2019 Novel Coronavirus Covid-19 Discussion

Forums › Health and fitness › 2019 Novel Coronavirus Covid-19 Discussion

1 | ... | 1112 | 1113 | 1114 | 1115 | 1116 | 1117 | 1118 | 1119 | 1120 | 1121 | 1122 | ... | 2422

3963 posts

Uber Geek

Lifetime subscriber

#2634876 13-Jan-2021 15:38

wellygary:

Australia have a pretty identical approach to NZ...

They have 10 million ( 5 million people- 20% population) doses of the Pfizer vaccine,

NZ has 1.5 million (750K ~15% population )

Australia also have ~50 million doses of the Novavax vaccine, (NZ also has a similar reservation of 10 million, but NZ notes its unlikely to be available until late 2021)

NZ and Aust have Astra Zeneca reservations , but NZ also has a reservation for 5 million single dose Janssen ( J&J) vaccines, and I suspect we are hoping this passes muster (results due end of January) ... to give us a choice between the Astra and Janssen ( both single shot )

Cheers, Had wrongly assumed based on the concern about AstraZeneca / Oxford vaccine that they were betting big on that one. You are correct that they have orders for 4 vaccine candidates: Pfizer / BioNTech, Novavax, AstraZeneca / Oxford University, COVAX Facility. It is just they are focusing on the Pfizer & AstraZeneca ones as they have currently completed stage 3 trials.

The AstraZeneca vaccine takes two shots, unlike the Janssen one. Clearly if the Janssen stage 3 trials find it to be safe and with high efficacy it will be very attractive to both countries, as it will half the logistically effort to roll out to the population.

Scott3

3963 posts

Uber Geek

Lifetime subscriber

#2634913 13-Jan-2021 16:42

frankv:

Scott3: Re the aussie vaccine situation, the big news story there today is that the cira 72% effecancy of the oxford vaccine (that aussie is producing under licence in near Melbourne) is not going to be sufficient to get herd immunity.

Why?

I understood that other vaccines (e.g. flu) have efficacies around 40-50% and they are perfectly acceptable. That, prior to the covid vaccines, efficacy of 75% would have been considered exceptionally good.

Surely herd immunity from a 72% vaccine is just a matter of inoculating a bigger percentage of the population than for a 95% vaccine?

Given that the efficacy is calculated by numbers in the trial infected with vaccine & with placebo, and these numbers are very small, the difference between 72% and and 94% may be a single person, essentially a rounding error.

In term's of why, given that 94.1% and 95% efficacy rate covid-19 vaccines have passed stage 3 trials, and we are a rich country that can afford their higher price-point's and can meet the logistical challengers of the -70C distribution of the pfizer one, there seems little reason to bother with a 70% efficacy vaccine.

Regarding the influenza vaccine, the 40-50% efficacy one is the best we have. Clearly far better than nothing, so I get mine each year. But if there was a 95% effective alternative at a non crippling price point I would absolutely want that one instead.

Your statement regarding herd immunity is correct, but we hit a ceiling in terms of a percentage of the population that can be vaccinated. Covid-19 vaccines are not approved for people under 16, people with certain medical conditions can't be vaccinated. In addition some of the population will opt out, and some while not opposed to being vaccinated are simply not engaged with medical care, or won't get around to it.

Very rough estimates of portion of the population that would need to be vaccinated.

Assumptions:

Covid-19 R0 rough estimate without containment measures (prior to more contagious variants): 3
How much more contagious is the UK variant: 70%
Max R0 for herd immunity: 1.0

70% effective vaccine:

3*1.70*(1-0.7)*X + 3*1.70*(1-X) = 1.0

Solve for X

X = 114% of the total population, clearly not viable.

95% effective vaccine

3*1.70*(1-0.95)*X + 3*1.70*(1-X) = 1.0

Solve for X

X = 84% of the total population.

Consider that only 80% of New Zealand population is 15 or older (don't have the stats for 16years old plus), and the other groups that can't / won't be vaccinated. As such, we either have to hope that my estimated for R-0 are too high, or stack the vaccine on top of other containment measures (such as covid-19 alert level 2 every winter).

But the point is that the 95% efficacy vaccine is somewhat close to herd immunity, where as a 70% is far away.

As a closing note, Estimated for wuhan covid-19 Range from 1.4 - 5.7, and estimates for how much more contagious the UK strain is range from 50% - 70%. High uncertainty with this stuff.

An example of where high vaccine efficacy is important is Measles. One dose of the MMR vaccine has 93% efficacy against measles. Yet as a country we are willing to carry double the cost to fund two vaccines to increase the efficacy to 97% (also increases mumps efficacy from 78% to 88%). In short given how highly contagious measles is (R0 12 to 18), a single dose at 93% efficacy is not sufficient for herd immunity at reasonably attainable vaccination levels (and children 12 months + can have that vaccine). Even with the two doses some area's of the community fell below the level of vaccination required for herd immunity and we had an outbreak.

The difference between 70% and 95% efficacy is not a single person and a rounding area. The pfizer trial had 8 people in the vaccine group show symptoms (out of a total of 170, with the remainder in the placebo group). A single extra person in the vaccine group getting symptoms would reduce about 0.6 percentage points of efficacy. (i.e. 95.3% reducing to 94.7, something that would have been hidden by rounding anyway).

Batman

Mad Scientist
29760 posts

Uber Geek

Trusted

Lifetime subscriber

#2634916 13-Jan-2021 17:01

Whatever the effectiveness I think in the the first people who should get the vaccine are those working at the "border" with human contact. Any human contact. Inc quarantine, flight /port etc

We don't need 1.5m vaccines to cover them. Say 10, 000 should be a good start? How difficult is it to get 10,000 shots now and 10,000 in 3 weeks.

Scott3

3963 posts

Uber Geek

Lifetime subscriber

#2634930 13-Jan-2021 17:34

Batman: Whatever the effectiveness I think in the the first people who should get the vaccine are those working at the "border" with human contact. Any human contact. Inc quarantine, flight /port etc

We don't need 1.5m vaccines to cover them. Say 10, 000 should be a good start? How difficult is it to get 10,000 shots now and 10,000 in 3 weeks.

It has been said repeatedly that there is no room for an emergency approval in NZ given we have no covid-19 in the community. As such, little point rushing to procure the vaccine prior to medsafe gathering the information that it requires to approve it.

Clearly carrying slightly higher risk can be justified in places like the UK and USA.

Really I have no idea how hard it is to get enough vaccines on our timeline, but there is a good bet that it would be very hard or extremely expensive. Covid-19 vaccines must be one of the hardest to come by things in the world at the moment, and I imagine all production has already been allocated. I don't imagine the US or the UK giving up 20k of their allocation to protect NZ border workers. India has placed a ban on export of all vaccines in order to ensure that all vaccines produced in their factories go to their population initially.

Unlike Aussie we don't have the ability to produce under licence domestically.

Situation will slowly improve as more vaccines pass stage 3 trials. But I think we will still be waiting until April for the first shipments. (And big numbers won't start arriving until mid-late 2021).

The Philippines 2 days ago placed an order for 25m doses of the Sinovac covid-19 vaccine with the first 50k arriving in feb, but I don't think that as a route NZ would want to go due to the low real world effectiveness numbers.

There is the potential we get lucky. If for example the USA distribution of vaccines start to lag behind production, and their ultra cold freezers are getting close to capacity, pfizer may offer to make early delivery on a chunk of our 1.5m dose order (knowing we already have ultra cold freezers). Given the mammoth effort inoculate the entire of the USA this situation could happen.

freitasm

BDFL - Memuneh
79250 posts

Uber Geek

Administrator

ID Verified

Trusted

Geekzone

Lifetime subscriber

#2634932 13-Jan-2021 17:44

Batman

Mad Scientist
29760 posts

Uber Geek

Trusted

Lifetime subscriber

#2634939 13-Jan-2021 18:03

Scott3:
Batman: Whatever the effectiveness I think in the the first people who should get the vaccine are those working at the "border" with human contact. Any human contact. Inc quarantine, flight /port etc

We don't need 1.5m vaccines to cover them. Say 10, 000 should be a good start? How difficult is it to get 10,000 shots now and 10,000 in 3 weeks.

It has been said repeatedly that there is no room for an emergency approval in NZ given we have no covid-19 in the community. As such, little point rushing to procure the vaccine prior to medsafe gathering the information that it requires to approve it.

Clearly carrying slightly higher risk can be justified in places like the UK and USA.

Really I have no idea how hard it is to get enough vaccines on our timeline, but there is a good bet that it would be very hard or extremely expensive. Covid-19 vaccines must be one of the hardest to come by things in the world at the moment, and I imagine all production has already been allocated. I don't imagine the US or the UK giving up 20k of their allocation to protect NZ border workers. India has placed a ban on export of all vaccines in order to ensure that all vaccines produced in their factories go to their population initially.

Unlike Aussie we don't have the ability to produce under licence domestically.

Situation will slowly improve as more vaccines pass stage 3 trials. But I think we will still be waiting until April for the first shipments. (And big numbers won't start arriving until mid-late 2021).

The Philippines 2 days ago placed an order for 25m doses of the Sinovac covid-19 vaccine with the first 50k arriving in feb, but I don't think that as a route NZ would want to go due to the low real world effectiveness numbers.

There is the potential we get lucky. If for example the USA distribution of vaccines start to lag behind production, and their ultra cold freezers are getting close to capacity, pfizer may offer to make early delivery on a chunk of our 1.5m dose order (knowing we already have ultra cold freezers). Given the mammoth effort inoculate the entire of the USA this situation could happen.

I've heard the phrase we do not have community transmission many times. I'm also not suggesting we vaccinate the community.

sbiddle

30853 posts

Uber Geek

Retired Mod

Trusted

Biddle Corp

Lifetime subscriber

#2634957 13-Jan-2021 19:09

Batman: Whatever the effectiveness I think in the the first people who should get the vaccine are those working at the "border" with human contact. Any human contact. Inc quarantine, flight /port etc

We don't need 1.5m vaccines to cover them. Say 10, 000 should be a good start? How difficult is it to get 10,000 shots now and 10,000 in 3 weeks.

It's my understanding (and I'd love somebody to correct me and tell me that it's not true) that currently we can't vaccinate until our new NIS platform (NZ's new vaccine register) is built. Our old NIR platform has been deemed incapable of supporting Covid vaccines, so in August the Govt funded a replacement.

Equinox IT

Cloud spending continues to surge globally, but most organisations haven’t made the changes necessary to maximise the value and cost-efficiency benefits of their cloud investments. Download the whitepaper From Overspend to Advantage now.

mattwnz

20141 posts

Uber Geek

#2634968 13-Jan-2021 19:47

sbiddle:

Batman: Whatever the effectiveness I think in the the first people who should get the vaccine are those working at the "border" with human contact. Any human contact. Inc quarantine, flight /port etc

We don't need 1.5m vaccines to cover them. Say 10, 000 should be a good start? How difficult is it to get 10,000 shots now and 10,000 in 3 weeks.

It's my understanding (and I'd love somebody to correct me and tell me that it's not true) that currently we can't vaccinate until our new NIS platform (NZ's new vaccine register) is built. Our old NIR platform has been deemed incapable of supporting Covid vaccines, so in August the Govt funded a replacement.

I wonder how countries managed rolling out vaccines before computers.

wellygary

8312 posts

Uber Geek

#2635060 13-Jan-2021 21:52

mattwnz:

I wonder how countries managed rolling out vaccines before computers.

Lots of paper, local and central records, + Individual vaccine books you would need to produce to travel or to prove immunisation..

Most recently in NZ "Plunket books" served as individual records of vaccination...

Oblivian

7296 posts

Uber Geek

ID Verified

#2635061 13-Jan-2021 21:52

mattwnz:

I wonder how countries managed rolling out vaccines before computers.

Head down to your childhood GP. Ask for your record book...

You were always meant to go to 'your' doctor clinic. They kept record of your visits and vaccinations on paper. And if you went elsewhere. Tell them your clinic so they could sync notes.

Those have since been put on a dbase. And in some cases the books in container storage.

Batman

Mad Scientist
29760 posts

Uber Geek

Trusted

Lifetime subscriber

#2635070 13-Jan-2021 22:12

sbiddle:

Batman: Whatever the effectiveness I think in the the first people who should get the vaccine are those working at the "border" with human contact. Any human contact. Inc quarantine, flight /port etc

We don't need 1.5m vaccines to cover them. Say 10, 000 should be a good start? How difficult is it to get 10,000 shots now and 10,000 in 3 weeks.

It's my understanding (and I'd love somebody to correct me and tell me that it's not true) that currently we can't vaccinate until our new NIS platform (NZ's new vaccine register) is built. Our old NIR platform has been deemed incapable of supporting Covid vaccines, so in August the Govt funded a replacement.

well that says it all (if true, that is)

sbiddle

30853 posts

Uber Geek

Retired Mod

Trusted

Biddle Corp

Lifetime subscriber

#2635183 14-Jan-2021 07:08

Interesting to see the CDC guidance on flying to the US now that they're enforcing testing.

Being vaccinated does not provide an exemption to this test - but proof of having had Covid is. Certainty around viral shedding of those who are vaccinated (and more importantly how this may differ between mRNA and more traditional vaccines) is something we definitely need ASAP.

frankv

5680 posts

Uber Geek

Lifetime subscriber

#2635223 14-Jan-2021 09:43

Scott3:

Batman: Whatever the effectiveness I think in the the first people who should get the vaccine are those working at the "border" with human contact. Any human contact. Inc quarantine, flight /port etc

We don't need 1.5m vaccines to cover them. Say 10, 000 should be a good start? How difficult is it to get 10,000 shots now and 10,000 in 3 weeks.

It has been said repeatedly that there is no room for an emergency approval in NZ given we have no covid-19 in the community. As such, little point rushing to procure the vaccine prior to medsafe gathering the information that it requires to approve it.

I think that "no room" is a bit strong. We are exposing our MIQ staff to a higher-than-necessary risk of illness and death, and also a risk of MIQ staff being the vector that brings the virus into the community.

I do wonder what information MedSafe needs that the UK, USA, and other countries haven't needed for their emergency approvals. Surely that information can be made available to MedSafe immediately?

frankv

5680 posts

Uber Geek

Lifetime subscriber

#2635228 14-Jan-2021 09:53

Batman:

sbiddle:

It's my understanding (and I'd love somebody to correct me and tell me that it's not true) that currently we can't vaccinate until our new NIS platform (NZ's new vaccine register) is built. Our old NIR platform has been deemed incapable of supporting Covid vaccines, so in August the Govt funded a replacement.

well that says it all (if true, that is)

I'd say that there would be widespread efforts to show that [some project or other] wouldn't work due to covid19, or would need improving to help fight covid19, and therefore need a large dollop of government money to be spent Right Now. Probably quite a few of these, like the immunisation register, would actually need fixing, because they had been not fit for purpose for some time.

Fred99

13684 posts

Uber Geek

#2635238 14-Jan-2021 10:08

frankv:

I do wonder what information MedSafe needs that the UK, USA, and other countries haven't needed for their emergency approvals. Surely that information can be made available to MedSafe immediately?

Trials don't stop at the end of phase 3 - it's an ongoing process. Some safety issue could crop up. So it's not information data they know - it's the risk of something cropping up that they don't expect.

It was pretty easy to see the increasing trend line in new cases would lead to the number of deaths per day and overrun that are happening now - it was and still is an emergency. Here in NZ - not so much (hopefully we can keep it that way).

1 | ... | 1112 | 1113 | 1114 | 1115 | 1116 | 1117 | 1118 | 1119 | 1120 | 1121 | 1122 | ... | 2422