7 ms·

The mRNA vaccines are obviously the gold standard, they're what you want, if you're in a position to pick. The traditional vaccines, like this one and the Astr

by tpmx 6y ago

The mRNA vaccines are obviously the gold standard, they're what you want, if you're in a position to pick. The traditional vaccines, like this one and the Astra Zeneca one appear to be efficient at preventing hospitalization/death. That's great - it will ease the extreme load on the hospitals, and also reduce deaths greatly. What I'm concerned about is the long-term chronical diseases that's been reported (https://www.mayoclinic.org/diseases-conditions/coronavirus/in-depth/coronavirus-long-term-effects/art-20490351 https://www.mayoclinic.org/diseases-conditions/coronavirus/i...), hitting a substantial part of the infected. We need more clarity to which degree the non-mRNA-vaccines prevent these pretty horrobile chronic diseases.

boulos 6y ago
> The mRNA vaccines are obviously the gold standard, they're what you want, if you're in a position to pick. That might end up being true, but see my comment about the different “efficacy” measures and demographic differences [1]. We don’t have as clear cut a statement as that, and instead need to proceed (for now) with “all of the approved ones seem to prevent death or serious illness. Take what you can”. [1] https://news.ycombinator.com/item?id=25959872 https://news.ycombinator.com/item?id=25959872
- tpmx 6y ago
  I would take a Johnson&Johnson or Astra Zeneca vaccine tomorrow if I were offered, don't misunderstand me.
  - thaeli 6y ago
    If it didn't disqualify me from receiving an mRNA vaccine later, sure. But right now it seems like you get one vaccine only and given that holding out for mRNA may be advisable.
    - tpmx 6y ago
      Yeah, that's also a concern. Any insights from people with knowledge - is this likely to be a problem or not?
      - bluGill 6y ago
        Unlikely. There has never been (to my knowledge) any vaccine that prevented your from getting a different one latter. People get flu vaccines yearly and nobody asks what the last one you got was even though there a dozens of manufactures. You shouldn't get one vaccine and then a week latter get a different one. (I'd guess this is safe, but there is no reason to do it). However getting one and then a year latter a different one is normal practice and shouldn't be a problem. In short, take what you can get now. If COVID is still a problem in a year (I'm assuming there is a lot more supply of vaccine then) ask your doctors if you should get a different booster. Odds are good than in 6 months to a year we will have a different vaccine anyway to cover the variants. The vaccines don't seem to be doing well against the South Africa strain of Covid (only applying to the few that have done real trials, many need more testing), so it is back to the drawing board already.
        tumblewit 6y ago
        from my understanding if you take a different vaccine your body treats it as a virus which it already knows from the first vaccine you took and then attacks the vaccine generating antibodies. So technically it should either work as a booster or if your body has forgotten about the virus (don't know how that works) then act as a first dose.
    - deleted 6y ago
      [deleted]
m12k 6y ago
I originally thought the Oxford/AstraZeneca vaccine was significantly behind the mRNA vaccines in efficacy. But then I learned that the Oxford trials PCR-tested every participant regularly, while the Pfizer and Moderna trials only tested participants that were showing symptoms. So there's a very real chance that behind that ~95% number the mRNA vaccines also had asymptomatic cases that were never discovered during trials, and the actual protection is nearly the same as the Oxford one. The mRNA vaccines still seem like a great leap forward, and they don't come with the potential complications of resistance to the vector virus that adenovirus-based vaccines do - but I'm less sure now that they actually offer better protection overall.
- tpmx 6y ago
  > But then I learned that the Oxford trials PCR-tested every participant regularly, while the Pfizer and Moderna trials only tested participants that were showing symptoms. That seems substantial, weird and important. Source?
  - m-ee 6y ago
    They did do more PCR but that isn’t reflected in the efficacy numbers. The end point for all trials has been prevention of symptomatic disease.
    - tpmx 6y ago
      And where is your source for that?
      - m-ee 6y ago
        It's quite literally one of the first things mentioned in the trial protocols and journal articles https://clinicaltrials.gov/ct2/show/NCT04516746 https://clinicaltrials.gov/ct2/show/NCT04516746 "The efficacy of 2 IM doses of AZD1222 compared to placebo for the prevention of COVID-19 in adults ≥ 18 years of age [ Time Frame: 1 year ] A binary response, whereby a participant is defined as a COVID-19 case if their first case of SARS-CoV-2 RT-PCR-positive symptomatic illness occurs ≥ 15 days post second dose of study intervention. Otherwise, a participant is not defined as a COVID-19 case." https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)32661-1/fulltext https://www.thelancet.com/journals/lancet/article/PIIS0140-6... "The primary efficacy analysis included symptomatic COVID-19 in seronegative participants with a nucleic acid amplification test-positive swab more than 14 days after a second dose of vaccine. "
agd 6y ago
The MRNA vaccines were tested prior to the existence of the variants. The Jansen vaccine efficacy was likely affected by the existence of these variants, so I’m not sure we can assume the MRNA vaccines are better.
martin1975 6y ago
Gold standard? They have not been previously used on us humans and there are far more side-effects w/mRNA than traditional vaccines. I'll take J&J's '66%' over any mRNA vaccine.
- coding123 6y ago
  Downvotes without replies again. It is definitely worth debate. What if J&J's second shot gets it up to the same 95%? (even if they are not advocating a second shot at this time) After all, these vaccines do not prevent the virus directly, they're just there to coax the body to produce new things. Both teach the body about the spike protein. It does seem like the mRNA vaccines are given a not-yet-due congratulations on every medium I see yet mRNA vaccines have absolutely zero history of pandemic ending at this time. Yes that may change, but to call them a gold standard now that's just not accurate.
  - jamesrcole 6y ago
    > Downvotes without replies again. Looking at that comment it might be because it just asserts “there are far more side-effects w/mRNA than traditional vaccines” without any explanation or sources.
- djrogers 6y ago
  Claiming that there are ‘far more side effects’ is more than a little disingenuous, and smacks of either ignorance or willful misrepresentation of the facts here.
  - coding123 6y ago
    Can you help me find the covid-19 side effects tracking website? I can't seem to find it. In fact I can't find anything that's enumerating the data publicly. I can't answer your comment at all without any data.
    - bluGill 6y ago
      The US has various vaccine trackers for side effects. They are anyone can put anything in them. (including things like alien abduction), but they give us a guide as to what is reported. Something like 1 in 100,000 has an allergic reaction in 15 minutes and needs treatment (an epi-pen). That is the only side effect I've heard of. The numbers of allergic reaction are different for Moderna and Pfizer. If you have a history of allergies you should consult your allergist for advice. The above numbers are public, but I'm not sure where I read them. As always I'm just a guy on the internet, if you need medical advice see a doctor.
mikem170 6y ago
> What I'm concerned about is the long-term chronical diseases that's been reported When I looked into it I was shocked at how many people have long term affects after the flu. One of the studies I saw in a comprehensive paper looking at heart swelling and the flu showed a shocking amount of this in even non-hospitalized flu patients! [0] Apparently any virus that attacks the lungs and.or nervous system leaves behind a lot of damaged people. Most of the time things like heart swelling go away after a couple months. But some people are permanently damaged. This can happen with all viruses, even the common cold kills people. Covid appears to be no different in this regard. [0] http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.685.8394&rep=rep1&type=pdf http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.685...
Alex3917 6y ago
> The mRNA vaccines are obviously the gold standard, they're what you want, if you're in a position to pick. Why? There isn't any evidence that they're more effective than the J&J one.
- ulfw 6y ago
  The evidence is literally in the post you're commenting on.
- bluGill 6y ago
  The mRNA vaccines are 95%, J%J is 66%. The former number is confirmed by the FDA, while the latter is a press release (probably accurate, but they might be hiding something while would be used to make them look better). The J&J vaccine just isn't as good. It is good enough, but not as good. Of course it is possible that the difference is because a vaccine resistant strain is running around now and so J&J got unlucky by not starting their trails as soon. However right now all the numbers we have say J&J isn't as good. Good enough probably, but not as good.
  - Alex3917 6y ago
    > The mRNA vaccines are 95%, J%J is 66%. I get that, but what makes you think that mRNA are any more effective than the J&J? You can’t just compare the numbers across trials. Just because 95% is bigger then 66% doesn’t make it more effective.
sdeep27 6y ago
Such confidence about "gold standard" is hard to justify without ANY studies on mRNA long-term effects (how could there be > this is brand new vaccine technology and delivery). I would actually argue it is "safer" to take a more traditional vaccine (which have a long history of safety studies, including longer-term one) than an untested (in the long-term sense) mRNA vaccine, given equal efficacies. So, maybe not the J&J if we can truly compare % efficacies given with the mRNA ones (as others have noted, they might not be comparable as different measures were used), but give what we know I would pick the Oxford-AstraZeneca vaccine over the mRNA ones.
- jimbob45 6y ago
  This is my thought process as well but currently the J&J and AZ vaccines are somewhat hard to come by and a vaccine is better than no vaccine.
- bluGill 6y ago
  There is no scientifically plausible way for there to be long term side effects. RNA is critical to life, so if there were long term side effects life itself wouldn't even be possible.
- maxerickson 6y ago
  The J&J and AstraZeneca vaccines are both also very new technology. Here's the "platform" for the AstraZeneca vaccine: https://en.wikipedia.org/wiki/ChAdOx1 https://en.wikipedia.org/wiki/ChAdOx1 They are somewhat similar to the mRNA vaccines, triggering cells in the recipients body to produce the SARS-CoV2 protein, but the mechanism is different, they use a virus to introduce the instructions into the cells instead of mRNA. The carrier virus has been altered so that it can't reproduce. So they aren't traditional vaccines either.
  - riffraff 6y ago
    But the Russian and Chinese vaccines are "old school", right? It would be fun if the least trusted sources ended up being the more reliable ones.
M5x7wI3CmbEem10 6y ago
are there any long-term concerns about mRNA vaccines? I have a feeling that the messenger response isn’t something that goes away easily. I’d rather take the AZ vaccine
iclosem 6y ago
Didn’t novavax just prove they have the best efficacy with a safety profile that’s miles ahead of either moderna or Pfizer/biontech?

by tpmx 6y ago

boulos 6y ago

> The mRNA vaccines are obviously the gold standard, they're what you want, if you're in a position to pick. That might end up being true, but see my comment about the different “efficacy” measures and demographic differences [1]. We don’t have as clear cut a statement as that, and instead need to proceed (for now) with “all of the approved ones seem to prevent death or serious illness. Take what you can”. [1] https://news.ycombinator.com/item?id=25959872 https://news.ycombinator.com/item?id=25959872

tpmx 6y ago
I would take a Johnson&Johnson or Astra Zeneca vaccine tomorrow if I were offered, don't misunderstand me.
- thaeli 6y ago
  If it didn't disqualify me from receiving an mRNA vaccine later, sure. But right now it seems like you get one vaccine only and given that holding out for mRNA may be advisable.
  - tpmx 6y ago
    Yeah, that's also a concern. Any insights from people with knowledge - is this likely to be a problem or not?
    - bluGill 6y ago
      Unlikely. There has never been (to my knowledge) any vaccine that prevented your from getting a different one latter. People get flu vaccines yearly and nobody asks what the last one you got was even though there a dozens of manufactures. You shouldn't get one vaccine and then a week latter get a different one. (I'd guess this is safe, but there is no reason to do it). However getting one and then a year latter a different one is normal practice and shouldn't be a problem. In short, take what you can get now. If COVID is still a problem in a year (I'm assuming there is a lot more supply of vaccine then) ask your doctors if you should get a different booster. Odds are good than in 6 months to a year we will have a different vaccine anyway to cover the variants. The vaccines don't seem to be doing well against the South Africa strain of Covid (only applying to the few that have done real trials, many need more testing), so it is back to the drawing board already.
      - tumblewit 6y ago
        from my understanding if you take a different vaccine your body treats it as a virus which it already knows from the first vaccine you took and then attacks the vaccine generating antibodies. So technically it should either work as a booster or if your body has forgotten about the virus (don't know how that works) then act as a first dose.
  - deleted 6y ago
    [deleted]

m12k 6y ago

I originally thought the Oxford/AstraZeneca vaccine was significantly behind the mRNA vaccines in efficacy. But then I learned that the Oxford trials PCR-tested every participant regularly, while the Pfizer and Moderna trials only tested participants that were showing symptoms. So there's a very real chance that behind that ~95% number the mRNA vaccines also had asymptomatic cases that were never discovered during trials, and the actual protection is nearly the same as the Oxford one. The mRNA vaccines still seem like a great leap forward, and they don't come with the potential complications of resistance to the vector virus that adenovirus-based vaccines do - but I'm less sure now that they actually offer better protection overall.

tpmx 6y ago
> But then I learned that the Oxford trials PCR-tested every participant regularly, while the Pfizer and Moderna trials only tested participants that were showing symptoms. That seems substantial, weird and important. Source?
- m-ee 6y ago
  They did do more PCR but that isn’t reflected in the efficacy numbers. The end point for all trials has been prevention of symptomatic disease.
  - tpmx 6y ago
    And where is your source for that?
    - m-ee 6y ago
      It's quite literally one of the first things mentioned in the trial protocols and journal articles https://clinicaltrials.gov/ct2/show/NCT04516746 https://clinicaltrials.gov/ct2/show/NCT04516746 "The efficacy of 2 IM doses of AZD1222 compared to placebo for the prevention of COVID-19 in adults ≥ 18 years of age [ Time Frame: 1 year ] A binary response, whereby a participant is defined as a COVID-19 case if their first case of SARS-CoV-2 RT-PCR-positive symptomatic illness occurs ≥ 15 days post second dose of study intervention. Otherwise, a participant is not defined as a COVID-19 case." https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)32661-1/fulltext https://www.thelancet.com/journals/lancet/article/PIIS0140-6... "The primary efficacy analysis included symptomatic COVID-19 in seronegative participants with a nucleic acid amplification test-positive swab more than 14 days after a second dose of vaccine. "

agd 6y ago

The MRNA vaccines were tested prior to the existence of the variants. The Jansen vaccine efficacy was likely affected by the existence of these variants, so I’m not sure we can assume the MRNA vaccines are better.

martin1975 6y ago

Gold standard? They have not been previously used on us humans and there are far more side-effects w/mRNA than traditional vaccines. I'll take J&J's '66%' over any mRNA vaccine.

coding123 6y ago
Downvotes without replies again. It is definitely worth debate. What if J&J's second shot gets it up to the same 95%? (even if they are not advocating a second shot at this time) After all, these vaccines do not prevent the virus directly, they're just there to coax the body to produce new things. Both teach the body about the spike protein. It does seem like the mRNA vaccines are given a not-yet-due congratulations on every medium I see yet mRNA vaccines have absolutely zero history of pandemic ending at this time. Yes that may change, but to call them a gold standard now that's just not accurate.
- jamesrcole 6y ago
  > Downvotes without replies again. Looking at that comment it might be because it just asserts “there are far more side-effects w/mRNA than traditional vaccines” without any explanation or sources.
djrogers 6y ago
Claiming that there are ‘far more side effects’ is more than a little disingenuous, and smacks of either ignorance or willful misrepresentation of the facts here.
- coding123 6y ago
  Can you help me find the covid-19 side effects tracking website? I can't seem to find it. In fact I can't find anything that's enumerating the data publicly. I can't answer your comment at all without any data.
  - bluGill 6y ago
    The US has various vaccine trackers for side effects. They are anyone can put anything in them. (including things like alien abduction), but they give us a guide as to what is reported. Something like 1 in 100,000 has an allergic reaction in 15 minutes and needs treatment (an epi-pen). That is the only side effect I've heard of. The numbers of allergic reaction are different for Moderna and Pfizer. If you have a history of allergies you should consult your allergist for advice. The above numbers are public, but I'm not sure where I read them. As always I'm just a guy on the internet, if you need medical advice see a doctor.

mikem170 6y ago

> What I'm concerned about is the long-term chronical diseases that's been reported When I looked into it I was shocked at how many people have long term affects after the flu. One of the studies I saw in a comprehensive paper looking at heart swelling and the flu showed a shocking amount of this in even non-hospitalized flu patients! [0] Apparently any virus that attacks the lungs and.or nervous system leaves behind a lot of damaged people. Most of the time things like heart swelling go away after a couple months. But some people are permanently damaged. This can happen with all viruses, even the common cold kills people. Covid appears to be no different in this regard. [0] http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.685.8394&rep=rep1&type=pdf http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.685...

Alex3917 6y ago

> The mRNA vaccines are obviously the gold standard, they're what you want, if you're in a position to pick. Why? There isn't any evidence that they're more effective than the J&J one.

ulfw 6y ago
The evidence is literally in the post you're commenting on.
bluGill 6y ago
The mRNA vaccines are 95%, J%J is 66%. The former number is confirmed by the FDA, while the latter is a press release (probably accurate, but they might be hiding something while would be used to make them look better). The J&J vaccine just isn't as good. It is good enough, but not as good. Of course it is possible that the difference is because a vaccine resistant strain is running around now and so J&J got unlucky by not starting their trails as soon. However right now all the numbers we have say J&J isn't as good. Good enough probably, but not as good.
- Alex3917 6y ago
  > The mRNA vaccines are 95%, J%J is 66%. I get that, but what makes you think that mRNA are any more effective than the J&J? You can’t just compare the numbers across trials. Just because 95% is bigger then 66% doesn’t make it more effective.

sdeep27 6y ago

Such confidence about "gold standard" is hard to justify without ANY studies on mRNA long-term effects (how could there be > this is brand new vaccine technology and delivery). I would actually argue it is "safer" to take a more traditional vaccine (which have a long history of safety studies, including longer-term one) than an untested (in the long-term sense) mRNA vaccine, given equal efficacies. So, maybe not the J&J if we can truly compare % efficacies given with the mRNA ones (as others have noted, they might not be comparable as different measures were used), but give what we know I would pick the Oxford-AstraZeneca vaccine over the mRNA ones.

jimbob45 6y ago
This is my thought process as well but currently the J&J and AZ vaccines are somewhat hard to come by and a vaccine is better than no vaccine.
bluGill 6y ago
There is no scientifically plausible way for there to be long term side effects. RNA is critical to life, so if there were long term side effects life itself wouldn't even be possible.
maxerickson 6y ago
The J&J and AstraZeneca vaccines are both also very new technology. Here's the "platform" for the AstraZeneca vaccine: https://en.wikipedia.org/wiki/ChAdOx1 https://en.wikipedia.org/wiki/ChAdOx1 They are somewhat similar to the mRNA vaccines, triggering cells in the recipients body to produce the SARS-CoV2 protein, but the mechanism is different, they use a virus to introduce the instructions into the cells instead of mRNA. The carrier virus has been altered so that it can't reproduce. So they aren't traditional vaccines either.
- riffraff 6y ago
  But the Russian and Chinese vaccines are "old school", right? It would be fun if the least trusted sources ended up being the more reliable ones.

M5x7wI3CmbEem10 6y ago

are there any long-term concerns about mRNA vaccines? I have a feeling that the messenger response isn’t something that goes away easily. I’d rather take the AZ vaccine

iclosem 6y ago

Didn’t novavax just prove they have the best efficacy with a safety profile that’s miles ahead of either moderna or Pfizer/biontech?