Cancer vaccines: the next immunotherapy frontier
nature.com
nature.com
We need to improve public education about why we believe these medicines work. I want to see the studies presented on social media: "We gave 30,000 people this drug and you won't believe what happened!" Less censoring people and more presenting the studies in a way people can understand. Less appealing to authority and more appealing to observations; yes, you observed your 2 relatives, and I observed 30,000 people, judge for yourself which is more persuasive.
Most people aren't going to read your 3 paragraph abstract, let alone the the full paper. You have to tell them the observations in a few sentences, preferably with minimal added interpretation.
When I think of vaccines, I think of something that’s preventative - regardless of the mechanism. Even the coming “Lyme Disease” vaccine is still preventative though it’s more of a tick bite vaccine.
Someone please school me.
Why is it a therapeutic vaccine - what’s wrong with calling it a treatment?
There are many vaccines that can be given after exposure, for example the rabies vaccine: https://en.wikipedia.org/wiki/Rabies_vaccine
While most are prophylactic, it's not a requirement to be considered a vaccine. Vaccines are not "meant to prevent a disease". They're meant to provide immunity to the disease, whether that be before (prophylactic/prevention) or during (therapeutic/treatment).
Vaccines are used to teach/modify your immune system to fight something. Whether you have it or not is not part of the definition[0].
[0] a substance used to stimulate the production of antibodies and provide immunity against one or several diseases, prepared from the causative agent of a disease, its products, or a synthetic substitute, treated to act as an antigen without inducing the disease.
We've had two years of that... get vaccinated and you won't get it, also get vaccinated and you won't get your grandparents ill!
Somehow all the censoring was done on people who didn't believe these claims.
...and people here got all snarky when I mentioned her death, and attacked me with stuff like "what are your qualifications to rule her death as caused by vaccines?" and "i'm guessing you did the autopsy yourself?"
I thought the vaccine message was "get vaccinated so you won't die when you get it."
Various people gave their hopefully somewhat informed opinion at the time to different members of the media, who reported on it with different levels of accuracy, attributing often undue levels of confidence to it. And that quickly mutated into "the media's trusted sources can confirm that the experts definitely know the vaccine will have exactly these effects and will be effective for these specific cases"
I think it's worth questioning what influence there was in which narratives did or didn't get pushed, but I also think it's worth keeping in mind that the media is also just... fallible.
https://news.ycombinator.com/item?id=33736959
I understand if some random chiropractic from alabama says something, that the data is probably questionable... but the director of CDC does carry some authority.
If if _we don't know something_, isn't mandating that something (vaccines in this case) somehow a bad thing? On one side... "take this, and you won't get sick"... who is responsible when that person gets sick? Or infects grandma? Or actually gets a clot?
That said, a doctor never says “you won’t get sick”. Medicine is never certain, the human body is too complex to generalize and say “this will cure you 100% sure, no bad reactions possible”. There’s always a chance that something will go wrong. Clinical essays are what makes possibility go down, but it is never 0.
If you want absolutes, go to a priest. They will give you an absolute that matches your own pre assumptions and if it turns out wrong later, well God wanted it this way, He works in misterious ways.
That's not bad communication it's an outright false statement.
My point was specifically about the expectation of fail proof medicine. It doesn’t exist.
But in my country (slovenia), at the height of pressure to get vaccinated, if you were a young girl/woman (15-24 age bracket), the "96%" from above turned to "you'll probably still get covid, you'll still spread it, if you do, not one girl in your age bracket died yet because of or even with covid, but one girl died due to the vaccine... but, if you don't take the vaccine, you'll have to get tested every 48 hours or you'll be unable to go to work (oh, no testing center in your village, and you're not allowed to take the bus to the closest test location without a test)".
It’s choosing between that and … “a girl who died in Slovenia”. How are those two things equivalent?
Even if you can spread COVID, if the effects in your body are lowered, chances are that you will remove the virus it from your body earlier (it can dedicate more resources to winning the battle instead of … breathing), so you will be effectively less contagious.
Instead, tell people about the trial control group vs treatment group, let people see that there is risk on both sides, but that the treatment group was ultimately better off. Use minimal interpretation. I'd like to see so much focus on the trial outcomes that the number of people who died in both groups is a household fact that families talk about.
There is nothing so obvious that people cannot fail to understand if sufficiently motivated.
So, 3/4 vaccines went from safe to "clot shots" in just a few months.
> Simonovič presented the composition of the five-member commission, namely, three doctors (neurologist, infectologist and vascular specialist), a pharmacologist and Zoran Simonovič, a representative of the epidemiological profession. The commission reviewed the medical records of a 20-year-old patient who developed thrombosis with thrombocytopenia syndrome following vaccination. The documentation included a treatment procedure as of the admission to the Clinical Department of Neurology in Ljubljana and a health record obtained from the patient’s personal doctor.
> The commission confirmed thrombosis with thrombocytopenia or vaccine-induced immune thrombotic thrombocytopenia. All criteria were met for the fulfilment of the diagnosis. Upon examining the medical records before the vaccination, the commission established that no conditions had been identified in the patient that could indicate problems after vaccine administration. “The commission unanimously assessed that there was a direct link between the vaccination with Janssen Johnson & Johnson and the tragic complication, i.e. the onset of the syndrome”, said Simonovič.
That said they also lost track of or dropped 500-1000 people from that 40,000 sample.
Multiple people died over the course of the efficacy study for the BioNTech/Pfizer vaccine, and yet they completed the study: https://www.nejm.org/doi/full/10.1056/nejmoa2034577
In general, what you claim would seem both surprising and impractical to me. There are many studies on very seriously ill groups, where the death of a large portion of participants is expected.
You realize people die all the time? Even when participating in clinical trials?
In the Pfizer mRNA vaccine clinical trial there were actually more deaths in the vaccine group than the control group, but the sample size wasn't large enough to draw any conclusions from this.
It was a massive cock-up by the government.
> And we have -- we can kind of almost see the end. We`re vaccinating so very fast, our data from the CDC today suggests, you know, that vaccinated people do not carry the virus, don`t get sick, and that it`s not just in the clinical trials but it`s also in real world data.
https://web.archive.org/web/20210402002315/https://www.msnbc...
TLDR: We knew the mRNA vaccines were effective at preventing serious disease in late 2020. We didn't know for sure (publicly) if the mRNA vaccines reduced transmission rates until mid 2021, as more research concluded. Mid 2021 is when it was demonstrated that mRNA vaccines reduce transmission of the variants of SARS-CoV-2 at the time. As SARS-CoV-2 continues to mutate, more research needs to be done.
Delta was named at the end of May 2021 and started to become the dominant strain worldwide in the following months. As shown in the chart under ”Prevention” (and described in the linked pages), Delta significantly reduced vaccine effectiveness against infection and symptomatic disease, though not against severe disease.
However, it’s also true that vaccine effectiveness, regardless of variant, significantly declines over the months following the dose - again, much less so for severe disease than for any symptomatic disease.
It was quite eye-opening how fast the mainstream narratives were rewritten.
(I have had 4 doses by the way, I'm not going to cut my nose to spite my face: knowing that vaccines were oversold is not the same as believing they're useless).
The Moderna CEO is at least honest enough to say by now it should be treated the same as a flu vaccine. If you want to you can get your yearly dose and if you don't up to you. Pfizer on the other hand was actively whining about how they created too many doses and how they can't milk it any more.
If it was up to me I wouldn't have gotten the third one, but the fact that they've intermingled it with travel restrictions when it does not in fact prevent spread is quite infuriating.
It seems that people have also forgotten that the antibodies compared to other vaccines(which can be in decades for hepatitis for example) fade rather quickly and that if you got infected quite far out from your last shot, and were only mildly symptomatic it might not actually have been the vaccine that protected you but rather your own immune system and the fact that the whole thing isn't as deadly anymore.
To be clear, are you saying that this is bad? "mainstream" and "rewritten" are loaded words usually deployed as insult.
But the scientific process is one of learning from reality, and admitting past errors, so isn't an increase in knowledge a good thing?
Admitting past errors without also acknowledging the current knowledge is just as fallible is nothing but empty words. It's also a very rose tinted interpretation of what has been happening. The messaging has always been "These are this week's truths. They are absolute truths, and we'll enforce these truths at gunpoint, for these truths are infallible, and The Science is settled."
What I didn’t expect was the overconfidence and then reversals, without missing a beat, and without acknowledging “hey, we were wrong”. The stuff around masks… first ”they don’t work”, “they make it more likely to get infected”, “people won’t know how to use a mask”, “masks are a superstition” then switching to mask mandates, without admitting that those who expressed those views got it wrong.
The reason I used “mainstream” was to show that these were people in positions of trust. News outlets with editorial controls, public health officials, elected politicians. Or doctors. It happened both on traditional, and social media and IRL. The term was not meant to be pejorative, but descriptive.
Vaccines are similar: there are many clips that show pundits, media figures and public health officials overselling vaccines. Instead of later saying “the preliminary data looked good so we assumed they would stop transmission and infection, but it turns out that these vaccines reduce serious illness and death. We were wrong, but it’s a new disease and we are all learning, that’s how science works” we got “we ALWAYS said that vaccines were meant to reduce illness and death and not infection and transmission”.
Maybe I hate being gaslit more than most. My mother, an intelligent woman who I love and respect, in an effort to spare my feelings as a young child, would try to warp reality: “oh you never had the toy that’s missing”. She probably thought I wouldn’t remember, but did. She continued that pattern throughout my childhood. Whatever the reason, I intensely dislike that sort of manipulation, and I think it’s corrosive.
I'm not in the USA, I got onto masks quite early. But I think that we still lag badly in anti-covid ventilation systems, while still over-emphasising hand-washing.
Some of the best people on the topic (of our evolving understanding of COVID, not of Scotsmen) have in fact been relative outsiders (i.e. neither medical researchers nor crazed conspiracists). I'm thinking particularly of Zeynep Tufekci on Airborne transmission, e.g.
https://www.theatlantic.com/health/archive/2020/07/why-arent... https://sils.unc.edu/news/2021/tufekci-lancet
You can access the clinical trial protocol by googling it. They never regularly tested patients in the trial, only when they were symptomatic. There is no clinical trial data to prove a reductions in infection or transmission.
If this was some non-mandatory voulountary vaccine.. sure, test one thing, then another,.... If you were put in a position where you were effectively forced to get it (or else you'd eg. lose your job), such things should be tested first.
Vaccines suffer from their effectiveness. For comparison with covid, measles killed only a few hundred each year (in the US). Vaccination to the level of herd immunity was required to reduce that number; if only half the population were vaccinated, we'd see half those deaths. Covid is still killing roughly the same number of people each day as measles killed in a year, yet people resist getting vaccinated. It's objectively stupid.
To your exact point, your employer should be entitled to set the safety protocols that are necessary to ensure the health of their workforce.
Lab coat Clickbait?
Antivaxxers aren't exactly scientifically inclined skeptics who will change their minds if fed more objective, impartial evidence.
They probably can be reached but I'm certain this isnt the way.
Censorship and hiding criticism (informed or not) ‘for the greater good’ is like throwing gasoline on the fire. I have a family member who was merely just a lightweight New Age/holistic type of…skeptic. But the whole COVID response made it way worse. She doesn’t watch videos about why vaccines are bad, 90% of them are how the virus government/billionaires/big tech did x shady thing, so therefore don’t trust the vacinnes.
It’s really easy to spin that sort of thing into “they must have something to hide”.
I highly doubt all of the effort Facebook, Twitter, YouTube etc put into silencing dissent really did anything to promote better science or quell the fringes.
I don’t think anyone even cares if it did or not after-the-fact.
The other problem is resorting to force. If you mandate something to a Texan, you better believe they're resist the hell out of it, even if they know it's in their best interest otherwise. I have several friends that knew it was in their best interest to get the vaccine, but their libertarian values/morals drove them to take a stand against their companies who tried to compel them to take it. Medical freedom, which I largely agree with, but I was first in line to get the shot voluntarily.
It is immensely satisfying to see people finally, finally saying this on here.
Somewhere around a year ago in one of the covid vaccine posts, the top post was something along the lines of "Fine, I don't care anymore, I'm done trying to help these people" in reference to mandating/coercing people to take the shots. I responded with "And their response will be 'Finally! That's all we've wanted this entire time!'. People on here [HN] don't seem to realize just how much 'these people' value freedom over safety."
My comment did get a lot of upvotes, but the large thread that generated had so many people who just didn't understand the sentiment at all, it was an amazing demonstration of the bubble HN exists in.
That's a poor stat for measuring ideological adherence when anyone who travelled over 1.5yrs+, worked a job with people, worked in gov, etc or lived in a place with mandates and wanted to go to retail stores or any public event was forced to take it.
If the overreaction to dissent ultimately played a bigger role in fueling - rather than preventing it - then it's not a worthy 'greater good' (Streisand effect en masse). Playing a central part in turning millions of people from harmless 'alternative health' skeptics to hardcore anti-gov is something that will have long term consequences.
You're either a good guy or villain.
Would they have been so receptive if it was a stranger rather than a family member feeding them the same information?
The example I was thinking of wasn't a blithering idiot. He was an engineer who was afraid of needles. That kind of turned him into an idiot with respect to vaccines.
I know a bunch of anti-vaxxers in New Zealand, and they notably each had a different stated reason for being antivax. Perhaps because we don’t have the same political partisanship in this country (although partisanship was still a factor: it was interesting hearing right leaning people here reproduce sound-bites that I thought were American Republican political cliches).
Which is why local censorship is becoming dumber than ever with a global internet, something I saw often here in Canada.
Although I guess some people hope their views become a part of some global cohesive overton window. Maybe with some super-efficient global media/internet moderation system it will finally stop people like my conspiracy relatives. But so far they've only made it worse.
I'd actually be OK with letting Darwin run his train on those populations, if they weren't also recklessly causing the illness, disability, and death of their innocent neighbors who for age, health, or other legitimate reasons cannot get a particular vaccine. Should a child that's allergic to the MMR vaccine experience encephalitis and face possible lifelong disability or even death because his schoolmate's mom or dad worships a blathering radio host or a washed up model peddling conspiracies for profit?
I suspect most of you grew up in clean western neighborhoods. I grew up with a schoolmate and a member of my household, each severely disabled by polio. They drew a short straw and weren't lucky enough to have well functioning healthcare apparatuses in their birth countries. And for that crime, they were robbed of significant bodily mobility forever. That so many in the US would have us move toward that awful state of affairs instead of away from that is disappointing but I suppose not terribly surprising.
When I was younger, I thought only the simple minded were so easily conned and steered by hacks and hucksters but the last 20 years or so have demonstrated that many intelligent and educated Americans are just acutely gullible.
I do however, consume lot's of media on how the vaccines are bad, and I'm skeptical of media that glosses over the science aspect and focuses on far fetched control conspiracies only. Limited hangouts and poisoning the well are misinformation tactics fwiw.
>more propaganda
No.. we need to improve transparency and actually do the studies?
do need masks we lied because we think you’re stupid and would hoard all the masks
now you don't believe we need masks because we said prevent instead of reduce, and nothing was prevented
now you bolstered your opinion because we said “no evidence” instead of “the study hasn't been completed”
yes we said it affects young people and that caused a panic as if it was 1918 all over again, but you have to understand that 50 year olds are young to us and we are always speaking in a health professional context that nobody else knows even during the one time the public needs clear communication
People panicked and hoarded toilet paper, of course they would also have hoarded masks and deprive healthcare workers of them.
B) This burns credibility by saying an obvious lie. People aren't just gonna immediately forget that the government just lied to them because "they couldn't handle the truth".
It with also be interesting to see if the technologies used could lead to dramatically better vaccines for ordinary acute conditions. There is some evidence that people with pre-existing cellular immunity to intercellular antigens expressed very early in the lifecycle of a Covid-infected cell confers very strong immunity. The current vaccines don’t provide this sort of immunity, but the cancer vaccines are mostly targeting cellular immunity to intracellular antigens.
That being said, we still have cost problems even for not-so exotic treatments like bio-similars drugs (the generic equivalent for biologic drugs such as insulin). A lot of these drugs are off patent but still highly difficult and expensive to produce. Solving this bottleneck will be hugely beneficial to a lot of people
It's not a silver bullet but it will help if the patient responds and the cancer is not aggressive enough to kill the patient before the immune system is reactivated to fight the cancer successfully.
If it does work it looks very likely there will be no relapse.
This is a bit disingenuous. The mentioned therapies were developed from scratch in those time frames, whereas vaccine technology has been around for over 3 times as long. CART cells are also a much more complex and difficult therapy than vaccines…
There are many different kind of cancers, and metastasis' complexity further complicates the treatment. I guess the best hope is to get a bleeding edge medical treatment by joining a clinical trial, (and hoping to not be in the control arm).
Did you hear about CUSP9:
This is like preventively giving broad spectrum antibiotics to animals raised in super dense cage farms. You wouldn't need most of them if you weren't raising them in hellish conditions, and the long term consequences are dire
Mostly post-surgical, but I wouldn't be surprised if eventually used for metastatic as well. Good luck to all involved.
Got to give it to the internet. Railing against a hypothetical cure for cancer.
Not if the cancer vaccines are as effective at preventing cancer as the covid vaccines are at preventing people getting covid.