Monday, May 3, 2021

The States That Will Need Vaccine Bounties

 I recently came across a story about West Virginia offering young people a $100 savings bond as a bounty for getting the COVID-19 vaccines. It seems to me this will be necessary in a number of states, particularly in the south, intermountain west, and to some degree, even in the midwest. Here's a chloropleth map I just built of first vaccinations per 100 population:

(The CDC has a similar map, but it only tracks population-adjusted vaccines administered, which tells us little about the overall number of individuals vaccinated.) The states in trouble are Idaho, Wyoming, Missouri, Arkansas, Louisiana, Mississippi, Tennessee, Alabama, Georgia, South Carolina, and Indiana. I expect to see these states follow suit presently.

Saturday, May 1, 2021

More On The J&J Vaccine "Pause" Causing Vaccine Hesistance

 A terrific and more detailed look at the aftermath of the "pause" causing people to walk away from vaccination by Dan Elton, looking at not just the total vaccination numbers, but the daily un-averaged figures, vaccination by age bracket, and the difference between the UK's approach (warn but keep vaccinating) and the US/EU approach ("pause" or outright ban). The post I wish I'd written (my less-detailed one here).

Friday, April 30, 2021

The Russians Are Coming! Peter Hotez's Zany, Evidence-Free Anti-Anti-Vax Rant In Nature

 Peter Hotez, Dean of Baylor College of Medicine's School of Tropical Medicine, has a theory about why there's so much antivax sentiment in the world. It's nice, he says, to offer solid, scientific evidence for vaccine efficacy and safety, but there are too many bad guys out there spewing disinformation.

I have a long-standing disagreement with many of my US public-health colleagues. I admire their commitment to disease prevention, but when I ask for a more direct way to counter anti-vaccine aggression, I’m told, “that’s not our approach; confrontation gives them a platform and oxygen.” In my opinion, this attitude reflects a time when we had dial-up modems. Today, the anti-vaccine empire has hundreds of websites and perhaps 58 million followers on social media. The bad guys are winning, in part because health agencies either underestimate or deny the reach of anti-science forces, and are ill-equipped to counter it.

So who are these shadowy forces?

Investigations by the US State Department and the UK Foreign Office have described how Russian intelligence organizations seek to discredit Western COVID-19 vaccines. One campaign implies that it could turn people into monkeys. This builds on a longer, well-documented history of Russia-sponsored disinformation, presumably to destabilize the United States and other democratic countries. The administration of US President Joe Biden has warned Russian media groups to halt their anti-vaccine aggression, and announced sanctions tied to disinformation and other behaviour, but we need much more.

But wait — has anyone ever claimed they didn't want Moderna because it would make them into a monkey? Who knows! Who cares? He's on a roll. The solution, he's certain, looks like "The United Nations and the highest levels of governments must take direct, even confrontational, approaches with Russia, and move to dismantle anti-vaccine groups in the United States." That is, the federal government should censor antivax groups in the US.

This of course is unconstitutional. Moreover, that it is unlikely to work even if it were implemented does not occur to him, as it does not to all would-be censors; they imagine themselves the beneficiaries and directors of such activity. The lessons learned from the CDC's early flip-flopping on mask-wearing shows no one has a monopoly on Truth. The likely result of such censorship would be more people, not less, asking, "What do they have to hide?"

If anyone were interested in finding out why people didn't want any of the safe, effective vaccines against COVID-19, the place to start is by asking them. The Kaiser Family Foundation has done a series of U.S. polls that are both informative but incomplete, telling us that some people won't get the vaccines, but not why. We need more of this. My (mostly unsubstantiated) belief is that the Johnson & Johnson vaccine pause has proven destructive to overall vaccination efforts. The April 13 pause directly correlates to a daily decline in the number of vaccinations as shown by the graph below (underlying data from Our World In Data):

In Kansas and Arkansas, vaccine distribution has stalled due to lack of demand. I anticipate more stories in the coming days of similar problems, particularly in the south and midwest. This is a serious issue that deserves serious thought and effort. Dr. Hotez provides neither.

Saturday, April 24, 2021

The J&J Pause Has Likely Poisoned Acceptance Of All Vaccines

 The FDA and CDC's April 13 pause of the Johnson & Johnson vaccine, which I predicted would cost lives, appears to have done so in the worst way. While we don't have polling data available yet (the KFF poll is probably wrapping up right about now), the last data available indicated Americans were losing their vaccine hesitancy. If this graph of daily vaccinations is any indicator, that hesitancy has come right back up:

 Good job, guys! Explain the risks and don't "pause".

Friday, April 23, 2021

The Big Lie About US COVID Vaccine Exports

 Last month, I expressed disbelief at EU claims the US had installed a vaccine export ban, which mainly was based on Israel's early vaccination program, one I assumed was based in the US, based on the early huzzahs about first doses leaving a plant in Portage, Michigan. But this was flatly contradicted by Charles Michel's claim that "Most of the doses with which Israel embarked on its mass vaccination programme were sent from Belgium."

There I left it, until another Politico EU article came to my attention, this one about AstraZeneca production shortfalls. The relevant grafs (emboldening mine, as usual):

While a Belgian subcontractor making the serum or "drug substance," was fulfilling its contract with AstraZeneca, another plant in the Netherlands wasn't producing enough to be included in the company’s application for approval to European regulators at the end of December, according to EU documents seen by POLITICO and the Belgian magazine Knack.

With so little drug substance coming from the EU, AstraZeneca turned to its U.S. plant in Maryland to make up the difference.

"The most important quantity" of drug substance came from the American plant, owned by Catalent, before being put into vials in Italy in a process known as "fill and finish," the documents said, detailing inspections in January and early February of three AstraZeneca plants in Belgium, Italy and the Netherlands that produced vaccines for the EU.

 So, perhaps they mean arm-ready shots? Either way, there is, as I suspected, a lot less there than meets the eye. The US has not, in fact, stopped exports of vaccines.

Tuesday, April 20, 2021

mRNA's Cherry On Top: The EU Buys Another 100M Pfizer Vaccines

The EU exercised its option to buy another 100 million doses of Pfizer/BioNTech COVID-19 vaccine, bringing the total to 600 million. Combining that with the 1.8 billion dose order drafted earlier in the month, this means the EU has essentially gone all-in on mRNA. Reviewing my post on the situation back in February, this means the EU has 3.365 billion mRNA vaccine doses either delivered or deliverable. Presumably CureVac's doses are still on order as part of that sum.

The buy makes it appear that the EU has lost faith in Sanofi's protein subunit vaccine, which had trouble with efficacy in the key older group. Sanofi has since shifted gears, and on March 12 announced with partner Translate Bio, that they, too, would have an mRNA vaccine candidate, with phase 1/2 trials commencing soon (?), but these are not expected to conclude until Q3, 2021.

Saturday, April 17, 2021

COVID Vaccine Bullets

  •  The European Union is negotiating a 1.8 billion-dose order with Pfizer to be delivered in 2022 and 2023 (!!!) and will not renew contracts with AstraZeneca or Johnson & Johnson. The doses will be manufactured in the EU.
  • For all that mRNA manufacturing has generally scaled well, we finally have a story of missed shipments from Moderna, who has announced they will cut vaccine deliveries to Canada and the UK due to manufacturing problems.

    While the company didn’t specify how many doses would be cut and where, Canada’s Procurement Minister Anita Anand said Friday that its shipments will contain 650,000 doses this month instead of the expected 1.2 million. 

    Moderna also warned up to 2 million of a planned 12.3 million shots scheduled for delivery in the second quarter would be delayed until the following quarter, according to a report from Reuters. However, a company spokesperson also told the news agency that its deliveries to the European Union and Switzerland remain on track.

  • Pfizer's CEO now says there will likely be a need for COVID booster shots, possibly annually.
  • CureVac plans on releasing trial data of its mRNA vaccine in the coming weeks.
  • Moderna is putting its mRNA influenza and HIV vaccines into phase I trials this year.
    Current flu vaccines in the market have efficacy rates in the regoin [sic] of 40-60%: which Moderna believes its mRNA technology can improve on. It also says that its technology has several advantages over egg-based vaccine production: not only in terms of production advances but in accurately targetting vaccines against strains (egg-based production has the potential to cause unintended antigenic change to the vaccine virus).
    They also released phase I trial data for a respiratory syncytial virus (RSV) vaccine, and a cytomegalovirus (CMV) vaccine.