Each vaccine has its merits and they all work

Image by Angelo EsslingerReports from the scientific community often meant bad news in the Corona year: Warnings, steep curves, mutated viruses. But lately, the scientific journals have more often featured hopeful messages. 

Just on Thursday, a new study from Israel came along. It drew the same conclusion as others before it: Vaccination works - often better than hoped.

The latest encouraging findings come from Britain and Israel. This is no coincidence. Both countries have high vaccination rates, so there is plenty of illustrative material. Israel in particular offers extremely good conditions for research: Just under nine million inhabitants, almost an island sealed off from the outside world, especially during the pandemic, a tightly organized healthcare system and, above all, hardly any data protection.

For the vaccine manufacturer Biontech/Pfizer, a deal with the government has turned the country into a veritable laboratory. The company guaranteed fast delivery and the government free access to health data on a scale that would have caused an outcry in most other Western countries.

But this has now enabled researchers to analyze vaccination data from around 1.2 million people insured by the Clalit health insurance company in order to test the vaccine under real-life conditions. The results, published in the New England Journal of Medicine, confirm earlier findings. After just the first dose of the Biontech/Pfizer vaccine, the probability of contracting severe covid-19 falls by more than 60 percent within two to three weeks; after the second dose, it is 92 percent lower.

Because probability calculation is not everyone's cup of tea, the absolute figures are not as scientifically precise, but they are more illustrative: among just under 600,000 vaccinated persons, there were only 55 severe courses compared to 174 in a group of non-vaccinated persons of the same size and similar composition. 32 non-vaccinated died, but only nine vaccinated.

Since the British mutant B.1.1.7 was already widespread in Israel at the time, the authors concluded that the Biontech/Pfizer vaccine also effectively suppressed this variant. Now, the preparation - like its technical relative from Moderna - has long been considered something like the current gold standard in corona vaccination. In contrast, the third vaccine from Astrazeneca currently approved in Europe has an unjustifably mixed reputation in Germany.

The reputation, they say, is the result of failed Eu politicising, poor communication and the special pitfalls of probability calculation.

Two figures are still haunting the debate today: Biontech/Pfizer cited 95 percent efficacy for its drug, while Astrazeneca came up with around 70 percent. Initially, only a small circle of specialists realized that this did not mean that approximately every third Astrazeneca vaccination was a complete waste of time.

In reality, the value indicates how strongly the probability of developing any Covid 19 symptoms at all decreases - regardless of whether it is a mild cold or a fatal course. The fact that not a single double-vaccinated person had to be hospitalized in the studies that Astrazeneca submitted for approval was completely lost in the supposedly easy-to-understand comparison of figures.

In the meantime, however, more recent data have become available that even confirm the advantages of the Astrazeneca drug over its competitors. Technically, it already has them anyway, because it does not have to be deep-frozen, but can be vaccinated in normal refrigerators by normal doctors. Otherwise, mass vaccination of Germans in the foreseeable future would be impossible.

In addition, there are now first indications that the Astrazeneca product is more effective earlier than the Biontech/Pfizer product. They come from a study, this time from Scotland, in which data from almost the entire population were included. In the paper, which is still published as a preprint, i.e., without critical counter-readers from the specialist community, the authors calculate that four to five weeks after the first Astrazeneca dose, the number of vaccinated patients who nevertheless had to be hospitalized with severe courses of the disease had already fallen by 94 percent compared with non-vaccinated patients. The Biontec/Pfizer drug "only" achieved 85 percent, which is still extremely good.

Moreover, another study indicates that the Astrazeneca drug seems to be able to catch up significantly in the original numerical race of probabilities if one waits longer than before with the second dose. Indeed, the likelihood of developing symptoms dropped by 80 percent instead of about 70 percent if the second dose was not vaccinated until after three months.

If these findings are confirmed, the vaccine developed in a British-Swedish collaboration at Oxford University would have a double technical advantage. The longer the vaccination interval can last without the protective effect dropping significantly in the meantime, the faster a larger proportion of the population can be protected, at least in a first round.

This could be of additional interest to poorer countries that lack the logistics for mass vaccination - but which are important for the global fight against Corona. Experts repeatedly point out that the danger of escape mutations, i.e. new types of virus that overcome vaccine protection, will not be averted until the virus is under control everywhere.

The fact that the Astrazeneca drug has stronger side effects than the competition is also no reason for experts to advise against it. The Paul Ehrlich Institute (PEI), officially responsible for the safety of vaccines, concludes in its current assessment that these vaccine reactions - ranging from malaise to flu-like symptoms with fever - disappear after a few days.

The vaccine specialists at the PEI have come to a sober conclusion: "Astrazeneca's Covid 19 vaccine is highly effective. It prevents Covid 19 disease in the majority of cases or alleviates symptoms in cases of disease." Faced with the choice of waiting or reaching for the British-Swedish vaccine, the recommendation of the experts in Langen, Hesse, is clear in any case: "Every single vaccinated person benefits from the expected protective effect." Because one thing is clear: for every non-vaccinated person, the protection is, logically, exactly 0 percent.



Image by Angelo Esslinger

 


Graduate Study MPhil and PhD
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