Following the science...maybe

 Michael - Thursday

I’ve been trying to understand what all this “following the science” (let’s call it FS) actually means, who actually does it and who doesn’t, and why or why not. A few countries don’t seem to have bothered at all. Tanzania is relying on prayer, and have no interest in vaccines. Brazil seems fine with vaccines, but ignores everything else as President Bolsonaro doesn’t want any delays with cutting down the rain forest. The US is, as always, complicated…

Wearing masks seems to be one of the few areas where FS is really clear, and there’s essentially no downside, so how come so many people just don’t do it?

It seems that FS means what our leaders say it means. Let’s consider a couple of countries who have claimed to be strongly FS.

One is the UK. (In their case FS is usually matched with PNHS – Protect the National Health Service.) They have chosen the Pfizer and AstraZeneca vaccines (the latter most probably because it was partly developed at the University of Oxford and chewed up a chunk of government money). Both have been trialed extensively. And for both – in all the trials – subjects were given two doses of the vaccine spaced about three weeks apart. This is the basis on which the vaccines were approved for use by the relevant regulatory authority. But in the UK, the government decided to only give people one dose of the vaccine until everybody who wanted to be vaccinated had been vaccinated or enough vaccine had been obtained to achieve that and the second doses. This means that the doses may be three months or further apart. Also, as older people were vaccinated early, they may have the longest wait for the second dose.

From The Times

Bearing in mind that the vaccines were never trialed this way, was this really FS? Hardly. But the one shot model seems to be working out pretty well. Boris Johnson is on a roll – first Brexit and now changing the vaccine regimen! (Other European countries seem to have decided to stick to the manufacturer's recommendations, however.) Boris's latest step is to offer the NHS workers a 1% increase instead of the 2.2% that had been mooted before the pandemic. PNHS! We really appreciate all your great work and commitment, folks!

The second country is Russia. They also claimed to be FS. As soon as the Sputnik vaccine had had a few human trials, they made it widely available in the country. The argument goes that they have it, it works in the lab, and it doesn’t kill people. So why not give it a go? What’s the worst that can happen? That people still get sick? Well, they would be no worse off with no vaccine at all, so what’s the difference? The counter argument is that sometimes side effects take time to develop and need a big spread of subjects to do so. But, again, there seems to have been a positive result from the decision. China has followed a similar approach.

Then we have the huge discussion about which vaccine is best. People feel fobbed off if they don’t get the Pfizer or the Moderna vaccines, which, in addition to being excitingly high tech with their RNA engineering, have stellar efficacy figures that the others don’t come close to matching.

Hmmm. Let’s take a look at that science. Time magazine came up with a good, short article this week comparing the three vaccines currently approved for use in the USA. You can read it at https://time.com/5945177/covid-19-vaccine-effectiveness/ Looking at the figures, FS, it looks as though Pfizer and Moderna at 95+% efficacy are 50% better than the Janssen Johnson & Johnson (JJ&J) vaccine at 66%. But if you look at the details, there’s quite a different picture. The vaccines were tested at different times, with different regimes, and in different areas. The RNA ones tended to be tested in the first world that had the appropriate facilities for their required storage temperatures. Furthermore, they were ahead of the pack, so they were mainly fighting the virus before it’d had much chance to mutate. On the other hand, the JJ&J faced the UK and SA mutants.

Then, what do those efficacy numbers actually mean? They count a success if the subject does not exhibit symptoms of the disease. That’s great, but what I care about is really serious disease – ending up in hospital or even in a box. I’ll deal with a couple of bad weeks if push comes to shove. In the trials, all three vaccines had 100% success rates at preventing death and near 100% success rates for avoiding hospital admission. So are they really all the same?

Well, finally, we come to the mutants. All the vaccines show reduced efficacy in laboratory experiments, but still do their stuff to some extent. As far as South Africa is concerned, only the JJ&J and the AstraZeneca have actually been trialed here comparatively recently when the mutant was already dominant. The JJ&J had little change in its results, but the AstraZeneca seemed to provide very little protection. Unfortunately, at that stage, the government had just taken delivery of 1 million doses of the AstraZeneca vaccine from India. It must have been tempting to say the hell with it, let’s go with what we’ve got. But they actually did FS. They took a lot of flack, but they dumped the AstraZeneca, and moved heaven and earth to get a supply of the JJ&J instead. Our health workers are being vaccinated with that right now. Personally, I think the government made the right decision.

A final thought. All this sifting through vaccine data is interesting and gives one, perhaps, an idea of where we are right now with the pandemic. But, if you’re offered a vaccine, any vaccine, take it. By next year we’ll probably need something different anyway and hopefully get something better. Meanwhile, let’s stay out of hospital and alive!