Thread by @SGriffin_Lab

I'm still curious to understand what the "bespoke model" involves.

What THIS involves is an even narrower offer for free vaccines in the UK.

This is a striking difference to the US (for now 😬), which offers KP2 mRNA for all >6m.

TLDR, false economy🧵

gov.uk/government/pub…

I'm not going to go into details, mainly cos it makes me so angry to sit reading it for any length of time.

Also, the bespoke model leaves me dumbfounded. What follows are generalisations, mainly because this is basically an iteration of the 23 model, where this attrition began.

First, yet again, the focus, or rather the most favourable cost-effectiveness, is avoiding deaths and acute hospitalisation.

Of course, this is critical, especially as we still do nothing to mitigate uncontrolled prevalence, and I include effective vaccination in this regard.

There're dozens of the usual platitudes, including the magical "endemic". In my opinion, these are little more than misinformation, including the soothing balm of infection-induced immunity.

Yet, despite trying to prevent deaths, the survivorship bias here isn't mentioned 💔

Another "triumph" in this regard is that eligibility for vax is now narrower than for antivirals, H/T @cv_cev ...

So, treat, but don't prevent?!

How wonderfully cost effective, both in terms of 💰, and people's SMEGGING lives...🤬🤬🤬

https://x.com/cv_cev/status/1856786445408907434?t=JcF9qBMrhkEQInXhFzVkoA&s=19

Yes, hospitalisation rates are lower than the previous year, mercifully, but do they ever wonder why?

Immunity is, of course, a huge beneficial influence. But, so little is from recent vax that "cost", in human terms, keeps going up.

Basically, vulnerable folks keep dying, ffs!

Moreover, there are so many papers extolling the virtues and benefits of vax for 6m-5 Yr, I've lost count, but this recently from @chrischirp @katebrown220 et al is great.
Comparing adult to juvenile disease has long been fallacy, yet it continues 🙄

pubmed.ncbi.nlm.nih.gov/39426795/?utm_…

Before we get the kids are fine/invulnerable, Us4Them 💩...

Acute COVID risk 3 u18 is U-shaped. 6m=highest, decreases to inflection point at ~5yr, then age related increases begin.

The case for kids vax needs more than tweets. See here if interested.

There's the usual nonsense about hospitalisation rates being lower than the start of the pandemic...well, yes, of course they are!

But, we still have 1000s more dying and hospitalised than in 2019, multiple waves, uncontrolled virus evolution...yes, better, but NOT GOOD!

Of course, now things ARE better, the plan is to take away the stuff that got us there! Bloody wonderful...
Despite brilliant juvenile vax with virtually no SAEs, we'd rather bet our future population immunity on a dangerous virus that outpaces immunity every 3-4 months...🤦‍♂️🙄

But, and this IS a big but, these things cost money, a lot of money, and I'm sure that there are sums that justify only paying for over 75s with this in mind.

But, and this is a BIGGER But, cost always balances against savings. I'm pretty sure they're missing a lot of these!!!

The focus on acute issues from COVID has permeated UK policy since the beginning. But now, #LongCovid accounting for many on long term sick, this STILL doesn't factor, somehow. It's almost 2025 ffs!
Neither does #LongCovidKids, or a raft of COVID juvenile and adult sequelae...

Cardiovascular, neurological, metabolic, autoimmune, autoinflammatory, and other conditions, all demonstrably increasing and affecting younger demographics.
NOT the vaccines (not perfect, obvs), COVID.

How much is a lifetime's supply of insulin for a 10yo diagnosed with T1D? 💔

At the risk of sounding like a broken record, a vaccine only strategy is more effective if you actually USE them...
The commercial price is insultingly high and discriminatory.
Vax + mitigation, reduced prevalence, exposure, illness, and evolution
Before I'm told to "move on"...

Getting the pandemic under control is, of course, additional to the health costs of endemic (so, clearly, not a problem? 😜) infections, where vax offers and mitigation are, shall we say, somewhat lacklustre...

JCVI FINALLY learned these lessons for VZV, why not other viruses?

We seem to value "normal" over better, especially if it's expensive up front, or gets in the way of "normal life"...climate change seems to get a similar reception...but, complacency, ultimately, is also a devastaring killer.
#VaccinesPlus

independentsage.substack.com/p/just-the-flu…