That’s a really good article and I’d encourage people to read some of the comments at the bottom as well, there are a lot of knowledgeable people answering some very FAQ’s
Everything that guy has written on COVID has been first rate IMO. And yes, he has a learned audience who provide thoughtful Q&A and expansion on the various points.
This comment seems extremely reassuring.
- Probability that remainder of study, 70 events, have a 0% efficacy, 35:35 ratio, is 0
- Probability that the remainder of the study, 70 events, have at least 80% efficacy, 12:58 ratio, is 0.95
- Probability that at the END of the study, after 164 events, the overall efficacy is at least 50%, which would be at least 55:109 ratio, is 1
- Probability that at the END of the study, after 164 events, the overall efficacy is at least 80%, which would be at least a 27:135 ratio, is 0.9993
- Probability at the END of the study, after 164 events, the overall efficacy is at least 90%, which would be at least 15:149 ratio, is 0.65
- Probability at the END of the study, after 164 events, the overall efficacy is at least 86%, which would be at least 20:144 ratio, is 0.95
- Probability at the END of the study, after 164 events, the overall efficacy is at least 84%, which would be at least a 23:141 ratio, is 0.99
An 8/86 split between the experimental and control groups is huge. The probability the observed split is due to random chance is essentially 0. The probability the vaccine is truly 80% effective is over 99.9%. I get a flu shot every year and those may be as low as 50-60% effective.
Due to the logistical issues around this vaccine, there’s a good chance it won’t be the one I get in the end. I hope what it does mean is that by the end of February almost all medical workers have finished their two injection course, and distribution has started on other front line workers.
As pointed out in the article, the other extremely encouraging thing these results mean, is that the “no vaccine” worst case scenario is off the table. I’m looking forward to a 2022 return to normal, except we all only have one arm due to long term side effects of the vaccine causing the dosed arm to fall off.
Anthony Fauci was quoted in the Times as predicting that the general rollout would begin in April. Of course, this doesn’t mean that anything like everyone will get it in April. I imagine they will start with medical personnel, move on to high risk groups and so on.
One question I have not seen addressed anywhere: Does the vaccine actually prevent an infection from starting or does it render the person asymptomatic? And if the latter can they still spread the disease?
Yes. There’s still a risk that there will prove to be long term risks that haven’t yet been seen, But these are incredibly positive results.
We don’t know that, yet. For practical reasons, they are not regularly testing every asymptomatic person in the study. But in addition to reducing the incidence of symptoms, this vaccine was found in the phase I studies to produce a high degree of neutralizing antibodies and active T cells. So the odds are pretty good that it actually prevents infection.
A little known oral vaccine was replaced by the Salk injection, which was replaced by the Sabin oral, which was replaced with the under-the-skin injection now in use.
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When I had the smallpox injection, it was done by topical application and scratching the skin: I understand that they now use a special needle on a syringe.
There is somebody working on a topical-injection COVID vaccine. I think any skin-prick injection is much easier/quicker/safer than an intramuscular or subcutaneous injection ?? (I don’t think anybody is suggesting an intravenous injection)
I think that perhaps ??? intra-dermal injection was used for smallpox and BCG* because they’re skin diseases, and you can get a good immune response by infecting the skin. I don’t know what they are trying for with the intradermal COVID vaccine.
*I think in the USA they were trying to do intradermal BCG, and I think in Australia it was actually sub-cutaneous. My doctor noted the much larger Australian scars.
Note: not something I know about.
My biggest fear is that this vaccine is nowhere near effective as Pfizer is saying and people get a false reassurance they are safe and let their guard completely down—leading to a massive resurgence of cases.
A small possibility most likely but completely devastating if it happens.
It could happen, nothing is certain and that’s why the stats always give margins of error.
However, the trial is huge and if the results continue to be replicated then it would be astonishing if the vaccine actually had no protective effects.
Mathematically possible, but it looks vanishlingly small at the moment.
I’m sure that those involved know exactly what is on the line here regarding public confidence and that leads me to think that the 90% is very much on the low end of what the data will bear.
And there are a bunch of other trials going on, mostly testing vaccines with a similar mechanism. (Attempting to train the immune system to recognize the business end of the spike protein.) Collectively, we are going to have a ton of data to give us a realistic sense of the efficacy of vaccines.
I wonder how you would optimize something like this; I figure there has to be a balance between vaccinating the vulnerable versus vaccinating people most likely to spread the disease, that would achieve the lowest number of deaths and new infections.
Is it expected there will be one vaccine that’s the clear winner that will be distributed everywhere? A dozen different vaccines with slightly different mechanisms of action providing differing levels of immunity in different geographical areas?
How does it work with the yearly flu vaccine?
it’s expected that there won’t be enough of any one vaccine to distribute it to everyone. At least at first, there are going to be different vaccines by region, too, as each nation is approving them separately. Russia is already distributing a vaccine that I don’t expect to be available outside of Russia, except maybe to its client states. (And they gave it regulatory approval before it completed phase 3 trials – effectively, the “trial” is a big chunk of their population.) China is testing a mostly separate set of vaccines from what is being tested in “The West” (US, Europe). I find it interesting that China has mostly gone for attenuated viruses and the front-runners in the US are both mRNA based – a never-before-used vaccine technology.
This article doesn’t seem to be paywalled, and has a nice overview:
This tracker is a little overwhelming, but it gives details of all the vaccines (and other treatments) on the horizon:
https://covid-19tracker.milkeninstitute.org/#vaccines_intro
This site may be a little easier to navigate:
Okay, I’m far from a medical expert. But even though nothing seems to be final about the reported results, I’ve been reading a lot of excitement by actual experts, like Fauci and some medical bloggers, so I’ve been taking this as a sign for optimism that said results will generally hold up and that a vaccine or three is waiting in the wings. Is that an appropriate reaction?
I think the most exciting thing here is that this is the first time an mRNA vaccine is being used in humans, and it is showing very promising results. We’ve been using them to great effect in livestock for years.
I think so. It will take a while before any of them get to you or me, but the preliminary results are about as good as they possibly could be. I have been auditing an MIT course on covid this year, and the lecturer speaking about “vaccines” this Tuesday said she wept for joy when she saw the results. (She is working on the Moderna vaccine, which is very similar to the Pfizer one.)
Can you give some examples? I didn’t realize mRNA vaccines were in use at all, and i find this news encouraging. Is like to learn more.
Not quite the first time. Moderno did a trial for a H10N8 vaccine a couple years back. They also had a mRNA vaccine trial targeting Zika.
I can find the NCTs, but I don’t know how to find the results.
NCT03014089
NCT03076385
~Max
I meant the first time it was going to be implemented in the population (should all go well) but you are quite right!