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Six fold reduction is extremely concerning! As the vaccine becomes more widespread, it will be tested more widely by exposure to the virus and this will trigge

Six fold reduction is extremely concerning! As the vaccine becomes more widespread, it will be tested more widely by exposure to the virus and this will trigger faster evolutionary cycles by the virus to defeat the vaccine. My forecast is we will have to get much faster at releasing updated vaccines and distributing them in order to stay ahead of this virus -- and that everyone will need to be vaccinated every 6 months until we hit sufficient heard immunity of the circulating strains such that is stops circulating so rapidly and the speed of mutation consequently reduces.

djrogers 6y ago
That scenario only plays out if vaccinated people can be carriers. If not, virus that is exposed to the vaccine will not have a chance to evolve more quickly.
- corin_ 6y ago
  Even if they cant, for the period when there are lots of people vaccinated and also lots of people infected, that's lots of mutations happening in infected people and then trying to jump into vaccinated people, giving it more chances that one of those mutations would then spread from vaccinations people even if current mutations don't (which isn't known yet). If it spreads from vaccinated people already then that would be even worse.
tachyonbeam 6y ago
I believe the same thing. We need a fast vaccine update cycle. We also need much faster production. It looks like the mRNA vaccines have the fastest turnover cycle. IMO the government should employ emergency measures to force Pfizer and Moderna to upgrade their production facilities to 10x what they are now. Get other companies involved. Pour as much money as necessary. Fortunately, it seems there is openness from the FDA to have a faster approval cycle for vaccine tweaks. Moderna is already working on a "booster shot" to try and increase immunity to the South-African variant. I wish that we also had other therapeutic tools to combat COVID. I wonder if we couldn't save people who are getting hospitalized by employing drugs that block the receptor the virus uses to enter cells. Similarly to the way HIV is kept under control. That could save lives and it would be more mutation-proof.
- temp667 6y ago
  I hate suggestion like this - most of the government involvement so far has been negative - don't wear masks, do wear masks and cloth masks are fine (they probably are not). We're going to cancel doctors license who go out of order in vaccine distribution (so now when the 65 year old drives their 75 year old partner in they can't both be vaccinated). If anyone actually cared about this there is an EXISTING mechanism to get business to produce pretty much any quantity of anything you want. You pay them money. Instead the government is constantly canceling contracts, seizing products, stopping the sale of products for more than 10% more than historic prices etc. ALL these steps REDUCE confidence in making a big / high risk investment. My guess - if we looked at even existing use of the DPA - probably most stuff got made by folks not expert in making it and sat in a warehouse. I'm serious - I want to know how many ventilators made under DPA by rando companies are actually in use? I've worked in govt contracting - the govt does not get "the best" producers to produce, in situations like this the hands reach out from the experts playing the govt contracting game. Not end of world normally, but with lives on the line some more standard approaches would be refreshing.
  - tachyonbeam 6y ago
    This is an emergency situation. I don't know if we can count on individual companies to just do the right thing. They might be risk-averse, afraid of financial losses, but we need them to go full-steam ahead. Pfizer and Moderna should definitely be financially compensated for everything they produce. We could pay them above cost and basically guarantee their financial success in this operation. It's possible that the current generation of vaccines could end up being outdated, and there could be some amount of waste, but the important thing is the production rate. When an updated vaccine becomes available, we want to be able to produce it and distribute it as fast as possible. On another note, there's also research into oral vaccines. IMO that would be amazing if it could pan out. Imagine if we could just mail people capsules containing booster doses updated for the latest strain every month. We'd crush any pandemic in no time.
    - maxerickson 6y ago
      The really wild vaccines use a self replicating viral vector. One of Merck's discontinued candidates used a live, replicating virus. I guess if you really nail the science, you can make it infectious and vaccinate by breathing on people.
throwaway894345 6y ago
I wonder what would be the implications for being able to develop and deliver RNA vaccines on this shorter, more regular timeline? Specifically, does the infrastructure required to accomplish this goal also bring other vaccines or treatments in the realm of feasibility?
- neuronic 6y ago
  Of course, mRNA vaccines on their own open up a new category of vaccination. E.g. Biontech is working on a mRNA multiple sclerosis vaccine and cancer vaccines.
maxerickson 6y ago
Aren't most antibodies at this point a result of infection?

djrogers 6y ago

That scenario only plays out if vaccinated people can be carriers. If not, virus that is exposed to the vaccine will not have a chance to evolve more quickly.

corin_ 6y ago
Even if they cant, for the period when there are lots of people vaccinated and also lots of people infected, that's lots of mutations happening in infected people and then trying to jump into vaccinated people, giving it more chances that one of those mutations would then spread from vaccinations people even if current mutations don't (which isn't known yet). If it spreads from vaccinated people already then that would be even worse.

tachyonbeam 6y ago

I believe the same thing. We need a fast vaccine update cycle. We also need much faster production. It looks like the mRNA vaccines have the fastest turnover cycle. IMO the government should employ emergency measures to force Pfizer and Moderna to upgrade their production facilities to 10x what they are now. Get other companies involved. Pour as much money as necessary. Fortunately, it seems there is openness from the FDA to have a faster approval cycle for vaccine tweaks. Moderna is already working on a "booster shot" to try and increase immunity to the South-African variant. I wish that we also had other therapeutic tools to combat COVID. I wonder if we couldn't save people who are getting hospitalized by employing drugs that block the receptor the virus uses to enter cells. Similarly to the way HIV is kept under control. That could save lives and it would be more mutation-proof.

temp667 6y ago
I hate suggestion like this - most of the government involvement so far has been negative - don't wear masks, do wear masks and cloth masks are fine (they probably are not). We're going to cancel doctors license who go out of order in vaccine distribution (so now when the 65 year old drives their 75 year old partner in they can't both be vaccinated). If anyone actually cared about this there is an EXISTING mechanism to get business to produce pretty much any quantity of anything you want. You pay them money. Instead the government is constantly canceling contracts, seizing products, stopping the sale of products for more than 10% more than historic prices etc. ALL these steps REDUCE confidence in making a big / high risk investment. My guess - if we looked at even existing use of the DPA - probably most stuff got made by folks not expert in making it and sat in a warehouse. I'm serious - I want to know how many ventilators made under DPA by rando companies are actually in use? I've worked in govt contracting - the govt does not get "the best" producers to produce, in situations like this the hands reach out from the experts playing the govt contracting game. Not end of world normally, but with lives on the line some more standard approaches would be refreshing.
- tachyonbeam 6y ago
  This is an emergency situation. I don't know if we can count on individual companies to just do the right thing. They might be risk-averse, afraid of financial losses, but we need them to go full-steam ahead. Pfizer and Moderna should definitely be financially compensated for everything they produce. We could pay them above cost and basically guarantee their financial success in this operation. It's possible that the current generation of vaccines could end up being outdated, and there could be some amount of waste, but the important thing is the production rate. When an updated vaccine becomes available, we want to be able to produce it and distribute it as fast as possible. On another note, there's also research into oral vaccines. IMO that would be amazing if it could pan out. Imagine if we could just mail people capsules containing booster doses updated for the latest strain every month. We'd crush any pandemic in no time.
  - maxerickson 6y ago
    The really wild vaccines use a self replicating viral vector. One of Merck's discontinued candidates used a live, replicating virus. I guess if you really nail the science, you can make it infectious and vaccinate by breathing on people.

throwaway894345 6y ago

I wonder what would be the implications for being able to develop and deliver RNA vaccines on this shorter, more regular timeline? Specifically, does the infrastructure required to accomplish this goal also bring other vaccines or treatments in the realm of feasibility?

neuronic 6y ago
Of course, mRNA vaccines on their own open up a new category of vaccination. E.g. Biontech is working on a mRNA multiple sclerosis vaccine and cancer vaccines.

maxerickson 6y ago

Aren't most antibodies at this point a result of infection?