Mix and match vaccine trial

[MarieIG]

Fascinating. I went back to listen to the listen to one of the podcasts about this, and then to be able to read Alan's first hand account.

[Alan]

Quote:

Originally Posted by audreyh1 Does the UK do sewage tests to assess the prevalence of Covid in a community?

Quote:

Originally Posted by Alan They have been doing this for over a year. The report below is from December. https://post.parliament.uk/monitorin...-for-covid-19/

the sewage testing now covers 2/3rds of England to try and get early indications of new variants.

https://www.bbc.co.uk/news/science-environment-57205126

Quote:

The government has ramped up its programme to analyse wastewater for early signs of coronavirus. The sewage-testing programme now covers two-thirds of England's population. Scientists discovered early in the pandemic that genetic fragments of the virus could be detected in sewage. Samples are now being are taken at wastewater treatment plants and sent to a new lab in Exeter that is dedicated to analysing wastewater.

[Chuckanut]

Quote:

Originally Posted by Alan the sewage testing now covers 2/3rds of England to try and get early indications of new variants. https://www.bbc.co.uk/news/science-environment-57205126

I have to say that we Americans can learn something from the British. They seem to be a lot more organized in terms of strategy and tactics than we were. And they still are.

[Alan]

Quote:

Originally Posted by Chuckanut I have to say that we Americans can learn something from the British. They seem to be a lot more organized in terms of strategy and tactics than we were. And they still are.

This sewage testing is only for England, not sure what the other UK countries are doing in this regard as they have their own governments and manage their own NHS health trusts.

England is only the same size geographically as Louisiana, tiny in comparison to the USA, so comparing England to the USA is not really feasible.

[audreyh1]

Quote:

Originally Posted by Chuckanut I have to say that we Americans can learn something from the British. They seem to be a lot more organized in terms of strategy and tactics than we were. And they still are.

This type of activity (sewage monitoring) has been very sporadic in the US AFAIK and generally on a very small scale. It was used to detect early outbreaks in some college dormitories, but after that impressive achievement I haven't heard much.

[Koolau]

Quote:

Originally Posted by audreyh1 This type of activity (sewage monitoring) has been very sporadic in the US AFAIK and generally on a very small scale. It was used to detect early outbreaks in some college dormitories, but after that impressive achievement I haven't heard much.

I wonder how much you have to pay folks to go take the samples. I had to do a bit of mucking around in chemical waste stream sewers back in the day and it was NOT fun. The added "dimension" of the source of human waste makes me queasy just thinking about it. Still, I'm glad there are folks dedicated to such an important source of data. Life is like a sewer... Wait! I already said that so YMMV.

[NW-Bound]

Quote:

Originally Posted by Koolau I wonder how much you have to pay folks to go take the samples...

US city sewage is usually pumped to a sewer treatment plant to process before discharging the waste water. It should not be hard to get samples there at the plant, meaning it is not needed to climb down the manholes.

[Koolau]

Quote:

Originally Posted by NW-Bound US city sewage is usually pumped to a sewer treatment plant to process before discharging the waste water. It should not be hard to get samples there at the plant, meaning it is not needed to climb down the manholes.

I feel better already. Of course, if I'd been thinking, I would have thought of that as all of our chemical (and probably sanitary systems on site) were monitored in such a fashion. My experiences "in the sewers" were when "things went wrong." Never what you wanted to hear on a Sunday morning phone call from a frightened plant director. YMMV

[Alan]

We each received an email today informing us of what we had for our 2nd dose. We both received Novavax and are eligible to receive a booster. We have been asked to talk to the trial team and have booked a call for Monday afternoon (18th October) since we will need to sign to give consent for a booster after receiving an as yet unapproved vaccine (Novavax) and also to book a slot in a vaccine centre so the booster is administered under a doctor's supervision.

[rodi]

Alan -

Does your booster have to be one of the two vaccine types you had before (Astro Zenica and Noravax)? Or can you get one of the MRNA types (Pfizer or Moderna)?

I had a friend who was part of a vaccine trial in order to get vaxed earlier, last January. He had 2 shots of Noravax. He's anxious to get a booster, but since he didn't have any of the FDA approved shots, he doesn't qualify, and he's been advised not to mix and match by the trial people....

[Alan]

Quote:

Originally Posted by rodi Alan - Does your booster have to be one of the two vaccine types you had before (Astro Zenica and Noravax)? Or can you get one of the MRNA types (Pfizer or Moderna)? I had a friend who was part of a vaccine trial in order to get vaxed earlier, last January. He had 2 shots of Noravax. He's anxious to get a booster, but since he didn't have any of the FDA approved shots, he doesn't qualify, and he's been advised not to mix and match by the trial people....

For those who volunteered in the Novavax trial, they are being offered 2 other vaccines in order to qualify for international travel.

https://www.bbc.co.uk/news/health-58844369

Quote:

People who took part in trials of Covid vaccines which haven't been approved yet will be offered two doses of another vaccine from next week, health officials say. This means more than 15,000 volunteers who received Novavax or other jabs will finally be able to travel abroad. An eight-week gap is needed between the third and fourth doses. The NHS Covid app will also be altered to permit travel after the extra two doses. The move, announced by the Department of Health in England, has been developed with the help of the UK's vaccine committee and investigators who worked on the clinical trials.

We have a telephone appointment with a trial doctor on Monday afternoon to discuss the next steps. I’ll report back on what we do. I am expecting to be offered Pfizer or Moderna as they have already been shown to have no side effects when mixing with Novavax or AZ, and are being used as boosters here.

[Alan]

Quote:

Originally Posted by rodi Alan - Does your booster have to be one of the two vaccine types you had before (Astro Zenica and Noravax)? Or can you get one of the MRNA types (Pfizer or Moderna)? I had a friend who was part of a vaccine trial in order to get vaxed earlier, last January. He had 2 shots of Noravax. He's anxious to get a booster, but since he didn't have any of the FDA approved shots, he doesn't qualify, and he's been advised not to mix and match by the trial people....

Today we were offered to either have a 2nd AZ vaccine or a Pfizer vaccine and we chose to have the Pfizer. The only reason we had the offer of another AZ is that some countries may not recognize mixing 2 approved vaccines as qualifying as being fully vaccinated for the purposes of international travel. The USA is the only country we plan to travel to in the next 12 months and I don't see them not recognizing all the Canadians that have had mixed vaccines as not been fully vaccinated.

[Alan]

They will be posting full results of the mixed vaccine trial in due course but he was able to tell us off the record that the AstraZeneca-Novavax combination did edge out the AstraZeneca-AstraZeneca in immune response performance but the main aim of the trial was to see if there were any adverse side effects (no) and how well the immune response lasts, and they won't know that until this last round of blood samples is taken in November.

[kyzymurgist]

Quote:

Originally Posted by Alan They will be posting full results of the mixed vaccine trial in due course but he was able to tell us off the record that the AstraZeneca-Novavax combination did edge out the AstraZeneca-AstraZeneca in immune response performance but the main aim of the trial was to see if there were any adverse side effects (no) and how well the immune response lasts, and they won't know that until this last round of blood samples is taken in November.

This is an interesting discussion since I received one Novaxax dose in summer 2020 and both Pfizer doses this spring. Trying to decide whether to get a booster when I qualify by reaching 65 in January.

Alan, your study coordinator is apparently more rigorous than mine. When I asked to be unblinded for permission to get the approved Pfizer or Moderna shot, I was told, "Just go ahead and get it. We will make a note in your file.". Didn't learn that I received the vaccine instead of placebo until recently.

What the heck?? So much for following protocol. I suspect that the study coordinator loses money when subjects drop out.

Well no serious side effects so it worked out. The question is, do I really need a fourth booster shot since it appears that the Novavax vaccine is effective even if unapproved? Is there a downside to too many or too frequent booster shots?

I'm leaning towards delaying until we have more information on optimum booster vaccine type, dose, and timing.

[Alan]

There were 15,000 folks here who received 2 doses of Novavax during the phase 3 trials. They have all been offered 2 doses of Pfizer. The reasons that they and all the participants in our mixed vaccine trial is not because of efficacy concerns but for the purposes of the international Covid passport and also to offer boosters.

I think the fact that we are going to have 3 different vaccines each using a different mechanism, and the Novavax trial folks are going to have 4 doses means the doctors here are confident that there is little chance of adverse side effects.

[Time2]

Is the Moderna Vaccine less used over there than in the states? I would opt for Moderna because the efficacy lasts longer. I received Moderna, my wife and son got the J&J. We are all ready for a booster, but I'm older and can get mine before Thanksgiving travel, looks like they will have to wait. I don't like them not having the booster before Thanksgiving. It does seem that most of the clan we are going to see has already had Covid. I don't know what they were thinking.

[Alan]

Quote:

Originally Posted by Time2 Is the Moderna Vaccine less used over there than in the states? I would opt for Moderna because the efficacy lasts longer. I received Moderna, my wife and son got the J&J. We are all ready for a booster, but I'm older and can get mine before Thanksgiving travel, looks like they will have to wait. I don't like them not having the booster before Thanksgiving. It does seem that most of the clan we are going to see has already had Covid. I don't know what they were thinking.

Moderna has been used less over here. Although the UK had 17 millions of doses pre-ordered there were supply issues getting it from the USA so it was well into April before it started to be used here. AZ and Pfizer have been manufactured in the UK and Belgium from the very start which gave them both a big head start as vaccinations started early in December.

Some months ago another 60 million doses of Pfizer were ordered specifically for the winter booster program. Half dose Moderna jabs are also being used now as part of the UK booster program. Novavax has 96% efficacy in trial 3 results and may be approved in the coming weeks, if that happens there are manufacturing sites ready to go in the UK plus the supply chain is easier as no freezing is required.

I think a number of factors are is still in play when it comes to vaccines here.

[Time2]

Just watch the ABC news and there was news about mix and matching of Vaccines from the FDA.


A quote with dramatic numbers listed for those getting a different vaccine booster rather than a J&J booster.


"Preliminary results from a government study of different booster combinations found an extra dose of any type revs up levels of virus-fighting antibodies regardless of the brand people first received. But recipients of the single-dose J&J vaccination had the most dramatic response -- a 76-fold and 35-fold jump in antibody levels, respectively, shortly after either a Moderna or Pfizer booster, compared to a four-fold rise after a second J&J shot."
That was with the full dose Moderna booster.



https://abcnews.go.com/Health/wireSt...shots-80662146

[Koolau]

Quote:

Originally Posted by Time2 Just watch the ABC news and there was news about mix and matching of Vaccines from the FDA. A quote with dramatic numbers listed for those getting a different vaccine booster rather than a J&J booster. "Preliminary results from a government study of different booster combinations found an extra dose of any type revs up levels of virus-fighting antibodies regardless of the brand people first received. But recipients of the single-dose J&J vaccination had the most dramatic response -- a 76-fold and 35-fold jump in antibody levels, respectively, shortly after either a Moderna or Pfizer booster, compared to a four-fold rise after a second J&J shot." That was with the full dose Moderna booster. https://abcnews.go.com/Health/wireSt...shots-80662146

That is an amazing report. I remain anxious to get my Moderna booster even though I'll probably not get the dramatic increase in immunity. Every bit helps. YMMV

[Time2]

Quote:

Originally Posted by Koolau That is an amazing report. I remain anxious to get my Moderna booster even though I'll probably not get the dramatic increase in immunity. Every bit helps. YMMV

Just went to Walmart where I got my two Moderna vaccines. I ask if they were giving the 1/2 dose Moderna booster Vaccinne. They are waiting for the CDC to recommend it, The FDA recommendation is not enough.