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Tag: Vaccination

Vaccines and Probabilities

April 9 2021

Many years ago as I tried to tell sceptical people that smoking killed people, the research was all about the probability of smokers getting diseases more often than non-smokers.  People would often reply, ‘Lies, damn lies and statistics’ as if this was some sort of frightfully clever response that neutralised any sensible discussion.

Statistics have been used by researchers for years and are the basis of the experimental method to get towards scientific truth.  Things are rarely ‘proved’ in science, they are just rendered more and more likely, so that the probability of their not being true becomes infinitesimally small. 

Where there are number of variables the statistics become ever more complicated and the proofs more arguable.  Some of us get a bit lost as the complexity rises, and try to retreat to ‘common sense’, with is another way of saying what is most probable based on facts we are already sure of. 

The Astra-Zeneca vaccine has been pushed in Australia, and there is a world shortage of vaccines, despite Prime Minister Morrison running around with an open chequebook for a long time and boasting that we were at the front of the queue for was it 4 different ones ‘in development’?

The loss of the Uni of Qld. vaccine because it gave a false positive in the HIV/Aids test was a bad blow, given that it was ‘ours’ and the vaccine against cervical cancer had been so successful. 

As more and more countries expressed reservations about the A-Z vaccine, it was becoming harder and harder to stick to the line that they were panicking and there was nothing in the stories about blood clotting in dangerous body locations. 

Now A-Z  is not recommended for the under 50 age group, which is most of the country.  Presumably this means that because under-50s are less likely to die of COVID19 even if they get it, the risk of dying from a clot becomes more significant.  Obviously in Australia, if we can keep COVID isolated forever, we will not need a vaccine at all unless we want to venture overseas.  So we are looking at the probability of the virus escaping, and the probability of other vaccines being available as well as the chance of dying at whatever age we are with whatever existing medical problems we may have, versus the chance of having a bad reaction to the vaccine. 

I want to get vaccinated so I can go on an overseas holiday at last, but the A-Z vaccine may be less effective against new and dastardly strains, and if I take that risk will I be stuck in a hotel in Mongolia unable to fly home because the government has changed its policy on my vaccination status or the absolute numbers who can be quarantined?

It is very hard to answer all these questions for anyone, and when older patients who have clotting problems ask for advice, it is very hard to give them an answer.  Doctors will have to spend a lot of time on this.   Our practice is not vaccinating at all, the red tape scared us off, despite the fact that we had bought a new vaccine frig and have been vaccinating people for 40 years.  Call me a coward if you will.  But for myself, I do have an appointment to have the A-Z vaccine next week.

Here is the SMH article:

AstraZeneca blood clot cases force major vaccine shake-up; Pfizer now preferred for under-50s

By Rachel Clun

April 9, 2021

Pfizer is now the preferred vaccine for people aged under 50 and the timing of Australia’s rollout is in doubt after medical experts expressed concerns about rare blood clots potentially linked to the AstraZeneca vaccine – the mainstay of the country’s existing COVID-19 strategy.

Prime Minister Scott Morrison said on Thursday night the government will review Australia’s vaccine portfolio and accept medical advice that will preference the Pfizer vaccine over AstraZeneca’s in adults aged less than 50 years old who have not already received a first dose of AstraZeneca, putting plans to vaccinate the entire population by October in doubt.

Australia’s decision follows changes by European medical regulators after a review of data confirmed a rare blood clotting condition seen in a small number of patients was linked to the AstraZeneca vaccine.

Mr Morrison said the new advice from the Australian Technical Advisory Group on Immunisation was not a prohibition on the use of the AstraZeneca vaccine in people aged under 50.

“This is not a directive. This is not an instruction,” he said, noting they were taking “an abundance of caution” with the new advice. He said the impact of this decision on the timeline of the rollout was uncertain.

“Tomorrow, and over the weekend, there will be a recalibration of how the program will need to be adjusted to take into account decisions the government’s taken tonight to accept those recommendations from ATAGI,” he said on Thursday evening.

Chief Medical Officer Professor Paul Kelly said the rare but serious blood clot disorder was discussed in the meeting, taking into account what was decided overseas and looking at what that would look like in Australia.

“This is a rare event,” he said. “But it is serious and can cause an up to 25 per cent death rate when it occurs.”

For those over 50, Health Department secretary Professor Brendan Murphy said AstraZeneca was strongly recommended.

“It is a vaccine that is very, very effective,” he said.

ATAGI spent hours on Thursday considering the medical evidence. It then issued new advice on the AstraZeneca vaccine, which it provided to the government just after 7pm.

The medical experts made three recommendations, including that AstraZeneca was preferred in adults over 50, after a lengthy meeting. They also recommended adults under the age of 50 should only be given AstraZeneca where the benefits clearly outweighed the risks. Third, it recommended that adults under 50 who had already received their first doses without experiencing serious side effects could safely be given their second dose.

Professor Kelly stressed the data on the rare clotting side effect, venous thromboembolism, was still only preliminary.

Britain’s vaccine advisory committee says adults under 30 should be offered an alternative to AstraZeneca’s COVID-19 vaccine when possible, due to a very rare side effect of blood clots in the brain.

“There are very few cases of this extremely rare event that have happened anywhere in the world, but the ones we’ve seen, there’s definitely a tendency for the younger people [to develop it],” he said.

The UK regulator has decided to offer an alternative vaccine for those aged under 30.

Australia has purchased 20 million doses of the Pfizer vaccine and has been relying on the AstraZeneca vaccine as the workhorse of the rollout. The country is expecting its first deliveries of the Novavax vaccine, pending regulatory approval, some time in the fourth quarter of the year.

Late on Thursday, Australian pharma giant CSL said “it remains committed to meeting its contracted arrangements with the Australian government and AstraZeneca for locally produced AstraZeneca COVID-19 vaccines.”

AstraZeneca Australia added that it respected the decision outlined by the government.

“Regulatory agencies have reaffirmed the vaccine offers a high-level of protection against all severities of COVID-19 and that these benefits continue to far outweigh the risks.” a spokeswoman for the company said.

Earlier, the Prime Minister said the risk of severe side effects with the AstraZeneca vaccine is much lower than with common drugs including paracetamol and the oral contraceptive pill.

Mr Morrison said it was important to know the risk of developing venous thromboembolism was much lower following the AstraZeneca vaccine than the risk of death from COVID-19.

“Let’s note that in the UK, the advice is that some 6000 people’s lives have already been saved by this very vaccine. So we need to consider the positive benefits,” he said.

From UK data, the risk of venous thromboembolism following the vaccine was about one to five per million people.

“To put that in some sort of perspective, the combined oral contraceptive pill, that can include adverse side effects of venous thromboembolism – that’s seven to 10 per 10,000,” Mr Morrison said.

The advice has been shared with the expert medical panel, the Australian Health Protection Principal Committee, which comprises all state and territory chief health officers and led by federal Chief Medical Officer Professor Paul Kelly.

The matter will also be discussed in national cabinet on Friday and in meetings with state and territory health ministers, who were due to meet on Thursday night to discuss the revised advice and its implementation.

On Wednesday 75,880 doses of the Pfizer and AstraZeneca vaccines were administered across the country, Scott Morrison said, taking the national total to 996,214 doses administered so far during the rollout.

The states and territories have administered 509,802 doses. Through the federal government, 486,343 doses have been administered, including more than 125,260 through aged care.

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Privatisation of Research will Kill Millions due to Vaccine Non-Availability 30/12/20

The COVID vaccines were an international race.   Many countries and companies competed.  The Uni of Queensland one fell over because it made the AIDS test a false positive.  There are now 5 principal ones in the media; Pfizer from Germany, Astra-Zeneca/Oxford from the UK, Moderna from the USA, Sputnik 5 from Russia, and Sinovac from China.  Over here we ignore the two from Russia and China, for some reason.  Do we not trust them, are we just racist, or do we want to support Big Pharma in ‘The West’?

I recently met with some medical sceptics, who said that there is no public proof that the vaccine works, i.e. published papers.  I said that it was in the media that there had been a 43,000 person trial with not very many side effects. They conceded that this was correct, but pointed out that you could inject water  into 43,000 people with few side effects, and that it was a question of how many of the 43,000 had been exposed to the virus, compared to a group of 43,000 in the same environment who had not been vaccinated.  And you could not ask a volunteer who had just had the vaccine to cuddle up to a COVID case- that would be foolhardy.  Their key point was that all the data was still in the drug companies’ hands and not publicly available.  Presumably the regulatory authorities have it, and hopefully they are still being rigorous under the pressure.  We have to assume the vaccines work as we need to open up the world economy.

Our government promised a fortune to these companies before they even had a product to sell, and all the bluster about having an equal world in terms of vaccine access does not seem to have dollars attached.   At present there is not enough vaccine to go around, but it still matters where you start.  Logically, vaccinating Australians where there is very little infection would likely save fewer lives than vaccinating people where the virus is rampant.

I have told the story before about Jonas Salk, who developed the polio vaccine with public funds and did not patent it so that the maximum amount of vaccine could be distributed to rid the world of polio.  This was in sharp contrast to Glaxo, the drug company, which found that an old unpatented drug worked against AIDS, patented it and then insisted that the price of it be at least $US2 a day, although an Indian company said that they could produce it for 7 cents.  The result was several million extra AIDS cases in Africa.

Sadly the Human Papilloma Virus (HPV) vaccine, Gardasil was a similar story.  HPV was found to be the cause of cervical cancer.  The vaccine was developed at Uni of Queensland by Prof Ian Frazer, and then marketed by CSL and Merck.  Its roll out was considerably delayed by its cost, despite the fact that the Uni of Qld declined to insist on royalties from sales in developing countries.  It is still $73 a shot in Australia (2 needed, 3 recommended), though our government makes it free to Australian schoolchildren.

This article says that the Coronavirus vaccines will worsen inequalities.  This is true, because not only will poorer countries not be able to afford the vaccine, they will also have more people die and have higher health costs as they will have to treat the cases. It will also have a bigger impact on their economies.  The fine rhetoric about sharing world knowledge will certainly be tested.  It might be noted that the Chinese released the draft genome of the Coronavirus to the world in January 2020 (Sciencemag.org) in the interest of stopping the outbreak, which was a credit to China and gives credence to their vaccine.  On the other hand, I seem to recall that Pfizer declined to be involved in information sharing, but have been unable to find the reference for this.

Pfizer did not get public funding but their development partner, BioNTech, did.   The question is how much profit will there be in all this, and how much will the price stop poorer countries getting the vaccine.

The fact that governments no longer fund the research directly and go into ‘private-public partnerships’ gives rise to the feeling that governments put in the funds but the private partners both determine the priorities in research with a bias towards research that can make a profit and then make that profit.  The governments then either largely fund the profit, or leave their populations unable to benefit from the research that they as taxpayers funded.

I have two relevant articles on this, one below, and one coming shortly.

www.internationalhealthpolicies.org/featured-article/why-does-pfizer-deny-the-public-investment-in-its-covid-19-vaccine/

https://amp.theage.com.au/business/the-economy/a-pitiful-response-global-economic-inequality-a-side-effect-of-vaccines-development-20201226-p56q99.html

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Cooperation on COVID Vaccines? 13/12/20

We hear a lot about 3 COVID vaccines; the Pfizer one being rolled out in the UK last week and in the US from tomorrow, the Oxford Astra-Zeneca one that is imminent, cheaper and has less problems with refrigeration, and the Moderna one, which is US based and does not yet seem to have a launch date.

There are two other vaccines in the news, the Russian Sputnik V one being rolled out there and in Eastern Europe, and the Chinese Sinopharm one that is going into Indonesia, India and elsewhere.  But it seems that no one is considering bringing these two into the Western world.  We might ask, ‘Why not?’

Is it racist?  Do we think their scientists are no good and would fake the results?   Are we simply in the thrall of Western pharmaceutical companies with captive regulators?  Perish the thought, would their vaccines be cheaper?  China has 1.3 billion people to protect and have goes to a lot of trouble to do so.  They had scientists working with the US until the fuss started.  They had a head start in the vaccine race.  If the vaccine did not work they would have wasted a lot of time and effort vaccinating their own country and would suffer a huge loss of face.  It seems unlikely that their vaccine does not work.  So again, why no evaluation here?  If Australia asked the Chinese to give us the data on their vaccine to evaluate it for licence here, it would be a nice peace gesture in the needless spat that was created when Morrison accused the Chinese of hiding the origins of the COVID epidemic.

It seems that some scientists in Britain and Russia have suggested cooperation between the Oxford and the Russian Sputnik V vaccine. This story is from RT- Russia Today. Will this actually happen?

www.rt.com/russia/509340-astrazeneca-sputnikv-vaccine-collaboration/

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COVID19 Vaccine Roll Out 11/12/20

People are asking me if they should get vaccinated. It shows how trust in our institutions has been eroded. A few years ago no one would have questioned it.

The side effects are far less than the death rates from COVID, particularly in older age groups or those with other health conditions. COVID also seems to have a considerable amount of long-term after-effects in a significant percentage of people; note the difference between the infection rate and the recovered rate in the statistics. (Of course some may have just been lost to follow-up).

Children seem to have few symptoms, but if they are not infected and grow older without immunity, it would be ironic if they are then badly affected later. Mumps is like that- relatively trivial in youth, but can cause pancreatitis, encephalitis and sterility later. Years ago in the pre-vaccination days, if a child had chicken pox or measles, the mothers would all bring their children to be deliberately infected at a ‘Pox Party’, though these are now discouraged. This sort of immunity may well be spreading and giving herd immunity in countries that have COVID now endemic, but it would be unwise to do it here as it would spread it to more vulnerable demographics.

Chicken pox can cause herpes zoster (shingles) in older folk, which is very painful, and now has a vaccine (Zostavax) that is very expensive but free after age 70.

This article is about the Oxford-Astrazeneca vaccine, which is not the Pfizer one that is currently being rolled out in the UK. It seems that the Oxford one is the first to publish the results of a Phase 3 trial, and though a lot of people have been vaccinated, not many people have been infected, which means that the numbers on which the conclusions are drawn are still not large. There is an embedded link in the article that gives a good summary of the trial procedures. It seems that the Oxford vaccine will have the advantages that it is easier to store, and transport and is cheaper. Presumably as this article is now published, its roll out is imminent also.

From an Australian perspective, there is now a huge rollout of the Pfizer vaccine in the UK, so we will know exactly how well it works by the time it gets here.

It is sad that the Qld Uni vaccine has been abandoned as it gives a false positive for the HIV/Aids Antibody test. Presumably it would have worked, and perhaps an alternative HIV/Aids test might have distinguished the two apart.

https://theconversation.com/the-oxford-astrazeneca-vaccine-is-the-first-to-publish-peer-reviewed-efficacy-results-heres-what-they-tell-us-and-what-they-dont-151755?utm_medium=email&utm_campaign=Latest%20from%20The%20Conversation%20for%20December%2011%202020%20-%201808017569&utm_content=Latest%20from%20The%20Conversation%20for%20December%2011%202020%20-%201808017569+CID_01f3cb2f6f072670ce3f7d184deeafcf&utm_source=campaign_monitor&utm_term=The%20OxfordAstraZeneca%20vaccine%20is%20the%20first%20to%20publish%20peer-reviewed%20efficacy%20results%20Heres%20what%20they%20tell%20us%20%20and%20what%20they%20dont

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AEC Approves Anti-Vaxxer Party name change

3 May 2020 In a move that will surely damage it credibility the Australian Electoral Commission has approved a name change for the ‘Involuntary Medication Objectors (Vaccination/Fluoride) Party’ to be called the ‘Informed Medical Options Party’. Amazingly this was under the Australian Electoral Act, as it did not allow confusion with another party, was not […]

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