I am becoming deeply troubled over the cavalier way the UK vaccine roll out is being changed on the hoof.

We have 2 approved vaccines that work to induce protective immunity.

They are both safe

I understand the haste to get them into as many people as possible.
But the phase iii data doesn’t exist to support their use in combination.

They are not quite the same immunogen. So homologous and heterologous boosting may accentuate different responses. And it might matter which order.

We do not know anything about this.
Next the timing

AZ boosting at 3 months turns out to boost higher Ab levels - another ‘serendipitous’ thing to fall out of the trial. Fine. But how protective is one shot?

And changing the Pfizer regimen, based reanalyzing the data to look for an answer they want. Probably true
But again no data. And in doing so pulling the boost from those already waiting for it. 🤦‍♂️

I’m all for pragmatism and not letting the perfect be the enemy of the good. But we do clinical trials for a reason.
And if something unexpected were to happen, the damage done to vaccines in general will be incalculable.

The antivax movement is just waiting to leap on any screw up.

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More from @stuartjdneil

23 Nov 20
We need a good hard look at the numbers and the longevity before we conclude that this is less effective than the mRNA based ones. bbc.co.uk/news/health-55…
Firstly it seems to rise to 90% when the first priming dose is lower. This might mean that less is more, and potentially anti-adeno responses might limit the boost. If so this is serendipitous as it will halve the cost of production of round 1
Secondly, in this trial they have evidence of reduced assymptomatic infection in vaccinees, suggestive of less transmission. This is something that we don’t know for the other vaccines thus far.
Read 7 tweets
19 Sep 20
There a lot of scientists in reflective mood as we face up the prospect of an autumn second wave of SARS CoV2 and what it may or may not mean, and in particular whether we can or even should contemplate further lockdowns. So I’ll add my twopenneth’ 1/n
At the beginning we didn’t heed the warnings from China and Italy until it was too late and we ended up playing catch up with a rapidly spreading virus that we didn’t understand. 2/n
The ability to test samples and act on that knowledge was rapidly outstripped by resources and the govt were woefully slow to alleviate bottlenecks in testing, diagnostics and PPE, all of which had been highlighted when wargaming a pandemic 2 years earlier. 3/n
Read 27 tweets
11 Mar 20
So hysteria helps noone. The point of flattening the curve is you mitigate the impact of SARS-CoV2 but minimize the the long term damage to the country. The way we get on top of this is by aggressive community testing and isolating infected people. 1/n
@PHE_uk job will made much easier if everyone follows the instructions: wash your hands, stay home and avoid visiting vulnerable people if you’re feeling ill. 2/n
More specific measures (eg sportscevents gatherings etc) should be brought in, but a Chinese style lockdown is not possible in a Western democracy. And ask yourself - what did Italy’s implementation of local lockdowns achieve? Very little it seems. 3/n
Read 5 tweets

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