Thread by @ashishkjha

Really important news out of UK

Important for UK and the world

But I have mixed feelings about the science here

So what's the news?

UK MHRA (their FDA) has authorized the Oxford Astra-Zeneca vaccine

Why such a big deal & why am I conflicted?

Thread

gov.uk/government/new…

First, the data

UK regulators suggesting that the data they evaluated suggests vaccine has 70.4% efficacy

gov.uk/government/pub…

With zero hospitalizations & zero severe disease in vaccine arm

So that’s good

But not as good as Moderna or Pfizer vaccines (in efficacy)

So why is it such a big deal?

1st, UK will start vaccinating people next week at large scale

2nd, India, other countries will likely now approve this vaccine

And India likely has tens of millions (if not more) doses ready to go

3/n

This is all in the context of other vaccines rolling out in other countries

China’s Sinopharm vax (79% efficacy?) and Russia’s Sputnik V are going to roll out in lots of countries over next month

So we'll see large numbers of people around the world getting vaccinated

4/n

So what about the US?

There’s a new trial happening here for AZ vaccine

We’ll have more data in late January, possible authorization in February and roll-out after that

Until then, we’ll plod along getting tiny fractions of our population vaccinated

5/n

Now what’s the mixed set of feelings here?

The data on AZ clearly not as strong (yet) as Pfizer and Moderna which have efficacy around 95%

But 70% efficacy not bad

Actually what I had expected from the best vaccines a few months ago

6/n

And UK would argue –a 70% vaccine is a lot better than no vaccine at all

But there are still other important caveats

AZ vaccine had too few people over 65 to see efficacy or safety

And the safety data that MHRA reports looks good but still sorting out some details

7/9

So would I recommend FDA authorize AZ vax in US based on these data?

Probably not

We need more data on people >r 65 (high risk group)

We need to understand dosing and dosing intervals better

BUT

We also have a fire raging across US with 3700 dying just yesterday

8/9

Ox/AZ vaccine appears to be safe, effective

But data not as solid (yet) as Moderna/Pfizer

Of course, we could actually get the 40M doses of the Moderna/Pfizer vaccines we have sitting in freezers out to the American people

But that requires a competent federal government

Fin