Fintan O'Toole "feels like an eejit"

Brendan Burgess

Brendan Burgess

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www.irishtimes.com

Fintan O’Toole: Those who did what they were told on vaccines now feel like eejits

Vaccine programme has left people in their 60s exposed to the Delta variant
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The message was clear: get your AstraZeneca now or you will not get vaccinated at all until the autumn, or whenever the rest of the population is done. This was Government policy: the bad (ie the Astra dodgers) will end unhappily.


These warnings were both unnecessary and patronising. As of last week, 92 per cent of us sexagenarians had received our jabs.

But the threats were also, to be polite about it, fictions. The good have ended unhappily; the bad have been rewarded.

Almost a fortnight ago, on June 14th, pharmacies were allowed to give a Janssen shot to anyone over 50 who had not been vaccinated. No need to register – just call for an appointment, walk in and you’re done in 15 minutes.

I am the same age as Fintan.

From a population point of view, it was and is critical that as many people as possible get vaccinated with one of the approved vaccines as soon as possible.

It would not be feasible to allow everyone choose which vaccine they wanted.

We could end up with a shortage of one type and a surplus of another.

I was delighted to get the AZ vaccine on 3rd May. I didn't have a choice, so I didn't bother researching which was the safest and most effective.

As far as I remember, at the time, it was as effective as the others.

I don't remember a big stick being waved at me telling me that I wouldn't get vaccinated until the autumn if I didn't go for the AZ. I knew that there was a lot of uncertainty about supplies, so when I was offered a vaccine, I took it.

It might have transpired since that it is less effective than the others against the delta variant.

But even if I had known that, from the population point of view, it was right to take it.

Another variant might develop where the AZ has the edge.

And it might transpire that some people need a booster shot or an additional vaccine.

But the overall job the system has done in vaccinating the population has been very good.

Brendan
 
The problem, however, is the arrival of the Delta variant. It has turned the situation of people in their 60s into a serious public health issue. Before Delta, one dose of AstraZeneca gave good enough protection to those of us who have had it. But the new variant changes everything: the effectiveness of our single shot against symptomatic Covid-19 has dropped dramatically, to just 33 per cent.

But while the effectiveness of the single shot against getting the delta variant may be just 33%, but in the 7 weeks since I got the first shot, the other variants were the dominant variants.

And if I do get the delta variant, I presume I will be a lot less sick as I have been vaccinated.

Brendan
 
However, the subsequent decision to use the 60 to 69 age group to mop up the supplies of AstraZeneca meant that this system would soon go out of synch. Younger people who get the Pfizer or Moderna vaccines have to wait just four weeks for a second shot. The sexagenarians had to wait at least 12 weeks. So people in their 50s are now fully vaccinated, while many 69-year-olds are still waiting. The programme is no longer calibrated to age-related risk.

But aren't we older folk less vulnerable to blood clots arising from the AZ? So it made sense to retain the other vaccines for younger people.
 
One of the comments on the IT website expresses it better than I did:

Sorry but it's the government's job to do their best for the entire population. Under 60s can't get AZ, so it makes best sense not to use other vaccines on this cohort.

It is not the government's job to look after Fintan's age group first.

Mrs. Q
 
And another one

In the middle of April those if us not in the 60s age bracket were quite envious of their call to be vaccinated. We were all envious of those in UK who were getting AZ and waiting more than 12 weeks in most instances. The gov could not have guaranteed back in April what vaccines would be available in June. It would have been foolish in the extreme to turn down the offer of an AZ jab in April for the hope of a Pfizer one later. And they did not know in April how prevalent the delta variant would be in June. The vast majority of people in their 60s were delighted to get the first job. The gov didn't con you into taking the AZ vaccine, Finton, but you are now definitely trying to con your readers by implying that they did.

Surely it is the ultimate first world privilege that you are now complaining about being vaccinated?

The real scandal is that healthy people in Ireland in their 50s, 40s and 30s are vaccinated at all while health care workers and the very elderly in the developing world are still waiting.
 
It's clear to me that the strategy was right back then.

The question is whether the strategy should change now.

Should those of us in our 60s who have not yet had the 2nd jab be given an alternative?

Is that advisable on an individual basis?
Is it operationally viable on a population basis?

Brendan
 
Brendan Burgess said:
The good have ended unhappily; the bad have been rewarded.
Click to expand...
I think what Fintan O'Toole possibly means by this is that people (i.e. the "bad") turned down their appointment for the AZ shot and were "rewarded" by being given an appointment for the Pfizer jab. I have spoken to two people recently who did exactly that and there's been one poster on AAM that I've seen who also was "rewarded" by refusing the AZ vaccine. These people have all now received their second Pfizer jabs and so are fully vaccinated and so are very much protected against the D variant. Whereas the "good" are still waiting on their second AZ jab and so are therefore much less protected than the "bad".
 
OK.

But they took a risk which paid off. It might not have paid off. They could have become very sick with Covid during the delay.

Brendan
 
What are the facts here. I can't find them.

1) Do we know what percentage of cases are the delta variant in Ireland? It seems that it will become dominant soon, but so far, it's not the dominant variant.

2) What is the difference between a double AZ vaccine and an AZ vaccine followed by an mRNA vaccine?
How much more likely am I to contract Covid?
If I do contract it, how much protection does the Double AZ give me from getting sick.

Brendan
 
I am reading the risk assessment from the ECDC

Based on the available evidence, the SARS-CoV-2 Delta (B.1.617.2) variant of concern (VOC) is 40-60% more transmissible than the Alpha (Β.1.1.7) VOC and may be associated with higher risk of hospitalisation. Furthermore, there is evidence that those who have only received the first dose of a two-dose vaccination course are less well protected against infection with the Delta variant than against other variants, regardless of the vaccine type. However, full vaccination provides nearly equivalent protection against the Delta variant.

Based on the estimated transmission advantage of the Delta variant and using modelling forecasts, 70% of new SARS-CoV-2 infections are projected to be due to this variant in the EU/EEA by early August and 90% of infections by the end of August.

It does not seem to distinguish between the different vaccines?

And full vaccination provides nearly equivalent protection.
 
How effective are the different vaccines against Delta

www.yalemedicine.org

Comparing the COVID-19 Vaccines: How Are They Different?

Keeping up with COVID-19 vaccines can be a daunting task. To help people keep up, Yale Medicine mapped out a comparison of the most prominent ones.
www.yalemedicine.org www.yalemedicine.org

Pfizer: two studies reported by Public Health England that have not yet been peer reviewed showed that full vaccination (after two doses) is 88% effective against symptomatic disease and 96% effective against hospitalization.

Moderna: While more research is needed on Moderna’s efficacy against Delta, some experts believe it may work similarly to Pfizer since both are mRNA vaccines.

Johnson and Johnson: More data is needed to determine the effectiveness the vaccine against the Delta variant.

Astra Zeneca: As far as the Delta variant, two recent studies (neither has been peer-reviewed) showed, respectively, that full vaccination after two doses is 60% effective against symptomatic disease and 93% effective against hospitalization.
 
A good article here

www.irishtimes.com

Experts call for vaccination of younger people amid Delta concerns

Preference among some scientists is to stick with mRNA vaccines if they are available
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Kingston Mills, professor of experimental immunology at Trinity College Dublin, said that it would be “sensible” to administer the one-dose J&J jab to younger people who account for a large majority of the new Covid-19 cases given the low risk from blood clotting side effects.

Newly published research this week has shown the effectiveness of mixing vaccines. Prof Mills said that giving people a “primer” first dose of the AstraZeneca with a follow-up booster dose of the Pfizer vaccine has resulted in a “dramatically enhanced” antibody response

“It might be sensible to vaccinate those now especially with any available spare vaccine. That seems to me to be an ideal cohort to give it to,” he said.


He advised that if the Government has substantial spare vaccines available, they should “just get it out as quickly as possible and stop the transmission of the virus.”

However, not everyone agrees. Sam McConkey, a professor of infectious diseases at the [broken link removed], said the Government should stick to its strategy.

“Moderna or Pfizer; if we got a large number of mRNA vaccines that would be preferable,” he said, “I’m not sure it should be a priority for us to change our national guidelines to AstraZeneca.”

The Delta strain of the virus is now accounting for one-fifth of Irish cases,

UCD virologist Dr Gerald Barry said supply should influence decisions. While mRNA is preferable, AstraZeneca could be appropriately used on younger people, if the only vaccine available.

The risk of clots amongst young people from AstraZeneca is small compared with the risk posed by the more contagious Delta variant, said Dr Barry: “That’s the risk equation that they are weighing up,” he said
 
Brendan Burgess said:
How effective are the different vaccines against Delta

Pfizer: two studies reported by Public Health England that have not yet been peer reviewed showed that full vaccination (after two doses) is 88% effective against symptomatic disease and 96% effective against hospitalization.

Moderna: While more research is needed on Moderna’s efficacy against Delta, some experts believe it may work similarly to Pfizer since both are mRNA vaccines.

Johnson and Johnson: More data is needed to determine the effectiveness the vaccine against the Delta variant.

Astra Zeneca: As far as the Delta variant, two recent studies (neither has been peer-reviewed) showed, respectively, that full vaccination after two doses is 60% effective against symptomatic disease and 93% effective against hospitalization.
Click to expand...

Given that Johnson is a similar profile vaccine to Astra Zeneca, I would be concerned about its effectiveness v Delta variant with only single dose.

I was keen on Johnson from the outset, single dose and done - in the end I got Pfizer and in light of Delta am relieved about that.
I would not be surprised if we see a situation where people over 50 who received Johnson require an mRNA booster.
 
Brendan Burgess said:
What are the facts here. I can't find them.

1) Do we know what percentage of cases are the delta variant in Ireland? It seems that it will become dominant soon, but so far, it's not the dominant variant.

2) What is the difference between a double AZ vaccine and an AZ vaccine followed by an mRNA vaccine?
How much more likely am I to contract Covid?
If I do contract it, how much protection does the Double AZ give me from getting sick.

Brendan
Click to expand...
I'll have a go at these.

(1) The delta variant is believed to be about 20 % of cases last week. However as its transmission is thought to be 70% higher than other variants to date.

(2) Very little, there are observational studies where this was done and no decrease in efficacy was noted. I seem to remember a study in Spain that showed there might be increased protection. But these are small studies and aren't peer reviewed.

Good question, you have received one AZ dose and that offers some protection in itself. However as the Delta variant transmits very easily, some say in seconds and in fleeting contacts, Scottish footballer for example, I would imagine if you continue good hygiene and observe social distancing etc and with your first dose its probably harder for you to become infected than someone who isn't vaccinated at all.

It's very difficult to be certain though.
 
odyssey06 said:
Given that Johnson is a similar profile vaccine to Astra Zeneca, I would be concerned about its effectiveness v Delta variant with only single dose.

I was keen on Johnson from the outset, single dose and done - in the end I got Pfizer and in light of Delta am relieved about that.
I would not be surprised if we see a situation where people over 50 who received Johnson require an mRNA booster.
Click to expand...
We all will need a booster Odyssey and it's going to be Pfizer no matter what your primary vaccine was. AZ aren't being ordered from next month and AZ will only fulfill a portion of its contract.

Pfizer are preparing hard for security of supply by getting Dublin, Zagreb and 2 plants in Austria producing drug substances for the vaccine.
 
My personal opinion is that all those over 60 and those deemed vulnerable need to be vaccinated fully first ,using everything we have that will take 10days to a week based on rollout run rate and deliveries to date.
Keep the registration going and then focus on the 2nd doses for 59 58.....until they can say that all over 50s are fully vaccinated then the 40s and so on.

Pfizer is dropping 1m doses a month now (250 a week) that dwarfs all other supplies by just over 2:1, but there are risks in this too.

If we let the Delta variant run wild in the younger age class we risk having thousands of cases a day. But many advocates of full reopening now say the younger people "can handle it" ?
 
Brendan Burgess said:
But they took a risk which paid off. It might not have paid off. They could have become very sick with Covid during the delay.
Click to expand...
Most of them didn't take a risk because word quickly went around the grapevine that if you refused the AZ jab you would then be offered the Pfizer. As a result they (as O'Toole calls them "the Astra dodgers" or "the bad") would be fully vaccinated weeks before "the good" who followed the official advice. O'Toole ends his article with "And if you make people feel foolish for obeying the authorities in a crisis, they will be less inclined to do so when the next one arrives". He's absolutely right.
 
Prosper said:
Most of them didn't take a risk because word quickly went around the grapevine that if you refused the AZ jab you would then be offered the Pfizer. As a result they (as O'Toole calls them "the Astra dodgers" or "the bad") would be fully vaccinated weeks before "the good" who followed the official advice. O'Toole ends his article with "And if you make people feel foolish for obeying the authorities in a crisis, they will be less inclined to do so when the next one arrives". He's absolutely right.
Click to expand...
Agreed. I missed out on that grapevine information but had rung my GP in mid-April to ask whether they could vaccinate me. No, but they would put me on 'the list'. A week later, I registered for AZ (age 68), though I was annoyed at being bullied by Leo: I would go to the back of the queue / not be vaccinated till Autumn if I didn't take it.

On 28 April, I was vaccinated with first AZ. On 3 May, the GP rang to say I could get Pfizer with them if I hadn't registered.

Shortly afterwards, I was told officially I had a 'vaccine bonus' and was 'fully vaccinated' with AZ after 4 weeks - yes those words were used though they seemed bizarre and I wondered if they were a patronising sop to those of us who realised our compliance had not necessarily served us.

Now waiting for second AZ vaccine, which should come in the next couple of weeks.

I get it: it's a global pandemic, it's a moving target and we've secured and paid for these vaccines. I am deeply grateful for geographical privilege. Future compliance is not encouraged by patronising and threatening this cohort.
 
jupiter said:
Agreed. I missed out on that grapevine information but had rung my GP in mid-April to ask whether they could vaccinate me. No, but they would put me on 'the list'. A week later, I registered for AZ (age 68), though I was annoyed at being bullied by Leo: I would go to the back of the queue / not be vaccinated till Autumn if I didn't take it.

On 28 April, I was vaccinated with first AZ. On 3 May, the GP rang to say I could get Pfizer with them if I hadn't registered.

Shortly afterwards, I was told officially I had a 'vaccine bonus' and was 'fully vaccinated' with AZ after 4 weeks - yes those words were used though they seemed bizarre and I wondered if they were a patronising sop to those of us who realised our compliance had not necessarily served us.

Now waiting for second AZ vaccine, which should come in the next couple of weeks.

I get it: it's a global pandemic, it's a moving target and we've secured and paid for these vaccines. I am deeply grateful for geographical privilege. Future compliance is not encouraged by patronising and threatening this cohort.
Click to expand...
I really don't understand why that cohort would feel they were patronised or threatened.
At that time the Delta variant wasn't understood fully, the AZ vaccine was very effective against all the variants that were present in our communities and decisions were made based on scientific evidence that the AZ vaccine was safe for people of a certain age profile and this wasn't just the Irish medical profession saying this,this was the EMA and other European countries.

At that time supply was ropey to say the least and while AZ had improved its supply it was still behind their commitments. The decision to use AZ exclusively for that cohort and protect that cohort as much as possible had the effect of limiting what the rest of the population would receive or indeed push the rollout schedule out beyond the stated goals.
There were very few criticisms of that move by the cohort who are now claiming to be " bullied " by the statement by Leo that they might have to put to the back of the queue.
At that time both Pfizer,AZ and Moderna were almost equal in the level of protection from serious sickness or hospitalisation from the virus and if there wasn't another variant now yes that would be described as a " bonus " as the original cohorts were scrapped and an age based system introduced in order to protect more of our older population earlier than was first decided.

Whatever about the past the future will be a lot simpler in that booster jabs will be all mRNA and the vast majority will be Pfizer.
 
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