COVID Vaccine !

[Rocky]

How about this from @srw:



Looks like a bold assertion to me, and there were plenty of similar ones from others.

A cautionary tale for all those on here who immediately slag off every government policy before it has even started.

I would also apportion a huge amount of credit to the NHS staff who have made this happen plus the volunteers at vaccine sites. I have connections with one North London practice which is acting as a centre. The partners and staff are working round the clock. They've repurposed 50% of the surgery to make it fit for purpose and to ensure no one gets infected while attending. Medical and nursing staff from a nearby teaching hospital have given up evenings and weekends to act as vaccinators.

Plus we must say chapeau to all those scientists who worked round the clock to get these vaccines rolled out in record time. I don't know much about the Pfizer jab but the Oxford Vaccine Group all deserve damehoods and knighthoods for what they've achieved.

 

[roubaixtuesday]

This is not a short race though; but by the end of spring the UK should be close to herd immunity (which is of course the overarching aim).

I'm not sure this is true.

The vaccination strategy at the moment, as I understand it, is to prevent serious disease rather than to achieve herd immunity.

As I understand it, the latter, even if vaccine is 100% effective against transmission, is very unlikely to be achieved for some time, if ever, particularly given that no vaccines are yet approved for children. And there is currently little or no evidence on protecting against transmission, though some protection is expected.

If there's a published strategy for achieving herd immunity, I'd be very interested to see it.

 

[mjr]

I can only assume that my Saturday assessment was not sufficiently clear, or that the maths is too difficult (for you).

No, you were on ignore, but someone told me about your insulting post. You make snide comments about the maths being too difficult when you probably remember my qualifications, so maybe you were trolling. Where we disagree is not due to the difficulty of the calculation, but the unjustified assumptions:

Reduce that by 20% 'offered but refused' = 12M. Add a million for 'bias'/offered = 13M doses

Both of these numbers appear to be pulled out of thin air. Why 20% refusals? That's even below the current UK average vaccine take-up willingness of 81%, and the priority groups are reportedly more willing than average, with some areas actually hitting 100% attendance (although some are then unable to receive it due to clinical reasons).

Without that particular assumption, even the optimistic calculations in the rest of the post (which seem to assume that everything continues at the current high rate, that all the jabs are going to priority groups and that the last few % of priority groups aren't the most difficult to reach) show the target being missed.

I don't know what "for 'bias'" means there. "Bias" is a term with a statistical meaning that does not apply here and its misuse is dashed irritating, bordering on trolling mathematicians IMO.

And let us remember that the target is "vaccinating all residents in a care home for older adults and their carers, everyone over the age of 70, all frontline health and social care workers, and everyone who is clinically extremely vulnerable" not merely "offered".

I anticipate that [...]

BBC Live
Social Care minister Helen Whately says

This sort of Aunt Sally (arguments against points no-one here was making - a sort of "I hit him back first" debating tactic beloved of politicians) and vague links to the top of ephemeral rolling-update pages that no longer appear to contain the claimed quote exemplify the main reason why I was ignoring this poster. The posts seem very misleading but constructed to make checking them very very time-consuming.

 

[Kingfisher101]

Are you suggesting that there's a link between the two events?

How do you know?

The Dr said to his wife, he also had it then collapsed straight away. Also a healthcare assistant friend of another neighbour had it and died in her late 30s as well of a bad reaction. It does happen.

 

[Ajax Bay]

No, you were on ignore, but someone told me about your insulting post. You make snide comments about the maths being too difficult when you probably remember my qualifications, so maybe you were trolling. Where we disagree is not due to the difficulty of the calculation, but the unjustified assumptions:

Welcome back!
If you had arranged not to read my earlier post, I can understand why you were unaware of the figures. I have absolutely no idea what your "qualifications" are. How do you mean "remember"? Do share your qualifications so we can see your maths credentials. Then I'll know it's not your maths letting you down. You have a low threshold for determining posts are (insulting, snide, trolling) imo.

Both of these numbers appear to be pulled out of thin air. Why 20% refusals? That's even below the current UK average vaccine take-up willingness of 81%, and the priority groups are reportedly more willing than average, with some areas actually hitting 100% attendance (although some are then unable to receive it due to clinical reasons).

I chose 20% 'refusals' (and that term includes all reasons, valid and less so, for those choosing not to be vaccinated when offered) because it's an easy number for people doing the maths (as opposed to 19% - which I was aware was the reported figure - see your link). See 'bias' below for more on this.

Without that particular assumption, even the optimistic calculations in the rest of the post (which seem to assume that everything continues at the current high rate, that all the jabs are going to priority groups and that the last few % of priority groups aren't the most difficult to reach) show the target being missed.

I AM assuming that the current 7-day average rate will be maintained: I say so explicitly - and that's a realistic not an optimistic assumption. You are the pessimist outlier here. The number of jabs currently going outside those in Gps 1-4 will be small - that's a reasonable assumption (within 9M jabs). Covered by my 'bias' tolerance qv. The last few % will be difficult. Do you think that if even one person in Groups 1-4 has not been "offered" a first dose the programme will have failed to meet its "exceptionally challenging target"?

I don't know what "for 'bias'" means there. "Bias" is a term with a statistical meaning that does not apply here and its misuse is dashed irritating, bordering on trolling mathematicians IMO.

In project management (PM) it is standard practice to include an allowance for 'optimism bias' and 8% is often used. That's what I did, adding a million to the calculated number (12M > 13M). This might cater (for example) for a lower percentage of 'refusals' in Groups 1-4, or that 15M was a slight underestimate. Project managers have to cope with the real world: 'trolling mathematicians' is, as you say, merely (and imo unreasonably and without foundation), your perception/opinion.

And let us remember that the target is "vaccinating all residents in a care home for older adults and their carers, everyone over the age of 70, all frontline health and social care workers, and everyone who is clinically extremely vulnerable" not merely "offered".

Naughty, naughty! You do yourself a disservice. From your link, the PM said "By the middle of February, if things go well and with a fair wind [tailwind on the road] in our sails, we expect to have offered the first vaccine dose to everyone in the four top priority groups identified by the JCVI. That means vaccinating all residents in a care home for older adults and their carers, everyone over the age of 70, all frontline health and social care workers, and everyone who is clinically extremely vulnerable."
Thank you for providing the link so that selective quoting can be identified/pointed out without making "checking them very very time-consuming."

This sort of Aunt Sally (arguments against points no-one here was making - a sort of "I hit him back first" debating tactic beloved of politicians) and vague links to the top of ephemeral rolling-update pages that no longer appear to contain the claimed quote exemplify the main reason why I was ignoring this poster. The posts seem very misleading but constructed to make checking them very very time-consuming.

I think this was the first time I've been rash enough to guess/ anticipate what the next thrust of criticism would be once it had become clear that the headline target was likely to be met - so not a good exemplar - and as for rolling-update pages of the BBC - do you really think I'm making it up?
The BBC quote I shared was a very accurate (almost verbatim iirc) record of what the Minister said on the radio. Sorry checking it was onerous.
Finally "the [my] posts seem very misleading". I've done my best not to mislead: you have just nibbled at the edges: I hope your teeth are still OK. You suggested that the vaccination programme would need to "accelerate" to hit the 15 Feb target. I sought, with figures, to show that your assessment was not, in fact, true.

 

[Ajax Bay]

The vaccination strategy at the moment, as I understand it, is to prevent serious disease rather than to achieve herd immunity.

I think you're absolutely right. My assertion that "achieving 'herd immunity' is the overarching aim of the strategy" is wrong.
Once Groups 1-9 are vaccinated, that'll be 30M 'done - I've suggested possible dates elsewhere (?mid April). Aiui the programme will continue, presumably at the same pace, for under 50s, with some juggling to the 'top' of sections of the working population whose employment renders them at greater risk, and others eg teachers and the police.
I suspect that our leaders are steering well clear of the 'herd immunity' phrase after the bad press it got in March (and rightly so).
Achieving country-wide herd immunity depends on, inter alia, on the extent to which vaccinated (+ 14 days) but then infected individuals can transmit the infection (qv).
And we don't know this (because the trials didn't have it as an objective to test), but I hope we will by April. I hope that Israel's early experience will help the world, here.
Same for vaccinating under 18s. I assume there's work ongoing to determine the efficacy and safety of the vaccine(s) in the yoof with a target for results by (say) midsummer.
There will be some decision challenges ahead, in particular when it'd be right for UK to reduce the domestic vaccination rate and divert some supply to other countries: eg Eire, Gibraltar and less prosperous Commonwealth Family countries. But such issues will be opportunity challenges, not wicked problems.
JCVI: "JCVI has considered a number of different vaccination strategies, including those targeting transmission and those targeted at providing direct protection to persons most at risk.
"In order to interrupt transmission, mathematical modelling indicates that we would need to vaccinate a large proportion of the population with a vaccine which is highly effective at preventing infection (transmission). At the start of the vaccination programme, good evidence on the effects of vaccination on transmission will not be available . . ."
"Given the current epidemiological situation in the UK, the best option for preventing morbidity and mortality in the initial phase of the programme is to directly protect persons most at risk of morbidity and mortality."

 

[PK99]

I think you're absolutely right. My assertion that "achieving 'herd immunity' is the overarching aim of the strategy" is wrong.
Once Groups 1-9 are vaccinated, that'll be 18-20M 'done - I've suggested possible dates elsewhere (?mid April). Aiui the programme will continue, presumably at the same pace, for under 50s, with some juggling to the 'top' of sections of the working population whose employment renders them at greater risk, and others eg teachers and the police.
I suspect that our leaders are steering well clear of the 'herd immunity' phrase after the bad press it got in March (and rightly so).
Achieving country-wide herd immunity depends on, inter alia, on the extent to which vaccinated (+ 14 days) but then infected individuals can transmit the infection (qv).
And we don't know this (because the trials didn't have it as an objective to test), but I hope we will by April. I hope that Israel's early experience will help the world, here.
Same for vaccinating under 18s. I assume there's work ongoing to determine the efficacy and safety of the vaccine(s) in the yoof with a target for results by (say) midsummer.
There will be some decision challenges ahead, in particular when it'd be right for UK to reduce the domestic vaccination rate and divert some supply to other countries: eg Eire, Gibraltar and less prosperous Commonwealth Family countries. But such issues will be opportunity challenges, not wicked problems.
JCVI: "JCVI has considered a number of different vaccination strategies, including those targeting transmission and those targeted at providing direct protection to persons most at risk.
"In order to interrupt transmission, mathematical modelling indicates that we would need to vaccinate a large proportion of the population with a vaccine which is highly effective at preventing infection (transmission). At the start of the vaccination programme, good evidence on the effects of vaccination on transmission will not be available . . ."
"Given the current epidemiological situation in the UK, the best option for preventing morbidity and mortality in the initial phase of the programme is to directly protect persons most at risk of morbidity and mortality."

Surely the long term STRATEGY is herd immunity, the current TACTIC is to focus on the most vulnerable groups to minimize morbidity and mortality before moving on to the rest of the herd.

 

[mjr]

I chose 20% 'refusals' (and that term includes all reasons, valid and less so, for those choosing not to be vaccinated when offered) because it's an easy number for people doing the maths (as opposed to 19% - which I was aware was the reported figure - see your link). See 'bias' below for more on this. [...] In project management (PM) it is standard practice to include an allowance for 'optimism bias' and 8% is often used. That's what I did, adding a million to the calculated number (12M > 13M). This might cater (for example) for a lower percentage of 'refusals' in Groups 1-4, or that 15M was a slight underestimate.

Which project management standard is that?

So, 20% was primarily to make the maths easy, not based on reality. This is why we disagree on the required rate.

Now going back a step to address a bit in between:

I AM assuming that the current 7-day average rate will be maintained: I say so explicitly - and that's a realistic not an optimistic assumption.

On what basis is that assumption realistic not optimistic? Even Boris reckoned the target was "if things go well", yet those assumptions resulted in calculating that the target will be reached early, which I feel suggests a reality check is probably required.

You are the pessimist outlier here.

What, just for pointing out that the many optimistic assumptions? I'm a realist and the current reality is a slight undershoot.

The number of jabs currently going outside those in Gps 1-4 will be small - that's a reasonable assumption (within 9M jabs). Covered by my 'bias' tolerance qv.

What do you consider "small" there and what reason is the assumption based on? I've not seen any recent data on how many vaccines have gone outside those groups. I think I know seven people in priority groups who have been vaccianted and one non-priority but who knows what the average picture is?

The last few % will be difficult. Do you think that if even one person in Groups 1-4 has not been "offered" a first dose the programme will have failed to meet its "exceptionally challenging target"?

That's what a target means, isn't it? Boris didn't say "we will vaccinate the vulnerable people who are easy to do and worry about the rest later" did he?

A near-miss may not matter much, but how many would they have to not vaccinate before you'd accept it was a complete miss? A thousand? Ten thousand? A hundred thousand?

Naughty, naughty! You do yourself a disservice. From your link, the PM said [...]

Nothing naughty there: he said "offered" "means vaccinating" so not only putting offers in the post. It is emphasising the "offered" without its meaning that would be naughty and misleading.

and as for rolling-update pages of the BBC - do you really think I'm making it up?

I think it more likely to have been quoted selectively to support a different interpretation to what I would have understood from it.

I sought, with figures, to show that your assessment was not, in fact, true.

And I have now shown where it relies on several optimistic assumptions and some unreasonable-looking figures seemingly chosen to make the maths easy, so my assessment is, indeed, true. If the vaccination rate does not accelerate slightly, that target will probably not be hit — and if there is any supply problem, it'll be missed, which may explain some of the recent so-called "vaccine nationalism".

 

[roubaixtuesday]

Surely the long term STRATEGY is herd immunity, the current TACTIC is to focus on the most vulnerable groups to minimize morbidity and mortality before moving on to the rest of the herd.

I don't think so.

The tactic is as you suggest.

The strategy, both for the UK and globally, is not clear to me, and may depend on current unknowns, particularly vaccine efficacy, rate of mutation of the virus, and rate of decay of immunity.

Accepting endemic infection but controlling morbidity/mortality, as flu, seems more likely than herd immunity to me.

 

[lane]

Slower day today with only 319k vaccinations. 2.7 million approximately for whole of last week isn't bad.

 

[Ajax Bay]

I'm a realist and the current reality is a slight undershoot.

Thank you for that reasoned response. Would you care to offer a few figures to help us understand the extent of the 'undershoot' you declare 'reality': not sure how a hitting, exceeding or undershooting a future target can be judged 'reality' btw.
Here's a template to make it easy. You fill in the figures. Please be realistic.
A) Target = Offer everyone in Groups 1-4 a first vaccination by 15 Feb - Number = ??M
Percentage assumed 'offered but not taken' = ??%
Data from: https://coronavirus.data.gov.uk/details/vaccinations (I suggest: maybe there's something more authoritative you can find)
1) As at 1 Feb total first doses: 9,???,??? (@ 31 Jan = 8,997,329)
2) Assumed Daily rate = ???,??? per day (first doses, in arms, not 'offered')
3) Number of days till 15 Feb = 14
4) Reasonable estimate of next fortnight capability - ?,???,???
B) Reasonable estimate of numbers of first doses administered by 15 Feb Number = ??M
Result: Difference between (A) and (B). If result is negative: target hit/exceeded, for the avoidance of doubt.

 

[SpokeyDokey]

Slower day today with only 319k vaccinations. 2.7 million approximately for whole of last week isn't bad.

I think you need to look at the preceding Sundays. Yesterday was a big jump in the right direction.

17/1 227 882

24/1 221 067

31/1 322 194

All inc' of first and second doses.

9 790 576 first and seconds to date.

 

[Ajax Bay]

Slower day today with only 319k vaccinations. 2.7 million approximately for whole of last week isn't bad.

Monday released figures have been consistently low (jabs given on Sunday, I assume). See the graph I shared in post #1919.
Note almost none of these are second doses - 7520 in last recorded week.
2.7M is superb and a measurable tribute to all those in the complex delivery chain.
If we achieve only 2.2M per week for the next fortnight we'll achieve the stated target (see maths in an earlier post).

 

[lane]

No need to slow down on a Sunday.

 

[PK99]

I don't think so.

The tactic is as you suggest.

The strategy, both for the UK and globally, is not clear to me, and may depend on current unknowns, particularly vaccine efficacy, rate of mutation of the virus, and rate of decay of immunity.

Accepting endemic infection but controlling morbidity/mortality, as flu, seems more likely than herd immunity to me.

You are right of course that herd immunity depends on a number of unknowns, but Whitty's Gresham lecture of 2018(?) argued that the way out of a pandemic is herd immunity. I would guess that that remains the ideal strategic objective, with what you describe being the fallback position.

I think we are saying the same thing?