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AstraZeneca (Latest Trials)

The home for all non-political Coronavirus (Covid-19) discussions on The Lemon Fool
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This is the home for all non-political Coronavirus (Covid-19) discussions on The Lemon Fool
onthemove
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Re: AstraZeneca (Latest Trials)

#404136

Postby onthemove » April 14th, 2021, 11:18 am

absolutezero wrote:
Arborbridge wrote:
absolutezero wrote:What's that noise?
Oh. It's Macron and Merkel bad mouthing the J&J vaccine.

Oh. No. My mistake. They don't seem to have much to say about it.
Funny, that...


Perhaps they've learnt the lesson?


Or perhaps there isn't a lesson to be learned and it *IS* all purely political.
But you don't seem to be very open to that possibility, do you?

You never know. Maybe money from the 'for profit' vaccines has managed to find a way into EU politicians' pockets.
That would go a long way to explaining why the EU crooks don't like the AZN jab if it's only £3 a jab... Not much nest feathering can come from that.


So let me get this straight...

Various countries, including several non-EU countries, and including the UK themselves, have raised concerns over blood clots in relation to the OAZ vaccine, and imposed varying degrees of restrictions as a precaution.

The medical evidence would seem to justify concerns of a connection between the vaccine and the blood clots : https://www.theguardian.com/society/202 ... n-hospital

But what you're saying is that when the UK does it, and the various non-EU countries have done so, that this is all either completely non-political, or political only in the sense of being about money.

That perhaps, worst case, all the various 'independent' medical regulators around the world are being harsh on the AZ vaccine vs other vaccines because these supposedly independent regulators are all part of some globally orchestrated conspiracy.

And then when the EU countries do the same, even worse, it's all political because they want to have a go at Britain for leaving the EU?

That therefore you think the EU deserve specific, additional condemnation and vilification compared to other countries because of this.

And of course you have no bias against the EU yourself, or anything like that - you're not being in anyway political yourself.

Ermmm.. OK... if you say so...

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Re: AstraZeneca (Latest Trials)

#404154

Postby absolutezero » April 14th, 2021, 12:18 pm

onthemove wrote:And of course you have no bias against the EU yourself, or anything like that - you're not being in anyway political yourself.


Please do show me where I said I didn't have a bias or wasn't being political.

I am, unlike some on here, willing to actually consider alternatives to my own viewpoint.

You appear to be missing the central crux of my point.
Which is about the noisy fuss. Not the regulators wanting further evidence.

It is possible some named people from the EU side (mainly Macron and Merkel) were acting with an over-caution.
I just don't think it is likely given the comparative lack of noisy fuss over other adenovirus based vaccines.

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Re: AstraZeneca (Latest Trials)

#404159

Postby dealtn » April 14th, 2021, 12:23 pm

onthemove wrote:
But going forwards, when you know that a safer vaccine exists, that also happens to be more effective against covid to boot, it's a different picture.



Are you saying we currently know which vaccines are safer, and also know which ones are more effective, and they happen to be the same? Or you are making a hypothetical point?

It would be remarkably early in any vaccine's life to know enough at this stage to make those kind of claims I would think.

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Re: AstraZeneca (Latest Trials)

#404161

Postby GrahamPlatt » April 14th, 2021, 12:27 pm

I’m not aware that France or Germany are using any other adenovirus vaccines. There’s only Hungary in the EU I think (who’ve opted to use some Sputnik vaccine).

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Re: AstraZeneca (Latest Trials)

#404166

Postby Julian » April 14th, 2021, 12:47 pm

absolutezero wrote:
onthemove wrote:And of course you have no bias against the EU yourself, or anything like that - you're not being in anyway political yourself.


Please do show me where I said I didn't have a bias or wasn't being political.

I am, unlike some on here, willing to actually consider alternatives to my own viewpoint.

You appear to be missing the central crux of my point.
Which is about the noisy fuss. Not the regulators wanting further evidence.

It is possible some named people from the EU side (mainly Macron and Merkel) were acting with an over-caution.
I just don't think it is likely given the comparative lack of noisy fuss over other adenovirus based vaccines.

The US press is all over the J&J/Janssen vaccine at the moment. It would have been interesting to see how that translated to the EU in terms of "noisy fuss" but J&J itself somewhat pre-empted that because it has proactively stopped the roll out to the EU (https://www.dutchnews.nl/news/2021/04/j ... -features/).

The other adenovirus based vaccine that I am aware of is Sputnik V, used only in a few select EU countries (or only Hungary?) that somewhat went "off-piste". There one could speculate about the level of pharmacovigilance going on. The last I heard it started being rolled out in Russia before Phase 3 trials were complete and even now I've only ever seen interim analysis on relatively small phase 3 trials. Although it might well be a very good vaccine, the interim analysis looked very good, such an approach doesn't seem to me to be very encouraging regarding the level of pharmaceutical rigour going on during the development phase which also gives me some suspicion about how rigorous post marketing surveillance might be in this case. If/when it gets approved by some big agency such as the FDA, EMA or MHRA then it comes under the remit of those very structured and rigorous PMS systems but right now who knows how well that whole process is working.

- Julian

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Re: AstraZeneca (Latest Trials)

#404187

Postby Bouleversee » April 14th, 2021, 2:19 pm

I don't understand why people keep saying that Pfizer and Moderna have not had any instances of thrombocytopenia post vaccination when the following article has been linked to on here several times. Could someone please explain. If this is founded on fact, how does it make sense to abandon the cheap and available AZN vaccine in favour of others which may not be reliably available and are more expensive, not difficult when AZN are doing it on a not-for-profit basis?

https://onlinelibrary.wiley.com/doi/10.1002/ajh.26132

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Re: AstraZeneca (Latest Trials)

#404199

Postby murraypaul » April 14th, 2021, 2:54 pm

Bouleversee wrote:I don't understand why people keep saying that Pfizer and Moderna have not had any instances of thrombocytopenia post vaccination when the following article has been linked to on here several times. Could someone please explain.
https://onlinelibrary.wiley.com/doi/10.1002/ajh.26132


Their conclusion:
It is not surprising that 17 possible de novo cases would be detected among the well over 20 million people who have received at least one dose of these two vaccines in the United States as of February 2, 2021. This would be less than one case in a million vaccinated persons
[..]
Thus, the incidence of an immune‐mediated thrombocytopenia post SARS‐CoV‐2 vaccination appears either less than or roughly comparable to what would be seen if the cases were coincidental following vaccination, perhaps enhanced somewhat by heightened surveillance of symptomatic patients.


In other words, the rate of cases amongst people who were vaccinated is no higher than would be expected if they had not been vaccinated.

Conversely, for AZ, the rates seen are (statistically) significantly (four times) higher:
The current data suggests that the overall incidence is around 4 per million frst doses of the AZ vaccine administered.


how does it make sense to abandon the cheap and available AZN vaccine in favour of others which may not be reliably available and are more expensive, not difficult when AZN are doing it on a not-for-profit basis?


A difficult balancing act, to be sure, especially for poorer nations, where the balance is buying X Pfizer doses or 10*X AZ doses.
To my mind, in almost all places in the world we are still at the point of taking any of the vaccines being discussed that is available. All are better than nothing, and they aren't enough to go around.
Last edited by murraypaul on April 14th, 2021, 3:00 pm, edited 1 time in total.

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Re: AstraZeneca (Latest Trials)

#404202

Postby Julian » April 14th, 2021, 2:59 pm

Bouleversee wrote:I don't understand why people keep saying that Pfizer and Moderna have not had any instances of thrombocytopenia post vaccination when the following article has been linked to on here several times. Could someone please explain. If this is founded on fact, how does it make sense to abandon the cheap and available AZN vaccine in favour of others which may not be reliably available and are more expensive, not difficult when AZN are doing it on a not-for-profit basis?

https://onlinelibrary.wiley.com/doi/10.1002/ajh.26132

I don't pretend to be an expert but as I understand it there are a few things that might be going on. Please consider everything I say in what follows to be prefaced by an implicit "as I understand it" despite my sometimes looking as if I'm making assertions, that's just for brevity...

The paper you linked to is to do with "apparent secondary immune thrombocytopenia (ITP)" which is to do with low platelet counts. The paper then goes on to say (my bolding)...

Twenty case reports of patients with thrombocytopenia following vaccination, 17 without pre‐existing thrombocytopenia and 14 with reported bleeding symptoms prior to hospitalization were identified


Bleeding symptoms is what one would normally expect to see from low platelet counts since platelets aid with clotting so what is described here is perhaps a less unusual condition that the much stranger low-platelet-count-plus-clotting being seen in a few cases with the AZ and now J&J vaccines.

Apart from its rarity another reason for the fuss about the low-platelet-count-plus-clotting incidents is to alert the medical profession to these incidence so that they can be treated in the most appropriate manner. A standard treatment for someone presenting with clots is apparently Heparin but this rare condition is similar to Heparin-induced thrombocytopenia (HIT) caused by "antibodies that bind to complexes of heparin and platelet factor 4 (PF4) activating the platelets and promoting a prothrombotic state". Apparently for that condition Heparin is (not surprisingly!) contraindicated as a treatment so the various authorities also want to ensure that if authorisation is continued and this rare side effect continues to be encountered then there is sufficient info out there about diagnosis and treatment to minimise the danger of hospitals etc falling into the trap of potentially trying to treat it with Heparin and making it worse (if indeed that is something that investigations conclude). There is a quite lengthy (27 minute) discussion of all of this here - https://www.youtube.com/watch?v=qFIxMGW ... nedCLEARLY

Having said all that, later in the paper you linked to it says...

Five additional patients with ”thrombocytopenia” or ”immune thrombocytopenia” post vaccination were identified in VAERS (last accessed 2/5/21), but either available information is insufficient for inclusion or the clinical scenarios suggest alternative processes contributing to thrombocytopenia. ... The third is a patient without age or gender reported who was found to have thrombocytopenia, neutropenia and a pulmonary embolism at an unspecified time following the Pfizer vaccine. This patient was hospitalized and passed away; no additional details were available.


Now the mention of a PE in that third patient does imply to me some clotting issue but as you can see from the description the details are really, really vague so perhaps that one possible case hasn't made it through collecting all the details so isn't in the data set yet or might have been ruled out as a bad report or clearly having some other causal factor.

Basically I have no idea what is going on but I can see some reasons why the paper you have linked to isn't necessarily a "slam dunk" re the same rare side effect being seen with the Pfizer vaccine.

- Julian

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Re: AstraZeneca (Latest Trials)

#404215

Postby Bouleversee » April 14th, 2021, 3:32 pm

Yes, Julian, it seems to me that they have been careful to distinguish between cases where there is a definite link between thrombocytopenia and the vaccines and cases where there remains some doubt or insufficient info. for certainty. Regardless of the numbers of cases, which might be random and not a constant in relation to the number of jabs administered and might easily change over months/years, the fact that it is happening at all in several of the vaccines suggests to me that ruling out AZN on that ground alone does not make sense. What does make sense and is now apparently starting to happen, thanks to that female doctor with the inquiring mind, is that this risk should be taken seriously and research should establish quickly whether any cohorts are at particular risk and reliable systems put in place to identify and treat any incidences which do arise rather than just brush them under the carpet as an unavoidable statistic, of little importance in the great scheme of things. That need not necessarily delay the roll-out of the vaccine unduly.

I still don't see how anyone can pretend that Pfizer or Moderna vaccines are demonstrably safer in this respect. As for the Russian one, would we ever know about any similar cases arising from their vaccine, which I believe we are going to use, maybe even in the mix-and-match trial? I can't help thinking the profit motive would come before the sacrificial lambs.

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Re: AstraZeneca (Latest Trials)

#404241

Postby Julian » April 14th, 2021, 4:51 pm

Bouleversee wrote:Yes, Julian, it seems to me that they have been careful to distinguish between cases where there is a definite link between thrombocytopenia and the vaccines and cases where there remains some doubt or insufficient info. for certainty. Regardless of the numbers of cases, which might be random and not a constant in relation to the number of jabs administered and might easily change over months/years, the fact that it is happening at all in several of the vaccines suggests to me that ruling out AZN on that ground alone does not make sense. What does make sense and is now apparently starting to happen, thanks to that female doctor with the inquiring mind, is that this risk should be taken seriously and research should establish quickly whether any cohorts are at particular risk and reliable systems put in place to identify and treat any incidences which do arise rather than just brush them under the carpet as an unavoidable statistic, of little importance in the great scheme of things. That need not necessarily delay the roll-out of the vaccine unduly.

I still don't see how anyone can pretend that Pfizer or Moderna vaccines are demonstrably safer in this respect. As for the Russian one, would we ever know about any similar cases arising from their vaccine, which I believe we are going to use, maybe even in the mix-and-match trial? I can't help thinking the profit motive would come before the sacrificial lambs.

Yes, but my point was that all but one of the cases in that paper seem to be bleeding events and if we accept that the one potential clotting event (the pulmonary embolism) might not have been fully validated yet so not officially in the data then purely on the basis of that paper there might indeed be zero cases of thrombocytopenia-with-clotting amongst the Pfizer group and, as I understand it, it is very specifically that much rarer thrombocytopenia + clotting as opposed to thrombocytopenia + bleeding that are the side effects of concern in the AZ and J&J groups due to their much greater rarity in the general population as opposed to simply the thrombocytopenia itself.

- Julian

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Re: AstraZeneca (Latest Trials)

#404251

Postby murraypaul » April 14th, 2021, 5:16 pm

murraypaul wrote:
Bouleversee wrote:how does it make sense to abandon the cheap and available AZN vaccine in favour of others which may not be reliably available and are more expensive, not difficult when AZN are doing it on a not-for-profit basis?


A difficult balancing act, to be sure, especially for poorer nations, where the balance is buying X Pfizer doses or 10*X AZ doses.
To my mind, in almost all places in the world we are still at the point of taking any of the vaccines being discussed that is available. All are better than nothing, and they aren't enough to go around.


Looks like the Czechs are happy to take any vaccine going:

https://www.bbc.co.uk/news/live/uk-5674 ... type=share
Czech deputy PM Jan Hamacek tweeted that he has asked the Czech ambassador in Copenhagen to negotiate the purchase of all of Denmark's unwanted AZ vaccines. That is about 2.4 million jabs.

"We are looking for vaccines all over the world. We are willing to buy AstraZeneca from Denmark. On Monday, I fly to Moscow, where I want to arrange possible deliveries of Sputnik V after its approval by the European Medicines Agency," he said.

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Re: AstraZeneca (Latest Trials)

#404271

Postby Bouleversee » April 14th, 2021, 6:08 pm

Julian wrote:
Bouleversee wrote:Yes, Julian, it seems to me that they have been careful to distinguish between cases where there is a definite link between thrombocytopenia and the vaccines and cases where there remains some doubt or insufficient info. for certainty. Regardless of the numbers of cases, which might be random and not a constant in relation to the number of jabs administered and might easily change over months/years, the fact that it is happening at all in several of the vaccines suggests to me that ruling out AZN on that ground alone does not make sense. What does make sense and is now apparently starting to happen, thanks to that female doctor with the inquiring mind, is that this risk should be taken seriously and research should establish quickly whether any cohorts are at particular risk and reliable systems put in place to identify and treat any incidences which do arise rather than just brush them under the carpet as an unavoidable statistic, of little importance in the great scheme of things. That need not necessarily delay the roll-out of the vaccine unduly.

I still don't see how anyone can pretend that Pfizer or Moderna vaccines are demonstrably safer in this respect. As for the Russian one, would we ever know about any similar cases arising from their vaccine, which I believe we are going to use, maybe even in the mix-and-match trial? I can't help thinking the profit motive would come before the sacrificial lambs.

Yes, but my point was that all but one of the cases in that paper seem to be bleeding events and if we accept that the one potential clotting event (the pulmonary embolism) might not have been fully validated yet so not officially in the data then purely on the basis of that paper there might indeed be zero cases of thrombocytopenia-with-clotting amongst the Pfizer group and, as I understand it, it is very specifically that much rarer thrombocytopenia + clotting as opposed to thrombocytopenia + bleeding that are the side effects of concern in the AZ and J&J groups due to their much greater rarity in the general population as opposed to simply the thrombocytopenia itself.

- Julian


Whether the end result is bleeding or clotting, surely the important thing is that the vaccine has prompted a reaction which has caused thrombocytopenia and the platelet count has been altered. With this common factor, it is difficult to understand any assertion that one vaccine is any safer than another at this stage.

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Re: AstraZeneca (Latest Trials)

#404278

Postby murraypaul » April 14th, 2021, 6:31 pm

Bouleversee wrote:Whether the end result is bleeding or clotting, surely the important thing is that the vaccine has prompted a reaction which has caused thrombocytopenia and the platelet count has been altered. With this common factor, it is difficult to understand any assertion that one vaccine is any safer than another at this stage.


the important thing is that the vaccine has prompted a reaction which has caused thrombocytopenia

That has not been demonstrated. The incidence in the Pfizer study, at about 1 per million, is around what they expected as a background rate in the population, so there is no evidence that the P vaccine did cause it.

In contrast, the incidence for AZ seems to be around 4 in a million, or four times the expected background rate.

That seems a pretty clear difference.

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Re: AstraZeneca (Latest Trials)

#404299

Postby Julian » April 14th, 2021, 8:04 pm

murraypaul wrote:
Bouleversee wrote:Whether the end result is bleeding or clotting, surely the important thing is that the vaccine has prompted a reaction which has caused thrombocytopenia and the platelet count has been altered. With this common factor, it is difficult to understand any assertion that one vaccine is any safer than another at this stage.


the important thing is that the vaccine has prompted a reaction which has caused thrombocytopenia

That has not been demonstrated. The incidence in the Pfizer study, at about 1 per million, is around what they expected as a background rate in the population, so there is no evidence that the P vaccine did cause it.

In contrast, the incidence for AZ seems to be around 4 in a million, or four times the expected background rate.

That seems a pretty clear difference.

Exactly. This is all looking at incidence in vaccinated population vs general background (general population) result. If thrombocytopenia on its own is not sufficient to trigger a signal but thrombocytopenia coincident with a clotting incident is then that is potentially significant.

- Julian

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Re: AstraZeneca (Latest Trials)

#404484

Postby Julian » April 15th, 2021, 1:02 pm

This is interesting news...

It has also been announced that chancellor Angela Merkel, 66, is to receive the AstraZeneca vaccine on Friday. The jab is only recommended for over 60 year olds in Germany.


[ Source: https://www.theguardian.com/world/live/ ... e46624710a ]

Nice to see at least some politicians leading by example and trying to do their bit to help defuse some of the distorted perceptions building up out there re absolute level of possible AZ vaccine side effect risks.

- Julian

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Re: AstraZeneca (Latest Trials)

#404491

Postby redsturgeon » April 15th, 2021, 1:12 pm

Julian wrote:This is interesting news...

It has also been announced that chancellor Angela Merkel, 66, is to receive the AstraZeneca vaccine on Friday. The jab is only recommended for over 60 year olds in Germany.


[ Source: https://www.theguardian.com/world/live/ ... e46624710a ]

Nice to see at least some politicians leading by example and trying to do their bit to help defuse some of the distorted perceptions building up out there re absolute level of possible AZ vaccine side effect risks.

- Julian


Unless she gets a blood clot...then AZ are in trouble!

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Re: AstraZeneca (Latest Trials)

#404562

Postby UncleEbenezer » April 15th, 2021, 5:03 pm

Julian wrote:This is interesting news...

It has also been announced that chancellor Angela Merkel, 66, is to receive the AstraZeneca vaccine on Friday. The jab is only recommended for over 60 year olds in Germany.



As I recollect it, that was news some time ago! Can't recollect when I first heard it, but she was clearly going public to counter hesitancy.

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Re: AstraZeneca (Latest Trials)

#404588

Postby Julian » April 15th, 2021, 7:08 pm

UncleEbenezer wrote:
Julian wrote:This is interesting news...

It has also been announced that chancellor Angela Merkel, 66, is to receive the AstraZeneca vaccine on Friday. The jab is only recommended for over 60 year olds in Germany.



As I recollect it, that was news some time ago! Can't recollect when I first heard it, but she was clearly going public to counter hesitancy.

The news you might have been thinking of from about a month ago is ...

"Yes I would take the AstraZeneca vaccine," Merkel told a news conference, adding she "would like to wait until it's my turn but I would in any case".


[ Source: https://www.voanews.com/covid-19-pandem ... ca-vaccine ]

I’m afraid my cynicism at the time made me think “I’ll believe it when I see it, she’s just as likely to end up getting Pfizer when the time comes” so I do consider today’s news to be a new (and welcome) development.

- Julian


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