‘Pure, liquid hope’: What the vaccine means to me as a GP

‘Clinicians everywhere are all nervous about what will happen if that loosening of restrictions occurs too quickly. Though death from Covid among the under-50s is relatively rare, it can still be a terrible, terrifying disease, capable of rendering its victims breathless and exhausted for weeks (and in some cases, months) after its fevers have run their course. One of my own patients, a nurse in his 20s, used to run 10km three or four times a week. The staff vaccination programme was too late for him: he caught Covid on the wards just before Christmas. Though he’s now back at work, he still hasn’t recovered sufficiently to be able to get back to running.

‘For the next six months, all my colleagues and I will be vaccinating as needed, as many hours as we’re able to. This week I’ve been gladly trudging the streets in the snow, vaccinating our housebound patients, and there aren’t too many still to go. In Scotland, the programme is anticipated to go on at least until 31 July, and the hope is that everyone over 50 will have had a first dose by May.

‘The numbers are daunting, but there’s a spirit of anticipation and celebration in the air. Many are starting to dare to plan for a world post-Covid, and I’m tempted to share that optimism. Opening my first box of vials, I thought of a friend in Orkney, a GP who’d already vaccinated all the over-80s of his practice, and who’d begun to call in the over-70s. We met briefly in Kirkwall, outdoors, on my journey from Orkney back to Edinburgh. “How did it feel to get started?” I asked him.

“I almost wept as I opened that box of vials,” he said, smiling at the memory. “Each one was hope – pure, liquid hope.”

Read here (The Guardian, Feb 11, 2021)

Trust in Covid vaccines is growing

‘Attitudes towards COVID-19 vaccines seem to be improving in some parts of the world, a survey of thousands of people in 15 countries has found. Researchers have welcomed the results, which suggest that an increasing proportion of people are willing to be immunized. But they caution that some problems persist, such as concerns about vaccine safety. “For the first time since the pandemic began, I can sense that optimism is spreading faster than the virus,” says behavioural scientist Sarah Jones at Imperial College London, who co-led the global attitudes towards a COVID-19 vaccine survey.

‘The survey is part of the COVID-19 behaviour tracker, run by Imperial together with the UK market-research company YouGov.’

Read here (Nature, Feb 10, 2021)

Variants v Vaccines: The race between the tortoise and the hare -- Tomas Pueyo

‘The B117 variant will probably take over between February and March in most developed countries. That’s without taking into account the Brazilian and South African variants. Emerging countries are in an even worse position: Not only will they have the 3 variants. They will also receive vaccines much later. And in the Southern hemisphere, they’re now enjoying summer. Winter, with more variants and not enough vaccines, might be less forgiving.

‘So keep tight for a few more months. Don’t let your guard down. The end of the tunnel is near. Get a vaccine if you can. If not, wait till the summer. By September, we’ll likely be back to the new normal in developed countries. And in emerging ones, let’s hope more vaccines and a fast rollout avoids a repeat of 2020.’ 

Read here (substack.com, Feb 8, 2021)

Pfizer withdraws vaccine application in India [after failing to present needed information to experts]

‘Pfizer Inc says it has withdrawn its application for emergency use of its COVID-19 vaccine in India. The company said Friday that it participated in a meeting of experts of the drug regulator on Feb. 3. Based on the deliberation of that meeting and “our understanding of additional information that the regulator may need, the company has decided to withdraw its application at this time,” it said in a statement.

‘The company was the first to approach the Indian regulator in December for its messenger RNA vaccine that it has developed with Germany’s BioNTech. They were closely followed by applications for two other vaccines --- a version of the AstraZeneca made by Serum Institute of India and another by Indian company Bharat Biotech -- which eventually got the nod for emergency use on Jan. 3. However, India’s Health Ministry has said that Pfizer hadn’t made its presentation to experts who needed to clear the vaccine, before the regulator could green-light its use in India.’

Read here (The Independent, Feb 6, 2021)

Covid-19 infection rates fall as millions are vaccinated in Britain

‘Infection rates in the over-80s have fallen by 36 per cent this month. Other age groups have seen similar falls. The biggest drop was recorded in people in their 20s. Rates in that age group have halved. Prof Harnden said: “The data we have is still is very early because it only reflects approximately three or four weeks of the program and it’s mainly based on the Pfizer vaccine.”

Read here (News.com, Feb 1, 2021)

The vaccine, migrant workers and herd immunity -- Jeyakumar Devaraj

‘Let us look at the numbers - our population is 31 million. We have six million migrant workers and another 200,000 refugees. So altogether there are 37.2 million people residing in Malaysia. 

‘The government has said that children and pregnant women will not be given the Covid vaccine - that is about six million children 12 years and below and 0.5 million pregnant women. 6.5 million is 17.5 percent of 37.2 million.

‘In other words, we could achieve our 80 percent immunisation rate if all migrant workers also took the vaccine. But if all of them didn’t, then we would have 12.7 million not vaccinated - children, pregnant mums, migrant workers and refugees - and 12.7 million is 34 percent of 37.2 million. We only achieve a vaccination rate of 63 percent - far short of the 80 percent we need to get herd immunity!’

Read here (Malaysiakini, Jan 30, 2021)

How influencers, celebrities, and FOMO [fear of missing out] can win over vaccine skeptics

‘Drawing from product innovation theory, Rohit Deshpandé and colleagues offer three recommendations to speed adoption of COVID-19 vaccines...

‘Governments are prioritizing certain groups to receive the vaccine, with medical professionals and certain government personnel at the top, followed by first responders and vulnerable populations, and then the general population. The diffusion of innovations model indicates that each of these groups will have five customer segments based on their willingness to get vaccinated earlier or later. For example, some medical professionals will be eager to get vaccinated early (the innovators, early adopters, and majority) while others will wait (the late majority and laggards).

‘So, how do we maximize the number of individuals in any prioritized group who are willing, if not eager, to get vaccinated as soon as possible?

‘The answer requires keen understanding of each segment, for example, of both the seniors in the early majority and the seniors that are laggards less keen on taking the vaccine. The diffusion of innovations research indicates that a combination of personal and societal factors influence the rate of adoption within and between segments factors, with the ultimate driver being word of mouth.

‘For the COVID-19 vaccine, the personal factors include people’s perceived efficacy and need for the vaccine, past immunization experiences, and opinions about vaccines more generally, along with those of their families.

‘Societal drivers include the advice of experts, media, and other influencers within their demographic, socioeconomic, and innovation adoption segment. Influencers will need to mitigate concerns about the “newness” of the vaccine, such as the probability of side effects and solutions when they occur. They will also need to reinforce the positive consequences of taking the vaccine, such as the ability to visit family, go to work, and have more entertainment options.’

Read here (Harvard Business School, Jan 29, 2021)

More than 85 poor countries will not have widespread access to coronavirus vaccines before 2023

• The rollout of vaccines against the coronavirus (Covid-19) has started in developed countries, but mass immunisation will take time. 
• Production represents the main hurdle, as many developed countries have pre-ordered more doses than they need. 
• The costs associated with mass immunisation programmes will be significant, especially for less-developed countries that have limited fiscal resources. 
• Vaccine diplomacy will play a role in determining which countries get access to a vaccine in the coming months. 
• Russia and China will use the rollout of their own coronavirus shots to advance their interests. 
• With priority groups vaccinated in rich economies by end-March, The EIU expects global economic prospects to brighten from mid-2021. 
• For most middle-income countries, including China and India, the vaccination timeline will stretch to late 2022. 
• In poorer economies, widespread vaccination coverage will not be achieved before 2023, if at all.

Read here (The Economist, Jan 27, 2021)

Vaccines have been oversold as the pandemic exit strategy

‘Covid will be around for a long time — virus suppression is the right policy...

‘If regions with raging transmission do act as breeding grounds for resistant variants, then failing to control spread will prolong the pandemic. Prof de Oliveira stresses that Taiwan, China, Australia and New Zealand, which have chased elimination, are the role models to follow. “This should be a wake-up call for all of us to control transmission, not just in our own regions but globally. This virus will keep outsmarting us if we don’t take it very seriously,” he says.

‘That means not just vaccinating but fast testing, accurate and quick contact tracing, quarantine and isolation. In short, vaccination must go hand-in-hand with virus suppression, not become a substitute for it. A successful vaccine rollout will count for little if the country then becomes a crucible for resistant variants.’

Read here (Financial Times, Jan 26, 2021)

Indonesia's Covid vaccination campaign prioritises workers

‘Indonesia has decided to prioritise vaccination for people aged 18-59, arguing the workforce needs to be protected first to boost the economy... The first two phases of Indonesia's vaccination campaign started on January 13 and are expected to run concurrently until April, according to the Health Ministry. The first shots will go to health workers and support staff. This will be followed by members of the public workforce, including public servants at ports and stations, electric companies, banks, water companies and any officials providing community services.’

Read here (DW, Jan 22, 2021)

Why kids might be key to reaching herd immunity

‘Vaccinating kids, however, is often not just about the direct and immediate benefits to them. It’s also meant to protect children against diseases that would otherwise become more dangerous for them as adults—measles, mumps, and chicken pox are three common examples—and dampen the overall spread of these diseases. In the short term, the primary reason to vaccinate children against COVID-19 may be that the U.S. will have a hard time reaching herd immunity otherwise.‘

Read here (The Atlantic, Jan 21, 2021)

Here's what Joe Biden can do about the Covid-19 pandemic starting on his first day as US president

‘If the pandemic unfolded in stages so too must it be contained that way. During the campaign, Biden promised swift action on such steps as testing, vaccine manufacture and distribution, and preventive measures like mask mandates. That, he’s said, will be followed by other steps like improving surveillance of emerging variants of SARS-CoV-2, extending unemployment benefits to people whose jobs were lost as a result of quarantining and lockdowns, extending the moratorium on evictions, and ensuring that people who contract COVID-19 and survive don’t face discrimination in insurance benefits. It would, the candidate promised, be nothing short of a stepwise, war-like mobilization...

‘If there’s a certainty in exactly how the Biden plan will unfold over the next 24 or 12 or even three months, it’s that there’s no certainty at all. Viruses are at once both mindless and clever—infecting and eluding, spreading and shape-shifting. It takes a set of policies that are equally adaptable, equally nimble to defeat them. The new president’s plan is an ambitious first step. A lot of sure-footed steps remain before the pandemic is defeated.’

Read here (Time magazine, Jan 20, 2021)

Vaccines need not completely stop Covid transmission to curb the pandemic

‘Influenza may provide the best blueprint of what to expect going forward. The most common flu vaccine—the inactivated virus—is not “truly sterilizing because it doesn’t generate local immune response in the respiratory tract,” Crowcroft says. This fact, coupled with low immunization rates (often shy of 50 percent among adults) and the influenza virus’s ability to infect and move between multiple species, enables it to constantly change in ways that make it hard for our immune system to recognize. Still, depending on the year, flu vaccines have been shown to reduce hospitalizations among older adults by an estimated 40 percent and intensive care admissions of all adults by as much as 82 percent.

‘Research on seasonal coronaviruses suggests that SARS-CoV-2 could similarly evolve to evade our immune systems and vaccination efforts, though probably at a slower pace. And data remain mixed on the relationship between symptoms, viral load and infectiousness. But ample precedent points to vaccines driving successful containment of infectious diseases even when they do not provide perfectly sterilizing immunity. “Measles, diphtheria, pertussis, polio, hepatitis B—these are all epidemic-prone diseases,” Crowcroft says. “They show that we don’t need 100 percent effectiveness at reducing transmission, or 100 percent coverage or 100 percent effectiveness against disease to triumph over infectious diseases.”

Read here (Scientific American, Jan 18, 2021)

Asia’s deadliest Covid country [Indonesia] to resist vaccination

‘A Saiful Mujani Research & Consulting survey last month found that only 37% of respondents were willing to take what might be the life-saving jab, with 40% uncertain and 17% saying they would refuse it, mostly because of concerns over safety and effectiveness. Health experts say even with a smooth rollout through hospitals and 10,000 first-level health clinics, it will be at least 15 months before the program reaches the percentage required for herd immunity among Indonesia’s 270 million-strong population. The government estimates it will need 427 million doses, factoring in a wastage of 15%, to vaccinate a targeted 181.5 million citizens, with Widodo saying he wants that done by mid-2022.’

Read here (Asia Times, Jan 18, 2021)

World questions whether China’s Covid jab is safe

‘Although Turkish researchers found that the Sinovac vaccine was 91.25 percent effective in preventing the onset of the coronavirus, trials in the United Arab Emirates found it to be somewhat lesser, at 86 percent effective, while Indonesian trials found the drug was only 61 percent effective. The Turkish trials were conducted on only 29 subjects. Even worse news emerged from Brazil, where the Chinese vaccine was found to be effective in only 50.4 percent of cases in clinical trials numbering13,000 participants. Too many across Asia and elsewhere believe there wasn’t sufficient scientific rigor, the trials were too short and too rushed, and that, in the words of one observer who declined to be named, “poor Asians and others are being given a shoddy vaccine because Beijing wants to score political points with its crappy jab.”

‘Whether that is true or not, those countries going ahead with the Chinese vaccine, however, seem to be proceeding on the basis that, while it may only be 50 percent effective, it’s better than zero percent without a vaccine. Pfizer and Moderna vaccines have been found to be more than 90 percent effective, but it’s a question of availability and price. Although legions of common citizens from the Philippines to Indonesia to Turkey to Brazil are shying away from China’s vaccine, governments are sticking with it. Singapore has announced it will continue with the Chinese products, as will Thailand although authorities have also bought 26 million doses of the UK-based AstraZenica vaccine – which won’t arrive until June. It will still need to be approved by the Thai FDA.’

Read here (Asia Sentinel, Jan 17, 2021)

Khairy: If you’re a healthy Malaysian under 60 and not a frontliner, expect to be vaccinated only by Q3 2021 or even later

‘Malaysians who are not active frontliners, below the age of 60 and in relatively good health can expect to receive their dose of Covid-19 vaccinations only by the third-quarter of this year or later, the science, technology and innovation minister revealed today. Khairy Jamaluddin, also the Special Committee on Ensuring Access to Covid-19 Vaccine Supply (JKJAV) co-chair, said this is because the first batch of vaccines to arrive will be prioritised to inoculate those within vulnerable groups. 

“Frontline workers from the healthcare and security sectors will go first. Then senior citizens and people with chronic illnesses. Only then we will move on to the general population in order to get to a meaningful herd immunity threshold.’

Read here (The Malay Mail, Jan 14, 2021)

Khairy explains Malaysia's vaccine procurement process, delivery schedule (full text)

‘As two of Malaysia's closest neighbours, Singapore and Indonesia, kicked off their vaccination programmes, Science, Technology and Innovation Minister Khairy Jamaluddin wrote a blog post to give an update on what Malaysia's vaccine procurement process is like — why it is not slow in getting its vaccines — and the delivery schedule that Malaysians can expect. Khairy is also the co-chair of the Special Committee on Ensuring Access To Covid-19 Vaccine Supply.’

Read here (The Edge, Jan 14, 2021)

Brazil trial finds efficacy of Sinovac vaccine at 50.4 percent

‘A coronavirus vaccine developed by China’s Sinovac Biotech was found to be just 50.4 percent effective at preventing symptomatic infections of COVID-19 in a Brazilian trial, researchers said on Tuesday, barely enough for regulatory approval and well below the rate announced last week.

‘The latest results are a substantial disappointment for Brazil, as the Chinese vaccine is one of two that the federal government has lined up to begin immunisation during the second wave of the world’s second-deadliest COVID-19 outbreak.’

Read here (Aljazeera, Jan 13, 2021)

Sinovac releases vaccine data in Brazil: 100% effective in preventing severe cases, could reduce hospitalizations by 80%

‘Sinovac's COVID-19 vaccine is 100 percent effective in preventing severe and moderate infections, 77.96 percent effective in preventing mild cases, and has an overall efficacy of 50.4 percent in Brazil's final-stage trials. Experts say the result is good enough considering almost all participants in Brazil are high-risk medical workers, and the 77.96 efficacy for mild-case protection means the vaccine can reduce 78 percent of people from needing hospitalization. 

‘We have today one of the best vaccines in the world, Dimas Covas, director of the Butantan Institute in Brazil, said during a news conference on Tuesday.’

Read here (Global Times, Jan 13, 2021)

Covid-19 herd immunity unlikely in 2021 despite vaccines: UN

‘The World Health Organization’s chief scientist warned that even as numerous countries start rolling out vaccination programs to stop COVID-19, herd immunity is highly unlikely this year.

‘At a media briefing on Monday (Jan 11), Dr Soumya Swaminathan said it was critical countries and their populations maintain strict social distancing and other outbreak control measures for the foreseeable future. In recent weeks, Britain, the US, France, Canada, Germany, Israel, the Netherlands and others have begun vaccinating millions of their citizens against the coronavirus.’

Read here (Channel News Asia, Jan 12, 2021)