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MIT study: Covid-19 vaccines may be less effective for racial minorities

60 points by tracyhenry 6y ago

umeshunni 6y ago
Worth clarifying that this is about Moderna and Pfizer’s new Covid-19 vaccines and about "minorities" in the US. Not all vaccines are developed in the US and people who are a minority in the US are not necessarily minorities elsewhere.
- jdxcode 6y ago
  At a meta level, does minority even truly mean “minority” anymore? If I said “minorities” referring to people in California people would assume I’m referring to Latinos and not White people even though there are more Latinos than White people. Is there a more accurate term I’m not aware of?
  - Ericson2314 6y ago
    Yes, we all know it's a terrible word for this purpose.
  - jedimastert 6y ago
    It really is just important to discuss the context. Usually, if a disadvantage is discussed in relation to a "minority", it generally has less to do with the real world diaspora they belong to and more the fact that they are in the minority. For instance, the fact that "minorities" are more susceptible to COVID in the first place (in the US, at least) isn't because of racial makeup or ancestral heritage, but rather because marginalized people in the US are more likely to be in "front line" jobs that come in contact with large groups of people (service workers, hospital janitorial staff, food workers, the like) and much less likely to be in a position to remove themselves or work from home.
  - AnimalMuppet 6y ago
    In this context, the context is the US, not California. Latinos are a minority in the US, regardless of what they are in California or the world. We're trying to talk about the vaccine's effectiveness. We're trying to talk about biology, and it's kind of urgent at the moment. Can we please give sociology issues a pass for a bit?
    - jdxcode 6y ago
      I'm not talking about this study or even sociological issues necessarily: I'm just looking to be able to use language to speak more directly.
  - HarryHirsch 6y ago
    It's a fact that there's a genetic component in susceptibility to different diseases. One example: the 1918 Spanish Flu killed > 5 % of people on the Indian Subcontinent, but in China it was hardly noticeable in the death figures. Instead of pussyfooting around the issue of Race in America (it is an issue, mind), one should say that in population X the vaccine may be less efficaceous.
    - jdxcode 6y ago
      literally nothing to do with what I asked EDIT: apologies HarryHirsch, it was relevant if I just read until the end. You did explain a better way to phrase it. I think you're right that using the word "population" is better here. Good reminder to me to make sure I understand what someone is saying before rejecting them.
      - deleted 6y ago
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- spuz 6y ago
  The article says: > the team found that the number of people whose immune system didn’t robustly respond to the vaccine ranged from less than half of one percent of white participants to nearly 10 percent of Asian participants. ... our preliminary results suggest that, on average, people of Black or Asian ancestry could have a slightly increased risk of vaccine ineffectiveness It would be more accurate to say that a person's race may have an effect on the effectiveness of a vaccine but it's still relevant to class them as minorities in the places where the effectiveness is being studied. If a vaccine is being studied in a population of 40000 and only 100 of those people are black, you won't be able to learn as much about the vaccine's effects on people of a certain race because of the low sample size. It's of course relevant for those in countries where those races are majority and more studies need to be done in those places as well.
- phobosanomaly 6y ago
  Exactly! There are some absolutely brilliant scientists in China working on vaccine development right now! Let's stop hand-wringing, this is a global public health issue, not a political issue, and China is working on it too. "If China’s COVID-19 vaccines work, manufacturers say they could turn out 1.5 billion doses in total next year. And countries that cannot access vaccines bankrolled by Warp Speed—especially those that hosted China’s efficacy trials—might have a more secure vaccine supply." "Yanzhong Huang, a global health specialist at both Seton Hall University and the Council on Foreign Relations, says the country is “actually using the vaccine to promote the diplomacy of foreign policy objectives.” This “vaccine diplomacy” he says, contrasts starkly with Warp Speed’s “vaccine nationalism” and aims to “fill in the void left by the United States.” “It is a very carefully executed and carefully thought out strategy,” says Stephen Morrison, who directs the Global Health Policy Center at the Center for Strategic & International Studies. “A strategic goal of the Chinese government is to achieve hegemonic influence in the bioeconomy within the next decade.” "At home, too, attitudes toward vaccines contrast with those in the United States and Europe, where mistrust is high, Morrison says. To the consternation of vaccine experts overseas, hundreds of thousands of people in China have already lined up to receive the experimental vaccines—even before their value and safety have been proved. “There has not been a collapse of faith and trust in science and in the state,” Morrison says. “There’s less fear about where this is all going.” https://www.sciencemag.org/news/2020/11/global-push-covid-19-vaccines-china-aims-win-friends-and-cut-deals https://www.sciencemag.org/news/2020/11/global-push-covid-19... I'm not a huge fan of a lot of what the Chinese government does, but the U.S. is in the throes of some seriously crazy shit right now, and could take a lesson.
deleted 6y ago
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tzs 6y ago
They also talk about a way to perhaps fix this: > Gifford and PhD students Ge Liu and Brandon Carter also presented a promising new ML-based approach for improving the vaccines’ effectiveness with certain populations: adding a small number of additional Covid-19 peptides to a given dose of the vaccine. > The team’s “augmentation” vaccines use vaccine components that have been observed to cause immune system responses in COVID-19 patients. As shown in the below chart, by adding somewhere between 5 and 50 additional peptides to a particular dose, the team says that preliminary tests show that they improved the vaccine’s effectiveness to nearly 100 percent in all populations. Is adding peptides to a vaccine something that has been done before, or is this new? And how do you add peptides to a vaccine?
young_unixer 6y ago
And how to forget the small percentage of Asian people that live in the world.
Ericson2314 6y ago
From the sub-headline (?) > some health experts have expressed caution about the companies’ confident assertions that the vaccines are 95 percent effective for all populations. Obviously a vaccine isn't going to erase preexisting differences in health outcomes. Closer to a factor on some prior susceptibility (though of course not so cleanly linear in reality).
sct202 6y ago
Moderna has a statement that, "Efficacy was consistent across age, race and ethnicity, and gender demographics. The 196 COVID-19 cases included 33 older adults (ages 65+) and 42 participants identifying as being from diverse communities (including 29 Hispanic or LatinX, 6 Black or African Americans, 4 Asian Americans and 3 multiracial participants)." https://investors.modernatx.com/news-releases/news-release-details/moderna-announces-primary-efficacy-analysis-phase-3-cove-study https://investors.modernatx.com/news-releases/news-release-d... The article makes it sound like they're not basing their finding on the actual vaccine trial data, so is this hyperbole?
- an_opabinia 6y ago
  The public wants something impossible, there are no time machines or time compressors, there are no regulatory changes to make, you can't get the same results as past vaccine trials from this vaccine's trials conducted with many fewer people and far less time.
- throwaway2245 6y ago
  So for Asian Americans, Moderna's findings are equivalent to flipping four (4) coins, and declaring from the results (which we don't see here) that coins come down as Heads 94% of the time.
- cambalache 6y ago
  > Hispanic or LatinX Jesuschrist, stop with this nonsense.
  - dqv 6y ago
    Folx, there is a minority within a minority here. The Latinx minority[0]. We need to ensure that the vaccine works as effectively for Hispanic people as it does for Latinx people. [0]: https://www.pewresearch.org/hispanic/2020/08/11/about-one-in-four-u-s-hispanics-have-heard-of-latinx-but-just-3-use-it/ https://www.pewresearch.org/hispanic/2020/08/11/about-one-in...
wbl 6y ago
If I'm reading this correctly this is not based on actual experimental evidence. There's some reason to think that Caucasians have more active innate immune system during to selective pressure from plague, but not much.
- nradov 6y ago
  The bubonic plague also heavily impacted Asia.
moomin 6y ago
I did a quick back of the envelope calculation of what MIT means by "racial minorities" in the context of this global pandemic. They mean more than 85% of the population of the planet.
- klipt 6y ago
  I assume they mean minorities with respect to the country where the vaccine was developed. However the main purpose of a vaccine is herd immunity. If a large enough majority of the population become immune that we achieve herd immunity, that will still protect the minority of people for whom the vaccine didn't work.
  - dragonwriter 6y ago
    > I assume they mean minorities with respect to the country where the vaccine was developed. I assume they mean “racial minorities” with respect to the country whose National Institutes of Health are listed as a sponsor of the research. Same-same, though.
    - asah 6y ago
      I assume they mean relative to themselves.
  - svrb 6y ago
    > However the main purpose of a vaccine is herd immunity. This is false when it comes to the COVID-19 vaccines under development. They do not—and are not meant to—prevent people from contracting and spreading the virus. They only reduce the symptoms. This does not help herd immunity (other than perhaps allowing the virus to spread faster, I guess).
    - phobosanomaly 6y ago
      Unless you're a PhD molecular biologist (I'm not) with some meta-understanding of mRNA vaccines and I've missed something, I think the person you're responding to is actually correct. "COVID-19 mRNA vaccines are given in the upper arm muscle. Once the instructions (mRNA) are inside the muscle cells, the cells use them to make the protein piece. After the protein piece is made, the cell breaks down the instructions and gets rid of them." "Next, the cell displays the protein piece on its surface. Our immune systems recognize that the protein doesn’t belong there and begin building an immune response and making antibodies, like what happens in natural infection against COVID-19." "At the end of the process, our bodies have learned how to protect against future infection. The benefit of mRNA vaccines, like all vaccines, is those vaccinated gain this protection without ever having to risk the serious consequences of getting sick with COVID-19." https://www.cdc.gov/coronavirus/2019-ncov/vaccines/different-vaccines/mrna.html https://www.cdc.gov/coronavirus/2019-ncov/vaccines/different...
archgoon 6y ago
Seems like mostly a non issue, even if their model is correct. If you have a 10% chance of the vaccine being ineffective for an individual, then the vaccine is still about 85% effective for that population, which is more than enough to pull the R values well below 1.
- fatjokes 6y ago
  I imagine it may not be that simple, given the segregation of ethnic populations. I.e., people probably interact more frequently and closely with others of the same ethnicity, so the average effectiveness may not be sufficient.
  - archgoon 6y ago
    It probably is that simple; not sure why I'm being downvoted for pointing out the obvious. Ah fuck it; nuking my account. I shouldn't waste time here arguing with people.
    - phobosanomaly 6y ago
      As long as you don't take things personally, arguing with folks on the internet who disagree with you is a great way to find potential weaknesses in your own arguments, and ultimately to shape and strengthen them in unexpected ways. It's like going to the gym, but it prepares you to have face-to-face discussions with real-world people whose opinions you actually care about, rather than strangers on the internet. I've been downvoted, and disagreed with many times, but I can't say I didn't learn something new each time, even if it was about something as basic as the way I phrase comments. Cheer up, maybe you were completely right, and other people just didn't quite get what you were saying!
drtournier 6y ago
Some interesting remarks to put in context before judging this MIT claim as true or false: - Racial bias in medical research is real and methods for increasing fairness are urgently needed in clinical trials - We don't know for sure how racial bias was balanced on most phase 3 trials, because most research protocols were not disclosed to the science community - Since efficacy was measured by the sub population in the phase 3 trials who got infected, we can perhaps have other confounding factors who can affect more, or less, some ethnicities (for example, someone can raise the hypothesis that some cultures are more prone to use masks and keep distancing, reducing inherent risks, and that can be true) - Sample sizes for the phase 3 studies so far very small (perhaps enough to assess minimal efficacy?) for ANY race/ethnicity. We hope that with the increase of the vaccinated population we can have a more precise estimate - We are talking about 95% inside a confidence interval which is still uncertain lower/higher boundaries, given the small sample - It is very dangerous to claim any statistical conclusion with small sample sizes - Almost all "advanced machine learning AI methods" fail miserably. And they fail even worse with small datasets (which is the case). Examples are the handful of "covid pollsters" we got since the beginning of 2020, trying to guess how many people would die, or get infected. - About vaccine efficacy in asians - we should monitor phase 3 results of CoronaVac (the chinese vaccine) trials (which are in course in China, Brazil and other countries), so we can account for these biases. I heard these results are coming in the next few weeks
- klipt 6y ago
  Also, the main purpose of a vaccine is herd immunity. If a large enough majority of the population become immune that we achieve herd immunity, that will still protect the minority of people for whom the vaccine didn't work.
  - acqq 6y ago
    No, at the moment "the main purpose of a vaccine" is still not "herd immunity" at all. The Phase 3 trial protocols measured and presented the "efficacy" which is defined as the reducing the chance of the vaccinated getting sick -- that is, merely reducing the severity of disease among those who were vaccinated. https://www.medscape.com/viewarticle/941030?src=soc_tw_201118_mscpedt_news_mdscp_vaccine&faf=1 https://www.medscape.com/viewarticle/941030?src=soc_tw_20111... "In an ideal world, a vaccine would prevent infection entirely and, it follows, also prevent disease and severe disease. But this may be hard to achieve for a respiratory virus vaccine. Animal challenge data suggest that vaccinated animals may still be infected even if they don't experience symptoms. A vaccine that is able to reduce the severity of disease, even if it cannot prevent infection entirely, would obviously still have enormous public health value. Therefore, this is what trials target as their primary aim." Not all vaccines are the same. For mumps, totally different kind of disease, to prevent an outbreak, there was a following calculation: https://vector.childrenshospital.org/2017/03/social-media-mumps-herd-immunity/ https://vector.childrenshospital.org/2017/03/social-media-mu... "since one in 10 vaccinated people are still susceptible to mumps, an overall vaccination rate of 96 percent is needed to prevent an outbreak" For Covid-19, to note from the first source again: "A vaccine that is able to reduce the severity of disease, even if it cannot prevent infection entirely, would obviously still have enormous public health value. Therefore, this is what trials target as their primary aim."
speedgoose 6y ago
Dear authors, if you are reading this message please consider not using the word race. > Modern scholarship regards race as a social construct, an identity which is assigned based on rules made by society. While partially based on physical similarities within groups, race does not have an inherent physical or biological meaning. https://en.wikipedia.org/wiki/Race_%28human_categorization%29 https://en.wikipedia.org/wiki/Race_%28human_categorization%2...
- djohnston 6y ago
  it does if that's the context in which bias is introduced to the medical studies designing these vaccines
- crusso 6y ago
  If it's a social construct, then it can't have a biological impact on the efficacy of a vaccine. You see the paradox?
  - RaptorJ 6y ago
    Why not? Money is a social contruct, but dollars to donuts, populations with less of it will have lower vaccine efficacy.
    - crusso 6y ago
      You're right. That would be a counter-example because of non-biological second-order effects. But in this context, we're talking about first-order biological effects that aren't accounted for because of race. If race doesn't have biological underpinnings then the larger argument is meaningless.
- kleer001 6y ago
  Thank you. This odd rash of race primacy in the zeitgeist is getting me down. "... by the content of their character.." people, come on. If indeed the vaccine may be less effective for certain populations then name them and leave the vagaries of race baiting to the tabloids.
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themgt 6y ago
It looks like this is the pre-print: https://www.cell.com/cell-systems/pdf/S2405-4712(20)30461-0.pdf https://www.cell.com/cell-systems/pdf/S2405-4712(20)30461-0....
stefantalpalaru 6y ago
> the vaccines’ effectiveness may vary depending on a person’s race There are no races in the human species, due to genetic reasons: the lack of well-delimited genetic clusters (like we see for dogs, cats, cows, horses, etc.) and the large number of inter-group genetic distances that are shorter than intra-group ones. US geneticists and anthropologists understand all that, but it seems that vast sections of the population are still on board with scientific racism - not very surprising, when official census forms still have separate fields for "race" and "ethnicity".
antipaul 6y ago
Thankfully they didn’t use just any “machine learning” nor even “AI” but “advanced machine learning AI”. Phew!
- OnlyMortal 6y ago
  They should have used blockchain.
  - tharne 6y ago
    blockchain-powered AI FTW
rlewkov 6y ago
"May be" less effective ... or may not be
bioinformatics 6y ago
I am hoping they didn't put the racist mRNA in the vaccine. As a minority, I don't want to become White.
- ampdepolymerase 6y ago
  As a bioinformatician, you ought to be ashamed of yourself for that comment. Is your grasp of biology truly that poor? The sheer gall of that comment. This is a forum of experts at building web apps and premature optimization. The average reader here knows next to nothing about genetics and cell biology. Spreading incorrect information about biology is contributing to disinformation and fake news.
  - UnFleshedOne 6y ago
    Frankly, people who would take the OP comment as anything but satire deserve whatever mush their brains have turned into.
  - bioinformatics 6y ago
    I am so ashamed of my comment, thanks for pointing that out. >Spreading incorrect information about biology is contributing to disinformation and fake news. Really, it is incredible how a one line comment changed the whole universe of fake news and disinformation. I can also only assume that you are not the average reader here, but some one with higher knowledge in every aspect of life and Science. Thanks for you comment. I am starting to clean my social media activity and in the next day or two, I will probably kill myself. Thanks for letting me see this, I cannot live with the drastic contributions I made to spread disinformation online. As a higher being, can you tell me the easiest way to end my life? I am looking for something not painful, and something that would not traumatize my son, as we live together and I work from home. Again, thanks to make me see the light. Without you, the world would have to endure another fake news spreader. Be assured that my family will send you part of my life insurance, as soon as we get your name and address.
drallison 6y ago
Much of the discussion here centers upon "race" and its use in the headline and in the medical literature. A better term might be "genetic variation" as it has less baggage than "race". What is significant is genetic variation tends to be geographically distributed. https://www-nature-com.stanford.idm.oclc.org/articles/ng1435 https://www-nature-com.stanford.idm.oclc.org/articles/ng1435. Making a universally effective vaccine needs to start off with a geographically diverse sample of both the virus and the population to be vaccinated.
tamaharbor 6y ago
Even the vaccines are racist?
partiallypro 6y ago
Unrelated to this, but did they test this vaccine on people that already had COVID? I'm kind of interested to know if antibodies accumulated from having it negate the vaccine or if they interact in any way.
GuB-42 6y ago
It makes me think about an idea that was heavily criticized in the beginning of the pandemic: to test vaccines in Africa. I remember a huge uproar: "we are not your guinea pigs". And I totally understand the sentiment. The vaccine will mostly benefit rich white people, while the poor Africans will, as always, get the short end of the stick. And I have no doubt it will happen like that. But, by refusing trials in your poor country, you basically lower your chances of getting an effective vaccine when it matters from not much to zero. Allowing trials should be a good way to negotiate a way to secure doses for yourself, since you can't do it with money like first world countries. But it is also a way to have the vaccine tested on your population rather than only on white guys. And sure, there are risks in doing that, but Covid-19 kills in Africa too. I didn't do a risk analysis but I am quite sure it is a net positive for the "guinea pig" countries. And sure, in an ideal world, we should all work together and treat everyone independent of status and wealth in order to end the global pandemic as quickly as possible. But past events showed us it doesn't work like that. Rich countries fighting to secure resources (tests, masks, vaccines, ...) for themselves. The push for buying domestic products instead of from evil China. The very idea of evil China, partly justified but overblown for patriotic effect... Africa will get nothing but scraps unless they have a bargaining chip, and hosting vaccine trials could have been that chip.
- bsanr2 6y ago
  The answer to your dilemma is in the premise: all these companies needed to do was to provide concrete assurances that the testing would net participants a spot in the front of the line and due compensation. That would mean spinning up resource supply chains and infrastructure to make sure not just testing, but actual administration, of the vaccine would happen there. But because of the neglect and exploitation much of Africa has experienced from major powers, that would have turned testing into a prohibitively funding- and time-intensive prospect. African leaders aren't stupid, they recognized that. So without those concrete assurances, any widespread testing would almost certainly have been yet another example of exploitation, where the spoils go north. And for what? Most African countries are dealing with COVID perfectly fine. Europe and America are the ones where the suffering is disproportionate to the norm. This is not a case of Africa suffering for its lack of desire to play ball with Western powers; it's one where Western powers killed hundreds of thousands of their own citizens unnecessarily. If there's any injustice, it's in that the people paying the price in our countries are the people who get screwed over by institutional neglect - sometimes, sabotage - time and again.
Exmoor 6y ago
I'm more than a little suspicious of a bunch of Computer Science folks running some data through their machine learning tool and then trying to tell the vaccine makers they should change their recipe because of it. Even assuming their data is correct, the variation in effectiveness is 10% and for people in their worst case scenario group it would still be one of the most effective vaccines every created.
Syzygies 6y ago
Health issues for racial minorities in the US are a result of structural racism, not their genetic makeup. Do vaccines fare worse with minorities because they aren't developed and tested on diverse genetic makeups? Or do they fare worse with people with health issues?
kyrieeschaton 6y ago
They express it as "racial minorities", but then talk about lower effectiveness on eg "asians", who last time I checked outnumber whites 3:1 or so. I'm guessing the contention isn't that it magically becomes ineffective on a Chinese in Brooklyn as opposed to a Chinese in Beijing, but for some reason they felt the need to communicate their results on a global phenomenon via parochial US racial politics.
- loxs 6y ago
  I came here to say exactly this. The way it is phrased, to me in means that the vaccines are not effective on whites.
- ed25519FUUU 6y ago
  This type of identity framing is on par for 2020.
a9h74j 6y ago
> There are obviously many other factors to consider [from the article] If "effectiveness" is currently being measured as reducing symptoms, could Vitamin D levels be a likely additional factor, known to correlate with ethnicity? Could "low Vit D" plus "no vaccine" be additive toward increased symptoms? Based on a quick scan of the preprint I see no reference to Vit D.
credit_guy 6y ago
Low effort content. There were 5 Covid infections in the vaccinated group and 90 in the placebo group. The efficacy of 94% is simply 1-5/90. When you have only 5 infections in the vaccinated group, you can have at most 5 minorities represented there. So, if for example you don't have any Native Americans, it will look like the efficacy for Native Americans is 100%. The better title for MIT's research would be "No statistical difference for the vaccine efficacy across racial groups", but that wouldn't be so exciting, would it?

60 points by tracyhenry 6y ago

Worth clarifying that this is about Moderna and Pfizer’s new Covid-19 vaccines and about "minorities" in the US. Not all vaccines are developed in the US and people who are a minority in the US are not necessarily minorities elsewhere.

jdxcode 6y ago
At a meta level, does minority even truly mean “minority” anymore? If I said “minorities” referring to people in California people would assume I’m referring to Latinos and not White people even though there are more Latinos than White people. Is there a more accurate term I’m not aware of?
- Ericson2314 6y ago
  Yes, we all know it's a terrible word for this purpose.
- jedimastert 6y ago
  It really is just important to discuss the context. Usually, if a disadvantage is discussed in relation to a "minority", it generally has less to do with the real world diaspora they belong to and more the fact that they are in the minority. For instance, the fact that "minorities" are more susceptible to COVID in the first place (in the US, at least) isn't because of racial makeup or ancestral heritage, but rather because marginalized people in the US are more likely to be in "front line" jobs that come in contact with large groups of people (service workers, hospital janitorial staff, food workers, the like) and much less likely to be in a position to remove themselves or work from home.
- AnimalMuppet 6y ago
  In this context, the context is the US, not California. Latinos are a minority in the US, regardless of what they are in California or the world. We're trying to talk about the vaccine's effectiveness. We're trying to talk about biology, and it's kind of urgent at the moment. Can we please give sociology issues a pass for a bit?
  - jdxcode 6y ago
    I'm not talking about this study or even sociological issues necessarily: I'm just looking to be able to use language to speak more directly.
- HarryHirsch 6y ago
  It's a fact that there's a genetic component in susceptibility to different diseases. One example: the 1918 Spanish Flu killed > 5 % of people on the Indian Subcontinent, but in China it was hardly noticeable in the death figures. Instead of pussyfooting around the issue of Race in America (it is an issue, mind), one should say that in population X the vaccine may be less efficaceous.
  - jdxcode 6y ago
    literally nothing to do with what I asked EDIT: apologies HarryHirsch, it was relevant if I just read until the end. You did explain a better way to phrase it. I think you're right that using the word "population" is better here. Good reminder to me to make sure I understand what someone is saying before rejecting them.
    - deleted 6y ago
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spuz 6y ago
The article says: > the team found that the number of people whose immune system didn’t robustly respond to the vaccine ranged from less than half of one percent of white participants to nearly 10 percent of Asian participants. ... our preliminary results suggest that, on average, people of Black or Asian ancestry could have a slightly increased risk of vaccine ineffectiveness It would be more accurate to say that a person's race may have an effect on the effectiveness of a vaccine but it's still relevant to class them as minorities in the places where the effectiveness is being studied. If a vaccine is being studied in a population of 40000 and only 100 of those people are black, you won't be able to learn as much about the vaccine's effects on people of a certain race because of the low sample size. It's of course relevant for those in countries where those races are majority and more studies need to be done in those places as well.
phobosanomaly 6y ago
Exactly! There are some absolutely brilliant scientists in China working on vaccine development right now! Let's stop hand-wringing, this is a global public health issue, not a political issue, and China is working on it too. "If China’s COVID-19 vaccines work, manufacturers say they could turn out 1.5 billion doses in total next year. And countries that cannot access vaccines bankrolled by Warp Speed—especially those that hosted China’s efficacy trials—might have a more secure vaccine supply." "Yanzhong Huang, a global health specialist at both Seton Hall University and the Council on Foreign Relations, says the country is “actually using the vaccine to promote the diplomacy of foreign policy objectives.” This “vaccine diplomacy” he says, contrasts starkly with Warp Speed’s “vaccine nationalism” and aims to “fill in the void left by the United States.” “It is a very carefully executed and carefully thought out strategy,” says Stephen Morrison, who directs the Global Health Policy Center at the Center for Strategic & International Studies. “A strategic goal of the Chinese government is to achieve hegemonic influence in the bioeconomy within the next decade.” "At home, too, attitudes toward vaccines contrast with those in the United States and Europe, where mistrust is high, Morrison says. To the consternation of vaccine experts overseas, hundreds of thousands of people in China have already lined up to receive the experimental vaccines—even before their value and safety have been proved. “There has not been a collapse of faith and trust in science and in the state,” Morrison says. “There’s less fear about where this is all going.” https://www.sciencemag.org/news/2020/11/global-push-covid-19-vaccines-china-aims-win-friends-and-cut-deals https://www.sciencemag.org/news/2020/11/global-push-covid-19... I'm not a huge fan of a lot of what the Chinese government does, but the U.S. is in the throes of some seriously crazy shit right now, and could take a lesson.

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tzs 6y ago

They also talk about a way to perhaps fix this: > Gifford and PhD students Ge Liu and Brandon Carter also presented a promising new ML-based approach for improving the vaccines’ effectiveness with certain populations: adding a small number of additional Covid-19 peptides to a given dose of the vaccine. > The team’s “augmentation” vaccines use vaccine components that have been observed to cause immune system responses in COVID-19 patients. As shown in the below chart, by adding somewhere between 5 and 50 additional peptides to a particular dose, the team says that preliminary tests show that they improved the vaccine’s effectiveness to nearly 100 percent in all populations. Is adding peptides to a vaccine something that has been done before, or is this new? And how do you add peptides to a vaccine?

young_unixer 6y ago

And how to forget the small percentage of Asian people that live in the world.

Ericson2314 6y ago

From the sub-headline (?) > some health experts have expressed caution about the companies’ confident assertions that the vaccines are 95 percent effective for all populations. Obviously a vaccine isn't going to erase preexisting differences in health outcomes. Closer to a factor on some prior susceptibility (though of course not so cleanly linear in reality).

sct202 6y ago

Moderna has a statement that, "Efficacy was consistent across age, race and ethnicity, and gender demographics. The 196 COVID-19 cases included 33 older adults (ages 65+) and 42 participants identifying as being from diverse communities (including 29 Hispanic or LatinX, 6 Black or African Americans, 4 Asian Americans and 3 multiracial participants)." https://investors.modernatx.com/news-releases/news-release-details/moderna-announces-primary-efficacy-analysis-phase-3-cove-study https://investors.modernatx.com/news-releases/news-release-d... The article makes it sound like they're not basing their finding on the actual vaccine trial data, so is this hyperbole?

an_opabinia 6y ago
The public wants something impossible, there are no time machines or time compressors, there are no regulatory changes to make, you can't get the same results as past vaccine trials from this vaccine's trials conducted with many fewer people and far less time.
throwaway2245 6y ago
So for Asian Americans, Moderna's findings are equivalent to flipping four (4) coins, and declaring from the results (which we don't see here) that coins come down as Heads 94% of the time.
cambalache 6y ago
> Hispanic or LatinX Jesuschrist, stop with this nonsense.
- dqv 6y ago
  Folx, there is a minority within a minority here. The Latinx minority[0]. We need to ensure that the vaccine works as effectively for Hispanic people as it does for Latinx people. [0]: https://www.pewresearch.org/hispanic/2020/08/11/about-one-in-four-u-s-hispanics-have-heard-of-latinx-but-just-3-use-it/ https://www.pewresearch.org/hispanic/2020/08/11/about-one-in...

wbl 6y ago

If I'm reading this correctly this is not based on actual experimental evidence. There's some reason to think that Caucasians have more active innate immune system during to selective pressure from plague, but not much.

nradov 6y ago
The bubonic plague also heavily impacted Asia.

moomin 6y ago

I did a quick back of the envelope calculation of what MIT means by "racial minorities" in the context of this global pandemic. They mean more than 85% of the population of the planet.

klipt 6y ago
I assume they mean minorities with respect to the country where the vaccine was developed. However the main purpose of a vaccine is herd immunity. If a large enough majority of the population become immune that we achieve herd immunity, that will still protect the minority of people for whom the vaccine didn't work.
- dragonwriter 6y ago
  > I assume they mean minorities with respect to the country where the vaccine was developed. I assume they mean “racial minorities” with respect to the country whose National Institutes of Health are listed as a sponsor of the research. Same-same, though.
  - asah 6y ago
    I assume they mean relative to themselves.
- svrb 6y ago
  > However the main purpose of a vaccine is herd immunity. This is false when it comes to the COVID-19 vaccines under development. They do not—and are not meant to—prevent people from contracting and spreading the virus. They only reduce the symptoms. This does not help herd immunity (other than perhaps allowing the virus to spread faster, I guess).
  - phobosanomaly 6y ago
    Unless you're a PhD molecular biologist (I'm not) with some meta-understanding of mRNA vaccines and I've missed something, I think the person you're responding to is actually correct. "COVID-19 mRNA vaccines are given in the upper arm muscle. Once the instructions (mRNA) are inside the muscle cells, the cells use them to make the protein piece. After the protein piece is made, the cell breaks down the instructions and gets rid of them." "Next, the cell displays the protein piece on its surface. Our immune systems recognize that the protein doesn’t belong there and begin building an immune response and making antibodies, like what happens in natural infection against COVID-19." "At the end of the process, our bodies have learned how to protect against future infection. The benefit of mRNA vaccines, like all vaccines, is those vaccinated gain this protection without ever having to risk the serious consequences of getting sick with COVID-19." https://www.cdc.gov/coronavirus/2019-ncov/vaccines/different-vaccines/mrna.html https://www.cdc.gov/coronavirus/2019-ncov/vaccines/different...

archgoon 6y ago

Seems like mostly a non issue, even if their model is correct. If you have a 10% chance of the vaccine being ineffective for an individual, then the vaccine is still about 85% effective for that population, which is more than enough to pull the R values well below 1.

fatjokes 6y ago
I imagine it may not be that simple, given the segregation of ethnic populations. I.e., people probably interact more frequently and closely with others of the same ethnicity, so the average effectiveness may not be sufficient.
- archgoon 6y ago
  It probably is that simple; not sure why I'm being downvoted for pointing out the obvious. Ah fuck it; nuking my account. I shouldn't waste time here arguing with people.
  - phobosanomaly 6y ago
    As long as you don't take things personally, arguing with folks on the internet who disagree with you is a great way to find potential weaknesses in your own arguments, and ultimately to shape and strengthen them in unexpected ways. It's like going to the gym, but it prepares you to have face-to-face discussions with real-world people whose opinions you actually care about, rather than strangers on the internet. I've been downvoted, and disagreed with many times, but I can't say I didn't learn something new each time, even if it was about something as basic as the way I phrase comments. Cheer up, maybe you were completely right, and other people just didn't quite get what you were saying!

drtournier 6y ago

Some interesting remarks to put in context before judging this MIT claim as true or false: - Racial bias in medical research is real and methods for increasing fairness are urgently needed in clinical trials - We don't know for sure how racial bias was balanced on most phase 3 trials, because most research protocols were not disclosed to the science community - Since efficacy was measured by the sub population in the phase 3 trials who got infected, we can perhaps have other confounding factors who can affect more, or less, some ethnicities (for example, someone can raise the hypothesis that some cultures are more prone to use masks and keep distancing, reducing inherent risks, and that can be true) - Sample sizes for the phase 3 studies so far very small (perhaps enough to assess minimal efficacy?) for ANY race/ethnicity. We hope that with the increase of the vaccinated population we can have a more precise estimate - We are talking about 95% inside a confidence interval which is still uncertain lower/higher boundaries, given the small sample - It is very dangerous to claim any statistical conclusion with small sample sizes - Almost all "advanced machine learning AI methods" fail miserably. And they fail even worse with small datasets (which is the case). Examples are the handful of "covid pollsters" we got since the beginning of 2020, trying to guess how many people would die, or get infected. - About vaccine efficacy in asians - we should monitor phase 3 results of CoronaVac (the chinese vaccine) trials (which are in course in China, Brazil and other countries), so we can account for these biases. I heard these results are coming in the next few weeks

klipt 6y ago
Also, the main purpose of a vaccine is herd immunity. If a large enough majority of the population become immune that we achieve herd immunity, that will still protect the minority of people for whom the vaccine didn't work.
- acqq 6y ago
  No, at the moment "the main purpose of a vaccine" is still not "herd immunity" at all. The Phase 3 trial protocols measured and presented the "efficacy" which is defined as the reducing the chance of the vaccinated getting sick -- that is, merely reducing the severity of disease among those who were vaccinated. https://www.medscape.com/viewarticle/941030?src=soc_tw_201118_mscpedt_news_mdscp_vaccine&faf=1 https://www.medscape.com/viewarticle/941030?src=soc_tw_20111... "In an ideal world, a vaccine would prevent infection entirely and, it follows, also prevent disease and severe disease. But this may be hard to achieve for a respiratory virus vaccine. Animal challenge data suggest that vaccinated animals may still be infected even if they don't experience symptoms. A vaccine that is able to reduce the severity of disease, even if it cannot prevent infection entirely, would obviously still have enormous public health value. Therefore, this is what trials target as their primary aim." Not all vaccines are the same. For mumps, totally different kind of disease, to prevent an outbreak, there was a following calculation: https://vector.childrenshospital.org/2017/03/social-media-mumps-herd-immunity/ https://vector.childrenshospital.org/2017/03/social-media-mu... "since one in 10 vaccinated people are still susceptible to mumps, an overall vaccination rate of 96 percent is needed to prevent an outbreak" For Covid-19, to note from the first source again: "A vaccine that is able to reduce the severity of disease, even if it cannot prevent infection entirely, would obviously still have enormous public health value. Therefore, this is what trials target as their primary aim."

speedgoose 6y ago

Dear authors, if you are reading this message please consider not using the word race. > Modern scholarship regards race as a social construct, an identity which is assigned based on rules made by society. While partially based on physical similarities within groups, race does not have an inherent physical or biological meaning. https://en.wikipedia.org/wiki/Race_%28human_categorization%29 https://en.wikipedia.org/wiki/Race_%28human_categorization%2...

djohnston 6y ago
it does if that's the context in which bias is introduced to the medical studies designing these vaccines
crusso 6y ago
If it's a social construct, then it can't have a biological impact on the efficacy of a vaccine. You see the paradox?
- RaptorJ 6y ago
  Why not? Money is a social contruct, but dollars to donuts, populations with less of it will have lower vaccine efficacy.
  - crusso 6y ago
    You're right. That would be a counter-example because of non-biological second-order effects. But in this context, we're talking about first-order biological effects that aren't accounted for because of race. If race doesn't have biological underpinnings then the larger argument is meaningless.
kleer001 6y ago
Thank you. This odd rash of race primacy in the zeitgeist is getting me down. "... by the content of their character.." people, come on. If indeed the vaccine may be less effective for certain populations then name them and leave the vagaries of race baiting to the tabloids.

deleted 6y ago

[deleted]

themgt 6y ago

It looks like this is the pre-print: https://www.cell.com/cell-systems/pdf/S2405-4712(20)30461-0.pdf https://www.cell.com/cell-systems/pdf/S2405-4712(20)30461-0....

stefantalpalaru 6y ago

> the vaccines’ effectiveness may vary depending on a person’s race There are no races in the human species, due to genetic reasons: the lack of well-delimited genetic clusters (like we see for dogs, cats, cows, horses, etc.) and the large number of inter-group genetic distances that are shorter than intra-group ones. US geneticists and anthropologists understand all that, but it seems that vast sections of the population are still on board with scientific racism - not very surprising, when official census forms still have separate fields for "race" and "ethnicity".

antipaul 6y ago

Thankfully they didn’t use just any “machine learning” nor even “AI” but “advanced machine learning AI”. Phew!

OnlyMortal 6y ago
They should have used blockchain.
- tharne 6y ago
  blockchain-powered AI FTW

rlewkov 6y ago

"May be" less effective ... or may not be

bioinformatics 6y ago

I am hoping they didn't put the racist mRNA in the vaccine. As a minority, I don't want to become White.

ampdepolymerase 6y ago
As a bioinformatician, you ought to be ashamed of yourself for that comment. Is your grasp of biology truly that poor? The sheer gall of that comment. This is a forum of experts at building web apps and premature optimization. The average reader here knows next to nothing about genetics and cell biology. Spreading incorrect information about biology is contributing to disinformation and fake news.
- UnFleshedOne 6y ago
  Frankly, people who would take the OP comment as anything but satire deserve whatever mush their brains have turned into.
- bioinformatics 6y ago
  I am so ashamed of my comment, thanks for pointing that out. >Spreading incorrect information about biology is contributing to disinformation and fake news. Really, it is incredible how a one line comment changed the whole universe of fake news and disinformation. I can also only assume that you are not the average reader here, but some one with higher knowledge in every aspect of life and Science. Thanks for you comment. I am starting to clean my social media activity and in the next day or two, I will probably kill myself. Thanks for letting me see this, I cannot live with the drastic contributions I made to spread disinformation online. As a higher being, can you tell me the easiest way to end my life? I am looking for something not painful, and something that would not traumatize my son, as we live together and I work from home. Again, thanks to make me see the light. Without you, the world would have to endure another fake news spreader. Be assured that my family will send you part of my life insurance, as soon as we get your name and address.

drallison 6y ago

Much of the discussion here centers upon "race" and its use in the headline and in the medical literature. A better term might be "genetic variation" as it has less baggage than "race". What is significant is genetic variation tends to be geographically distributed. https://www-nature-com.stanford.idm.oclc.org/articles/ng1435 https://www-nature-com.stanford.idm.oclc.org/articles/ng1435. Making a universally effective vaccine needs to start off with a geographically diverse sample of both the virus and the population to be vaccinated.

tamaharbor 6y ago

Even the vaccines are racist?

partiallypro 6y ago

Unrelated to this, but did they test this vaccine on people that already had COVID? I'm kind of interested to know if antibodies accumulated from having it negate the vaccine or if they interact in any way.

GuB-42 6y ago

It makes me think about an idea that was heavily criticized in the beginning of the pandemic: to test vaccines in Africa. I remember a huge uproar: "we are not your guinea pigs". And I totally understand the sentiment. The vaccine will mostly benefit rich white people, while the poor Africans will, as always, get the short end of the stick. And I have no doubt it will happen like that. But, by refusing trials in your poor country, you basically lower your chances of getting an effective vaccine when it matters from not much to zero. Allowing trials should be a good way to negotiate a way to secure doses for yourself, since you can't do it with money like first world countries. But it is also a way to have the vaccine tested on your population rather than only on white guys. And sure, there are risks in doing that, but Covid-19 kills in Africa too. I didn't do a risk analysis but I am quite sure it is a net positive for the "guinea pig" countries. And sure, in an ideal world, we should all work together and treat everyone independent of status and wealth in order to end the global pandemic as quickly as possible. But past events showed us it doesn't work like that. Rich countries fighting to secure resources (tests, masks, vaccines, ...) for themselves. The push for buying domestic products instead of from evil China. The very idea of evil China, partly justified but overblown for patriotic effect... Africa will get nothing but scraps unless they have a bargaining chip, and hosting vaccine trials could have been that chip.

bsanr2 6y ago
The answer to your dilemma is in the premise: all these companies needed to do was to provide concrete assurances that the testing would net participants a spot in the front of the line and due compensation. That would mean spinning up resource supply chains and infrastructure to make sure not just testing, but actual administration, of the vaccine would happen there. But because of the neglect and exploitation much of Africa has experienced from major powers, that would have turned testing into a prohibitively funding- and time-intensive prospect. African leaders aren't stupid, they recognized that. So without those concrete assurances, any widespread testing would almost certainly have been yet another example of exploitation, where the spoils go north. And for what? Most African countries are dealing with COVID perfectly fine. Europe and America are the ones where the suffering is disproportionate to the norm. This is not a case of Africa suffering for its lack of desire to play ball with Western powers; it's one where Western powers killed hundreds of thousands of their own citizens unnecessarily. If there's any injustice, it's in that the people paying the price in our countries are the people who get screwed over by institutional neglect - sometimes, sabotage - time and again.

Exmoor 6y ago

I'm more than a little suspicious of a bunch of Computer Science folks running some data through their machine learning tool and then trying to tell the vaccine makers they should change their recipe because of it. Even assuming their data is correct, the variation in effectiveness is 10% and for people in their worst case scenario group it would still be one of the most effective vaccines every created.

Syzygies 6y ago

Health issues for racial minorities in the US are a result of structural racism, not their genetic makeup. Do vaccines fare worse with minorities because they aren't developed and tested on diverse genetic makeups? Or do they fare worse with people with health issues?

kyrieeschaton 6y ago

They express it as "racial minorities", but then talk about lower effectiveness on eg "asians", who last time I checked outnumber whites 3:1 or so. I'm guessing the contention isn't that it magically becomes ineffective on a Chinese in Brooklyn as opposed to a Chinese in Beijing, but for some reason they felt the need to communicate their results on a global phenomenon via parochial US racial politics.

loxs 6y ago
I came here to say exactly this. The way it is phrased, to me in means that the vaccines are not effective on whites.
ed25519FUUU 6y ago
This type of identity framing is on par for 2020.

a9h74j 6y ago

> There are obviously many other factors to consider [from the article] If "effectiveness" is currently being measured as reducing symptoms, could Vitamin D levels be a likely additional factor, known to correlate with ethnicity? Could "low Vit D" plus "no vaccine" be additive toward increased symptoms? Based on a quick scan of the preprint I see no reference to Vit D.

credit_guy 6y ago

Low effort content. There were 5 Covid infections in the vaccinated group and 90 in the placebo group. The efficacy of 94% is simply 1-5/90. When you have only 5 infections in the vaccinated group, you can have at most 5 minorities represented there. So, if for example you don't have any Native Americans, it will look like the efficacy for Native Americans is 100%. The better title for MIT's research would be "No statistical difference for the vaccine efficacy across racial groups", but that wouldn't be so exciting, would it?