Thread by @Vish_Sharm

1/ Feels weird not to be doing another pensions thread but really angry about the change in vaccine schedule. Fortunately @goldstone_tony has this covered.

Normal pension stuff will be resumed (once I have calmed down)

2/ Rules of Research Trial Design (own views)
- Specify your primary and secondary end points at the outset (including areas for post-hoc analysis)

Was efficacy of 1 dose of the Pfizer vax a specified end-point – NO!

Endpoints were efficacy 7 days after the 2nd dose and safety

3/ Always quote, confidence intervals, standard deviation or inter-quartile range when quoting results. Do people referring to these results quote the confidence interval – NO.

The figure of 52% effective after 1 dose has a confidence interval of 29.5% to 68.4%.

4/ Don’t extrapolate small numbers to make major claims relating to a large population. Have JCVI done this -YES.

39 patients got COVID in the vaccine group between dose 1 and 2 compared to 82 in the placebo group. Very small numbers to base this claim on.

5/ Don’t make claims that the study doesn’t support. Have JCVI done this - YES.

In the trial patients received a second dose at 21 days with the largest gap between doses being 42 days. Therefore, no patient in the study received a second dose after 12 weeks. There is no data

6/ ...The majority received the second dose between 21 and 28 days.

This claim of 52% effective is essentially based on a period of a few weeks.

7/ If you don’t know – don’t assume. Have JCVI done this – YES.

There is no data that immunity will last beyond 42 days and there is NO data to suggest that the final efficacy of 95% seen in the trial will be replicated with a 12-week dosing schedule. They THINK it will work...

8/..... Pfizer DON’T agree with this approach and have said so publicly. The same is not true for the Oxford AstraZeneca vaccine for which there is better data to support the 12 week interval

9/The primary aim of this approach is to get as many people vaccinated as quickly as possible. But in the case of the Pfizer vaccine it is not following the science - This is rationing of a vaccine and hoping for the best.

10/ This approach doesn't taken into account the different needs for healthcare and social care workers. They can socially distance at home but this is now impossible at work and they are at real risk of contracting COVID-19. Many are already off sick as a result.

11/ Health and social care workers need the maximum individual protection that is delivered by a 2 dose vaccine given in the shortest gap possible. This will reduce their risk of death and long COVID simply by doing their job.

12/ It will keep HCWs safe in order to look after patients and make it much less likely that they will transmit the virus to those that they care for. 52% (if true) vs 95% efficacy for healthcare workers may lead to higher numbers of staff suffering serious COVID complications

13/ Given the relatively small numbers of staff (compared to the whole population) ensuring they have the second dose will have minimal delays on the rest of the population receiving a vaccine.

14/ @MattHancock Please ensure health and social care staff are better protected.

Update Pfizer have doubled down in saying that their vaccine should be given 21 days apart. FDA in USA also concerned by this approach. 12 weeks is fine for the Oxford vaccine but an urgent rethink is needed for the Pfizer jab.