The Pfizer vaccine has received Emergency Use Authorization in the UK and Canada and the vaccination campaign in the UK has commenced. An FDA expert panel has recommended approval of the Pfizer vaccine.
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44,000 patients were enrolled in the Pfizer-BioNTech trial. Half received two doses of the COVID-19 vaccine separated by 21 days, the other half received a placebo. Data from the first 36,621 patients was analyzed in mid-November
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The study included persons with asthma, diabetes, hypertension and approximately 20% of the study population was > 65 years of age. 76% of participants were from the US.
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8 cases of COVID -19 in the vaccinated group, and 162 cases in the unvaccinated group, which indicates a vaccine efficacy of 95% overall. nejm.org/doi/full/10.10…
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Efficacy:
95.6% in the 16-55 year age group
93.7% in those older than 55 years
93% in those were older than 65 years.
>90% efficacy in older people with additional risk factors for severe disease (obesity, high blood pressure, diabetes, chronic heart and lung disease).
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No major safety concerns. Side-effects included pain at the injection site, headache, fever and fatigue. These occurred more commonly after the second dose of the vaccine and in those younger than 55 years of age. Side-effects resolved in 24 hours
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The vaccination seemed to have a protective effect as early as 14 days after the first dose of the vaccine. The benefit from vaccination evident starting 14 days after the first dose bodes well for control of the pandemic.
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Note that Immunosuppressed individuals, those younger than 16, pregnant and breastfeeding women were excluded from the trial. Thus pregnant and breast feeding women, and those less than 16 years of age will likely be excluded from the EUA.
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While the efficacy in persons with weakened immune systems is unknown, there should be no risk to them from the vaccine.
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Health care workers and nursing home residents will be the first to be vaccinated, followed by additional groups.
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The United States has pre-ordered 100 million doses of the Pfizer-BioNTech vaccine and approximately 50 million doses are expected to be available by the end of December. @pfizer@BioNTech_Group
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13/ note: while vaccine begins protecting as early as 12-14 days after first dose, this should not be interpreted as only one dose is needed. Two doses are necessary until we have an RCT that tells us otherwise
Vaccinated individuals should continue to wear a mask in public as we don’t know whether vaccination protects against asymptomatic infection and transmission
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1/ Vaccines may be the solution to ending the COVID-19 pandemic. Vaccines typically take several years to develop. But COVID vaccines are being developed at warp speed. More than 200 vaccines are in development.
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COVID vaccines in development are using different approaches
What are the stages of development of a vaccine?
Preclinical stage: Lab and animal studies to evaluate whether the candidate vaccine can trigger immune response
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Phase I trials: Done in a small group of volunteers to determine safety, dosage, and learn about the immune response it generates.
Phase II trials: Larger number of healthy volunteers (typically in the 100s or less) to learn more about safety and effectiveness.
Several studies now suggest that T cells reactive to COVID may be present even in persons without prior exposure to SARS CoV-2 suggesting presence of cross reactive immunity presumably from prior corona virus infections.
This is the United States of America!!! The PPE we need is not complicated. Open a factory today that can make reusable isolation gowns. Gowns can be laundered using standard hospital procedures. It’s not rocket science @JInterlandi@bschapiroMD
#2 surgical masks are simple things with elastic ear loops. I cannot believe that a medium sized factory couldn’t make a few million masks in a matter of days #notscarvesandbandanas
#3 Third essential is eye protection. Goggles, visors anything that prevents splashes to the eyes ?Welders masks again not hard to make. @CDCDirector@AnilRaiGupta@elonmusk Titans of industry we need you
The @CDCgov advice on PPE was problematic during H1N1, but they did eventually provide decent advice. With #COVID19 the CDC has failed us. This has made the job of hospital epidemiologists very difficult. Let me explain. Thread @SHEA_Epi@CarlosdelRio7@ASlavitt@JInterlandi
Problems with US response 1) Failure to acknowledge the magnitude of this threat at the very highest levels of government.
2) Lack of availability of testing in the early stages when containment was possible.
3) Impeding private labs (including direct threats) from developing and using their own tests. @DrMattBinnicker
4) Political manipulation of epidemiology /numbers in the early stages to make things appear better than they were. This has caused the virus to spread to all states