You've got the right Robin Hanson.
The key argument is that there is lots of uncertainty, but variolation is probably worth trying. And if volunteers can be found, why not? One shouldn't need to be a virologist to credibly make that argument.
The key argument is that there is lots of uncertainty, but variolation is probably worth trying. And if volunteers can be found, why not? One shouldn't need to be a virologist to credibly make that argument.
https://docs.google.com/document/d/1x91Ef7G6xbm77DcRDvjAXbFm...
Since variolation has basically the same principle as vaccination, it's hardly an alternative to vaccination. Is it really worth trying?
To me (with my very crude understanding), proposing variolation as an alternative to vaccination is akin to proposing knife without a handle as an alternative to a regular knife.
Is there any case where vaccination fails to work, while variolation succeed?
Yes: the blog post by economist Robin Hanson suggested deploying it without waiting for the results of testing. (Of course, it would be good to test as fast and as much as possible concurrent with the deployment.)
"deploying it": making available to the public a variolation service or procedure designed by medical experts.
Though vaccine trials aren't quite as safe for the public as variolation. If a vaccine doesn't work, the person can spread the disease. If variolation doesn't work, then it has the same mortality as natural infection, but afterwards the person is immune and can't spread the disease.
There is no real time advantage to variolation. Anybody making the case for variolation without validation would be better off making the case for vaccination with one or several of the 30 vaccine candidates under study for SARS-Cov-2 right now (a case could be made... allow volunteers to be given the candidate vaccine of their choice in larger numbers than normal clinical trials, scaling up as the risk profile of each candidate vaccine is known).
>Anybody making the case for variolation without validation would be better off making the case for vaccination with one or several of the 30 vaccine candidates under study for SARS-Cov-2 right now
The advantage variolation has over the 30 vaccine candidates, I am guessing if the question is what to do before the results of testing are available is that most of those 30 candidates will turn out after being tested to fail to confer significant immunity.
I believe that the fate of most vaccine candidates for any disease is that testing reveals that the candidate fails to confer immunity to most or all of the people it is given to. Also I believe that it usually takes at least a year to produce enough of a vaccine to test, then test, then analyze the results of the testing.
Of the 79 infected, 19 died. E block (where the index patient was), had 53 infections and 15 deaths for a mortality rate of 28%. Other units had 26 infections and 4 deaths, for a mortality rate of 15%. The death rate of patients in E7 (closest to the index patient and with the highest viral load) was 70%. That's more than 4x difference in mortality based on viral load!
It would be very surprising if low doses of SARS-CoV-2 caused higher mortality. Therefore should allow researchers and volunteers to experiment with low dose deliberate infection. It could save hundreds of thousands of lives.
If there was, no one would consider variolation.
I'm working on just such a public proposal [1] and have been in correspondence with Hanson but haven't heard of any registered.
[1] "SARS-CoV2 Live Virus Skin Vaccine" - https://tinyurl.com/y8ujrcze
Do we really? I don't keep up with the news, did we already dismiss those reports about re-infection? Does it last long enough to be globally useful?
> The main risk is to the volunteer, not to others.
The main risk, sure, but the volunteer will become infectious. Vaccines constrain the risk to volunteers a lot better.
It seems to be extremely rare, and it's hard to know how many of those cases are due to incorrect initial diagnosis or people with odd immune systems. Immunity seems to be much greater than that conveyed by vaccines (which protect 85-95% of recipients).
> The main risk, sure, but the volunteer will become infectious. Vaccines constrain the risk to volunteers a lot better.
In vaccine challenge trials, people are exposed to the virus and kept quarantined until after the incubation period. Those who aren't protected by the vaccine must remain quarantined until their immune system defeats the disease. It would be the same for deliberate infection. Volunteers wouldn't be allowed to leave until the virus is no longer detectable. Hanson makes this clear in his blog post (linked to at the top of this thread).
That said, most vaccine trials are not challenge trials. Researchers give patients the vaccine and wait a while to see how many of them naturally contract the disease. During that time, the patients may or may not have immunity and can potentially infect others.