I am so curious about this. Last I knew, Moderna was having trouble sourcing Black participants for their vaccine trials.
Direct link to the text-only NPR story: https://text.npr.org/935239294
"Easier to distribute" is a misnomer. "can be distributed using existing infrastructure" is more accurate. Al Jazeera Moderna’s vaccine has an advantage in that area because it expects its vaccine to be stable at normal fridge temperatures of 2-8C (36-48F) for 30 days and it can be stored for up to six months at -20C (-4F). It will not surprise anyone to discover that vaccine storage is an FDA-defined and regulated practice. There are entire categories of medical equipment for this. If you have vaccines, you buy vaccine fridges. Here's ours. We are a part of the CDC's Vaccines for Children Program, which is a nice switch from LA where it was all about seminars to teach people how to get their unvaccinated child through life. This basically means the CDC fronts us tens of thousands of dollars worth of vaccines in exchange for our storing them in a controlled environment. That controlled environment is allowed a degree of deviation and if it goes out more than five(ten?) degrees it's a sentinel event - we have to log it, report it, toss the vaccines and hope we still get to play. The CDC can demand to see our logs at any time - we have to write down what the temperature is twice a day and report it every two weeks. As a consequence vaccine fridges have all sorts of alarms. Ours has two thermometers connected to the Internet, the whole mess on a battery backup that shoots me an email if things get more than a degree and a half out of pocket (opening the door raises stuff half a degree - in other words, I get "the door is ajar OH SHIT RUN" emails). It will not surprise you to discover that there are two vaccine storage temperatures: 4-ish and -20ish. Thus, if we wished to distribute Moderna's vaccine, we would just... put it in the fridge. Pfizer's, on the other hand, likes to live ten degrees warmer than dry ice. Not quite cryogenic temperature, but hella colder than our fridge goes. Sanyo Medicools can't go colder than 35 below. We didn't do any comparison shopping on minimum temperatures but I am unaware of any other vaccines that require "dry ice plus ten" storage so I reckon other fridges are in a similar zone. There's an entire industry arrayed around dry ice storage and transportation; none of it is powered. I'm guessing that Pfizer is expecting everyone to fly foam coolers full of dry ice with RFID temp loggers around and accomplish vaccination via Fedex. Moderna, on the other hand, has created just another vaccine.The Pfizer-BioNTech vaccine must be shipped and stored at -70 degrees Celsius (-94 degrees Fahrenheit) – Arctic winter temperatures – and can be stored for up to five days at standard refrigerator temperatures or for up to 15 days in a thermal shipping box.
As far as I've read, Pfizer has created and is manufacturing, special dry ice boxes that can store the vaccine for a few weeks, supposing that the storage/distribution facility is replenishing the dry ice up to twice. This won't be a big deal for hospitals, as any hospital worth its salt has -70 to -80 freezers on double redundant backup generators. But it's unreasonable to think that only hospitals are going to be their distribution centers, so hopefully their custom dry ice boxes are sufficient (or they figure out how the hell Moderna did it, and add whatever stabilizers are necessary to raise the storage temp to -20). The thing about storage conditions, as I'm sure you know, is that they are what you define them to be, as dictated by the stability studies that you showed the FDA. RNAs are generally considered some of the most unstable biomolecules, so they are typically stored at -70/-80. It's possible that Pfizer, in all their haste to make a mRNA product, which they've never done before, just did stability studies at -70 and haven't completed any data on other storage conditions yet (they're long, expensive, and tedious). Moderna on the other hand, as their name suggests, specializes in mRNA product development, so their know-how in that space is bound to be vast. Considering that both vaccines are based on mRNA for the now famous spike protein, hopefully there will be some data sharing so that the best, easiest, and most widely available distribution will be possible. Hopefully, the feds don't mind stepping in and forcing data sharing if necessary, as is their right under IP law.
Thanks for the insight. I found this comment very informative. I’m bullish Re our ability to return to a more normal way of life by the end of 2021.
I'll nitpick that a bit, because our other experiences are with flu strains. We don't really know whether and how corona virus pandemics are different. Plus, the expected short lived immunity means that we need effective vaccines, even if they're not delivered on time to affect this round of the pandemic. It should hedge strongly against future bouts.
I totally agree, and I hope it's sooner than that even. I think we've exposed some pretty big rips in our social fabric over the last 9 months, so that, if anything, could hold us back. Surveys tend to show that there are a lot of vaccine skeptics out there on the left and the right, but I think everyone will make the right choice when presented with more of the same vs. return to society.
I don't think so. And this is a point I keep making... once it is available, how do I know you had the vaccine? If I own a coffee shop, bar, or restaurant, how do I know YOU are one of the ones who can safely be seated at one of my tables? If I go into an office for a meeting and there are 6 people around the table, how do I know they have all been vaccinated? If I go to a football game, how do I know the people around me have been vaccinated? I have yet to see anyone posit any way for people to identify themselves as having the vaccine. The only thing I can come up with is a new endorsement on your driver's license or ID, right below organ donor, that identifies the bearer as vaccinated. And the logistical aspect of getting proof of vaccination, presenting that proof to the DMV, them independently confirming it, and then issuing you a new license... and doing that for 360m Americans... the mind boggles at how long that would take. But any other method - self-identification, a paper slip from your doctor, an ID Card you can flash - are all easily falsified/forged and will only allow the anti-vaxxers to remain plague spreaders, and keep the virus alive in the general population. I just don't see "returning to normal" as happening. Ever. It would take literally suspending the Bill of Rights and Constitution to impose a government-mandated vaccination on everyone... and we all know how well THAT's gonna go. "...I think everyone will make the right choice when presented with more of the same vs. return to society..."
And don't forget that there is a sizeable portion of the country that will not take a vaccine because they believe it will contain the mark of the beast. The exact situation you described as 'necessary' is described by fundamentalist Christianity as the beginning of the apocalypse. No buying and selling without the mark of the beast you see.
Because they will reduce their already low compliance with best practices for avoidance of contact with the virus. They will feel "safer" since everyone else CAN'T get the virus, that there's less chance for them to contract it. So they will relax their precautions. (As will the 50% of people who are asymptomatic spreaders.) And even if they recover from their bout with COVID, there's the permanent lung and brain damage, as well as the tendency for major organs to suddenly have blood clots. And, the younger they are, the longer they have to live for one of these knock-on effects of COVID to kill them before they "should have" died. It'll be a cleansing of biblical proportions. It only takes one person in a crowd to spread it to hundreds of people and kill dozens. And if you are already an anti-science anti-vaxxer, you aren't even adhering to the most rudimentary protection measures... and are probably having other anti-vaxxers over for coffee and conspiracy-watching sessions on YouTube with other people with poor hygiene... and that's just a matter of time before everyone in that "club" get it, and has lifelong health issues from it.
Yep. Mortality from COVID. But they will have an entire (short) lifetime of ongoing health problems. There is no "recovery" from COVID. The flu-like symptoms will subside (in most people), but the long term brain, lung, and blood issues turn the individual into a fragile health risk and make them more susceptible to other maladies in the future. (At least that's what it seems at this point, with the long term studies that are coming out now that we have about a year of cases under out belts to examine...) And the reason that concerns me, is that our health system is due for a very large socialized overhaul... just as the Boomers are getting VERY expensive to keep alive, and the generation behind me doesn't respect the potential long-term effects of COVID. There's already a historically low number of people in my generation propping this whole Ponzi Scheme up with our taxes and profligate spending... and I don't see us being able to support half of America's healthcare, while also keeping everything else running and in proper condition (roads, bridges, military, etc)... There's a macro economic problem coming, and half the population of America is expecting ME to be their blood bag...
Obviously the data is preliminary, since the first subjects were only infected 11 months ago, and the most vulnerable (aka the elderly and immunocompromised) make up a very large percentage of the critical data we have. That's because you don't get to go to the doctor when your symptoms are mild, and those people are often refused care, especially if they don't fall into a high-risk demographic. As "critical" infections dwindle and the number of infected and tested increase, the current thinking is that there will be issues cropping up throughout the recovered-person's life, due to these other effects. (Note that "long-haulers" - those with sustained, long-term COVID symptoms - are a different class.) There are two good studies I recently found, from the Mayo Clinic and Harvard, which look specifically at the long term damage to heart, lungs, and brain function, and what that might mean for young people who get it and recover. https://www.mayoclinic.org/diseases-conditions/coronavirus/in-depth/coronavirus-long-term-effects/art-20490351#:~:text=COVID%2D19%20symptoms%20can,within%20a%20few%20weeks. https://www.health.harvard.edu/blog/the-hidden-long-term-cognitive-effects-of-covid-2020100821133 Again, these are Ns of under 10 for now, because it hasn't been a long time, and infected young people are grossly underrepresented in the data we have today.
The article by "Mayo Clinic Staff" says that "Even in young people, COVID-19 can cause strokes" but there is no link to show which of the 16 references might back that up. The blog post from Harvard says "even young individuals are seven times more likely to have a stroke from this coronavirus versus a typical flu virus" with a link to an article in The Lancet "COVID-19 related stroke in young individuals". The Lancet mentions "a 7.6-fold increase in the odds of stroke with COVID-19 compared with influenza" citing Merkler which says "The youngest patient with ischemic stroke in the cohort was age 51 years." The Lancet also describes "a 7-fold increase in the rate of large vessel stroke in young people compared with the previous year" citing Belani which gives a median age of 65.5 ± 15.3 for the 41 cases and does not mention a minimum age.
Tyranny of the majority, baby. Most people decided they'd prefer not to be part of this little coronavirus experiment. Trope-tastic, but: good science takes time. We don't understand covid well enough that anyone should be recommending something like "Yeah, should be OK if only young folks get it." OK, what protective orders are in place preventing the virus from getting into nursing homes? Not restrictions. A testing program? Rising positivity rate concerns aside, a robust testing program doesn't definitively prevent the virus from walking through the front door. A positive test for a nursing home worker is like a "Congratulations, it's pretty likely someone you tend to is about to die. Oh, and the nursing home is now a prison." I'm sure there're enough existing business incentives that almost every nursing home has some mask requirements, though, so that's good. Edit: Of course, only wealthy families can afford to put up N̶a̶n̶ NaN somewhere she'll be safer than at home with the grandkids, who brought it back from school, or wherever. There are many, many ways in which covid is screaming out the depths of our societal wealth inequality. Obviously, wealth inequality also breaks down along racial lines, hence one major reason why the virus "targets" minorities. Medical professionals are collectively saying: "Other than the fact that it's much more deadly without hospitalization, and the fact that we are running out of hospital space, we simply do not know enough about this virus to recommend anything but extreme measures." Counter argument: "I'm not a doctor, but Scott Atlas and I are not concerned with the virus, it's not so bad, do NOT stop working, because that would destroy the economy." Probably almost no doctor enjoys recommending a gov't-imposed lockdown. But neither do gov't researchers and doctors enjoy shit like being slandered and having their science politicized, which, hey, led to the lockdown recommendations. Ugh, I'm fortunate to study something that would be much more difficult to demonize. We don't know that covid-19 won't mutate into an even worse strain, or become more transmissive, or able to more effectively harm children, whatever. The sooner herd immunity is reached, by whatever ratio of vaccinating and infections, the more unlikely or more prolonged an effective mutation would be. edit 2: no, actually, I think attempting to reach herd immunity via infections could also potentially facilitate a wicked mutation, as the cumulative "virus rolling dice for yahtzee" time is minimized with a vaccine. A vaccination developed by a company outside of the gov't, though incentivized by the federal government, is acceptable to me. I don't automatically hate the various business groups honing their anti-covid brews, so long as they are conducting sound science confirmable by peer review. The vaccine could prevent another million deaths-ish... We may have 10% or 15% nationwide exposure, tops, and so herd resistance is probably another 7x to 4x the existing covid death toll. Sorry, got sidetracked, but a mutation could always be a possibility, unless we eradicate it. Probably not this side of at least thirty years, if ever. Personally, I might try to go the vaxxin' route in maybe... March? April? I think we should ship vaccine to elders who volunteer first. I'm sure the Trump administration has also spent plenty of time thinking about the best way to distribute the vaccine like that, or with another medically-informed rationale. LOL Dr. Atlas will be X-raying all of the vaccines on their way out the door to check for drugs, inadvertently destroying every dose. The out-of-control transmission centered around Sturgis is a pathetic failing of Donald Trump and at least one comically stupid governor. I don't think it's equivalent to point to Cuomo, NY is probably the national epicenter of international mixing, and we had almost no idea what we were dealing with at the time, thanks, again, in some part to Trump ignoring the advice of experts (major theme, here). Truly, I pity Trump's base up in the heartland. They were lied to. They still haven't hit "critical mass" for that to sink in, I'm worried. Hopefully they're close. All corrections and weigh-ins on my pro-establishment propaganda are welcome.
How much do you value credibility? When the president said a vaccine was around the corner in October, I didn't believe him because he has repeatedly demonstrated willingness to say things that aren't true. Is the mask & vaccine message so important that it justifies trampling the truth? I think that's a dangerous path to follow. What's wrong with appealing to young people with honesty? "Hey kids, you probably don't worry too much about your health. You're right, there has never been a safer time for young people to live. But that's not an excuse to be stupid, nobody is immortal. Over a million people have died while infected with this virus, and we don't yet know what the long term health effects will be for people who recover, even young people. Old people are scared, the chance of surviving infection at age 85 is only 85%. You can help slow down the spread of the virus, so fewer vulnerable people get sick before a vaccine is available to reduce their risk. Using a mask and reducing socializing in person is inconvenient but effective. A thin layer of fabric helps people say it, don't spray it. Keeping your hands clean and away from your face can reduce other diseases too, like annoying colds. Our grandparents survived world wars with gas masks, we can make some sacrifices to help keep them safe." Compare that to "If you don't wear a mask and get vaccinated, you're going to die in biblical proportions, and it will be your own fault because you are selfish and unscientific."
The unfortunate truth of Covid-19 is that symptom-less spread is indeed possible, and most young-ish people of modest health won't suffer much. They will however spread the disease to everyone else. They will however thwart all attempts at high compliance rates with vaccination.
Can someone explain to me as a non-professional, why are we seeing news about these 2 particular vaccines recently? There are currently quite a few in Phase III trials. Are these 2 further advanced? More advanced stage of analysis? Better results? Something else?