Yeah, the fact that this doesn't even need a freezer is great news.
The fact that we have three highly effective vaccines in such a short period is amazing and between them we might stand a chance of making and distributing them at the scale necessary to get things under some kind of control by August.
The safety concerns cannot be resolved yet. Effective - yes. Safe? We won’t know for a while.
Pandemrix, a flu vaccine, caused a notable uptick in narcolepsy in Sweden, Finland and likely the UK. This was not (and could not) be seen in smaller trial populations.
It is not a given that any of the covid vaccines is safe enough. Historically, two cases of rushed vaccines (cutter polio and Gullah barre) were worse than the disease - and these were for diseases worse than covid. Those were 50-60 years ago. Pandemrix was 10-20. I’m not sure we’re that much better on safety now to rush vaccines.
If the association between Pandemrix and narcolepsy is because it caused narcolepsy (as with Guillain-Barré it's also plausible the problem is that this is an auto-immune problem and so the vaccine wasn't actually the problem it just highlighted a problem you already had) then the incidence rate was estimated at like 18k patients per case.
So if you give the entire US population a vaccine like that, less than twenty thousand of them develop narcolepsy. As a reminder a quarter million of them already died from COVID-19 and more are dying every day - not to mention the tens of thousands whose cause of death isn't listed as COVID-19 but would not be dead if not for an ongoing pandemic.
Cutter screwed up. No amount of prior safety testing can fix that. Their Polio vaccine had Polio virus in it (to be clear: The traditional Oral Polio Vaccine is supposed to have a "live" virus in it, but the injected vaccine Cutter were selling is not). Obviously nobody is going to test "What happens if we inject children with the Polio virus" because the answer is "Some of them get Polio. Duh" and so no test could have prevented Cutter from screwing up.
I have no idea what you meant by "Gullah barre" the Google results I get are all about Guillain-Barré syndrome, which I mentioned above. Guillain-Barré is not a vaccine, it's a weird auto-immune disorder, and arguably even where it's listed as very rare side effect of a vaccine, that's misleading because it's also a side effect from getting viral infection, so if you avoid vaccination but do get the virus you may get GBS as a result anyway. The human immune system is pretty inscrutable.
> less than twenty thousand of them develop narcolepsy. As a reminder a quarter million of them already died from COVID-19 and more are dying every day
I assume the concern is that an unknown unknown means it could cause/trigger/amplify some other disease/condition that may be comparable/worse than the problem it solves.
Cause/effect and morals are hard. Add to the mix a general statistical innumeracy, and some general suspicion about authorities, and it makes it really hard for the general populace to actually weigh the two different options.
I don't think we should dismiss these concerns as just stuff for nutjobs. I've seen otherwise reasonable people having trouble making up their minds about that.
The association in Sweden is strong enough to say “it does”.
And yes, the mechanism is likely that Pandemrix activated a predisposition. But it was not activated in statistically equivalent kids who did not get Pandemrix.
Why is it so hard to acknowledge that not all vaccines are perfect, and that there’s a risk involved? I am not avtivax. I am pro vaccination. I am anti religious “a vaccine can never be bad” thinking which seem to be prevalent among otherwise rational scientific people.
covid risk varies wildly depending on socioeconomic factors. Educated, WFH, small family, stable or low IRL social interaction: pretty low risk. Low-education, multiple in-person jobs, lots of casual social interaction, large family: very high risk. We've seen it very starkly in England. When entire communities are being ravaged by exponentially-growing transmission, it's hard to argue that a vaccine might be worse, because the chances are really minimal.
> Historically, two cases of rushed vaccines (cutter polio and Gullah barre) were worse than the disease - and these were for diseases worse than covid.
This is just patently untrue.
The Cutter Incidence gave patients Polio due to an improperly activated virus. While this is bad, it could not be worse than the disease itself - since it is the disease itself, no worse, no less.
Regarding risk of Gullain-Barre syndrome due to vaccination, Wikipedia has this to say: "In fact, natural influenza infection is a stronger risk factor for the development of GBS than is influenza vaccination and getting the vaccination does reduce the risk of GBS overall by lowering the risk of catching influenza." So here I also find it hard to believe the vaccine would be worse than the disease,
I'm also sceptical of the claim that Polio or the 1976 Swine Flu would unambiguously be worse than Covid19. 70% of Polio case have no symptoms, and less than 0.5% cause permanent injury, according to Wikipedia. The 1976 Swine Flu outbreak seems to have caused a few hundred cases and only one death.
No, the cutter incidence was worse than the disease, because the activated virus was injected into a population, whereas naturally only a tiny part would be exposed at the same level, and the rest would be exposed at a much lower level - that would give them immunity but not disease.
Cutter was, most definitely, much worse than the disease if you look at it from a population perspective.
The 1976 Guilian barre was at least comparable to the flu it was supposed to stop, if not worse. According to https://en.m.wikipedia.org/wiki/1976_swine_flu_outbreak, the disease caused one death and 13 hospitalizations, and an uptick of Giullan barre reports - a disease that more often than not requires hospitalization and sometimes death. I can assure you it caused more than 13 hospitalizations, and - having known two GBS people who made a full recovery - a very long and painful months long process. So, at 50,000,000 immunized - a 1 in 1,000,000 would still be worse than the flu.
I am not anti vax even if HN constantly seems to interpret my comments as such.
I am vaccinated, so are my kids. But whenever I mention that immunizations have risks, I’m treated like a heretic.
Everyone is assuming something like cutter cannot happen again. This is a religious assumption, not a scientific one.
> No, the cutter incidence was worse than the disease, because the activated virus was injected into a population, whereas naturally only a tiny part would be exposed at the same level, and the rest would be exposed at a much lower level - that would give them immunity but not disease.
This is a more reasonable assessment, but it is still patently false. According to Wikipedia, 0.04% vaccinations resulted in paralysis in the Cutter Incident, compared to 0.1-0.5% of wild type polio. So the vaccine was 2-10x safer than wild polio. Without vaccinations, virtually all children were infected with polio virus early in life [1], so being administered the defective vaccine was still a lot better than taking a chance with the real disease.
Of course, you are correct regarding the 1976 flu outbreak. If you administer something to a large segment of the healthy population, even a small risk of side-effects will add upp to a large number of cases. If the disease itself turns out to be very rare, as was the case with the flu outbreak, the vaccine itself could cause more damage than the disease even if the disease is much worse.
However, this is clearly not applicable Covid-19, which we already know is spreading very fast and will need to infect a large number of the population before herd immunity is achieved. The situations are simply not comparable at all – even the vaccine from the 1976 flu outbreak would be less risky than the odds of being infected with a serious case of Covid 19 (of which the long term effects are also unknown, to be clear).
> But whenever I mention that immunizations have risks, I’m treated like a heretic.
Mainstream media, healthcare professionals and social media are all worried about the risks of a rushed vaccine. I literally see articles and hear conversations about this several times a month. Nobody is denying that large scale vaccinations have risks.
I'm not criticizing you because I'm against being cautious of vaccination risks. The criticism is that you are spreading false facts and misleading analysis that grossly mischaracterise what the risks of vaccinations really are, both presently and historically.
"Some vaccines can have rare but serious side effects" is a perfectly alright statement. But "Historically, two cases of rushed vaccines (cutter polio and Gullah barre) were worse than the disease - and these were for diseases worse than covid" is just not. Some of it is false and the comparison to Covid19 is misleading.
> According to Wikipedia, 0.04% vaccinations resulted in paralysis in the Cutter Incident, compared to 0.1-0.5% of wild type polio.
From https://en.wikipedia.org/wiki/Polio_vaccine#1950%E2%80%93195... : "The Cutter vaccine had been used in vaccinating 200,000 children in the western and midwestern United States.[76] Later investigations showed that the Cutter vaccine had caused 40,000 cases of polio, killing 10.[76]". So, 20% incidence; mentions 250 "paralytic illness", so 0.125% paralysis (no idea where you took the 0.04% - it does not appear in the Wikipedia text).
From https://en.wikipedia.org/wiki/Polio#Paralytic_polio : "In children, nonparalytic meningitis is the most likely consequence of CNS involvement, and paralysis occurs in only one in 1000 cases." ; So, for children, the incidence of paralysis is 0.1%
Who got the cutter vaccine? Mostly children. See e.g. from https://www.washingtonpost.com/history/2020/04/14/cutter-pol... "By April 30, within forty-eight hours of the recall,” Offit wrote. “Cutter’s vaccine had paralyzed or killed twenty-five children: fourteen in California, seven in Idaho, two in Washington, one in Illinois, and one in Colorado."
So, I just tried to check your numbers, and I couldn't; Could you post references?
But I also wanted to check my memory, and Wikpedia seems to agree with me, Go on, please do check my quotes.
still patently false. pfft. Perhaps false under some assumptions, definitely not "patently false".
On the one hand I tend to agree, and all my expectations for this vaccine are positive. The medical industry tends to be paranoid to a level that exceeds rationality and even if they dropped their standards for this that should only get them down to "conservative and rather safe" levels of caution.
On the other, a cursory search says the current record for fastest developed vaccine was mumps at 4 years. So this is a vaccine setting new milestones, and there is a risk that not all of them will be positive. I'd rather be a little late to be vaccinated than a little early, especially being in a lower risk demographic.
I'm not an expert by any means, but I do know that a lot of the speed comes from moving along the CHEAP-FAST side of the CHEAP-FAST-SAFE triangle, without necessarily changing anything on the FAST-SAFE axis. In particular, governments paid for the companies to start producing enough vaccines for phase 3 trials before phase 1 was complete, while normally drug companies would wait for phase 1 to be completed before preparing for phase 2 for economic reasons.
BiondVax recently finished their phase 3 trial of a universal flu vaccine. It was 15 years in the making. Science was (still is solid). Phase 3 took two years to account for ADE and other safety issues.
At the 1-year mark, everything looked perfect. At the towo years mark (original endpoint) the conclusion was that while it was safe, it offered statistically insignificant protection.
Properly designed tests need those 2 years, at the very least. The “SAFE” confidence axis was compromised. Whether or nit it is justified is what we’re discussing here.
I'm very pro-vaccine, and not disagreeing with your conclusions, but your logic leaves out the consideration that the natural risk also depends on catching the disease, whereas the vaccine is administered systematically.
I have had Guillain-Barre Syndrome (not due to a vaccine). No matter what, I still always get my vaccines and make sure that I am up to date and never late on any of them.
Sure, having Guillain-Barre is scary, but it is something that you can make a full recovery from.
It is never an excuse NOT to get a vaccine, unless you actually know that you got Guillain-Barre Syndrome from a vaccine. That is a discussion between that particular patient and their neuromuscular neurologist. In that case, you do not get the flu vaccine any longer because it can cause you to experience Guillain-Barre Syndrome again.
But, this really is an isolated situation that can be categorized as very rare and the general public should always get their vaccines.
If you catch the flu, it can absolutely trigger Guillain-Barre Syndrome, and would be far more likely to trigger Guillain-Barre Syndrome than the flu vaccine itself. If you get the flu and had the flu vaccination, it typically makes the flu illness less worse, making you less likely to get something like Guillain-Barre Syndrome.
There are lots of infectious agents that can trigger Guillain-Barre Syndrome, so it is wise to get your vaccines to prevent them as much as possible. They prevent serious infections, at minimum, which would help prevent Guillain-Barre Syndrome.
I also have the long term variant of Guillain-Barre Syndrome, known as Chronic Inflammatory Demyelinating Polyneuropathy, which is in pharmaceutical remission due to me taking subcutaneous immunoglobulin twice a week for 3 hours each time.
What I am saying is that while all of this sounds rare and devastating, it’s treatable. Not only that, you’re more likely to get Guillain-Barre Syndrome from a bad case of the flu than from a flu shot.
“Even at this stage, it does not appear that narcolepsy following vaccination against pandemic influenza is a general worldwide phenomenon, as no excess of narcolepsy has been reported from several other European states where Pandemrix was used, or from Canada where a pandemic vaccine similar to pandemrix was used. This complicates interpretation of the findings in Finland and Sweden. It seems likely that some as yet unidentified additional factor was operating in Sweden and Finland. The findings from the VAESCO project and further investigations in Finland and Sweden, may help clarify the determinants of any increased risk of narcolepsy, which currently appears to be restricted to the months following vaccination and by age group and country.”
What’s certainly true that for some effects to be observable, millions have to be vaccinated first.
“In total, the GSK shot was given to more than 30 million people in 47 countries during the 2009-2010 H1N1 swine flu pandemic.”
“Independent teams of scientists have published peer-reviewed studies from Sweden, Finland and Ireland showing the risk of developing narcolepsy after the 2009-2010 immunization campaign was between seven and 13 times higher for children who had Pandemrix than for their unvaccinated peers.”
“Europe’s drugs regulator has ruled Pandemrix should no longer be used in people aged under 20.”
> Pandemrix, a flu vaccine, caused a notable uptick in narcolepsy in Sweden, Finland and likely the UK.
"The increased risk of narcolepsy due to vaccination was 1 in 18400 or 0.005%."[1] Considering the fatality and long term disability rate of Covid, and the way testing and safety protocols are done for vaccines, I don't really see how there could be an unknown and unseen risk that would outweigh the risk of contracting Covid.
The risk of death in kids without underlying diseases is is approximately 0. It is not clear that giving (e.g. in the US) 30,000 of these kids narcolepsy is reasonable.
As far as I know, none of the COVID19 vaccines have been tested on children under 12 or are currently planned on being given to children.
Additionally, it's not as if the average vaccine has a 0.005% chance of giving you narcolepsy. That figure was for the one vaccine in one country which appears to be the only example in most people's living memory of a vaccine possibly causing long-term side effects (it's not even proven the vaccine was the cause). There have been tens of billions of vaccines given during this time period and this is the only example where there may have been long term side effects.
I've also mentioned the cutter polio vaccine and the 1976 swine flu vaccine which seems to have caused an uptick of GBS.
> There have been tens of billions of vaccines given during this time period and this is the only example where there may have been long term side effects.
No, there are other examples, the other two I just mentioned are from memory, I suspect if I go research I will find more (I don't have the time). You know what else is common to those other two cases? They were rushed (pandemrix wasn't AFAIK).
SARS-Cov-2 vaccines were all rushed, and the safety protocols used to confidently ascertain those billions of vaccines were NOT followed - The standard is to wait 2-4 years to see that there's no ADE or other issues.
I am pro-vaccination. I don't understand why it is hard to acknowledge and discuss the risk profile of vaccines - they re not risk free. Excuse me if I don't automatically think a rushed vaccine is perfectly safe.
I wonder if because the Oxford vaccine has taken an already tested and approved vaccine approach it has a higher chance of safety than the other 2 which use a new approach that has never been approved by regulators before.
FTA: "The Oxford vaccine (ChAdOx1 nCoV-19) is made from a virus, which is a weakened version of a common cold virus (adenovirus), that has been genetically changed so that it is impossible for it to grow in humans. Adenovirus vaccines have been researched and used extensively for decades"
I think the cold storage issues are a bit overblown.
Apparently the pfizer and Moderna vaccines will keep for 30 days at refrigerator temps after thawing out. You can ship in dry ice and then I can't imagine the vaccine sitting around in any doctors office or pharmacy for longer than 30 days.
Another huge differentiator is price. At $3 to $4, many countries will jump on board ASAP and stay away from the expensive vaccines from Pfizer and Moderna.
>At $3 to $4, many countries will jump on board ASAP and stay away from the expensive vaccines from Pfizer and Moderna.
The price difference will likely remain substantial, but in case anyone is unaware, the difference is currently greater due to AstraZeneca pledging to the sell the vaccine at cost "during the pandemic", while Pfizer and Moderna have indicated that they fully intend to profit. [1]
Once AstraZeneca deem the pandemic to be over, the price will likely rise.
It was reported a few months ago that internal AstraZeneca documents showed them projecting the "Pandemic Period" to end on 1 July 2021. [2]
No, the main driver for the price difference is that this is a "traditional" vaccine produced using existing technology, while Pfizer/Moderna are newfangled mRNA ones.
Also, all 3 have made various noises about not making a profit etc, it's quite hard to sort out the marketing from what will actually happen at this point. Oxford/Astra have committed to supplying at least 100M doses to low-income countries for under $3 though.
As I understand it, whatever gets us to herd immunity more quickly is the best solution. That probably means a mix of both heavily tilted to the Oxford one.
This vaccine is cheap, 90% efficient and easy to get people vaccinated. The other ones are expensive, 95% efficient and difficult to get people vaccinated.
No, it means deploy everything we have as fast as we can. If we have a choice prefer the mRNA vaccines as they seem to be more effective. If you are in a city with cold storage abilities (most have this already, though how much...) the Pfizer is better, but only to reserve the Moderna vaccine for those who don't live so close to cold storage.
The Oxford is best only if you either live in a very remote place, or are a very poor place. If you rely on the oxford vaccine it will be a little longer to get herd immunity, but overall your costs will be cheaper.
But I must reemphasize, the above is only about logistics. Because most people live in cities, all vaccines will be distributed in big cities just to get the numbers they need. What ever vaccine you are offered first is the one to take. You personally are unlikely to be offered a choice other than take it or leave it.
If they actually get to 90% or more, why would anyone bother with the more expensive and cumbersome vaccines? Except that the EU already signed a deal to buy the vaccines from AstraZeneca, Sanofi and Johnson & Johnson.
Especially in the next few months, supply of all of these will be limited by production capacity and supply chains. Having multiple available means more doses can be delivered sooner.
Because there is only so much to go around in the initial stages, so they will buy whichever one is available to them. The 10x increase in price is peanuts compared to the ecconomic benefits of getting more people vaccinated sooner.
Additionally, lots of countries have already preordered all the major candidates, so in those cases its already spent money.
Because 95% efficacy is twice as good as 90%. And some people are willing to pay the $30 it costs to be 5% likelihood to have a non-functioning vaccine vs. a 10% likelihood the vaccine you just got won't work on you.
Aren't people worried about the fact that mRNA vaccines haven't been deployed before? I don't see much apprehension about that generally, but a few months of testing of a brand new delivery technique don't sound that extensive to me.
The delivery technique relies on LNP (lipid nano particles) which is fairly refined and existing therapeutics use today. There are potential patent violations though (both Phizer and Moderna possibly violating Arbutus patent) but it’s unclear to me how this affects distribution.
We don't have evidence that is possible. There have been vaccines in the past that protected without stopping spread. We think that the reasons that happened don't apply, but we don't know that.
Honestly, why would any 1st world country "vaccinate everyone immediately"? Wouldn't it be more prudent for a rich country to wait until 3rd world countries vaccinate first in order to see what the side effects actually are? Not to mention the fact that we know nothing about potential long-term side-effects.
The mRNA vaccines are better and protect more people. AZ leaves 10% unprotected, mRNA leaves 5%. That's a big difference if trying to get to herd immunity.
While for now just speculation and without a doubt Machiavellian, it could be that this price difference ends up a significant factor for major economies in their choice for an expensive vaccine. I guess we will know, if/when/once examples of individual discrimination based on what vaccine people received start emerging (hopefully, never).
Regretfully, it would be not the first example of major economies using the current reality as an excuse/cover to conveniently push political policies/agendas that would otherwise have been impossible to implement (at least not without violating laws/treaties and maybe even basic human rights). I have no intention to fear monger, but I believe way too many are too naive about some of the things that are currently happening. That is, mostly people within those major economies, for people in less fortunate countries already learned the hard way how double-faced those major economies turned out.
How all this will eventually turn out ... anyone's guess is as good as mine. I guess we will all learn, when the immediate emergency of the current situation is over. I would prefer to be/remain optimistic, but thus far there appear to be more reasons for caution and skepticism (at best).
I've read this 3 times and can't figure out what you're trying to say.
Are you saying that rich countries are going to intentionally choose more expensive vaccines, with the intention of suppressing the lower classes?
That's so rediculous. In rich countries (other than the usa) the gov pays for these things not the citizens. Even then, the expensive vaccine is only $40, that's within the means of most poor people.
Not to mention that would screw over the rich people who want to benefit from (vaccine induced) heard immunity.
> .. the gov pays for these things not the citizens ..
You do know that the only money governments have, is the money they got from its citizens, right? That is, aside from what they may have earned (though plundered or extorted might be more fitting) from other nations.
> .. the expensive vaccine is only $40, that's within the means of most poor people ..
You may want to reevaluate your knowledge about the rest of the world. That is, outside the USA and some the more affluent parts of Europe. Also, that vaccine probably won't cost "just" $40 equally for everyone.
However, believe whatever you want. Time will no doubt teach us all a lessen. Personally, I hope it will teach me that I was wrong with my skepticism.
I'm not sure why i'm replying here. Guess i'm bored.
> Time will no doubt teach us all a lessen.
I doubt it. You need to actually have a position that can be shown to be true or false with the passage of time before you can learn something from the passage of time. You have a bizare, logically disconnected, rant that does not make any predictions. I don't think any course of events would prove you right (or wrong).
> You may want to reevaluate your knowledge about the rest of the world
In context, we were discussing afluent countries, canada europe, etc.
> Also, that vaccine probably won't cost "just" $40 equally for everyone.
They will cost $0 directly. As you say there will be indirect costs based on taxes. However that will be true regardless of if you get the vaccine and be scaled based on your income, so im not sure how you think that applies to your argument sbout class divide.
Needs to be repeated again & again:
"Governments have no money of their own, it's citizens' (past, present and future - mostly the latter these days) who provide the cash via taxes".
Price is not an issue for rich countries. 500 Million vaccines for USA leaving kids and some other out...cost, what $25 Billion? Peanuts, compared to the damage it did /can do. Same for USA, EU, Japan, CA, Australia etc.
Poor countries are hit by covid-19 as well. Those folks deserve a vaccine too. Even if you don't care about the Humanitarian side of this, the west benefits from that directly by not having giant reservoirs for the virus.
Plus, they travel to the rich countries.New vaccines are coming in. China will probably use their own, India will copy one and costs next to nothing. Donations will make sure everyone has one.
My understanding is that they actually haven't tested at anything but -80C, and that it is potentially possible that it could be stored at higher temperatures, but it hasn't been examined yet.
Dry ice is very common, and you get 5 days at refrigerator temperature. Everywhere in the world is reachable in 5 days if you need to. It gets really expensive to charter flights to many areas, but it is possible if you have money to burn.
Of course we now have reason to believe that vaccines that don't need dry ice will be approved, so logistics will direct the easier to ship ones to remote places.
You can reach everywhere in 5 days but that's not enough. People have to come and get it, there's also a chance there will be a slow start due to concerns over a new drug that the media may emphasize was "rushed". Then there's the logistics of scheduling so many people. If you don't bring yourself a cold storage freezer you're committing to using 100% of your doses within 5 days which may not be possible.
It is, especially for far flung places. This stable vaccine will be very useful in places like the pacific islands, where air transport isn’t always an option.
Any island that doesn't have air transport doesn't really need the vaccine (if transit take weeks, infections on ships burn out before they get there).
Realistically, every major population can be reached in 24 hours by modern transport, and the Pfizer 5000-dose transport package keeps the temperature for 5 days.
mRNA is a term from molecular biology [0]. "MRNA" is the stock symbol of Moderna [1]. Both Pfizer/BioNTech and Moderna use a mRNA based method for their vaccine.
You might want to update the comment to avoid confusion.
The key differentiator is the mechanism of action, not the storage system.
The other two current candidates are mRNA vaccines, an approach which hasn't been used in humans before -- looks like the harbinger of a revolution but we have no past experience.
This O/AZ uses the actual spike protein embedded in a simian virus (that does not affect humans and has its own DNA removed). It's possible to generate antibodies to the vehicle (virus) which is why a simian virus is used (humans won't already have encountered it) but also means your own immune system could target the vaccine itself. Loewe speculates that this is why the higher dose was less effective.
The storage system is important and a key differentiator, tons of countries cannot effectively distribute a virus at -70° to population in the most vulnerable spots. I don't know why you felt the need to be so dismissive.
I am dismissive because distribution is not big-H Hard. It consists of known unknowns and can "simply" be solved by application of money. Yes, actually it's a systems problem: there is not infinite money, there are political interests. But compared to the science the problems are well understood.
On the other hand we still have no idea how well these vaccines will work. First, we have (as I discussed) two different approaches in the three current candidates, one of which is fairly new and one which is completely novel. We have had only limited time to see how well they work and have only limited experience in broad efficacy, duration of effect, and, crucially, how long they last (it takes a long time to learn if you'll need a 10 year booster!). We don't know how fast the virus mutates away from the vaccine's target (though we do currently think we have a good idea). And we simply haven't tried enough people to get a good handle on side effects.
One of the difficulties in solving these is that new approaches contain unknown unknown. Look at CRISPR-CAS: got a (deserved) Nobel this year yet may already have been discovered to be ineffective or worse in the real world. That takes time to learn.
Now it's not that the people doing the work are idiots -- they know all these problems better than I do. But I am appalled that this is treated by the press as a distinction between, say, a pair of beta implementations of something, one in Python and one in Ruby.
Going back to systems issues: when we don't know these factors we take a calculated risk (really an estimated risk). The social aspects of vaccination (close to ubiquitous use, the risk of any side effects increasing the anti-vaxx rate for other immunizations, which itself could become a public health disaster etc) mean these factors are upmost in public health officials, not whether they have adequate refrigeration.
Vaccines are particularly difficult for reasons like these above -- there's a reason why they have their own special laws and government-assumed liability insurance. I haven't worked on vaccines, so take this as you will, but I have worked in anti-invectives, have designed preclinical and clinical protocols (including first-in-human) which were submitted and approved by the FDA, run clinical trials, have presented to the FDA and defended protocol design, so I have some idea what's involved and how to read the presented endpoints and findings.
What does this imply? Is the approach by Oxford worse, or just more well known / less surprises? Does this mean that dosing the vaccination is somehow more difficult?
I'd argue that it is more accessible to everyone including developed nations. It only requires a standard technology freezer - like that you have in a residential home. COVID-19 has already cost the UK hundreds of billions, so being able to roll out a vaccine with minimum hassle and without needing specialist storage and training on its handling, is an absolutely enormous benefit.
Honestly I feel like this vaccine is going to leave the mRNA-based vaccines trailing in its wake in terms of global government adoption.
Moderna vaccine also seems to have similar storage requirements with a high price tag. BioNTech otoh has impractical storage requirements for the third world. AstraZenca's price and storage combiation may open possibilities for distributing this globally.
The fact that we have three highly effective vaccines in such a short period is amazing and between them we might stand a chance of making and distributing them at the scale necessary to get things under some kind of control by August.