It's important to note that the AstraZeneca vaccine is adenovirus based [0], not mRNA based like the Pfizer and Moderna candidates. It was to be expected that this approach could cause more complications. mRNA vaccines have their own issues, but they do not involve live viruses being injected [1]. Instead they use lipid nanoparticles as a substrate to enter the body's cells [2].
> rather than producing them outside the body and then injecting them
That's not what the Oxford/AZ vaccine does, is it? From what I understand, it's a viral vector vaccine engineered to deliver DNA that encodes the SARS-CoV-2 spike protein into human cells and induce them to express the protein, stimulating the immune response.
The plan was never to introduce spike protein "produced outside the body." The mechanism of action is getting the body to produce spike protein and learn to attack it as foreign. If the Oxford/AZ vaccine doesn't "take advantage of your own cells to produce the spike protein," I don't know what does.
Yes, the ChAdOx is an adenovirus carrier (chimp? to minimize human pre-infection) while Moderna and BioNTech as the parent states involve injection of mRNA (not DNA although there are other vaccines that do that) lipid particles that human cells then generate spike protein to simulate viral infection.
There are still other attenuated virus and other vaccines under development, they just haven't reached Phase III. Novavax even does something similar to what you describe (spike proteins with adjuvant), but it's also not past Phase I/II.
I think COVID is going to be make or break for mRNA, at least for infectious disease. It's either going to usher in an exciting new era of treatments, or we're going to see a lot of funding dry up and shops close. I for one obviously hope for the former, but given the prior actions/statements of some in Inovio, Moderna, et al, it gives me pause.
The chimpanzee adenovirus is used as a vector, with its payload replaced with instructions to manufacture SARS-CoV-2 spike protein.
Virus enters body, hopefully survives immune system long enough to insert instructions into your cells, your cells churn out tons of copies of coronavirus spike protein, your immune system sees the surfeit of spike protein and develops a response (antibodies and T* cells).
> Imagine a 4 billion year old codebase, written by dice throws and unit testing.
That's a great analogy, except it doesn't go quite far enough. The code for the toolchain that compiles the codebase (not to mention the unit testing framework) is just as old, and written the same way.
Note to self: while the code (including the toolchain code etc.) is in a monorepo, it is actually surprisingly modular. OTOH, much of the functionality was implemented by copy-and-paste of existing code elsewhere in the repo, and the copies then diverged with subsequent modification.
His point was more along the lines of it being poorly designed.
Evolution isn't going to nicely separate functionality into clean, single-purpose biochemical pathways.
It's going to overload something that it already has to support a new feature, leading to a rat's nest of intertwined effects.
The hard part in drug development isn't affecting your target: that's pretty easy to guarantee with modern tools. It's finding out that that target also governs 10 other, completely unrelated bodily functions.
It sounds harmless because it omits the incredibly complex process of developing immunity.
Your body basically is trying to do a sort of brute force/random combination of immune cells on the retrieved virus spike proteins until it comes up with the right combination.
This process can result in B cells that produce antibodies which stick to virus proteins but also stick to your own cells. The B cells are essentially permanent, that’s how you develop lasting immunity, that unfortunately also means you have lasting immunity on one of your own cell types — autoimmunity https://en.wikipedia.org/wiki/Autoimmune_disease
A 50000 people study is likely to see adverse events completely unrelated to the vaccine. Halting the trial is not a sign that they think it is related either, since it is protocol to rule things out before continuing.
Yes, they don’t replicate virons that could be assembled the virus was modified to mainly replicate the spike proteins since your cells send samples of anything they replicate to the cell wall for your immune system to monitor and sample this is how the adaptive immune response is achieved.
Thought Emporium has a decent video where he modifies an Adenovirus to inject the lactase gene into the cells of his intestinal tract.
https://www.youtube.com/watch?v=J3FcbFqSoQY
According to the NY times, the adverse reaction was transverse myelitis
> The individual also said that a volunteer in the U.K. trial had been found to have transverse myelitis, an inflammatory syndrome that affects the spinal cord and is often sparked by viral infections.
Transverse myelitis, usually causes by viral infections, can cause complete paralysis below the level of the lesion. Just like a transection of the spinal cord. Quite serious, I would guess determining the etiology in this case is going to be critical, but very hard to do.
Can also be autoimmune, perhaps triggered by vaccine. Or, in this case, could be triggered by the adenoviral vector used in the vaccine.
So if this was triggered by the vaccine (rather than the adenoviral vector), would it mean that this person might have also had TM if they had caught Covid19?
That's what you have studies for! Glad they caught it before it got into the wild.
Also, it's really great that there are multiple vaccines. Just imagine what happens when everyone gets a single vaccine that turns out to very often cause an adverse reaction...
All drugs have adverse side effects. The idea is the "therapeutic index" being the ratio of the good to the bad. In this case, balancing the risk of the vaccine against the reality of all the deaths that covid is causing.
Waiting for a zero risk vaccine is not the optimal decision.
What's the alternative? A few months ago drug discovery chemist Derek Lowe wrote an article saying that frequently strict experimental procedures are the only way to tease out enough statistical power.
Meaning the adverse effects are small enough to require large numbers to discern. Balance this against the predictable number of covid deaths from waiting for those large numbers.
Most countries have already had SARS-2 work its way through them significantly. The utility of a vaccine might be lower than you think.
NZ comes to mind as a country that has barely built up any immunity (due to them trying to contain it completely). They can expect more utility from a vaccine than otherwise.
Anyway, given the incredibly low rate of both mortality and also any real consequences in, say, those under age 55, their personal benefit of a vaccine is incredibly low. So it really comes down to whether you’re a Sweden person or a New Zealand person.
> Most countries have already had SARS-2 work its way through them significantly.
Noope, that isn’t what antibody testing shows. Take England for example. Coronavirus working its way through a mere, say, 6% of the population is devastating.
> The utility of a vaccine might be lower than you think.
The problem with aggregate numbers like that 6% is that they assume a uniform distribution of the virus within the population, which is not the case: some areas are far more hit than others. I think this should always be kept into account.
A lot seems to fall into this false dichotomy of “we must act with drastic measures else people die” mindset where said measures is just a bizarre cargo cult. Sad
And this is why trials must be allowed to run their course, not use vaccines as political propaganda, like what the Russian gangster and the orange clown are doing for their own political gains.
how do they find volunteers for such a trial? If I get it right, the risks are high (including death?) so seems like a big risk, and I suppose they need to start with someone that's healthy to avoid confounding factors?
The risk of death or serious injury with an investigational product is very low, but it does happen.[1]
Clinical trials start after a lot of toxicology screening in vitro and then in animals. For first in human trials, the doses are sub-clinical and then dose-escalation studies are done to find out when adverse events start.
They basically work their way up to therapeutic doses very slowly, monitoring the health of subjects very closely.
The Oxford trial isn't paying anyone. I'm in the trial myself. I assume other people are volunteering because they want a COVID vaccine to come out.
Volunteers for this trial range in age from 5 to 75+. Not everyone is perfectly healthy.
People here are reacting like the vaccine isn't safe and is cancelled now. All this news means is that one person out of tens of thousands had a possible reaction and they have to investigate to see if it is even related to the vaccine (which is the proper procedure). This isn't even the first time that this has happened during this trial - it just wasn't reported so widely last time. The most likely outcome is they pause for a few days and then keep going as normal.
Thanks this is very helpful. I also just read in the Guardian that they paused it back in April due to a similar issue. Fingers crossed it resumes to plan.
The risk of getting the virus is death too. If you're already in a risky position (say you're a teacher in a district that is insisting on in school teaching or a paramedic or cashier at a grocery store) then the vaccine trial might be the less risky option.
Getting COVID-19 now you would know the risk of death is very low, especially if you live in a society where you would have access to adequate intensive care.
With the vaccine trial you are taking on an unknown risk which to me seems way worse.
I think there are factors that drive people to join these trials though. For example if you have a loved one that has a much higher risk of severe complications if they catch the virus. Then it is in your interest to help get a vaccine ready.
> "With the vaccine trial you are taking on an unknown risk which to me seems way worse."
There's a reason why clinical trials are done in phases. If you are one of the very first to receive a new medicine or vaccine, then yes, you are taking a risk - and are compensated accordingly.
By the time it gets to phase 3 trials, you already have a pretty good idea of the safety. One possible adverse event amongst 30,000 participants doesn't seem so bad to me. Certainly it's less than the risk of developing serious illness if you are infected with SARS-CoV-2.
That would be 11,000 people with quadriplegia or worse amongst a population of 330M.
And keep in mind that the people participating in this trial are already pre-screened, taking the healthiest of the potential candidates. Known side effects would typically occur at higher frequency amongst the population than found in a clinical trial.
EDIT: To add to this. The cost of rolling out medicine with SAEs at this rate would cost the company / government in the order of about $4,730,000,000 (430k x 11k) [1], which is about the equivalent to the amount paid out for all other vaccine caused injuries over the last 30 years. This is likely low-balling it though, as I bet the families sueing would get more than $430k with the numbers of eyes on this.
My comment was in regard to the risks of clinical trial participation, not approved vaccines.
There is some precedent for the scenario you describe, however: the 2009/10 H1N1 vaccine “Pandemrix” caused permanent narcolepsy in 1 in 55,000 children it was administered to:
Unless you're a teacher over the age of 55, your risk, even around a bunch of school children, is incredibly low (95% of fatalities in the US are over 55, with most of those being over 65).
I've read a few of these "long term damage" studies that are scaring everyone. Of the 60+ people in the UK one published by the journal in Charlottesville, most of them were elderly or in "high risk" jobs (it didn't mention what jobs for privacy. Health care workers? grocery store? who knows).
I heard decades ago that prisoners will sometimes be recruited in exchange for reduced sentences, but not sure if that was the United States or elsewhere.
That's something that is explicitly not done, unless there is a very good rationale for why it would need to be prisoners studied. The reason being, it is all but impossible for a prisoner to give a proper informed consent. There is just too large a conflict for testing to be considered voluntary, especially if there is some kind of quid pro quo. See here [0] for a list of permitted research on prisoners (45 CFR 46).
True, it has been done in the past, but there are many... many horror stories associated with the practice [1].
Not good news, but don't panic - as the article says "Clinical holds are not uncommon", and “in large trials illnesses will happen by chance but must be independently reviewed to check this carefully.”
The russian vaccine is also based on adenovirus vectors.
Not clear if the method of delivery is to be blamed here, but it could be the cause for the adverse effects..
They (russians) are conducting large scale phase 3 experiment, with up to 40k volunteers. Need to watch closely; most of the volunteers are in Moscow, and it will be difficult to conceal high rate of side effects .
Careful, because a "high rate" would be ~1/100k.
Even a two SAEs in that cohort size, would be a huge deal and enough to shut down most efforts.
Edit: also note that the Russian Gamaleya vaccine is actually 2 vaccines one with a human adeno virus carrier and the other with a (chimp?) Ad5 and Ad26. So you could have a response to either one of them, or both. The problem with using a human viral carrier is that pre-exposed might fight it off without developing nCoV immunity.
maybe this is off-topic, but it's interesting to me that this is the first time i've heard this referred to as the "astrazeneca vaccine". all the previous good-news stories seemed to call it the oxford vaccine.
I followed the first link in the stat article, which says
"A large, Phase 3 study testing a Covid-19 vaccine being developed by AstraZeneca and the University of Oxford at dozens of sites across the U.S. has been put on hold due to a suspected serious adverse reaction in a participant in the United Kingdom"
As I read that, it was a UK participant in a AZ and US-run study.
AstraZeneca and Oxford have subjects in the US, UK, Brazil, and South-Africa. The aim was to have diverse make-up of the testing groups, to have an order of magnitude more people in the Phase 3 trial than normal for a vaccine, to test in countries with high infection rates, and to deliver the results on 15th of September. A British subject from the British trial got ill.
I presume these countries have deals with Oxford/AstraZeneca so if a safe vaccine is available, they get guaranteed access. I've heard India is already producing the vaccine ahead of the Phase 3 conclusion. The phase 3 is only on hold since it is not clear if the vaccine was the cause. There are other causes for the adverse reaction, such as viral herpes infection, or onset nerve diseases not caught during subject checkup. Since not all vaccines offer 100% protection (while still being useful), COVID may have also been the cause of spinal nerve inflammation.
As I would classify it, they're running multiple phase 3 trials in multiple countries, but applying policy as if it's one big study (that wasn't clear). An action in the UK study caused all the studies to halt. This is not strictly required, but it's clear they're playing things conservatively.
So Oxford (the Jenner Institute / Oxford Vaccine Group) developed the vaccine but they're partnering with AZ to get it tested and then manufactured and distributed if the testing goes well. Oxford sponsored the initial studies and AZ is taking over now that it's more sophisticated and expensive.
yeah just realized it s the ChAdOx vaccine. Perhaps a more systematic naming scheme would be appropriate here, as people do watch these studies. There are a lot of adenoviruses studies going on in russia, china etc, and they are somewhat related.
> It was not immediately clear who placed the hold on the trial, though it is possible it was placed voluntarily by AstraZeneca and not ordered by any regulatory agency. The nature of the adverse reaction and when it happened were also not immediately known, though the participant is expected to recover, according to an individual familiar with the matter.
What would be a reason why they don't disclose this detail immediately but only to tell public the trial is on hold?
At least for the details of the adverse reaction, it's not unusual for it take 1-2 weeks to collect all the details and form a complete picture. No sense in rushing out initial details, only to have the conclusion change a week from now.
Don't forget that the drug companies sponsor the studies, they don't actually run them. They are typically run by academic centers supported by third party vendors who handle the data collection, etc.
Someone will likely need to go back and look at the patient's clinical data to see if anything was amiss before this event. Then you'd need to collect a bunch of data to make a determination of the cause - was it the vaccine? was it some unrelated medical condition? a combination of the two?
Investor disclosure. That the trial is on hold is material information to investors but the medical reasons why it’s in hold (like the type of adverse reactions) probably isn’t.
The illusion of control. It is the same reason people doomscroll on twitter hoping more information will somehow how change the result. Our brains, all human brains, are not rational but instead are their own thing.
Vaccine progress is of enormous practical consequence. Effective reporting of material information can move markets, and that means it's useful for efficient capital allocation.
Of course, there's diminishing returns and problems with many kinds of noise, and AstraZenica isn't strongly interested in marginal efficiencies in the broader market.
This is a medical treatment sort of scenario, trial participant confidentiality regulations probably prevent release of anything specific about the case.
What is meant by that is vaccine and all FDA type of drug should not be trusted unless they have several decade if not intergeneration studies to back it up.
Question for people who understand the Phase 3 process - would the first step in an investigation of this type be to "unblind" the patient with the adverse reaction to see if they got the vaccine or a placebo?
Seems to me if the reaction wasn't caused by the vaccine there's a 50/50 chance this person received a placebo. In which case, you could instantly discount the vaccine being the cause.
I'm in the trial. We all got little cards with our trial number to keep in our wallet. If we get seriously ill or end up in a hospital, there's a number for the doctor to call to unblind us if necessary. So there is definitely a procedure in place.
Even if the person got the vaccine, the illness could be unrelated. They need time to investigate and this is the proper procedure to follow. This happened once before earlier in the trial, but it wasn't reported as widely and there want a media frenzy.
There is nothing wrong with the media reporting this, but it would be great if the media was better at contextualizing information instead of maximizing clicks with scary headlines.
The principal investigator of the trial knows who got placebo and who did not, although neither the people working on the data nor the clinical staff know.
It's likely that the participant will be "unmasked" to see why the adverse event occurred.
The Moderna mRNA vaccine was producing 103 degree fevers (and passing out) in a Phase 1 volunteer. [1]
If that's the reaction in small sample with a healthy 29 year old (most volunteers had high fevers), I can't imagine old or unhealthy people will be unharmed. I was more concerned about the mRNA vaccines being at risk initially.
Phase 1 trials are used to determine dosage. Different participants are given different doses of the vaccine so researchers can identify the proper dosage with maximal efficacy and minimal side effects.
The 29 year volunteer who experienced the 103° fever received the highest dose of the vaccine given out during the Phase 1 trial. Such a adverse reaction is not unexpected during a Phase 1 trial, but the vaccine did move forward to Phase 2 and Phase 3 so it appears that the lower dosages do not trigger such a reaction.
It’s disingenuous to call it “the Moderna mRNA vaccine” when it was more accurately “one early Moderna mRNA vaccine candidate, which was ruled out for being far too high of a dose”.
There was a pretty high severe systemic adverse rate in the high dose group (20%). Severe local response rate was 5% in the middle dose. [1]
I have no idea how this compares to other vaccines, and you can pessimistically extrapolate a bit from this tiny, healthy sample from the high dose (n=15 in middle dose group).
I'd imagine some % of people when this scales to millions will have a bad response, and the high dose group might provide some model of the worst cases.
Fevers are very common in vaccines, normally. It is an indication that the immune system developing an immune response. It is not an indication of complication.
Yes, but at some threshold wouldn’t this indicate a problem?
103F+ fevers are relatively rare from typical vaccines, and from my understanding a lot of the damage from COVID is immune response related.
mRNA vaccines and our immune responses to these are uncharted territory, so I’m not sure how much we can reason by analogy from other vaccines vs. first principles.
High fevers are not uncommon in babies receiving their first vaccines.
I'm not sure it indicates a problem. A fever is, itself, just an immune system response, not a "symptom" of disease.
You are correct that there is a threshold beyond which a fever becomes unsafe, but it's above 103. But fevers of 103 in the test group do not indicate that fevers of say 105 will occur in some patients.
mRNA would not have hit Phase III if found unsafe in earlier phases. If mRNA succeeds things will look really great, since it in principle it can protect against many other viruses and upcoming pandemics with slight modifications. The most reported side effect for mRNA is mild stiffness at application spot.
The idea a vaccine can be safely made in less than a year is absolutely insanity. Many of these things shouldn't even be considered vaccines in the traditional sense.
Are there any vaccines out on the market today that are not one of the two: 1) inactivated virus, 2) attenuated virus (run through another host/egg or a related virus found in an animation that's less harmful to humans)?
Everything I've found indicates all our current viral vaccines are one of those two (excluding bacterial vaccines, which shouldn't be called vaccines either).
The modeRNA vaccine is an mRNA vaccine, a completely new type of vaccine. While theoreticall less likely to have adverse effects, it did have adverse effects, and its efficacy remains a question. These are completely new types of vaccine, that presumably would need even more testing than the relatively well understood attenuated viruses.
Then is it a vaccine at all? Vaccines were traditionally live, dead, or attenuated virus/bacteria injections, some with adjutants, to stimulate an immune response.
Technologically speaking, it's bicycle vs airplane. Similar underlying purpose, entirely different implementation.
Both a bicycle and an airplane are transportation vehicles. Likewise, anything that illicits imunity is a vaccine, regardless of how novel the approach is.
Every time we see or hear an expert on the topic of COVID-19 vaccines, she/he is either circumspect to the point of pessimism (this is rare, but see e.g. Robert Gallo) or obviously trapped in a spiral of wishful thinking (this is common). We've never made anything like this hypothetical drug. Forget about election day. I'll be surprised if we have a commonly-available and effective COVID vaccine in 2021.
Not the question you asked but the Chinese company Sinopharm has started phase 3 trials of a classic inactivated virus vaccine (and Bharat Biotech is starting phase 2 trials as well in India). The difficulty will be mass-producing it, of course, but we aren't necessarily reliant on novel vaccine technologies.
Meanwhile, the CEOs of Pfizer and BioNTech have been talking up how their vaccine will be ready for approval in mid/late October the last few days. It's honestly a little disconcerting.
Where are you seeing that? Pfizer's CEO's comments seems quite measured.
"Last week, he said the company could have results from its late-stage coronavirus vaccine trial as early as October after enrolling 23,000 volunteers."
"Pfizer and BioNTech are confident they can have a vaccine against the novel coronavirus ready for regulatory approval by the middle of October or early November."
This doesn't seem extreme to me. "ready for regulatory approval" just means they've submitted a complete package to the FDA.
However, this is a really stupid comment.
"It has an excellent profile and I consider this vaccine ... near perfect, and which has a near perfect profile,"
And at least according to FDA regulations, that statement violates a number of rules around the promotion of unapproved products.
If memory serves right, the CEOs were talking about it late August but from yesterday's announcement[0] :
"Nine drug companies issued a joint pledge on Tuesday that they would “stand with science” and not put forward a vaccine until it had been thoroughly vetted for safety and efficacy"
“The platform has not been used in an approved vaccine, but has been tested in experimental vaccines against other viruses, including the Ebola virus.”
hmmm... this method of vaccination has never been used in an approved vaccine.
>hmmm... this method of vaccination has never been used in an approved vaccine.
Yes, frightening isn't it? Anyone else worried that we're going WAY too fast with vaccine business? Typical development time is 5-10 years now down to less than a year? Its insane to me but yeah I get it, people are so sick of masks they might be willing to accept _any_ vaccine, efficacious or not.
We almost owe Trump a thank you for saying "lets get this out by October 31st" (almost, but not really). The media predictably took the opposite stance as Trump as it always does and now we're beginning to have much needed discussion on the safety risks of rushing a vaccine. Vaccine safety is a topic that is rarely talked about (mostly due to censorship) and frankly, even suggesting such a topic gets you called an "anti-vaxxer". Clown world.
Key phrase here. Cui bono? It just so happens there are multiple, patented competing technologies hoping to get approved. The biggest advertising spenders for the media. The media hyping up a 'vaccine.' Governments handing over hundreds of billions of dollars to private corporations so they can race to release a newly patented product that they're hoping will be forced on literal billions of people.
Plenty of medicines were new and then removed from the market.
Being cautious about new techniques seems reasonable, given the history of medicine. (And frankly, a lot of other fields)
It would be nice to be able to say this new vaccine is based on existing methods that we know from years of experience are very safe; but we can't for this candidate. That doesn't make it less safe (or more safe), but it makes the risk more unknown.
There's nothing inherently safe about injecting stuff into humans. There's nothing inherently crazy about questioning if injecting specific things into people is safe.
Vaccines on the market today are only safe because they've been studied and trialed extensively. Many vaccines, doses, additives, etc have and will continue to be proven to not be safe.
I swear the pro vaxxers are as much of a cult now as the anti vaxxers. I've been attacked so many times for simply saying that I would wait a while for results before trusting a rushed vaccine, especially one that has a massive financial upside for the creator.
What's really funny is even if they can prove it's not an adverse reaction the anti-vaxers will run with this forever.
If you can prove anything.
If it's not real.
And absolutely this is just the beginning.
These things normally don't make the news. This will be all the time over the hundreds of vaccines and when they get rolled out properly there will be hundreds of stories to pick from.
At a certain point, the choice between: "Do I want to lose a few days of my life to a disease with a tiny chance of a bad outcome?" vs "Do I want to lose a year+ of my life not doing what I enjoy?" becomes overwhelmingly obvious.
In March/April - I didn't leave my apartment for a month (besides tossing trash across the hall).
I still avoid most any indoor spaces, wear n95 masks and am not planning any plane travel (one of my biggest enjoyments) or visiting friends/family indoors this winter...
But I'm starting to seriously debate licking every door knob I pass just to get it over with already.
Getting sick puts not just you at risk, but your family, friends, coworkers, and anyone you come in contact with after and during the fact.
It also could generate unnecessary strain on our health system that is already over capacity.
There's no need. Stay at home, stay protected, and don't take an unnecessary risk because you can't be mildly inconvenienced to save someone else's life.
Really starting to get sick of this moral posturing. 1 year isn't a "mild inconvenience", the lockdown have been absolutely devastating to many many people, but of course you wouldn't know that because you probably WFH on a comfy salary for a tech company?
I said their specific reasoning is a mild inconvenience.
And no, funnily enough, I'm unemployed (working on an early stage startup) and my savings are in the low triple digits -- total -- thanks to the pandemic. Might want to start limiting the number of assumptions you make.
And of not doing what you want. At a year, you start going through math around the likelihood you'd die from the virus and realizing that even with a 1% mortality rate, for someone with the whole life ahead of them, the time/opportunity EV is negative.
There are people who set a monetary value on human life, and we have good estimates on that. What we don't have a good number for is what's the value of different degrees of freedom. Is a life where traveling is impractical, meeting people is challenging, you can't go to Disneyland, all that stuff, is it worth 75% of a life at 2019 levels? I don't mean this economically, I mean this as living life.
> , you start going through math around the likelihood you'd die from the virus and realizing that even with a 1% mortality rate, for someone with the whole life ahead of them, the time/opportunity EV is negative.
Could you elaborate on this? By EV you mean the expected value?
Yeah. It's not quite the same as EV, but the idea is that living one year of your life 75% "fully" is like reducing your life expectancy by 3 months. If you have another 50 years to live, if the choice is between 75% fully and any less than a 1 in 200 chance of dying or having lasting complications, you take your chances. Where this gets awkward is the elderly because it takes away one of their five good years left, but the alternative is a 15% chance of dying.
> "Do I want to lose a few days of my life to a disease with a tiny chance of a bad outcome?"
There's a high chance of a bad outcome, there's a tiny chance of death. The virus affects your lungs and brain, and who knows what other parts of the body we haven't been alerted to yet.
As time goes on we'll be back to "plague doors" for cafes and restaurants. We'll adjust our way of doing business so that we don't rely on having all the key people in a company in one room for irrelevant meetings (I mean we can dream, right?).
maybe we re more likely to find a cure rather than vaccine. most epidemiologists think a vaccine won't even be possible considering past experience with coronaviruses
> most epidemiologists think a vaccine won't even be possible
Unsourced statements like this are unhelpful.
The language I've heard is "there is no guarantee of a vaccine" which is very different to thinking it won't be possible at all. I'd suggest with the 200+ plus vaccine candidates being developed that many believe it is possible.
And notice that there haven't been very exciting news from the vaccine developmnent trials. If anything there were more setbacks than pleasant surprises.
There were concerns because SARS vaccine attempts hadn't been further developed due to apparent cytokine storm problems. I think we're far enough along to be confident that that isn't an issue with vaccines for this virus.
Some people also make a comparison to the common cold coronaviruses which have a lot of strains and might be rapidly mutating. Honestly, it's a bad comparison because it's clear this coronavirus isn't mutating rapidly, and besides we haven't really tried to target common cold coronaviruses - why would we when rhinoviruses are the most frequent cause of the common cold?
There's a bit more to it. The reason vaccines weren't developed previously for other coronaviruses is because in trials for a RSV vaccine, 80% of treated kids that got infected needed hospitalisation and two died, while something like 5% of the control infections needed hospitalisation. Due to antibody-dependent enhancement.
So yes there are immunopathology concerns with eliciting a T-cell response, and inducing a humoral immune response has the potential to make things worse.
That's why most trials take a look at the Th1 vs Th2 response to see if there's any indication of ADE. The currently available data do not seem to point to that.
It's unlikely. I'm much more likely fatalities will drop to zero per week before the end of the year in countries with high spread and we'll have herd immunity (which is where Sweden is at now).
> we'll have herd immunity (which is where Sweden is at now).
No, even Sweden's epidemiologists say that up to 30% of their population could be immune.[1] They tried to shoot the moon but missed. They are in a similar place to nearby countries now but got there with a much higher death toll
Herd immunity isn't possible when antibodies are as transient as those seen for COVID-19. Only a massive public push with an actually effective vaccine will control this pandemic.
SARS-CoV-2 and A/H1N1 aren't even in the same phylum. It would be silly to expect them to have precisely the same effect. Besides, when people gush about "herd immunity" they don't usually include the caveat "of course it's going to kill fifty million people first!"
Your understanding of the immune system is not quite correct. Just because you can't detect antibodies doesn't mean you lack immunity.
B-cells can stop producing antibodies and reactivate production in response to an antigen. T-cell memory appears to be quite robust for coronaviruses (and this one in particular)
To establish a lack of durable antibody response, challenge trials would need to be done, where the host is challenged by the virus (or something that looks like the virus like it's spike protein). These trials have not been run.
We can only guess without data specific to SARS-COV-2, but for seasonal coronaviruses, antibodies disappear after ~6 months and reinfection with the same strain can occur after 1 year.
It isn't entirely irrelevant. If you can get reinfected but not get sick twice, it's as if we reached herd immunity at 100%.
And it's perfectly normal that antibodies don't stay in the bloodstream forever. The immune system remembers how to make them and can produce new ones when needed.
Something recent that's been under-reported. The US, the country pulling an accidental Sweden, has seen a 33% decline in new cases since mid-July. The narrative is still that the US has done worse than any other developed country, but look at Spain and France. Both have surpassed their ~April peaks, have per capita new infection rates above the US.
How's Sweden's new case rates? Stable, and 1/4 of the US's.
The list of countries that have been able to maintain their low case counts is getting shorter, and the US is looking less exceptional in its response.
"Listen to the epidemiologists" only works for a bit. It turns out psychology was just as important.
France sent students back to school, and re-opened its universities, and allowed gatherings of 5,000 or more people, and did not require masks in public, or in workplaces, with predictable results.
Their response, and the results mirror that of the worst-performing US states.
Not to mention Sweden is more locked down than the US - _0_ gatherings over 50 people allowed. 0.
I'm astounded there's still people doing the 'debate me!' act about it, most gave up by July in the US, we had already clearly chose a more intense version of the Swedish 'strategy'
It was also the strategy of South Dakota, Nebraska, Iowa, Arkansas, Oklahoma, Wyoming and Utah, and they seem to be doing a lot better in terms of both GDP hit and caseload than places like California and New York with heavy lockdowns.
Iowa has a projected 9.5% GDP hit. New York has a projected ~14% GDP hit, and due to its density and reliance on elevators and public transit, will of course have a higher case load, and require harsher measures to control the spread.
Half of the population of Iowa can fit in the 22 square miles of Manhattan. Oh, and infection rates in Iowa are climbing, whereas infection rates in New York peaked five months ago... And they are currently neck-and-neck in per-capita cases.
So, how did a mostly rural state get a case rate that's as bad as a state that packs half of its population into a single sardine-can of a city? Is their strategy actually working, if they are getting the same outcome, despite having a much easier set of starting conditions to deal with?
Meanwhile, in Canada, BC is projected to take a ~6% GDP hit... While having 1/10th the per-capita case load of Iowa, and higher population densities.
Because the virus isn't coming back in Sweden, whereas its neighbours are already experiencing a second wave. Sweden's argument was always that it was "front-loading" the infections, so over the long-term other countries would see a similar number of infections as they experienced multiple waves.
Plus they avoided the rise in depression and domestic violence that countries with lockdowns endured. As well as avoiding massive violations of human rights, although you leftists seem to care nothing about that.
Because the virus isn't coming back in Sweden, whereas its neighbours are already experiencing a second wave. Sweden's argument was always that it was "front-loading" the infections, so over the long-term other countries would see a similar number of infections as they experienced multiple waves.
Are you talking about antibodies? There are papers on T-cell immunity and clicks who've tested staff a month apart with no increase in antibody positive tests.
It's probably WELL over 10%. There are more ways our immune system can develop memory than just antibodies and a number of studies are showing that.
Then home come their case rate just keeps falling? And their death rate. And unlike the countries that locked down, they're not experiencing a second wave of cases.
Even in countries where a second wave is happening, it’s a wave of infection only, not deaths. There is not reason to be scared of a disease that don’t kill. International travel restrictions should be lifted. We don’t need to wait for a vaccine that might be more a dangerous than to virus it’s supposed to fight. Current practices in East-Asia have shown to be enough to handle the thing.
This is not universally true. In parts of California there was a jump in death rate reasonably close to a partial reopening. And has very slowly been trending downwards since they re-closed everything.
My point is insofar as one would/should fear death, they would/should fear a decent probability long term nonfatal consequences to some degree. Incomplete information doesn't obviate that.
I wonder what are informed positions about these vaccines potentially modifying and patenting your DNA or using aerogels (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6539078/) since these stories float around in particular for this vaccine to my understanding.
"as Lack's cells were popularized and used more frequently throughout the scientific community, Lacks's relatives received no financial benefit and continued to live with limited access to healthcare"
I'm having trouble more details information on how the messenger-RNA based vaccines work. They appear to transcribe proteins in the cytoplasm. I think the fear is that these vaccines may contain some combination of Reverse Transcriptase and Integrase enzymes. Do they contain these enzymes? If not, do they simply try to get your cells to create spike proteins?
I'm not really interested in the goals but on what parts are true/not true.
But it seems easier to get upset and downvote rather than explain, which in turns fuels conspiracy theories. Now I understand most of us arent biomedical engineers or something like that - but I'm just hoping someone sees it and gives an informed reply.
People are downvoting you because what you said is so nonsensical, there's not even a good place to begin the conversation. None of the vaccines modify your genome, so they can't "patent your DNA". And aerogels have nothing to do with vaccines.
You're lacking in imagination if you can't come up with ways that someone might be able to profit from legal rights to or the ability to modify the genetic code of other persons.
[0] https://www.astrazeneca.com/media-centre/press-releases/2020...
[1] https://www.phgfoundation.org/briefing/rna-vaccines
[2] https://www.nature.com/articles/s41586-020-2639-4