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Good, but the real question is whether the immune system will "remember" the vaccine for long enough. From [1]: > Although the magnitude of neutralizing antibo

Good, but the real question is whether the immune system will "remember" the vaccine for long enough. From [1]: > Although the magnitude of neutralizing antibody (nAb) responses correlated with disease severity, there was a rapid decline in nAb titres in most patients within 3 months after onset of symptoms. [...] However, the consequences on secondary immune responses and their ability to prevent reinfection remain to be determined. [1]: https://www.nature.com/articles/s41577-020-0405-3 https://www.nature.com/articles/s41577-020-0405-3

CyanLite2 6y ago
nAbs don't last forever, for any infectious virus. That's what T-Cells and B-Cells are for. This vaccine showed a T-Cell response, which means it SHOULD last long enough. T-Cells from SARS survivors have lasted 11+ years. But we won't know until 2-3 years from now. We can't wait that long. I say ship it to production now, and do a v2.0 release later.
- zmk_ 6y ago
  This is a very dangerous approach and would just add fuel to the antivax fire. Even if drugs/vaccines are effective that does not mean that they do not come with severe side effects. Imagine injecting the whole population with Thalidomide...
  - objektif 6y ago
    Obviously nobody will force you to get the vaccine. A lot of people will be ready to take the minimal amount of risk. I assume you are not forced to work from home while taking care of kids at the same time :)
    - libertine 6y ago
      I'm pretty sure it will be mandatory in a lot of countries, but it will probably be done in waves.
      - dvirsky 6y ago
        It won't be mandatory but you probably won't be able to work and your kids won't be able to go to school.
    - zmk_ 6y ago
      It is not about me; and I actually think that if there is a safe and effective vaccine that vaccination should be obligatory. This was just a Phase I (healthy subjects) and most of drugs/vaccines are successful at this stage. Drugs are not software, you cannot ship a broken product and then fix it. Even if it is safe, but not effective, it would do more harm than no vaccination, as vaccinated people would change their behaviour.
  - libertine 6y ago
    >This is a very dangerous approach and would just add fuel to the antivax fire. I still haven't wrapped my head around antivax... I mean, isn't that the product of poor education and lack of mandatory vaccination programs? Where I'm from, you can't even sign-up children in school if they don't have the proper mandatory vaccinations - and school is mandatory, which makes it impossible to evade. If they don't get the parents because they didn't take their child for vaccines (which is almost impossible because you're assigned a family doctor and he would flag it), they will get them when they'll sign them up for school. If they don't sign them up, social services all over them by then. I know there are antivax people here, but they basically just avoid taking flu shot, all the rest they had to have them at some point. Hell if they cut themselves and need stitches, they will get a tetanus shot.
    - zmk_ 6y ago
      In Poland, where I am from, there is both obligatory vaccination programme and schooling; yet the antivaxers are plentiful. The obligation to vaccinate rests on the parents (+requires their approval from what I understand) and their current GP so if they are creative they can avoid vaccination of their kids. This also affects recommended vaccinations, like HPV. In Denmark, media coverage of alleged side effects led to a substantial drop (or delay) in vaccination against HPV (Hansen et. al, 2018).
    - Zenst 6y ago
      > I still haven't wrapped my head around antivax... It's a tough one in some ways, but more gets down to how you define what an antivaxer is. I have a friend who will never have another flu shot and be weary of this vaccine - WHY, well he had his first ever flu jab a few years back, which had bad side effects for him and he lost hearing due to it in one ear. Hence, he's very weary of such vaccines now and yet, some people would label him an antivaxer! I don't think he is as he is basing his opinion on self education and more so, experience as well as he don't push his choice decisions onto others. See medicines and vaccines have side effects, most people won't get any, some will get a few and a very few will have adverse effects. My worry is those who have had bad experiences and maybe more prone to side effects in some medicines due to genetics etc, get labeled as antivaxers and their very real personal experience is overlooked and they are viewed as crackpots when talking to medical advisers in the future, let alone society. But then for me an antivaxer is somebody who actively promotes the non-use for everybody period and run with that. Now I don't know anybody like that, but can see how some may of come about via a few edge cases and propergating that onto the whole. That is a case of needing education. If some people want to make an informed choice about individual vaccines based upon their medical concerns that are real and not anxieties - well, that's how it should work. Though if they actively promote their choice onto others, well, that's not right and what I would class as an antivaxer. Me, I sent email to to the research folks offering to be a human lab rat if it helped speed up vaccine development, not that i'd call myself a provaxer - just case of the maths made sense and as spoke said - the lives of the many outway the lives of the few. Besides I'm still here :-). But I can respect an informed choice made by some, as long as they don't feel the right to impose that free choice of theirs onto others.
  - KaiserPro 6y ago
    but thats not quite what OP was hinting at. They were talking about long term protection. Realistically it only needs to last a year or so. After all the flu vaccine is only valid for a year because it evolves so quickly. As for safety, that's the entire point of these three phases of trials. seeing if its effective is a nice bonus, but in reality to see if there are any problems like there were with the dengue fever jab.
    - zmk_ 6y ago
      > I say ship it to production now, and do a v2.0 release later. I commented on that part. And yes, it seems to be safe in healthy subjects (Phase I). The OP wants to move from Phase I to production immediately. I take an exception to that approach and I agree with you that there is a point in doing the three phases. The later of which actually focus on effectiveness as well. Shipping something that's not effective is counterproductive. Being vaccinated would affect people's behaviour, if you told them that they should not change their behaviour back to pre c19, you would be just faced with questions on what's the point of vaccination. We can ship placebo right now.
  - adrianmonk 6y ago
    I think they mean don't block the release for not knowing whether it confers long-term immunity. I don't think they mean to remove all conditions (like safety) for blocking the release.
- skunkworker 6y ago
  Here’s a source if anyone’s interested. https://www.nature.com/articles/s41586-020-2550-z https://www.nature.com/articles/s41586-020-2550-z
  - blackbear_ 6y ago
    Very interesting, thank you!
baybal2 6y ago
The immune system works that way that even single digit amount of antibodies can start a chain reaction very quickly. I don't think it's possible to say a yes or no answer if somebody has immunity using a lab test today. Though, the vaccine is only needed to last long enough to eradicate the virus. If mass application of vaccine can plunge the r-factor well below 1, it should be more than ok if its protection only lasts 3-4 months.
- marcosdumay 6y ago
  How long does it take to vaccinate the entire world? If the each contaminated person transmits it to two other people, you'll need to keep half of the people immune to each at any single time. If you are doing this by vaccines, you'll need to give it to half of the people on that immunity window. And you must also syncronize it internationally.
  - abdullahkhalids 6y ago
    In Canada 42% of the people got the flu shot in 2018-2019, up form 36% two year prior [1]. [1] https://www.canada.ca/en/public-health/services/publications/healthy-living/2018-2019-influenza-flu-vaccine-coverage-survey-results.html https://www.canada.ca/en/public-health/services/publications...
    - chosenbreed37 6y ago
      That looks high. I wonder how it compares with other countries.
      - YetAnotherNick 6y ago
        I think we will be more limited by supply rather than willingness. Locking down for months has much more economic impact than one shot for each citizen even for poor country.
      - Angostura 6y ago
        In England n England, flu vaccine uptake in people aged 65 years and over has fluctuated over time between 71% and 75%.
BurningFrog 6y ago
Interesting question, I guess, but the world CANNOT WAIT for studies of long term effects. If this turns out to work in the short run, we should deploy it. Not wait 2 years while the pandemic rages to produce the perfect science paper.
- option 6y ago
  last thing you want is long term effects being harder than the disease itself. Even moderate effects will undermine trust in vaccines and the world absolutely can not afford that. I hope we’ll thread carefully here.
  - ArkVark 6y ago
    The median age of death from COVID is about 80, and those people have serious existing health conditions. Statistically people in this group will have a life expectancy of about another 5 years. This is not a group that you have to worry about side-effects. The death toll from COVID lockdown is so much higher - from excess suicides, poverty, crime and violence - that anything we can do to alleviate the panic and get back to normal life is worth it.
    - Falling3 6y ago
      > The death toll from COVID lockdown is so much higher - from excess suicides, poverty, crime and violence That's the same false dichotomy we've been hearing since the pandemic began.
      - mensetmanusman 6y ago
        Would like to see a discussion about whether it is a false dichotomy. I mean, in an ideal population set where people acted rationally, it might be. In the real world, where fear motivates counterproductive behavior, it’s hard to imagine a different scenario where you don’t slow the economy (associated harms) while trying to mitigate the virus.
rogerkirkness 6y ago
Making antibodies is a hugely expensive process in the body. You'd only want to do it for mortal dangers like Smallpox. So I'm pretty sure our body decides if it's worth it. The reason colds are endemic is that they aren't worth having a special forces team training to take them out of circulation at all times. You can just have the army look at it when there's an issue.
- ksml 6y ago
  Do you have a source for this? I don't know much about immunology, but I know a little bit, and I don't think it's that thoughtful of a process. We have antibodies for all sorts of diseases, certainly not just for things like smallpox. This article suggests colds are endemic because they mutate too quickly for antibodies to be effective: https://www.technologynetworks.com/immunology/news/why-dont-we-ever-develop-immunity-against-the-common-cold-294551 https://www.technologynetworks.com/immunology/news/why-dont-... but we still make antibodies for them.
  - rogerkirkness 6y ago
    We make antibodies, that's not the analogy I'm using, and I am studied in immunology. Some diseases are so harmful, our body keeps antibodies floating around perpetually in case we encounter it (e.g. smallpox). Coronaviruses are mild enough that we can "remember" it with t-cells and spin up antibodies as needed. Part of what bones do is this antibody production process, and it requires more energy than vital organs.
usrusr 6y ago
But what exactly is long enough? Compared to repeated lockdowns, even monthly vaccine reinjections would be a relief because ramping production is easier than locking down. We don't really need perfect immunity, we just need to force average spread per infected to a value significantly lower than one and even a vaccine that turns out ineffective for a fraction of the population could be a major contributor to that. The most important concern is side effects, particularly antibody-dependent enhancement. Once production is the bottleneck things can only get better.
- chapium 6y ago
  Considering we already do this once per year for the flu, its not even that unreasonable of a measure if its necessary to do monthly, bimonthly, quarterly, etc.

CyanLite2 6y ago

nAbs don't last forever, for any infectious virus. That's what T-Cells and B-Cells are for. This vaccine showed a T-Cell response, which means it SHOULD last long enough. T-Cells from SARS survivors have lasted 11+ years. But we won't know until 2-3 years from now. We can't wait that long. I say ship it to production now, and do a v2.0 release later.

zmk_ 6y ago
This is a very dangerous approach and would just add fuel to the antivax fire. Even if drugs/vaccines are effective that does not mean that they do not come with severe side effects. Imagine injecting the whole population with Thalidomide...
- objektif 6y ago
  Obviously nobody will force you to get the vaccine. A lot of people will be ready to take the minimal amount of risk. I assume you are not forced to work from home while taking care of kids at the same time :)
  - libertine 6y ago
    I'm pretty sure it will be mandatory in a lot of countries, but it will probably be done in waves.
    - dvirsky 6y ago
      It won't be mandatory but you probably won't be able to work and your kids won't be able to go to school.
  - zmk_ 6y ago
    It is not about me; and I actually think that if there is a safe and effective vaccine that vaccination should be obligatory. This was just a Phase I (healthy subjects) and most of drugs/vaccines are successful at this stage. Drugs are not software, you cannot ship a broken product and then fix it. Even if it is safe, but not effective, it would do more harm than no vaccination, as vaccinated people would change their behaviour.
- libertine 6y ago
  >This is a very dangerous approach and would just add fuel to the antivax fire. I still haven't wrapped my head around antivax... I mean, isn't that the product of poor education and lack of mandatory vaccination programs? Where I'm from, you can't even sign-up children in school if they don't have the proper mandatory vaccinations - and school is mandatory, which makes it impossible to evade. If they don't get the parents because they didn't take their child for vaccines (which is almost impossible because you're assigned a family doctor and he would flag it), they will get them when they'll sign them up for school. If they don't sign them up, social services all over them by then. I know there are antivax people here, but they basically just avoid taking flu shot, all the rest they had to have them at some point. Hell if they cut themselves and need stitches, they will get a tetanus shot.
  - zmk_ 6y ago
    In Poland, where I am from, there is both obligatory vaccination programme and schooling; yet the antivaxers are plentiful. The obligation to vaccinate rests on the parents (+requires their approval from what I understand) and their current GP so if they are creative they can avoid vaccination of their kids. This also affects recommended vaccinations, like HPV. In Denmark, media coverage of alleged side effects led to a substantial drop (or delay) in vaccination against HPV (Hansen et. al, 2018).
  - Zenst 6y ago
    > I still haven't wrapped my head around antivax... It's a tough one in some ways, but more gets down to how you define what an antivaxer is. I have a friend who will never have another flu shot and be weary of this vaccine - WHY, well he had his first ever flu jab a few years back, which had bad side effects for him and he lost hearing due to it in one ear. Hence, he's very weary of such vaccines now and yet, some people would label him an antivaxer! I don't think he is as he is basing his opinion on self education and more so, experience as well as he don't push his choice decisions onto others. See medicines and vaccines have side effects, most people won't get any, some will get a few and a very few will have adverse effects. My worry is those who have had bad experiences and maybe more prone to side effects in some medicines due to genetics etc, get labeled as antivaxers and their very real personal experience is overlooked and they are viewed as crackpots when talking to medical advisers in the future, let alone society. But then for me an antivaxer is somebody who actively promotes the non-use for everybody period and run with that. Now I don't know anybody like that, but can see how some may of come about via a few edge cases and propergating that onto the whole. That is a case of needing education. If some people want to make an informed choice about individual vaccines based upon their medical concerns that are real and not anxieties - well, that's how it should work. Though if they actively promote their choice onto others, well, that's not right and what I would class as an antivaxer. Me, I sent email to to the research folks offering to be a human lab rat if it helped speed up vaccine development, not that i'd call myself a provaxer - just case of the maths made sense and as spoke said - the lives of the many outway the lives of the few. Besides I'm still here :-). But I can respect an informed choice made by some, as long as they don't feel the right to impose that free choice of theirs onto others.
- KaiserPro 6y ago
  but thats not quite what OP was hinting at. They were talking about long term protection. Realistically it only needs to last a year or so. After all the flu vaccine is only valid for a year because it evolves so quickly. As for safety, that's the entire point of these three phases of trials. seeing if its effective is a nice bonus, but in reality to see if there are any problems like there were with the dengue fever jab.
  - zmk_ 6y ago
    > I say ship it to production now, and do a v2.0 release later. I commented on that part. And yes, it seems to be safe in healthy subjects (Phase I). The OP wants to move from Phase I to production immediately. I take an exception to that approach and I agree with you that there is a point in doing the three phases. The later of which actually focus on effectiveness as well. Shipping something that's not effective is counterproductive. Being vaccinated would affect people's behaviour, if you told them that they should not change their behaviour back to pre c19, you would be just faced with questions on what's the point of vaccination. We can ship placebo right now.
- adrianmonk 6y ago
  I think they mean don't block the release for not knowing whether it confers long-term immunity. I don't think they mean to remove all conditions (like safety) for blocking the release.
skunkworker 6y ago
Here’s a source if anyone’s interested. https://www.nature.com/articles/s41586-020-2550-z https://www.nature.com/articles/s41586-020-2550-z
- blackbear_ 6y ago
  Very interesting, thank you!

baybal2 6y ago

The immune system works that way that even single digit amount of antibodies can start a chain reaction very quickly. I don't think it's possible to say a yes or no answer if somebody has immunity using a lab test today. Though, the vaccine is only needed to last long enough to eradicate the virus. If mass application of vaccine can plunge the r-factor well below 1, it should be more than ok if its protection only lasts 3-4 months.

marcosdumay 6y ago
How long does it take to vaccinate the entire world? If the each contaminated person transmits it to two other people, you'll need to keep half of the people immune to each at any single time. If you are doing this by vaccines, you'll need to give it to half of the people on that immunity window. And you must also syncronize it internationally.
- abdullahkhalids 6y ago
  In Canada 42% of the people got the flu shot in 2018-2019, up form 36% two year prior [1]. [1] https://www.canada.ca/en/public-health/services/publications/healthy-living/2018-2019-influenza-flu-vaccine-coverage-survey-results.html https://www.canada.ca/en/public-health/services/publications...
  - chosenbreed37 6y ago
    That looks high. I wonder how it compares with other countries.
    - YetAnotherNick 6y ago
      I think we will be more limited by supply rather than willingness. Locking down for months has much more economic impact than one shot for each citizen even for poor country.
    - Angostura 6y ago
      In England n England, flu vaccine uptake in people aged 65 years and over has fluctuated over time between 71% and 75%.

BurningFrog 6y ago

Interesting question, I guess, but the world CANNOT WAIT for studies of long term effects. If this turns out to work in the short run, we should deploy it. Not wait 2 years while the pandemic rages to produce the perfect science paper.

option 6y ago
last thing you want is long term effects being harder than the disease itself. Even moderate effects will undermine trust in vaccines and the world absolutely can not afford that. I hope we’ll thread carefully here.
- ArkVark 6y ago
  The median age of death from COVID is about 80, and those people have serious existing health conditions. Statistically people in this group will have a life expectancy of about another 5 years. This is not a group that you have to worry about side-effects. The death toll from COVID lockdown is so much higher - from excess suicides, poverty, crime and violence - that anything we can do to alleviate the panic and get back to normal life is worth it.
  - Falling3 6y ago
    > The death toll from COVID lockdown is so much higher - from excess suicides, poverty, crime and violence That's the same false dichotomy we've been hearing since the pandemic began.
    - mensetmanusman 6y ago
      Would like to see a discussion about whether it is a false dichotomy. I mean, in an ideal population set where people acted rationally, it might be. In the real world, where fear motivates counterproductive behavior, it’s hard to imagine a different scenario where you don’t slow the economy (associated harms) while trying to mitigate the virus.

rogerkirkness 6y ago

Making antibodies is a hugely expensive process in the body. You'd only want to do it for mortal dangers like Smallpox. So I'm pretty sure our body decides if it's worth it. The reason colds are endemic is that they aren't worth having a special forces team training to take them out of circulation at all times. You can just have the army look at it when there's an issue.

ksml 6y ago
Do you have a source for this? I don't know much about immunology, but I know a little bit, and I don't think it's that thoughtful of a process. We have antibodies for all sorts of diseases, certainly not just for things like smallpox. This article suggests colds are endemic because they mutate too quickly for antibodies to be effective: https://www.technologynetworks.com/immunology/news/why-dont-we-ever-develop-immunity-against-the-common-cold-294551 https://www.technologynetworks.com/immunology/news/why-dont-... but we still make antibodies for them.
- rogerkirkness 6y ago
  We make antibodies, that's not the analogy I'm using, and I am studied in immunology. Some diseases are so harmful, our body keeps antibodies floating around perpetually in case we encounter it (e.g. smallpox). Coronaviruses are mild enough that we can "remember" it with t-cells and spin up antibodies as needed. Part of what bones do is this antibody production process, and it requires more energy than vital organs.

usrusr 6y ago

But what exactly is long enough? Compared to repeated lockdowns, even monthly vaccine reinjections would be a relief because ramping production is easier than locking down. We don't really need perfect immunity, we just need to force average spread per infected to a value significantly lower than one and even a vaccine that turns out ineffective for a fraction of the population could be a major contributor to that. The most important concern is side effects, particularly antibody-dependent enhancement. Once production is the bottleneck things can only get better.

chapium 6y ago
Considering we already do this once per year for the flu, its not even that unreasonable of a measure if its necessary to do monthly, bimonthly, quarterly, etc.