Tag Archives: Oxford

The Oxford vaccine has unique advantages, as does Pfizer’s. Using both is Australia’s best strategy

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Kylie Quinn, RMIT University; Holly Seale, UNSW, and Margie Danchin, Murdoch Children’s Research Institute

On Sunday, federal Chief Medical Officer Professor Paul Kelly said most Australians will be offered a vaccine from Oxford-AstraZeneca.

Australia currently has agreements in place to receive 53.8 million doses of the AstraZeneca shot, and 10 million doses from Pfizer-BioNTech.

So how do these two vaccines compare, how will they be used in Australia, and what can we learn from other vaccines?



Read more:
Australia’s vaccine rollout will now start next month. Here’s what we’ll need

Comparing the two

Both the Pfizer and AstraZeneca vaccines induce immunity but in different ways. They both deliver the instructions for how to make a target on the virus for our immune system to recognise the spike protein.

The Pfizer vaccine packages the instructions up in a droplet of fat, while the AstraZeneca vaccine packages the instructions up in the shell of a virus, the adenovirus.

Clinical trials for both vaccines have shown they’re broadly safe.

In terms of efficacy, the Pfizer vaccine protects 94.5% of people from developing COVID.

The AstraZeneca shot protects 70% of people on average — still pretty good and on par with the protection given by a flu vaccine in a good year.

However, the optimal dose and timing of AstraZeneca’s shots is still unclear. One trial reported 62% efficacy, and another 90%, with a low dose for the first shot and/or longer break between doses possibly improving protection. More studies are underway to define this and the Therapeutic Goods Administration, Australia’s regulatory body, will evaluate new data as it comes through.

In any scenario, the AstraZeneca vaccine will still protect the majority of people that receive the vaccine from disease.



Read more:
The Oxford/AstraZeneca vaccine is the first to publish peer-reviewed efficacy results. Here’s what they tell us — and what they don’t

While the Pfizer vaccine was more protective in clinical trials, the AstraZeneca vaccine has other advantages that could make it more appropriate for use outside of clinical trials:

From a logistical perspective, the AstraZeneca vaccine has a major advantage. The ability to distribute vaccines can be almost as important as the vaccine’s effectiveness.

The effect of these advantages on the impact of this vaccine shouldn’t be underestimated. We have lots of people to vaccinate, a low disease burden currently, are far away from the rest of the world in terms of shipping, and Australia is a pretty big country, so distribution to rural and remote communities is a massive hurdle.

Efficacy isn’t the only thing we should consider

It can be helpful to look at the flu vaccine as a contrast. The flu vaccine is far from perfect — it provides moderate protection, with effectiveness varying between different groups of people and from season to season. For example, in the 2015/16 season in the United States, the quadrivalent influenza vaccine (which covers four strains) was about 54% effective against laboratory-confirmed influenza.

People know it’s not perfect, but people don’t generally judge whether they’ll receive a vaccine based on its effectiveness alone. We know from talking to the community that many factors influence motivation, especially perceived risk and severity of infection, and confidence in the safety of the vaccine.

Every year, access to flu vaccines is prioritised to those at most risk, such as people with medical conditions, Aboriginal and Torres Strait Islanders and those aged 65 years and older. The public has confidence in this approach. We need to protect those most at-risk first, and we don’t have an issue doing this day-to-day. We now have a similar challenge with the new COVID vaccines.

The best approach for protecting everyone’s health amid the pandemic is to provide different vaccines to different people according to need and availability, at least in the short term. The best vaccine is always the one you can get to the communities that need it before they urgently need it.

Australia’s combination strategy

Because Australia is essentially COVID-free at present, it means we’re in a unique situation that permits a “combination” vaccine strategy.

The Pfizer vaccine is perfect for preventing the most extreme outcomes for people at very high risk of infection or disease: people on the frontlines of the fight against COVID and older people or people with high-risk health conditions.

The AstraZeneca vaccine has the ability to protect a large number of people against disease quickly, because we can make it easily and distribute it quickly.

As a result, Pfizer is likely to be prioritised for people with higher risk and AstraZeneca is likely to be prioritised for everyone else.

We won’t all be able to get the Pfizer vaccine straight away, so for many of us the choice in the short term will be between a 70% efficacious vaccine or no vaccine.

We all stand to benefit from a strategy that protects extremely vulnerable groups from severe disease and aims to rapidly generate immunity in the rest of our community.

There may also be other vaccines that become available. Australia is part of COVAX which can distribute a variety of vaccines, and it also has an agreement for a vaccine made by Novavax, pending the outcome of phase 3 clinical trials. There could be other vaccines that emerge or other agreements developed, and Australia’s strategy will no doubt respond to that.



Read more:
Australia’s just signed up for a shot at 9 COVID-19 vaccines. Here’s what to expect

Nevertheless, both the Pfizer and AstraZeneca vaccines are essential tools in our public health toolkit, with vital roles to play in protecting the entire Australian population. We’ll also need to continue to use other public health tools like testing and contact tracing.

Factoring in effectiveness, availability and distribution challenges, a strategy that uses a combination of the two vaccines for Australia is the best of both worlds.

Shane Huntington co-authored this article. He is Deputy Director, Strategy and Partnerships, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne.The Conversation

Kylie Quinn, Vice-Chancellor’s Research Fellow, School of Health and Biomedical Sciences, RMIT University; Holly Seale, Associate professor, UNSW, and Margie Danchin, Associate Professor, University of Melbourne, Murdoch Children’s Research Institute

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Threat of Return to Hindu State in Nepal Looms

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With deadline for new constitution approaching, Christians fear end of secular government.

KATHMANDU, Nepal, March 30 (CDN) — Four years after Nepal became officially secular, fear is growing that the country could revert to the Hindu state it was till 2006, when proclaiming Christ was a punishable offense and many churches functioned clandestinely to avoid being shut down.

Concerns were heightened after Nepal’s deposed King Gyanendra Shah, once regarded as a Hindu god, broke the silence he has observed since Nepal abolished monarchy in 2008. During his visit to a Hindu festival this month, the former king said that monarchy was not dead and could make a comeback if people so desired.

Soon after that, Krishna Prasad Bhattarai, a former prime minister and respected leader of the largest ruling party, said that instead of getting a new constitution, Nepal should revive an earlier one. The 1990 constitution declared Nepal a Hindu kingdom with a constitutional monarch.

There is now growing doubt that the ruling parties will not be able to fashion the new constitution they promised by May.

“We feel betrayed,” said Dr. K.B. Rokaya, general secretary of the National Council of Churches of Nepal. “The Constituent Assembly we elected to give us a new constitution that would strengthen democracy and secularism has frittered away the time and opportunity given to it.”

The clamor for a Hindu state has been growing as the May 28 deadline for the new constitution draws near. When a Hindu preacher, Kalidas Dahal, held a nine-day prayer ritual in Kathmandu this month seeking reinstatement of Hinduism as the state religion, thousands of people flocked to him. The throng included three former prime ministers and top leaders of the ruling parties.

“The large turnout signals that Hinduism is enshrined in the hearts of the people and can’t be abolished by the government,” said Hridayesh Tripathi, a former minister and Constituent Assembly member whose Terai Madhes Loktantrik Party is the fifth-largest in the ruling alliance. “It was a mistake to abolish Hinduism in a hurry.”

Another blow for a Hindu state was struck by the Rastriya Prajatantra Party-Nepal (RPP-N), the only party that fought the 2008 election in support of monarchy and a Hindu state. It is now calling for a referendum. As a pressure tactic, it paralyzed the capital and its two neighboring cities in February by calling a general strike.

“The election gave the Constituent Assembly the mandate of writing a new constitution, not deciding issues of national importance,” said Kamal Thapa, the RPP-N chief who also was home minister during the brief government headed by Gyanendra. “Most people in Nepal want a Hindu state and a constitutional king. If their demand is not heeded, they will feel excluded and refuse to follow the new constitution. We are asking the government to hold a referendum on the two issues before May 28.”

With only two months left, it is clear the demand can’t be met if the constitution is to come into effect within the stipulated time. Now the specter of anarchy and violence hangs over Nepal.

Nepal’s Maoists, who fought a 10-year war to make Nepal a secular republic and who remain the former king’s most bitter enemy, say attempts have begun to whip up riots in the name of a Hindu state. The former guerrillas also allege that the campaign for the restoration of Hinduism as the state religion is backed by ministers, politicians from the ruling parties and militant religious groups from India.

Effectively Hindu

Even if a new, secular constitution is approved by the deadline, there is still no guarantee that the rights of religious minorities would be protected.

Nilambar Acharya, who heads the committee that is drafting the new constitution, said it would be merely a broad guideline for the government; compatible laws would have to be drafted to protect rights.

“The previous constitution abolished ‘untouchability’ [a practice among Hindus of treating those at the bottom of the social ladder as outcasts],” Acharya told Compass. “But untouchability still exists in Nepal. To achieve all that the constitution promises, the mindset of society has to be changed first. For that, you need political will.”

Though Nepal became secular in 2006, Hinduism still gets preferential treatment. The state allocates funds for institutions like the Kumari, the tradition of choosing prepubescent girls as protective deities of the state and worshipping them as “living goddesses.” The state also gave money to organizers of a controversial, five-yearly religious festival, the Gadhimai Fair, where tens of thousands of birds are slaughtered as offerings to Hindu gods despite international condemnation.

There is no support, predictably, for Christian festivals. When the Constituent Assembly was formed – partly though election and partly by nomination – no Christian name was proposed even though the prime minister was authorized to nominate members from unrepresented communities.

Christian leaders want such religious bias abolished. Rokaya of the National Council of Churches of Nepal said Christians have recommended full freedom of religion in the new constitution: allowing one to follow the religion of one’s choice, to change one’s religion if desired or have the right not to be associated with any religion.

The churches have also asked the state not to interfere in religious matters.

“We are asking the government not to fund any religious activity, not to be part of any religious appointments and not to allow public land for any religious event,” Rokaya said.

The recommendations, however, may not be heeded. During their brief stint in power, the Maoists tried to stop state assistance for the Kumari. It led to violence and a general strike in the capital, forcing the party to withdraw the decision.

In its 2009 report on religious freedom in Nepal, the U.S. Department of State notes that while the interim constitution officially declared the country secular, “the president, in his capacity as head of state, attended major Hindu religious ceremonies over which the king previously presided.”

It also notes that there were reports of societal abuses and discrimination based on religious affiliation, belief, or practice.

“Those who converted to a different religious group occasionally faced violence and were ostracized socially,” it states. “Those who chose to convert to other religious groups, in particular Hindu citizens who converted to Islam or Christianity, were sometimes ostracized. They occasionally faced isolated incidents of hostility or discrimination from Hindu extremist groups. Some reportedly were forced to leave their villages.”

Dr. Ramesh Khatri, executive director of Association for Theological Education in Nepal, has experienced such persecution first-hand. When he became a Christian in 1972, his father disowned him. Then in 1984 he was arrested for holding a Bible camp. Though the case against him was dropped in 1990 after a pro-democracy movement, Khatri said hatred of Christians still persists.

“Christians can never sleep peacefully at night,” he said wryly. “The new constitution will make Nepal another India, where Christians are persecuted in Orissa, Gujarat and Karnataka.” The Oxford University-educated Khatri, who writes a column in a Nepali daily, said violent responses to his articles show how Nepal still regards its Christians.

“I am attacked as a ‘Rice Christian,’” he said. “It is a derogatory term implying I converted for material benefits. The antagonistic feeling society has towards Christians will not subside with the new constitution, and we can’t expect an easy life. The Bible says that, and the Bible is true.”

Christians continue to face persecution and harassment. In March, missions resource organization Timeless Impact International (TII) noted that a church in northern Nepal, near the foothills of Mt. Everest, was attacked by a local mob.

The newly established church in Dolakha district was attacked during a fellowship meeting in January. An ethnic mob headed by religious leaders destroyed the church meeting place, assaulted participants and warned them not to speak about Christianity in the village, TII said.

The situation, even now, remained unchanged.

“None of the church members have been able to return to their homes,” TII stated. “They feel completely unsafe and at risk.”

Report from Compass Direct News