The Vaccine Thread

[whitestavern]

3 minutes ago, Not_a_Number said:

I had the impression Moderna had a higher dosage? Is that correct, does anyone know? 

But yes, I thought they were VERY similar. 

Yes, Moderna has over double the dose, IIRC. 

[Not_a_Number]

8 minutes ago, Penelope said:

Pfizer is going to be better at marketing because they are pros at it. Also, it’s been in the news more because they were first to get EUA for adults, then more recently, first for teens. They also took a chance and asked for down to 16 with the adult EUA even without much data, so they have been the only one available for under 18. 
 

Moderna is given at a higher dose, though, and there is a perception that there are more symptoms after Moderna and that the dose may be the reason. Maybe that’s due to subtle marketing, too, but it is a higher dose. Today at the ACIP meeting discussing myocarditis, there was a suggestion that Moderna may be “driving” the cases of myocarditis in younger people, though the caveat was given that numbers are small so even slight differences in numbers over time could make it seem to go either way with more cases after one brand vs. the other.

When I ran the symptoms poll on here, it definitely suggested more symptoms for Moderna. Not randomized, of course, but given the dosage and the trial data, highly suggestive. 

[Drama Llama]

I signed up, and was told I'd get Pfizer, and when I showed up all they had was Moderna.  I was mildly disappointed.  A week later, when my mom got Pfizer, I was pleased for her.

At that point, things were surging here, and I wanted to be protected a week earlier.  It also seemed like the people in our family who got Pfizer had less annoying symptoms.  

A bigger issue, here, was that initially the first group of 16 and 17 year olds who qualified were individuals with IDD.  Because of my job, I know a fair number of people in that category, and several signed up for Pfizer clinics and then arriving and finding out that the clinic had changed fo Moderna and they had to go home.  

[wathe]

6 minutes ago, whitestavern said:

I would be uncomfortable with this. Those people are essentially guinea pigs as there has been no testing of that regimen. 

In my circle, everyone thinks Pfizer is better. Most people I know waited to be vaccinated until they could choose. 

You are right about testing, but we are stuck with imperfect due to supply limitations.

We've, as a country, been forced to make difficult decisions with imperfect data.  We've had such limited supply.  We elected to delay second doses to get as many people a first dose as possible, even though delayed second dosing hadn't been tested.   Which was the only ethical choice from a public health point of view, really, during our horrific third wave that came a hair's breadth away from causing total health care system collapse; pretty good immunity with one dose in twice as many people would save many more lives than full immunity in half as many.  So we didn't save product-matched second doses; we couldn't ethically hold back vaccine.  Now we are in a position, with the delta variant breathing down our necks, where we really, really want to accelerate second doses.  But we don't have the supply of matched product to  do that.  Mixed-dose regimens now will save more lives than delaying second doses for a matched-dose regimen.  Again, from a public health point of view, it's a very ethical choice.  

Unfortunately, the regimen change wasn't as well advertised as it should have been and people felt blind-sided.

[KSera]

@Catwoman New study showing promising results for third dose for transplant recipients:

https://www.nejm.org/doi/full/10.1056/NEJMc2108861?query=featured_home

[Catwoman]

48 minutes ago, KSera said:

@Catwoman New study showing promising results for third dose for transplant recipients:

https://www.nejm.org/doi/full/10.1056/NEJMc2108861?query=featured_home

Thank you so much for posting this!!!!!

[KSera]

35 minutes ago, Catwoman said:

Thank you so much for posting this!!!!!

You’re welcome. I thought of you immediately. Would be so wonderful for transplant recipients to be able to be better protected. 

[Roadrunner]

Israel is reporting infections with Delta variant for vaccinated people. 😞 

the good news is infections are less severe, but still. 

[Penelope]

Novavax, same general type of vaccine as used for Hep B, HPV, pertussis.

https://www.theatlantic.com/health/archive/2021/06/novavax-now-best-covid-19-vaccine/619276/

Quote

Persistent hype around mRNA vaccine technology is now distracting us from other ways to end the pandemic

At the end of January, reports that yet another COVID-19 vaccine had succeeded in its clinical trials—this one offering about 70 percent protection—were front-page news in the United States, and occasioned push alerts on millions of phones. But when the Maryland-based biotech firm Novavax announced its latest stunning trial results last week, and an efficacy rate of more than 90 percent even against coronavirus variants, the response from the same media outlets was muted in comparison. The difference, of course, was the timing: With three vaccines already authorized for emergency use by the U.S. Food and Drug Administration, the nation is “awash in other shots” already, as the The New York Times put it.

Practically speaking, this is true. If the FDA sees no urgency, the Novavax vaccine might not be available in the U.S. for months, and in the meantime the national supply of other doses exceeds demand. But the asymmetry in coverage also hints at how the hype around the early-bird vaccines from Pfizer and Moderna has distorted perception. Their rapid arrival has been described in this magazine as “the triumph of mRNA”—a brand-new vaccine technology whose “potential stretches far beyond this pandemic.” Other outlets gushed about “a turning point in the long history of vaccines,” one that “changed biotech forever.” It was easy to assume, based on all this reporting, that mRNA vaccines had already proved to be the most effective ones you could get—that they were better, sleeker, even cooler than any other vaccines could ever be.

 

Quote

But the fascination with the newest, shiniest options obscured some basic facts. These two particular mRNA vaccines may have been the first to get results from Phase 3 clinical trials, but that’s because of superior trial management, not secret vaccine sauce. For now, they are harder and more expensive to manufacture and distribute than traditional types of vaccines, and their side effects are more common and more severe. The latest Novavax data confirm that it’s possible to achieve the same efficacy against COVID-19 with a more familiar technology that more people may be inclined to trust. (The mRNA vaccines delivered efficacy rates of 95 and 94 percent against the original coronavirus strain in Phase 3 trials, as compared with 96 percent for Novavax in its first trial, and now 90 percent against a mixture of variants.

Quote

The Novavax vaccine also has a substantially lower rate of side effects than the authorized mRNA vaccines. Last week’s data showed that about 40 percent of people who receive Novavax report fatigue after the second dose, as compared with 65 percent for Moderna and more than 55 percent for Pfizer. Based on the results of Novavax’s first efficacy trial in the U.K., side effects (including but not limited to fatigue) aren’t just less frequent; they’re milder too. That’s a very big deal for people on hourly wages, who already bear a disproportionate risk of getting COVID-19, and who have been less likely to get vaccinated in part because of the risk of losing days of work to post-vaccine fever, pain, or malaise. Side effects are a big barrier for COVID-vaccine acceptance. The CDC reported on Monday that, according to a survey conducted in the spring, only about half of adults under the age of 40 have gotten the vaccine or definitely intend to do so, and that, among the rest, 56 percent say they are concerned about side effects. Lower rates of adverse events are likely to be a bigger issue still for parents, when considering vaccination for their children.

 

[KSera]

1 hour ago, Penelope said:

The latest Novavax data confirm that it’s possible to achieve the same efficacy against COVID-19 with a more familiar technology that more people may be inclined to trust. (The mRNA vaccines delivered efficacy rates of 95 and 94 percent against the original coronavirus strain in Phase 3 trials, as compared with 96 percent for Novavax in its first trial, and now 90 percent against a mixture of variants.

Between this and the lower side effects, I think this one should get more attention and get approval as soon as is prudent. Maybe this is the one people would finally feel comfortable enough with to get. Especially people who think there's something woo about mRNA vaccines.

[Laura Corin]

3 hours ago, KSera said:

Between this and the lower side effects, I think this one should get more attention and get approval as soon as is prudent. Maybe this is the one people would finally feel comfortable enough with to get. Especially people who think there's something woo about mRNA vaccines.

The UK is planning to use it if an autumn booster is needed.

[Roadrunner]

Novavax news is great especially now that we know Chinese vaccine is ineffective. So many countries were counting on the Chinese one and will have to shift gears. 

[Corraleno]

Novavax's covid vaccine has a significant manufacturing issue that the mRNA vaccines don't — it relies on a proprietary adjuvant to boost immunity, and that adjuvant contains a saponin that only exists in the bark of a tree that grows in Chile. That can obviously create a bottleneck when trying to scale up to the level of billions of doses, and it seems that was part of the manufacturing problem Novavax had last year that delayed their US trial. But there are companies working on synthetic and semi-synthetic versions of it, as well as efforts to increase the number of trees being planted, improve extraction efficiency, etc. The Atlantic had a really interesting article about this last fall. If they're able to solve the manufacturing issues and really scale up, Novavax seems to offer the best of both worlds — the efficacy of the mRNA vaccines with the simple storage and transport requirements of AZ or J&J. They also have a new flu vaccine (NanoFlu) that was highly effective in Phase 3 trials, and they are looking into the possibility of a combined flu/covid vaccine.

It will be interesting to see what conspiracy nuts do with the fact that Novavax uses cells from army worm ovaries (actually moth larvae) to grow their spike proteins, though... (cue a flurry of new Mothman sightings, lol)

[Laura Corin]

https://www.theguardian.com/world/2021/jun/26/vaccine-hesitancy-wanes-despite-thousands-joining-freedom-march

[Kanin]

Since the UK has so many more people vaccinated than the US, does that mean we're pretty much guaranteed to see cases rise again soon? I'm already feeling nervous about fall teaching...

[KSera]

3 minutes ago, Ordinary Shoes said:

What do you think about lying about DD's birthday and getting her vaxxed with the Pfizer vaccine? There is a surplus of vaccines now so it wouldn't be taking a vaccine from someone else. 

I wouldn't do it, but I'm a rule follower like that. I would also worry if whoever gave her the vaccine could get in trouble if/when it is discovered (which it seems likely would be once it shows up in the vaccine data base, unless you live in Texas). I'm actually hopeful the trials of lower doses for younger kids will go well and will mean they can use a lower dose for younger kids and hopefully that will also reduce side effects even more. It's crummy timing with school, because it's likely approvals won't come through until September.

[Syllieann]

@Ordinary Shoes I wouldn't do that.  The adult dose seems excessive to me to be using for an eleven year old, and I think that it might be part of the issue with the myocarditis.  I'm actually waiting on getting my twelve year old the second shot and was wondering about lying and saying he's 11, so he could get the smaller dose.  It just seems crazy to me to give the same does to a 300 pound man and an 80 pound kid, but then give only a third of that to a child a month younger.  Also, I don't think the school will have a lower vax rate just because it's Catholic.  Most Catholics I know are pro-vax.  The anomaly is the homeschool Catholics who are also more anti-vax and anti-science in general, but that's not going to bear out on the teachers in the school.

[Wheres Toto]

I might have lied about dd's age if I was really worried about exposure situations AND she was within 6 months of being 12 AND she was not small in stature/weight.  My youngest is turning 14 but she started her period when she was 9 and has been 5 foot 5 inches and over 100 pounds since she was 10 1/2.  

[Drama Llama]

31 minutes ago, Ordinary Shoes said:

 

This would be so much easier if I would rely on other people to do the right thing but you can't. 

Quoted for truth.

I would worry that if her vaccine info was entered into the health department with the wrong birthdate it wouldn't get connected to her record.  So, if you were in a situation down the line where you needed to prove her immunization status, it would be hard. I think this vaccine will be mandatory in schools once it's no longer under EUA.  It would be totally illogical to require polio vaccination and not covid.  So, being able to prove that she got it at the right time seems key.

I will also say, that for my kid who is a few months younger, I'm not that worried about him getting it.  I'm super protective of him, because other people being cautious made a huge difference for our family, as did people who weren't cautious, and I want to repay society the favor, but I'm not that worried that he himself will get sick.  He's scheduled to go to our big local public middle school in the fall, and although we have mask policies, and high vaccine rates, it's still huge with crowded classrooms and kids coming in on buses which means that kids from different classes are mixing.  

My kid weighs more than his Grandma at this point, and she got vaccinated.  So, I get the temptation, but I'm not doing it. 

[popmom]

Is there any info on whether the J and J vaccine is effective against the Delta variant? I can't find anything online. Dh and 2 of my dds opted to get J and J. 

 

[Catwoman]

51 minutes ago, popmom said:

Is there any info on whether the J and J vaccine is effective against the Delta variant? I can't find anything online. Dh and 2 of my dds opted to get J and J. 

 

I read somewhere that it is effective against the Delta variant, but I forgot to save the link and I’m not sure where I read it. My family had the J&J vaccine, so I have been keeping an eye out for any new information that becomes available. 

One positive thing I read was that the J&J vaccine has proven more effective than was originally stated. I will try to find the links tomorrow so you can see the exact numbers. 

[AurieD]

Cross posting from the covid megathread. This seems promising regarding protection against the delta strain. Not sure which vaccine but would have had the Pfizer or AZ depending on age and when they had it.

'The highly contagious Delta strain of COVID-19 infected everyone who attended a Sydney birthday party except for the six people who were vaccinated, the NSW Government said.'

https://www.abc.net.au/news/2021-06-28/vaccinated-attendees-west-hoxton-birthday-party-avoid-covid-19/100249612

[Laura Corin]

9 hours ago, Kanin said:

Since the UK has so many more people vaccinated than the US, does that mean we're pretty much guaranteed to see cases rise again soon? I'm already feeling nervous about fall teaching...

The rise here in symptomatic  cases has mostly,  I believe, been among young people who have only just become eligible for vaccination. The cases in my son's university town are extremely high. So vaccination does seem to be important. ETA: https://www.theguardian.com/world/2021/jun/27/leeds-waits-for-vaccine-as-covid-rates-go-sky-high-in-student-areas

4 hours ago, popmom said:

Is there any info on whether the J and J vaccine is effective against the Delta variant? I can't find anything online. Dh and 2 of my dds opted to get J and J. 

 

I haven't heard of J and J being used in India, and it's not part of the main programme in the UK, so I  don't know if there are any actual data. This article contains a suggestion of what efficacy might be.

https://slate.com/news-and-politics/2021/06/booster-shots-johnson-and-johnson-vaccine.html

Edited June 28, 2021 by Laura Corin

[Laura Corin]

@Kanin this is from the Zoe symptom study app. About a million people are providing data regularly,  I think. Minute 1.45 here

https://youtu.be/yoSuW2fkavM

 

[Laura Corin]

https://www.thetimes.co.uk/article/vaccines-drive-third-wave-covid-death-rate-below-1-in-1-000-d6p7q8mws this is largely Delta.

[Not_a_Number]

9 minutes ago, Laura Corin said:

https://www.thetimes.co.uk/article/vaccines-drive-third-wave-covid-death-rate-below-1-in-1-000-d6p7q8mws this is largely Delta.

Unsurprising, but very good to see 🙂 . 

[Laura Corin]

1 minute ago, Not_a_Number said:

Unsurprising, but very good to see 🙂 . 

Particularly as it's Delta.

[Kanin]

7 hours ago, Laura Corin said:

The rise here in symptomatic  cases has mostly,  I believe, been among young people who have only just become eligible for vaccination. The cases in my son's university town are extremely high. So vaccination does seem to be important. ETA: https://www.theguardian.com/world/2021/jun/27/leeds-waits-for-vaccine-as-covid-rates-go-sky-high-in-student-areas

I haven't heard of J and J being used in India, and it's not part of the main programme in the UK, so I  don't know if there are any actual data. This article contains a suggestion of what efficacy might be.

https://slate.com/news-and-politics/2021/06/booster-shots-johnson-and-johnson-vaccine.html

Thanks, it's good to know that rates are highest with young, unvaccinated people. 

[Penelope]

9 hours ago, Catwoman said:

I read somewhere that it is effective against the Delta variant, but I forgot to save the link and I’m not sure where I read it. My family had the J&J vaccine, so I have been keeping an eye out for any new information that becomes available. 

One positive thing I read was that the J&J vaccine has proven more effective than was originally stated. I will try to find the links tomorrow so you can see the exact numbers. 

I also read that it is a bit more effective at 60 days than at 14 or 28 days. 
 

There is this laboratory study indicating activity against alpha, beta, and gamma, and we know from the original phase 3 trial results that it showed effectiveness against beta and gamma. https://www.nature.com/articles/s41586-021-03681-2

I read that someone is doing a study on this vaccine and Delta. I would expect it would be similar to results from Pfizer and AZ, still expected to be effective against hospitalization and death.
 

Unfortunately, the number that keeps going around is that 33% after dose 1 of Pfizer, but that’s only when they counted any case occurring after first dose. For more than 2 weeks after first dose, it gets up in the 90’s percentiles, and overall numbers are apparently not much different for Pfizer and AZ than they are for alpha variant. Given that, I am not sure why some reports are still saying you need two doses of mRNA for Delta. Maybe they mean for symptomatic disease, and not hospitalization? I’m not sure. 
 

There are questions about whether people who got J&J should get an mRNA booster shot because of Delta, or just because it’s one dose, and mixed opinions with no data. Andy Slavitt said he asked several experts and some said wait for data, while others said you could get a booster if you want. I don’t know how feasible that is to do if you are already in a registry as having been vaccinated.

I saw an article about studies that should allow for updated recommendations about this in a couple of months. Some people seem to wonder about this just because AZ is two doses, but there are some major differences in the vaccines. 
 

 

[ieta_cassiopeia]

On 6/26/2021 at 4:57 AM, KSera said:

Between this and the lower side effects, I think this one should get more attention and get approval as soon as is prudent. Maybe this is the one people would finally feel comfortable enough with to get. Especially people who think there's something woo about mRNA vaccines.

Novovax has been trying to get UK approval since March, but so far as not managed it due to problems with production consistency (presumably because of the sap issue @Corraleno cited). It is not clear when it will successfully demonstrate the necessary production consistency.

Penelope, the reports do mean two shots are needed to get the headline figure for not catching COVID-19 in the first place (symptomatic or otherwise). Due to the problems that are being reported from people who have complications not involving a hospital visit for COVID (11.6% chance of post-COVID first-time psychiatric/neurological problem in certain specific categories in the 6-month period after catching COVID without hospitalisation for COVID), that's starting to become a concern for the medical profession; we could be carrying the consequences of COVID for a long time even after reducing the infection itself to a rare and mostly-minor issue.

Edited June 28, 2021 by ieta_cassiopeia

[Corraleno]

1 hour ago, Penelope said:

Unfortunately, the number that keeps going around is that 33% after dose 1 of Pfizer, but that’s only when they counted any case occurring after first dose. For more than 2 weeks after first dose, it gets up in the 90’s percentiles

I'm curious where you read that, because that's not what the preprint says: 

"Vaccination status was considered as dose 1 for symptom onset 21 days or more after the first dose up to the day before the second dose was received; dose 2 for symptom onset = 14 days or more after the second dose."

So the 33% stat for 1 dose actually covers days 21 to 120.

https://www.medrxiv.org/content/10.1101/2021.05.22.21257658v1.full.pdf

Edited June 28, 2021 by Corraleno

[mommyoffive]

Vaccinated people are dying from the Delta variant, but in small numbers and almost all are over 50, UK data shows (msn.com)

[mommyoffive]

16 hours ago, Ordinary Shoes said:

Question - DD is 11. She turns 12 in November. She's going back to school in August and I don't think they will have any COVID precautions at the school. It's a Catholic school so I don't think will be high vaccine compliance amongst the teachers. It's a K-8 school so most kids will not be vaccinated. 

What do you think about lying about DD's birthday and getting her vaxxed with the Pfizer vaccine? There is a surplus of vaccines now so it wouldn't be taking a vaccine from someone else. 

 

I get the temptation, but I wouldn't do it.   I think the complications with the kids doesn't have to to do with weight because there are small size adults getting the same dose as 300lbs adults.  I think it has to do with their immune systems and the reactions.  I sure wouldn't just test on my own kid when that hasn't been approved yet.  

But also you would probably  have trouble tying her vaccination record to her.  

[Not_a_Number]

2 minutes ago, mommyoffive said:

I get the temptation, but I wouldn't do it.   I think the complications with the kids doesn't have to to do with weight because there are small size adults getting the same dose as 300lbs adults.  I think it has to do with their immune systems and the reactions.  I sure wouldn't just test on my own kid when that hasn't been approved yet.  

Eh, I'd go with common sense and assume that a big kid who's started puberty is actually a good candidate for the vaccine and is likely to do better than smaller kids that are actually 12. 

 

2 minutes ago, mommyoffive said:

But also you would probably  have trouble tying her vaccination record to her.  

This would be the deterrent for me. 

[ieta_cassiopeia]

17 hours ago, Ordinary Shoes said:

Question - DD is 11. She turns 12 in November. She's going back to school in August and I don't think they will have any COVID precautions at the school. It's a Catholic school so I don't think will be high vaccine compliance amongst the teachers. It's a K-8 school so most kids will not be vaccinated. 

What do you think about lying about DD's birthday and getting her vaxxed with the Pfizer vaccine? There is a surplus of vaccines now so it wouldn't be taking a vaccine from someone else. 

 

I wouldn't do it, because we don't even know what amount of vaccine is needed for it to work in an 11-year-old yet (it may well be less than for a 12-year-old), nor whether there will be reactions in that age group not seen (or not yet seen) in the 12-15 crowd. While it's not likely that there would be adverse consequences since trials in 12-year-olds have been successful, there could be a lot of problems if DD turns out to be the exception (especially since, being in the USA, getting the vaccine against medical advice).

Is there a trial to which DD can be signed, or is it feasible to defer returning to school until January? Indeed, if there are some special reasons why DD should be an exception, is there a doctor who would be willing to grant a medical exemption [EDIT: exemption to the conventional rules regarding vaccine administration] (if an exemption is to be granted, it definitely shouldn't be by internet forum but by professional medical opinion)?

Edited June 28, 2021 by ieta_cassiopeia

[mommyoffive]

Just now, Not_a_Number said:

Eh, I'd go with common sense and assume that a big kid who's started puberty is actually a good candidate for the vaccine and is likely to do better than smaller kids that are actually 12. 

 

This would be the deterrent for me. 

Yeah I bet it would probably be fine.  Probably.  But if your kid has any side effects and has to go to the doctor you have to report that you lied.  I am 100% a rule follower.   There is no way I would do it. I also am not going to  teaching my kids to not follow rules.  I have younger kids who I would love to have vaccination, but there isn't a way in the world that I would test them on something that hasn't been approved for their age (outside of being in a vaccine study). 

[Kanin]

16 minutes ago, mommyoffive said:

Vaccinated people are dying from the Delta variant, but in small numbers and almost all are over 50, UK data shows (msn.com)

So... This says that 117 people have died from Delta in the UK, and half of them were fully vaccinated? 

[KSera]

1 hour ago, Kanin said:

So... This says that 117 people have died from Delta in the UK, and half of them were fully vaccinated? 

That seems bad on the surface, but over 85% of adults over 50 are vaccinated in the UK. That means 57% of the cases came from the less than 15% who were not fully vaccinated. 
 

eta: while this shows the vaccines are working very well, they’re not perfect and it illustrates why I don’t think anyone should think poorly of the fully vaccinated elderly who are still masking everywhere. Or the fully vaccinated young people, for that matter. 

Edited June 28, 2021 by KSera

[Kanin]

2 minutes ago, KSera said:

That seems bad on the surface, but over 85% of adults over 50 are vaccinated in the UK. That means 57% of the cases came from the less than 15% who were not fully vaccinated. 

My brain hurts from constant analyzing. Thanks for this!

[Corraleno]

Excerpt from today's NYT article with some really excellent news about the mRNA vaccines:

"Dr. Ellebedy’s team sought to address that question by looking at the source of memory cells: the lymph nodes, where immune cells train to recognize and fight the virus. After an infection or a vaccination, a specialized structure called the germinal center forms in lymph nodes. This structure is an elite school of sorts for B cells — a boot camp where they become increasingly sophisticated and learn to recognize a diverse set of viral genetic sequences. The broader the range and the longer these cells have to practice, the more likely they are to be able to thwart variants of the virus that may emerge.

 

“Everyone always focuses on the virus evolving — this is showing that the B cells are doing the same thing,” said Marion Pepper, an immunologist at the University of Washington in Seattle. “And it’s going to be protective against ongoing evolution of the virus, which is really encouraging.”

 

After infection with the coronavirus, the germinal center forms in the lungs. But after vaccination, the cells’ education takes place in lymph nodes in the armpits, within reach of researchers. Dr. Ellebedy and his colleagues recruited 41 people — including eight with a history of infection with the virus — who were immunized with two doses of the Pfizer-BioNTech vaccine. From 14 of these people, the team extracted samples from the lymph nodes at three, four, five, seven and 15 weeks after the first dose. That painstaking work makes this a “heroic study,” said Akiko Iwasaki, an immunologist at Yale. “This kind of careful time-course analysis in humans is very difficult to do.”

 

Dr. Ellebedy’s team found that 15 weeks after the first dose of vaccine, the germinal center was still highly active in all 14 of the participants, and that the number of memory cells that recognized the coronavirus had not declined. “The fact that the reactions continued for almost four months after vaccination — that’s a very, very good sign,” Dr. Ellebedy said. Germinal centers typically peak one to two weeks after immunization, and then wane. “Usually by four to six weeks, there’s not much left,” said Deepta Bhattacharya, an immunologist at the University of Arizona. But germinal centers stimulated by the mRNA vaccines are “still going, months into it, and not a lot of decline in most people.” Dr. Bhattacharya noted that most of what scientists know about the persistence of germinal centers is based on animal research. The new study is the first to show what happens in people after vaccination.

 

The results suggest that a vast majority of vaccinated people will be protected over the long term — at least, against the existing coronavirus variants. But older adults, people with weak immune systems and those who take drugs that suppress immunity may need boosters; people who survived Covid-19 and were later immunized may never need them at all.

 

Exactly how long the protection from mRNA vaccines will last is hard to predict. In the absence of variants that sidestep immunity, in theory immunity could last a lifetime, experts said. But the virus is clearly evolving. “Anything that would actually require a booster would be variant-based, not based on waning of immunity,” Dr. Bhattacharya said. “I just don’t see that happening.”

 

People who were infected with the coronavirus and then immunized see a major boost in their antibody levels, most likely because their memory B cells — which produce antibodies — had many months to evolve before vaccination. The good news: A booster vaccine will probably have the same effect as prior infection in immunized people, Dr. Ellebedy said. “If you give them another chance to engage, they will have a massive response,” he said, referring to memory B cells.

 

In terms of bolstering the immune system, vaccination is “probably better” than recovering from the actual infection, he said. Other studies have suggested that the repertoire of memory B cells produced after vaccination is more diverse than that generated by infection, suggesting that the vaccines will protect better against variants than natural immunity alone.

 

https://www.nytimes.com/2021/06/28/health/coronavirus-vaccines-immunity.html

 

 

[kristin0713]

3 hours ago, Penelope said:

There are questions about whether people who got J&J should get an mRNA booster shot because of Delta, or just because it’s one dose, and mixed opinions with no data. Andy Slavitt said he asked several experts and some said wait for data, while others said you could get a booster if you want. I don’t know how feasible that is to do if you are already in a registry as having been vaccinated.

I wish there was a firm recommendation about this.  I would get a booster today if it was recommended. I haven't seen anything about the two dose J&J trials, either. 

[Corraleno]

There's also news on AZ that is being widely reported today, but many of the stories miss or gloss over the actual significance of the study. What is being reported is that a 3rd dose of AZ further boosts immunity, but there's no reason to believe that a booster is currently necessary. What's really important about the study, though, is that it alleviates concerns that boosters for adenovirus vaccines might not work well because the body would react to the adenovirus rather than the coronavirus. That's why Sputnik uses two different adenoviruses in the first & second doses, and why there are trials combining mixed vaccines to see if those work better than repeated doses that use the same adenovirus. This small (n = 30) AZ trial showed that a 3rd shot of AZ continued to stimulate an immune response.

https://www.nytimes.com/2021/06/28/world/astrazeneca-vaccine-booster-shot.html

Edited June 28, 2021 by Corraleno

[KSera]

47 minutes ago, Corraleno said:

Germinal centers typically peak one to two weeks after immunization, and then wane. “Usually by four to six weeks, there’s not much left,” said Deepta Bhattacharya, an immunologist at the University of Arizona. But germinal centers stimulated by the mRNA vaccines are “still going, months into it, and not a lot of decline in most people.” 

Any ideas why it would be that the mRNA vaccines would stimulate the germinal centers differently than other vaccines? It seems like the mRNA is just the method for getting the spike protein produced by the body so the immune system can respond to it. I’m trying to think why the method by which the spike protein comes about would change the immune response to it  (I’m not an immunologist, clearly). I would think they would need to look at the same germinal centers in people who have been given different kinds of COVID-19 vaccines, to see if it’s specific to the type of vaccine, or if it’s more to do with to this particular spike protein, and similar would be seen with any of the vaccines that introduce the spike protein in one way or another. 

[Penelope]

4 hours ago, Corraleno said:

I'm curious where you read that, because that's not what the preprint says: 

"Vaccination status was considered as dose 1 for symptom onset 21 days or more after the first dose up to the day before the second dose was received; dose 2 for symptom onset = 14 days or more after the second dose."

So the 33% stat for 1 dose actually covers days 21 to 120.

https://www.medrxiv.org/content/10.1101/2021.05.22.21257658v1.full.pdf

There are higher numbers for hospitalization.

https://khub.net/web/phe-national/public-library/-/document_library/v2WsRK3ZlEig/view_file/479607329?_com_liferay_document_library_web_portlet_DLPortlet_INSTANCE_v2WsRK3ZlEig_redirect=https%3A%2F%2Fkhub.net%3A443%2Fweb%2Fphe-national%2Fpublic-library%2F-%2Fdocument_library%2Fv2WsRK3ZlEig%2Fview%2F479607266

 

I did see something else on an article and some feed that said personal communication with the authors showed analysis of the 33% after dose one was higher after 14 days, but maybe they meant something else, or I am confused. I don’t see it in the paper. 
But there is this unpublished from India that showed workers had about the same percentage of infections after one dose as they did after two doses.https://www.aninews.in/news/national/general-news/covid-vaccines-provided-protection-in-over-95-pc-of-vaccinated-healthcare-workers-says-study20210616200420/

From this report, though, with alpha there was only 49% effectiveness of first dose, but I didn’t seem to hear as much concern then about the one dose strategy. https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/997418/Variants_of_Concern_VOC_Technical_Briefing_17.pdf
page 38-39.

 

 

 

 

Edited June 28, 2021 by Penelope

[Laura Corin]

Delta symptoms after two Pfizer jabs

BBC News - Marr on catching Covid after being double vaccinated
https://www.bbc.co.uk/news/health-57640550

[Corraleno]

49 minutes ago, KSera said:

Any ideas why it would be that the mRNA vaccines would stimulate the germinal centers differently than other vaccines? It seems like the mRNA is just the method for getting the spike protein produced by the body so the immune system can respond to it. I’m trying to think why the method by which the spike protein comes about would change the immune response to it  (I’m not an immunologist, clearly). I would think they would need to look at the same germinal centers in people who have been given different kinds of COVID-19 vaccines, to see if it’s specific to the type of vaccine, or if it’s more to do with to this particular spike protein, and similar would be seen with any of the vaccines that introduce the spike protein in one way or another. 

AFAIK there is no similar research on other covid vaccines yet, so the comparison is to other types of vaccines. This is from the preprint:

"More robust [germinal center] responses are consistent with antigen dissemination to multiple [lymph nodes] and the self-adjuvating characteristics of the mRNA/lipid nanoparticle vaccine platform compared to nonadjuvanted inactivated vaccines used for seasonal influenza virus vaccination."

and 

"GC responses induced by immunization with more robust adjuvants such as sheep red blood cells, complete Freund’s adjuvant, or saponin-based adjuvants tend to peak slightly later, 2–4 weeks after vaccination, and can persist at low frequencies for several months. Although studies of extended durability are rare, antigen-specific GC B cells have been found to persist for at least one year, albeit at very low levels. In this study, we show SARS-CoV-2 mRNA vaccine-induced GC B cells are maintained at or near peak frequencies for at least 12 weeks after secondary immunization."

I know that Novavax uses a saponin-based adjuvant, but I don't know what adjuvants (if any) the other vaccines use.

[Penelope]

So that is saying that mRNA has a timeline of germinal center development similar to adjuvanted vaccines? 

I have seen comments by immunologists and virologists suggesting that the lipid particle may be acting as a kind of adjuvant. 

[Corraleno]

1 hour ago, Penelope said:

So that is saying that mRNA has a timeline of germinal center development similar to adjuvanted vaccines? 

I have seen comments by immunologists and virologists suggesting that the lipid particle may be acting as a kind of adjuvant. 

It seems to suggest that the "self-adjuvanting" characteristic of the lipid particle is significantly better than the other adjuvants mentioned, because the GC B cells persist at peak levels for at least 12 weeks after the 2nd shot, instead of peaking and then quickly waning to very low levels, as occurs with other adjuvants.

Edited June 28, 2021 by Corraleno

[whitestavern]

Food for thought for the under 12 group:

https://www.medpagetoday.com/opinion/marty-makary/93029
 

[Syllieann]

7 hours ago, ieta_cassiopeia said:

I wouldn't do it, because we don't even know what amount of vaccine is needed for it to work in an 11-year-old yet (it may well be less than for a 12-year-old), nor whether there will be reactions in that age group not seen (or not yet seen) in the 12-15 crowd. While it's not likely that there would be adverse consequences since trials in 12-year-olds have been successful, there could be a lot of problems if DD turns out to be the exception (especially since, being in the USA, getting the vaccine against medical advice).

Is there a trial to which DD can be signed, or is it feasible to defer returning to school until January? Indeed, if there are some special reasons why DD should be an exception, is there a doctor who would be willing to grant a medical exemption [EDIT: exemption to the conventional rules regarding vaccine administration] (if an exemption is to be granted, it definitely shouldn't be by internet forum but by professional medical opinion)?

They determined dosing in phase 1&2.  The current phase 3 Pfizer trial is 10 micrograms for 5-11 year olds and 5 micrograms for the under 5.  The adult dose is 30 micrograms.  I'm not disagreeing with anything you said, just adding more info.