Results for “astrazeneca” 93 found
Those reckless, reckless British, moving to a “first shot” strategy
The UK will move to a “first shot” strategy. The priority will be to give at-risk groups one shot of vaccine, even if it means delaying the second dose. That’s a massive change of strategy.
Here is further information. And here, via Peter Whittaker. C’mon American public health establishment get your act together, I don’t see that very many of you have had the stones to endorse such a change.
Friday assorted links
1. Using K-Pop to teach economics.
2. Redux of my April 4 post on tethered pairs.
4. Long blog post on DeepMind and protein folding, interesting throughout, but the most interesting section is toward the end on why DeepMind outperformed academic groups.
5. To be clear, I don’t know the answer, but why is no one even asking: “Can’t we just use the Sanofi vaccine on the young people only?” Is it that the answer is so obvious? Or is there excess confomism in this sphere? Is this simply the “this would cause the public to lose confidence in vaccines” mantra, an increasingly under-theorized and unsatisfactory substitute for an actual answer? (Would it even get a “B-” on an undergraduate, upper division psychology term paper or honors thesis?) Inquiring minds wish to know.
5b. And AstraZeneca is testing together with Russian options. Still an open question, but I’ve been saying that the Russian vaccine is underrated.
6. Good evidence for an Italian case of Covid in early December 2019.
Thursday assorted links
India vaccine markets in everything
Doses of the coronavirus vaccine developed by AstraZeneca and the University of Oxford could be available for purchase in India as soon as March, according to one manufacturer, in the first sign that the sought-after jab will make its way on to the private market.
Serum Institute of India, the world’s largest vaccine manufacturer, has a licence to produce the shot and has already manufactured 40m doses. Once the job is approved for use, Serum will initially supply the Indian government but then expects to sell 20m-30m doses to private facilities, according to Adar Poonawalla, chief executive.
“Everybody’s asking ‘When can I access the vaccine?’ I’ve told those guys it’s probably going to be March or April,” Mr Poonawalla told the Financial Times.
…the future availability of vaccines for sale privately in other countries, such as India, increases the likelihood of a secondary market developing for vaccines where locals or foreign visitors could pay for a vaccination if not eligible to be inoculated under their own government’s scheme.
Here is the full FT article, via J., the price is expected to be around eight dollars.
Why we should be optimistic about various vaccines
I’ve been a long-time reader of your blog, and I have enjoyed your analyses of how the pandemic could play out in the US.
I saw that you gave some space to Arnold Kling’s pessimistic take on the vaccines. I’m a volunteer in the J&J Phase 3 vaccine trial, and my experience of the trial design makes me more optimistic about the vaccines than even the headline numbers in the so-far announced trials would suggest. I think the trial set-ups particularly for J&J have some biases that would lead to understated effectiveness results:
First, these trials are effectively unblinded. The placebos are saline solution in J&J, AstraZeneca, Pfizer and Moderna. Per the Phase 2 results for J&J, >60% of participants had significant side effects, with flu-like symptoms the most common; I believe other vaccine trials had similarly intense side effects. When I got a shot, I was nearly bedridden for 24 hours; it felt as if I had the flu, and the effect was far more pronounced than for any other vaccine I’ve had. If I got the placebo, I need a psychotherapist. Though I plan to remain generally responsible and not take too many incremental risks, given I’m only mostly sure I got a vaccine that is still unproven, I’m sure my assumption that I’ve been vaccinated will influence my behavior, and the behavior of anyone else who has had significant side effects from their injection too.
Second, upcoming trials are likely going to suffer from a “too much COVID effect” on an absolute basis, and relative to prior trials in particular. J&J counts any infection more than 14 days after injection toward its efficacy calculation. If full immunity takes longer (and my understanding is that antibodies build after infections for 3+ weeks in many cases), then there will be people out there getting infected before the vaccine has taken full effect. That wasn’t particularly likely to happen in the summer when there were fewer cases overall. This is particularly going to affect 1-shot vaccines, as other trials have their effectiveness measured only after the second dose (but I could still imagine this dynamic having some impact, if full immunity builds gradually after the second dose).
Anyway, hope this is of some interest. I found it encouraging to conclude that study bias could understate, not overstate, the effectiveness of vaccines.
That is from my email, identity of the author is redacted.
Thanksgiving assorted links
1. Suppressing Covid by blocking membrane fusion (Fast Grants funded).
2. Early contagiousness mutation now established (NYT, also Fast Grants funded work).
The biggest cost of the trade war — less access to Chinese vaccines
The current portfolio is multinational, including investments in Pfizer, Sanofi, AstraZeneca and Johnson & Johnson. Ideally, there should be at least one Chinese vaccine included, but there is not.
Obviously, given the rhetoric of the current administration, using a Chinese vaccine would be politically difficult. You can’t call it “the Chinese virus” and then tell Americans they ought to take a Chinese vaccine. So the Trump administration has made no serious effort to make a vaccine-sharing deal with China.
And:
The matter is hardly settled, but at the very least the Chinese vaccines are not dropping out of contention.
Note that a year’s worth of partial protection still could go a long way. Recommended.
Monday assorted links
1. Data on the oldest companies in the world. Often small, and related to food and/or hospitality. Often Japanese.
4. While America has been dithering, good (but not surprising) news on AstraZeneca. The vaccine may come to UK hospitals by November.
5. a16z podcast on textiles, with Virginia Postrel and Sonal Chokshi.
Thursday assorted links
1. Should there be more cats in prison? (An installment of “Questions that are rarely asked.”)
2. AstraZeneca closer to a USA restart, not much further information however.
3. Is 5G overrated?
4. Jordan Schneider on what to do about Xinjiang.
5. The greatest stagnation?: “Decades of study at Olorgesailie by Potts’ team and collaborators at the National Museums of Kenya have determined that early humans at Olorgesailie relied on the same tools, stone handaxes, for 700,000 years. Their way of life during this period was remarkably stable, with no major changes in their behaviors and strategies for survival.”
6. German data: “Our main finding is that mandating shared governance does not lead firms to pay measurably higher wages.”
The AstroZeneca saga, according to one source
This seems unconfirmed, and do note some sources in the story do not believe this account, but here goes:
AstraZeneca, whose Phase 3 coronavirus vaccine clinical trial has been on hold for more than a month, did not get critical safety data to the US Food and Drug Administration until last week, according to a source familiar with the trial.
The FDA is considering whether to allow AstraZeneca to restart its trial after a participant became ill. At issue is whether the illness was a fluke, or if it may have been related to the vaccine.
The source said the root of the delay is that the participant was in the United Kingdom, and the European Medicines Agency and the FDA store data differently.
“They had to convert data from one format to another format. It’s like taking stuff off a PC and putting it onto an Apple. They had to spend a lot of hours to get what they wanted,” the source said.
On Friday, a federal official hinted there might be some word this week on the trial’s future.
Or maybe they just fooled CNN with it?
Otherwise, good thing we are kept safe from such dangerous data formats! Would it really not be better to move to reciprocal recognition procedures? Not to mention a unified data format, or perhaps some FDA methods to read data produced for the EU?
For the pointer I thank Jackson Stone.
And yet the American trial remains suspended
Those nasty, reckless Brits:
The NHS is preparing to introduce a coronavirus vaccine soon after Christmas. Trials have shown it will cut infections and save lives, Jonathan Van-Tam, the deputy chief medical officer, has privately revealed.
He told MPs last week that stage three trials of the vaccine created at Oxford University and being manufactured by AstraZeneca mean a mass rollout is on the horizon as early as December. Thousands of NHS staff are to undergo training to administer a vaccine before the end of the year.
The government changed the law this weekend to expand the number of health professionals able to inoculate the public. The regulations will enable pharmacists, dentists, midwives and paramedics to administer jabs.
C’mon U.S. public health authorities, let’s get on this one and demand a resumption of the suspended AstraZeneca trial. You are advocates of science, right? You don’t actually want to make Donald Trump correct, do you? (Maybe that one will work.)
You don’t have to make it the vaccine, as the Brits seem to be doing, you just have to resume the trial, as the even more reckless Japanese did weeks ago. How about it?
Here is the article from Times of London (gated, but a cheap and worthwhile subscription for foreigners), via Linda Yueh.
Solve for the rational Bayesian equilibrium
I now read quite a few public health experts on matters of the day, and I have noticed that none of them have condemned the British government for proceeding with the AstraZeneca vaccine trial, even after two adverse health events experienced by participants, noting that those events presumably have been examined and considered by the oversight committee.
At the same time, the American trial for AstraZeneca has remained halted. I also have not read any public health experts criticizing that decision either.
What is the most likely equilibrium to be holding here?
1. Public health experts don’t express many opinions, especially these days.
2. Plenty of commentators think the British decision to resume is rash, Tyler just isn’t reading enough of them.
3. Most public health experts think it is fine for the British to keep on going. But they won’t criticize the American trial halt, because their incentives and natural temperamental tendencies are to express mainly the risk-averse opinions, and rarely if ever say that the regulatory process should allow for more risk to be taken.
4. The mainly American experts actually are happy to see America free-riding upon British data, so they are content with things as they stand, but don’t want to quite come out and admit they enjoy exploiting the Brits.
5. In reality the commentators think the whole trial is so risky it never should have been started in the first place.
6. What they really enjoy writing is philosophical pieces about how social process have all these twists and turns, and natural bumps in the road, and so they don’t wish to work too hard to remove those bumps.
7. The public health experts think that Americans and British have optimally different tolerances for risk, and the split regulatory outcomes reflect that difference.
Your choice?
Oxford’s Jenner Institute to Prepare for Challenge Trials for COVID-19
I am one of the signatories to an open letter from 1DaySooner on challenge trials sent to Dr. Francis Collins at NIH. A major development announced with the letter is that 1Day Sooner and Oxford’s Jenner Institute are collaborating to prepare viral production for use in challenge trials.The Jenner Institute is the creator of the AstraZeneca produced vaccine, the vaccine farthest along in development.
A key goal of the letter is to encourage the NIH to start its own preparation for challenge trials:
The undersigned urge the U.S. government…its allies, international funders, and world bodies (e.g. the World Health Organization), to undertake immediate preparations for human challenge trials, including supporting safe and reliable production of the virus and any biocontainment facilities necessary to house participants.
Among the signatories are 15 Nobel prize winners including Oliver Hart and Al Roth, Molecular geneticist Mario Capecchi, professor of medicine William G. Kaelin and physician Barry Marshall (who knows a thing or two about volunteer trials.)
As I discussed earlier, since challenge trials restrict the volunteers to be young and healthy, you can’t apply their results directly to the sick and elderly (the external validity problem) but “challenge trials could help us whittle down [candidate vaccines]… to the best two to three, substantially speeding up the vaccine discovery process.” You could also use challenge trials to help figure out the right dosing which is unusually important in the current situation because if a vaccine can work with .5ml instead of 1ml that’s equivalent to doubling the available supply. The Director of the Jenner Institute, Adrian Hill, agrees writing:
We see considerable potential in the use of human challenge studies to accelerate COVID-19 vaccine development, down-select and help validate the best candidate vaccines, and optimise vaccination approaches.
You can read the whole letter here.
The NIH Should Run Human Challenge Trials for COVID
As I have been warning, social distancing measures are making it more difficult to test COVID vaccines even as the cost of COVID remains very high.
WashPost: The Oxford group earlier boasted that it had an 80 percent chance of developing an effective vaccine by September. Hill said the difficulty of testing the vaccine in Britain may mean there’s only a 50 percent chance of success within that time frame now.
The probability of an Oxford vaccine by September has fallen by 30 percentage points. Oxford isn’t the only vaccine and we may be able to find clinical trial candidates in Brazil and the United States where infections continue to occur. So let’s be generous and convert this into say a 10% increase in a one month’s delay of any vaccine. The world economy is losing $375 billion a month so this means we have lost an expected $37.5 billion. That number highlights why we should be willing to pay large sums to speed vaccines and it also indicates the immense value of human challenge trials.
More than 28,000 people have already volunteered to be part of a challenge trial and if we paid a few hundred volunteers a million dollars each it would be worthwhile (and would surely increase the number of volunteers).
The main impediment to human challenge trials appears to be skittish firms rather than bureaucratic governments which is why challenge trials should test multiple vaccines under the auspices of the NIH. The NIH umbrella can protect the firms and increase the efficiency of the trials.
Addendum: China is adopting a bold approach. We used to be bold. Apathy is killing us.
Operation Warp Speed Needs to Go to Warp 10
Operation Warp Speed is following the right plan by paying for vaccine capacity to be built even before clinical trials are completed. OWS, however, should be bigger and should have more diverse vaccine candidates. OWS has spent well under $5 billion. At current rates, the US economy is losing about $40 billion a week. Thus, if $20 billion could advance a vaccine by just one week that would be a good deal. As I said in the LA Times, “It might seem expensive to invest in capacity for a vaccine that is never approved, but it’s even more expensive to delay a vaccine that could end the pandemic.”
I am also concerned that OWS is narrowing down the list of candidates too early:
NYTimes: Moderna, Johnson & Johnson and the Oxford-AstraZeneca group have already received a total of $2.2 billion in federal funding to support their vaccine programs. Their selection as finalists, along with Merck and Pfizer, will give all five companies access to additional government money, help in running clinical trials and financial and logistical support for a manufacturing base that is being built even before it is clear which if any of the vaccines in development will work.
These are all good programs and one of them will probably be successful but we also want to support some long-shots because a small probability of a very big gain is still a big gain.
The five candidates also all use new technologies and are less diverse than I would prefer. There are a lot of different vaccine platforms, Live-Attenuated, Deactivated, Protein Subunit, Viral Vector, DNA and mRNA among others. The Accelerating Health Technologies team that I am a part of collected data on over 100 vaccine candidates and their characteristics. We then created a model to compute an optimal portfolio. We estimated that it’s necessary to have 15-20 candidates in the portfolio to get to a 80-90% chance of at least one success and that you want diverse candidates because the second candidate from the same platform probably fails if the first candidate from that platform fails. Moderna and Pfrizer are both mRNA vaccines–a platform that has never been used before–while AstraZeneca, Johnson and Johnson and Merck are using somewhat different viral vector platforms (Adenovirus for AstraZeneca and J & J and measles for Merck) which is also a relatively novel approach. I think it would be better if there were some tried and true platforms such as a Deactivated or Protein Subunit vaccine in the mix. As Larry Summers said, “if you will die of starvation if you don’t get a pizza in two hours, order 5 pizzas”. I would change that to order 10 pizzas and order from different companies!
One way to diversify the portfolio is to make deals with other countries to avoid the prisoner’s dilemma of vaccine portfolios. The prisoner’s dilemma is that each country has an incentive to invest in the vaccine most likely to succeed but if every country does this the world has put all its eggs in one basket. To avoid that, you need some global coordination. One country invests in Vaccine A, the other invests in Vaccine B and they agree to share capacity regardless of which vaccine works.
So my critique is that OWS is good policy but it would be even better if more vaccine candidates and more diverse vaccine candidates were part of the program. In contrast, the critiques being offered in Congress are ridiculous and dangerous.
Democrats in Congress are already seeking details about the contracts with the companies, many of which are still wrapped in secrecy. They are asking how much Americans will have to pay to be vaccinated and whether the firms, or American taxpayers, will retain the profits and intellectual property.
How much will Americans have to pay to be vaccinated??? A lot less than they are paying for not being vaccinated! The worry about profits is entirely backwards. The problem is that the profits of vaccine manufacturers are far too small to give them the correct social incentives not that the profits are too large. The stupidity of this is aggravating.
Skepticism about Trump administration policies is understandable but I am concerned that one of the best things the Trump administration is doing to combat the virus will be impeded and undermined by politics.