Sign me up for this the second it is available.
As an aside, to spite anti vaxxers I’m on a mission to get every vaccine I can. I want my bloodstream to be like the Library at Alexandria before it burned down.
As an aside, to spite anti vaxxers I’m on a mission to get every vaccine I can. I want my bloodstream to be like the Library at Alexandria before it burned down.
What vaccines do is move some books to the front of the building, so your dentritic cells don't have to spend a few days finding them.
You want the right books at the front. A mission to move all the books to the front is perhaps misguided.
The problem is that IgMs are not very specific. They bind to a lot of things, but they bind poorly. In the library of Alexandria analogy, it's like a book that happens to mention a subject you care about, but only in passing.
Vaccines (and infections) result in your immune system developing IgG. That's the hyper-specific books for the pathogen you care about.
So it's not that the book wasn't at the front. Your immune system has to write the book on the fly, during the fight, using chopped up pieces of pathogen gathered by antigen-presenting cells.
Someone else has mentioned the Kurzgesagt resources, which are great. If you want something more formal, OME is also a great resource I think.
https://onlinemeded.org/spa/immunology
>I always assumed the body generated matching snippets at random and the law of large numbers would result in a match eventually.
Right. Antibodies have a Y shape, where the two tips of the Y are variable, and the base is fixed. The IgM are the completely random snippets that happen to match a wide variety of things. However, because it's chemistry, it's more subtle than match or no match. Think of it like a variable degree of stickiness.
When a pathogen is found, your body is going to iteratively mutate new antibodies and select those that bind the best to the collected antigens, until you have something very specific (= sticks very readily). I'm simplifying a little bit, but that's the process for generating IgGs that I was talking about.
The shuffling is done by recombination, which means joining segments of DNA in a random fashion (a similar recombination process is actually used for DNA repair, though with somewhat less randomness!)
There's a lot more to say about all of this, but I don't know how much immunology I can usefully describe in a few HN comments =]
Does that imply that there's a good chance someone's immune system will just fail to generate any appropriate antibodies against a novel intruder? Or does the "fuzzy matching" aspect mean that exploring a small percentage of the space mean you're very likely to get at least some degree of success?
https://www.amazon.com/-/es/gp/aw/d/0593241312/ref=tmm_hrd_s...
Pretty cool illustrations too.
Listening now, thanks!
Is that actually how it works in any sense?
It’s like getting a superpower in a video game!
And, vaccines have general positive effects of health: https://ec.europa.eu/research-and-innovation/en/horizon-maga...
Infections can be the trigger for auto-immune diseases. We're not sure precisely how, but there seems to be a complex combination of genetic and environmental factors.
Your immune system is very much not playing games, it's in the business of reacting on a hair trigger, and doing more damage to foreign bodies than it does to your own body. It has an intricate system to avoid turning against yourself, but the system can fail.
If a B cell that produces auto-antibodies falls through the cracks, it will not die. You now have the problem of being in a permanent fight against your own immune system, with a variety of unfortunate results.
Now that's a lot of scary outcomes, and thankfully those diseases are uncommon. The system almost always works well. But it's a very complex system with ugly failure modes, so I wouldn't encourage you to poke the beast too much.
For example, Japanese encephalitis is rare in Japan, but only because many Japanese people have been vaccinated against it. It's endemic in most other parts of east, southeast, and south Asia. It kills 10K+ people every year, and it spreads through mosquito bites just like malaria. But most travelers only worry about malaria.
When you say "exposure to diverse mild pathogens actually makes your immune system less dangerous to the self", I suspect you're referring to the hygiene hypothesis that has become part of popular culture.
It's important to know that that hypothesis, nowadays, is about early exposure to benign microbes. Meaning from in utero exposure to early childhood at the latest.
I have seen no evidence that voluntarily exposing yourself to pathogens is a good idea. The point to my post was that you shouldn't understand the immune system like an RPG element that needs training to level up.
Please do get vaccinated for relevant diseases, but I would not go too far in the direction of treating your immune system like a safe thing to play with.
A lookup of systematic reviews on Cochrane & Epistemonikos paints the opposite picture, with a positive correlation between daycare attendance and respiratory tract disorders or asthma.
Just some anecdotal early-exposure advocacy.
If you believe that vaccines may have potentially positive effects beyond their original scope, you must also be ready for the opposite, potential negative effects beyond their original scope. If you don't, you are just being brainwashed by big Pharma.
It would make such comments much more meaningful and honest.
Big Pharma is a thing. A consolidated industry with very few major players who have huge regulatory capture. You can either continue being blind to it or realize they have a disproportionate influence in how decisions are taken.
And just like your doctors aren't incentivized to misdiagnose you to run more tests and get more money from you, pharma companies are not incentivized to mislead patients and make them think they need 10 shots when 1 will do. There are so, so many independent research groups, including several in the government, that would love to publish findings that pharma companies are misleading people. It does happen, but not often.
It’s more like rare candy in Pokémon, which isn’t as good as naturally leveling up your Pokémon.
Vaccines could potentially trigger some dangerous side effects, however rare it is.
However, vaccine for incredibly rare or non-existent disease isn't likely worth the tradeoff. Or maybe a particular vaccine is too dangerous or experimental.
Anyway, if the CDC recommend a vaccine for something, it's likely that they had looked into it and decided that the upside is worth more than the risk.
1. You can become invalid
2. You can kill buss of kids
3. You can go to jail
4. It can be very hard on your finance
5. You can have your car stolen
6. You can lose your nerves
7. There are bunch of diseases involved due to gasses
etc...
Basically, every single person I know had some problem with the car. Probably the best not to have them.
I found it highly pleasurable.
Subjecting yourself to immune response, which for some vaccines can have high amount of reactogenicity, is having your body undergo heavy inflammation, a fair amount of tissue damage, etc. The people that just treat vaccines like they're a wheatgrass shot is pretty strange.
Discovered that vaccines spike sugar prety significantly after getting my two shots this year. Won't be getting boosters anytime soon as the side effects were gruesome.
For most people this is not really harmful but for people with blood glucose problems it can cause severe issues.
Other people have reported similar things online. Again one must take it with a grain of salt.
Just skimming the CDC list of common vaccines in use in the US, do most really need vaccines for everything: anthrax, Japanese encephalitis, polio, rabies, smallpox, tetanus, tuberculosis, typhoid fever, and yellow fever? If you're not traveling outside the US and living a fairly normal life, most likely not and some of these have potentially nasty yet rare side effects. If they were given/taken at the scale COVID vaccines were, many would die from such side effect who otherwise would have lived healthy lives, all because they took an unnecessary risk trying to prevent a very low risk. COVID is an exception because of exposure and transmissibiliy, the rare side effects are worth the risk for most people because the chance of getting it and having a life ending result is relatively high.
TB, tetanus, and rabies may be useful vaccines for some professions or life exposures in high risk cases, say veteranarians and healthcare workers, but for the most part, you probably don't need it. If you travel a lot to certain locations and say do missionary type work or whatever, perhaps some others make sense as well. Should every sexually active person take PrEP regularly since HIV is a potential risk to everyone? No, there are populations of risk exposure where it makes sense though. Your dentist only takes x-rays every so often because the x-ray exposure increases risk of various forms of cancer. You could get x-rays more frequently to detect issues that might not be obvious to your dentist but it's pretty low risk, there has been a lot of study into the rate of progression of disease and risk tradeoff to help your dentist determine a reasonable frequency for x-rays vs radiation exposure.
If you start looking at your regular risks, you take many risks across a lot of aspects of life every single day, even in a modestly safe life style, from hopping in a car to picking up takeout at a local resturaunt or even walking down a street. A massive unknown asteroid could be on a collision course with Earth right now that results in mass extinction ending the human race or a gamma ray burst from inside our galaxy could set the atmosphere on fire and radiate us all to death near instantly... they are all non-zero yet incredibly low risk to our understanding probabilisticly. They're so low and some even inactionable that we need to ignore them and/or treat them with low priority and continue on with life.
It's good to have a preventative mindset and take preventative action to try and control and manage risk, but in order to do this effectively, be sure you assess your risks, or have someone knowledgable (like a doctor when it comes to vaccines) lay it out for you so you can make a good decision about what you should or shouldn't do. If you truly can do the assessment yourself then by all means do it but it doesn't hurt to explain your assessment and rationale to someone knowledgeable to make sure you're not overlooking something. It certainly is possible to perform a better risk assessment for yourself than anyone else will be able to because you can know your behaviors and exposures better than anyone else but be careful playing this game.
Alternative explanation: nobody knows the risks in details, and side-effects are widely under-reported anyway. Ask any doctor how often they report even serious side effects, you will be very surprised.
> The biggest harm done by taking vaccines you don't really need is probably that the money could have been used for something more useful.
What kind of nonsense is that? Its the same as saying "there is no problem in taking any drug, the worst it can get is lose some money". You can't clamp entire technology as good or wrong. Vaccine as technology obviously has merit. Any particular vaccine may be problematic or not. Think H1N1 and narcolepsy, anthrax vaccine in gulf war etc.
This kind of trash talk is exactly the same as anti-vax talk. I have no sympathy for either clan. As usual, people convert complex topic into binary decision which is madness.
Most vaccines are much older than a decade. We know who gets vaccines; it's in their medical record, if not centralized anywhere. Longitudinal studies aren't impossible. So any random hospital could do a longitudinal retrospective data-collection study on the consequences for their own patients of either having received a given vaccination decades previous or not, no?
> What kind of nonsense is that?
I understood what they meant, and they're right. They're making an incomplete-information decision-theory argument. To rephrase them with more precision:
Selecting a person from the population at random; and taking the category of "vaccines that will confer absolutely no benefits to that person specifically", and selecting a vaccine at random from that category; that person will, with high probability, incur more QALY-risk from paying for the vaccine (because they'll then have fewer dollars to pay for unplanned expenses, which can be quite problematic for the median member of the population), than they will from any iatrogenic illness induced by getting the vaccine itself.
Outlier vaccines do nothing to change this, any more than those few poisoned bottles of aspirin did anything to increase the non-contingent risk profile of taking aspirin. Especially because, like the poisoned aspirin, outlier vaccines aren't on the market for very long compared to safe vaccines.
No! If you think its possible to pin point exactly what is the source of the problem with decade of various stressors piling up on anybody you should think again. It basically has infinite confounding variables.
> those few poisoned bottles of aspirin did anything to increase the non-contingent risk profile of taking aspirin.
Please educate more about this - do you know that ibuprofen is result of long time search to replace aspirin due to its toxicity (such as stomach bleeding that you will get sooner or later).
Its insane that people outsource medicine. One should strive to know as much as possible about it, with focus on prevention.
Yes, but: Law of Large Numbers. The great thing about retrospective data-collection studies is that you can potentially get hundreds of thousands of histories as datapoints. With those numbers, basically every confounder washes away, other than the selection effect of "what kind of person frequents this hospital rather than some other hospital." And you can get rid of that confounder, too, if you meta-analyze studies done in hospitals in very different areas.
One should actively question all things again and again. Most things we believe to be true are just true because we have no reason to think they are false.
Hell, most here write some code, look at it, it looks fine? Then it doesn't run because there are one or more typos. Note here how the whole thing doesn't work. If you organize your life like that the whole thing wont work.
I so often told people to ask anyway in stead of already "knowing" what someone is going to say. Even if you are 95% certain you are still 100% wrong. If you do life like that you will never find a book you like, a job, a partner, a place to vacation, an interesting new food, a pet, a study. There is no need to bother, you already "know", they are all just going to disappoint you.
God might be real, Trump might be a woman, Aliens might walk the earth, people might be living on mars, someone might have a working antikythera mechanism in their private collection, King Enmen-lu-ana might have ruled for 43,200 years, he might have visited the martians in his Vimana.
What would I know about it?
> say a decade, with the current approach.
Lots of other possibilities of immunization causes a small but unnoticed inury that later on proves to be fatal, but because of the gap between injury and fatality is very hard to track down.
My son participated in a 'long term' vaccine trial of a slightly different combination of childhood vaccines (if it had been successful in the US, it would have reduced the number of needles by one, but I don't recall the specifics). But long term means they followed up for one year.
It's just not really possible to keep track of participants for very long outside of very small studies. Maybe if one day we have decent medical records, it will be easy to run epidemiological studies and find small effects. But you would need to make the decision on the immunization with the known information; maybe 20-40 years later you might find out that it increased or decreased the likelyhood of some disease in old age.
They likely laid all the groundwork for you in term of cost/benefit.
But there's no point in blindly taking vaccines for the sake of taking vaccines and increasing your risk of becoming part of the fatality statistics.
> If you're not traveling outside the US and living a fairly normal life
Globally, given an at-least-middle-class lifestyle (and any other years than 2020–2021), "not travelling outside [your home country]" is actually rather abnormal. It's mostly an American thing.
I've seen it hypothesized that higher risk-aversion from a media-inculcated culture of fear could be responsible for Americans' unique disinterest in international travel.
If that were true, then "properly calibrating your risk-aversion" as we're talking about here, would potentially result in the average American desiring to travel a lot more — which would then mean that the extra vaccinations would have rather more justification.
> Should every sexually active person take PrEP regularly since HIV is a potential risk to everyone? No, there are populations of risk exposure where it makes sense though.
I mean, if we just had a huge supply of PrEP laying around so that we could afford to be wasteful with it, we could just give it to every sexually-active person for a while to stop transmission, and so effectively eradicate HIV. (Everyone already infected would keep taking it until death, but nobody new would be getting infected, so as soon as all those people passed away, there'd be no more HIV.)
Personally, I'd see it as my duty as a citizen of the world to participate in a program like that. I want to live to see that virus die.
But moreover, doing so would eliminate the risk of anyone ever contracting HIV again; which doesn't just have personal consequences for arbitrary individuals from the population; but also has societal effects (in any country with socialized healthcare), and even cultural effects (in terms of changing the landscape of sexual mores.) Those effects could have net-positive utility that greatly outweighs the personal calculus of "am I more likely to get HIV, or an iatrogenic illness from PrEP." (I don't think anyone's done the true cost-benefit for the societal-level effects. It'd be interesting to see.)
See also: the argument to eliminating homelessness. Where, in that case, the societal-level "economically externalized from the individual" effects (e.g. fewer unpaid ER visits per homeless person) clearly do come out highly net-positive, such that we should strive to do that even if such programs were economically net-negative per homeless person. Thus thinking like "just give every homeless person a house."
> Your dentist only takes x-rays every so often because the x-ray exposure increases risk of various forms of cancer.
X-rays are an outmoded technology, though. If we could make MRI machines cheap enough, dentists could do what they do now with X-rays, by instead taking MRI captures and using a spectrum that highlights the bone-density sections.
In that hypothetical world, there'd be no downside to getting a new MRI every time you visit the dentist.
My dentist just upgraded their gear, the tech no longer leaves the room when shooting the image, and I didn't get a lead blanket. Presumably that means the technology improved again and the total X-ray energy went down.
I suspect it has more to do with the distance between most of the US and other nations combined with the variety Americans perceive within their own borders. Hawaii and Alaska are very different climatically and to a lesser degree culturally from Iowa. In many other nations national borders are closer and there's no intervening ocean, or perhaps only a narrow, theoretically swimmable strait, separating you from the next nation over.
Japanese people don't leave Japan much either. And between those two countries we've now called half the developed world "abnormal". It may be just as accurate to say Europe is the outlier, especially when you consider all of humanity and all of civilized history. Also it obviously depends where people travel to, developed or otherwise.
Either way though, the vaccination recommendations in the US (as I'm sure every country) vary depending on whether you plan to travel or not. There isn't a fixed policy for everyone, at least when it comes to recommendations.
Not taking away from your main point, but Tetanus is generally recommended once every ten years (or on potential exposure five years from last vaccination). I wouldn't put it in the same category as those other diseases.
As for the rabies vaccine, I don't think you can just ask for that to be administered -- unless, I suppose, you lie about being bitten by a random animal. As an aside, I have amusing memories of my own rabies vaccine 25 years ago -- a series of injections of thick syrup into my butt.
> Despite the widespread modern belief that the Library of Alexandria was burned once and cataclysmically destroyed, the Library actually declined gradually over the course of several centuries.
Also, you should think sometimes about aspirin and Spanish fever phenomena.
> The hypothesis presented herein is that aspirin contributed to the incidence and severity of viral pathology, bacterial infection, and death, because physicians of the day were unaware that the regimens (8.0–31.2 g per day) produce levels associated with hyperventilation and pulmonary edema in 33% and 3% of recipients, respectively.
5% death in military vs 1% in sanitoriums which used heat therapy. Its amazing what modern medicine did back then, and you know... history repeats.
I'll check if you post in a few months. Otherwise, thank you for your contribution to science. In the mean time, don't recommend taking up competitive soccer.