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It took two days to develop Moderna’s vaccine

• melling 6y ago
  The technology was years in the making. DARPA was also involved. “In October 2013, DARPA awarded Moderna up to approximately $25 million to research and develop potential mRNA medicines as a part of DARPA’s Autonomous Diagnostics to Enable Prevention and Therapeutics, or ADEPT, program”
  • spamizbad 6y ago
    One of the best $25 million in defense spending ever.
    • oblio 6y ago
      The internet? :-)
      • SftwreEngnr 6y ago
        Please.
      • btilly 6y ago
        You are more correct than you probably realize. As http://cis471.blogspot.com/2012/08/seeding-internet-cost-government-1245.html http://cis471.blogspot.com/2012/08/seeding-internet-cost-gov... lays out, the government spent $25 million on ARPAnet, the first packet switched network and the granddaddy of our current Internet. So it was actually the same figure as this grant. (There were followup investments from the government, but the whole thing was around $125 million.)
        • jancsika 6y ago
          So $25 million on a decentralized system to spread the idea not to wear a mask or social distance during a pandemic, and another $25 million on a vaccine.
          • zamfi 6y ago
            You’re being downvoted presumably for snark, which as a lover of snark I can’t support. However, your point is also mislaid: there were plenty of anti-maskers at the time of the 1918 Influenza pandemic. Ignoring or selectively using facts to support the narrative you wish were true did not start with the internet!
            • oblio 6y ago
              > Ignoring or selectively using facts to support the narrative you wish were true did not start with the internet! My guess is that those probably predate speech :-D
            • freeflight 6y ago
              There even was a whole "Anti-Mask League" in SF [0], with others demanding jail time for "mask slackers" [1]. [0] https://en.wikipedia.org/wiki/Anti-Mask_League_of_San_Francisco https://en.wikipedia.org/wiki/Anti-Mask_League_of_San_Franci... [1] https://www.history.com/news/1918-pandemic-public-health-campaigns https://www.history.com/news/1918-pandemic-public-health-cam...
            • DiogenesKynikos 6y ago
              There was also heavy government censorship of the press during WWI, which suppressed early reports of the pandemic. That should be a cautionary tale to people in the present day who want more centralized control over what people can say online - the censors might not always be on your side.
          • Darmody 6y ago
            Is that the only thing you get from the internet? I'd say that more like a small price to pay in order to have something really great.
      • scottlocklin 6y ago
        The jury is still out on that one.
        • domador 6y ago
          The Internet: Yes! Social media: Debatable.
        • oblio 6y ago
          The internet? I think we can all agree that the wheel and writing were some of mankind's greatest inventions. Yet I can use writing to send a letter to someone so that they try to hurt you with a breaking wheel, if you get what I mean ;-)
      • carabiner 6y ago
        The internet was a mistake.
        • themaninthedark 6y ago
          >Many were increasingly of the opinion that they’d all made a big mistake in coming down from the trees in the first place. And some said that even the trees had been a bad move, and that no one should ever have left the oceans. The internet is great, how we use it may not be. I don't have twitter, rarely delve into comment on most news sites and Youtube. Browse and sometime comment on Reddit and here. I prefer here, less shouty. When you are able to talk to thousands or millions of people without having to have connections, its a wonderful thing. The friction arises from a number of things; contrarians who love to argue, trolls, governments/companies who are trying to influence opinion but also people who have a genuine different opinion and are unwilling to listen to the other side. I did enjoy the internet more when it was younger but at the same time, there was a less diverse population on it then.
  • DalasNoin 6y ago
    But it is very interesting that mRNA vaccines can be very quickly developed for new viruses. The underlying technology may have taken years, but it can be applied to new viruses as soon as the virus is sequenced.
    • kemiller2002 6y ago
      I think this is the silver lining for this pandemic. Covid-19 is lethal, I'm not discounting that, but in terms of real lethality, this was a good test run to show that this approach works. (At least in my lay person's knowledge.) What really scares me are the highly lethal flu strains (I think H5N5?) The fact that we can produce a vaccine this quickly now gives me hope when we encounter a scenario like out of the movie Contagion.
      • tialaramex 6y ago
        High lethality is often associated with reduced transmissibility. Which makes sense - dead people certainly aren't going to cough on you. In a Sci Fi movie maybe the virus has a long delay, you're infectious for a month with no symptoms, then drop dead in seconds. But in the real world that's less likely the more extreme it gets. One thing that did make this virus more dangerous was that many humans became infectious significantly before they realised they had symptoms. With some viruses you get symptoms, then (sometimes as a result of the symptoms) you become infectious, making it easier for public health messages to be effective. "Stay at home if you have symptoms" is extremely effective if people aren't vectors until 12-24 hours after the symptoms are obvious, but almost useless if they're infectious a week earlier. I'd argue that countries which think the lesson is "We developed a vaccine quickly, good job" are mistaken. The lesson was just, "Elimination strategy works" and the many countries that didn't even attempt that got lucky they weren't decimated for their incompetence.
        • fat-chunk 6y ago
          It makes me wonder how the world would cope today with a Bubonic Plague or Spanish Flu, those two I reckon would probably be more similar to your hypothetical Sci-Fi disease.
  • redis_mlc 6y ago
    "The first identified case [of MERS] occurred in June 2012 in Jeddah, Saudi Arabia, ..." https://en.wikipedia.org/wiki/Middle_East_respiratory_syndrome https://en.wikipedia.org/wiki/Middle_East_respiratory_syndro... Shame a vaccine wasn't made for SARS-1 in 2002.
  • megaman821 6y ago
    Sure, and that website I made in 24 hours was only possible because of DARPA's funding of the first Internet and decades of efforts into programming languages, etc. The point being, if a novel deadly virus was discovered tomorrow, how fast could Moderna develop a potential vaccine?
    • iskander 6y ago
      It depends complete on what kind of virus it is. All of the interesting research required to hit "print" on mRNA-1273 was already done in MERS. It would have been surprising if the vaccine didn't work. If a new pandemic emerges from a less well understood family of viruses for which we don't have any good preclinical vaccines, it could still take decades. Sticking the genome into synthetic mRNA isn't the rate limiting step, it's knowing to target the spike protein, inserting the stabilizing proline mutations, &c and also having experience getting safe and protective responses from a similar vaccine for a related virus.
      • tinus_hn 6y ago
        Not to mention politics, if the disease wasn’t as big as COVID they’d have to wait for years for approval.
  • stainforth 6y ago
    We should always remind ourselves that government is the best investor of first resort.
• andyv 6y ago
  The great thing is that the next time this happens, a vaccine can be created equally quickly.
  • api 6y ago
    Maybe... depends on the virus. This won’t work for things like HIV or rapidly mutating viruses. It will probably work for any relative coronaviruses
    • superbaconman 6y ago
      Actually, Moderna is working on an hiv vaccine using similar tech. Sounds like they're pretty early on in testing though.
      • bluGill 6y ago
        There are many working on HIV vaccines. The virus mutates so fast that all previous attempts have failed. I wish them luck, but I'm not confident that it is possible. Time will tell.
        • djsumdog 6y ago
          I don't think that's the issue. With any virus, your immune system grows countermeasures exponentially (memory t-cells, antibodies, protein complements) to stop it. These stick around after the virus is gone. It's an immune system "memory" In another infection, your cells still get infected, but the infection is just stopped very quickly. HIV has inscription and reverse transcription enzymes in it, so it can actually glue its sequence into your DNA. It changes your DNA enough to replicate it, but not enough that your cells change their structure so your immune system can't recognize them as infected (and those changes can cause your immune system to fail over time: AIDS). Even if your body is primed to deal with HIV infections, if the infection happens, it's already too late. I'm not sure who antiviral drugs like PREP work, but you'd need something like that permanently in your system.
  • evancox100 6y ago
• causality0 6y ago
  I wonder if any, or if many, Moderna employees have been walking around off-the-books immunized since January. I know I would've been tempted.
  • tehjoker 6y ago
    Probably not since January, but maybe after the phase 1 trials and the dosing schedule was figured out. To be honest, if it doesn't come out that they were using it off the books, either they're suckers or we are.
    • phreeza 6y ago
      > if it doesn't come out that they were using it off the books, either they're suckers or we are. Or it doesn't come out because they are good at keeping it secret.
      • brodie 6y ago
        Would they need to keep it a secret? Could their own employees have entered the trials?
      • tehjoker 6y ago
        It could be a good thing to leak it to the press. The press would feign a scandal but it would actually have the effect of showing people that they believe in their product and only a slap on the wrist would actually happen (if anything).
    • zbrozek 6y ago
      Would it even be a problem if they did? Like presumably people are generally free to do things to themselves. If they self-administered and they were allowed to consume the resource (e.g., it wasn't theft) who was harmed?
      • mywittyname 6y ago
        I wouldn't personally mind. I mean, these researchers are, presumably, the most informed people in the world on the subject.
• seafoam 6y ago
  I could write Twitter in a weekend.
  • djohnston 6y ago
    You're being downvoted but the point is valid. To say that this was built in two days is to completely ignore the near decade of investment into mrna vaccines. Total nonsense.
    • renewiltord 6y ago
      That's not relevant. The point is that Moderna had a low-latency solution when the moment showed itself. It isn't that it's easy. It offers some thinking that their technology is revolutionary and that perhaps we need to revisit our calculations to see if the risk/reward means we should attempt earlier roll out. We know, this time with hindsight, that it would have saved hundreds of thousands of lives and billions of dollars if we'd used their product on day 3. Can we develop a protocol that can tell us that so we can use this tech on day 10 next time? Then we can save those lives.
      • Barrin92 6y ago
        > if the risk/reward means we should attempt earlier roll out you still need to make sure the vaccine actually works in trials and has no severe side effects. It takes one, and only one minor vaccine scandal to completely blow the trust of the public in public health. There is no linear risk/reward when it comes to vaccines. You need to be incredibly confident that they are safe or else you're going to screw yourself possibly for decades.
        • renewiltord 6y ago
          Sure, but we have experimental drug programs. People will sign up for challenge trials. We don't do it for the same reason IBM doesn't end up making the iPhone: risk aversion is really strong. If trust in the public were a thing the HHS were interested in they wouldn't have lied to the public about masks.
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• feross 6y ago
  Key quote: > The question ultimately comes down to risk vs benefit. We need to get over our evolved but suboptimal instinct to avoid directly causing harm preferentially over passively allowing harm to occur. In the end, the amount of harm is all that matters. In a situation like this, delivering a vaccine as quickly as possible while maintaining sufficient safety and efficacy, there is a sweet spot somewhere that minimizes disease, death, and disruption. We want that sweet spot, even it if means delivering a vaccine that has not been tested as much as we would like. It would mean accepting more risk form the vaccine in order to reduce risk from the pandemic.
  • Rochus 6y ago
    Looking at various safety standards, risk/benefit analysis is well established in the medical environment (and only there); e.g. ISO 14971 states "If the residual risk is not judged acceptable using the criteria established in the risk management plan and further risk control is not practicable, the manufacturer may gather and review data and literature to determine if the medical benefits of the intended use outweigh the residual risk."
  • infoseek12 6y ago
    I think that is the key quote but I believe their conclusion about balancing risks is mistaken. People don’t statistically assess risks the way actuaries do, even the most rational people don’t think like that. There’s already a significant percent of the population that believe any number of irrational things about vaccinations. Around a third of Americans aren’t planning to get the vaccine. If there are a significant number of adverse reactions convincing people to behave rationally will become even more difficult. When assessing the risk we can’t just look at the direct effects we also need to consider the effects on how the population at large will behave.
• ballenf 6y ago
  Just curious -- would it be that much harder to develop a vaccine that was itself contagious? Recipients would expel the vaccine in their own respiration?
  • alanbernstein 6y ago
    Interesting, like a fully engineered virus with the same spike proteins, but none of the "bad stuff"? Seems tricky, I think in order to be contagious, it needs to replicate, which is part of what makes viruses so harmful, right? Even if you can make it harmless, replicating means mutations will happen, so that's an interesting new kind of risk to take.
  • DalasNoin 6y ago
    There is a vaccine against polio that can infect and immunize others. It uses a live polio virus genetically modified to not cause severe disease. "The OPV is less expensive and easier to administer, and can spread immunity beyond the person vaccinated, creating contact immunity. It has been the predominant vaccine used. However, under conditions of long-term vaccine virus circulation in under-vaccinated populations, mutations can reactivate the virus..." from https://en.wikipedia.org/wiki/Polio_eradication https://en.wikipedia.org/wiki/Polio_eradication
  • cwp 6y ago
    Interesting. That's not a vaccine anymore that's a strain of SARS-CoV-2 that's never produces symptoms, but is still similar enough to the original to prime the immune system. Presumably it would out compete the original in a Darwinian sense, because people who caught it would never get sick and stay home. Risky, though, because if it turns out to be less benign than we thought - or mutates in such a way as to become lethal - we've just started a second pandemic.
  • _ph_ 6y ago
    I had the same idea and was convinced by a biologist, that his is a very bad idea. To be able to spread, this vaccine-virus needs to infect the people vaccinated. Any infection is dangerous, as it means the virus is multiplying in your body until the immune system hopefully takes hold of it. What happens if it doesn't? This happens with traditional vaccines all the time, but the consequence is only that you are not acquiring immunity, no other harm done. The other point is, you have made a completely new human-transmissable virus. How do you reliably prevent it from mutating into something more dangerous?
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• tehjoker 6y ago
  I don't know how Moderna was made, but the Pfizer vaccine is a modified spike protein: they use two edits to lock it in a pre-fusion conformation. Maybe this is easy to model in software, but I suspect that does take a little bit of trial and error to confirm it works in vitro too.
  • blackbear_ 6y ago
    Moderna did that too [1]. I have no clue how they found the mutation but it was already known for a few years [2,3] [1] https://www.biorxiv.org/lookup/doi/10.1101/2020.06.11.145920 https://www.biorxiv.org/lookup/doi/10.1101/2020.06.11.145920 [2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6200764/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6200764/ [3] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5223232/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5223232/
• parsimo2010 6y ago
  No, it took years to develop the vaccine. Luckily they started on it before they even knew whether there would be a big payoff. Otherwise we wouldn't have either the Moderna or Pfizer vaccine. I'm generally against pharmaceutical companies charging ridiculous prices for their drugs, but we've benefited from the fact that they use this money to pursue risky research opportunities. If the chance at a big payoff wasn't there, big pharma might not have had this in the hopper. Government funding alone probably can't incentivize pharma to continue pursuing long-shot bets at their current level. Now I have to think about which option I would prefer- cheaper prescriptions or a better chance at being prepared for catastrophic events.
  • hn_asker 6y ago
    those options don't have to be mutually exclusive
• tzs 6y ago
  Suppose an mRNA vaccine is developed for some virus, but it fails to clear phase 1 safety testing. Question: what would be the likely reasons for that? In particular, is it almost certainly going to be due to whatever carries the mRNA, or could the mRNA itself be the problem? If it is the carrier in which potential safety issues lie, does that mean that once we have one successful safe mRNA vaccine for virus A, then when some new virus B comes along an mRNA vaccine for B that uses the same carrier is going to be as safe as the vaccine for virus A? If so, does that mean for future new viruses, the mRNA approach will let us go right into effectiveness testing, skipping phase 1 safety testing?
  • bluGill 6y ago
    Phase one is about dosage at least as much as safety. The most likely reason to fail is probably that it doesn't produce an immune response at any reasonable dosage.
    • NoodleIncident 6y ago
      Is there any risk of a "doesn't produce immune response" failure that would make it unsafe to start giving to healthcare workers immediately? Could it make later vaccines ineffective? I'm sure that it would ruin the data for later vaccines, but if high-risk people just take each new vaccine as it starts trials, their data doesn't have to count towards the actual trial.
      • bluGill 6y ago
        Don't downplay the safety. Phase 1 can fail because of lack of immune response OR safety concerns. Phase 2 and 3 trials are also about safety, and both of them somewhat often fail because of safety issues. A vaccine can make a disease worse by priming the immune system to overreact and attack the entire body when a single cell is infected. The more we know about a vaccine the more confident we are. The flu vaccine is changed every year without long safety studies: we have learned enough about how people response to the flu vaccines in use to not need them anymore. When the same process is used to make a non-flu vaccine though we still have to start over because there isn't any way to be sure. You are quickly getting beyond my area of knowledge though. I didn't answer all of your questions because I don't know.
• fabian2k 6y ago
  I think the title alone might be a bit misleading, I'd rather state it as "it tooks two days to develop a vaccine candidate". The mRNA vaccine method does mean that you can design a vaccine this quickly, just based on the sequence and some general knowledge about the virus. But what you don't from this are safety and efficacy, you still have to determine those the hard way. Which the article of course also mentions at length. As far as I know Moderna and Biontech tried different variants of their vaccine. And to determine how well those work you have to do some animal experiments, and that is always much slower than designing and synthesizing mRNA sequences. The mRNA vaccines were the fastest ones, and they worked better than expected. So I think there is a lot of promise in the technology, but further speedups are hard because they're in the clinical study part.
• ape4 6y ago
  There was much hoopla about the Pfizer vaccine scientists. I'm sure they're smart but maybe not geniuses.
• tzs 6y ago
  The layman's explanation I've seen about how these mRNA vaccines work is that they get some of your cells to manufacture a protein that is characteristic of the virus, which the cells release and the immune system takes care of. Then later if you get the virus, the immune system already recognizes that protein and takes care of the virus. Question: why do we need to have our cells make the protein? Couldn't we synthesize and distribute the protein itself and inject that? Question 2: what happens to the cells that take in the mRNA and make the protein? Do they just make a certain amount of it, then go back to normal? Or do they keep making it for the lifetime of the cell, and stop doing whatever that cell is normally supposed to do? Or do they get killed doing this, much like if they were infected by the virus (except, of course, that unlike the with the virus, what they are making is not viral, so the maximum number of cells that would be killed making the protein is equal to the number of mRNA strands in the injection)?
  • djsumdog 6y ago
    It's not just proteins. The cells infected with the mRNA present those proteins on the outside of the cell to be recognized by other cells which start a chain process. Skip to around 12:30 in here: https://www.youtube.com/watch?v=35Idb_lCU4o https://www.youtube.com/watch?v=35Idb_lCU4o He goes through the entire biochem process. Even the cells infected with the mRNA will need to be removed by the immune system using cytotoxic T-cells, so they need to get the chain process going. The reason we have "memory" for viruses is because a ton of random stuff in our immune systems evolved to multiply exponentially when they come in contact with viruses or proteins that indicate certain infections. It's a lot of stuff and you can't just inject that memory in; you have to stimulate the immune system to create them at a very large scale. It's not just antibodies. There are memory T-cells, parts of the complement system that get activated; a whole host of things. My issue is that our immune systems are incredibly complex, and there are a lot of components to this "memory" that are not entirely understood. Every other vaccine is an inactivaed virus (via heat treatment) or attenuated (virus run through other hosts to make it less dangerous to humans). The first vaccine was just a close relative: cow/horse pox instead of smallpox. The former are not dangerous in humans, but seem to produce the same immune memory. The mRNA vaccines are at attempt to say, "Let's strip out all that other stuff and find just the thing we need." But our immune systems are incredibly complicated. It will be interesting to see if these things actually work at scale. The trials were to make sure the vaccine is safe in a short about of time. It's not really going to test effectiveness until deployed at scale.
• djsumdog 6y ago
  Big pharma companies have wanted mRNA vaccines for years. Others have been developed and even gone through trails that never got approved for markets. There are also trials for therapeutics such as inhaled steroids; something doctors in certain regions have been prescribing off-label for months and claim to have very high success rates. Yet organizations like the NIH are saying they shouldn't be used until the trials/studies are done... and they've been saying that since August. Honestly, I'd rather more effort be put into seeing if existing therapeutics can be used to reduce the effects of moderate/severe COIVD. Let's face it. The drug companies got millions just to attempt to develop these vaccines, many of those attempts which will be failures. They don't care. They already have tax payer money from countries all around the world. This is a push to the first mRNA vaccine out, so the Gavi Health Alliance can start pushing more of them. There is a huge money incentive we're ignoring. It's not on this particular vaccine; it's on all the future vaccines--some which have already been developed and never made it through all their trails/approved--and the billions they stand to make from them.
  • bluGill 6y ago
    A vaccine reduces the effects of moderate/severe Covid to zero. All other treatments mean at best time off of what I want to be doing while I'm treated. That is at best, the most likey case is you still get the bad side effects - including long-covid (whatever that is, science is still working that out), just a bit reduced. I'll take zero effects.
• aazaa 6y ago
  > They identified the sequence for the spike protein, plugged that into their vaccine platform, and voila – an mRNA vaccine against the SARS-CoV-2 virus. Moderna zeroed in on the spike protein thanks th large amount of previous research on SARS-CoV-1. Vaccines effective in animal models of SARS were developed based on this approach starting around 2004: https://www.pnas.org/content/101/17/6641 https://www.pnas.org/content/101/17/6641 The article continues: > The win-win here, however, is that the more we develop a universal vaccine platform, the more we can have the best of both worlds – fast plus safe and effective. But this also means we need public buy in, which requires reassuring the public about the process and the strategy. It also means reassuring the public that the process has not been politicized, and that objective experts are driving (something the TA did poorly). The MRNA approach requires an understanding of viral vulnerabilities and a lot of animal studies prior to the synthesis of a vaccine candidate. Again, that seemingly fruitless work with SARS more than a decade ago was the key to the success of Moderna and Pfizer today. It's a lesson that should not be forgotten but probably will. The other thing to keep in mind is that the Pfizer and Moderna approvals represent the first ever large-scale use of MRNA vaccines in humans. That substantially lowers the barrier to entry of new vaccines based on the same platform.
  • sp332 6y ago
    I understand why they went for the spike protein first, but now maybe they could try for something more generic, against all coronaviruses?
    • aazaa 6y ago
      That would require the kind of understanding of viral vulnerabilities I'm thinking of. The same applies to any virus, of course. To my knowledge, that kind of understand does not exist because coronaviruses have been largely ignored historically, with the exception of SARS and MERS. And we've been trying for decades to get a broad-spectrum or even single-dose-forever vaccine for the flu, so far without much to show for it.
  • IfOnlyYouKnew 6y ago
    The idea that while it may have taken only a few days, it still wasn't "easy" is probably best demonstrated by the Pfizer/BioNTech joint venture: Pfizer has tens of thousands of biologist of any stripe working for them, but they chose to partner with a comparatively tiny startup that had the expertise to design the vaccine.
• Pandabob 6y ago
  On a related note, the fast development of a COVID vaccine seems to have triggered a sense of techno-optimism in certain bloggers / commentators. Here’s a recent summary by Noah Smith on the topic: https://noahpinion.substack.com/p/techno-optimism-roundup https://noahpinion.substack.com/p/techno-optimism-roundup
• shdon 6y ago
  The article say that they spent a decade of research on mRNA vaccines before. That was obviously well before anybody knew about SARS-CoV-2/COVID-19. Does this mean that the research basically was about creating sort of like a "template" vaccine that can then be specialised or programmed with the specifics of the thing you're trying to vaccinate against?
  • djsumdog 6y ago
    None of those came to market. Many did make it through trials. This is more about pushing this as a first onto the market so pharma companies can finally prove they're safe, and then making a shit ton of money on more vaccines after.
  • dragonwriter 6y ago
    > Does this mean that the research basically was about creating sort of like a "template" vaccine that can then be specialised or programmed with the specifics of the thing you're trying to vaccinate against? That may (or may not) have been the effect (at least within a narrow family of similar viruses), and is definitely something they market about their “mRNA platform”, but their immediately-previous mRNA vaccine work which was ongoing when they shifted to SARS-CoV-2, was specifically directed at MERS-CoV, another very similar betacoronavirus of significant public health impact (though a lot less widespread than SARS-CoV-2 has become.)
  • bluGill 6y ago
    The goal is to take someone with cancer, and then create a vaccine for the exact cancer mutation that person has. this would be a custom one-off vaccine that wouldn't work for anyone else because their cancer is different in some way. I don't know if this will work, but it would be a great improvement to cancer treatment if it does.
• hn_throwaway_99 6y ago
  There are these 2 quotes from the article that I think are a little too "handwavy" over potential real problems for the future: > Since the platform itself is pre-tested, we won’t need to do months of testing before distribution. Still, we may need to do some testing on the specific vaccine. Perhaps much of this testing can be done with computer modeling, and some with animal testing. and > The question ultimately comes down to risk vs benefit. We need to get over our evolved but suboptimal instinct to avoid directly causing harm preferentially over passively allowing harm to occur. In the end, the amount of harm is all that matters. In a situation like this, delivering a vaccine as quickly as possible while maintaining sufficient safety and efficacy, there is a sweet spot somewhere that minimizes disease, death, and disruption. We want that sweet spot, even it if means delivering a vaccine that has not been tested as much as we would like. It would mean accepting more risk form the vaccine in order to reduce risk from the pandemic. Think of the crazy amount (highlight on the crazy) of opposition you have to vaccines now. Imagine if you get one vaccine with just a slightly higher amount of negative reactions, and even a few deaths that were clearly vaccine-caused, due to rushing the approval process. You will have set back public health decades. Look at covid: its fatality rate is actually quite low, well well below 1%. If we give the vaccine to everyone, you need to have extremely low adverse reactions for it to be a net positive because we're giving it to so many people. I feel that these types of articles that argue "We need to get over our fundamental human irrationality" are pointless, because we are, after all, human.
  • jcampbell1 6y ago
    Rationality can be induced if the vaccine is highly effective. If I get my family vaccinated and learn that the neighbors died due to the disease, it will be common wisdom that they died due to poor decision making.
    • gnusty_gnurc 6y ago
      > it will be common wisdom that they died due to poor decision making so when, for example, someone gets raped after a night out while intoxicated or dies due to alcohol overdose after joining a frat...is the socially acceptable response now "poor decision, didn't assess risk correctly."?
• unchocked 6y ago
  Yes. We need accelerated testing. In the case of a pandemic, we need to make better use of volunteers. I believe that as the history of this one is reckoned with, one of the more interesting moral failures to be acknowledged will be the failure to utilize challenge testing protocols with willing volunteers (give them the vaccine and then deliberately expose them to the virus. It is a calculated risk.) Earlier phases could have been accelerated as well. For mRNA vaccines, deleterious effects are unlikely, inefficacy is the likeliest problem. It might be possible to be challenge testing (highly informed) volunteers within a week of a novel virus being isolated. On a similar note, national stockpiles of RT-PCR machines and reagents would allow widespread testing within the same week. If I’m right, these indicate moral failures deeply embedded within our political and medical systems. Better luck next time.
  • DalasNoin 6y ago
    Maybe a new test would look like this: 1. Vaccinate humans and animals and see if they create antibodies and test if they can neutralize the virus. 2. Infect animals on placebo and vaccine on purpose. 3. If it improves outcome, infect humans on the vaccine. The old system could be run in parallel
    • jononor 6y ago
      Don't you need a control group for stage 3 (no vaccine)? If so, that might be highly problematic/unethical.
      • sfblah 6y ago
        No, you don't, because you're infecting them on purpose. It's safe to assume that an extraordinarily high percentage of them would be infected if they were on a placebo leg of the trial.
  • WalterGR 6y ago
    We need accelerated testing. In the case of a pandemic, we need to make better use of volunteers. How would you attract volunteers for these less-safe clinical trials? Pay them money?
• hanoz 6y ago
  That's great. Well, if they're in at all between Christmas and New Year maybe they can quickly sort the common cold out. Then full steam ahead in January and they should have all the plagues of humanity pretty much wrapped up by Easter?
• JohnJamesRambo 6y ago
  I’m glad to see this and we need to concentrate on speeding this process up. This isn’t the last pandemic and all things considered this one was a pretty benign one to have to fight. The next one might not just kill mainly the old and weak and might need much more than a mask (that we still can’t get people to wear!) to prevent its spread. Hopefully before then, we can work to get everyone more on the same page and have a rapid vaccine task force ready. My brother is a doctor and he got his Pfizer shot yesterday. Less than one year has passed since the first case in the USA. I consider this one of the great accomplishments of science. It will go unnoticed by many idiots on social media but it is an amazing achievement by all the scientists and doctors involved.
  • mrits 6y ago
    To get worse than COVID you'd need a virus that takes a long time to develop symptoms and then has a high death rate. In that scenario there would be a lot more public fear and we'd have an easier time keeping people at home. So I'm still of the opinion it's harder to have a worse situation than COVID.
    • jayrot 6y ago
      Yeah this pandemic has been described as the perfect middle ground for politicization, denialism, and just laissez-faire attitudes. Any more deadly (like Ebola) it becomes incredibly scary and people likely do whatever it takes when they see people around them dropping like flies (especially in horrific ways). Any less deadly (basically the yearly flu) and it becomes easy to ignore and just becomes part of the background process. COVID is somewhere in between. Deadly enough that hundreds of thousands of people are dying unnecessarily. But can still feel a million miles away for so many people. This was not a good "training pandemic".
      • chrononaut 6y ago
        > This was not a good "training pandemic". Was it not though? I assume you'd want a pandemic deadly enough for that convinces a majority of the populace that it's a serious event (to encourage downstream change to better prepare for a worse pandemic), while at the same time not causing people to drop like flies. As you stated, anything less severe would be taken less seriously. To have something to be taken more serious, it has to be more deadly. Despite the denialism we currently have, it seems to have made the world recognize the importance of preparation.
• l33tman 6y ago
  I'm not a virologist but this is clickbait I think, it does not take long to synthesis fragments of the spike protein for a traditional vaccine either or program the rhinovirus vector in a more modern vaccine. I don't think that really is the bottleneck. You still need a LOT of testing as the viral antigen you are trying to vaccinate against can have similarities to human proteins for example, and the antigen might simply be a bad antigen for immunization - and this requires a lot of testing and studies. The normal yearly influenza vaccines are also fast for example because they are well known platforms and also the antigens repeat historically and are thus (relatively) well tested. I guess my point is that the problem of the vector to get the antigen in contact with the immune system is orthogonal to the problem of selecting the antigen for overall cross reactivity and efficiency and the latter is still a difficult and timeconsuming problem.
• air7 6y ago
  I think the key would be provable lack of ill-effects. With that we could start immediately using a kind of bandit testing to try and phase out different tweaks until finding the perfect one.
• coding123 6y ago
  https://www.youtube.com/watch?v=XAQ_Ef-OqrI https://www.youtube.com/watch?v=XAQ_Ef-OqrI India's death rate has been much lower than the US. Part of this is because they're already doing widespread cholecalciferol roll-out. If cholecalciferol is not on 2021's CDCs/FDA/AMA number one recommendation list for pre-Covid control, I will have considered the AMA a complete and utter failure in the united states. Edit: Also https://www.youtube.com/watch?v=ha2mLz-Xdpg https://www.youtube.com/watch?v=ha2mLz-Xdpg
  • fortran77 6y ago
    Don't underestimate how much of the US's problem (and UK, Canada, etc) was caused by obesity, too. https://www.sciencemag.org/news/2020/09/why-covid-19-more-deadly-people-obesity-even-if-theyre-young https://www.sciencemag.org/news/2020/09/why-covid-19-more-de...
    • jgalt212 6y ago
      Perhaps, but I'm sure we'd figure out another way to justify The Fed gifting the investor class $2T.
      • deleted 6y ago
        [deleted]
    • hjnilsson 6y ago
      Average age in India is 26. Average age in the US is 38. This probably accounts for the difference in death rate.
      • fortran77 6y ago
        From this article > We didn’t understand early on what a major risk factor obesity was. … It’s not until more recently that we’ve realized the devastating impact of obesity, particularly in younger people,” says Anne Dixon, a physician-scientist who studies obesity and lung disease at the University of Vermont. That “may be one reason for the devastating impact of COVID-19 in the United States, where 40% of adults are obese.”
• fortran77 6y ago
  Two days...and 15 years. But this is a very exciting and important development. Akin to a moon landing. How many diseases will be treatable or curable in the near future with this technology? Do any cancers have characteristics that can be used to direct our immune systems to go after them with this technology? I suspect a few might.
• renewiltord 6y ago
  The problem is one of medical ethics in an unequal society. The problem is that there's a sum of money for which I would have taken the risk and got a vaccine in January and had exposure to the disease in February. Everyone in society would have been better off if I had been permitted that. America could have paid me and 49 others a million dollars each and come out wayyy ahead (since direct exposure tests will yield results way faster). Then a 3 month safety protocol and we're off to the races. But I can make that choice because I am comfortably above subsistence. If I do it, you know it's because it's a combination of bravado, bragging rights, and this money I could survive without. But if you actually allow the market to price this, the real price for the tester is approximately $10 in sub-Saharan Africa, and we know he's on below subsistence and is really trading his body for another few days of life. We find that doing this is abhorrent. An interesting effect that inequality prevents us from Pareto optimal actions and improving the human race as a whole.
  • pjscott 6y ago
    A few workarounds spring to mind: 1. Run challenge trials, but don't pay participants in money. Talk up the danger and risk, and publicize the heroism of the people who volunteer. Make a spectacle of it. If you ask for fifty heroes, is there any doubt that you'd get them? 2. Pay participants, but impose a minimum price they need to be paid in order to assuage people's squeamishness. That hypothetical guy in sub-Saharan Africa might be exploited at $10, but if he's getting paid $1,000,000 then he has practically won the lottery. Either of these would be a big improvement over the status quo, where challenge trials aren't run at all and countless people die because of it.
    • hnracer 6y ago
      Or 3. only recruit people who earn over X dollars. Any of these are good solutions.
  • winston_smith 6y ago
    It's great that you care about poor people, but it's also elitist to treat them like they're too poor to afford free will.
• amelius 6y ago
  > It Took Two Days The virus started spreading in 2019 ...
• JoeAltmaier 6y ago
  All correct. But also, disturbingly Utilitarian. Release vaccines before they are tested, and withdraw those that cause more deaths than they save? Trading lives for lives, coldly. There are costs to calculated Utilitarianism. The damage to public confidence in vaccines springs to mind. If a vaccine is provably killing 1% of those receiving it, yet saving the lives of 2% (and more once herd immunity is reached) it may raise some alarmist criticism (to say the least) over the safety and advisability of getting vaccinated. Making it harder to convince the public to get vaccinated at all. Other costs are, mis-estimating the ultimate death toll may lead to killing more up front than was strictly necessary. Or the vaccine may have side effects down the road, shortening lives or diminishing quality of life (sterilization? memory loss? immune system compromises?). Unless all the costs are factored in, Utilitarianism become a guess, and can be used to serve profit or social agendas. The law of unintended consequences will loom large. We have a vaccine protocol for a reason.
  • mchusma 6y ago
    2 main comments: 1) your example of 1% death rate would be detected very early in a rollout, and would represent something akin to a 10000x worse vaccine outcome that has ever been experienced. The worst vaccine ever is generally regarded as causing 1 in 10,000 narcolepsy. 2) the word "approved" is misleading. Of you change this to say "banned" or "not banned", this reads very differently. The requirement to ban everyone from taking a vaccine in order to mitigate some extreme long tail event and maintain public confidence is hard to justify on utilitarian grounds, but pretty much any other ethical framework.
  • cma 6y ago
    > There are costs to calculated Utilitarianism. The damage to public confidence in vaccines springs to mind. If a vaccine is provably killing 1% of those receiving it, yet saving the lives of 2% (and more once herd immunity is reached) it may raise some alarmist criticism (to say the least) over the safety and advisability of getting vaccinated. Making it harder to convince the public to get vaccinated at all. If that can already be calculated, calculated utilitarianism could take it into account.
    • 6y ago
• kart23 6y ago
  Does anyone know the specific differences between the Pfizer and Moderna vaccines? I know the quoted reason is that its something to do with the structure of the delivery method, the lipid nanoparticles. And I've seen news articles saying that this information is proprietary and won't be released. Is that really an acceptable excuse for the first mRNA vaccine to be used on a massive scale and with about 6 months of trials? I think this information should be made open so that other countries/companies can produce vaccines with the higher temperature requirement, not to mention that the public should know these differences and why they exist. There's gotta be more factories that have the necessary equipment, but the plans just aren't available. https://www.npr.org/sections/health-shots/2020/11/17/935563377/why-does-pfizers-covid-19-vaccine-need-to-be-kept-colder-than-antarctica https://www.npr.org/sections/health-shots/2020/11/17/9355633...
• noodlesUK 6y ago
  I am very concerned that moderna is such an incredibly inexperienced company when it comes to actually delivering products. Companies like Pfizer and Astra etc have lots of infrastructure for manufacturing and logistics, as they’ve been making drugs for years. Moderna hasn’t ever released a product before, and now we need them to successfully make hundreds of millions or billions of doses of it very quickly? I have every confidence that the drug itself is safe and effective, but I fear that they won’t be able to deliver on the quantities required.
  • rpedela 6y ago
    McKesson is handling distribution for Moderna, and one of the main goals of Operation Warp Speed was to ramp up production using companies who are good at it so the vaccine developers wouldn't necessarily have to do large scale manufacturing themselves.
• person_of_color 6y ago
  What happened to the take that some here held that this is “obviously” a scam?
• xjlin0 6y ago
  The title is somewhat misleading. A better title would be " It took two days to design Moderna’s vaccine with available technologies and data." Another analogy would be something like "It took X days to design Blue Origin's New Glenn".
  • undersuit 6y ago
    OK but what would X be? Would I be impressed by the number?
  • asutekku 6y ago
    Everything has always been done with ”available technologies and data”. That the vaccine was made in two days is pretty impressive in itself.
• etqwzutewzu 6y ago
  It's like the story of Picasso doing a quick sketch. "It took me 5 minutes + 40 years".
• hn_asker 6y ago
  I'm concerned about the long-term effects of taking these mRNA vaccines. Have there been any studies? Is it true that you may need to take the vaccine more than once?
• futevolei 6y ago
  I think most importantly of all it seems that this wasn’t a very hard problem to solve, relatively speaking. Like we could throw all the scientists all over the world who worked on this at cancer and there won’t be a cure for cancer a year from now. At least I don’t think. Nonetheless I remain impressed and salute any and all scientists who either did the work or paved the way.
• raarts 6y ago
  Does anybody think our grand kid's kids will get vaccinated with hundreds of vaccines when they're born? The industry will make a lot of money out of that sure, but I have my doubts where this is going.
  • CydeWeys 6y ago
    Hundreds of vaccinations in infancy and then they never get sick for the rest of their lives? Hell yeah, that's the ultimate dream right there.
• fierarul 6y ago
  > They identified the sequence for the spike protein, plugged that into their vaccine platform, and voila – an mRNA vaccine against the SARS-CoV-2 virus. A COMPUTER took two days to develop the vaccine. Think about that.
• timwis 6y ago
  If I came across this article on facebook or something, I wouldn't trust it because I've never heard of the source (and, to be honest, I'm kind of judgy of the old design). How do you determine its credibility?