To Arms

The Janssen vaccine is now approved for use in NZ; AstraZeneca should be close behind. As best we can tell, the Pfizer vaccine slowly being rolled out is better than either, but availability of doses seems to be a binding constraint.

There's some evidence now that AZ as a first shot followed by Pfizer may be better than two shots of Pfizer, or at least no worse. If we could get AZ faster, then that could speed up the vaccination roll-out. 

There are NIH trials currently underway checking what Janssen-based combinations are like. Safety data should soon be available. If Janssen followed by Pfizer is safe, and if NZ could get doses of it, then we could think about rolling out Janssen as first doses. That too could speed up the vaccination roll-out. Adding a second dose of Pfizer later, at the time that it would have been being rolled out as first doses, would give more protection in that interval. See also the Washington Post on it.

The Conversation summed up the case a few weeks ago:

Emerging coronavirus variants are one of the most intriguing reasons to consider mixing vaccines. Administering vaccines that target different variants would provide broad collective immunity and limit emergence of new possibly more dangerous strains.

It’s possible that people who are currently fully vaccinated will need a third shot to address genetic differences in new variants. Changing platforms for this booster shot – for instance, if your first round was viral-vector based, switching to mRNA or one that is protein-based – could help bolster your immune response.

The whole public sector seems really not to see any urgency about getting doses in arms. I don't really understand why. Is it just fatalism and resignation, figuring it's impossible to get more doses so no point in thinking about it? Too much trust in that we've not had a real bad breach so far, so it'll be fine next time? 

Australia is getting a delta outbreak, and our border protocols are really not very good. 

They still haven't gotten all border workers vaccinated. They're not bothering checking Covid test results for incoming passengers. Our contact tracing system still isn't up to the job. 

There's no decent roll-out of saliva testing, and what looks like a near-corrupt tendering process. Access to vaccines across the country seems haphazard, with no access in Canterbury (and see here) but easy access in parts of Auckland. [Update: oh - and border workers really do want the saliva tests.]

Getting piles of doses ordered for fast delivery gives us options. At worst, if the NIH trials don't look so hot, pass the Janssen doses on to other places. 

Pfizer is working on a new booster aimed at the Delta variant. Shouldn't we be getting a big order in right now, before the thing's approved, so we can have delivery of it as soon as it's ready rather than being back of another queue?