Chris Whitty moves to head off GPs' rebellion over vaccine doses

I am not entirely convinced that CW is not being manipulated, over this and other things.

So many times I have had the feeling that he is uncomfortable with the political decisions that have been taken and that they are against his advice. There has often been something rather lukewarm in his endorsement of BJ's pronouncements.

Like everyone else I have no way of knowing whether the policy currently being pursued of giving only one dose is scientifically valid or not - I can see the attraction of giving lots of people partial protection rather than full protection to a handful of people; but it only makes sense if that is what the science tells us.

I have no faith in BJ - too much bluff and bluster and too many entirely predictable u-turns (e.g. London schools as the latest). If ever there was a time when we needed clear leadership it is now.

Nezumi65

The New York Times has raised a different issue www.nytimes.com/2021/01/01/health/coronavirus-vaccines-britain.html

Which still (IMO) isn’t as much of a concern as the increased risk for development of vaccine resistance.

It sounds as if quite a few doctors are refusing to change anything and are ploughing ahead with 3 week gap, for those already vaccinated at least.

Vaccine resistance is much less likely to develop than resistance to antibiotics, which behave in a different way.

www.ncbi.nlm.nih.gov/pmc/articles/PMC6304978/

I'm far more concerned that the vaccine just won't work.

Luckygirl It depends how success is measured. No doubt the statistics for deaths will go down and a political victory will be claimed.

That really is no consolation to the individual. Quite honestly, if I were to be told that I only had partial protection, I would still carry on taking all the precautions I had previously.

I really like him too. Very open and honest and makes it easier to understand the science.

The suggestion to leave a longer gap between the first and second jabs might just be a temporary policy to maximise the stocks we already have.

There has been talk of problems accessing materials including the glass vials.

However The Times today reports that someone on the Astra Zeneca team has stated that two million doses per week should be delivered by the third week of January, so if that does happen we may well revert to the normal three week gap.

I think the government are reacting to circumstances rather than “the science”.
Pfizer have been reported as saying that there is no data that immunity is retained after 21 days, so perhaps the U.K. will be able to supply this data after they have tried it??

The Oxford/Astra Zeneca and Pfizer vaccinations work in very different ways.

I agree with you Greeneyedgirl. It seems to me that once again the government over-promised and is determined to hit its target for political/PR reasons, rather than listening to what Pfizer is saying.

Yes I know the NYT has raised something different. And yes I know that vaccine resistance is not as much of an issue as antibiotic. It if you WANTED to produce a vaccine resistant strain - this is basically what you would do.

This is not entirely the same - but it gives a good idea of the issues. The biggest concern isn’t so much the later parts of the article, I don’t think that will necessarily apply to Covid, but the fact that they are introducing a selection pressure when they do not know whether vaccination prevents transmission in a population where it is transmitting wildly and at speed. To guard against development of resistance you basically need to do everything you can go reduce transmission. Maybe it will be fine - it will certainly be an experiment.

www.quantamagazine.org/how-vaccines-can-drive-pathogens-to-evolve-20180510/

From the Read paper you linked to the key concept is this: Resistance mutations are less likely to appear in small populations (7), and when such mutations appear and confer partial resistance within a host, they are unlikely to replicate to the large population sizes that are associated with onward transmission

The issue we have here is changing the dosing regime increases the risk of larger population sizes & onward transmission. So you are removing one of the safety features.

It wouldn’t be so dangerous fiddling with the regime in NZ because there is zero community transmission - here we have rampant community transmission.

Anyway experiments on all fronts.

This is a good discussion, GNers. Please keep it up. Yesterday morning I still felt elated from knowing the AZ vaccine was approved for use but today, agreeing with growstuff, I am concerned that one dose of either vaccine will be only partial protection and so I will not feel confident to stop taking my current precautions. Perhaps I was naive to think otherwise. I also would like to hear from Professor JVT but, as someone upthread has already said, I reckon he will not appear unless he can speak his mind. That will definitely be an indicator for me.

growstuff

The Oxford/Astra Zeneca and Pfizer vaccinations work in very different ways.

I agree with you Greeneyedgirl. It seems to me that once again the government over-promised and is determined to hit its target for political/PR reasons, rather than listening to what Pfizer is saying.

It is so depressing. We have the tool to get us out of this mess and our government is taking unnecessary risks.

I definitely thought medics should get the first vaccines. BUT now that they have been given, we should not waste them simply for political spin, but should go ahead with the 2nd dose as planned.

I am hoping that pressure will cause a u-turn, as I think the risk of mix and match and delay has as yet zero empirical evidence.

It was CW that stopped testing and tracing back in the spring so I don’t actually have a great deal of faith in him.I read something on Facebook about people being vaccinated with the Pfizer vaccine followed by the Oxford one. This must surely be fake news. I’m not concerned about the spacing between first and second vaccines: the Oxford vaccine is probably more efficacious with a 12 week gap. What I’m really worried about is a delay in rolling out the Oxford vaccine as this government seems incapable of getting anything right. The exception being food supplies which have been very well maintained throughout the pandemic. Let’s hope brexit doesn’t change that.

What I don’t understand is, how the mix and match idea can possibly work, given that entirely different technologies- were used to produce the two vaccines.

Pfizer used the newer technology of genetic engineering, using part of the DNA of the virus, whilst Oxford was based on the older more tried version, of using a coronavirus in the form of primate cold virus, rendering it harmless.

Until we have the empirical evidence showing that the two can be mixed, I think the risk is too great.

This is a good discussion, GNers. Please keep it up.
I agree NotToOld. The man CW, the scientists, the government the vaccine companies, the technology etc.

The mix and match may work. But it may not. Really they should keep data of this experiment on the British public. And people should have the choice to consent to it. That is basic medical ethics.

If this little experiment does lead to vaccine resistance (which the 12 week gap and possibly the mix and match approach) increases the risk of then we are not going to be popular with the rest of the world.

The reason I am concerned they may not keep the data is that one reason for mixing and matching is if the first dose is unknown. It should not be unknown - it should be recorded fgs!

Nezumi65

From the Read paper you linked to the key concept is this: Resistance mutations are less likely to appear in small populations (7), and when such mutations appear and confer partial resistance within a host, they are unlikely to replicate to the large population sizes that are associated with onward transmission

The issue we have here is changing the dosing regime increases the risk of larger population sizes & onward transmission. So you are removing one of the safety features.

It wouldn’t be so dangerous fiddling with the regime in NZ because there is zero community transmission - here we have rampant community transmission.

Anyway experiments on all fronts.

I misunderstood you. I thought you meant the kind of resistance which occurs with antibiotics.

Nezumi65

The reason I am concerned they may not keep the data is that one reason for mixing and matching is if the first dose is unknown. It should not be unknown - it should be recorded fgs!

The JVCI in the UK has just announced that it's unacceptable to give people two different vaccines. That's going to cause problems because there's a global shortage of the Pfizer vaccine, which is what people in the UK have been given.

It won't work Whitewave.

GagaJo

growstuff

The Oxford/Astra Zeneca and Pfizer vaccinations work in very different ways.

I agree with you Greeneyedgirl. It seems to me that once again the government over-promised and is determined to hit its target for political/PR reasons, rather than listening to what Pfizer is saying.

It is so depressing. We have the tool to get us out of this mess and our government is taking unnecessary risks.

I definitely thought medics should get the first vaccines. BUT now that they have been given, we should not waste them simply for political spin, but should go ahead with the 2nd dose as planned.

I'm not sure that there are enough doses left for a second dose. I still can't find any definitive details of Pfizer deliveries.

It is the same growstuff. It is just less likely to happen with vaccines. It happens with chemotherapy as well.
I’ve just discovered that Andrew Read (who is a bit of a hero of mine ) has written about monitoring resistance in Covid vaccinations here:

journals.plos.org/plosbiology/article?id=10.1371/journal.pbio.3001000

This is the key line from that paper Strongly suppressing pathogen transmission through vaccinated hosts is key to preventing the spread of partial resistance should it arise, since it reduces the opportunities for selection to act

And that’s the bit that meddling with the gap between doses (& possibly mixing and matching, I’m less clear on that in this specific case) messes with.

If there was more transparency from the government in their decision making with regard to vaccine usage and availability I think the public would have more confidence in them, and may even be sympathetic. I don’t want to hear any more silliness such as the cavalry coming over the hill.

I also think the MHRA should publish their evidence for apparently authorising the new Pfizer regime.

Not sure if this is old news on here but both Pfizer and AZ now say (lunchtime news) that there are no hold-ups on delivery of either of these vaccines. So why is Chris Whitty reported as saying there are hold-ups and, apparently, giving that as a reason for the one-jab policy? Could it be there is a shortage of staff to give the vaccines? Potential volunteers on GN and other places have reported the general bureaucracy surrounding applications to volunteer. I smell a few rats.
I agree that the MHRA should publish their evidence for authorising the new Pfizer regime.