3 ms·

A vaccine is months or years away whereas variolation can be deployed right now.

by frank2 6y ago

powersnail 6y ago
To deploy it, wouldn't it need to be tested just like a vaccine? Or is it suggested to just deploy virolation without testing?
- frank2 6y ago
  >is it suggested to just deploy [variolation] without testing? Yes: the blog post by economist Robin Hanson suggested deploying it without waiting for the results of testing. (Of course, it would be good to test as fast and as much as possible concurrent with the deployment.) "deploying it": making available to the public a variolation service or procedure designed by medical experts.
  - vikramkr 6y ago
    If we're lowering the standard, why only lower it for inoculation? We can just start deploying the dozen+ vaccines we have in development too if we decide testing isn't important.
    - ggreer 6y ago
      I'm pretty sure Robin Hanson would want challenge trials with experimental vaccines as well. The issue is that authorities won't allow such trials, not that there is a lack of willing medical experts or volunteers. Though vaccine trials aren't quite as safe for the public as variolation. If a vaccine doesn't work, the person can spread the disease. If variolation doesn't work, then it has the same mortality as natural infection, but afterwards the person is immune and can't spread the disease.
janekm 6y ago
The reason a vaccine is months or years away is only because we are testing whether it is safe enough to give to billions of people. The reason we do that is because a virus can cause disease both directly but also in unexpected ways (e.g. by immune over-reaction to some of the viral RNA in some individuals). Variolation as a public policy would have to go through the same safety testing for the same reasons (as it is a form of vaccination with un-weakened virus). You would also still have to produce doses of the variolate, both in terms of replicating the virus and bottling it. There is no real time advantage to variolation. Anybody making the case for variolation without validation would be better off making the case for vaccination with one or several of the 30 vaccine candidates under study for SARS-Cov-2 right now (a case could be made... allow volunteers to be given the candidate vaccine of their choice in larger numbers than normal clinical trials, scaling up as the risk profile of each candidate vaccine is known).
- frank2 6y ago
  I am not an expert (but neither are you, I am guessing). >Anybody making the case for variolation without validation would be better off making the case for vaccination with one or several of the 30 vaccine candidates under study for SARS-Cov-2 right now The advantage variolation has over the 30 vaccine candidates, I am guessing if the question is what to do before the results of testing are available is that most of those 30 candidates will turn out after being tested to fail to confer significant immunity. I believe that the fate of most vaccine candidates for any disease is that testing reveals that the candidate fails to confer immunity to most or all of the people it is given to. Also I believe that it usually takes at least a year to produce enough of a vaccine to test, then test, then analyze the results of the testing.
  - vikramkr 6y ago
    Variolation could fail as well. It would still need to be tested for safety and efficacy.
    - Matticus_Rex 6y ago
      Tested for safety? We know what it does. It gives a low dose of the virus. If we know most people will get it anyway, then we don't need to know more than that in terms of either safety or efficacy.
      - vikramkr 6y ago
        A low dose could trigger an incomplete immune response leading to antibody dependent enhancement (ADE) on exposure to the virus in the future. Other Coronavirus are known to have that characteristic, we dont know if this strain does. Safety is making sure that we aren't priming people to get worse versions of the disease like what unfortunately happened with dengue. https://www.pnas.org/content/117/15/8218 https://www.pnas.org/content/117/15/8218 https://en.m.wikipedia.org/wiki/Dengvaxia_controversy https://en.m.wikipedia.org/wiki/Dengvaxia_controversy

A vaccine is months or years away whereas variolation can be deployed right now.

by frank2 6y ago

A vaccine is months or years away whereas variolation can be deployed right now.

To deploy it, wouldn't it need to be tested just like a vaccine? Or is it suggested to just deploy virolation without testing?

frank2 6y ago
>is it suggested to just deploy [variolation] without testing? Yes: the blog post by economist Robin Hanson suggested deploying it without waiting for the results of testing. (Of course, it would be good to test as fast and as much as possible concurrent with the deployment.) "deploying it": making available to the public a variolation service or procedure designed by medical experts.
- vikramkr 6y ago
  If we're lowering the standard, why only lower it for inoculation? We can just start deploying the dozen+ vaccines we have in development too if we decide testing isn't important.
  - ggreer 6y ago
    I'm pretty sure Robin Hanson would want challenge trials with experimental vaccines as well. The issue is that authorities won't allow such trials, not that there is a lack of willing medical experts or volunteers. Though vaccine trials aren't quite as safe for the public as variolation. If a vaccine doesn't work, the person can spread the disease. If variolation doesn't work, then it has the same mortality as natural infection, but afterwards the person is immune and can't spread the disease.

janekm 6y ago

The reason a vaccine is months or years away is only because we are testing whether it is safe enough to give to billions of people. The reason we do that is because a virus can cause disease both directly but also in unexpected ways (e.g. by immune over-reaction to some of the viral RNA in some individuals). Variolation as a public policy would have to go through the same safety testing for the same reasons (as it is a form of vaccination with un-weakened virus). You would also still have to produce doses of the variolate, both in terms of replicating the virus and bottling it. There is no real time advantage to variolation. Anybody making the case for variolation without validation would be better off making the case for vaccination with one or several of the 30 vaccine candidates under study for SARS-Cov-2 right now (a case could be made... allow volunteers to be given the candidate vaccine of their choice in larger numbers than normal clinical trials, scaling up as the risk profile of each candidate vaccine is known).

frank2 6y ago
I am not an expert (but neither are you, I am guessing). >Anybody making the case for variolation without validation would be better off making the case for vaccination with one or several of the 30 vaccine candidates under study for SARS-Cov-2 right now The advantage variolation has over the 30 vaccine candidates, I am guessing if the question is what to do before the results of testing are available is that most of those 30 candidates will turn out after being tested to fail to confer significant immunity. I believe that the fate of most vaccine candidates for any disease is that testing reveals that the candidate fails to confer immunity to most or all of the people it is given to. Also I believe that it usually takes at least a year to produce enough of a vaccine to test, then test, then analyze the results of the testing.
- vikramkr 6y ago
  Variolation could fail as well. It would still need to be tested for safety and efficacy.
  - Matticus_Rex 6y ago
    Tested for safety? We know what it does. It gives a low dose of the virus. If we know most people will get it anyway, then we don't need to know more than that in terms of either safety or efficacy.
    - vikramkr 6y ago
      A low dose could trigger an incomplete immune response leading to antibody dependent enhancement (ADE) on exposure to the virus in the future. Other Coronavirus are known to have that characteristic, we dont know if this strain does. Safety is making sure that we aren't priming people to get worse versions of the disease like what unfortunately happened with dengue. https://www.pnas.org/content/117/15/8218 https://www.pnas.org/content/117/15/8218 https://en.m.wikipedia.org/wiki/Dengvaxia_controversy https://en.m.wikipedia.org/wiki/Dengvaxia_controversy