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Comment by shock | Hacker News Reader

> Vaccine is the only thing that can (and does) make this pandemic manageable.

This is false. There are treatments available, like monoclonal antibodies, they just have not been publicized as much.

Somebody, somewhere made a choice to push the vaccines and not the monoclonal antibodies. As an interesting fact, before the pandemic the knowledge to produce the nanolipid capsule existed in only 2 small companies worldwide. Big scale facilities for producing the nanolipid particles necessary for the mRNA vaccines were non-existent, they had to be built. Just as well, facilities for producing monoclonal antibodies en-masse could have been built, but were not.

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Monoclonal antibodies cost thousands of dollars per transfusion. A vaccine costs a couple bucks.

We are not going to make the pandemic manageable with monoclonal antibodies. The reason governments made the choice to push vaccines over them is because vaccines are actually in the range of economic possibility.

The vaccines cost in the tens of dollars, depending on the negociating power of the country/bloc.

Their cost, as well as the cost of monoclonal antibodies, depends on the economies of scale.

Monoclonal antibodies are easier to produce than mRNA vaccines, so at similar production scale should be cheaper.

A dose of antibodies is ~20,000 times the mass of a dose of Moderna (which is 3x the dose of Pfizer).

AFAIK, monoclonal antibodies are a valid and approved treatment, but a vaccine is much more of a prophylactic measure. Part of managing a pandemic is avoiding a huge crunch on the medical system (like we're currently living). Vaccines help keep people out of the hospital to begin with.

Even if we were interested in using monoclonal antibodies as a prophylactic, the current monoclonal antibody treatments that we have available are delivered via IV infusion. That's much more time-consuming and resource intensive than two vaccine shots imo.

That’s because prevention is better than treatment. Prevention means less spread and can be administered at any time. Monoclonal antibody treatment is only usable within a specific window when a person is already ill. That means the person has had the opportunity to spread the infection, further increasing demand for treatment, and there’s no guarantee the monoclonal antibodies will save them (no treatments are perfect).

Prevention always makes more sense than trying to patch a problem later on.

> Monoclonal antibody treatment is only usable within a specific window when a person is already ill.

This is not correct. See my other comment in the thread.

> Somebody, somewhere made a choice to push the vaccines and not the monoclonal antibodies.

Monoclonal antibodies have been investigated at the same time as vaccines. Companies could have offered low cost production at large scale, but they didn't. What makes you think monoclonal antibodies can be produced and sold for $5-20 per dose like the vaccine?

The fact that the technology to produce monoclonal antibodies is older than the technology to produce mRNA vaccines.

There is probably less of a profit motive for monoclonal antibodies, since it is just a few doses.

Vaccines with continual boosters mandated by law and required for travel or normal business entrance are a perpetual goldmine. Basically the exact opposite of what Gilead did with the Hepatitis C cure.

The giant bigpharma companies have the lobbyists to influence legislators & government executives, as well as controlling the social media "fact checkers" [1]

[1] https://www.youtube.com/watch?v=44B-OJcOXxc

This is outright wrong.

Monoclonal antibodies are, as you say, a treatment. They are not used to prevent infection in the first place. They lessen the severity of the disease but do essentially nothing to avoid its transmission.

You cannot end a pandemic without stopping the disease from spreading. For one, monoclonal antibodies do nothing to stop transmission. Second, their supply is constrained and availability is limited. Third, it cannot be used in all cases, most notably for folks whose symptoms have already become severe.

> Monoclonal antibodies are, as you say, a treatment. They are not used to prevent infection in the first place. They lessen the severity of the disease but do essentially nothing to avoid its transmission.

You, fundamentally, do not understand how antibodies work.

Just as with the antibodies from a vaccine, if the monoclonal antibodies are in your blood before contact with an infected person you will not get sick. So, monoclonal antibodies can be used profilactically, if so desired.

> if the monoclonal antibodies are in your blood before contact with an infected person you will not get sick.

So now you are advocating vaccination by another name.

First, that's not how monoclonal antibodies are designed to be administered. Second, that's not how they are administered (anywhere). Third, even if they were, we would call it a vaccine.

Why don't we? Because they're many orders of magnitude more expensive than the actual vaccines which are designed to be used prophylactically and do not provide the immunity.

Theres also mask mandates that were actually working super fine.

We (the US) decided for political points that it's time to stop with masks.

Nobody made that choice. Treatment and prevention are not the same thing.

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