Thanks for your continuous work on this news letter! It is very informative.
I am European, more specifically Dane located in London. The big story over the last two weeks on mainland Europe has been AZ and the risk for blood clots. Here is a small article from BBC about it: https://www.bbc.co.uk/news/world-europe-56440139 It has not been covered much in the UK news compared to the Danish news. I am wondering if these press stories might have influenced AZ release of preliminary data?
There is still no more blood clots in the people that got AZ compared to the once that did not. The main concern is that the blood clots in question have an unusual combination of symptoms (blood clots, haemorrhages and low platelet counts). If this is related to the AZ vaccine it is very rare and I would still take the AZ jab if I was offered. For me the benefit outweighs the possible risk.
"AstraZeneca is an extremely well-established pharmaceutical company that really ought to know better." Not to mention, you know, their partners at the University of Oxford. I'm not in your field, but I hear their rep is pretty impressive.
I actually get my own first dose on Friday. (I've been fanatically isolating for the past week, because the last thing I want to do is the ending of a war movie, where someone gets killed two days before peace is declared.) I also delayed a while despite a comorbidity because I'm lucky enough to be able to work from home.
Something I read last week, I believe in Nature, that surprised me: the AZ half-dosing mess was also a timing mess. The people who initially got a half-dose of the vaccine also had a longer wait between doses than was specified by the protocol, and at least some researchers think that this longer wait was responsible for the improved effectiveness. Yet another protocol breach, but an interesting effect if it's real--there have also been reports that other vaccines continue to have strengthening effects for several weeks after the arbitrary cutoff point set by study protocols.
You're the expert, but to me that implies that booster shots, should they be required, will be quite effective.
I think you're kind of missing the point on RaDVaC.
RaDVaC was put together by people with the appropriate expertise applying reasonable design criteria, and it uses a delivery mechanism that is (as far as I know) incredibly difficult to render unsafe. So I'd ballpark a 10% chance that it does work, and a 1% or less chance that using it could hurt you.
A 10%-chance effective (but almost certainly safe) vaccine is pretty crummy, but you can't evaluate that in a vacuum - you have to compare it to what the regulated pharma pipeline has produced, which is, for me, a 34-year-old healthy male in the United States, no vaccine whatsoever so far. And there's not a lot of reason to believe that the existing system would move any faster for a variant that evaded existing vaccines. Given that situation, I think "take your chances with RaDVaC (assuming they updated it to address emerging strains)" is far from a stupid move.
You correctly point out that RaDVaC isn't produced according to modern pharmaceutical standards, but I think this is not an especially compelling objection. The impossible-to-homebrew part (peptide synthesis) is handled by firms with the specialized equipment to do it, and there's no strong reason to think that they'd fail to do their job. And I think you overstate the extent to which careful production controls are strictly necessary, even for products that are complex mixes of large organic molecules: as far as I know, smallpox vaccination ~100 years ago involved individual pharmacists just kinda getting vaccinia preparations from a catalog and mixing them up in the kitchen, so to speak. I doubt that this would pass modern regulatory scrutiny, and yet it worked well enough.
At a high level, I think the level of care our civilization has taken around COVID-19 vaccines is striking the wrong cost-benefit tradeoff in the face of a disease that's killing thousands of people every day.
Thanks for your continuous work on this news letter! It is very informative.
I am European, more specifically Dane located in London. The big story over the last two weeks on mainland Europe has been AZ and the risk for blood clots. Here is a small article from BBC about it: https://www.bbc.co.uk/news/world-europe-56440139 It has not been covered much in the UK news compared to the Danish news. I am wondering if these press stories might have influenced AZ release of preliminary data?
There is still no more blood clots in the people that got AZ compared to the once that did not. The main concern is that the blood clots in question have an unusual combination of symptoms (blood clots, haemorrhages and low platelet counts). If this is related to the AZ vaccine it is very rare and I would still take the AZ jab if I was offered. For me the benefit outweighs the possible risk.
Keep up the good work :D
"AstraZeneca is an extremely well-established pharmaceutical company that really ought to know better." Not to mention, you know, their partners at the University of Oxford. I'm not in your field, but I hear their rep is pretty impressive.
I actually get my own first dose on Friday. (I've been fanatically isolating for the past week, because the last thing I want to do is the ending of a war movie, where someone gets killed two days before peace is declared.) I also delayed a while despite a comorbidity because I'm lucky enough to be able to work from home.
Something I read last week, I believe in Nature, that surprised me: the AZ half-dosing mess was also a timing mess. The people who initially got a half-dose of the vaccine also had a longer wait between doses than was specified by the protocol, and at least some researchers think that this longer wait was responsible for the improved effectiveness. Yet another protocol breach, but an interesting effect if it's real--there have also been reports that other vaccines continue to have strengthening effects for several weeks after the arbitrary cutoff point set by study protocols.
You're the expert, but to me that implies that booster shots, should they be required, will be quite effective.
I think you're kind of missing the point on RaDVaC.
RaDVaC was put together by people with the appropriate expertise applying reasonable design criteria, and it uses a delivery mechanism that is (as far as I know) incredibly difficult to render unsafe. So I'd ballpark a 10% chance that it does work, and a 1% or less chance that using it could hurt you.
A 10%-chance effective (but almost certainly safe) vaccine is pretty crummy, but you can't evaluate that in a vacuum - you have to compare it to what the regulated pharma pipeline has produced, which is, for me, a 34-year-old healthy male in the United States, no vaccine whatsoever so far. And there's not a lot of reason to believe that the existing system would move any faster for a variant that evaded existing vaccines. Given that situation, I think "take your chances with RaDVaC (assuming they updated it to address emerging strains)" is far from a stupid move.
You correctly point out that RaDVaC isn't produced according to modern pharmaceutical standards, but I think this is not an especially compelling objection. The impossible-to-homebrew part (peptide synthesis) is handled by firms with the specialized equipment to do it, and there's no strong reason to think that they'd fail to do their job. And I think you overstate the extent to which careful production controls are strictly necessary, even for products that are complex mixes of large organic molecules: as far as I know, smallpox vaccination ~100 years ago involved individual pharmacists just kinda getting vaccinia preparations from a catalog and mixing them up in the kitchen, so to speak. I doubt that this would pass modern regulatory scrutiny, and yet it worked well enough.
At a high level, I think the level of care our civilization has taken around COVID-19 vaccines is striking the wrong cost-benefit tradeoff in the face of a disease that's killing thousands of people every day.