Moderna booster increased neutralizing antibody levels against Omicron ~37-fold | Hacker News Reader

Moderna booster increased neutralizing antibody levels against Omicron ~37-fold

investors.modernatx.com

91 pointsKoftaBob186 comments

Seems from this case in Norway (https://www.eurosurveillance.org/content/10.2807/1560-7917.E...) that Moderna is a tad bit better at preventing infection from Omicron, but when you see the overall number of cases among fully vaccinated people I'm not very optimistic that vaccine with do something at limiting the spread of infection, however I'm optimistic that they will still be efficient to prevent severe disease.

> When asked to grade the severity of symptoms on a scale from 1 (no symptoms) to 5 (significant symptoms), 42% (33/79) reported level 3 symptoms, whereas 11% (9/79) reported level 4 symptoms. None of the cases required hospitalisation up to 13 December 2021.

I am extremely optimistic.

All this talk about "mild" cases with Omicron are failing to grasp the whole situation at two very important corners:

- countries affected so far have excellent immunization rates, i.e. if I take these populations as a reference, I'm just checking how immunized people are affected. Not every country has had either a lot of cases or large/successful immunization programs

- if the transmission rate in South Afrika and GB is any indication (reminder, both have quite good immunization rates), there will still be enough severe cases, because there will be just an unbelievable amount of overall cases in a very short timeframe and even with Omicron and a well immunized population, some remaining x% will land in the hospital.

I would argue that at the rate Omicron currently growing in GB, NL, DK, NO, etc. this thing will go on a rampage all over Europe. The amount of spread virus is so much not comparable to Delta getting to populations that were so far better protected, i.e. child care, elderly care, etc.

Countries like Germany and Austria are seriously in for a ride. Yes, I'm quite pessimistic here and I really hope I am wrong.

Yeah, Omicron is is still potentially a huge threat to countries which both have low vaccine uptake amongst the most at risk and avoided people being infected by previous variants. I think that might only apply to Germany, Austria and China at this point though - almost everywhere on the planet had widespread infection in past waves, and the exceptions generally have high vaccination rates by now.

No country on earth has vaccinated children under 5.

SA allegedly has had a huge amount of hospitalized children under 10 in the past weeks.

This alone can cause havoc. And suffering for the affected (incl. health workers and parents).

South Africa has extremely low vaccination rates, correct?

Edit: Yes, your premise seems to be quite wrong. South Africa has only 26% vaccination rate.

But South Africa has a lot of previously infected people with some degeree of natural immunization.

Sure, but so does America and the UK and so on.

Incidence in UK over the last 12 months is not comparable to large parts of Europe.

Quite astonishing how you just "confirmed" how my premise is wrong without reading what I wrote in the first place

Hospitalizations [0], and perhaps even cases [1,2], appear to have peaked in South Africa.

[0] https://www.bloomberg.com/news/articles/2021-12-17/s-africa-...

[1] https://twitter.com/pieterstreicher/status/14718990936853954...

[2] https://nymag.com/intelligencer/amp/2021/12/the-south-africa...

And this means... ?

It means that if (big ifs!) (a) the South African peak is truly a peak and (b) vaccine-acquired immunity staves off severe illness to the same extent that infection-acquired immunity does[*], Europe is not in for “quite a ride.” As in South Africa, cases will briefly peak at a very high level, but without a corresponding high level of hospitalizations or deaths.

[*] while only ~30% of SA’s population has been vaccinated, some estimate an additional 40% of the population have been infected, for an overall immunity rate of ~70%, which is comparable to the vaccination rate in the US/Europe.

The likely higher transmissibility in combination with a generally more elderly population and vaccination gaps among older individuals in some European countries (e.g. Germany) could still spell trouble.

And experts are pretty sure by now that it will.

Also NL, DK and the London area are already putting drastic measures up. They are not doing this just for fun.

It is already 2 weeks for "Omicron" hogging the news. If it is as deadly as Delta, by now you should have heard a lot of death and not "number of infected". Even if there is a delay in death due to better care, hospitals in SA should have full of patients in ICU rooms with pictures showing rows and rows of patients on ventilations. Even if you use the arguments lots of them are vaccinated, there are stil many not vaccinated especially outside of 1st world categories. SA isn't exactly at western EU level. I think this isn't as severe as most healthcare professional have expected. I would speculate this would be nature's way to confer us with some immunity.

0 out of 79 cases requiring hospitalization? If we assumed a _generous_ vaccination rate of, say, 80% for SA or GB, then we could say that 16 of these cases are with unvaccinated individuals. So, 0 out of 16 is still pretty good for no hospitalizations.

Or am I figuring this wrong?

Infection also leads to immunization.

Both GB and SA had considerably higher incidence numbers over the last 12 months than most of the EU, with GB running a very successful vaccination program.

Particularly in SA researches estimate that almost anyone has had one or more infections in the last 24 months.

96% of the participants were fully vaccinated.

> well immunized population, some remaining x% will land in the hospital.

Compare that to that 8% fatality rate for the common cold amongst the vulnerables. Here we have 1.4% so far. It's a a ride, yes, but this ride looks good. We have such rides every single year.

in terms of covid hospitalisations overwhelming our hospitals: i‘m optimistic as well that this might not happen at scale.

but in terms of a large part of society getting sick (level 3 still makes you stick in bed) at the same time - this will lead to worker shortage - i’m kind of neutral-pessimistic.

in terms of longterm long covid effect on our demographic - i’m fearful.

in terms of society getting their act together to avert anything of this: absolutely pessimistic.

I can't stress enough how dangerous it is to pretend society can end a virus that is not only incredibly contagious between humans but also has many animal carriers.

There is nothing more dangerous than society with no trust and this completely fabricated idea that people's behavior is to blame for the continued existence of covid serves no purpose other than to erode trust.

How did humanity ever survive this long without modern medicine?

Law of large numbers. The widespread plagues of the past were never 100% lethal, or we wouldn't be here - a sizable fraction of the population survived, and over several rounds of infection/reinfection gained something we'd think of sterilising immunity.

In the meanwhile, the plagues and their knock-on effects may have eliminated approximately HALF of the entire population of their times.[0]

0: https://en.wikipedia.org/wiki/Black_Death ("is estimated to have killed 30 percent to 60 percent of the European population")

By letting people die. If covid came around in the 1200s, then everyone would have gotten it and ~3% of the world population would have died. Definitely suboptimal but nowhere near an extinction event.

Given COVID’s risk/age relationship and already lower life spans in that time period plus higher vitamin D exposure rates it’s quite likely rate of death would have been lower in that population.

The infection fatality rate was never as high as 3%. The CDC estimated it at 0.6% back when almost no one was vaccinated.

Nobody said it was?

The question was about a world without modern medicine. It's totally reasonable to speculate there would be a higher fatality rate without medical intervention keeping people from dying.

Well, a lot of people died, mostly.

> in terms of covid hospitalisations overwhelming our hospitals: i‘m optimistic as well that this might not happen at scale.

I see no reason for this optimism. Every hospital that I know of in SE Michigan has been over capacity for several weeks. We have gotten regular emails from both hospital systems in Ann Arbor begging everyone to get vaccinated.

This is inaccurate https://www.michigan.gov/coronavirus/0,9753,7-406-98159-5236...

Most people don’t realize that hospitals typically run at 98%+ capacity in the winter in a pre-COVID environment. This maximizes their profitability and allows them to operate relatively at a loss for the rest of the year.

Pre-covid, if you picked a random hospital at a random point in time in the U.S. there was a 16% chance it would be at max capacity and something like a 30% chance it would be over 80% capacity. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3840149/

It amazes me that hospitals are shutting down, healthcare worker numbers have barely recovered to 2018 numbers, bed capacity is shrinking in many areas and even still people think we have a healthcare crisis.

We've created 80% of all dollars ever created in the past two years. We have the money. It seems obvious (to me, anyways) our healthcare spending would explode in that sector and solve simple issues like capacity and worker shortage, if in fact that was an issue to begin with.

Healthcare workers take many years to train. When they die of COVID, go on long term disability because of long COVID, or burn out because they can't mentally handle watching another willfully unvaccinated person die, that person is irreplaceable in the short term.

HCW aren't on the decline because of any of those things (at least not primarily). This is made abundantly clear by looking at the steep dropoff in march of 2020 https://fred.stlouisfed.org/series/PAYEMS

HCWs are below where they would otherwise be because of policy.

Aside from that, long covid is psychosomatic. https://jamanetwork.com/journals/jamainternalmedicine/fullar... which means the root cause of long covid is likely misinformation about long covid to begin with (thanks "The Atlantic", for scaring everyone into being sick)

Michigan has certificates of need for hospital beds. Capacity is centrally planned (no doubt the incumbents are good friends with their regulators).

That's in addition to the games CMS plays with Medicare certification and funding.

This varies greatly between countries. In many countries hospitals don't have profits - they operate like courts or army with yearly budgets assigned by the government.

Above 75% is roughly considered to be high occupancy. Efficiency drops at that point for various reasons, such as the difficulty in moving patients between units due to a lack of beds. These numbers are also comprised of large regions of the state with multiple facilities, but the facilities still operate independently.

For adults, those regions of Michigan have the following ICU utilizations:

Region 1: 90%

Region 2N: 82%

Region 2S: 89%

Region 3: 94%

Region 5: 85%

Region 6: 87%

Region 7: 94%

Region 8: 72%

The NYT compiles per-hospital stats at [1], although the data is incomplete.

If Detroit were to not have beds available for patients, one option might be to transport patients as far away as Cleveland. There's a recent article discussing the situation at the Cleveland Clinic's 64 bed MICU [2].

[1] https://www.nytimes.com/interactive/2020/us/covid-hospitals-...

[2] https://fox59.com/news/national-world/not-gonna-make-it-out-...

The thing with the worker shortage is it'll be brief. SA's already peaked. We'll have maybe a month of worker shortage I guess.

Even if Omicron infected patients have half the rate of hospitalization as delta infected patients, that means the wave crushes the hospitals one doubling period later. Currently, the incidents numbers for omicron double every 2 to 4 days. So having less severe cases means the meteor will hit us a few days later. That is not a big improvement. For the individual risk of hospitalization, it is quite significant.

In practice it's worked out ok https://mobile.twitter.com/ScottGottliebMD/status/1472664060...

If my net worth is 1 cent, and I pick up 37 cents on the street, I’ve increased my net worth over 37-fold.

But I’m still worth only 38 cents. Maybe I can buy a gumball. Maybe.

37-fold is meaningless. Unfortunately this press release doesn’t have anything more useful either.

Compared to not having the booster (but being previously vaccinated).

>37-fold compared to pre-boost levels

It's there in the first paragraph. Why are you doing this?

GP didn't ask "compared to what". They said that showing an increase is not relevant without knowing the base value amount (or final value amount). Or hell, what the implications of the increase are in meaningful terms. Is this more than expected from a booster? Less? About the same?

I get this is a report to investors so I'm not the target audience, but unless the reader is familiar with the field, it's just "big number increase good".

Neutralising antibody levels are not in a linear correlation with protection from Covid infection or prevention of a severe illness. Lot's of biological measurements have to be interpreted on a log scale. I.e. it is not obvious how much difference that makes. But it definitely improves protection.

"Salesman says product he's selling is great!"

It's the only solid metric they can report on quantitatively. What else could they report on? There's no way to measure T/B-cell immunity.

Plus you can understand that if 2 shots give a low immunity level of like 30%, the increase is substantial which would put 3 shots easily above 50% which is solid.

sounds like vaccine marketing is crossing into the "25% more nuts and 8g protein per serving" territory. I suppose that regular consumer isnt ready to evaluate all the aspects of the difference between say 20-fold and 37-fold antibody levels beside the "bigger is better" (is it? does high antibody levels come for free? i remember a study where methotrexate treatment to kill B-cells which were of high levels after flu cured Chronic Fatigue Syndrome for example).

Shame you’re being downvoted and people don’t get that there might be just a small conflict of interest for the Pfizer ceo to be the one dictating that we need a fourth vaccine. [1]

[1] https://www.google.com/amp/s/www.cnbc.com/amp/2021/12/08/omi...

Us sheep will put up with this one, if it’s the last one. Just this one last booster. Now if we tread into the 4th or 5th booster for the n-th variant, then that’s my breaking point and I will have to call out the shenanigans.

Moderna’s revenue since 2016:

https://www.statista.com/statistics/1107794/revenue-and-net-...

These companies certainly don’t mind the state of things.

800 million in revenue seems really reasonable for having developed one of the best, it not the best, COVID 19 vaccines in the world.

Consider that Apple's annual revenue from just airpods is over 10 billion.

Wasn't the Moderna COVID vaccin funded by the German taxpayers?

BioNTech is a German company, so it seems more likely that the Pfizer/BioNTech vaccine was at least partially funded that way.

Oh, you're right, Moderna was funded by the US taxpayers:

https://www.forbes.com/sites/judystone/2020/12/03/the-people...

As an investor in Pfizer I really love it when there are new variants and we all need more vaccines. It’s more money for me. As a human being, I worry about the (currently unknown) long term effects on my health.

I applaud your ability to appropriately hedge your long term health risks with a short term financial gain to provide for your care in the event you have debilitating long term effects. Remember to cash out before the lawsuits hit.

Good luck. I already reached my breaking point with omicron. I am not taking a booster at all. It is quite clear that this will never end. We have to send a message to the authorities.

What is the exact message? I agree this is frustrating but I don’t understand what message not getting a booster will send.

The message is stop playing political theater and creating a media cycle at every variant less it be particularly fatal one.

And how is this archived by not getting the booster?

They don’t try to sell a 4th one when the 3rd one doesn’t sell well.

The point is they gotta get boosters in people before the hospitals get overcrowded (only then people will realize they should've gotten a booster or the shots). People can't figure this out, so they need to use the media to get the message out.

Why? We get a flu booster every year, and that’s fine. I’m happy to get a shot every so often if it means I can go about my life like normal.

Flu shots are “updated” every year for new variants.

I might be wrong, but I think covid boosters so far are all just extra doses of the same old material. I don’t think anyone would get flu shots if we were expected to get 4 doses of the same thing with demonstrated lower efficacy.

I’m perfectly fine with getting boosters if they’re adjusted to be more effective against new strains. Getting a third, fourth, or fifth dose of the same old strain that’s basically been evolutionarily eliminated seems off to me.

Which is why all of these companies are currently working on "v2" of the vaccine which specifically targets omicron. But since the current version of the vaccine was found the be effective anyway, that's why it's being used. I imagine by the time next year it won't be in use anymore, purely because of its lack of effectivness for whatever variant is around then.

I think that is exactly the way we are heading as pandemic becomes endemic.

A yearly shot for vulnerable people possibly rolled in with your flu shot (or at least scheduled the same way).

I go get my flu shot every year since I'm classed as vulnerable for health reasons - the exact same reasons I went and got both covid shots and the booster the second I could.

The response to the COVID shots isn't linear, so it doesn't come down to just doing the same thing 3 times.

You’re thinking about the booster wrong. Having a vaccine for the ancestral strain is actually pretty great, because it confers (or has to this point) some level of protection against all child strains due to there being at least enough similarity still.

If you make some highly specific omicron booster, it might not do anything against whatever variant comes next.

As long as the original shot keeps working, it’s the best one to ride with for now.

With how much more contagious omicron is, I wonder what the odds are that future strains will come from it or an earlier strain? In particular, I assume there is some zero-sum competition going on between strains—if someone gets infected with Omicron it becomes very unlikely that they would later contract Delta—thus at a certain point Omicron is everywhere and less contagious strains largely die out? This has happened in the past with syphilis, for example.

It’s sort of interesting to think about. One epidemiologist I follow mused that we could end up with delta and omicron co-existing, with omicron hitting the vaccinated (but not boosted) while delta continues to wreak havoc among the unvaccinated. It’s hard to tell if omicron is actually more contagious than delta, or if it just appears to be because of its immunity evasion.

Why do people keep saying this? I have literally never received a flu shot, they have always been reserved for the sick and elderly

Why not, instead of shots, do these pharmaceutical companies not prioritise developing an effective at home treatment for the symptoms of Covid-19? It's very hard to see light at the end of this tunnel, which appears to be becoming a booster merry-go-round.

>>Why do people keep saying this?

Because the population on HN is not homogeneus and different regions in the world approach the flu vaccine differently? In some countries it's completely free and it's normal to get it every year, and even in some countries where it isn't, there's only a nominal cost and usually the employer covers it - so most people get the flu shot too. Not a big deal at all.

>> they have always been reserved for the sick and elderly

See above. Maybe that's true where you live.

>> instead of shots, do these pharmaceutical companies not prioritise developing an effective at home treatment for the symptoms of Covid-19

Why not both? Treatment for symptoms is under development, as well as vaccine which you take with an inhaler at home. Or would you rather that they stopped the development of vaccines completely and focused just on the treatment of symptoms?

>>Or would you rather that they stopped the development of vaccines completely and focused just on the treatment of symptoms?

No, but surely it would be easier to produce an antiviral for home use that would alleviate the symptoms of Covid-19, rather than relying on the development of a vaccine, and then demanding almost universal uptake for it to work?

Then we could have had vaccines for the sick, elderly, immunocompromised and whoever else wanted them after a while, and treatment of symptoms for everyone else.

We knew, pretty much from the beginning, that Covid was here to stay. I would like to know what the path out of this pandemic is now, now that we still aren't discussing treatment and are talking about additional boosters.

That's the equivalent of 'a mere matter of engineering'. Developing anti-viral drugs is hard, for plenty of viruses we have vaccines but no anti-virals, for RNA based viruses (which mutate rapidely) anti-virals are even harder.

Thank you. I'm not aware of the complications of developing an anti-viral for this disease (and I'm not going to go into the debate around existing anti-virals). I did not intend to be dismissive of the effort involved. I'm coming at it from a place of real frustration.

I can't see how this pandemic ends without an effective treatment.

It may not end.

We missed the 'golden window' early on in the epidemic when (for instance like SARS-CoV) it could have been contained. But now we have a real problem. The big difference between SARS-CoV and COVID-19 is that the former first gives you symptoms and then makes you contagious and with COVID-19 it is the other way around. That simple fact alone possible made it impossible to contain this. But we never really tried (except for a very few countries).

Yeah, I had a real hard time with this at the beginning, knowing how people behave.

Trying to be as apolitical as possible here, but the leadership flopped hard and wrong here, and…well…welcome to the endemic reality.

As an aside: the World of Warcraft model was more accurate than most would have expected.

> surely it would be easier to produce an antiviral for home use that would alleviate the symptoms of Covid-19, rather than relying on the development of a vaccine

What makes you think that? Honest question.

Vaccines are specific and usually take years to produce (this time being the exception), it was more of a question than a statement of fact because I genuinely don't know (hence the use of 'surely', it seems intuitive to me but I really can't say.)

Making an anti-viral is hard. No where near as easy as making an antibiotic (and even that can be hard, because: evolution).

In my country (USA) flu vaccines are certainly not "reserved for the sick and elderly," they are emphatically recommended for almost everyone.

https://www.cdc.gov/flu/prevent/flushot.htm

>CDC recommends use of any licensed, age-appropriate influenza vaccine during the 2021-2022 influenza season.

>Everyone 6 months of age and older should get an influenza (flu) vaccine every season with rare exception. CDC’s Advisory Committee on Immunization Practices has made this recommendation since the 2010-2011 flu season.

>There are many flu vaccine options to choose from, but the most important thing is for all people 6 months and older to get a flu vaccine every year.

Rates of flu vaccination in the US are a little over 50%. I've never been vaccinated for it, nor my family.

I don't get a severe fever from flu shots.

Do you not? I certainly do, at least in the last few years, every single time. And if we're sharing anecdotes, I was absolutely fine after all 3 of my covid shots, just a painful arm the next day and that's about it.

Many people do.

Lol you get the booster. I’ve never had a flu shot and don’t intend to get one unless I’m forced to. I’ve never been accused of killing anyone or putting anyones life at risk like the case with the current virus.

I honestly don't know what this adds to the discussion though. Like....good for you? And of course you didn't get accused of such things, because it would have made zero sense in context.

Of course it makes zero sense, same with COVID vaccinations.

You don’t lose your job for not getting the flu vaccine. Again, it’s an unprecedented situation and I’ll accept the mandate for the three shots, but this has to have an end at some point.

Maybe at your place of employment you won't get fired for not keeping your vaccinations up to spec, but there are many employees that have had vaccine mandates for decades...nearly every hospital, most research laboratories (especially ones that handle human biological specimens), nearly every school...

I only “accepted” the mandate from my employer because I won’t risk my family’s well being for a piece of paper. I’m 100% pro vaccination (got a Moderna booster two day ago even) but am 110% against mandates.

The government using private industry as a proxy to enforce policy they know will not pass the legal process is wrong.

This isn't something that can be willed away. Your acceptance means nothing to a virus.

What's likely to happen is a covid vax will get rolled in with the quadrivalent annual flu vax so most people will just get one annual booster.

Clinics routinely require staff and physicians to be vaccinated against the flu lest there be an exemption on file.

Granted this article shared that the rate is low, it also surfaced mandates for healthcare:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3020194/

I have never heard of a population wide mandate for a flu vaccine however.

And since 2004 the average effectiveness for the flu vaccine is about 40% so I guess if you are in a high risk group it might increase your survival a bit, but not enough effectiveness for a national mandate. The death rate of the flu is about 0.01% for all populations.

I mean, would you get a surgery that had a 40% success rate if your chance of dying without the surgery was 0.01%?

You are basing your argument on population based statistics. Healthcare workers are an important, large, and uniquely at risk sub-population.

Should you rx chemo therapy this afternoon? Probably not… unless you have a known tumor. Radiating random people off the street is not a good idea—I fully agree!

Yes, which is why we should be only vaccinating "important, large, and uniquely at risk sub-population"s.

I do not mind mandates for vaccines for certain workers, but for young bartenders?

That's a false equivalence .

A jab isn't as evasive as surgery, it doesn't carry the same risks,costs,time etc

How can you be so sure?

Of course it ends, when the hospitals aren't a mess? Until then, we have to keep getting vaccines. It's clear that the wave after wave it's getting easier in the hospitals.

Remember, that hospital systems in pretty much all countries has collapsed. They have to move surgeries and some patients are even afraid to go to hospitals at this point.

> Remember, that hospital systems in pretty much all countries has collapsed.

This is just factually incorrect. This kind of fearmongering is helping nobody.

They stopped surgeries here (more or less), but it has nothing to do with any kind of shortage or lack of capacity.

Why is it three? Why can’t they make it effective with one vaccine? Hmm maybe because three vaccines is 3x the revenue they get vs. from one vaccine. They’re just not incentivized for our long term health and well being. It is a pure capitalism.

>>Why can’t they make it effective with one vaccine?

There are actual technical and medical answers to this, but somehow I have a feeling you aren't interested in knowing them.

I am interested to know. I have worked with big pharma executives, and frankly they are probably less interested to know the answer to this than I am.

I want to know why they never fully investigate why there is such a disparity of outcomes between people who catch SARS2.

One can say obesity, but what does that mean physiologically? Is it just they already how too much inflammation?

https://www.ahajournals.org/doi/full/10.1161/CIRCRESAHA.119....

Of is it that they are deficiency in some nutrient that causes the inflammation?

https://www.sciencedirect.com/science/article/abs/pii/S09466...

https://onlinelibrary.wiley.com/doi/full/10.1002/fsn3.2203

https://link.springer.com/article/10.1007/s12011-020-02060-8

Vaccines are the low hanging fruit but they are obviously are not working so well. Maybe we should all be talking about human nutrition a bit more.

>I want to know why they never fully investigate why there is such a disparity of outcomes between people who catch SARS2.

It's been, and is being very intensively investigated. We know an awful lot about some aspects of it, but the factors that lead to different immune system responses are very difficult to figure out despite many decades of research into the mechanisms.

In the first instance, the specific sites and pathways in the body the virus initially infects and propagates through make a big difference. It might initially infect the nasal passage, throat, lungs or even the nervous system. Even the specific sites in those areas and the initial viral load make a big difference to the progression of the disease.

As the infection spreads the many, many different combinations of which systems in the body are infected, in what order, how severely and in combination with what stages in the immune response, together with the weaknesses and strengths of different systems in an individual leads to a massive explosion in the number of possible different scenarios and hence likely outcomes.

A big problem though is our limited understanding of the various failure modes of the immune system, or at least in our ability to manage it. Inflamation is our immune system causing collateral damage to our own bodies. There are many, many diseases related to this and they can all be extremely difficult to treat.

> the factors that lead to different immune system responses are very difficult to figure out despite many decades of research into the mechanisms.

I totally disagree with this. It is not difficult, they are ignoring it.

Zinc deficiency is a well known risk for immunological dysfunction, yet where is all the zinc testing and research during this pandemic?

https://www.nature.com/articles/1601479

https://www.annualreviews.org/doi/abs/10.1146/annurev.nutr.2...

And Why is all this not front page news?

https://www.sciencedirect.com/science/article/pii/S221454002...

https://sljch.sljol.info/articles/abstract/10.4038/sljch.v50...

https://wjpr.s3.ap-south-1.amazonaws.com/article_issue/800cc...

https://www.cambridge.org/core/journals/british-journal-of-n...

The correlation, if it exists, is marginal and there's even some reason to suspect there's a slight negative correlation.

https://www.frontiersin.org/articles/10.3389/fimmu.2021.6993...

I have an aunt who's adamantly ant-vax. She goes on and on about how we should all be 'boosting our immune systems' to naturally protect us against the virus. The fact is there's no such thing as boosting a naturally healthy immune system. You can mitigate deficiencies to strengthen a compromised immune system, yes, but load up excessively on supplements and such and you can quickly end up suffering from toxicities to no measurable advantage. Nutrition is best left to being managed by doctors and nutritionists using the established health service mechanisms for that discipline (well, here in the UK anyway).

Nutrition may well play an important role for individuals based on their specific needs, but it's just not at all appropriate to push it as a mitigation at a population level. For the vast majority of people it's either a complete distraction or could even do more harm than good. People need specific guidance based on their health circumstances - if there even are any significant benefits at all which isn't even entirely clear.

That study did not measure anyone's zinc status, it just assumed people were not zinc deficient based on the food supply.

"The estimate was based on the food balance sheets, the bioavailability of Zn in the food supply, the estimated physiological requirement of Zn in individuals, population demographics, and stunting observed in children."

I am not pushing it as a population level mitigation. But what if 50% of people could avoid covid if they fixed their zinc deficiency?

And you even admit "Nutrition may well play an important role for individuals based on their specific needs". So why are they not letting people get tested for nutritional deficiencies? What wold that even hurt?

And I agree that your aunt is an idiot and knows nothing about nutritional genomics.

>But what if 50% of people could avoid covid if they fixed their zinc deficiency?

That's a truly absurd exaggeration. We're talking about a marginal effect on at best a marginal proportion of the population.

>So why are they not letting people get tested for nutritional deficiencies?

"they' (whoever "they" may be) are preventing people from getting tested for mineral deficiencies? Really? How are 'they' doing this?

I'm in the UK so if you're in the US maybe there's a different process, but if you're worried about your Zinc levels can't you just talk to your doctor?

>We're talking about a marginal effect on at best a marginal proportion of the population.

You have no evidence for this statement because it is not being tested. When they test patients with severe covid they find a high level of zinc deficiency.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7482607/

"The study data clearly show that a significant number of COVID-19 patients were zinc deficient. These zinc deficient patients developed more complications, and the deficiency was associated with a prolonged hospital stay and increased mortality."

I do not see how you could deny the importance of that. Does that sound marginal? So why are they not testing EVERY every COVID patient for a zinc deficiency?

>but if you're worried about your Zinc levels can't you just talk to your doctor?

1) You have to KNOW to ask and doctors SHOULD know this but they do not. 2) Doctors here will say it is useless even when you are chronically ill. 3) Most health insurance companies in the US will not reimburse for the test if they cannot give a medical reason. 4) If Fauci came out and said all doctors should test their patients for nutritional deficiencies Doctors it would help. But he never talks about it.

So no, it is not easy.

It's bee extensively, directly tested by randomised controlled trials using vitamin supplements and no effect was found:

https://www.health.harvard.edu/blog/do-vitamin-d-zinc-and-ot...

"The researchers found that people receiving the supplements, whether individually or combined, had no improvement in symptoms or a faster recovery when compared with otherwise similar patients receiving neither supplement."

Also it's just an absurd fantasy to say that 'they' are stopping people taking supplements or being tested.

"Despite questions about the overall benefit of these supplements, many doctors began prescribing them routinely in the early days of the COVID-19 pandemic..."

So some doctors have been doing this and all the options have been explored, and the kind of evidence you'd need to push this at the population level just isn't there. Look, the information is out there, these supplements are available, you can get tested for deficiencies any time you like, go for it. There is no conspiracy, it's just that overall many medical professionals feel that this has been studies and they just don't agree with you that this is a significant factor, that's all.

Why do you think they disagree, if not a genuine difference of opinion? What's the alternative narrative? The entire medical profession across many disciplines and diverse political opinions and different nationalities is united against humanity?

I am tired of people posting ONE study and think it discredits the plethora of other studies on zinc and the immune system.

I can say several things about that zinc study; it was give too late, it was not mucosal, it was performed in non-hospitalized patients. All these patients might have been fine with Zinc but low in selenium of vitamin D.

But you will not listen.

I can ask you, is a zinc deficiency good or bad for balanced immunity?

I’ve been on the other side of these types of press releases and you’re exactly right. Always report the most “impressive” numbers even if you know they don’t actually translate to a difference in outcome (usually because you don’t have that data yet).

Meta: Let say I'm 30 years old, healthy, vaccinated with JJ over 6 months ago. Denmark, Sweden, Finland have banned Moderna for younger than 30. Some countries were recommending it to people over 50. Whole communication is a mess.

Should I get a booster shot? What are the pros and cons? Is there any data on that? I asked a friend doctor and she said that I should get a test for antibody count (a lab one, not garbage test you can buy anywhere)

I was quite sick from the last shot so I'd like to avoid it. I probably had Covid in April 2020. (no tests, I had a unusually mild cold-like symptoms and my partner lost the sense of taste for a few days)

Risks (Yes, I know some of them are extremely small)

- Booster won't help with stopping transmission

- myocarditis[1], allergy reaction (boosters are only Pfizer and Moderna, which I haven't taken), driving to and from, catching COVID and other diseases in the walk-in centre.

- I could spread COVID to people in the queue for booster shots, doctors and nurses.

[1]hence the ban it for younger males in some countries.

The risk of getting a myocarditis from Covid19 is 4 times higher, than from the vaccine. Billions of people got mRNA vaccines in the last year. Probably hundreds of millions of people got Covid19 last year. Can you find an overall number of deaths by vaccination versus deaths by Covid19 somewhere? Germany recommends a second vaccine shot with an mRNA vaccine for everybody who JJ as their first shot. That is only 4 weeks after the original shot.

Generally yes, but for young men, it looks like the risks of getting myocarditis is higher from the Moderna vaccine than from covid. It is not the case for Pfizer/BioNTech.

In every case, the benefits still seem to outweigh the risks but it is recommended that young men get the Pfizer/BioNTech shot over Moderna.

> The risk of getting a myocarditis from Covid19 is 4 times higher

That's not true for people under 40 who vaccinated with Moderna, see: https://www.nature.com/articles/s41591-021-01630-0/figures/2

Do you have any source? I couldn't find data that would show it by the age group.

One that I found

Norway

Total vaccinated with mRNA vaccine = 3.765.354

Total myocarditis + pericarditis = 274 (0.0073%)

One case in 13,743

Not published yet https://youtu.be/YdVymGK3OzM?t=1095

He's given his age and sex, are you sure the 4x higher number is accurate with that additional context?

I'd get it -- J&J is already known to be weaker coverage, and Omicron spreads so easily that the odds you get COVID are fairly high if you interact with people regularly. If you're looking at it from a sickness perspective, the expected value of sickness without the shot is probably higher (lower chance of many days of feeling bad vs high chance of a single day).

Single person anecdote: I was quite sick from J&J and had zero symptoms from my booster. So just know it's not necessarily guaranteed you'll be sick from this one too if that's your main concern.

Sickness from the shot is not my main concern. I'd love to see the whole risk profile for my case. I have a feeling that governments are doing "booster for everybody" for political reasons. They don't want to single out particular age group.

Can you elaborate on these "political reasons"? I've heard other people say this, too, but I can't follow the reasoning. What is the government's ulterior end result of "booster for everybody" besides increased public health?

The only conspiracy I can at least follow along is the one where government is funneling money to their buddies at evil BigPharma, however there are plenty of easier ways to do this than a nation-wide vaccination campaign.

All the restrictions that were imposed in my country hit everybody equally. Which doesn't make sense from the risk reward perspective. For people in age group 0-30 the risk of death is close to zero. For age group 80+ is more than 15%. Orders of magnitude difference. The government tried to do a lock down for 65+, but there was a huge backlash (why they can go out but I cannot?), so the ordinance only said it's a recommendation for 65+ to stay indoors. Only thing they did is "Hours for Seniors". Only 65+ can go to shops in morning hours - 10-12 am, even though it was illegal.

There is a strong argument that boosters are pointless for young people (or even bad due to small myocarditis risk for young males), but politicians are scared of making mandatory vaccinations for 50+ only.

(Based on an interview with a well known sociologist)

Same for me. I had J&J and now moderna booster. Other than mild body pain and tiredness, booster was pretty smooth. Maybe because it's a half dosage

I don't know, I got all three shots of Moderna (two doses at 1 month interval in the summer + booster last week):

1) first dose: nothing

2) second dose: some (minor) pain in the arm I received the shot, that lasted only the morning after I got the dose (that I got around 21:00, so I probably was sleeping when it began)

3) booster (half dose): same (a little stronger) pain in the arm, nothing relvant but this time it lasted a couple days + and it was accompanied by some - cannot really describe it - slight fogginess in my brain, again nothing serious, just the feeling of not being 100% prompt/reactive

Given that this time it was half dose, I tend to believe that while in July I was probably in a better overall status before the dose due to the season (or whatever).

Exactly the same happened to my wife (we had together all the shots).

Cons: you might be sick for a day. (Had very bad reactions to the shots and this one lasted 1 day - but I caught something else before/after...)

Pros: seems to help against Omikron. And given the speed at which it spreads you don't have time to wait for updated shots or alike.

JJ was particularly bad in not catching it, and even worse after 6 months. Get a booster or have a close to 100% chance to catch Omikron.

Official communication is often skewed by availability. E.g. Germany didn't order enough BionTech but got plenty of Moderna so they announced that Moderna is way better. Just check the numbers and forget about anything else in the news. Numbers are like a weather forecast. Read it, prepare, put it aside.

The lack of transparency since day one of the pandemic is, in my opinion, the main reason for so many people to be against all measures, including vaccination mandates. From making assertions about the virus before the science was out (science rarely ever speaks in certainty), to straight out lies. From science, to pharma, to state medical officers, to government, to media, we're stuck in a terrible game of phone.

What did they lie about? lol. Cherry-picking everything

Could you cite exactly where "they announced that Moderna is way better"? All official sources I can find say that Moderna and BioNTech are "gleichwertig" (equivalent).

E.g. "Das Vakzin von BioNTech sei der Mercedes und der von Moderna der Rolls-Royce, sagte Spahn."

> https://www.tagesschau.de/inland/corona-booster-spahn-modern...

This came out the moment that the deliveries of BionTech were low. Weekly estimates are available at

> https://www.bundesgesundheitsministerium.de/fileadmin/Dateie...

The recommendations usually follow that curve. And given the current availability: good luck getting a BionTech shot.

Related: I am pretty happy how open the underlying data is. Data quality is sometimes shit (hey RKI/Gesundheitsämter, looking at you) but overall the stuff is open.

Ah, and...

KW49, 2021-12-06 until 2021-12-12 had originally 3M BionTech shots available, with KW50 blocked for kids. At the same time 10M Moderna shots were available, or 20M booster shots.

2 weeks earlier, when those order volumes became clear, Spahn advertises for Moderna.

A few weeks later and we got an extra 3M BionTech shots.

Official medical sources have been clear. But StiKo & politicians an thus media communication is skewed.

I recently pondered the should I bother boosting thing. I had covid in 2020 and 2x pfizer. I decided to get a pfizer booster - seems a bit less side effecty than moderna, and while I wasn't really worried about getting omicron myself I figured I'd be less likely to pass it to family at Xmas (I'm in London with crazy infections presently). Also it renews the vax pass thing so it should be ok for summer in the EU who are talking about a 9 month validity from the last shot. Anyway... maybe get a pfizer booster.

(Random aside - it took me till now to figure my past injections hurt because I tensed the muscle - if you relax it you feel way less)

FWIW your reaction to previous vaccines/doses doesn't predict your reaction to future vaccines/doses.

Up until my second COVID vaccine I had never had any reaction to any vaccine other than a bit of pain in the injection site. My first COVID shot caused zero symptoms. So I was surprised when my second shot caused a day of flu-like symptoms. My booster, however, caused no symptoms other than swollen lymph nodes in one armpit.

I had J&J in April, and it kicked my butt for a solid 24 hours. I got Moderna's booster in early Nov and had I not gone for a 12 mile run the morning afterwards, I probably wouldn't have noticed it. Obviously everyone will have different reactions, but thought I'd share my anecdote.

Get a Moderna. Omicron isn't the only variant that you have to worry about, Delta is still ravaging people (and the booster is much more effective against it).

Often the booster is a half dose, so you may not be as affected by a booster as you were from the original shot(s).

Another pro you might not hear about much is sleep. I slept like a baby the night I had each shot.

This number is unfortunately fairly meaningless. Neutralizing antibody-titer is of course somewhat related to ability to resist infection, but how much is unclear.

Also there is no reason to expect the antibody-titer to stay high and it will probably go down quite a lot within the next 3-6 months, just like antibody-titers did after first round of vaccinations and seems to do after Covid-infection.

At this point it almost seems a bit disingenuous for Moderna to not study and publish numbers on expected antibody-titer half-life.

And what is difference in outcomes? That's the important stuff.

https://www.nature.com/articles/d41586-021-03672-3

Best I could find says 40x better protection which isn’t the same comparison in above article.

But how does this reduce over time?

This concerns omicron, and omicron is a quick worker. The British measured its doubling time to 1.5 days in London, which means that it goes from one infectee to a million in just a month. What happens later is not really significant.

No, I meant how does the booster effect reduces over time.

The effectiveness of the first two over time went down much quicker than initially anticipated. The question is if the 3rd shot is somehow different.

Nobody knows for now since I haven't read any official study/data on that.

One thing for sure is that it is likely to follow the path of the previous two shots: antibodies are going to fade with time but you will still be protected against severe illness.

I see. It has to be an improvement AIUI, but how large is an open question still.

So how does this compare to all the other boosters?

From the few information that we have now, it looks similar to Pfizer/BioNTech. Better if you get a full dose instead of the usual half dose.

I only realised how serious a threat omicron was when I looked at the South African data recently and you can see how much of a impact it's had on deaths in a largely unvaccinated population.

Even if you just compare the case numbers in South Africa to the UK (where most are double or triple vaxed) you get a good idea of how well vaccines are working.

For example, in South Africa deaths have gone from about ~15 a day before omicron to ~30 a day since the variant was first identified, which is terrifying. And in South Africa they have around 20,000 new cases a day compared to about 80,000 in the UK -- imagine how much worse it would be in the UK right now if they weren't vaccinated.

Anyone still doubting the efficacy of triple vaccination in healthy populations really needs to look at the data. The South African health authorities are wrong, omicron is a serious threat to our health and if we must fire a few people to ensure another successful Pfizer vaccine rollout, then so be it.

Apologies for the sarcasm, but as some with COVID antibodies from a prior infection which I recovered from in about a day, I am genuinely getting frustrated by how much fear and pressure the government is pushing on me to get vaccinated every few months, when the data on how effective they are at managing the pandemic (even after several doses) seems completely inconclusive. Even if this booster did prevent infection by any substantial amount, are we sure we all need them? And further, are we sure the risk justifies governments and employers pushing them on us via the rollout of various mandates and health passports?

South Africa has 20,000/day cases which is about the same they had in July, yet they peak at 30 deaths/day vs 400 deaths/day in July. To estimate the fatality rate of a variant, you need to do it within the same population. At the current rate, Omicron is literally as deadly as influenza in South Africa [1] and, as the current wave passed its peak, it might be even less deadly than that.

PS: parent post is sarcastic

[1] https://www.cdc.gov/globalhealth/countries/southafrica/what/...

You can't go by cases/day though--there's a cohort problem.

In the slow growth scenario, when you are at 20,000 cases a day, the deaths on that day are from the seeds of cases that started "long" ago. When you get to 20k on the back of a growth explosion, those cases are all "brand new."

This is not to say that it won't be less deadly, just that judging it that way is very flawed.

This is true in theory but I don't think it matters in practice. Median time between symptoms onset and death is 7 days for the 2nd wave in the UK [1] which is pretty short and doesn't allow for "old seeds". The tail of distribution is also quite thin. Those number might be different for Omicron but nothing points to that as far as I know. Unless Omicron-sick people die on average 2 months after infection I don't see how it could be equally or more deadly.

[1] https://assets.publishing.service.gov.uk/government/uploads/...

I really hard to compare UK and SA.

- average age 28 SA vs 40 UK

- a lot of immunocompromised people in SA (AIDS)

- UK has most of it immunity from vaccination which was mainly targeting AC2 receptor. It's possible that natural immunity or Sinovac (attenuated virus) has better protection than mRNA vaccines - not confirmed.

- SA is doing fewer tests.

> average age 28 SA vs 40 UK

I think this is definitely part of the explanation.

> A lot of immunocompromised people in SA (AIDS)

Wouldn't this mean more deaths or am I missing something? Are COVID deaths in AIDS patients attributed to AIDS not COVID?

> UK has most of it immunity from vaccination which was mainly targeting AC2 receptor. It's possible that natural immunity or Sinovac (attenuated virus) has better protection than mRNA vaccines - not confirmed.

Okay, so should we perhaps not be pushing vaccination on healthy individuals? I had a COVID infection early on in the pandemic and I've interacted with infected people since and not caught it. My sister who's younger than me (in her 20s), but was vaccinated before being infected has tested positive for it 5 times. Perhaps just a coincidence but odd that she's so much more susceptible to it.

> SA is doing fewer tests.

Sure, but deaths are much lower too.

>Wouldn't this mean more deaths or am I missing something? Are COVID deaths in AIDS patients attributed to AIDS not COVID?

I don't know about SA but many countries count any dead person who was infected with COVID as a COVID death, which is a convenient way of padding the numbers.

Yeah, this was my immediate thought. In the UK it would be counted as a COVID death, so assuming South Africa are recording numbers similarly you would expect COVID deaths to be higher in the more immunocompromised population if anything.

> Wouldn't this mean more deaths or am I missing something? Are COVID deaths in AIDS patients attributed to AIDS not COVID?

That's the thing, it's really hard to compare. There is no standardisation. You can have a person dying from AIDS counted as a COVID death. The other extreme is that someone with AIDS, in theory, could have a COVID infection for decades and be tested n times.

I think you're right overall, but that the data doesn't yet support the conclusion. Omicron got traction in the UK at least a week later than SA, probably 2 weeks, so the death rate will lag by the same margin. We need to compare the death rate in the UK now to the death rate in SA a few weeks ago.

All the early indications are that the complete data will support your conclusion when it comes in, but frustrating as it is we'll have to wait and see.

So in terms of a government response do we care about data now or are we at the point where we just restrict liberties and mandate vaccines assuming the worst possible scenario every time something changes? I guess if we're lucky when the data shows they over reacted they might give some liberties back and hopefully the vaccine rollout won't result in too many adverse side effects. Common.. This is insanity.

I honestly don't know what you're arguing for here. I don't care if people take the vaccine or what the outcome of omicron is, my issue is with the government response given the data we have. The data supporting the use of vaccines to tackle omicron is extremely questionable. And that's not even mentioning the fact that it's already questionable enough to mandate COVID vaccines on healthy individuals given recent data suggesting those vaccinated have less robust immune responses to COVID and all of its potential future variants.

>I honestly don't know what you're arguing for here.

I'm arguing for correct interpretation of the data. I didn't advocate for any particular action to be taken in my post, so somewhat surprised you inferred such.

>when the data shows they over reacted

When. You seem very sure. Almost as though you've already made up your mind about facts we don't have yet, exactly what I'm cautioning against.

OK, since you seem to want me to argue for something more I'll do so. I support the booster programme based on the same reasons it was already started long before Omicron was discovered. The risks seem extremely low, while the potential benefits seem extremely high. The vaccine rollout here in the UK has been a fantastic success that's transformed our ability to manage the effects of the virus, and I think we need to push forward with it.

With respect to comparing South Africa to UK, there’s probably a lot more going on besides vaccine availability. Presumably as a wealthier country, UK healthcare is better and not as thinly stretched as South Africa (where Omicron was first detected), for example.

I'm sure there are a number of factors worth considering here which could account for some of the data, but if vaccines were truly as efficacious as governments and pharma companies have been suggesting then given the success of the UK vaccine rollout can we honestly say this is the trend we would expect to see?

I completely accept this isn't proof that vaccines are not effective at managing the pandemic, but the fact data like this is so hard to justify within the context vaccines being highly efficacious it's a bit concerning, especially since it's not like we have much of a choice but to get it here in the UK. My partner is getting her booster today, not because she wants to or feels she needs to (also had a prior infection) but because she feels pressured by government policy. Then just last night I was out shopping and a ~30 y/o guy in the store was complaining about having chest pain since getting his booster, and I've had many similar experiences over the last few months. I hate brining up anecdotal evidence because I know it means nothing, but what I'm seeing with my own eyes in the real world and in the data right now is so hard for me to understand within the context of a safe and effective vaccine. If the data was clear then fair enough, but it's far from clear. I don't want that to be the case, but it is.

What's worse is that every time I've brought this up the response I've received has basically been dismissal, "must be some explanation, vaccines are effective".

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