A couple of things I found interesting from the study:
- The eligible participants in the study tended to be over the age of 65 (Moderna median = 66, Pfizer median = 68)
- The Pfizer cohort (738 eligible participants) was almost twice the size of the Moderna cohort (476 eligible participants)
Would these factors have skewed the results at all? To me it seems like the study strongly indicates a difference for those age 65 and over but not necessarily for younger groups.
There is also still evidence of strong protection from hospitalization and death with both vaccines so I don’t think anyone necessarily needs to be regretting the fact that they got a pair of Pfizer shots at this point.
It's consistent with basically all non-US research too though, this is just one study out of many with consistent results.
The evidence for Moderna providing a larger immune response due to the 3x dosage and longer intervals between doses isn't really in dispute at this point.
> due to the 3x dosage and longer intervals between doses
Aren't these just hypotheses? They're very plausible, but I wouldn't go as far as saying the mechanism isn't in dispute. It's the outcome that isn't in dispute.
I think they are. The third factor that differs between the two is the design of the vaccine. Presumably they both target the spike protein and use mRNA so they should be similar but still different nonetheless.
Stupid question, could this come down to the volume of the shot? I understand Moderna is ~3x as much as pfizer volume wise, otherwise I thought the method of action is roughly the same.
Among other differences, Moderna dosages had ~3x more mRNA compared to Pfizer (100 v 30 micrograms), and their regime had longer periods between dosages. Apparently rationale for Pfizer doses was to minimize side effects because from their initial testing they did not find a significant increase in antibodies with a higher dosage [1].
"It found that, after the second vaccine dose, neutralising antibody concentrations were higher after an interval of 6-14 weeks than after the 3-4 week regimen that was initially recommended.
When looking at the delta variant, researchers also noted that, though there were good levels of antibodies after the shorter dosing interval, levels were 2.3-fold higher with the longer dosing interval."
This isn't really "new" knowledge, double vaccine shots for other illnesses are usually spaced months apart because it usually boosts immune response and vaccine longevity. I feel quite fortunate that I got Moderna, spaced 7 weeks apart, here in Norway.
My comment comes from chatter I've seen from actual infectious disease specialist and my friend who's has a masters in public health. My friend was assuring people that getting the second dose 'late' wasn't going to be a problem.
Other chatter I've seen is that which part of the immune system does the heavy lifting varies depending on the infectious agent. With Covid it's the CD4 T lymphocytes that appear to what's important. Antibodies by themselves aren't that effective. (Notable antibody based therapy has been a bust with Covid19)
This is interesting. In canada we had a longer waiting time between the shots because of lack of supply. People who got it earliest (older, etc) generally had a 12 week waiting time I think though it may have been shortened as we got more supply. I got my first (pfizer) as soon as I was eligible, and could get my second 8 weeks later. I think people that got their first shot later could wait a much shorter time, i.e. the recommended 3/4 weeks. It would be interesting to see if its possible to disentangle the effects of the way they were rolled out in different countries to see how much of a difference timing makes.
There are broader points to be made about the voting system on HN, and the efficiency with which we're sorting information. It bothers me how little conscious time we spend improving the mechanisms of the places we discuss in.
If the sorting system were a little better at avoiding good comments being downvoted, when they are pointing out something not immediately obvious and agreeable, that would elevate the efficiency of discourse.
That seems more valuable than the time that has been spent on it would seem to indicate.
Downvoting on HN is poorly implemented. It creates an unstable initial condition for a new comment. Downvote from initial 1->0 cascades into a snowball effect for ganering downvotes from other users who are pursuaded by the gray text. Similarly, if is upvoted from 1->2, then you have a strongly positive comment that will most likely stay positive.
Delaying the visual indicator of gray text for 1 hour would solve this problem. As it stands, it rewards pathological downvoters who continue to degrade healthy discussion on this site.
I think that's what they're all trying to do. The problem isn't the sorting system, it's the fact that a "good comment" can't be an objective thing in every possible context.
I feel like the error we have is in ranking down things that are uncertain.
If it's a certainty, people will vote for it quite a lot more than if it isn't.
That is a mistake. I want to look at factual posts that are new to me, but also non-obvious posts. We burry non obvious posts more easily than we should, today, I think.
The current system on HN is not too bad, but it could do a slightly more subtler job of promoting ideas that take a little bit more effort before they seem obviously true, in retrospect.
We're too quick to hide the subtle and the uncertain.
Indeed. To some extent, we can use pretty basic principles like the Law of Mass Action (https://en.wikipedia.org/wiki/Law_of_mass_action "In chemistry, the law of mass action is the proposition that the rate of the chemical reaction is directly proportional to the product of the activities or concentrations of the reactants.") to inform our priors on this. We should expect the Moderna one to be both somewhat more effective and have somewhat worse side effects simply due to the higher dose and similar action.
News was just coming out that Moderna faired better against the Delta variant than Pfizer which I had received back in February. I had an upcoming trip so I decided to go get the Moderna. The CVS pharmacist asked if I had received a Moderna shot before, nope, which is the truth. So I got the first Moderna shot about 3 weeks before my trip, and went ahead and got the 2nd round about 4 days ago.
I would much rather that every dose going un-used somehow find it's way into the arm of someone in the world that would take it and get us that much closer to stopping variants and achieving herd immunity, but that's not the world we live in. Instead doses are being thrown away, and enough people with access to the vaccine are instead insisting on dragging this pandemic out. So I'll take every defense available to me, and all the benefits it incurs to those around me, and not apologize for it (yes, I still wear a mask indoors even after 4 rounds.)
Did you have any side effects from the Moderna shots? I did the same thing as you (originally got Pfizer, decided to get a Moderna booster based on Delta efficacy; I have a young child who can’t be vaxxed yet). However, I haven’t yet had the 2nd Moderna dose. I am still debating it. So far I have pushed it out to the recommended 42 day maximum interval in the US. The thing that is keeping me on the fence is that the 1st Moderna booster I got hit me like a truck. I had much more severe fatigue and discomfort (i.e., body aches, maybe chest pain) than with the 2nd Pfizer dose (I had no side effects with the 1st Pfizer). I usually feel like crap for a couple of days after flu shots, so none of this is too alarming to me.
I initially thought about treating the Moderna round 1 as a booster to my 2 rounds of Pfizer. But the first time I posted from this account (I never should have used my real name for my primary account, too many crazies) it was to comment on a story about studies that Pfizer is less effective than Moderna vs Delta, that was 38 days ago. Now this discussion is coming from a story about hospitalizations rates for Pfizer vs Moderna. As the science regarding this pandemic changes my risk tolerance for myself and those for whom I'm responsible will change too. Right now "over vaccinated" isn't even a concept, if that changes I'll accept the consequences of my actions.
I lucked out and didn't have any side effects from either round of both types. My wife did the same as I did (the inability for our kids to get vaccinated was a huge driver in this decision for us too); the second round of both Pfizer and Moderna left her feeling crappy and tired the next day and she basically slept it off both times but she was back to normal the following days.
My first Moderna was way worse than the second other than a stronger headache. I am curious how common my experience is and how many decided not to have their second because of a poor first experience. I was for required for various reasons to take quick tests throughout which were all negative.
I had Pfizer for first dose and Moderna for second (Canada did a lot of vaccine mixing). Hard to isolate variables but I was almost totally fine after first dose but completely demolished with side effects of second dose for 36 hrs.
Wasn't expecting that... or was that because of the carefully asked and answered question about previously having had moderna, and not mentioning the previous pfizer?
was that because of the carefully asked and answered question about previously having had moderna, and not mentioning the previous pfizer?
Nope. I'm not going to bullshit anyone here, if I had been asked if I was already vaccinated I would have lied (BUT NOT IF THE DOSES COULD HAVE BEEN REDIRECTED, I never would have requested the Moderna round if doses weren't sitting unused.)
Kinda funny thay you’re more concerned about those that may have not gotten your doses instead of your own person, given that your combination of vaccines was very likely never tested on anyone.
Your assertion is trivially disproved by the fact that studies are required before recommending combining vaccines or additional doses. A vaccine is not like water, where nothing spectacular happens if you just take more of it or combine it with water from another well.
In Canada, many people got Pfizer as first dose and Moderna as 2nd. I'm curious to see the data on that. We also got our 2nd dose 2-4month after the first.
Angela Merkel did one Astra dose in April and then one Moderna dose in June. It likely works quite fine. I've yet to see any data showing that mixing vaccines produces a particularly greater risk of a bad outcome.
It did make me wonder why Merkel went with Moderna instead of BioNTech. I would assume she could have easily chosen either. Perhaps because Moderna was thought to be more potent by the June timeframe.
It may have been political. Germans are more likely to trust the BioNTech vaccine than the Moderna vaccine, so taking the Moderna vaccine sends the message that "All vaccines are good enough", which is the correct message if the intention is to maximise uptake of limited vaccine supplies. This was also probably the reason why she took the AstraZeneca vaccine in the first place.
This is what I had, and my one frustration is having such little data to suggest how this regime (mixing mRNA vaccines and long interval between doses) will or won’t perform over time.
This is a good question. Are you in the US? I think they are only approving the pfizer boosters right now for those 65+. However people are definitely going into CVS or whatever and say they need to get their first moderna shot…
No need to call out that it's for horses. Ivermectin is also used in humans for the same purpose (parasites). It's ineffective for covid, but adding the "horse" bit makes it seem more dangerous than it really is.
While it's true invermectin is also approved for humans, some people do buy/take the veterinarian tablets that target the, uh, "horse market". So they are in fact using a horse drug.
Ya know, I keep hearing this, but no one ever seems to quote any actual statistics of the practice happening. Even the big Rolling Stone article that half the media quoted and went viral regarding the Oklahoma ERs having a rash of veterinary ivermectin ODs was complete BS. Some other article I read quoted about a “rash” of calls about horse ivermectin to poison control, which buried a few paragraphs in the article turned out to be like 4-5 calls total and pretty much all were just general calls inquiring if it was dangerous.
So while I am sure there are some people taking it, I imagine it’s about as prevalent a practice as the “some people took fish tank cleaner” last year…which turns out apparently the only actual case was just some crazy lady trying to kill her husband.
But hey I’m open to real evidence of the practice if someone can find some actual data and post it. Until then I chalk this up as rumor and assumption.
Most (if not all) states aren't requiring an ID, so it's pretty easy. I'm getting suspicious of the Santa Clara county vaccination numbers. I wouldn't be shocked if 5% of people got a third dose.
The Pharmacist wording his question if I had previously received a Moderna shot instead of any covid vaccination at all makes me wonder if it was a nod to people looking for a vaccination most effective at the time.
I got the J&J back in early April which was all I could get my hands on back then(no side effects aside from a sore arm). After seeing its efficacy (specially against the delta variant) I went and got a Pfizer shot in early July which hit me like a truck. Since I was already "fully vaccinated" I delayed the second dose of my Pfizer shot till now (~10 weeks) to maximize the induced immunity. I gotta say the second dose of Pfizer only give me mild side effects for half a day.
I'm pretty sure we had plenty of evidence this was the case long before covid-19 was a thing. Wealthy people have better lawyers which affords them to do things like get away with murder, not pay taxes, have better medical care, have better housing, have better education, on and on and on.
Can confirm. The irony of the GP comment is, is this is the one rare time when healthcare access in the US doesn't differ between the rich and the poor, the vaccine is free for all.
>The irony of the GP comment is, is this is the one rare time when healthcare access in the US doesn't differ between the rich and the poor, the vaccine is free for all
There no irony here. It's just bad business for the ruling class if the proletariat that works for them and is the pillar of their wealth, dies off.
If there's no one left to grow and harvest your food, maintain water and energy infrastructure, then it doesn't matter how much cash, stocks, how many jets, yachts and McMansions you own.
I know plenty of rich people that got their shots really early. They didn’t do that using money; they used their creativity. They printed up a fake letterhead for a non-existent medical company and just went for it.
That attitude of ‘just go for it’ has a propensity to make people rich as well.
...unless they're unlucky to get caught early enough or don't have support of their rich family, in which case that's a propensity to make people go to jail.
How old are you that you’re even considering this? You’re unlikely to be posting here and belong to the at-risk demographic.
Also, since you believe the vaccines are valuable (otherwise you wouldn’t want a third), how do you deal with the thought that most of the world hasn't had an opportunity to get a first shot?
77% still quite a bit better than flu vaccines (40-60) but not nearly as good as some like measles (~97). They basically eradicated polio but that was 99-100% after three doses.
77% is the effectiveness against hospitalization. Effectiveness against infection and transmission tends to be lower. To stop the spread, what matters is effectiveness against transmission. And since there are animal reservoirs for COVID, it will not be eradicated.
Are there? It might have come from another species, but humans might not interact with it all that often. Other animals can clearly get it, but do we know the R0 for covid in, say, cats?
> Studies have shown that SARS-CoV-2 can infect many domesticated and captive creatures, from cats and dogs, to pumas, gorillas and snow leopards in zoos, and farmed mink. Outbreaks in mink farms have already shown that infected animals can pass the virus back to humans.
So is the 77% comparable to the effectiveness of polio vaccine? Or has the meaning changed. If a lot of these vaccines leave people walking around with no symptoms but still infectious it's a miracle they ever eradicate anything. It's starting to make sense why most diseases are still around actually.
My understanding is that for the polio vaccine, the effectivenesses are the same, but they are not for the COVID vaccine. I would appreciate it if someone could explain this.
Several inactivated virus vaccines exist for COVID-19. SinoVac/CoronaVac.[1] Sputnik-V.[2] Janssen.[3] (The Johnson and Johnson vaccine.) None are as effective as the messenger RNA vaccines at preventing symptomatic illness, although they're pretty good at preventing death.
All three are easier to store and transport than the mRNA vaccines, as well as being one-shot vaccines. There's a political problem - they're seen as inferior vaccines for poor people, at least in the US.
It’s unfortunate that went that way. There were supply problems with J&J, and by the time that cleared up, states had mostly built out infrastructure to handle the storage and transport limitations of the RNA vaccines.
One shot is a miracle for vulnerable populations — my dad was a very vulnerable person with limited mobility; the county sheriffs went out and vaccinated him and others. The two shot regimens are also difficult for workers in swing /night shift and other scenarios.
Yes, one shot is also good for rural population vaccinated with a mobile unit and maybe for some people are who are at risk getting a very powerful immune response and end up getting stuck with an incomplete vaccination scheme, because they can't take the second dose. I have an acquiantance in that position, she still has an off the scale antibody count after covid and the first Pfizer dose. It's great that we have more options now.
When the French gov't announced that you need a vaccination pass to be admitted into restaurants, more than 600k people registered for vaccination in the folliwing days, most of them for the one shot J&J vaccine. So I guess it's also good for undecided people?
Supply problems makes it sound like they didn't have enough ingredients to make it. IIRC the labs making it were contaminated. That's less of a supply problem than a competency problem.
There was a push for offering homeless individuals the Johnson and Johnson vaccine in several places due to it being a single dose vaccine. There was concern about the logistics of scheduling a second dose for the unhoused and adherence rates.
Sputnik V and Johnson and Johnson are not live or attenuated virus but adenovirus vaccines. They infect the host with a harmless virus that make your cell produce spike protein. They are a fairly new tech.
Also Sputnik V is a two dose vaccine, like Astra Zeneca’s
Sinovac is considered barely effective, even by WHO, who consider it to be 51% effective, vs. 70+% for Western vaccines. (50% is considered to be ineffective.)
Most countries who have an alternative don't use Sinovac.
Japan reported contamination of Moderna, and recalled a million doses:
There's plenty, Sinovac and Sinopharm to name a few. They aren't as effective because a dead virus doesn't trigger the same immune response as the live version. The western vaccines replicate an important piece of the live virus which produces a better immune response.
In general a whole cell vaccine is better as the entire virus gets targeted. I believe the mRNA was done the way it was for calendar speed. Hopefully whole cell vaccines will be approved in the near future as odds are they'll be much better at handling variants.
How can we talk in generalities about dead virus vaccines vs mRNA when these are the first ever mRNA vaccines approved? And the current attenuated vaccines are certainly not more effective than the mRNA vaccines.
Better stated would be that for other diseases, live attenuated and dead virus vaccines seem to target most of the virus vs just a small part of the virus (spike in this case). I think the target of just the spike was done for calendar speed. If a larger target can be used in the future, I think it'll have more success. Delivery can be mRNA or traditional.
Why would you expect a vaccine to confer significantly longer lasting immunity than an ordinary infection? What evidence do we have that natural immunity lasts any longer than a year?
In general natural immunity is as good or sometimes better than a vaccine.
N=1 that natural immunity lasts long has to do with my 70+ year old dad who got covid Summer 2020 and has been doing blood donations ever since as he has type O blood. Every time he goes in they report back that his antibody count is still high. I can't offer you any studies on that, just a personal antidote.
Edit guess I'll get more minus points for my N=1 antidotes
(Speculating here.) What I think might be a good idea is to do both. The mRNA vaccines seem extremely effective at what they do, but there might be benefit in giving the immune system experience with other parts of the virus besides the spike as that may make immune escape a lot harder for the virus to pull off.
It looks like there have been a few studies with inactivated SARS-CoV-2 vaccines. It looks like they are effective but I’m not sure if they are expected to be more effective than the current mRNA vaccines:
Wonder of the number and frequency of these 'surprises' has anything to do with them being trialed and authorized in 3-6 months rather than the standard 6-10 years.
Is there somewhere that tracks the number of Pfizer/Moderna/Other vaccines administered in the US?
> “That’s the beauty of the emergency use authorization,” said Monto, an epidemiologist at University of Michigan. “It can be changed based on changing data.”
It is pushing 2 years. Although this is technical language, really there should be a move away from the word 'emergency' to talk about what is going on. This is now what business as usual looks like for the next 5 years.
It is not pushing two years. The initial vaccination campaigns began last November in limited quantities.
Israel is the leader here, and has better control of reactionary elements of the population. Their data is pretty solid. Personally, I’d focus on the Israeli reports and ignore hot takes from the US government - between the chaos of the previous POTUS and the stresses of the pandemic, I think the US agencies are hurting.
- The eligible participants in the study tended to be over the age of 65 (Moderna median = 66, Pfizer median = 68)
- The Pfizer cohort (738 eligible participants) was almost twice the size of the Moderna cohort (476 eligible participants)
Would these factors have skewed the results at all? To me it seems like the study strongly indicates a difference for those age 65 and over but not necessarily for younger groups.
There is also still evidence of strong protection from hospitalization and death with both vaccines so I don’t think anyone necessarily needs to be regretting the fact that they got a pair of Pfizer shots at this point.
Source study: https://www.cdc.gov/mmwr/volumes/70/wr/mm7038e1.htm#T1_down