Chat message

Slack / Private Message Drop, p.375 [SLACK_000589] · slack_pm:msg:03908

Date: 2021-01-10 12:07
Type: chat message · slack
recipient: Kristian G. Andersen, Edward C. Holmes, Andrew Rambaut
speaker: Robert F. Garry
Topics: Vaccines

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This might be worth considering and based on the above there is not a minor chance of this making it worse. Nevertheless - Looking back at least at the Pfizer vaccine they got very similar immunological/neut results with 10,20 and 30 ug doses - yet they went with the 30 ug dose in the phase 2/3. Don't know why. The pfizer vaccine isdiluted to about 2 ml per vial. 0.3ml dose. 5-6 doses per vial. I bet based on the Phase I you could double thevolume of the diluent and inject 0.2 mls instead of 0.3 mls and get similar immunity. That's 15-18 doses per vialinstead of 5-6.

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2021-01-10 11:27 Robert F. Garry open

Oh my - that's concerning if this is what emerges out of close to "herd immunity."
2021-01-10 11:32 Andrew Rambaut open

That is the main point - close to herd immunity is the worst for selecting for escape. Why vaccination needs to befast and comprehensive. Its also why I am going more in favour of delaying second dose if you can get universal coverage quickly but the worse would be slow and delayed.
2021-01-10 11:39 Robert F. Garry open

How about splitting up the doses? Like they have done for smallpox...
2021-01-10 11:41 Robert F. Garry open

"Slow and delayed" is definitely the Trump approach.
2021-01-10 12:07 Robert F. Garry

This might be worth considering and based on the above there is not a minor chance of this making it worse. Nevertheless - Looking back at least at the Pfizer vaccine they got very similar immunological/neut results with 10,20 and 30 ug doses - yet they went with the 30 ug dose in the phase 2/3. Don't know why. The pfizer vaccine isdiluted to about 2 ml per vial. 0.3ml dose. 5-6 doses per vial. I bet based on the Phase I you could double thevolume of the diluent and inject 0.2 mls instead of 0.3 mls and get similar immunity. That's 15-18 doses per vialinstead of 5-6.
2021-01-10 12:12 Robert F. Garry open

Yes - risky!
2021-01-10 12:28 Edward C. Holmes open

@Robert Garry He sent me that to comment on.
2021-01-10 12:30 Edward C. Holmes open

@Andrew Rambaut Tasted fine in the stir fry.
2021-01-10 12:44 Edward C. Holmes open

"That is the main point - close to herd immunity is the worst for selecting for escape. Why vaccination needs to befast and comprehensive. Its also why I am going more in favour of delaying second dose if you can get universal coverage quickly but the worse would be slow and delayed." I can't agree because we don't know how good protection is going to be for 12 weeks. May be fine, but may also be that one dose maximises selection pressures. BUT it's also clear that it's Sophie's Choice in UK...in fact, they have no choice but to delay the 2nd dose. Very hardto balance theoretical evolution against hard deaths. It's also absolutely clear that plus of supply issues no country isgoing to be able to employ the perfect vaccination schedule. The virus is going to evolve and we'll just have to live with it.

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