#MSCOVID19 Vaccine. The One dose approach

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As you may now the UK is in abit of a pickle at the moment as there more COVID-19 around than Zombies in Zombieland. It has similarities, go to the Shopping Mall and you are surrounded by Zombies (not wearing masks and no understanding what socially distancing is) that may kill you.

Sorry I can’t give a fraction of Great British Public alot of credit for understanding this one, you just have to watch the news or go to a supermarket (If they can’t wear a mask….they should be shielding). Perhaps, this is why there are so many parking crashes…. when the person guiding you into the space says that you have 12 inches (30cm) pf space when it is only 6 inches (15cm).

Wonder where that idea comes from? Go ask your Dad:-)

In Zombieland you have to get bitten and you have the pleasure of wiping out the undead, however here in Covidland, you just get breathed on and is sometimes a slow miserable death for someones mum, dad, grandad and gran. Lock downs cannot go on forever and vaccination is one of the best ways out of this.

“I don’t need the vaccine” as I’m young and healthy,(yep as virus reactor)…but tell that to the young and old who are not so healthy or those that have not done so well. In 1914 the young were probably told those “bullets won’t kill you, off you go and charge that machine gun”. But this view is not quite right and have to tell that to millions of soliders how were not so invincible. However, who would have thought that the real killer from the First World war was not the bullet, but the Flu virus that the solider, possibly from the US, took to Europe and killed 50 million people including my great nan.

The best way to get rid of a virus quickly is to have a strong immune response so that it is destroyed before you can pass it on or before it has time to mutate into something that the immune response can’t get rid of.

This may be important as you may eventually get a variant that you do not have not enough immunity to and the cycle repeats itself. It has been suggested that new variant developed in someone who had been immunosuppressed and the virus had hung around and mutated and mutated such that it was more infective and perhaps abit less sensitive to the immune response generated by vaccines to the original virus strain.

Will we get an escape mutant that the vacccines don’t work on, then we are back to square one. The virus will be around forever and eventually the youth become the oldies and get all those co-morbidities and now it is their turn for death destruction and COVID-long. I speak to deaf ears, who may only care if they find out that they can’t go abroad to watch the Euros as their name is on the anti-Vaxxer list.

As the SH1 hits the fan in ZombieLand UK, desparate measures are being put in place, the vaccines that we have developed are going to used in a way they have not been envisioned to be used. The view of protecting people as quick as possible. The vaccines we have are going to be given up to 12 weeks apart.

So let’s have look at one dose what happens. First the Oxford Astrazeneca vaccine.

I will start you off with the Ebola vaccine which uses the basic viral contrstuct as the covid vaccine, This was designed for a single shot.

Here within one month 71% made a response to the vaccine but the SARS-COV2 vaccine is better. Within 28 days more than 98% of people make an antibody response of one dose.

This information is from the information within the blog post

As you can see (in yellow) within 14 days of the first dose there was an antibody response that was evident at 8 weeks (day 56)

prime = 1 dose prime boost = 2 doses and you can see the response does not drop of at least 56 days (8weeks). Yellow is one dose only

and there was a T cell response

A maximum T cell response was evident within 14 days of the first dose and the second dose did not add more.

Although the dose schedule we thought would occur was day week 0 second dose week 4 but could be up to week 12. In one of the vaccine trials 53·2% of 2741 participants a second dose at least 12 weeks after the first (50% got second dose by 84 days, (25% by 77days and 75% got the dose by 91 days =13 weeks)  and 0·8% received a second dose within 8 weeks of the first. The average interval between doses for the standard double dose group was 69 days (50–86days). This is probably the reason 12 weeks was selected by this ranged from 4 to 26 weeks. Therefore in the trials some people got the second dose up to 6.5 months after the first.

Therefore if you are dosed 2-4 weeks before treatment if you have cells that can respond they will have responded. The second dose boosts the levels of antibody

If you have been previously infected you may make an even better responses after the first dose the level of antibody went up alot (GMT=175,120.84 [N=28; 95% CI: 120,096.9 to 255,354.8] of one dose

Now to the Pfizer/BioNTech vaccine and things here are clearer because the trials were not quite as “Pick & Mix” as the Oxford-run DB trial. They will have the data on how quick and how long on dose of vaccine worked but you can see that it is not so quick acting in the graph below at day 21 they would have had one dose waiting for the second doses, so the antibody response was not strong

However that and a T cell response must bedoing something good as

VE = vaccine efficiency 95%CI = confidence interval meaning in this case we have about 95% belief that the efficiency of one dose is somewhere between 76% and 87% effective

This is hard yo work out as there is not supportive information but lets look at the Dolly/Moderna vaccine

No-one with any of the vaccines have been hospitalised and died after having any vaccine and they are no doubt less infective as a result of being vaccinated. One dose maybe all that you need to get enough protection but clearly two will make you less infective.

CoI None relevant

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MouseDoctor

25 comments

  • The first four people I encountered after the news about the Pfizer vaccine broke (either on the phone or out running) all said they wouldn’t be having the vaccine, or not yet. I didn’t hide my dismay and asked them if they were anti-vaxxers. All four hotly denied this.

    Two were >80, one with COPD. One was nearly 80. Various stupid reasons were put forward.
    “““`”I had a bad reaction to a flu jab once and it affected one of the cats.”
    “I’ve never been ill and never had flu jab.” Presumably she received BCG and other childhood vaccines.
    “We (by which she meant she) decided to wait until it’s been shown to be safe.” What is Phase 111 for? She’s the one who’s husband has COPD.

    Another friend in Canada always advises people not have the flu jab. What a bunch fo idiots. Where I know these people well, I told them in their Christmas cards to do their civic duty if they wouldn’t do it for them selves. They’re still apparently talking to me and I think the couple have reversed their stupid decision.

    • This is the major battle to convince people to be vaacinated….safe there have been millions of people vaccinated with the pfizer vaccine…
      we have to educate the covidiots

  • I was just wondering how blunted would be the inmune response of a pwMS on anti-CD20 with this new vaccination schedules.

    Should this people avoid this vaccine dosing schedule???

  • Nice post

    Since all vacine ares gear to prevents serious disease and not sterilizing immunity

    Will the one shot regime

    Make those vaccinated more likely to be carrying more virus and spreading it to others that dont yep have the shot?

    Compare two the two shots regime?

    • the higher the levels of antibody the more sterilizing immunity you will have , it is like an anti drug antibody response ,

      The vaccinated people will get rid of the virus quicker and so will pass the virus on less

        • Thanks

          But the 80% 90% 95%

          From diferent vaccines its protecion from severe disease

          Not protection from infection ,so people who get vaccineted can still spread the virus

          And if you give just one shot will they be spreading more virus?

          • no protection from infection as well, maybe people can get infected but they will spread less

  • Do we have any idea how one shot of the mRNA vaccines 3 weeks before an anti CD20 (ocrelizumab in my case) would work? Looking at local availability, I doubt I could fit in the usual protocol without a 6-8 week delay, but one dose might work with minimal delay. Second dose would obviously be more flexible.

    I consider MS by far the bigger issue than COVID FWIW.

    • A 6-8 week delay will have minimal influence on the activity of ocrelizumab based on the COVID induced delay experience. However, based on US label none-live vaccine can be given 2 weeks before ocrelizumab week-5 vaccine week -2 vaccine week 0 = 5 weeks

  • What is your (anyone can chime in) opinion on the strategy of COVID-19 spike protein mRNA vs inactivated whole virus vaccine? I’ve read that there are vaccines in the pipeline. Would using whole virus provide a more broad based T cell and antibody response?

    • They might not like it and us immunologists ain’t that keen either but as COVID is running out of control, both in the UK and US they may have little choice but to adopt it as an emergency measure IMO.

      • Yep but

        The trial were made and aproved on the 2 doses regimen

        It might be that in the end if you go one shot route

        You have to boost (second shoot) in a shorter period ,those same persons

        All in all almost same result ,

        You ,could buy a bit more time (in the end its all we can aford)

    • Really good article here on dosing strategy and why extending the interval or indeed reducing the dose by 50% is not warranted by the data.

  • Could there be a higher risk of the virus mutating in people that have been vaccinated partly, but not completely? Are the English bringing a ‘British No.2’-variant to the rest of the world, by extending the dosage interval? A new mutated variant that is able to escape the immune system of previously infected/vaccinated people?

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