Moderna is announcing three new vaccine programs
investors.modernatx.com
investors.modernatx.com
[1] https://en.wikipedia.org/wiki/2018_Nipah_virus_outbreak_in_K...
I just submitted about this:
* https://www.bbc.com/future/article/20210106-nipah-virus-how-...
Disclaimer: I'm absolutely no expert. The above is only my best guess.
btw, maybe moderna can go after AIDS sometime later? I wonder how mRNA vaccines will work for AIDS patients...
"The development programs announced today are mRNA vaccine candidates against seasonal flu, HIV and the Nipah virus."
(Pedantry: HIV is the virus that causes the disease AIDS. The goal is to prevent AIDS by vaccinating against HIV. It's unlikely that the vaccine would be able to help patients who already have AIDS.)
Props for modesty, I guess, but this is a weird instance to suddenly get coy.
Those two factors mean that it is nearly guaranteed to upset a bunch of religious nutjobs.
It spread pretty well. It doesn't kill you instantly, so you can walk around and spread it before you inevitably die.
https://www.sciencenews.org/article/bats-immune-system-virus...
There's much more to it, of course.
https://www.washingtonpost.com/science/why-do-bats-have-so-m...
Unfortunately due to flashbacks, which introduce non-linearity, it may be difficult for those who are not native speakers to follow through the movie. The problem is no obvious visual highlighting indicating that a scene was a flashback (like going black and white). Otherwise a really solid watch.
It's not like this is without controversy; it's an active political battle.
Very different than "putting down" terminally ill people on their own choice and action.
Tho, maybe similar to the eugenic endeavors of the past. I hope you're not implying that's what's in debate again.
Depending on where you live, you can have humans "put to sleep" as well.
It is legal in 9 US states, Canada, parts of Australlia, and probably otherplaces as well.
> You can also keep a dog on a leash.
Some people keep their children on a leash as well.
I wonder about the trolley problem that is medical testing requirements.
It seems like we, as a society, would tend to never want to pull the lever to save more at the cost of risking a few. Social and contractual liability makes it a bad trade.
Acceptable risk is very low which can, paradoxically, cause more death and discomfort.
It would be nice to see a greater awareness of the tradeoffs. These things tend to get emotional, though, so not much gets done.
Older medicine is filled with supposed cures to issues that cause issues down the road. We also have countless medical trials that show no positive effects on the disease it's trying to cure, and outright ill effects (both short term and long term).
If we _did_ have visibility and a good understanding of the effects of stuff, you would think that Covid, of all things, would push at least some people more down this argument you are making.
But basically everyone involved (including many many people who had extreme incentives to push a vaccine through) stuck to the trial discussions.
I do understand the "Extenuating circumstances" argument. But this sort of massive generality reeks of Dunning-Krueger.
If you want to play Jesus here, then I’m sure the rest of society will support you.
Aa mentioned in the article, it's very possible the vaccine triggers a rare, genetically associated autoimmune disorder normally caused by Lyme disease. It was also released roughly concurrently with at least one vaccine that was legitimately withdrawn for safety reasons.
Compared to, say, the covid-19 vaccines, or the MMR vaccines, I find the public hesitation more understandable. It's not like a disease with an especially high mortality rate or one that's spread person to person.
Not saying the push to shame it out of existence was right, since it sounds like the benefits outweighed the risks at least for some people, but there's a lot to unpack. Definitely worth a read.
But if you begin saying you need shots to go in Poland, it's maybe not going to be accepted as easily as for tropical countries...
BTW the side effects of the shots we give to go to French Guyane is something to behold. Roommate was literally covered with red dots and it itched like hell.
In this case the vaccine's purpose is defeated, as the real life-spoiler is the chronic Lyme. Acute Lyme is well treated by the antibiotics.
Btw. the molecular mimicry of the spike protein may cause autoimmunity as well. Time will tell if that only applies to SARS2 or the vaccine as well.
No source: There was a paper on a model for cross reacting to normal cell proteins in /r/COVID19, but I am on mobile and blocked reddit everywhere now. Should be easy to find.
> First, the vaccine efficacy of <80% meant that 20% of fully vaccinated individuals could still get Lyme disease [20]. Second, achieving full protection required three vaccine doses given at the time of the initial dose and 1 month and 12 months after the initial dose. Third, the vaccine safety and efficacy database lacked tests in young children, a population at high risk of developing Lyme disease [3]. Also the vaccine was effective only against the predominant North American Borrelia strain without necessarily conferring protection against international subspecies [16, 22]. Finally, uncertainty about the length of vaccine-induced immunity implied that recipients might need booster vaccine doses as often as every year to prevent waning immunity.
The real underlying malicious behavior here was from the lawyers who actively recruited and fomented anti-vax culture...
> The final agreement included over 1 million dollars in legal fees for the prosecuting lawyers, but provided no financial compensation to the ‘vaccine victims’.
I am not an expert, but I think it would be amiss to omit the Lyme disease controversy with these statements. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4477530/
Lyme disease has a simple antibiotic treatment. The Lyme serology test has high false-positive rate. There might be many people who believe they have Lyme disease therefore sadly miss out on their actual diagnosis.
>Even if CLD lacks biological legitimacy, its importance as a phenomenon can be monumental to the individual patient. This is because many if not most patients who believe they have this condition are suffering, in many cases for years. Many have undergone frustrating, expensive, and ultimately fruitless medical evaluations, and many have become quite disaffected with a medical system that has failed to provide answers, let alone relief.
>Many patients referred for Lyme disease are ultimately found to have a rheumatologic or neurologic diagnosis. Rheumatologic diagnoses commonly misdiagnosed as Lyme disease include osteoarthritis, rheumatoid arthritis, degenerative diseases of the spine, and spondyloarthropathies. Some patients are found to have neurologic diseases, including multiple sclerosis, demyelinating diseases, amyotrophic lateral sclerosis, neuropathies, and dementia. Some CLD advocates have argued that these various conditions are simply manifestations of Lyme disease, but these hypotheses are untenable.
Except that one thing... the chronic Lyme could very well caused by an autoimmune side-effect (this is among the most serious explanations), in which case I don't think the vaccine would help.
Finding lingering bacteria would be the right call. Autopsy or biopsy. And then get better testing, less "false positive".
With no specific (set of) symptoms, symptom based evidence seems inherently weak.
It proposes the idea for the mechanism of vitamin D supplementation to better certain conditions in the short term, but worsen health long term, by acting as a immune suppressant similar to other steroids.
Here are some excerpts:
> "Consequently, if patients with autoimmune disease succeed in killing bacteria associated with their disease state, their symptoms should be expected to escalate, at least in the short-term, as cytokines and endotoxins are generated[28]. Conversely, in cases in which the immune response has been suppressed by supplementation with an immunosuppressant such as the secosteroid 25-D, one would expect to see fewer clinical manifestations of disease in the short-term, yet more advanced disease in the long-term. At a certain point, depending on the clinical symptom or physiological markers of disease, patients supplementing with vitamin D would be expected to approach a "crossover point" when additional reduction of the immune response is eclipsed by the advancing disease (Figure 2). This outcome has been demonstrated in longitudinal studies, with studies on sicker or older patients taking less time to realize the effect."
> "The Iowa Women's Health study showed vitamin D intake seemed to protect against breast cancer in the first five years after it was taken. However, the effect began to reverse between years five and ten and was completely lost after year ten, trending towards an opposing effect[29]. Lappe et al published work, conducted over four years, that seemingly showed vitamin D might lower the incidence of colorectal cancer[30]. In a similar study looking at a larger cohort and over a longer period of time, Rossouw et al found no such effect[31]."
Why can't we have nice things, eh?!
Since, vitamin D is frequently advertised as the cure all supplement, I also want to mention "antagonistic pleiotropy" as something to keep in mind, as conceptual "immunization":
https://en.wikipedia.org/wiki/Antagonistic_pleiotropy_hypoth...
Edit: OMG. I just realized, it may very well be possible that winter's VD deficiency may be needed for good health to some extent, if the body is indeed more active against lingering pathogens. This may also explain the COVID19 and VD connection, as steroids have been shown beneficial as well, maybe it's the immune suppressant quality of VD, which turns out beneficial!
Because thus vitamin D would be a great solution against autoimmune diseases, among which are a lot of the cases under the umbrella Chronic Lyme Disease (it is supposed that the borreliosis can provoke an autoimmune dysfunction that continues beyond the disappearance of the bacteria).
A lot of cases of chronic fatigue would be treated by vitamin D, which is a huge news.
They say the VD supplementation is comparable to steroid treatment. I don't see what's to be enthusiastic about, tbh.
In the case where the Borrelia are just hiding and in a latent state, then all is a question of comparating the dynamics of the two sides: the time required by the Borrelia to wake up and proliferate, vs the time required by the vitamin D to reduce the autoimmunity to the point where the body is again desensitized about itself.
A short treatment of vitamin D would be sufficient to cure the immune problem and not long enough to allow the bacteria to take over. (Hypothetically. This is just a possibility and has to be researched, but this is exactly why I am enthusiastic.)
Also, contrary to steroidal treatment, vitamin D bolsters a part of the immunity (lymphocytes T), even if it dampens an other part. So, it would restore a balance which is lost in case of defective aquiered immunity.
I don't see how the linked article contributes to your argument.
Tho, it's an interesting read and a warning to those supplementing vitamin D like it's the solution to everything.
Malingering exists, but the profile of the chronic Lyme patients you speak about is not at all the one of persons in need of being nursed by the society like babies...
Just imagine you go to the doctor and all you say is dismissed because he thinks you make it up? What a despair you would be in! Speaking of a closed logical system your physician would be in! The same kind as the ones making famous conspiracy theories.
"I had <insert illness> and I was not taken seriously for <X> years" is such a recurrent theme that it is very concerning.
Just recently, the "long covid" was very much mocked by smug doctors. Imagine the distress of the patients.
You're wrong, these patients just failback on Lyme as a default and would be very pleased to discover the real causes of their ailments if it was found. To suppose that people are that much irrational and to generalize to this extent is... sorry but I am shocked.
In medicine, a golden rule is always assume your patient is honest in describing his problems.
Finally, contrary to what you said, the problem is not outside of the real world. Just as a link was proved between some tickborne pathogens and red meat allergy, you cannot exclude that one day a scientific team would prove that under some conditions the borreliosis provokes an autoimmune illness. And such a study would most likely point towards chemical markers to look for in blood and, at last, be able to diagnose it with certitude.
I have absolutely no doubt that their problems are real. I fully believe that these patients are honest and that they really suffer, and they need treatment. I do not believe at all that they are "making it up".
But they don't suffer from "chronic Lyme".
There's just no evidence that it's a real thing. But just like with electromagnetic hypersensitivity, Morgellon's disease, "Wind Turbine syndrome", or any of a legion of "diseases" from medical history, you can't treat them medically if there's no evidence they exist. It would be malpractice for doctors to prescribe real drugs for fictitious syndromes, and it wouldn't do anything to convince their patients either.
If these patients get a diagnostic, even if it is not Lyme, I am sure that would help them very much.
It is true that the medicine is more than often not yet capable of giving satisfying diagnostics, and that misdiagnostic is counterproductive...
However I remember I saw some sound studies on biofilm protein immunity that was triggering autoimmune disorder, in relation to the borreliosis. This is why I had this strong opinion. I will report here if I manage to retrieve the exact reference.
CLD is real and even if it’s over diagnosed, it still doesn’t take away the many real diagnoses that exist and a vaccine would eliminate its potential permanently.
If you are posting in good faith...more recent studies are centered around making the findings in the European strain viable in the American one.
>CLD is real
Well, I believe the right thing to do is to at least mention that these are controversial statements.
This is common in north eastern state rural areas and has been getting steadily worse.
We are constantly doing tick checks on the kids after one of our friends related that she suffered lifelong issues after being bitten by a tick 40 years ago in our neighborhood.
A vaccine would be a huge relief.
An example: https://www.jhsph.edu/news/news-releases/2019/three-antibiot...
Even people here in Australia passionately declare that they have Lyme disease (without overseas travel). Our ticks don't even carry Lyme disease...
Almost all those citations are outdated studies from almost 20 years ago and one recent from 2016 where patients _did_ improve with antibiotics according to the data but the abstract concludes they didn't. ¯\_(ツ)_/¯ If they have to ignore recent studies and go back 20 years to "prove" antibiotics don't work then what does that tell us about bias in medicine?
2018: >Conclusions: Using multiple corroborative detection methods, we showed that patients with persistent Lyme disease symptoms may have ongoing spirochetal infection despite antibiotic treatment, similar to findings in non-human primates. The optimal treatment for persistent Borrelia infection remains to be determined. https://www.researchgate.net/publication/324539470_Persisten...
2019: >We collected data from an online survey of 200 of our patients, which evaluated the efficacy of dapsone (diaminodiphenyl sulfone, ie, DDS) combined with other antibiotics and agents that disrupt biofilms for the treatment of chronic Lyme disease/post-treatment Lyme disease syndrome (PTLDS). ... Conclusion DDS CT decreased eight major Lyme symptoms severity and improved treatment outcomes among patients with chronic Lyme disease/PTLDS and associated coinfections. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6388746/
2020: > This study, which drew on a sample of over 3500 patients ... Approximately half (53%) of the patients in the study reported some improvement, and more than a third (35%) were “high responders” to antibiotic treatment, underscoring the value of large samples, subgroup analysis, and real-world evidence as standard components of Lyme disease treatment studies. This spectrum of improvement is consistent with reports for most pharmaceuticals due to patient treatment response variation https://www.mdpi.com/2227-9032/8/4/383
They only test for Borrelia Burgdorferi. We know there are several more out there that cause Lyme symptoms. Borrelia
japonica – Discovered 1994
andersonii – Discovered 1995
lusitaniae – Discovered 1997
bissettii – Discovered 1998
spielmanii – Discovered 2006
californiensis – Discovered 2007
mayonii – Discovered 2016
I'm betting we can add the Australian variant to that list in the future.
https://www.aidsmap.com/news/jul-2020/novel-vaccine-induces-...
Global mandatory inoculations using a safe and effective HIV vaccine that causes false-positive results on HIV antibody tests would be a field day for anti-vaxxers and conspiracy theorists everywhere.
[1] https://www.livescience.com/australia-covid-19-vaccine-false...
Though they've apparently now stopped.
I don't think anyone has ever seriously suggested that the CIA has tampered with the vaccines. They merely co-opted the inoculation process in order to gain a biological sample.
Its not about CIA tampering with the vaccines. The assumption was that the vaccination programs were politically neutral, a system meant to better humanity regardless of politics or military targets etc etc and in many places, that's what was said to convince people on the ground.
Unfortunately, the use of a doctor to aid in information gathering for the CIA in a vaccination campaign means that that assumption is completely gone.
The context is that the Pakistan and Afghanistan border region is the only place in the world where polio still spreads, while the rest of the world it has been eradicated.
However, there is already suspicion due to lack of education and literacy that the vaccine is some sort of Western plot. So all this did was ensure that there continue to be attacks on polio and other vaccination workers in the area by 1. terrorist groups which was happening anyway, but 2. by uneducated paranoid people who think that the vaccine has been the "plot" of the western governments to do something bad to them.
All in all, the CIAs use of a charity organisation and a vaccination drive as a front for its activities has basically led to hundreds being affected by polio, unable to live their lives in good health or even in death.
There's no reason for it to be mandatory. It's not like COVID19 or the flu where it is often transmitted through casual contact. There is simply no reason to delay/halt an HIV vaccine for just causing an false positive on a test. As you said, any effective HIV vaccine will likely have this issue so pushing forward is the only option.
E.g. SARS2 PCR will often fail for blood samples.
If we get an HIV vaccine it may also be therapeutic for HIV+ people. So far vaccine development wasn't getting anywhere because we're at loss with the nature of the virus. _If we find a persistent target, HIV may burn out in those infected and vaccinated. Seroconversion may then be something to look forward to.
It's very different to a false positive to _another pathogen. That leaves you blind, indeed.
What I mean by that anecdote is that conspiracy theorist don't need anything special for creating their theories, they cannot be the ones leading the agenda. Work on explaining why and how these vaccines work / create FPs is the way to go.
I'm less interested in how anti-vaxxers think, than the fact that the HIV test will need to re-target a different protein.
Personally, I think most people care more about having vaccines for diseases like HIV than worrying about what anti-vaxxers and conspiracy theorists believe.
If we had a widely available vaccine and effective vaccine for HIV that affected certain tests, this would easily be justified by the benefit of the vaccine in preventing HIV. And the results of the antibody tests could potentially still be used to assess HIV immunity.
But a COVID vaccine that caused HIV tests to report positive without conferring any immunity would be bad — the test would essentially become useless. Re-engineering the vaccine to avoid this seems like a no-brainer.
I've been re-watching Queer as Folk which isn't that old and it's crazy how aged it feels because we've made so much progress over the last 10 years. BTW amazing show if anyone hasn't seen - wish you could get HD version with the original soundtrack.
For what its worth, PrEP is not without its own costs. Besides the documented side effects, it also seems to rapidly accelerate cellular aging.
Wow i didn't know the cellular aging part thank you. Do you have anymore info? I'm on it (or was when I could actually be around humans ;( )
The biggest downside I know about is the cost. It's insane even though i have really great insurance. Gilead does reimburse but it takes like 6 weeks or more. A low income person can't be out almost 2k for that long. Medicade/care is also a pain especially those most at risk, IV users, etc. Hopefully I've heard it goes generic soon.
I feel like we are 5-15 years away from being able to eradicate or relegate sadly to the developing world only.
The cellular aging - it's something I discovered recently myself, when it was mentioned in passing during a talk on aging. I did some reading and I think this is it:
* [Brief Report: Differential Effects of Tenofovir, Abacavir, E... : JAIDS Journal of Acquired Immune Deficiency Syndromes](https://journals.lww.com/jaids/Fulltext/2017/01010/Brief_Rep...)
* [Tenofovir disoproxil fumarate induces peripheral neuropathy and alters inflammation and mitochondrial biogenesis in the brains of mice | Scientific Reports](https://www.nature.com/articles/s41598-019-53466-x#Sec24)
* [Pharmacogenetic Analysis of the Model‐Based Pharmacokinetics of Five Anti‐HIV Drugs: How Does This Influence the Effect of Aging? - Chen - 2018 - Clinical and Translational Science - Wiley Online Library](https://ascpt.onlinelibrary.wiley.com/doi/full/10.1111/cts.1...)
Accelerated cellular aging has been noticed in HIV+ patients for a while, and there is some growing evidence that at least some of it might be due to ART, including the formulations used in PrEP. I'm not aware of a study looking at accelerated aging in HIV -ve people using PrEP.
I suppose the risks are elevated with the daily dose regimen, and Event Driven PrEP (2+1+1) might be safer long term. Of course, Event Driven PrEP recommendations also assume fewer than two sexual encounters per week, so it's not for the more 'social' amongst us.
I'm unfamiliar with the pricing. How much is the out of pocket costs? Does Gilead reimburse the entire copay?
HN is amazing sometimes ;)
I was 17/18 just becoming independent in college when I discovered the show and it gave me so much confidence.
'No excuses. No apologies. No Regrets", "F*ck em all", or Justin's self actualizing speech to his therapist and mom that I won't repeat here lol.
Yeah Gilead will reimburse all the copay. I guess so they can charge insurance/government an insane amount. Which is passed along to us anyways...
I think it was like $2000 out of pocket for me for 3 month supply. and i have really really good insurance.
Yeah the one dating experience i have had in covid that actually progressed I used that short time frame dosing.
Though in normal times for most PrEP users it would seem impossible to schedule sex in advanced or too frequent to do that.
But still really good research on how effective these drugs are. maybe we'll get more research into short term PeP - though i think that's a different drug combo.
In the case of HIV, the problem is not that the body is unable to properly respond to the disease, the initial infection is usually benign and the immune system produce the antibodies necessary to fight it, that's what being HIV+ means.
Problem is, HIV mutates so quickly that the immune system is essentially playing whack-a-mole and cannot eradicate the virus completely.
A vaccine that imitates a real infection perfectly is mostly useless, because it will train the immune system on the wrong mutation.
The trick here is to focus the immune response on parts of the virus that don't change, by using mRNA that only produce these parts.
It is like telling the body what the weak point of the virus is. It is useful both before and during the attack.
Influenza can barely even copy itself accurately.
* [HIV evolution: CTL escape mutation and reversion after transmission - PubMed](https://pubmed.ncbi.nlm.nih.gov/14770175/)
I (mostly) understand the mRNA process, just curious about why it'd be superior.
You don't have to mess around with proteins.
Producing a new protein and especially purifying it is a ton of work. mRNA is comparatively simple to produce
Cheaper, well, it depends. (Vaccines are already cheap, especially because they are mass produced.)
But I'm guessing - but I'm a total layman - that Moderna is betting big on their mRNA platform. The "beauty" of it is that you really need to just copy-paste some part of the virus (pick protein from the viral genome), and literally just paste it into their vaccine deliver platform. (See the link.) And this means R&D costs could go waaaaay down.
Sure, clinical trials are still needed to make sure it's safe and effective, but now they have a very good choice of nailing it on the first try, every try. (Basically unless they pick a wrong protein, it will work "every time". And it's already possible to get antibodies from folks who have "seroconverted" - that is they have become immune to something, because they have the antibodies against that thing. So, they sample a lot of people, look at what the human immune system did, and just pick the most common/stable protein target.)
The flu virus is problematic because it evolves/mutates fast, so old antibodies might not fit the new proteins. Yeah, sounds crazy, but some (!) small mutations lead to still functioning but sufficiently different proteins. (Of course we don't really see all the mutations that led to non-functioning proteins.)
It's also possible - super total speculation here - that the scientists/professionals/experts have a better guess on what to target than our immune system. (Relevant buzzwords: immunodominant / conserved epitope; epitope is the part of the target protein that the antibody/T-cell/B-cell actually matches/binds-to , and if the virus changes that part, boom, new virus, "doesn't look like anything to me", for example in case of HIV: https://pubmed.ncbi.nlm.nih.gov/21115730/ )
Influenza genetics are weird: https://www.cdc.gov/flu/about/viruses/change.htm
Economics is the largest barrier in my mind. While my understanding is that these vaccines are less expensive to produce, it's hard to convince people to get the flu shot, let alone a common cold shot. What's more is that with hundreds of variants, it's efficacy would be hard to get right.
That said, I'd gladly pay a heft amount yearly if it meant I had a >60% chance of not catching a cold that year.
I now have the same for covid, lol - but I'm overweight and 41, high risk as a result, and have two kids under 4 I'd like to see make it to graduation.
I have a constant nasal drip, that I don't think is flu related, I get the vaccine every year, but I do get bronchitis like every other year and it wipes me out for at least 2-4 weeks.
Conspiracy glasses on, what if the annual flu vaccine manufacturers are actively preventing a universal vaccine from happening? It's a big recurring source of income for them after all.
https://www.verywellhealth.com/why-there-will-never-be-a-vac...
> Vaccines target a specific virus or pathogen. One difficulty with developing a vaccine for the common cold is there are at least 200 different viruses that can cause cold symptoms, including rhinovirus, coronavirus, adenoviruses, and parainfluenza.1
> Rhinovirus makes up about 75% of colds. Still, there are more than 150 strains of it circulating at the same time.
> At this time, there is currently no way for one vaccine to protect against all possible strains that can cause the common cold.
It also goes on to say it self-resolves and only causes mild illness.
So they potentially could find a vaccine that covers most, but I'm guessing would be a waste of resources.
How the organism would react to such a flurry of foreign proteins, that is another question. 175 unknown proteins is a lot, the immune system could be roused beyond safe levels. It is possible to kill a person (or a mouse) by overstimulating its immune system.
The other reply has a solid point. Maybe you can find a country where it’s not possible to distribute daily PrEP, but is possible to vaccinate people and then test them for HIV monthly.
Some people who start the trial not taking PrEP will also continue the trial without taking the PrEP they're offered and educated about for free.
https://www.who.int/news-room/spotlight/why-the-hiv-epidemic...
Even in the West, isn't it really expensive?
I think the production cost is not that much, so the high price is just a means of extracting profit from the insurance programs.
(Apparently event driven PrEP is indeed not approved or recommended for women.)
> Even in the West, isn't it really expensive?
One datapoint: In Belgium the out of pocket cost is 5 euros per package of 30 pills.
1) Do both, for additional safety.
2) PrEP has changed formulations, and may change again. This implies that the previous formulations were not completely optimal.
3) From what I understand, PrEP can be expensive, although your insurance may cover it. You can also get it overseas for much less but many are not comfortable with that.
4) It's a lifetime expense, even with insurance and a lifetime of having to take a drug versus one or more shots.
5) Not having to undergo kidney function tests on the regular might be nice.
I was joking to my doctor that when I get access to the COVID vaccines, I plan on Moderna in one arm and Pfizer in the other.
The larger, latter trial that needs to study efficacy could simply use a large population. While HIV transmission is much more rare outside of certain high risk groups, infection does occur through accidents or deviations in behavior (e.g an EMT gets a needle prick while trying to administer Narcan). It would take a larger population and longer study but it should still be able to reach statistical significance.
Hopefully these get approved relatively quickly. I'm most excited about the seasonal flu vaccine. That could be a major game changer.
The hope is that with a much faster time from approval -> production, in theory we could reassess in October / December / February and vaccinate against the most virulent strains that are actually showing up in populations. There are reports that Moderna had a vaccine developed in two days once they received the sequence from researchers. If they or similar companies received "platform" approval to ship new vaccines with abbreviated testing, it could dramatically change how we vaccinate for the flu.
If we had generic facilities that could produce any mRNA vaccines, and an mRNA vaccine approval process that takes 30 days then we could have had covid vaccines ready to go before March 2020, and those whole story looks very different.
This means the relatively mild flu load in Australia and especially New Zealand actually hurt this year's Northern Hemisphere guess - they were isolating because of COVID-19 and so they had far fewer than usual cases on which to base guesses.
“Fortunately” we get to see how much further their mental gymnastics will go as the death count will begin greatly exceeding all other causes over the next 3 months!
Any guesses?
“It was a tough winter for people that already were stressed!”
Some anecdata: I had the flu NUMEROUS times as a child/young adult. I know what the flu feels like. A couple of years ago, I got the flu (no, I didn't go to the doctor because I knew it was 'just' the flu). I was feeling crummy one day, and the next I was curled up in bed, unable to move, fever with body aches, and slept most of that day. My wife told me about elderberry and gave me 4 or 5 spoonfuls of an elderberry tincture throughout the day. The next day, I was shoveling compost in the yard.
You can have flu you barely notice as well as common cold that keeps you semi-conscious for a couple of days. Unless you get swabbed, you just can't know.
2020 - https://pubmed.ncbi.nlm.nih.gov/32929634/
“We found no evidence that elderberry benefits the duration or severity of influenza. Post hoc analysis suggested primary outcomes with elderberry taken alone (without oseltamivir) were 2 days worse than with placebo taken alone. Our results contradict previous studies and demonstrate the need for further studies.”
We can all do our part to stop pubmed abuse.
As a Moderna shareholder I think that is stupid. As a healthy eater I think that is really stupid. Now I can only think I must be really stupid.
And on top of those excellent reasons, getting a flu shot is a momentary discomfort, so why not, even if just to avoid the potential discomfort of a flu?
The vaccine is harmless both for you and your elderly relatives, so it is (a) smart to get it to avoid suffering yourself and (b) socially responsible to get it to lessen its spread to people it will kill.
The reason to vaccinate for the flu is to stop the spread of the flu to vulnerable populations. The cost of vaccination is a little arm soreness for a day or two (hardly anything).
The added benefit is that you've decreased your odds of being put out of commission for 7->9 days (if you are being responsible). Current flu vaccines are around 40->70% effective. Not great, but better than nothing.
The reason I'm so excited about the moderna vaccines is that it can drive those efficacy rates much higher. That's because they can delay manufacturing to be far nearer to the outbreak. The key to a highly effective flu vaccine is matching the strains. mRNA vaccination presents a way to do that a lot better because you don't need 7->10 months of lead time to make sure there is enough supply.
* [Impact of mRNA chemistry and manufacturing process on innate immune activation | Science Advances](https://advances.sciencemag.org/content/6/26/eaaz6893)
Anyways, I really hope them to succeed, my mother didn't take the flu vaccine ,,because it's risky and not that useful anyways''.
Moderna can make it much more efficient with less side effects, so I'm looking forward to it.
The next 5 years are going to be incredibly exciting - it has the potential to fundamentally change humanity's relationship with many kinds of disease.
Astrazeneca is working together with Moderna on respiratory diseases, which is interesting for me, as I have asthma.
So, the question is, given we already have medication which works well as treatment for those with HIV - what exactly will this vaccine do for HIV - if not stop the transmission? My understanding is HIV is primarily spread through sex and sharing of needles. A vaccination program won't stop that.
Thanks in advance. I would love to read more about this.
Now, about HIV - HIV is extremely difficult to spread from a single contact (it's got very low virulence) and can be managed very well with treatment, making transmission effectively stop from people in state-of-the-art treatment. However, said treatment is expensive and inconvenient, and has risks of its own, and you need to use it all your life, and it's not available to many people, especially risk groups. By vaccinating people at risk, or large parts of the population, HIV could be eliminated, or dramatically reduced at least, saving the people who would get infected from a life of being medication-dependent, assuming they have access to treatment. So for HIV, a vaccination program won't stop needle sharing and unprotected sex, but will stop people getting even more severe consequences from that. There's a similar vaccination program for hepatitis which has shown excellent results.
You should most definitely point out that yours is a conjecture. A reasonable one, but still completely unsupported by clinical data - not because data refutes it, but because there is no data. All trials only examined the reduction of symptomatic infection; they didn't even try to measure whether vaccinated people were able or not to spread the virus.
I would expect your conjecture to be true, but humans are weird, viruses are weird and medicine should be based in evidence, and evidence isn't in yet.
Not to mention there is already limited/preliminary data that the Moderna vaccine reduces asymptomatic infection (https://www.wsj.com/articles/can-you-still-spread-covid-19-a...).
If you want to gamble, just gamble, you don't need anyone's permission.
This is interesting, but so far a weak first step on flu. Each year experts stare at numbers and perhaps read some tea leaves to choose 4 strains to cover, often missing somewhat.
The innovation I'd like to see: ignore the "choose 4" process, and instead aim to cover all known strains.
https://www.nature.com/articles/s41591-020-1118-7 (“A chimeric hemagglutinin-based universal influenza virus vaccine approach induces broad and long-lasting immunity in a randomized, placebo-controlled phase I trial”)
I don’t think experts are reading tea leaves and it’s pretty wild to claim that. There are literally billions of dollars at stake. To bring it bag to software, that’s like me claiming I think machine learning people are just using fancy excel formulas.
I mean... you can do it in excel it is just a lot... slower - you can do like anything in excel
The real problem they have is the flu mutates. They know what strains they see now and can add them all easily enough. In the few months between deciding on strains and manufacturing them the flu can mutate to some new strain that wasn't even seen before.