One more piece I was a little surprised you didn't mention, but which makes a lot of sense to me about variants and dosage: both Pfizer and Moderna are only barely less effective at full immunization* but both have been mentioned to have a much smaller (1/4?) neutralizing antibody response to certain VOC then they do to Covid Classic. Just they already had such a huge immune response that it was still enough. So if Curevac wasn't starting with anywhere near as huge and immune response then I could see it mattering a lot more that the VOCs were pretty much everything it was dealing with.
(Another bit that informs my query here is that some of the initial data from Hopkins' research with transplant patients seem to be that Moderna, with three times the genetic material, was somewhat more likely to produce spike antibodies than Pfizer. (They've just published something about a third dose, mix and match, seeming helpful for these immune compromised patients but I have not looked at it and that's attention anyway))
Am I off base on this, or would embracing the power of And (less mRNA -> less good at variants b/c less NA) be the rest of the story?
* Or after one dose for everybody but Delta so far, but Delta was at around 30ish percent for one dose of Pfizer or AZ; haven't seen the data for Moderna
My impression was that most of the VRBPAC members recognized at least some need to vaccinate young children, but expressed concerns about whether the safety and efficacy data will be enough to permit authorization later this year. It seems to me, though, that increasing the follow-up time wouldn't be particularly helpful (Paul Offit said the same in the meeting); and increasing the size of the trial to the point where it could detect rare safety signals would take an untenably long time.
An interesting question hung over the meeting, which is whether we should consider just direct costs vs. benefits to individual patients, or also factor in the benefits to the wider society. I favor the latter position, but I also don't think you need to do so in order to support vaccination of kids under 12. It may not have been clear a year ago that the short- medium- and potential long-term effects of the virus are a very significant danger to people in every age group, but it absolutely is now.
I'm pretty embarrassed by my off-the-cuff reaction to the missing numerator from Indonesia.
One thing I didn't notice in the article: CureVac's vaccine uses unmodified mRNA. Moderna and Pfizer make vaccines that contain nucleoside-modified mRNA. This might be in some way responsible for the apparent difference in effect. At least, I'd like to hear your opinion.
One more piece I was a little surprised you didn't mention, but which makes a lot of sense to me about variants and dosage: both Pfizer and Moderna are only barely less effective at full immunization* but both have been mentioned to have a much smaller (1/4?) neutralizing antibody response to certain VOC then they do to Covid Classic. Just they already had such a huge immune response that it was still enough. So if Curevac wasn't starting with anywhere near as huge and immune response then I could see it mattering a lot more that the VOCs were pretty much everything it was dealing with.
(Another bit that informs my query here is that some of the initial data from Hopkins' research with transplant patients seem to be that Moderna, with three times the genetic material, was somewhat more likely to produce spike antibodies than Pfizer. (They've just published something about a third dose, mix and match, seeming helpful for these immune compromised patients but I have not looked at it and that's attention anyway))
Am I off base on this, or would embracing the power of And (less mRNA -> less good at variants b/c less NA) be the rest of the story?
https://yourlocalepidemiologist.substack.com/p/vaccine-table-update-june-4-2021 is where I'm getting the 1/4.
* Or after one dose for everybody but Delta so far, but Delta was at around 30ish percent for one dose of Pfizer or AZ; haven't seen the data for Moderna
My impression was that most of the VRBPAC members recognized at least some need to vaccinate young children, but expressed concerns about whether the safety and efficacy data will be enough to permit authorization later this year. It seems to me, though, that increasing the follow-up time wouldn't be particularly helpful (Paul Offit said the same in the meeting); and increasing the size of the trial to the point where it could detect rare safety signals would take an untenably long time.
An interesting question hung over the meeting, which is whether we should consider just direct costs vs. benefits to individual patients, or also factor in the benefits to the wider society. I favor the latter position, but I also don't think you need to do so in order to support vaccination of kids under 12. It may not have been clear a year ago that the short- medium- and potential long-term effects of the virus are a very significant danger to people in every age group, but it absolutely is now.
I'm pretty embarrassed by my off-the-cuff reaction to the missing numerator from Indonesia.
One thing I didn't notice in the article: CureVac's vaccine uses unmodified mRNA. Moderna and Pfizer make vaccines that contain nucleoside-modified mRNA. This might be in some way responsible for the apparent difference in effect. At least, I'd like to hear your opinion.