-CoV-2 even with 40+ million “confirmed cases” globally, and an actual number of infections most likely over 10x that number. Every month that passes without seeing a large number of confirmed reinfections with COVID should strengthen our confidence in robust immunity for most people and lengthen the time that we think robust immunity endures.
I don’t think there is much doubt that immunity is long lasting (decades rather than a few years) Many immunologists agree. It has been confirmed that both memory B cells and memory T- cells are formed and are very long lived. This was actually well established by SARS-CoV-1 research before CoVID came along. These are infections in which the T-cell response is far more important than the antibody response (demonstrated by research from Yale and elsewhere). That’s why vaccine manufacturers tried to produce vaccines with at least some T-cell response, though none actually have a very good T-cell response. I am very concerned that vaccines will skew and pre program the immune response towards acquired immunity and antibody production and away from the first line defences of our innate immune system, including T-cells. This could mean that there is a chance that if a new novel SARS-COV-3 turns up in future, those who are vaccinated could possibly have a very bad reaction via ADE (antibody dependent enhancement). This happened with the Dengue vaccine when many vaccinated people died or became seriously sick on encountering a different strain of Dengue. This is quite scary and
is a possibility with this type of virus. But what is more scary is why no one is taking about it. Also those who gain natural immunity to CoVID will have the advantage that their immune system will be prepared much better for a new coronavirus -unlike vaccines which prep the immune system to recognise only one or two antigens, natural immunity will ensure that many antigens are recognised so making it more likely there will be at least some cross reacting antigens.
I have not come across a vaccine yet that is superior to natural immunity. The only way to achieve that would be a playoff between immunity and autoimmunity. Anything that elicits a too strong antibody response will by necessity also increase cases of autoimmunity where antibodies are produced against self antigens causing conditions like TM, GB, MND, MS, Lupus etc . The immune response is highly complex and delicately balanced and there is much interdependency. We need to tread with great care and caution.
If there’s a finish line in sight for the grim marathon that has been Covid-19, it’s a vaccine.
That’s a huge “if” and it may well be misguided. The question of a finish line has been going on here for some time, and it is vigorously ignored by a political class that has tasted unfettered power and likes it.
We’ve seen this movie before. Every alleged finish line has quickly been replaced by another, the goalposts put on wheels for easier relocation to whatever the new metric of “safe” is. And that’s the whole point – no one can define ‘safe’ because no one knows what it looks like. Worse, no one wants to know because that would mean taking the govt boot of citizens’ necks.
To that point about “safe”, there are a couple very good quotes on that subject from Scott Atlas in his recent interview with Freddie Sayers:
“We cannot guarantee that we can protect everybody ” there is not such thing as zero risk in life” and
“This sort of bizarre, maybe well-intentioned but misguided idea that we are going to eliminate all risk from life, we are going to stop people from taking any risk that they are well aware of, we’re going to close down businesses, we’re going to stop schools ” these are inappropriate and destructive policies.”
The latter quote was in the context of Dr. Atlas’ 93 year old mother-in-law telling him that she doesn’t find confining herself all the time to her home to be a life that’s worth living, and that she should be allowed to decide her own balance of taking some risk in order to function enough to make life worth living. Not stated explicitly – but strongly implied – is that she recognizes that she likely only has a limited amount of time left on Earth independent of additional risk from COVID.
Whatever one thinks of Dr. Atlas’ overall policy views on COVID, it’s a far more realistic attitude toward risk – and how we act regarding other risks – than a simplistic dichotomy of “safe” or “not safe”, particularly when the latter is defined by some people to mean “zero risk of death from COVID”.
Genuine question…. I read that there is a UK trial going ahead where participants are given the vaccine (or placebo) and then infected with the virus. If the virus can be injected into these trial subjects, why couldn’t it be used to inject low risk individuals, who could then self isolate for 2 weeks, thus saving everyone a lot of time, effort and money?
I know I’d rather be injected with a disease that we now know what the risks are than a rushed through vaccine that we have no idea what the risks are.
Yes but then all those companies hoping to make even more money, won’t be as rich. 🙁
Can someone please explain to me why Tom thinks we need to vaccinate the whole world? That’s just not practical or sensible, we vaccinate the vulnerable only. COVID is not going to be eradicated and we shouldn’t waste time and money trying to. Tom used to write very sensible, fact based articles. His latest outputs are becoming increasingly hysterical in nature and he seems to be following the herd in when writing anything about COVID, it needs to be hyperbolic and almost deranged. Tom, please go back to your sensible articles.
Yes, that was what I was thinking as I was reading this – we should start with the elderly and vulnerable – there is no need to vaccinate everyone (and not everyone will take it anyway). Thanks for the insightful analysis though!
The problem is that the elderly are the people least likely to be protected by a vaccine. We inject them with flu vaccines every year, and they get sick anyway, in large numbers. A vaccine works because it primes the immune system of the vaccinated so that when it encounters the target disease it
gets rid of it before the person gets really sick.
All of this requires a working immune system. If the immune system doesn’t
work properly then you can get the case where a vaccinated person, exposed to the disease they are being protected against, has an immune system that recognises the disease — but cannot mount an effective defence to it. You can also get the case where the immune system of the infected person doesn’t recognise the disease when it encounters it. Or you can get a situation where the immune system is confused — it recognises that there is a disease there, but, in flu studies, instead of pumping out antibodies for this new flu they were vaccinated against it decides to pump out antibodies for some other flu the person was infected with in 1972.
And the elderly and vulnerable are most likely to suffer any side-effects from the vaccine!
So let me get this straight, we’re not going to give the vaccine to the old and vulnerable because it might not work and we’re not going to give it to the fit, healthy and young as they don’t need it, so who are we supposed to be giving this vaccine to? How about we shield and protect the old and vulnerable through masks, testing, tracing, etc. and the fit, healthy and young go about their lives. Now if only a declaration was created espousing these ideas, oh wait…
I actually think that the old are going to get the vaccine, and then they will immediately go out and start living their lives as normal, and get sick in huge numbers.
More grist for the Great Barrington mill! We have enough “vaccine” circulating in the population at the moment. Just keep it away from the aged and vulnerable.
COVID-19 is 80% identical to SARS. As the NHS website states clearly, we are still looking without success for a vaccine for SARS.
There will be no vaccine. And if there is, damned if I will take it. At 69, I have never had ‘flu, do not get colds, and have been affected by none of the many respiratory pandemics that have hit the world since I was born.
I agree fully Jeremy and I won’t be taking it either.
(It’s worth noting here that the Oxford-AstraZeneca vaccine trial will be declared a success if there are half as many infections among people given the real vaccine as among those given the control ” so if there were 100 in the control arm and 50 in the vaccine, that would be enough.
Which, according to recent studies, makes a vaccine about as effective as Vitamin D. Ok – we’re not talking about quite the same thing – vaccine prevents infection while Vitamin D reduces severity of infection (and not just from Covid) but, for the time being at least, you’d think there’d be a big push to ensure Care Homes and such like were providing residents with cheap Vitamin D supplements throughout the winter.
Perhaps it’s happening and I’m just not aware of it.
This is something I have been saying since March but there is not a word spoken of it. Just more jabs of flu vaccines.
Interesting article and goes to show that if we are relying on a vaccine to get us out of this mess we are taking a huge risk and we are going to destroy the economy in the meantime (with all the non-covid related health issues that will cause). Pursuing herd immunity with protection for the elderly and sick is the only sensible way forward. If we do get a working vaccine that will be a bonus not a necessity.
The vaccine is being tried on young healthy individual as it should be; we know this virus behaves extremely different on old and frail or people with comorbidities, the same may be true with the vaccine, therefore it should not be use on high risk people without further studies.
Now the moral conflict, we will ask the young and healthy to take a small unknown risk (vaccination) to prevent a very small known risk for them (getting Covid-19) so the old get protection from herd immunity.
I’m living in New Zealand where this is the only exit strategy, I’m a father of four, young and healthy in their twenties and thirties. I find the idea that my children may get sick from the vaccine to protect me utterly repulsive, immoral and perverse.
Luckily, millions of people around the world have proven themselves to be immune from the more hysterical levels of scientific and governmental involvement in Covid-19.
Perhaps. But they are not immune from the effects of the hysterical and deeply evil scientists, politicians and media.
Many seem to be under the impression that the Covid vaccines now under development will impart immunity. Not true. The vaccinated can still be infected, but, if it works, symptoms will be less severe or never develop. Can they still spread the virus? Most likely, I would think.
“It appears that all the pharmaceutical companies assume that the vaccine will never prevent infection. Their criteria for approval is the difference in symptoms between an infected control group and an infected vaccine group. They do not measure the difference between infection and noninfection as a primary motivation….and…
One of the more immediate questions a trial needs to answer is whether a vaccine prevents infection. If someone takes this vaccine, are they far less likely to become infected with the virus? These trials all clearly focus on eliminating symptoms of Covid-19, and not infections themselves…These protocols do not emphasize the most important ramifications of Covid-19 that people are most interested in preventing: overall infection, hospitalization, and death. It boggles the mind and defies common sense that the National Institute of Health, the Center for Disease Control, the National Institute of Allergy and Infectious Disease, and the rest would consider the approval of a vaccine that would be distributed to hundreds of millions on such slender threads of success.” Prof. William A. Haseltine, “Covid-19 Vaccine Protocols Reveal That Trials Are Designed To Succeed”, Forbes, Sep 23, 2020.
Well Tom, what can I say? Covid is simply a tool, a weapon to put the fear of God into the population. It’s a behavioural control mechanism for implementing the “Global reset”. It was engineered and planned by the World Bank, the World Economic Forum, the United Nations, the Gates foundation, and WHO. As a science writer, you should know that this virus is no different to any other flu bug. It’s a complete nothing-burger, that’s been deliberately hyped up to the max by the media. But then, you know all this don’t you Tom?
Are we concerned that so many of the vaccines are based on provoking an immune response to the Spike (S) protein on the coronavirus rather than any of its other 3 structural proteins? This seems to have serious drawbacks: a) putting all our eggs in one basket. b) presenting the body with the spike protein (as many of these vaccines will do) seems to be what causes illness – the spike protein binds to transmembranal ACE2 receptors and interferes with the body’s renin- angiotensin system and so the regulation of blood pressure and may mean the vaccine will make you no less ill than the virus c) the S protein is less stable than the others so the vaccine is likely to be outdated more quickly than if another protein were targeted and d) antibodies to the S protein might well also prove to be antibodies to the body’s own angiotensin 2 (as both the S protein and angiotensin 2 have the same ending that fits the ACE2 receptor) as well this provoking an undesirable auto-immune and/or inflammatory response of the types seemingly seen twice in the Astra Zeneca trial. Might just be me who worries about this uniformity of approach… (and I am admittedly a dabbling amateur) but I would love to know someone else has thought about it and why the concern is not valid.
Interesting article and useful background on the pros and cons of the different technologies being deployed. However not so sure that:
“Now, though, we need to vaccinate everyone, fast.”
If the data I have been reading is correct the median age of death for Covid in the UK is 82 and the IFR (Infectious fatality rate) below the age of 50 is 0.02% which is pretty much in line with normal flu. So we don’t need to vaccinate everyone, as below the age of 50 this disease is 99.98% survivable and herd immunity will become effective over time. The over 50’s in UK are around 32% of the population so that would require roughly 20 million doses for everyone at real risk plus another 5 milion for careworkes, NHS etc. Not a million miles away from the 30 million ordered – so I would guess that the Government is basing their vaccination strategy on the logic above.
The average of Covid death in the UK is 82.4. This is over a year higher than the average age of overall death, which is 81,1. And last week, 19 fewer people died in the UK than the equivalent week last year. For this, we are destroying the economy and the lives of millions, and students are committing suicide in their rooms having been isolated for no reason whatsoever. There are no words to express the folly and the evil.
Oh I don’t disagree with you Fraser, I think the current situation and government strategy is bonkers. Why do things such as the Great Barringdon Declaration get either buried or pilloried in the press rather than assessed on merit? I just thought it was interesting to see a possible congruency between government strategy and actual data – which would be a bit of a first you just admit.
Good article. No mention of what is added to the vaccine, the adjuvant. That it itself can be a problem and can cause side effects depending on what it is. The other point that was not mentioned is that when the vaccine is grown in animal tissue and the vaccine is collected it is not pure. You collect the vaccine but also DNA from the host as well. This could be DNA debris from thousands of other virus’s that reside in the host. There was also no mention of natural attenuation of the COVID virus. Notice that the case numbers recorded have increased because of increased testing but the death rate numbers are decreasing. Stop and think about it. There will eventually be no need for a vaccine. The Big Pharma want to rush the vaccine out so that they can declare that the results from natural attenuation are the result of their vaccine. And the notion that it takes two shots instead of one seems to me to be highly suspect. Especially since we heard Bill gates tell us that very thing months ago. Bill Gates the Capitalist who used unethical practices to force his Windows operating system and software on us for decades. I say be skeptical and cautious about taking any vaccine but especially this vaccine. Thee is a political element, The Lefts “great reset” is a scam that is using the virus and the pandemic, and the vaccine to force their Leftist authoritarian globalist agenda on the world.
I wouldn’t trust Bill Gates as far as I could toss him. He is a dangerous person.
‘The light is real, but the tunnel it’s at the end of is still pretty long.’
Unfortunately the light at the end of this particular tunnel looks increasingly like it’s going to be the front of an oncoming train.
Spanish flu in 1918 was infinitely more deadly than COVID. And a year or so later it was gone. Enter the roaring twenties and the good times for everyone.
Then in 1968 we had Hong Kong flu. It killed 4 million worldwide. Again far worse than COVID. And consider, the world population then was under half of that today. Hong Kong flu never stopped normal life. I was barely if at all aware of it. School stayed open and I continued watching Hull City matches with crowds of 20 thousand plus. And Hong Kong flu passed.
I read in some scientific report that coronaviruses tend not to mutate much, unlike influenza viruses. So once you have been exposed to the virus you likely have long immunity.
So look to history. COVID will pass. Herd immunity will be achieved before any vaccine arrives.
And don’t believe all rubbish spouted by main stream media.
I’ve got nothing to say about covid, the virus, the vaccine, the lockdown, etc. It has all been said. Profusely. Repeatedly. Ad Nauseum.
We are just repeating the same old stuff and always preaching to the converted.
I think it is worth me saying this, though, because no one else seems to say it: Get to your local Member of Parliament and tell him/her you want lockdowns lifted, old and sick protected, now, immediately. Tell him/her you want hem telling the Parliament what you’ve just told them. Telling the party leaders, the cabinet, the Whip, anyone and everyone.
And then get to them again, tomorrow. And then again the next day.
Get to them many times in one day.
via: snailmail, sneakernet, telephone, fax, email, twitter, facebook, instagram and anything else you can think of.
do it now.
that’s what I think need saying. in order to save millions of lives perhaps. You’ve seen the reports? That millions of lives could be lost in the third world because of our lockdowns and crippling of trade.
Stop talking to each other. Hassle the MP’s. Tell the unaware to hassle the MP’s.
Now isn’t that right?
Awesome suggestions and I have been doing, just that.
Agree. There is a surprisingly large groundswell of dissent and even more surprisingly it seems to be in the at risk groups. Gum bumping won’t get the job done.
Tom pretty much argues the case that, no, vaccination is unlikely to come galloping over the hills to the rescue. Joining a long list of draconian measures we have been assured would be far more effective than they have proved to be. And in the developing world where the challenges of deploying vaccines are greatest, there are just so many more pressing medical, let alone social and economic concerns to deal with.
It is almost touching (I mean it) how naive people can be, that esentially we should undergo as many lockdowns as it takes until the whole population can be vaccinated. They are simply unwilling to countenance the possibility that we may not get to a safe effective vaccine, and even if we do, will only in fact be able to admister it to a small proportion of the population. (You could look at Freddie Sayers interview with Piers Morgan on Lockdown TV as an example of this).
I am open to being corrected, but if a vaccine works, then some level of immunity following exposure to the live virus surely must as well. But many people seem to believe that vaccines will work but that herd immunity doesn’t exist… Yes, some people are vulnerable to the live virus but most young people are not.
I am not trying to be a troll, but why is a 50% working vaccine needed for a respiratory disease with a survival rate:
Age 0-19 ” 99.997%
Age 20-49 ” 99.98%
Age 50-69 ” 99.5%
Age 70+ ” 94.6%
(source https://tallahasseereports….
Why is it needed, let alone on a global scale? The older a person is, the less likely he/she will tolerate the vaccination well. Many older people will not survive it. In other words, if we want people stop dying from covid, it is like trying to stop people dying from pneumonia. In every single case, everything must be done to save one’s life, clearly, but with a 50% successful vaccine (meaning that 50% are unsuccessful, i.e. very sick, crippled, injured or even dead from it) – does the end justify the means, actually? And how about people who cannot tolerate the vaccination at all, people with autoimmune diseases taking immunosuppressants and people with allergies? Was the vaccine tested on kids and toddlers? BTW, the subject in Brazil DIED.
A very good point. And if they have to pull back resources they use for vaccination against more deadly diseases, it’s a tradeoff that makes no sense.
Hello Lena. The stats that you produce are interesting and important, but it would not be insightful to compare directly the efficacy rate of a vaccine with the survival rate of the disease. The survival rate is based on the set of people who have actually got Covid-19, whereas the efficacy rate prevents people from entering that set.
There are two ways to think of the efficacy rate (in my humble and total unqualified opinion), supposing it is 50%, i.e. the minimum.
(a) If you get vaccinated, you become 50% less likely to get Covid-19.
(b) For some vaccines, those vaccinated might become less spready. So consider two hypothetical situations in which you come into contact with, say, a hundred random people in situations where you are at risk from getting Covid-19 from those in the hundred who have it.
(1) None have been vaccinated: then the risk is at it is today.
(2) Say 80 of the hundred have been vaccinated: then 50% of those vaccinated, i.e. 40, present a much lower risk of spreading Covid-19 to you. So with (b), you have a lower risk of getting Covid-19. (I realise that not all candidate vaccines are designed to eliminate the vacinee’s ability to spread.)
Thanks to Tom Chivers for a very useful summary of the state of play. Just a couple of quibbles. First, the article says “But then if you want to keep them for more than 24 hours or so, you need to keep them at -80°C.”. It is not as bad as that. once thawed, Moderna’s vaccine can be stored in a fridge for 14 days and Pfizer’s for five days.
Secondly, the article states that all the SARS-Cov-2 vaccines currently under development look like they’ll require two doses each. But Johnson and Johnson’s candidate vaccine is single-dose. Furthermore, it may be the case for some of the vaccine products that several boosters are required.
Finally, the article only mentions wastage of vaccine indirectly. E.g., vaccine stored or transported at the wrong temperature, so it has to be discarded.That was a huge problem during the Swine Flu epidemic in 2010 and could be even worse this time round.
I’m not fully up on vaccine trials but I understand that they are carried out on healthy people. How is it confirmed that it will work on at risk groups such as those with comorbidities such as diabetes, or those with other respiratory compromises or immunosuppressed? Does this require further trial activity? I don’t know so if anyone does and can add anything please do.
Tom
When you talk about the methodology of RNA vaccines it reminds me of the scene in Curse of the Were-Rabbit in which Wallace puts a cod-sci-fi hood over his head and talks about ‘a bit of harmless brain alteration’. Perhaps there should be some major ethical debate before such technology is introduced rather than trying to rush everybody? According to a recent BBC report one of the deep-frozen Covid vaccines (don’t know whether it is the Moderna or Pfizer RNA vaccine) is actually codenamed by a the British government “Ambush”. I think at some point some common-sense ought to be introduced here.
COVID-19: You will be getting an unsafe and barely tested vaccine. Vaccination injury has been repeatedly covered up by our CDC and HHS. Why take this risk when good nutrition, supplements, and damage avoidance can help boost your body’s immune system? Everyone wants a quick and easy solution… and that will come with a high cost.
Look up Barbara Loe Fisher, Andrew Wakefield, 1986: The Act, Children’s Health Defense, and Dr. Mercola dot com.
“Not only will pharmaceutical companies developing and marketing COVID-19 vaccines be shielded from what should be their liability in the civil court system, but federal compensation will likely be difficult to obtain, as it is in the existing vaccine court created under the National Childhood Vaccine Injury Act of 1986”
“The expansion of a federal vaccine court to include makers of experimental COVID-19 vaccines allows the irresponsible sale and marketing of vaccines that have been poorly tested and formulated because the manufacturers have no liability and “nothing to lose” “
COVID is a gold mine for pharmaceutical companies, and they have historically shown they are willing to sacrifice health and lives to make money. Gates, banking institutions, and pharmaceutical/health industry has invested in this scenario, and have received TRILLIONS in “relief” money from the federal govt. Gates’ Event 201 corona outbreak scenario along with Chinese CDC in attendance? Bloomberg School of Public Health that hosts the Bill & Melinda Gates Institute for Population [control] and Reproductive Health? Extensive legal protections for vaccines. You really think they have not been calling the “shots” for the whole scamdemic?
The finish line is not a vaccine, it is not being afraid of the virus. There is no expectation presently of an effective safe vaccine and we have to stop being scared out of our wits by global oligarchies. If we had any sense we would be terrified of RNA vaccines invading our DNA manufactured by indemnified criminal corporatocracies. Tom Chivers should stop touting technologies he has no responsibility for.
You must be kidding me! How did we go from “flatten the curve” to “no back-to-normal until all 8 billion are injected with a rushed vaccine”? Did someone even contemplate the possibility that we might never even get a proper vaccine, ever? It is a possibility, after all, and the WHO has acknowledged as much. What then? It seems really imprudent to me to assume that the arrival of a vaccine is some kind of silver bullet.
But hey, I am no “expert”!
“If there’s a finish line in sight for the grim marathon that has been Covid-19, it’s a vaccine.”
Yes, you have been properly targeted to understand what needs to be done… which is to shut up and take your vaccine, so that your government can pay the pharmaceutical sponsors absurd amounts of money for it. You might die, or have longlasting effects from the rapidly procured and poorly understood new chemical, but they don’t care about that, because the govt (well, you, the taxpayers) will pick up the bill for that liability. They just need your participation. And your govt’s promise of a liability-free payout.
Or you could just take some selenium, zinc, D3, and Vitamin C… which we know boosts your immune system and resistance to all disease. (Wait, no one was supposed to tell you that!)
Considering the expense of delivering vaccines, it’s a good thing the world hasn’t spent the last few months destroying the global economy through overzealous lockdowns. Oh, wait . . .
The problem of keeping vaccines refrigerated might eventually be eliminated. “UK-based Stablepharma has come up with a solution for stabilised vaccines so that they are no longer reliant on refrigeration or freezing…”.
https://stablepharma.com/
Then of course to try to achieve herd immunity through vaccination you need folks to accept it…a few months ago when death rate was high.
https://www.nbcnews.com/pol…
I’ve been trying to reply to a couple of comments but they are just disappearing. Is it something to do with sharing a link to an online document? Help!
Yep. Disqus/Unherd doesn’t seem to like live links and anything it thinks is too lengthy and/or copied and pasted, even if attributed.
Thanks for the help. Appreciated.
This article presumes that you have to vaccinate everyone to end the crisis. The data clearly shows that it predominately harms the old and sick. If you protect this group then the “problem” pretty much goes away. There is probably a good case for not bothering to vaccinate healthy people under 40. The dramatically decreases the amount of vaccine required. In this case the only ” herd immunity” required is the at risk part of the population. There are lots of instances of this approach. For example, the use of pneumonia jabs in Australia. Covid is simply not dangerous to the young and healthy and we should not be wasting vaccines on them.
Aye whey, I’ll take the Oxford vacc if and when it becomes available.
Any American vacc, delivered under immense pressure from an unstable American president pressuring US pharma to announce a successful vacc before The November election, no thanks.
no difference – haven’t you seen that someone died from the Oxford Vaccine? there is no difference in testing time.. all are being rushed through…
When they stop testing the pandemic will stop. A vaccine will provide the excuse to declare victory and stop testing if they want to.
Is this clown for real? He is glibly talking about permanently altering the DNA structure of mankind?…Seriously? https://www.rt.com/news/504…
A Tsunami of protest!!!
Mahyar Live From Anti-Lockdown March
you tube /watch?v=IXVg7YBsAgE
Why do we need a vaccine? In Sweden more people died in 2015 so far than in 2020. Bigger deadly months in 1993,1996,2000,2003 and 2009 than the peak months of March/April this year. Currently, the death rate on a like for like basis in ICU is down by almost 65%. Better experience and improved therapeutics are more than sufficient. Vaccine is an overkill.
I wonder why would people allow to inject something that is barely tested & not sure of its effectiveness???
Good job the virus isn’t more deadly, I guess!
As for the ‘cold chain’, maybe instead of medical refrigeration units, some sort of lower tech solution using liquid nitrogen is possible?