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Covid-19 mRNA vaccines best at preventing symptomatic infection against variants

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SINGAPORE - Covid-19 vaccines that use mRNA technology have been found to be the best at preventing symptomatic infection against variant strains, a comparison of the efficacy levels of different vaccines against the variants has shown.

mRNA vaccines, notably the ones developed by Pfizer-BioNTech and Moderna, involve injecting snippets of the virus' genetic material - and not the whole virus - into the body to stimulate an immune response.

mRNA vaccines were found to induce high levels of neutralising antibodies against the original strain, as well as against Britain's B117 strain and the Brazilian P1 variant. However, these levels of neutralising antibodies decline when used against South Africa's B1351 variant.

Neutralising antibodies bind to specific, important sites of the virus, preventing it from starting its invasion.

The success of mRNA vaccines is likely due to the high levels of antibody and T-cell response they induce in the body, according to Associate Professor David Allen from the National University of Singapore's Yong Loo Lin School of Medicine.

"Antibodies have the capacity to block infection entirely... and when it comes to limiting spread and severity of infection in an individual that has already been infected, both T-cells and antibodies play a role," Assoc Prof Allen said.

The more traditional inactivated vaccines make use of killed virus particles. These may elicit lower responses or none at all.

People with low levels of neutralising antibodies may still be protected from Covid-19 if they have robust T-cell immunity.

The immune system depends on the T-cells, a type of white blood cells, working together with antibodies to eradicate the virus.

These findings were shared in a monthly webinar, titled "Season Two of Covid-19: Updates from Singapore'' last Thursday (March 25). The webinar brought together local and international experts to discuss the latest medical and scientific finding around the coronavirus.

The show was hosted by Assoc Prof Allen, who is also the Associate Vice-President of Health Innovation and Translation in NUS; Professor Dale Fisher, group director of Medicine at the National University Health System and chair of the World Health Organisation's Global Outbreak Alert & Response Network (GOARN); and Dr Louisa Sun, an associate consultant with the infectious disease team at the National University Hospital and Alexandra Hospital.

Work on variant-specific vaccines has already started globally, said Dr Richard Hatchett, a special guest of the show. Dr Hatchett is chief executive of the Coalition for Epidemic Preparedness Innovations (CEPI) - an international coalition set up to prepare for future infectious disease threats.

But challenges remain. Although global vaccine-sharing scheme Covax aims to deliver some two billion doses this year, the scarcity in vaccine supply remains the key bottleneck.

"Vaccine supply is a major issue right now that will gradually improve... We have at least nine manufacturers currently that are massively scaling up their production, and those vaccines will become available over time," Dr Hatchett said.


Here are some other highlights from the hour-long webinar:

On allergies:

Q: What should individuals with anaphylactic reactions do since they cannot receive the Covid-19 vaccination for now?
A: As the Singapore vaccination programme is still being ramped up, vaccination guidelines will keep being updated. Current vaccination recommendations are unlikely to be the finalised versions. There are also other vaccine candidates which are being currently reviewed. With time, there should be options for everyone to be vaccinated.

Q: Should individuals with chronic stable medical conditions get vaccinated?
A: Yes, they are encouraged to get vaccinated. But if you have a newly diagnosed serious medical condition, and are receiving intense treatment or frequent medication, then you should postpone the vaccination until your condition stabilises.

Q: Can I get vaccinated if I have had surgery in my limbs?
A: Yes you can get vaccinated. But local site reactions are quite common for mRNA vaccines, so it will be good to wait for the post-surgical healing process to be over before proceeding with the vaccination.

On Sinovac:

Q: Different trials in different countries have reported different efficacy levels for Sinovac. Is this of concern?
A: Calculating efficacy is a highly complex affair. There is an interplay of different factors such as participation numbers, prevalence and rate of transmission of Covid-19, the presence and effectiveness of existing public health measures as well as testing strategies.

Hence, trials that have been done cannot be compared head to head, as even the recruitment of trial participants has been very different. For instance, Indonesia recruited only the general public while Brazil recruited only healthcare workers. Trials have also been done under very different pandemic situations, with places like Brazil experiencing a very rampant Covid-19 outbreak. Hence, these factors will also influence vaccine efficacy, and official data will be needed from Sinovac before conclusions can be drawn.

The efficacy of mRNA vaccines is also very high and that has unfortunately set the bar unfairly high for other vaccine candidates. A successful vaccine is one that is safe and can achieve an efficacy of over 50 per cent.

The next webinar will be held on April 29.

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SINGAPORE - Covid-19 vaccines that use mRNA technology have been found to be the best at preventing symptomatic infection against variant strains, a comparison of the efficacy levels of different vaccines against the variants has shown.

mRNA vaccines, notably the ones developed by Pfizer-BioNTech and Moderna, involve injecting snippets of the virus' genetic material - and not the whole virus - into the body to stimulate an immune response.

mRNA vaccines were found to induce high levels of neutralising antibodies against the original strain, as well as against Britain's B117 strain and the Brazilian P1 variant. However, these levels of neutralising antibodies decline when used against South Africa's B1351 variant.

Neutralising antibodies bind to specific, important sites of the virus, preventing it from starting its invasion.

The success of mRNA vaccines is likely due to the high levels of antibody and T-cell response they induce in the body, according to Associate Professor David Allen from the National University of Singapore's Yong Loo Lin School of Medicine.

"Antibodies have the capacity to block infection entirely... and when it comes to limiting spread and severity of infection in an individual that has already been infected, both T-cells and antibodies play a role," Assoc Prof Allen said.

The more traditional inactivated vaccines make use of killed virus particles. These may elicit lower responses or none at all.

People with low levels of neutralising antibodies may still be protected from Covid-19 if they have robust T-cell immunity.

The immune system depends on the T-cells, a type of white blood cells, working together with antibodies to eradicate the virus.

These findings were shared in a monthly webinar, titled "Season Two of Covid-19: Updates from Singapore'' last Thursday (March 25). The webinar brought together local and international experts to discuss the latest medical and scientific finding around the coronavirus.

The show was hosted by Assoc Prof Allen, who is also the Associate Vice-President of Health Innovation and Translation in NUS; Professor Dale Fisher, group director of Medicine at the National University Health System and chair of the World Health Organisation's Global Outbreak Alert & Response Network (GOARN); and Dr Louisa Sun, an associate consultant with the infectious disease team at the National University Hospital and Alexandra Hospital.

Work on variant-specific vaccines has already started globally, said Dr Richard Hatchett, a special guest of the show. Dr Hatchett is chief executive of the Coalition for Epidemic Preparedness Innovations (CEPI) - an international coalition set up to prepare for future infectious disease threats.

But challenges remain. Although global vaccine-sharing scheme Covax aims to deliver some two billion doses this year, the scarcity in vaccine supply remains the key bottleneck.

"Vaccine supply is a major issue right now that will gradually improve... We have at least nine manufacturers currently that are massively scaling up their production, and those vaccines will become available over time," Dr Hatchett said.


Here are some other highlights from the hour-long webinar:

On allergies:

Q: What should individuals with anaphylactic reactions do since they cannot receive the Covid-19 vaccination for now?
A: As the Singapore vaccination programme is still being ramped up, vaccination guidelines will keep being updated. Current vaccination recommendations are unlikely to be the finalised versions. There are also other vaccine candidates which are being currently reviewed. With time, there should be options for everyone to be vaccinated.

Q: Should individuals with chronic stable medical conditions get vaccinated?
A: Yes, they are encouraged to get vaccinated. But if you have a newly diagnosed serious medical condition, and are receiving intense treatment or frequent medication, then you should postpone the vaccination until your condition stabilises.

Q: Can I get vaccinated if I have had surgery in my limbs?
A: Yes you can get vaccinated. But local site reactions are quite common for mRNA vaccines, so it will be good to wait for the post-surgical healing process to be over before proceeding with the vaccination.

On Sinovac:

Q: Different trials in different countries have reported different efficacy levels for Sinovac. Is this of concern?
A: Calculating efficacy is a highly complex affair. There is an interplay of different factors such as participation numbers, prevalence and rate of transmission of Covid-19, the presence and effectiveness of existing public health measures as well as testing strategies.

Hence, trials that have been done cannot be compared head to head, as even the recruitment of trial participants has been very different. For instance, Indonesia recruited only the general public while Brazil recruited only healthcare workers. Trials have also been done under very different pandemic situations, with places like Brazil experiencing a very rampant Covid-19 outbreak. Hence, these factors will also influence vaccine efficacy, and official data will be needed from Sinovac before conclusions can be drawn.

The efficacy of mRNA vaccines is also very high and that has unfortunately set the bar unfairly high for other vaccine candidates. A successful vaccine is one that is safe and can achieve an efficacy of over 50 per cent.

The next webinar will be held on April 29.

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Thanks for sharing, it validates my understanding of the science around mRNA. I theorized last April that mRNA will be more effective against mutations of the virus and I expected mRNA will be easier to mass produce. Can you imagine the only bottle neck to tripling production is shortage of rubber seals for the vials!
 
Moderna has just been approved in the UK, so it will be coming online in the next few weeks.

mRNA is indeed interesting technology, and one that AstraZeneca needs to start looking at, for sure.
 
Moderna has just been approved in the UK, so it will be coming online in the next few weeks.

mRNA is indeed interesting technology, and one that AstraZeneca needs to start looking at, for sure.

NOVOVAX is also interesting in that it is made from insects and its is cheap and easy to mass produce.

To create its vaccine, Novavax modified a virus that infects insects to instead deliver the gene that makes the coronavirus's spike protein.

The virus was then used to infect insect cells. The insect cells manufacture the coronavirus spike protein, which is then harvested and purified for use in Novavax's COVID-19 vaccine.

 
l
Fake stats. Real world numbers speak for themselves.

What rubbish, look like Singapore is using any excuse to feeling better using experimental vaccines.
 
Q: Different trials in different countries have reported different efficacy levels for Sinovac. Is this of concern?

and official data will be needed from Sinovac before conclusions can be drawn.
China’s vaccine diplomacy stumbles as clinical trial data remains absent

Last month, a shipment of Sinovac coronavirus vaccine doses arrived without fanfare in Singapore from China.

Today, the vaccine sits unused in a storage facility. The wealthy city-state is moving ahead with Pfizer-BioNTech and Moderna shots for its coronavirus immunization program, with officials saying Sinovac needs to provide more data before they will consider rolling out its doses.

The case highlights the limitations of Beijing’s vaccine diplomacy. China’s lack of transparency in its clinical trials has hurt public confidence, even as national leaders from Indonesia to Sierra Leone have gotten the shots to rally their populations to do the same.

China’s coronavirus vaccine makers Sinovac and Sinopharm were among the earliest in the world to begin clinical trials last year. It remains unclear why they still have not published the data from the studies, even after dozens of governments have greenlighted their vaccines for emergency use.

“It’s extremely unusual,” said Peter English, a British expert in communicable-disease control, of the widespread use of these vaccines before the publication of peer-reviewed data. “It leaves a lot of questions.”

There have been signs the Sinovac and Sinopharm vaccines are less effective than hoped, even as Beijing is pushing for foreigners to use them and enjoy streamlined access to resume travel to China. This week, Sinopharm’s distributor in the United Arab Emirates said a “very small number” of people are being invited to take a third dose of the vaccine after insufficient antibody response from the first two doses.

State-owned pharma giant Sinopharm has self-reported a 79 percent efficacy rate. Smaller rival Sinovac’s efficacy rate has varied in trials from 50.4 percent in Brazil — barely above the 50 percent threshold that governments find usable — to over 80 percent in Turkey.

The Chinese Center for Disease Control and Prevention, Sinopharm and Sinovac did not respond to requests for comment.

China’s coronavirus vaccines remain oversubscribed by developing countries, as wealthier nations hoard the most effective vaccines made by U.S. biotech company Moderna and U.S. pharmaceutical firm Pfizer with its German partner BioNTech.

In Singapore’s case, the government has the luxury of a small population of 5.7 million people to immunize and more effective vaccines at hand.

Chong Ja Ian, an associate professor of political science at the National University of Singapore, said Singapore’s government did not turn down the Sinovac vaccine, which would be an affront to Beijing, but regulators also couldn’t approve its use on such limited data.

“Singapore has options, unlike some of the countries who have received Sinovac,” Chong said.

Other countries with larger populations and fewer options have accepted China’s vaccines, sometimes after considerable griping from top leaders.

Brazil, South America’s most populous country, has adopted Sinovac’s vaccine after initial resistance from President Jair Bolsonaro. The Philippines accepted a donation of Sinovac vaccines from China last month, despite President Rodrigo Duterte saying he personally wants to take a different Chinese vaccine, according to Reuters.

Vaccine makers usually release details of their Phase 3 clinical trials in peer-reviewed journals before the vaccines gain regulatory approval. Pfizer-BioNTech and Moderna published theirs in the New England Journal of Medicine in December.

Sinopharm and Sinovac have self-reported some key results, but they have not published the underlying data in a journal, which would require vetting by third-party experts.

Chinese government officials and industry executives have largely deflected questions about when they will release the data. In an interview with state-run tabloid Global Times this month, Shao Yiming, a vaccine expert with China’s CDC, claimed that the countries where Sinovac and Sinopharm ran trials — including Brazil and the UAE — must be the ones to release it.

“Whether to release the clinical trial data, when and how, must be decided by the foreign institutions,” Shao said. “China has no power to decide.”

At a Beijing news conference on March 15, health regulators ignored a question on when data will be released, according to the transcript. Sinopharm and Sinovac executives also have not addressed the question.

More than 60 countries have approved one of China’s coronavirus vaccines for market use or emergency use, according to the China International Development Cooperation Agency.

Malaysia began using Sinovac’s vaccine this month, after kicking off its vaccination drive with limited supplies of vaccines from Pfizer-BioNTech and British-Swedish firm AstraZeneca, which developed a shot with Oxford University. Malaysia’s science minister, Khairy Jamaluddin, took the first shot of the Sinovac vaccine to shore up confidence.

“I want to say, it is safe,” he wrote in Chinese on Twitter after receiving the first dose. “I feel great. And my Chinese has suddenly gotten better.”

Chinese leader Xi Jinping has yet to publicly take a vaccine. Sinopharm said this month more than 5,000 senior officials attending the country’s annual legislative session had been vaccinated.

In Hong Kong, vaccine mistrust has jumped after seven people died following Sinovac doses and one after receiving the Pfizer-BioNTech vaccine, although no causation has been established.
The Chinese territory has expanded its vaccine program to include anyone over 30, who can choose from either the Pfizer-BioNTech vaccine or Sinovac’s, after priority groups were reluctant to take up the shots. That is a situation Singapore is trying to avoid, experts say, as it could delay the reopening of borders and the economy.

English, the communicable-disease expert, said vaccine makers typically publish clinical trial results transparently to build public trust. This is especially critical during a pandemic, where public indecision about whether to get a vaccine costs lives.

Singapore’s ministry of health said that it received its first shipment of Sinovac doses on Feb. 23. The country’s Health Sciences Authority said this week it has begun reviewing the data that Sinovac had submitted, but it needs more information from the company.
Regulators are “still waiting for the company to submit the data,” the Health Sciences Authority said.


Alicia Chen in Taipei, Taiwan, and Lyric Li in Seoul contributed to this report.
 
Thanks for sharing, it validates my understanding of the science around mRNA. I theorized last April that mRNA will be more effective against mutations of the virus and I expected mRNA will be easier to mass produce. Can you imagine the only bottle neck to tripling production is shortage of rubber seals for the vials!


Protection against mutations and symptons is not the only important measure of the efficacy of a vaccine.

The other really important point is protection against hospitalisations and UK data, where both the traditional viral-vector(AstraZeneca) and mRNA(Pfizer) have been given in the millions and so probably the best country to make a direct comparison, suggest that AstraZeneca may even be slightly better in this respect.

Also AstraZeneca vaccine seems to be 90%+ protection from severe disease after just one dose, whereas Pfizer is around 60% from a single dose and needs 2 doses to get to the 90%+ level.

I think both types of vaccine have a role to play and will act to complement each other's strength and weaknesses.
 
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mRNA new technology, I believe not yet tested on animals. I would avoid.
 
Sinovac, the one Chile has been using for mass immunization, doesn't seem to stop the emergence of new cases but seems to prevent deaths. https://www.worldometers.info/coronavirus/country/chile/

Recently the number of new cases clearly increases but the number of deaths doesn't.

It is also seasonal. Currently Chile is going into winter which will be nasty. America is going into spring which should be better until about October when America goes into winter.
 
I second that no way would I go near an mRNA vaccine.
I’m booking AZ.
If you are under 50 don't take any covid vaccine, not worth the risk. You are at risk as you get older.
 
If you are under 50 don't take any covid vaccine, not worth the risk. You are at risk as you get older.

The thing is we may all have to.
AZ is traditional methods anyway, well tested.
 
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