MedEwok wrote:
I am more optimistic, because the tool of mRNA vaccines – if successful – is extremely powerful. They are much easier to produce than classic vaccines, especially in large quantities. You no longer need any “boosters” for the immune system response, which tend to create most of the side effects in other vaccines.All you need is the genome of a virus and then – in theory – you can create a vaccine against any virus. In practice, medicine is never that simple because there are always complex interactions at work that we don’t fully understand, but we nevertheless might be onto something great here.
Note that the same technology holds promise in fighting cancer, and Biontech has already announced they will research that next…
That is interesting, I nearly wrote somethin similiar. What has slighly shifted my view was reading not so much how long it takes to develop a new vaccine (which as you indicate with with mRNA, and even the more conventional approaches) has improved significantly, it seems to me no where near as much progress has been made in the trials, production and distribution and these remain far more the bottle necks. It is difficult to see how you can speed up the trtials significatnly, and even with vaccines of the same type it seems unlikely we will move to reduced trials anytime soon. Production times presumably may improve, but I wonder by how much they can improve. Batch testing it would seem is still slow(ish), and it would also seem each production run of a new vaccine is sufficiently different that you cant use exactly the same approach for each type. Distribution comes with all the usual challenges of getting the product out to the coal face in sufficient volume, easier in the developed west, always a challenge elsewhere I suspect.
By how much do you think the current window of perhaps 24 months from start to vaccinating the vast majority of Europe’s population can be reduced?
Fuji_Abound wrote:
By how much do you think the current window of perhaps 24 months from start to vaccinating the vast majority of Europe’s population can be reduced?
It’s all a question of how hard we try and how much we are willing to invest into it.
With enough money we can quite easily cut 6 months out of manufacturing time: production of mRNA vaccines scales linearly with parallelization and the means to produce are theoretically unlimited. Therefore it is only a cost issue that today we do not have enough doses of any of the vaccines already today. If German government had decided beginning this year to invest billions into ramping up manufacturing capacity in parallel to development, we would already be there (the government, however, would most likely not be if they had invested billions into manufacturing capacity for the wrong compound and therefore they didn’t).
Another 1-2 months we can easily cut out of the approval process if the authorities would not wait for the completed dossier but would start working immediately on first documents a little bit what the British did this year.
A major improvement would be (in the ballpark of 3-6 months) if we would skip that whole Stone Age documentation process altogether and have the development organizations and authorities work together on the raw data in real time. This, however is not wanted by the industry as they would loose some levers to tweak the results and at least fear that too much transparency does not help them.
The earlier stages of the process have already been quite optimized in recent years and therefore I would only see more limited improvement potential in the near term.
They have to do much better than 24 months.
The UK is going to take 10 years at current rates, but they are doing the old peoples’ homes first and the occupants have to be ferried to where it is done, and with appropriate precautions this is obviously very slow. It will speed up over time.
Peter wrote:
but they are doing the old peoples’ homes first and the occupants have to be ferried to where it is done, and with appropriate precautions this is obviously very slow. It will speed up over time.
The limiting factor for quite some time will be availability of vaccine, not bringing people to the needle (or the needle to people). It would be “extremely unwise” if a politician decides that they rather pile up vaccination doses that arrive faster than patients than vaccination other (i.e. younger) patients out of order as long they have doses.
Malibuflyer wrote:
A major improvement would be (in the ballpark of 3-6 months) if we would skip that whole Stone Age documentation process altogether and have the development organizations and authorities work together on the raw data in real time.
That seems to be something the MHRA did at least to some extent: “The Medicines and Healthcare Products Regulatory Agency gave temporary authorisation to the supply of specific batches of Pfizer and BioNTech’s vaccine on 2 December,1 on the basis of efficacy data submitted between 1 October and 2 December 2020. The regulator credits the rapid turnaround to its “rolling review” process, which allowed it to analyse the data as they were submitted.”
Not quite embedded in real-time data gathering, but not ‘please attach all data to form ABC-1232 in triplicate’ either.
See BMJ
Malibuflyer wrote:
The limiting factor for quite some time will be availability of vaccine, not bringing people to the needle (or the needle to people). It would be “extremely unwise” if a politician decides that they rather pile up vaccination doses that arrive faster than patients than vaccination other (i.e. younger) patients out of order as long they have doses.
It’s not a limiting factor yet. We have 800k doses in the country right now, with another 4m due by the end of the year, and in the first week we have given the first jab to 138k people.
The very old and those in care homes are obviously extremely slow and cumbersome to do. Once they are done (how long will that take, if they don’t start taking the vaccine to the people rather than trying to bring the least-able-to-move people to the vaccine?) they will need to roll out some mass-jabbing system for the rest of us.
With ~100 mass vaccination sites across the country, each site with 100 jabbers, each doing 30-40 jabs per hour you can easily get to 1-2m jabs per day. The limiting factor would be finding and training the 10,000 jabbers, or realistically 2-3 times that many to make it sustainable.
You can’t just give it to hospitals and GPs and let them get on with it. That way it will take a few years.
Having 10,000 people to perform vaccination should not be that difficult, unless one pointlessly insists all of them must be specialist doctors.
In Germany the “needle work” will largely be done by other health professionals: physician assistants, paramedics, nurses. The only step of the process that legally requires a doctor is the information of the patient before they can give their informed consent to the jab.
Btw., 27 million people were vaccinated against the flu in the span of a few weeks, in Germany, mostly by GPs in addition to their regular work, so I don’t think mass vaccination is a difficult logistics exercise if you have enough of the vaccine. For SARS-CoV2 it would be beneficial to have a vaccine that does not require deep freezing to conserve it.
You don’t need to vaccinate the whole population either. In Switzerland 80% of the Covid hospital intakes are in the 60-80yo (and there’s no reason to expect significant variance elsewhere in Europe).
Vaccinate that demographic and that’ll have a very significant impact on healthcare availability & general infection dynamics.
T28 wrote:
In Switzerland 80% of the Covid hospital intakes are in the 60-80yo (and there’s no reason to expect significant variance elsewhere in Europe).Vaccinate that demographic and that’ll have a very significant impact on healthcare availability & general infection dynamics.
Fully agree – if (or rather as long as) the primary objective of the vaccination is to avoid overload of the health system in terms of ICU beds, then vaccination of the 55+ will do most of the trick.
If we want to avoid that up to 10% of the working population acquires some form of long term disability due to long Covid, we need to vaccinate many more very quickly.
The health care center of my old man asked me yesterday evening if we wanted to give him a vaccine. He (and all the others at the center) have been pretty much isolated since Mars. He will get the first injection within a week or two, then another one 2-3 weeks later. After that, things will be back to normal.
