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Can someone fill me in here. I have tried my best to read, and educate myself about these mRNA vaccines. But I have yet to see any conclusive evidence or proof

Can someone fill me in here. I have tried my best to read, and educate myself about these mRNA vaccines. But I have yet to see any conclusive evidence or proof that having the vaccine for COVID-19 prevents you from actually getting COVID-19. And i've seen many people debating this in the comments of other HN threads. It might mean you are asymptomatic, and _less_ likely to spread your symptoms - but it still means you can theoretically harbour the virus and spread it on to others (e.g. through kissing) So, the question is, given we already have medication which works well as treatment for those with HIV - what exactly will this vaccine do for HIV - if not stop the transmission? My understanding is HIV is primarily spread through sex and sharing of needles. A vaccination program won't stop that. Thanks in advance. I would love to read more about this.

notJim 6y ago
As I understand it, the reason we don't have that data about the COVID vaccines is that it's costly to check for it. It's much easier to measure symptomatic cases than it is to regularly test everyone in the study to confirm that they don't have an unsymptomatic case. I believe we do think the vaccines prevent COVID, but we just haven't confirmed that.
Kliment 6y ago
I'll try. I'm no expert but I read a lot about this and people keep asking me to explain it to them. First of all, there is no way to entirely prevent infections and transmission of something that replicates in poorly perfused (low blood flow in the area) upper airways. The immune system works by carrying stuff to infection sites via blood, and so you need enough blood at the place where the virus is before it can be attacked. That's why nobody is claiming total protection from infection and transmission. However, this is highly misleading - the number of replication cycles before immune response stops further spread is dramatically reduced in a vaccinated person, and therefore both their chances of developing disease, and their chances of passing it on, are severely diminished, and the window of transmission is shortened from days/weeks to hours. So yes, you can theoretically spread it, but once vaccinated you're about as effective at spreading it as a doorknob someone sneezed on, rather than being a walking virus manufacturing factory. Now, about HIV - HIV is extremely difficult to spread from a single contact (it's got very low virulence) and can be managed very well with treatment, making transmission effectively stop from people in state-of-the-art treatment. However, said treatment is expensive and inconvenient, and has risks of its own, and you need to use it all your life, and it's not available to many people, especially risk groups. By vaccinating people at risk, or large parts of the population, HIV could be eliminated, or dramatically reduced at least, saving the people who would get infected from a life of being medication-dependent, assuming they have access to treatment. So for HIV, a vaccination program won't stop needle sharing and unprotected sex, but will stop people getting even more severe consequences from that. There's a similar vaccination program for hepatitis which has shown excellent results.
- lultimouomo 6y ago
  > So yes, you can theoretically spread it, but once vaccinated you're about as effective at spreading it as a doorknob someone sneezed on You should most definitely point out that yours is a conjecture. A reasonable one, but still completely unsupported by clinical data - not because data refutes it, but because there is no data. All trials only examined the reduction of symptomatic infection; they didn't even try to measure whether vaccinated people were able or not to spread the virus. I would expect your conjecture to be true, but humans are weird, viruses are weird and medicine should be based in evidence, and evidence isn't in yet.
  - Kliment 6y ago
    This is true of the large scale vaccine trials, yes. However, there have been several small long term monitoring studies that test immunity persistence post infection recovery, and they seem to show that replication is effectively prevented when exposed to blood serum with acquired immunity with a fairly short time delay (this is what motivated the attempt to do serum transfusions from recovered patients as treatment, but I'm not sure what came of that). That said, you're right that my comparison is overstating the confidence we currently have in this.
argonaut 6y ago
Absence of evidence is not evidence of absence. Most scientists fully expect the approved vaccines to prevent infection and transmission for some significant % of people. The only thing that hasn't been conclusively proven is what that % number is. Not to mention there is already limited/preliminary data that the Moderna vaccine reduces asymptomatic infection (https://www.wsj.com/articles/can-you-still-spread-covid-19-after-you-get-vaccinated-11610379107 https://www.wsj.com/articles/can-you-still-spread-covid-19-a...).

notJim 6y ago

As I understand it, the reason we don't have that data about the COVID vaccines is that it's costly to check for it. It's much easier to measure symptomatic cases than it is to regularly test everyone in the study to confirm that they don't have an unsymptomatic case. I believe we do think the vaccines prevent COVID, but we just haven't confirmed that.

Kliment 6y ago

I'll try. I'm no expert but I read a lot about this and people keep asking me to explain it to them. First of all, there is no way to entirely prevent infections and transmission of something that replicates in poorly perfused (low blood flow in the area) upper airways. The immune system works by carrying stuff to infection sites via blood, and so you need enough blood at the place where the virus is before it can be attacked. That's why nobody is claiming total protection from infection and transmission. However, this is highly misleading - the number of replication cycles before immune response stops further spread is dramatically reduced in a vaccinated person, and therefore both their chances of developing disease, and their chances of passing it on, are severely diminished, and the window of transmission is shortened from days/weeks to hours. So yes, you can theoretically spread it, but once vaccinated you're about as effective at spreading it as a doorknob someone sneezed on, rather than being a walking virus manufacturing factory. Now, about HIV - HIV is extremely difficult to spread from a single contact (it's got very low virulence) and can be managed very well with treatment, making transmission effectively stop from people in state-of-the-art treatment. However, said treatment is expensive and inconvenient, and has risks of its own, and you need to use it all your life, and it's not available to many people, especially risk groups. By vaccinating people at risk, or large parts of the population, HIV could be eliminated, or dramatically reduced at least, saving the people who would get infected from a life of being medication-dependent, assuming they have access to treatment. So for HIV, a vaccination program won't stop needle sharing and unprotected sex, but will stop people getting even more severe consequences from that. There's a similar vaccination program for hepatitis which has shown excellent results.

lultimouomo 6y ago
> So yes, you can theoretically spread it, but once vaccinated you're about as effective at spreading it as a doorknob someone sneezed on You should most definitely point out that yours is a conjecture. A reasonable one, but still completely unsupported by clinical data - not because data refutes it, but because there is no data. All trials only examined the reduction of symptomatic infection; they didn't even try to measure whether vaccinated people were able or not to spread the virus. I would expect your conjecture to be true, but humans are weird, viruses are weird and medicine should be based in evidence, and evidence isn't in yet.
- Kliment 6y ago
  This is true of the large scale vaccine trials, yes. However, there have been several small long term monitoring studies that test immunity persistence post infection recovery, and they seem to show that replication is effectively prevented when exposed to blood serum with acquired immunity with a fairly short time delay (this is what motivated the attempt to do serum transfusions from recovered patients as treatment, but I'm not sure what came of that). That said, you're right that my comparison is overstating the confidence we currently have in this.

argonaut 6y ago

Absence of evidence is not evidence of absence. Most scientists fully expect the approved vaccines to prevent infection and transmission for some significant % of people. The only thing that hasn't been conclusively proven is what that % number is. Not to mention there is already limited/preliminary data that the Moderna vaccine reduces asymptomatic infection (https://www.wsj.com/articles/can-you-still-spread-covid-19-after-you-get-vaccinated-11610379107 https://www.wsj.com/articles/can-you-still-spread-covid-19-a...).