A vaccine timeline

Great stuff from David Leonhardt on a realistic vaccine timeline in his newsletter this morning.  I think a lot of the timelines I’ve seen are too pessimistic because they are working on the assumption that we’ll only be using the mRNA vaccines.  The J&J vaccine currently coursing through my body is probably running just a couple months at most behind the others.  And it is designed to scale with 1 dose and a simpler technology.  Anyway, we’ll see.  My science optimism hasn’t let me down yet.  My caveat, though, is that vaccine distribution isn’t really about science.  But, especially once Biden’s people are in charge (and to be fair, seems like even the vaccine people operating under Trump are competent), I think good things will happen relatively quickly. 

December: Health care workers and nursing home residents will likely be the first people to receive the vaccine, as the panel recommended.

Up to 40 million doses could be available to Americans before the end of this year, from a combination of Pfizer’s and Moderna’s vaccines. That would be enough to vaccinate the three million people who live in long-term-care facilities, as well as most of the country’s 21 million health care workers.

January: Keep in mind that both the Pfizer and Moderna vaccines require a second dose a few weeks later to be effective. So an initial batch of 40 million doses would be enough to vaccinate only 20 million people.

By early next year, Pfizer and Moderna are likely to be able to ship about 70 million doses per month, Moncef Slaoui, a top federal vaccine official, told The Washington Post yesterday. People will likely receive the shots at doctor’s offices, hospitals and pharmacies, as well as at specially created clinics in some places, my colleague Katie Thomas says.

February and March: The next priority groups are likely to be people over the age of 65 (and especially those over 75); people with medical conditions that put them at risk of death if infected; and essential workers, like those in education, food, transportation and law enforcement.

One exception to this second wave of vaccine recipients may be people who have already had the virus, making them immune from it for at least some period of time.

If other companies in addition to Pfizer and Moderna receive approval for their vaccines, the total number shipped each month could reach 150 million by March, Slaoui said.

April, May and June: The most likely scenario is that even people who don’t qualify as a priority — like healthy, nonessential workers younger than 65 — will begin receiving the vaccine by the spring. The vast majority of Americans could be vaccinated by early summer.

Once that happens, life will still not immediately return to normal, partly because the vaccines are not 100 percent effective. “There will still be risks to people,” as Caitlin Rivers, a Johns Hopkins epidemiologist, told me.

But those risks will be small compared with today’s risks. Treatments continue to improve, reducing the death rate for people who get the virus. And widespread vaccination will sharply reduce the spread, helping protect even people for whom a vaccine is ineffective. Rivers predicted that social gatherings will again be common and largely safe by the summer.

All things considered, the spring isn’t that far away, which is yet another reason for people to make extra efforts to avoid unnecessary risks — like eating inside restaurants and gathering indoors with friends — for the next few months.

Vaccine follow-up (I spoke too soon!)

So, I actually wrote the vaccine post shortly before bed last night and queued it up to run this morning. I should’ve waited. Unless my body is playing a hell of a trick on me, I was actually vaccinated yesterday. Last night featured chills (the first indication), fatigue, headache, and probably fever if I had cared enough to take my temperature during the night. Now, in theory, I managed to do all this psychosomatically in response to a shot of saline, but Occam’s razor says otherwise (not to mention, I didn’t even realize chills were a potential vaccine side effect until after I had them.

Of course, what’s cool in this modern age is that I can actually look up the study reporting on side effects in phase 2 of the trial:

RESULTS We here report interim analyses after the first dose of blinded safety data from cohorts 1a, 1b and 3 and group unblinded immunogenicity data from cohort 1a and 3. In cohorts 1 and 3 solicited local adverse events were observed in 58% and 27% of participants, respectively. Solicited systemic adverse events were reported in 64% and 36% of participants, respectively. Fevers occurred in both cohorts 1 and 3 in 19% (5% grade 3) and 4% (0% grade 3), respectively, were mostly mild or moderate, and resolved within 1 to 2 days after vaccination. The most frequent local adverse event (AE) was injection site pain and the most frequent solicited AEs were fatigue, headache and myalgia.

Anyway, it’s pretty damn cool to be 90%+ sure I’ve been vaccinated.  It’s not ideal that the vaccine can make a lot of people feel like crap– we sure don’t need to give people any more reason not to take the vaccine– but certainly a worthy trade-off.

I’m vaccinated for Covid! (Or not!)

That’s right.  As of yesterday afternoon, I’m part of the Phase 3 trial for the Janssen/Johnson & Johnson Covid vaccine!  Absolutely zero symptoms so far, including locally in my arm, so I’m thinking there’s just a shot of saline in there, but certainly not everybody who gets the actual vaccine gets side effects.

Its actually a very similar vaccine to the Oxford/AstraZeneca vaccine, delivering it to your cells by a harmless adenovirus.  Great article in the NYT about how the development and how it works:

By 2004, when Dr. Barouch opened his first lab at Harvard Medical School, he had gained a reputation as an ambitious young researcher. He immediately set a suitably daunting goal: a vaccine against H.I.V., the virus that causes AIDS.

The virus had been found in 1983, but two decades of vaccine work had led to one disappointment after another. The standard ways to train the immune system to recognize a virus failed when it came to H.I.V.

Dr. Barouch decided to try something different: a vaccine made from another virus. They chose adenovirus serotype 26 — Ad26, for short — a relatively rare virus that causes mild colds but is very effective at invading human cells.

To create the vaccine, they collaborated with Crucell, a Dutch company that was bought by Johnson & Johnson in 2011. The researchers disabled the Ad26 virus so that it could only invade cells but not multiply in them.

Then they added a gene from H.I.V. Cells infected with Ad26 would make H.I.V. proteins that drifted in the bloodstream, priming the immune system.

In experiments on monkeys, the vaccine offered protection against H.I.V. In trials on people, the vaccine was safe and triggered a strong immune response against the virus. But the trials to see if it effectively protects against the virus are still underway.

In 2016, amid the Zika epidemic, Dr. Barouch and his colleagues quickly retooled their Ad26 vaccine to make Zika viral proteins. They got as far as trials that showed the vaccine was safe in people and generated a long-lasting immune response, but shelved the project when the Zika epidemic retreated.

As the new coronavirus began to spread in January, the lab already knew how to make a vaccine for a sudden outbreak. What they needed now was a way to target the new virus.

Previous research on SARS and other coronaviruses made the choice clear. They would prime the immune system to attack the so-called spike proteins that cover the surface of the new coronavirus.

So cool!

I’ve mentioned this vaccine before because it has the potential to be super-scalable in a way the mRNA vaccines are not.  For starters, one shot.  But, it’s a lot more than that:

And if those trials show that the vaccine is effective, the factory will use the same master virus seed to manufacture an emergency supply that would be distributed at the start of 2021. “We can theoretically produce 300 million vaccines,” Dr. Stoffels said.

The company has formed a partnership with an American vaccine maker and is also setting up two more plants in Asia and Europe, “so that we can come to a manufacturing capacity north of a billion vaccines,” Dr. Stoffels said.

Also, interestingly, in my recruitment phone call, they said the study would be two years.  We all know there’s no way that’s happening.  It’s highly likely this vaccine will be approved within months, at which point it become ethically dubious to deny the vaccine to those in the placebo group.  I’m willing to go a little longer than absolutely necessary potentially on a placebo for science, but, I’m sure not going to be sitting around with a placebo while everyone else is getting vaccinated.

Anyway, I love that I’ve got a 50/50 shot of having the vaccine in me.  I will, of course, keep you updated.