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Comment by hughes | Hacker News Reader

Between this and Moderna's mRNA HIV vaccine, it's possible we'll see HIV eradicated in the coming years. Really amazing.

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hope they don't jack up the prices to some unreasonable levels like some companies like to do

I hope they jack up the vaccine prices really high and then use the money to cure every other disease.

you F R E E M A R K E T people really boggle my mind

Us free market people built the world's best vaccines. You're welcome.

That so? Why was the definition changed after mRNA was being forced into people?

I oppose vaccine mandates yet believe, backed by good evidence, that the mRNA vaccines dominate any other COVID vaccine available. The two should not be related.

I can agree with you. I am not trying to press antivax or for vaccines. I am trying to highlight how terminology was changed to allow covid mRNA to qualify under the FDA.

I also was taken aback by the full on defense of 'capitalism' as it relates to the covid shots.

That was not a freemarket driven choice. It was paid for by the US government via tax payers. To conflate them because of social purpose, or whatever ideology people want is just wrong.

They stand to make decades of profit and it wasn't some high moral road. It was only for money.

Thanks for the reply, most just downvote me into nothing.

That's not exactly true. Vaccines don't tend to be highly profitable, and R&D is often subsidized by the government. Salk's polio vaccine was developed in a university lab and never patented.

I wouldn't mind at least some subsidization by the government to keep prices affordable and cheap.

I love the engine of capitalism and free market, but when you're in ill health, you really need all the help you can get.

All this will do in mid and long term is they'll jack prices up even higher because they can, just went government did to college loans.

I was reading somewhere where people linked price growth to growth of medical insurance, the point was that add soon as people stopped print from their own pockets they stopped caring and started to take whatever doctors said and the companies started marketing to doctors and making agreements with then and so on and do on. Can't find the link unfortunately.

I won't try posting from my phone every again :picardfacepalm:. Because the edit button is gone now, I'll just re-write it in a readable way.

All this will do in mid and long term is that they'll jack prices up even higher because they can, just like what government did to college loans.

I was reading somewhere where people linked price growth to growth of medical insurance, the point was that as soon as people stopped paying from their own pockets they stopped caring and started to take whatever doctors said and the companies started marketing to doctors and making agreements with them and so on and so on. Can't find the link unfortunately.

I mean, I would pay $350 to have the peace of mind that I am immune. I don't engage in any risky behaviors, no drug use, monogamous relationship, but if my $350 protects me from a stay blood transfusion or freak accident and helps cover the cost of at-risk populations getting protected, then that would be fantastic.

Thats not how this works. Extra money goes to investors who then choose to do what they want with it. Rather, seek subsidies and use the success to chase government grants and reinvest that money for the greater good.

Sure that’s how it works. Average R&D spend is ~20%, so 20% of the price paid goes back into R&D right now.

And yes, money goes back to investors who often reinvest it into biotech.

It amuses me to imagine, how grandparent imagines investors cash out of biotech: buying a large pool of gold and swimming in it?

If you make a billion dollars on biotech... it has to go somewhere (banks are for chumps!), so it's going back into either the public market, or venture capital. And if you made a billion on biotech once....

Similar to tech, the founders who walk away with billions start their own funds as well.

No one’s pushing. If PrEP had come out in the 80s, you can be certain that HIV would have been eradicated by now by force of public will.

Have you met COVID?

PrEP prevents transmission 99% of the time. COVID has the same rate…but only for preventing serious infection.

Yea but like, is everyone going to take PrEP all of the time? It’s great I’m sure if you’re planning on doing otherwise risky behavior, but in my experience, risky sex is never especially premeditated. It’s just a “just this once”, and then suddenly you’re buying plan B.

Compliance can definitely be a challenge with pharma in pill form, but even with a modest amount of effort, it would radically reduce transmission throughout a population as those who are able to adhere to the dosage schedule would act as a firebreak in the greater population. Like those who are vaccinated against high transmission communicable diseases.

The UK is on track to eliminate HIV transmission within the decade [1] [2] assuming PrEP use within and near high risk populations. So, to answer your question ("is everyone going to take PrEP all of the time?"), that seems like a reasonable solution until a vaccine is approved for prevention and a CRISPR protocol is developed for therapy in the already infected. It may even take some time for HIV production to ramp, making prEP even more important so the at risk don't get complacent and an unnecessary bump in infections occurs.

(it's important to note that kidney function should be monitored in those on PrEP)

[1] https://www.aidsmap.com/news/nov-2017/uk-moving-towards-elim...

[2] https://www.medicalnewstoday.com/articles/how-likely-is-engl...

Oh, cool. I think I hadn’t thought my comment through very well - don’t need to get transmission down to zero, just r below 1. Prep plausibly helps with that

No worries at all, I hope this information was helpful!

There are long-acting (e.g. 8 weeks) injectable versions that are outperforming[1] the daily pill so that approach shows some promise. Not that anybody enjoys injections…

[1] https://www.hiv.gov/blog/long-acting-injectable-form-hiv-pre...

Once every 8 weeks is entirely more palatable and manageable than a daily pill in my mind. Daily pill forgetfulness leads to things like unplanned kids. Unplanned kids are life altering, but generally not deadly, unlike a communicable disease like HIV.

I don't want to downplay the severity of contracting a life-altering disease like HIV, but with modern antiretroviral therapy the life expectancy for HIV positive people is actually about 70-80 years, though not that ART is side effect free...

If you're the sort of person who does risky things you tend to know. Hooking up every night in the Castro isn't something that just happens, even if the acts aren't particularly premeditated.

Dunno, I think self deception is a powerful thing. I certainly have taken a number of sexual risks that, in retrospect, were really stupid, but I was able to rationalize at the time.

Medication compliance is ~80% at the best of times. Even with an every 8 week injection the patient needs to show up.

Perhaps if PrEP were free so that it could be effectively used in developing countries, where, to my knowledge, at least some people still believe that having sex with a virgin cures HIV.

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