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

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 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/

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.

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.

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

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.

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.

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.

Thankyou Growstuff ?

Dorsetcupcake Frontline health workers are in the second group to be vaccinated, just after care home residents in staff. That makes absolute ethical and organisational sense to me because care home residents are still the group most likely to die. They are also the group most likely to be hospitalised and needing one-to-one care.

"JCVI advises that the first priorities for the COVID-19 vaccination programme should be the prevention of mortality and the maintenance of the health and social care systems. As the risk of mortality from COVID-19 increases with age, prioritisation is primarily based on age."

In reality some health workers have been vaccinated before care home residents as a result of the logistical problems in getting the vaccine to care home residents.

I still have a contract with a care home,although I'm not actively working for them at the moment. In December permission forms were sent out regarding the vaccine. I completed them but wasnt sure if I would take up the offer as it felt wrong as I wasnt actively working there.
Initially I was a little wary of the vaccine. I then felt it was safe but wondered if the governments roll out would be as effective as everything else they have done in this pandemic.
The current situation really worries me. Maybe they are vaccinating care homes/over 80s first as most at risk group. Surely with the current stress the NHS is under frontline medical workers should also be vaccinated?
If I really wanted to I could go to my care home as documentation for vaccine is being handed out. I'm following my gut instinct and waiting.
This governments love of positive soundbites then disappearing whilst it all goes pear shaped is genuinely worrying. All be ok by Spring! Spring 2022 if we are lucky.
They have shown precious little real concern for vulnerable groups since March. Most promises made to care homes have not been fulfilled.
I just dont trust them. If JVT doesnt appear its probably because he refuses to bend the truth or lie by omission.

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.

Scientists elsewhere are pretty agog WW. Make no mistake - this is turning the U.K. into one big experiment, not just on effectiveness of single doses but also on mixing doses & more technically on viral evolution & selection pressures (& that last is far more reckless than leaving people not properly covered, but I have no confidence they even understand why it is so risky).

If nothing else I can’t believe so little has been learned about public confidence in vaccination in the last 20 years. You just cannot have people consent to a clinical treatment then change it to an experiment.

The £10 won’t begin to cover changing all the appointments already booked either. GP’s were struggling with what they had been asked to do anyway - this will push them over the edge.

This

“By denying people their second vaccine dose, the UK government has tricked them into taking a drug in an unlicensed, untested way. It risks the UK incubating a vaccine resistant mutation. All for the sake of optics. It is a new low. And that's really saying something.”

Are they doing this anywhere else in the world?

How about our nearest neighbours? European countries, are they taking this risk?

Pfizer have stated that it won’t work. It only gives 3 weeks immunity and rapidly reduces. The whole thing has been set up to give 2 injections.

This is back of a fag packet stuff.

And it's the most vulnerable, along with care staff, who are the guinea pigs.

lemongrove

I think that what they say makes sense and gets more people vaccinated quickly.
The first dose is the important one( in terms of percentage)
Efficacy.

What's the efficacy of a single dose? Where's the data?

Who claimed the first dose is the important one?

In any case the people waiting for their second dose have not consented to take part in a trial so ethically it stinks.

Yes it does.

I’m sure fear of something like this is exactly why some people are not jumping to get in the queue.

It’s really so poorly planned out, that it couldn’t look worse if they tried.

Urmstongran

I like Professor VT best - he’s a great communicator.

I’m just amazed that GP ‘s are to be paid a tenner (yes £10) for each vaccination they perform! The vaccine itself only cost £3,50 and when you think of all the research by the scientists to deliver it too.

Also volunteer vaccinators are to be paid £25 per day for their services. A retired nurse said she had volunteered - not expecting to be paid at all!

Why are you amazed at Gp surgeries being paid £10 per vaccine? Let's look at what's involved in setting up vaccination clinics. Bear in mind they are doing this ON TOP of everything else they are doing.
So, you need reception and admin to identify vulnerable patients, to book appointments, update medical records, manage waiting areas.
You need extra Docs, nurses and trained staff to draw up, administer and supervise the process of vaccination.
You need extra auxiliary staff to clean between each client.
You need extra PPE
That's just off the top of my head. I'm sure there's a lot of other tasks associated, especially paperwork of all kinds that are part of the service.
It's not as though this is a tenner being slipped into the GP's back pocket for every client jabbed.
I doubt it's even cost neutral when all is said and done.

It introduces a selection pressure into a partially immunised population.

This is not necessarily sensible. It depends how much transmission is taking place - something that is not yet known. Partly why a number of people who work in viral evolution are standing back watching what happens in a somewhat horrified way.

If you want some idea of the issues of viral evolution in response to vaccination google Andrew Read’s work. I haven’t seen his take on this (have seen others who work in the field) but he writes widely about pathogen evolution & vaccination & a lot of his work is quite accessible.

They are also now talking about mixing and matching vaccinations which also may not he wise.

In any case the people waiting for their second dose have not consented to take part in a trial so ethically it stinks.

I think that what they say makes sense and gets more people vaccinated quickly.
The first dose is the important one( in terms of percentage)
Efficacy.

If they’re right about 90% immunity they may be all right - typo