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Texas Jeff

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Any info on Moderna efficacy against the South African variant?

No real world definitive example but lab studies seem to indicate that there’s a drop in antibodies, but not to the point that it isn’t protective. So you could see a slight drop in efficacy but it’s far from neutered. And likely still very protective in terms of severe disease.
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Houston had to toss some vaccine doses because they couldn’t get them stored. Expect statewide vaccinations to be basically zero this week and for the impact to linger with regards to second doses appointments. This weather and power event is going to be a big setback nationwide.

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56 minutes ago, gmr548 said:

Houston had to toss some vaccine doses because they couldn’t get them stored. Expect statewide vaccinations to be basically zero this week and for the impact to linger with regards to second doses appointments. This weather and power event is going to be a big setback nationwide.

Also, expect transmission of the virus to be limited because Texas is shut down due to weather probably even more than last April.

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3 minutes ago, wild_turkey said:

I'm curious what effect this winter storm is having on vaccine efforts. Hopefully there aren't a lot of doses going to waste due to interruptions in supply change, storage, clinic schedules, etc.

I assume all of that to be true, but also what Sizzle gets at.  We basically have 3-4 days of shelter in place in centex right now that should drive down transmission in short term. 

 

 

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1 hour ago, wild_turkey said:

I'm curious what effect this winter storm is having on vaccine efforts. Hopefully there aren't a lot of doses going to waste due to interruptions in supply change, storage, clinic schedules, etc.

 

I guess we're going to find out pretty quickly whether the bottleneck is supply or distribution now. In theory, assuming we lose all of this week, we should have both this week and next week's allocations available whenever it thaws out. So hopefully we'll just catch up quickly. 

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Also, expect transmission of the virus to be limited because Texas is shut down due to weather probably even more than last April.

I assume all of that to be true, but also what Sizzle gets at.  We basically have 3-4 days of shelter in place in centex right now that should drive down transmission in short term. 
 
 

Probably so on net, but you’ve also got plenty of people looking to stay with friends and family with power and water. It’s a setback at things considered. Not a world ending one, but with potential to alter the timeline in a nontrivial way depending on how many doses are tossed and how we’re able to recover in the coming weeks.
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I guess we're going to find out pretty quickly whether the bottleneck is supply or distribution now. In theory, assuming we lose all of this week, we should have both this week and next week's allocations available whenever it thaws out. So hopefully we'll just catch up quickly. 

That assumes that doses are not spoiled by lack of refrigeration during the power outages. It would be nice if major cities could implement regional collection efforts to round up vaccines that are at risk and move them to hospitals or wherever. Maybe that’s already happening or maybe refrigeration failure isn’t actually a problem right now.
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My appointment for today was rescheduled for Friday. Still at Kelly Reeves. Imagine it’ll still be cold AF since I heard they were giving the shots in tents outdoors.

Yeah I doubt that’s happening. I’m due for my 2nd shot next week and haven’t seen anything about an appointment.
Also all the supply shipments were on hold due to inclement weather.
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29 minutes ago, texhorn said:


Yeah I doubt that’s happening. I’m due for my 2nd shot next week and haven’t seen anything about an appointment.
Also all the supply shipments were on hold due to inclement weather.

Got a message yesterday that they rescheduled it for Monday. Looking at the forecast, that should happen...assuming electricity is back on by then.

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Have a friend who got Moderna dose 1 on Monday at a CVS in college station.  Drove through the ice / snow to get there, system down at location when she arrived but they gave her the shot.  Then yesterday she gets an email that her dose 2 appointment set for mid March has been cancelled. No other explanation.  She called the location who passed her to the national CVS number.  The national CVS number passed her to the CVS Covid hotline who told her "sorry but all appointments are booked, but that new appointments might open between now and then. Good luck."

Anybody have ideas of other ways to address this?  Anybody have a CVS hookup that might get a better response than "sorry and good luck"?

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6 minutes ago, orange dream said:

Have a friend who got Moderna dose 1 on Monday at a CVS in college station.  Drove through the ice / snow to get there, system down at location when she arrived but they gave her the shot.  Then yesterday she gets an email that her dose 2 appointment set for mid March has been cancelled. No other explanation.  She called the location who passed her to the national CVS number.  The national CVS number passed her to the CVS Covid hotline who told her "sorry but all appointments are booked, but that new appointments might open between now and then. Good luck."

Anybody have ideas of other ways to address this?  Anybody have a CVS hookup that might get a better response than "sorry and good luck"?

Please enter your cvs number or phone number for the answer.  

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Some good news for a change. This means that you can basically operate as "fully vaccinated" three weeks after your first shot.

https://www.ctvnews.ca/health/coronavirus/canadian-researchers-say-pfizer-vaccine-s-second-dose-can-be-delayed-as-first-is-highly-effective-1.5313926

 

 

The second dose of Pfizer Inc's COVID-19 vaccine could be delayed in order to cover all priority groups as the first one is highly protective, two Canada-based researchers said in a letter published in the New England Journal of Medicine.

The vaccine had an efficacy of 92.6% after the first dose, Danuta Skowronski and Gaston De Serres said, based on an analysis of the documents submitted by the drugmaker to the U.S. Food and Drug Administration (FDA).

These findings were similar to the first-dose efficacy of 92.1% reported for Moderna Inc's mRNA-1273 vaccine, according to the letter on Wednesday.

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Got a message yesterday that they rescheduled it for Monday. Looking at the forecast, that should happen...assuming electricity is back on by then.

Got an email a little while ago that my 2nd dose appointment at FHS, which should have been M next week, will be pushed to Th-F-Sa of next week. Have not received any sort of confirmation or option to schedule otherwise.
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https://www.bloomberg.com/news/articles/2021-02-18/how-many-vaccine-doses-are-available-u-s-should-see-a-surge
 

Chart in the article shows total number of Americans fully vaccinated crossing the 300M mark in May.

I doubt there is any significant number of covid hospitalizations after mid-April, as I think 150M is when we will start to see the virus have a hard time finding high-risk hosts, even without other safety measures in place.  Thank god for these vaccines.

Edited by Snake Diggity
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https://www.bloomberg.com/news/articles/2021-02-18/how-many-vaccine-doses-are-available-u-s-should-see-a-surge
 
Chart in the article shows total number of Americans fully vaccinated crossing the 300M mark in May.
I doubt there is any significant number of covid hospitalizations after mid-April, as I think 150M is when we will start to see the virus have a hard time finding high-risk hosts, even without other safety measures in place.  Thank god for these vaccines.
You and me are diamond handsing "normal by memorial day" all the way.

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Some good news for a change. This means that you can basically operate as "fully vaccinated" three weeks after your first shot.
https://www.ctvnews.ca/health/coronavirus/canadian-researchers-say-pfizer-vaccine-s-second-dose-can-be-delayed-as-first-is-highly-effective-1.5313926
 
 

The second dose of Pfizer Inc's COVID-19 vaccine could be delayed in order to cover all priority groups as the first one is highly protective, two Canada-based researchers said in a letter published in the New England Journal of Medicine.

The vaccine had an efficacy of 92.6% after the first dose, Danuta Skowronski and Gaston De Serres said, based on an analysis of the documents submitted by the drugmaker to the U.S. Food and Drug Administration (FDA).

These findings were similar to the first-dose efficacy of 92.1% reported for Moderna Inc's mRNA-1273 vaccine, according to the letter on Wednesday.


If that data holds, the second dose becomes basically obsolete.
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This analysis was not a separate study.  Just a different statistical breakdown of the data (these folks need to publish).  So, only another clinical trial will tell you more clearly if a single shot works.  I believe Pfizer and Moderna both have 6 months post blood collection to check antibody levels.  We don't have that data yet.  Theoretically, the second shot is supposed to boost protection and make it sustainable over a longer period of time.

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Yeah, I don't think that makes the second shot obsolete. As Sizzle indicates, unfortunately neither PFE or MRNA studied a single shot regimen. And in reality we don't really know what the durability of the two shot regimen is going to be, much less a one shot regimen. What that analysis suggests however, at least to me, is that there does appear to be a good measure of protection afforded as early as a few weeks after the first dose. That indication is consistent in both that reanalysis of the PFE data (granted its just a letter) and the MRNA study where they actually did an analysis among people that only received one dose. The events rates are small, so the estimates are not particularly stable, but it's fairly consistent (92.6% and 92.1%, respectively).  What this suggests to me is that there is likely a substantial protection a couple weeks after first dose, and we have some flexibility if necessary around the timing of the booster dose if supply is constrained.  Bottom line imo, get as many shots in arms as quickly as possible, manage the supply chains for second dose, but don't be inflexibly dogmatic about the 3/4 week timing and holding reserves back. If the supply chain is a little bumpy and you get pushed out a few weeks, or if your 2nd shot appointment gets pushed out because snowpacalypse now, it will be fine and you are better off for having that first shot in your arm. 

Edited by Anastasis
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Yeah, I don't think that makes the second shot obsolete. As Sizzle indicates, unfortunately neither PFE or MRNA studied a single shot regimen. And in reality we don't really know what the durability of the two shot regimen is going to be, much less a one shot regimen. What that analysis suggests however, at least to me, is that there does appear to be a good measure of protection afforded as early as a few weeks after the first dose. That indication is consistent in both that reanalysis of the PFE data (granted its just a letter) and the MRNA study where they actually did an analysis among people that only received one dose. The events rates are small, so the estimates are not particularly stable, but it's fairly consistent (92.6% and 92.1%, respectively).  What this suggests to me is that there is likely a substantial protection a couple weeks after first dose, and we have some flexibility if necessary around the timing of the booster dose if supply is constrained.  Bottom line imo, get as many shots in arms as quickly as possible, manage the supply chains for second dose, but don't be inflexibly dogmatic about the 3/4 week timing and holding reserves back. If the supply chain is a little bumpy and you get pushed out a few weeks, or if your 2nd shot appointment gets pushed out because snowpacalypse now, it will be fine and you are better off for having that first shot in your arm. 


I really wish the media and the PR folks for these companies would put their severe illness numbers forward more prominently.

If we knew that both the 1 and 2 shot regimens are 99% against severe illness then that's even more of a game changer than what we're already learning. I don't know about the rest of you, but I don't really give a shit if I get Covid and have the sniffles for a few days. I just don't want me or my wife to end up in the hospital or worse.
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13 minutes ago, BradInATX said:

I really wish the media and the PR folks for these companies would put their severe illness numbers forward more prominently.

If we knew that both the 1 and 2 shot regimens are 99% against severe illness then that's even more of a game changer than what we're already learning. I don't know about the rest of you, but I don't really give a shit if I get Covid and have the sniffles for a few days. I just don't want me or my wife to end up in the hospital or worse.

Yeah, I totally agree.  The event rates for severe illness and death in particular are way low in the interim analyses from PFE and MRNA. IIRC, there were no deaths (or maybe only 1 death) in the interim analysis for both PFE and MRNA across both active and control. FWIW, MRNA reports severe illness as a secondary endpoint 14 days post 2nd dose in Table 14 of their filing (11 adjudicated cases + 4 more that couldn't be adjudicated in time for the filing, all in the placebo group). If they would have powered the study to those endpoints, the necessary sample size would have been untenable. But yeah, those are the real meaningful clinical outcomes. So they have to lead the PR and the FDA filings with the primary endpoint, and at best put those other data points out as supplementary. But almost everything that we have seen wrt severe illness out of all of the trials, including JNJ, is very promising. 

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https://www.pfizer.com/news/press-release/press-release-detail/pfizer-and-biontech-submit-covid-19-vaccine-stability-data

 

 

Quote

PFIZER AND BIONTECH SUBMIT COVID-19 VACCINE STABILITY DATA AT STANDARD FREEZE TEMPERATURE TO THE U.S. FDA

Friday, February 19, 2021 - 07:00am 
EST

NEW YORK and MAINZ, GERMANY, February 19, 2021 — Pfizer Inc. (NYSE: PFE) and BioNTech SE (Nasdaq: BNTX) today announced the submission of new data to the U.S. Food and Drug Administration (FDA) demonstrating the stability of their COVID-19 vaccine when stored at -25°C to -15°C (-13°F to 5°F), temperatures more commonly found in pharmaceutical freezers and refrigerators. The data have been submitted to the FDA to support a proposed update to the U.S. Emergency Use Authorization (EUA) Prescribing Information, which would allow for vaccine vials to be stored at these temperatures for a total of two weeks as an alternative or complement to storage in an ultra-low temperature freezer.


 

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12 hours ago, Anastasis said:

Yeah, I totally agree.  The event rates for severe illness and death in particular are way low in the interim analyses from PFE and MRNA. IIRC, there were no deaths (or maybe only 1 death) in the interim analysis for both PFE and MRNA across both active and control. FWIW, MRNA reports severe illness as a secondary endpoint 14 days post 2nd dose in Table 14 of their filing (11 adjudicated cases + 4 more that couldn't be adjudicated in time for the filing, all in the placebo group). If they would have powered the study to those endpoints, the necessary sample size would have been untenable. But yeah, those are the real meaningful clinical outcomes. So they have to lead the PR and the FDA filings with the primary endpoint, and at best put those other data points out as supplementary. But almost everything that we have seen wrt severe illness out of all of the trials, including JNJ, is very promising. 

There should be more transparency in the severe illness numbers, but some anecdotal information I heard recently is demonstrating that these vaccines are shutting down the virus completely (in work environments where exposure to the public is high and rigorous COVID-19 testing protocols are in place).  So, I can see why we haven't seen some of this data yet, because there may not be any.  Not trying to over-simplify this, but this could well be the reality.

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@WhatTheBuck

Clarification on the mutation comment - 

Broadly, it circulates in pigs and chickens in China and whatever strain emerges is some combo of H and N strains. Say there are 5 strains of each. That's 25 possible combos. It's essentially a new species every year. I think it's less mutation and more recombination. And the annual evolution within an animal reservoir is key. A reservoir that has 100% fatality rate every year. 

Every chicken and pig dies before they are 1 year old.

Except the broodstock but that's a tiny percentage, so every year there's a clean slate to make a new influenza A.

 

There is no such mechanism/reservoir in SARS-CoV-2

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[mention=1330]WhatTheBuck[/mention]
Clarification on the mutation comment - 
Broadly, it circulates in pigs and chickens in China and whatever strain emerges is some combo of H and N strains. Say there are 5 strains of each. That's 25 possible combos. It's essentially a new species every year. I think it's less mutation and more recombination. And the annual evolution within an animal reservoir is key. A reservoir that has 100% fatality rate every year. 
Every chicken and pig dies before they are 1 year old.
Except the broodstock but that's a tiny percentage, so every year there's a clean slate to make a new influenza A.
 
There is no such mechanism/reservoir in SARS-CoV-2

Spoken like someone who hasn’t eaten/fucked a bat.

Like we believe you.
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@WhatTheBuck

To get better numbers I did some reading. It's actually 18x11=198 possible combos although far fewer are known to exist (but the doomsday scenario is a novel combo emerging) New strains generally start in wild birds then jump to chickens then jump to pigs then to humans. There is a fair amount of mutation within a strain as well. There's just way more diversity and way more opportunity for change in influenza A. Rona unlikely to have such complicated dynamics - it's animal reservoirs (bats, minks) are minimal and less likely to harbor it long enough to allow a new strain to develop and then jump. And it's structure is not prone to recombination/reassortment. Man is the main reservoir. Which means we'll adapt to it via natural selection if we didn't have the vaccine.

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On 2/18/2021 at 1:49 PM, BradInATX said:

Some good news for a change. This means that you can basically operate as "fully vaccinated" three weeks after your first shot.

https://www.ctvnews.ca/health/coronavirus/canadian-researchers-say-pfizer-vaccine-s-second-dose-can-be-delayed-as-first-is-highly-effective-1.5313926

 

 

The second dose of Pfizer Inc's COVID-19 vaccine could be delayed in order to cover all priority groups as the first one is highly protective, two Canada-based researchers said in a letter published in the New England Journal of Medicine.

The vaccine had an efficacy of 92.6% after the first dose, Danuta Skowronski and Gaston De Serres said, based on an analysis of the documents submitted by the drugmaker to the U.S. Food and Drug Administration (FDA).

These findings were similar to the first-dose efficacy of 92.1% reported for Moderna Inc's mRNA-1273 vaccine, according to the letter on Wednesday.

This study in Israel is 75% effective, 85% at symptoms (the delta is asymptomatic infection) after one shot:

https://www.reuters.com/article/health-coronavirus-israel-vaccine/israeli-study-finds-pfizer-vaccine-85-effective-after-first-shot-idUSL8N2KO72J

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This study in Israel is 75% effective, 85% at symptoms (the delta is asymptomatic infection) after one shot:
https://www.reuters.com/article/health-coronavirus-israel-vaccine/israeli-study-finds-pfizer-vaccine-85-effective-after-first-shot-idUSL8N2KO72J
That's still pretty strong. And that's a pretty rudimentary study. They needed to control or attempt to adjust for Covid prevalence at the time of the before and after parts of the studies.

Sounds like they didn't at all: "But she also noted that the Sheba study took place during a surge in COVID-19 infections in Israel, which flooded hospitals with new cases."

So if they compared infection incidence in the last month or so (mid-spike) to pre-vaccine (less community spread), then it's going to be underselling efficacy.

All good news IMO.
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Texas Week 11 is out.  Welcome to Texas, FEMA...

https://www.dshs.state.tx.us/news/updates/COVIDVaccineAllocation-Week11.pdf

FEMA will be setting up sites at Jerry World, Fair Park, and NRG Stadium.  42k doses for DFW, 42K for Houston.

UT and Seton getting more allocation in Austin, along with some other non-APH sites.

Shots at Fair Park cost 10 tickets and come with a fried item of your choice.

 

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