21 ms·

Neutralizing antibodies against SARS-CoV-2 variants after infection, vaccination

224 points by 11thEarlOfMar 6y ago

mcwone 6y ago
A January 2021 study in the annals of internal medicine estimating the death rates of non institutionalized patients of .26 percent with age breakdowns . https://www.acpjournals.org/doi/10.7326/M20-5352?utm_source=24-scientists-determine-death-rate-covid-19-general-population&utm_medium=email&utm_content=published+in+the+Annals+of+Internal+Medicine&utm_campaign=ag&#t1-M205352 https://www.acpjournals.org/doi/10.7326/M20-5352?utm_source=...
- ed25519FUUU 6y ago
  Some more: > Indiana's IFR for noninstitutionalized persons older than 60 years is just below 2% (1 in 50). In comparison, the ratio is approximately 2.5 times greater than the estimated IFR for seasonal influenza, 0.8% (1 in 125), among those aged 65 years and older (5).
  - legulere 6y ago
    That is just one factor though in which COVID-19 is worse than the seasonal influenza though. COVID-19 has a basic reproduction number of 3.3 – 5.7, while the seasonal influenza has one of 0.9 – 2.1 [1], which means that it spreads far more easily. You cannot just wait until summer for influenza season to be over. With influenza you have a higher rate of existing immunity in the population. With COVID-19 it is basically non-existent, except maybe for a few single people that had SARS or MERS before. Younger people are also more affected [2] You are longer sick from COVID-19 and if you have to stay in the hospital you will stay there longer and are more likely to end up on the intensive care unit [2] In the end you cannot compare a pandemic situation to influenza season. [1]: https://en.wikipedia.org/wiki/Basic_reproduction_number https://en.wikipedia.org/wiki/Basic_reproduction_number [2]: https://www.nature.com/articles/s41598-021-85081-0 https://www.nature.com/articles/s41598-021-85081-0
    - ed25519FUUU 6y ago
      I wasn’t comparing it to anything. I was just writing more of the studies findings.
    - timr 6y ago
      "Younger people are also more affected [2]" The paper you're citing says "younger" means 59, vs 66 for influenza: > Patients with COVID-19 were younger (median age [IQR], 59 [45–71] vs 66 [52–77]; P < 0001) and had fewer comorbidities at baseline with a lower mean overall age-adjusted Charlson Comorbidity Index (mean [SD], 3.0 [2.6] vs 4.0 [2.7]; P < 0.001) than patients with seasonal influenza. Also, this is data from a single hospital, across two different years. The overall trends for SARS-CoV2 are not even remotely debatable: the risk of mortality rises exponentially with age. It's one of the most striking features of the virus. To claim, based on this one paper, that "younger people are more affected" is to miss the forest for the trees. "In the end you cannot compare a pandemic situation to influenza season." You absolutely can, and in fact, you're doing it. What you're trying to say is that Covid is somehow unilaterally much worse than influenza, but that isn't true. It's much worse for the elderly (>65), but for most other age groups, it's about the same, if not a little bit better. You have to squint and split hairs and pick sources selectively to start making strong claims of increased severity in age groups under ~50, and it's simply not a believable claim for people under the age of ~30. The disease can be bad without exaggerating its threat.
      - legulere 6y ago
        I just took the first study I could find. You seem to claim that it’s conclusions are wrong and that young people are less affected of COVID than influenza. Do you have good studies to back this up?
        timr 6y ago
        I am telling you that your comment is not supported by the source you cited. You can find a wide range of publications showing the age-specific mortality profile of Covid by Googling. Here is one that is commonly cited: https://link.springer.com/article/10.1007/s10654-020-00698-1 https://link.springer.com/article/10.1007/s10654-020-00698-1
- raphaelj 6y ago
  That seems pretty low compared to what is happening here in Belgium. We are at 22k deaths with +/- 25% of a 11M of the population having been infected (based on serology and statistical estimates).
  - idoubtit 6y ago
    If I'm not mistaken, the rate in the paper is bigger, 0.25% against 22k/11M = 0.20% in Belgium. But if the newspaper I read are right, there is a catch: when tests were not available, Belgium counted as a covid death every case where it could be suspected. Even nowadays, in case of comorbidity, covid is always written down as the cause of death. So 22k is probably a maximum, and, taking into accound the 25% uncertainty on the denominator, the real rate could very different.
    - timerol 6y ago
      I think you're misreading the comment you replied to. "+/- 25% of a 11M of the population having been infected" means about 25% of 11M, or 2.75M, officially infected. 22k/2.75M would imply a 0.8% fatality rate.
      - raphaelj 6y ago
        Exactly. And with respect to the counting, it seems like the Belgian numbers more of less match the reported excess deaths in 2020 within 10% [1]. [1] https://www.medrxiv.org/content/10.1101/2021.01.27.21250604v1.full.pdf https://www.medrxiv.org/content/10.1101/2021.01.27.21250604v...
  - lukeinkster 6y ago
    Seems low compared to New York City as well. NYC has already had 30,564 deaths. Even if the whole population had already been infected, that would put the death rate at around 0.36% Antibody surveys suggest around 40% have been infected which puts the death rate around 0.91%
    - 6y ago
- jquery 6y ago
  For every person that dies (an agonizing death akin to medieval torture), a few more are in intensive care fighting for their lives. For every one of those, others end up in the hospital, spread the disease to others, suffer from “long covid”, or merely suffer greatly. Every person that gets covid adds to the likelihood the disease will become uncontrollable in the long term and endemic. Keep wearing your masks and social distancing people. It’s hard, it’s a sacrifice, but together we can conquer this disease and return to life “as normal”.
  - idoubtit 6y ago
    > For every person that dies (an agonizing death akin to medieval torture) I think this is wrong, at least in rich countries, at least those that are sane enough to cure their ill citizens. A friend of mine died of covid last year. Then a family member this year. They were both sedated, and did not suffer at all on their last days in hospitals.
    - jquery 6y ago
      Sedation is death with a respiratory illness like this. How were they feeling before they were sedated? Probably like they’d been drowning for hours. For all intents and purposes, that was the end of their life as far as their experience of it. Don’t get me wrong, it’s great that we can provide palliative comfort for those final hours/days. But it doesn’t tell the full story.
      - mlyle 6y ago
        Just for clarity/augmentation/pedantic detail: you might be sedated and end up an a ventilator. But ventilators are really bad for COVID survival and really a last ditch, long-shot chance try to salvage your life. Practitioners hold off on the sedation and associated required ventilation as long as possible to try and spare your life.
  - mrfusion 6y ago
    I don’t see any reason new variants would ever stop coming. What are you proposing is the end point of all of this?
simonebrunozzi 6y ago
It seems that the AstraZeneca vaccine is not effective against the South African variant [0]. [0]: https://www.nejm.org/doi/full/10.1056/NEJMoa2102214?fbclid=IwAR3zOZYHFGj2gIwH6V1kbOJim55Cwk7JkPfe6cOyh0eaeBHy-p-kELY0hM4 https://www.nejm.org/doi/full/10.1056/NEJMoa2102214?fbclid=I...
- amelius 6y ago
  That's wrt mild to moderate cases. It might still be effective against severe cases.
  - modularform123 6y ago
    They didn’t design the study to look for severe cases in South Africa and this variant isn’t widespread in other countries where the vaccine is in use, so it will be hard to get evidence on effectiveness against severe disease anytime soon.
  - theduder99 6y ago
    good point, it might raise our IQ as well!
  - paulmd 6y ago
    nevertheless, you have to actually support that hypothesis with research. Just the fact that it's ineffective against mild to moderate doesn't mean it will be effective against more severe cases. it might also be ineffective against severe cases, making it just entirely ineffective against those strains. a year later and people are still trying to twist studies into support of their favored medical treatments without actual supporting research...
    - dbetteridge 6y ago
      It is being worked on, animal studies only so far with human studies to come as SA rolls out their 100k doses of AZ I am sure. Animal model study - Syrian hamsters https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciab083/6124512 https://academic.oup.com/cid/advance-article/doi/10.1093/cid...
modularform123 6y ago
The plural ‘variants’ in the title is a bit misleading. Only one of the four viruses they tested is one we are actually concerned about at this time. The first is the original virus, which was displaced by the second early in the pandemic and against which vaccines are already known to be effective. The third one is the UK variant, which is of interest and the fourth is an artificial virus with a single mutation of interest, which doesn’t circulate in nature. This is all good but the study doesn’t add anything that wasn’t already known. It appears that better funded groups at the NIH, UTMB, Fred Hutch and Columbia beat them to the goal and to publication in the even more prestigious publications like NEJM and Nature. In any case, reproducing important research is a laudable and underrated goal. However, I would suggest a more modest title - ‘Study adds to data for vaccines’ effectiveness against the UK variant of SARS-COV-2’. There are other variants - Brazilian, South African, Californian, New York, etc - which need to be studied in more detail. There are already data from the aforementioned research groups for at least some of these variants that suggest that vaccines will continue to be at least partially effective.
- rimliu 6y ago
  Nothing is misleading in the title.
  - frongpik 6y ago
    The title implies that "[All] vaccines are effective against [all] variants", but that's a lie. And when people realize this, they'll lose trust in vaccines in general.
cadence- 6y ago
Thanks for sharing this. I actually see very little reporting on how this virus spreads among the vaccinated population. I would love to see new case numbers broken down by vaccinated and not-vaccinated people from countries like UK, US and Israel. So far I’m unable to find such data on the internet.
- jaredsohn 6y ago
  This post seems like it might be the closest to what you are looking for: https://www.reddit.com/r/COVID19/comments/loljxz/effectiveness_results_of_the_pfizer_covid19/ https://www.reddit.com/r/COVID19/comments/loljxz/effectivene...
- sjg007 6y ago
  Breakthrough infections have been identified. https://www.webmd.com/vaccines/covid-19-vaccine/news/20210308/reports-of-break-through-covid-cases-after-vaccine https://www.webmd.com/vaccines/covid-19-vaccine/news/2021030...
rzzzt 6y ago
I might be missing something. Isn't the report solely about the neutralizing capabilities of the Moderna vaccine? What other vaccines were tested?
psychlops 6y ago
The immune system still works as advertised.
- jquery 6y ago
  What’s the purpose of comments like this? EDIT: I see someone mentioning Trump below and I can’t reply. Trump was never interested in managing covid-19 or effective border control. This would’ve been the perfect opportunity for him to show why having smart borders was useful. He would’ve received support from within the government. He would’ve managed covid-19 successfully perhaps, and won re-election. The problem was Trump was a completely ineffective and incompetent leader, who didn’t care at all about the things he claimed to care about. Mandatory quarantines and tests for people traveling to America would’ve been a lot of work and Trump was allergic to that. He was a man who preferred the cheers at his rallies over the difficult work of administrating and governing.
  - war1025 6y ago
    Probably that patience has worn thin for the extremely overly cautious people who have been hiding in their homes for a year when they are realistically at zero risk of severe illness. We have known since early summer of last year that being fat or being old are your two biggest risk factors. Beyond that, if you have some serious pre-existing condition that makes you susceptible to all illnesses. The messaging should have been "Stay home if you are a high risk group. Otherwise live your live." All current data shows areas that have taken that approach are significantly better off today than the places that hid in a hole the past year. We have let people treat this like it's an end of the world scenario and it's been good for no one.
    - jquery 6y ago
      So you’d prefer we be like Brazil? Because the alternative for us was not Taiwan or Korea. They went far and beyond what Americans were willing to tolerate. Never mind the bad statistics behind your claim that covid is no worse than the flu. A athlete friend of mine in his 20s has permanent heart damage caused by the virus. Covid-19 is not a joke, no matter how much you wish it was. Americans could be out free, today, if we took this virus more seriously from the start. Now people like you want to make the disease endemic when the end is in sight.
ta8645 6y ago
This is good news. Now maybe Fauci should rethink his idea that people need to wear their masks for another year even after getting vaccinated. One of his reasons was because of worry about the variants.
- halfmatthalfcat 6y ago
  Wearing masks have benefits beyond covid. Think about how many lives per year we could save from the flu let alone other airborne respiratory viruses if mask wearing was normalized.
  - JasonFruit 6y ago
    Wearing foam rubber padding all the time has benefits, but that doesn't mean everyone should do it. There are other considerations beyond mere safety.
    - ghaff 6y ago
      Or at least bike helmets all the time. Lots of people get seriously injured or killed because of falling and hitting their head. I expect mask wearing will be more common in cultures where it was almost unheard of like western Europe and the US. But even in a country like Japan where it wasn't unusual, it certainly wasn't anything like the norm.
    - brandon272 6y ago
      Wearing a mask is a lot more convenient than foam rubber padding.
  - mrfusion 6y ago
    I’ve heard it argued that our immune systems need exposure to germs to keep them effective.
    - bluGill 6y ago
      I've heard that too. But never does anyone back it up with anything that could be remotely called good science.
spchampion2 6y ago
This is not well aligned with other research[1] showing the Pfizer and Moderna vaccines perform little better against the B1351 (South Africa) variant than they do against plain old SARS and distantly related bat COVIDs. They're also only semi-effective against the Brazilian P1 variant. Right now, all of the vaccines are reasonably effective against the variants commonly circulating in the US (including B117), which is what the JAMA article tested. But I worry for how well they'll perform in a few months when the other variants get a foothold. [1]: https://www.cell.com/cell/pdf/S0092-8674(21)00298-1.pdf https://www.cell.com/cell/pdf/S0092-8674(21)00298-1.pdf
- anonuser123456 6y ago
  The article is talking about "escape neutralization". Neutralizing antibodies are not the only mechanism of the immune system, and the article even discusses another such mechanism: T cell immunity. T cell immunity appears robust for all variants from the data I've seen.
  - spchampion2 6y ago
    As far as I can tell, both the JAMA study linked in this post and the study I linked are describing antibody responses. I was trying to make an apples-to-apples comparison by sharing a similar study with contradictory results on a broader swath of virus variants.
carbocation 6y ago
The title of this article, which performs an in vitro test, is "Neutralizing Antibodies Against SARS-CoV-2 Variants After Infection and Vaccination". The editorialization in the current Hacker News headline ("Vaccines Are Effective Against Covid Variants") is not warranted.
- jquery 6y ago
  In other words it’s a little early to start the victory chants. Unfortunately this will get used to justify reckless behavior.
- ttul 6y ago
  If I can pass on what I’ve learned in the past 12 months as a newly minted virus enthusiast whose peak education in the area was human physiology 101: “In vitro” means testing outside of the human body. Just because a result is confirmed in vitro does not mean it will be replicated when tested “in vivo” (in the actual human).
  - kweinber 6y ago
    In vitro literally means “In glass” (like in a test tube). In vivo means “in life” (like IRL)
    - schoen 6y ago
      Strictly speaking, in vivo means "in a living [organism]"; "in life" would be in vita (not a term used for a kind of test). https://en.wiktionary.org/wiki/vivus#Latin https://en.wiktionary.org/wiki/vivus#Latin https://en.wiktionary.org/wiki/vita#Latin https://en.wiktionary.org/wiki/vita#Latin
vondur 6y ago
I assume unless the spike protein mutates, these variants would still be covered under the current vaccines.
idoubtit 6y ago
The current HN title deviates from the original title in a way that is misleading. "Vaccines Are Effective Against Covid Variants" is a wrong affirmation. The original article only states that in vitro experiments show that some vaccines are effective against some variants. Not all vaccines, not all variants, and no test on human beings. A counter point is that some vaccines seem to be ineffective agains some variants. For instance AstraZeneca against B.A.351 (South-Africa). From a preprint: "Conclusions A two-dose regimen of ChAdOx1-nCoV19 did not show protection against mild-moderate Covid-19 due to B.1.351 variant, however, VE against severe Covid-19 is undetermined." https://www.medrxiv.org/content/10.1101/2021.02.10.21251247v1 https://www.medrxiv.org/content/10.1101/2021.02.10.21251247v... The US CDC does state that, according to current publications, some variants present a "moderate reduction on neutralization". Their page about "Variants of Interest" and "Variants of Concern" mentions many scientific papers. https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/variant-surveillance/variant-info.html https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/vari...
- dbetteridge 6y ago
  I've posted this before regarding the SA paper on AZ, worth taking a look at the below. The probable outcome is minor to moderate symptoms that would normally be blocked by antibodies can still present (So no reduced transmission) but severe symptoms are still prevented by the vaccinated patients T-cells response. This paper is looking at a small scale human study in SA with mostly younger participants, which does make the results difficult to apply to the wider population. They also only use a 4 week dosing schedule where the suggestion and actual rollout in the UK is following the 10-12 week schedule between first and second doses which was shown to increase efficacy from ~70 to ~80% after the second dose (UK - Kent variant) The variant in question seems to escape the majority of Antibody detection, but T-Cells still seem to provide significant protection against severe disease and death. https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciab083/6124512 https://academic.oup.com/cid/advance-article/doi/10.1093/cid... https://www.biorxiv.org/content/10.1101/2021.03.11.435000v1 https://www.biorxiv.org/content/10.1101/2021.03.11.435000v1 The main published results aren't yet from human scale studies but here is one in hamsters showing a comparison in organ damage and results between unvaccinated and vaccinated with the Oxford/AZ vaccine.
marcodiego 6y ago
For people arguing that not being part of a risk group is a reason not to protect yourself, please take a lesson from brazil. Being part of a 'high risk group' does not saves you from infecting other people who are part of such groups. That's basically what happened in brazil: people who were not part of risk groups crowded, encouraged by the president himself[0][1][2]. The number of infected poeple soared and variants that affect younger people appeared[3][4]. The health system has now collapsed because there is not enough ICU for such a high number of ill people[5][6]. [0] https://www.em.com.br/app/noticia/politica/2021/02/26/interna_politica,1241415/ignorando-a-covid-19-bolsonaro-esteve-em-7-aglomeracoes-em-4-dias.shtml https://www.em.com.br/app/noticia/politica/2021/02/26/intern... [1] https://noticias.uol.com.br/politica/ultimas-noticias/2021/02/19/bolsonaro-volta-a-provocar-aglomeracao-em-visita-ao-nordeste.htm https://noticias.uol.com.br/politica/ultimas-noticias/2021/0... [2] https://cultura.uol.com.br/noticias/15258_bolsonaro-mergulha-na-praia-grande-e-causa-aglomeracao-com-banhistas.html https://cultura.uol.com.br/noticias/15258_bolsonaro-mergulha... [3] https://www.cartacapital.com.br/saude/segunda-onda-de-covid-19-no-brasil-ataca-cada-vez-mais-jovens/ https://www.cartacapital.com.br/saude/segunda-onda-de-covid-... [4] https://www.brasildefato.com.br/2021/03/19/tres-novas-cepas-identificadas-no-brasil-sao-mais-potentes-e-transmissiveis https://www.brasildefato.com.br/2021/03/19/tres-novas-cepas-... [5] https://www.cnnbrasil.com.br/saude/2021/03/19/17-estados-e-o-df-estao-em-colapso-na-saude-mt-ms-rs-e-rr-nao-tem-mais-leitos https://www.cnnbrasil.com.br/saude/2021/03/19/17-estados-e-o... [6] https://www.cnnbrasil.com.br/saude/2021/03/19/em-meio-ao-colapso-do-sistema-de-saude-faltam-medicos-intensivistas-nas-utis https://www.cnnbrasil.com.br/saude/2021/03/19/em-meio-ao-col...
- mherrmann 6y ago
  Also for selfish reasons. I know a 24 year old ballerina (so a professional athlete) who had it two months ago and is now at 80% lung capacity.
  - outside1234 6y ago
    And to pile on this, I know a triathelete in my group, 24 years old, who had it in April of LAST YEAR and is still not at 100% (can't do any hard aerobics without getting wildly out of breath). We are still in a pandemic. Stay distant.
eqvinox 6y ago
54 patients total? That's not a sample size to draw strong conclusions on :(
- nanidin 6y ago
  Assuming normal distribution, the law of large numbers kicks in at n=30.
  - eqvinox 6y ago
    The actual number of examined vaccinated people('s serum) is 14. The other 20+20 are acute/recovering cases. (I was being generous with the 54.) Also the page itself says Limitations include the small sample size under "Discussion".
arisAlexis 6y ago
the most bothersome variants (SA,P1 brazil) are not reported in the paper
WalterBright 6y ago
We've been vaccinating people since December. There ought to be statistical evidence now of whether and how much vaccinated people still get sick from Covid and its variants. Why do we still hear that epidemiologists have no idea about this? For example, everyone being tested for covid or being admitted to the hospital for covid, should be asked if they've been vaccinated, when, and which vaccination. 70 million people in the US have received vaccinations. There ought to be plenty of data by now.
- figaroniguzo 6y ago
  To keep the fear and lockdown measures justified. Just like "we don't know if vaccines affect transmission" or "masks work to mitigate the spread" (as if masks were discovered in 2020)
  - osrec 6y ago
    But why? Why would any government want to justify longer than needed lockdowns?
    - offby37years 6y ago
      “Power tends to corrupt, and absolute power corrupts absolutely” — John Dalberg-Acton
      - SteveNuts 6y ago
        But don't lockdowns cause a "loss of power" (economic, trade, prestige)? This just doesn't make sense to me.
        oblio 6y ago
        They do, but people complaining about this tend to convenient focus on the powerful people making money because of lockdowns while absolutely ignoring the powerful people <<losing>> money because of them.
davak 6y ago
This was not testing against the South African and Japan/Brazil variants that are much more likely to escape vaccination antibodies. This UK variant is mostly problematic against the unvaccinated. In the lab the South Africa and Japan/Brazil variants have severe reduction in neutralizing antibodies which is very concerning for vaccine escape. That being said, we don’t have a great way to test for T cell and other immunity which also plays a role. Getting the vaccine decreases severity of illness regardless of the variant. The answer is get any vaccine as soon as possible. Then get the booster too when it’s available.
2ion 6y ago
Still not getting my vaccine shots. So great they are, my government is sabotaging my safety by continueing to deny me access.
standardUser 6y ago
I don't think I've ever seen an HN thread with so many anecdotes, assumptions and off-the-cuff theories and so little data or useful links.
- albertgoeswoof 6y ago
  Somewhat ironic that this is also an an anecdote
yawaworht1978 6y ago
I am very clueless on the vaccine topic (not a denier of covid or anti vaxxer). All I know is from listening to some interviews with a scientist in the field. But i still do not know what is the definition of "effective vaccine". What does it do? If you have covid and take the vaccine, will the covid go away? Are you still contagious after having the vaccine or can you still get the covid but without the bad effects? What kind of immunity is given by the vaccine and how long does it last? All I remember is that scientist said that herd immunity will likely never happen, or not in a long time(years, according to him). There are too little comprehensive sources on the matter and too much superficial noise. Thanks for any input.
- oblio 6y ago
  Well, based on my understanding, we don't know for sure. What we do know, is that they give you a much higher chance of avoiding serious symptoms, including that most serious of symptoms, death. You won't be "virus-proof" completely, but someone vaccinated fully (so 2 doses for vaccines which require it), after a certain immunization period, which varies between 2-4 weeks after being fully vaccinated, will be super resilient to being in contact with Covid patients. Don't go get coughed on by 10 Covid patients, though. Regarding contagion, apparently after vaccination, you can still get Covid with most vaccines, you just become "asymptomatic", i.e. it doesn't really affect you. However it seems that you're also much less contagious, which is still great, since it reduces the infection rate, it becomes much harder to spread it. If you get Covid while immunity from vaccination hasn't kicked in fully... you can still be screwed. People have died 1 week after being vaccinated. So you probably want to stay put for a while until your immunity ramps up. Regarding immunity, as I was saying, it's primarily lack of serious symptoms. I think they also make it harder for you to catch it, but I don't think we have super solid proof of this yet. And for immunity, it's hard to say. We're basically just counting up days from initial vaccinations to see how long it lasts. For the other vaccines we know the time intervals because... time has passed. So far, for the current vaccines it seems that immunity is at least 6+ months. From what I've read we should be reasonably optimistic that we'll be immune for 1+ years. I don't think anyone expects lifetime immunity, yet. TL;DR: Get vaccinated, it will keep you much safer, it will probably also help others around you, by making you spread it less if you do get it. You'll still get Covid but it will be much less of a deal. Side effects are temporary and not massive in the vast majority of cases.
overcast 6y ago
Good explanation on efficacy of vaccines. https://www.youtube.com/watch?v=K3odScka55A https://www.youtube.com/watch?v=K3odScka55A
known 6y ago
https://www.worldometers.info/coronavirus/#countries https://www.worldometers.info/coronavirus/#countries shows cases are increasing; Which means there is something wrong with the vaccines or with the distribution of vaccines;
sampo 6y ago
> Vaccines Are Effective Against Covid Variants This Hacker News title is inaccurate, as the study concerns only the Moderna mRNA-1273 vaccine.

224 points by 11thEarlOfMar 6y ago

A January 2021 study in the annals of internal medicine estimating the death rates of non institutionalized patients of .26 percent with age breakdowns . https://www.acpjournals.org/doi/10.7326/M20-5352?utm_source=24-scientists-determine-death-rate-covid-19-general-population&utm_medium=email&utm_content=published+in+the+Annals+of+Internal+Medicine&utm_campaign=ag&#t1-M205352 https://www.acpjournals.org/doi/10.7326/M20-5352?utm_source=...

ed25519FUUU 6y ago
Some more: > Indiana's IFR for noninstitutionalized persons older than 60 years is just below 2% (1 in 50). In comparison, the ratio is approximately 2.5 times greater than the estimated IFR for seasonal influenza, 0.8% (1 in 125), among those aged 65 years and older (5).
- legulere 6y ago
  That is just one factor though in which COVID-19 is worse than the seasonal influenza though. COVID-19 has a basic reproduction number of 3.3 – 5.7, while the seasonal influenza has one of 0.9 – 2.1 [1], which means that it spreads far more easily. You cannot just wait until summer for influenza season to be over. With influenza you have a higher rate of existing immunity in the population. With COVID-19 it is basically non-existent, except maybe for a few single people that had SARS or MERS before. Younger people are also more affected [2] You are longer sick from COVID-19 and if you have to stay in the hospital you will stay there longer and are more likely to end up on the intensive care unit [2] In the end you cannot compare a pandemic situation to influenza season. [1]: https://en.wikipedia.org/wiki/Basic_reproduction_number https://en.wikipedia.org/wiki/Basic_reproduction_number [2]: https://www.nature.com/articles/s41598-021-85081-0 https://www.nature.com/articles/s41598-021-85081-0
  - ed25519FUUU 6y ago
    I wasn’t comparing it to anything. I was just writing more of the studies findings.
  - timr 6y ago
    "Younger people are also more affected [2]" The paper you're citing says "younger" means 59, vs 66 for influenza: > Patients with COVID-19 were younger (median age [IQR], 59 [45–71] vs 66 [52–77]; P < 0001) and had fewer comorbidities at baseline with a lower mean overall age-adjusted Charlson Comorbidity Index (mean [SD], 3.0 [2.6] vs 4.0 [2.7]; P < 0.001) than patients with seasonal influenza. Also, this is data from a single hospital, across two different years. The overall trends for SARS-CoV2 are not even remotely debatable: the risk of mortality rises exponentially with age. It's one of the most striking features of the virus. To claim, based on this one paper, that "younger people are more affected" is to miss the forest for the trees. "In the end you cannot compare a pandemic situation to influenza season." You absolutely can, and in fact, you're doing it. What you're trying to say is that Covid is somehow unilaterally much worse than influenza, but that isn't true. It's much worse for the elderly (>65), but for most other age groups, it's about the same, if not a little bit better. You have to squint and split hairs and pick sources selectively to start making strong claims of increased severity in age groups under ~50, and it's simply not a believable claim for people under the age of ~30. The disease can be bad without exaggerating its threat.
    - legulere 6y ago
      I just took the first study I could find. You seem to claim that it’s conclusions are wrong and that young people are less affected of COVID than influenza. Do you have good studies to back this up?
      - timr 6y ago
        I am telling you that your comment is not supported by the source you cited. You can find a wide range of publications showing the age-specific mortality profile of Covid by Googling. Here is one that is commonly cited: https://link.springer.com/article/10.1007/s10654-020-00698-1 https://link.springer.com/article/10.1007/s10654-020-00698-1
raphaelj 6y ago
That seems pretty low compared to what is happening here in Belgium. We are at 22k deaths with +/- 25% of a 11M of the population having been infected (based on serology and statistical estimates).
- idoubtit 6y ago
  If I'm not mistaken, the rate in the paper is bigger, 0.25% against 22k/11M = 0.20% in Belgium. But if the newspaper I read are right, there is a catch: when tests were not available, Belgium counted as a covid death every case where it could be suspected. Even nowadays, in case of comorbidity, covid is always written down as the cause of death. So 22k is probably a maximum, and, taking into accound the 25% uncertainty on the denominator, the real rate could very different.
  - timerol 6y ago
    I think you're misreading the comment you replied to. "+/- 25% of a 11M of the population having been infected" means about 25% of 11M, or 2.75M, officially infected. 22k/2.75M would imply a 0.8% fatality rate.
    - raphaelj 6y ago
      Exactly. And with respect to the counting, it seems like the Belgian numbers more of less match the reported excess deaths in 2020 within 10% [1]. [1] https://www.medrxiv.org/content/10.1101/2021.01.27.21250604v1.full.pdf https://www.medrxiv.org/content/10.1101/2021.01.27.21250604v...
- lukeinkster 6y ago
  Seems low compared to New York City as well. NYC has already had 30,564 deaths. Even if the whole population had already been infected, that would put the death rate at around 0.36% Antibody surveys suggest around 40% have been infected which puts the death rate around 0.91%
  - 6y ago
jquery 6y ago
For every person that dies (an agonizing death akin to medieval torture), a few more are in intensive care fighting for their lives. For every one of those, others end up in the hospital, spread the disease to others, suffer from “long covid”, or merely suffer greatly. Every person that gets covid adds to the likelihood the disease will become uncontrollable in the long term and endemic. Keep wearing your masks and social distancing people. It’s hard, it’s a sacrifice, but together we can conquer this disease and return to life “as normal”.
- idoubtit 6y ago
  > For every person that dies (an agonizing death akin to medieval torture) I think this is wrong, at least in rich countries, at least those that are sane enough to cure their ill citizens. A friend of mine died of covid last year. Then a family member this year. They were both sedated, and did not suffer at all on their last days in hospitals.
  - jquery 6y ago
    Sedation is death with a respiratory illness like this. How were they feeling before they were sedated? Probably like they’d been drowning for hours. For all intents and purposes, that was the end of their life as far as their experience of it. Don’t get me wrong, it’s great that we can provide palliative comfort for those final hours/days. But it doesn’t tell the full story.
    - mlyle 6y ago
      Just for clarity/augmentation/pedantic detail: you might be sedated and end up an a ventilator. But ventilators are really bad for COVID survival and really a last ditch, long-shot chance try to salvage your life. Practitioners hold off on the sedation and associated required ventilation as long as possible to try and spare your life.
- mrfusion 6y ago
  I don’t see any reason new variants would ever stop coming. What are you proposing is the end point of all of this?

simonebrunozzi 6y ago

It seems that the AstraZeneca vaccine is not effective against the South African variant [0]. [0]: https://www.nejm.org/doi/full/10.1056/NEJMoa2102214?fbclid=IwAR3zOZYHFGj2gIwH6V1kbOJim55Cwk7JkPfe6cOyh0eaeBHy-p-kELY0hM4 https://www.nejm.org/doi/full/10.1056/NEJMoa2102214?fbclid=I...

amelius 6y ago
That's wrt mild to moderate cases. It might still be effective against severe cases.
- modularform123 6y ago
  They didn’t design the study to look for severe cases in South Africa and this variant isn’t widespread in other countries where the vaccine is in use, so it will be hard to get evidence on effectiveness against severe disease anytime soon.
- theduder99 6y ago
  good point, it might raise our IQ as well!
- paulmd 6y ago
  nevertheless, you have to actually support that hypothesis with research. Just the fact that it's ineffective against mild to moderate doesn't mean it will be effective against more severe cases. it might also be ineffective against severe cases, making it just entirely ineffective against those strains. a year later and people are still trying to twist studies into support of their favored medical treatments without actual supporting research...
  - dbetteridge 6y ago
    It is being worked on, animal studies only so far with human studies to come as SA rolls out their 100k doses of AZ I am sure. Animal model study - Syrian hamsters https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciab083/6124512 https://academic.oup.com/cid/advance-article/doi/10.1093/cid...

modularform123 6y ago

The plural ‘variants’ in the title is a bit misleading. Only one of the four viruses they tested is one we are actually concerned about at this time. The first is the original virus, which was displaced by the second early in the pandemic and against which vaccines are already known to be effective. The third one is the UK variant, which is of interest and the fourth is an artificial virus with a single mutation of interest, which doesn’t circulate in nature. This is all good but the study doesn’t add anything that wasn’t already known. It appears that better funded groups at the NIH, UTMB, Fred Hutch and Columbia beat them to the goal and to publication in the even more prestigious publications like NEJM and Nature. In any case, reproducing important research is a laudable and underrated goal. However, I would suggest a more modest title - ‘Study adds to data for vaccines’ effectiveness against the UK variant of SARS-COV-2’. There are other variants - Brazilian, South African, Californian, New York, etc - which need to be studied in more detail. There are already data from the aforementioned research groups for at least some of these variants that suggest that vaccines will continue to be at least partially effective.

rimliu 6y ago
Nothing is misleading in the title.
- frongpik 6y ago
  The title implies that "[All] vaccines are effective against [all] variants", but that's a lie. And when people realize this, they'll lose trust in vaccines in general.

cadence- 6y ago

Thanks for sharing this. I actually see very little reporting on how this virus spreads among the vaccinated population. I would love to see new case numbers broken down by vaccinated and not-vaccinated people from countries like UK, US and Israel. So far I’m unable to find such data on the internet.

jaredsohn 6y ago
This post seems like it might be the closest to what you are looking for: https://www.reddit.com/r/COVID19/comments/loljxz/effectiveness_results_of_the_pfizer_covid19/ https://www.reddit.com/r/COVID19/comments/loljxz/effectivene...
sjg007 6y ago
Breakthrough infections have been identified. https://www.webmd.com/vaccines/covid-19-vaccine/news/20210308/reports-of-break-through-covid-cases-after-vaccine https://www.webmd.com/vaccines/covid-19-vaccine/news/2021030...

rzzzt 6y ago

I might be missing something. Isn't the report solely about the neutralizing capabilities of the Moderna vaccine? What other vaccines were tested?

psychlops 6y ago

The immune system still works as advertised.

jquery 6y ago
What’s the purpose of comments like this? EDIT: I see someone mentioning Trump below and I can’t reply. Trump was never interested in managing covid-19 or effective border control. This would’ve been the perfect opportunity for him to show why having smart borders was useful. He would’ve received support from within the government. He would’ve managed covid-19 successfully perhaps, and won re-election. The problem was Trump was a completely ineffective and incompetent leader, who didn’t care at all about the things he claimed to care about. Mandatory quarantines and tests for people traveling to America would’ve been a lot of work and Trump was allergic to that. He was a man who preferred the cheers at his rallies over the difficult work of administrating and governing.
- war1025 6y ago
  Probably that patience has worn thin for the extremely overly cautious people who have been hiding in their homes for a year when they are realistically at zero risk of severe illness. We have known since early summer of last year that being fat or being old are your two biggest risk factors. Beyond that, if you have some serious pre-existing condition that makes you susceptible to all illnesses. The messaging should have been "Stay home if you are a high risk group. Otherwise live your live." All current data shows areas that have taken that approach are significantly better off today than the places that hid in a hole the past year. We have let people treat this like it's an end of the world scenario and it's been good for no one.
  - jquery 6y ago
    So you’d prefer we be like Brazil? Because the alternative for us was not Taiwan or Korea. They went far and beyond what Americans were willing to tolerate. Never mind the bad statistics behind your claim that covid is no worse than the flu. A athlete friend of mine in his 20s has permanent heart damage caused by the virus. Covid-19 is not a joke, no matter how much you wish it was. Americans could be out free, today, if we took this virus more seriously from the start. Now people like you want to make the disease endemic when the end is in sight.

ta8645 6y ago

This is good news. Now maybe Fauci should rethink his idea that people need to wear their masks for another year even after getting vaccinated. One of his reasons was because of worry about the variants.

halfmatthalfcat 6y ago
Wearing masks have benefits beyond covid. Think about how many lives per year we could save from the flu let alone other airborne respiratory viruses if mask wearing was normalized.
- JasonFruit 6y ago
  Wearing foam rubber padding all the time has benefits, but that doesn't mean everyone should do it. There are other considerations beyond mere safety.
  - ghaff 6y ago
    Or at least bike helmets all the time. Lots of people get seriously injured or killed because of falling and hitting their head. I expect mask wearing will be more common in cultures where it was almost unheard of like western Europe and the US. But even in a country like Japan where it wasn't unusual, it certainly wasn't anything like the norm.
  - brandon272 6y ago
    Wearing a mask is a lot more convenient than foam rubber padding.
- mrfusion 6y ago
  I’ve heard it argued that our immune systems need exposure to germs to keep them effective.
  - bluGill 6y ago
    I've heard that too. But never does anyone back it up with anything that could be remotely called good science.

spchampion2 6y ago

This is not well aligned with other research[1] showing the Pfizer and Moderna vaccines perform little better against the B1351 (South Africa) variant than they do against plain old SARS and distantly related bat COVIDs. They're also only semi-effective against the Brazilian P1 variant. Right now, all of the vaccines are reasonably effective against the variants commonly circulating in the US (including B117), which is what the JAMA article tested. But I worry for how well they'll perform in a few months when the other variants get a foothold. [1]: https://www.cell.com/cell/pdf/S0092-8674(21)00298-1.pdf https://www.cell.com/cell/pdf/S0092-8674(21)00298-1.pdf

anonuser123456 6y ago
The article is talking about "escape neutralization". Neutralizing antibodies are not the only mechanism of the immune system, and the article even discusses another such mechanism: T cell immunity. T cell immunity appears robust for all variants from the data I've seen.
- spchampion2 6y ago
  As far as I can tell, both the JAMA study linked in this post and the study I linked are describing antibody responses. I was trying to make an apples-to-apples comparison by sharing a similar study with contradictory results on a broader swath of virus variants.

carbocation 6y ago

The title of this article, which performs an in vitro test, is "Neutralizing Antibodies Against SARS-CoV-2 Variants After Infection and Vaccination". The editorialization in the current Hacker News headline ("Vaccines Are Effective Against Covid Variants") is not warranted.

jquery 6y ago
In other words it’s a little early to start the victory chants. Unfortunately this will get used to justify reckless behavior.
ttul 6y ago
If I can pass on what I’ve learned in the past 12 months as a newly minted virus enthusiast whose peak education in the area was human physiology 101: “In vitro” means testing outside of the human body. Just because a result is confirmed in vitro does not mean it will be replicated when tested “in vivo” (in the actual human).
- kweinber 6y ago
  In vitro literally means “In glass” (like in a test tube). In vivo means “in life” (like IRL)
  - schoen 6y ago
    Strictly speaking, in vivo means "in a living [organism]"; "in life" would be in vita (not a term used for a kind of test). https://en.wiktionary.org/wiki/vivus#Latin https://en.wiktionary.org/wiki/vivus#Latin https://en.wiktionary.org/wiki/vita#Latin https://en.wiktionary.org/wiki/vita#Latin

vondur 6y ago

I assume unless the spike protein mutates, these variants would still be covered under the current vaccines.

idoubtit 6y ago

The current HN title deviates from the original title in a way that is misleading. "Vaccines Are Effective Against Covid Variants" is a wrong affirmation. The original article only states that in vitro experiments show that some vaccines are effective against some variants. Not all vaccines, not all variants, and no test on human beings. A counter point is that some vaccines seem to be ineffective agains some variants. For instance AstraZeneca against B.A.351 (South-Africa). From a preprint: "Conclusions A two-dose regimen of ChAdOx1-nCoV19 did not show protection against mild-moderate Covid-19 due to B.1.351 variant, however, VE against severe Covid-19 is undetermined." https://www.medrxiv.org/content/10.1101/2021.02.10.21251247v1 https://www.medrxiv.org/content/10.1101/2021.02.10.21251247v... The US CDC does state that, according to current publications, some variants present a "moderate reduction on neutralization". Their page about "Variants of Interest" and "Variants of Concern" mentions many scientific papers. https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/variant-surveillance/variant-info.html https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/vari...

dbetteridge 6y ago
I've posted this before regarding the SA paper on AZ, worth taking a look at the below. The probable outcome is minor to moderate symptoms that would normally be blocked by antibodies can still present (So no reduced transmission) but severe symptoms are still prevented by the vaccinated patients T-cells response. This paper is looking at a small scale human study in SA with mostly younger participants, which does make the results difficult to apply to the wider population. They also only use a 4 week dosing schedule where the suggestion and actual rollout in the UK is following the 10-12 week schedule between first and second doses which was shown to increase efficacy from ~70 to ~80% after the second dose (UK - Kent variant) The variant in question seems to escape the majority of Antibody detection, but T-Cells still seem to provide significant protection against severe disease and death. https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciab083/6124512 https://academic.oup.com/cid/advance-article/doi/10.1093/cid... https://www.biorxiv.org/content/10.1101/2021.03.11.435000v1 https://www.biorxiv.org/content/10.1101/2021.03.11.435000v1 The main published results aren't yet from human scale studies but here is one in hamsters showing a comparison in organ damage and results between unvaccinated and vaccinated with the Oxford/AZ vaccine.

marcodiego 6y ago

For people arguing that not being part of a risk group is a reason not to protect yourself, please take a lesson from brazil. Being part of a 'high risk group' does not saves you from infecting other people who are part of such groups. That's basically what happened in brazil: people who were not part of risk groups crowded, encouraged by the president himself[0][1][2]. The number of infected poeple soared and variants that affect younger people appeared[3][4]. The health system has now collapsed because there is not enough ICU for such a high number of ill people[5][6]. [0] https://www.em.com.br/app/noticia/politica/2021/02/26/interna_politica,1241415/ignorando-a-covid-19-bolsonaro-esteve-em-7-aglomeracoes-em-4-dias.shtml https://www.em.com.br/app/noticia/politica/2021/02/26/intern... [1] https://noticias.uol.com.br/politica/ultimas-noticias/2021/02/19/bolsonaro-volta-a-provocar-aglomeracao-em-visita-ao-nordeste.htm https://noticias.uol.com.br/politica/ultimas-noticias/2021/0... [2] https://cultura.uol.com.br/noticias/15258_bolsonaro-mergulha-na-praia-grande-e-causa-aglomeracao-com-banhistas.html https://cultura.uol.com.br/noticias/15258_bolsonaro-mergulha... [3] https://www.cartacapital.com.br/saude/segunda-onda-de-covid-19-no-brasil-ataca-cada-vez-mais-jovens/ https://www.cartacapital.com.br/saude/segunda-onda-de-covid-... [4] https://www.brasildefato.com.br/2021/03/19/tres-novas-cepas-identificadas-no-brasil-sao-mais-potentes-e-transmissiveis https://www.brasildefato.com.br/2021/03/19/tres-novas-cepas-... [5] https://www.cnnbrasil.com.br/saude/2021/03/19/17-estados-e-o-df-estao-em-colapso-na-saude-mt-ms-rs-e-rr-nao-tem-mais-leitos https://www.cnnbrasil.com.br/saude/2021/03/19/17-estados-e-o... [6] https://www.cnnbrasil.com.br/saude/2021/03/19/em-meio-ao-colapso-do-sistema-de-saude-faltam-medicos-intensivistas-nas-utis https://www.cnnbrasil.com.br/saude/2021/03/19/em-meio-ao-col...

mherrmann 6y ago
Also for selfish reasons. I know a 24 year old ballerina (so a professional athlete) who had it two months ago and is now at 80% lung capacity.
- outside1234 6y ago
  And to pile on this, I know a triathelete in my group, 24 years old, who had it in April of LAST YEAR and is still not at 100% (can't do any hard aerobics without getting wildly out of breath). We are still in a pandemic. Stay distant.

eqvinox 6y ago

54 patients total? That's not a sample size to draw strong conclusions on :(

nanidin 6y ago
Assuming normal distribution, the law of large numbers kicks in at n=30.
- eqvinox 6y ago
  The actual number of examined vaccinated people('s serum) is 14. The other 20+20 are acute/recovering cases. (I was being generous with the 54.) Also the page itself says Limitations include the small sample size under "Discussion".

arisAlexis 6y ago

the most bothersome variants (SA,P1 brazil) are not reported in the paper

WalterBright 6y ago

We've been vaccinating people since December. There ought to be statistical evidence now of whether and how much vaccinated people still get sick from Covid and its variants. Why do we still hear that epidemiologists have no idea about this? For example, everyone being tested for covid or being admitted to the hospital for covid, should be asked if they've been vaccinated, when, and which vaccination. 70 million people in the US have received vaccinations. There ought to be plenty of data by now.

figaroniguzo 6y ago
To keep the fear and lockdown measures justified. Just like "we don't know if vaccines affect transmission" or "masks work to mitigate the spread" (as if masks were discovered in 2020)
- osrec 6y ago
  But why? Why would any government want to justify longer than needed lockdowns?
  - offby37years 6y ago
    “Power tends to corrupt, and absolute power corrupts absolutely” — John Dalberg-Acton
    - SteveNuts 6y ago
      But don't lockdowns cause a "loss of power" (economic, trade, prestige)? This just doesn't make sense to me.
      - oblio 6y ago
        They do, but people complaining about this tend to convenient focus on the powerful people making money because of lockdowns while absolutely ignoring the powerful people <<losing>> money because of them.

davak 6y ago

This was not testing against the South African and Japan/Brazil variants that are much more likely to escape vaccination antibodies. This UK variant is mostly problematic against the unvaccinated. In the lab the South Africa and Japan/Brazil variants have severe reduction in neutralizing antibodies which is very concerning for vaccine escape. That being said, we don’t have a great way to test for T cell and other immunity which also plays a role. Getting the vaccine decreases severity of illness regardless of the variant. The answer is get any vaccine as soon as possible. Then get the booster too when it’s available.

2ion 6y ago

Still not getting my vaccine shots. So great they are, my government is sabotaging my safety by continueing to deny me access.

standardUser 6y ago

I don't think I've ever seen an HN thread with so many anecdotes, assumptions and off-the-cuff theories and so little data or useful links.

albertgoeswoof 6y ago
Somewhat ironic that this is also an an anecdote

yawaworht1978 6y ago

I am very clueless on the vaccine topic (not a denier of covid or anti vaxxer). All I know is from listening to some interviews with a scientist in the field. But i still do not know what is the definition of "effective vaccine". What does it do? If you have covid and take the vaccine, will the covid go away? Are you still contagious after having the vaccine or can you still get the covid but without the bad effects? What kind of immunity is given by the vaccine and how long does it last? All I remember is that scientist said that herd immunity will likely never happen, or not in a long time(years, according to him). There are too little comprehensive sources on the matter and too much superficial noise. Thanks for any input.

oblio 6y ago
Well, based on my understanding, we don't know for sure. What we do know, is that they give you a much higher chance of avoiding serious symptoms, including that most serious of symptoms, death. You won't be "virus-proof" completely, but someone vaccinated fully (so 2 doses for vaccines which require it), after a certain immunization period, which varies between 2-4 weeks after being fully vaccinated, will be super resilient to being in contact with Covid patients. Don't go get coughed on by 10 Covid patients, though. Regarding contagion, apparently after vaccination, you can still get Covid with most vaccines, you just become "asymptomatic", i.e. it doesn't really affect you. However it seems that you're also much less contagious, which is still great, since it reduces the infection rate, it becomes much harder to spread it. If you get Covid while immunity from vaccination hasn't kicked in fully... you can still be screwed. People have died 1 week after being vaccinated. So you probably want to stay put for a while until your immunity ramps up. Regarding immunity, as I was saying, it's primarily lack of serious symptoms. I think they also make it harder for you to catch it, but I don't think we have super solid proof of this yet. And for immunity, it's hard to say. We're basically just counting up days from initial vaccinations to see how long it lasts. For the other vaccines we know the time intervals because... time has passed. So far, for the current vaccines it seems that immunity is at least 6+ months. From what I've read we should be reasonably optimistic that we'll be immune for 1+ years. I don't think anyone expects lifetime immunity, yet. TL;DR: Get vaccinated, it will keep you much safer, it will probably also help others around you, by making you spread it less if you do get it. You'll still get Covid but it will be much less of a deal. Side effects are temporary and not massive in the vast majority of cases.

overcast 6y ago

Good explanation on efficacy of vaccines. https://www.youtube.com/watch?v=K3odScka55A https://www.youtube.com/watch?v=K3odScka55A

known 6y ago

https://www.worldometers.info/coronavirus/#countries https://www.worldometers.info/coronavirus/#countries shows cases are increasing; Which means there is something wrong with the vaccines or with the distribution of vaccines;

sampo 6y ago

> Vaccines Are Effective Against Covid Variants This Hacker News title is inaccurate, as the study concerns only the Moderna mRNA-1273 vaccine.