I got a good kicking for for talking about an MS drug that we know is inferior to the big guns (High efficacy DMT), when the little guns (Lower efficacy DMT) is all that is offered. As I said, a little gun is better than no guns (OK bad analogy as Guns are bad! We should not have them and I am sure the National Rifle Association will be after me for this…yep I know many of our US readers won’t understand this one). However, it looks like roll reversal time.
Maybe all I will be offered is an adenoviral vaccine after all the UK has bought 100 million doses and little of the RNA vaccines (40million Pfizer + 5 million moderna). The US and EU have snapped up the RNA vaccines.
If you have MS and are on a disease modifying treatment the chances are your neuros won’t risk a live viral vaccine….so is that good news for you.
Although it is replication defective it is live. (I looked as some cancer adenoviral gene therapy work and I was surprised that the virus was still detectable 90days after injection although some got rid of it within 8 days and remember they are immunocompromised). So that suggests you won’t be getting the Oxford vaccine or the J& J vaccine. This leaves the RNA vaccine or the antigen based vaccines. The RNA vaccines have been reported and are citing 90-95% protection although full data hasn’t been released. That they both find the same thing suggests this is real. Now the Oxford vacine has come in at 70%. Being a glass half-full person in contrast to the media). Better than the flu vaccine (hurray) but not 90% unless (Boo), you pick at the results for subgroup analysis to get the 90%. (Surely that means a new trial is needed) and the main study was in the 60s%.
On the news of the successs of the RNA vaccine, the one shot J&J approach was expanded to be a two shot trial, so I suspect the results of the one shot were not as good as 90% protection. Maybe I am reading to much into it, but if they were that great they would be singing from the rafters.
This does not surprise me because if you look at the antibody levels induced by the RNA vaccines, they were seemingly higher than the adenoviral vaccines based on the published phase I data. I have seen a presentation of the classical protein adjuvants and the antibody responses were seen to be higher still so maybe good news for the tortoise, even though first hare is more tasty. However longevity of response may be key and on this point we know nothing
However it seems nobody on the Oxford vaccine trial who go COVID-19 did badly (Severe COVID) and so the 70% does not look that bad. I am sure survival is the endpoint we are looking at and at the moment that have all been 100% effective.