Why vaccinate people under 50 years of age?

Treatments and their effectiveness, herd immunity, masks, testing, etc.
fon
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Re: Why vaccinate people under 50 years of age?

Post by fon »

thinksaboutit wrote: Sun Feb 07, 2021 2:39 pm
Splatt wrote: Fri Feb 05, 2021 2:02 pm
Almost no under 50s outside risk groups die of it.
According to NHS publications valid to 4 February
19% (6) of 0-19 yo deaths were without pre-existing conditions
14% (68) of 20-39 yo deaths were without pre-existing conditions
10% (497) of 40-60 yo deaths were without pre-existing conditions
Splatt has a great deal of knowledge about biology and drugs. And he is well informed. But it is spoiled because he can't resist adding a bit of spin. Splatt, you don't have to wing it, stick to the basic facts.


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MikeAustin
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Re: Why vaccinate people under 50 years of age?

Post by MikeAustin »

thinksaboutit wrote: Sun Feb 07, 2021 2:39 pm
Splatt wrote: Fri Feb 05, 2021 2:02 pm Almost no under 50s outside risk groups die of it.
According to NHS publications valid to 4 February
19% (6) of 0-19 yo deaths were without pre-existing conditions
14% (68) of 20-39 yo deaths were without pre-existing conditions
10% (497) of 40-60 yo deaths were without pre-existing conditions
Those are high proportions of small numbers, so let's get some perspective.
nhs-deaths.jpg
nhs-deaths.jpg (112.13 KiB) Viewed 657 times
For under 60s, the fatality rate is 1/10 (0.013%/0.13%) of the average and for under 40s it is 1/71 (0.0018%/0.13%). If we wanted an under 50s figure, we could provisionally take a geometric mean of 1/27. And this assumes similar exposure, even though the older people will mix less.

So we have the chances of dying of covid, from these figures (a pseudo IFR), for under 50s of 0.13%/27 = 0.0049%. Splatt is vindicated!

Splatt
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Re: Why vaccinate people under 50 years of age?

Post by Splatt »

Once you're vaccinated <50s with co-morbidities the IFRs are in line with seasonal flu.
Very little point doing any more.

thinksaboutit
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Re: Why vaccinate people under 50 years of age?

Post by thinksaboutit »

Splatt wrote: Sun Feb 07, 2021 3:41 pm
thinksaboutit wrote: Sun Feb 07, 2021 2:52 pm Where is your peer reviewed data showing it confers any sort of lasting immunity?

https://science.sciencemag.org/content/ ... 9/eabf4063
https://www.gov.uk/government/news/past ... smit-virus
https://www.cidrap.umn.edu/news-perspec ... t-8-months
https://www.cell.com/cell/fulltext/S009 ... 20)31008-4
https://directorsblog.nih.gov/2020/07/2 ... -covid-19/
https://www.nature.com/articles/s41586-020-2550-z
https://jamanetwork.com/journals/jama/f ... e/2770758/
https://www.news-medical.net/news/20200 ... ID-19.aspx
https://www.cebm.net/covid-19/what-is-t ... ntibodies/
https://pubmed.ncbi.nlm.nih.gov/32668444/
https://www.nature.com/articles/s41577-020-00436-4
https://directorsblog.nih.gov/2020/10/2 ... or-months/
https://pubmed.ncbi.nlm.nih.gov/33033172/

There are more but thats just some starting references.
These look like references relating to infection generated immunity.

Pointing to first emerging data for immunity, relating to vaccine. There was the news last week on the oxford vaccine.

https://www.ox.ac.uk/news/2021-02-02-ox ... h-interval#

Headline findings here.

"analyses reveal single standard dose efficacy from day 22 to day 90 post vaccination of 76% with protection not falling in this three-month period
After the second dose vaccine efficacy from two standard doses is 82.4% with the 3-month interval being used in the UK. (82.4% effective, with a 95% confidence interval of 62.7% - 91.7% at 12+ weeks)
Data supports the 4-12 week prime-boost dosing interval recommended by many global regulators
Analyses of PCR positive swabs in UK population suggests vaccine may have substantial effect on transmission of the virus with 67% reduction in positive swabs among those vaccinated"

https://papers.ssrn.com/sol3/papers.cfm ... id=3777268

While this does not show anything beyond 90 days, it does not show protection against disease or infection reducing in this time period. It is likely to be helpful in both respects beyond this time and certainly nothing suggests the opposite.

So it is very likely to be helpful to the whole population that under a good proportion 50s get vaccinated. Planning an approach on reasonable information and expectation seems very rational. The timing of such vaccination will also allow much more data on effectiveness to emerge and people can reconsider their stance.

I'm not sure if your stance is that vaccines produce no immunity, or that there is no evidence of such.

Useful if you would clarify.

Splatt
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Re: Why vaccinate people under 50 years of age?

Post by Splatt »

There's no evidence of such.
Many vaccines for many diseases do not produce immunity.
There are *very* few vaccines that produce lasting sterilising immunity which is the holy grail.

There's also a huge difference in vaccine efficacy. None of the trials compare like-for-like.
Some are concerned with only studying symptom reductions, some only tested if symptoms appeared, others tested everyone regardless.
So an "efficacy" means too many different things.

There was some data that Pfizer massively reduced infection and very early data Novavax might even be sterilising which is great news in the small timescale studied.
On the flip side we know the Oxford ZA in particular (more and more looking like the 2nd division vaccine) isnt sterilising, might reduce transmission a bit but jury is still out and is less effective at preventing mild or moderate symptoms.

So if you're going to vaccinate people with that one (which is likely the UK plan) then no, theres very little point at all. They're better off catching it, being at worst grumpy for a few days and then picking up longer lasting immunity.
If they're vaccinated with Oxford, they'd STILL need to catch it to generate that sort of immunuty.

The equation changes if we can get lasting sterilising or semi-sterilising from the likes of Pfizer, Novavax etc. But currently we simply dont have any data.

amanuensis
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Re: Why vaccinate people under 50 years of age?

Post by amanuensis »

One reason to be cautious regarding universal vaccination is that it produces a homogeneous immunity profile. This might increase risks for the vulnerable groups.

Community wide vaccination is beneficial when it offers sterilising immunity, or with very slowly mutating viruses -- in these cases the community vaccination can offer beneficial control of the disease.

However, if the immunity is not sterilising and where there is rapid mutation in the virus, then there is a risk of the virus mutating to evade the immunity offered by the vaccine.

In the case of community-wide vaccination (and thus there being similar immunity characteristics in everyone) there is immense evolutionary pressure for the virus to mutate so that it can escape the vaccine. What's more, because everyone has the same vulnerability to that escaped variant, it can spread very rapidly in the population once it has achieved vaccine escape. The risk then is an increase in hospitalisations/deaths in vulnerable groups.

The way to minimise this risk in our current situation is to vaccinate as few people as possible, consistent with achieving protection for vulnerable groups. This way you achieve a robust (rather than fragile) herd immunity; the population is dominated by those with a heterogeneous immunity profile resulting from natural infection (with low hospitalisation/death rates because they are not vulnerable to Covid-19). This ensures that variants that achieve vaccine escape are suppressed within the herd, because the immunity profile in the greater population is complex and likely to offer protection against vaccine escape variants.

RichardTechnik
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Re: Why vaccinate people under 50 years of age?

Post by RichardTechnik »

I would agree with this. Natural ( used to called 'herd' immunity ) gives a wider Gaussianaspread against mutation.

But it undermines the vaccine facists who are seeking control by using Covid and universal vaccination as a proxy.

Splatt
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Re: Why vaccinate people under 50 years of age?

Post by Splatt »

amanuensis wrote: Mon Feb 15, 2021 10:29 am One reason to be cautious regarding universal vaccination is that it produces a homogeneous immunity profile. This might increase risks for the vulnerable groups.
That's the issue nobody seems to be bothered about.

Currently all of our vaccines target a tiny (and most mutationally active) part of the spike.
Its an incredibly narrow immune response to a small, very specific part of the virus.

This is going to hugely increase selection pressure for evasion and once that happens (which it appears it already has in E384K, it could very rapidly render *everyone's* immunity null and void.

So yes, its better to only protect the vulnerable so the virus itself is exposed to that resistance as fewer times as possible to reduce the chance of it evolving evasion.

Same principle as ours antibiotics of last resort for treating resistant strains. You only bring them out to play when theres no other option.

If we had fully sterilising vaccines then that's different but we do not.

We're creating the most favourable conditions possible for escape mutants and thats without us adding the partial immunity plan on top of that again.

Even PHE have now admitted naturally immunity provides robust lasting immunity. Its also highly likely to be far more resistant to mutants in generally as its a whole body response to whole virus.

thinksaboutit
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Re: Why vaccinate people under 50 years of age?

Post by thinksaboutit »

A. The public health response is focussed on vaccinating as many adults as possible, to reduce cases, admissions and deaths. But also states that reducing the amount of virus circulating, reduced reproduction and the probability of problem mutations arising.

B. Against that, there is the case that increasing immunity levels creates evolutionary pressure, which could allow some mutations to dominate (those resistant to the immunity created in the population). If immunity from vaccination is narrower than that from surviving natural infection, this could lead to a vaccine resistant mutation dominating. There are some here with an absolute conviction that this effect will dominate.

So 2 questions arise, since both are plausible :

1. What evidence is there that vaccine derived immunity is narrower than disease derived immunity?
2. How are the do the mechanisms A and B balance against each other?

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