17 ms·

mRNA vaccines – a new era in vaccinology (2018)

211 points by elsewhen 5y ago

haltingproblem 5y ago
mRNA vaccines are not new, just newer than existing platforms. mRNA vaccine clinical trials which usually last years (or a decade), were completed in 2017, as per the nature article summary. The technology and its effects are well known in both in mice and human models. Is there residual risk that there were will be some unintended side-effect when billions of doses are administered? Yes, of course. There is no way to prove a vaccine is safe for everyone in all conditions, (see: Popper's falsification and the demarcation problem). Same goes for any other pharma formulation, food stuff or procedure. However, we have to weigh the residual risks against the risk of death from Covid and its variants and risk of long term damage to me or those around me who might be unwittingly in a higher risk category. Vaccination is a moral obligation and even if I would rather not, decency and civic duty to our fellow humans dictates that I must. And so should you.
- deleted 5y ago
  [deleted]
- jeremyis 5y ago
  > Vaccination is a moral obligation and even if I would rather not, decency and civic duty to our fellow humans dictates that I must. And so should you. Well put
  - aeternum 5y ago
    By that logic, shouldn't you also through that same sense of decency and civic duty donate to prevent starvation? How is it morally decent to live in an expensive city while that money could prevent others from dying? In fact, instead of taking that vaccine shouldn't you give it to a school teacher or hospital worker in a country that doesn't yet have the vaccine? This 'moral obligation' nonsense sounds good at face value but really doesn't hold up in practice.
- medicineman 5y ago
  >[...]civic duty to our fellow humans dictates that I must. It appears you grew up with more privilege than I can even fathom.
- lolbrels 5y ago
  No thanks. If someone is high risk that is their responsibility to accommodate themselves and their surroundings. You have a twisted sense of morality.
- Pompidou 5y ago
  My fear with mRNA vaccine is that we place too much hope in this technology. Maybe it's much less efficient from what was expected.
  - alexfromapex 5y ago
    My fear is that we still don’t fully understand genetic and epigenetic coding and there are probably latent dangers lurking with this class of vaccines that may not even be apparent until a new generation of posterity.
    - jcadam 5y ago
      I suppose there's always a (very) small chance that we're making a civilization-ending mistake with this new vaccine :) On the flip-side, while COVID can cause serious illness (and death), with a survival rate north of 99%, there's virtually no risk of societal collapse if we do nothing (OTOH, our response to it has been far more de-stabilizing).
  - elicash 5y ago
    I think we probably place too much hope in improving technology, in general. It's a tremendous breakthrough, I'd say. But rather than focus on the tech, I'd rather see a rethinking of our governmental approach to issues concerning public health and how approval processes are set up. I'd rather focus on how we incentivize breakthroughs on issues that are most important, rather than developing another medicine that's 1% better at treating acne, for example. And I'd rather see cultural changes around adopting already existing technologies -- less than half of folks take flu shots! I'd argue that getting flu shot numbers way up would be more of a breakthrough than any benefits from mRNA, as incredible as it is. Not that we have to choose one or the other. I'm just saying I'd like these other issues to get more prominence.
- seriousquestion 5y ago
  > moral obligation and even if I would rather not, decency and civic duty to our fellow humans dictates that I must. And so should you. When people are not on stable scientific ground, they invoke morality. That's what priests and politicians do, not scientists. (edited)
  - diegoperini 5y ago
    For someone who doesn't work in the field, deciding to take the vaccine is an act of faith.
    - ubercore 5y ago
      By that logic, doing anything you aren't expert in is an act of faith. It's pretty reductive.
      - diegoperini 5y ago
        I'm not reducing it to entirely faith, but faith takes part in it.
      - mnw21cam 5y ago
        That logic seems sound to me.
      - donw 5y ago
        You’re more correct than you realize. If I get on a Boeing aircraft, I am indeed engaging in an act of faith: that it was built properly, maintained well, and all the rest. When that faith is violated, say by the control systems having the RANDOMLY_FALL_OUT_OF_THE_SKY flag set to “true”, then society engages in faith-restoring rituals: grounds the aircraft, leads an inquiry, does a recall, that sort of thing. What you are seeing here is what happens when a large chunk of the population has lost faith in, and thus no longer trusts, its institutions.
        throwawayboise 5y ago
- traviswt 5y ago
  > Vaccination is a moral obligation Only if the mechanism of its action contributes to herd immunity. If it provides symptom abatement without lowering infection and transmission, then vaccination of those not at risk can prove counterproductive due to asymptomatic spread.
  - klyrs 5y ago
    Death isn't the only negative outcome of covid. We're seeing a relatively high rate of long-term damage caused by low-level symptoms. If we can reduce those symptoms with a (perhaps annual) shot, then covid turns into the "just a cold" that we were all hoping it would be
    - TheBlight 5y ago
      >We're seeing a relatively high rate of long-term damage caused by low-level symptoms. Source? I've seen it reported that this may actually be dubious. [1] [1] https://archive.ph/CConv https://archive.ph/CConv
      - klyrs 5y ago
        https://www.sciencedaily.com/releases/2021/03/210331204431.htm https://www.sciencedaily.com/releases/2021/03/210331204431.h...
        mdorazio 5y ago
        I'm not saying COVID doesn't have long-term impacts in certain portions of the population, but this sentence is pretty important: "However, the findings are observational, and the authors cannot rule out the possibility that rates of diagnoses in general might have decreased indirectly because of the pandemic, particularly in people not admitted to hospital with covid-19." It's really hard to draw meaningful conclusions when COVID has completely changed all kinds of factors in healthcare ranging from people being stuck at home and eating poorly to opting not to visit the doctor because of overburdened hospitals and fear of infection. I'd like to see some studies a year from now before forming a strong opinion.
- padobson 5y ago
  This had me nodding my head: However, we have to weigh the residual risks against the risk of death from Covid But then this made me wonder if there was a paragraph I missed: Vaccination is a moral obligation I think it's a mistake to think the weighing process you endorse in the first quote will land everyone with the moral obligation you endorse in the second.
- krona 5y ago
  Informed consent, a cornerstone of medical ethics, has very little to do with the fact that we can't prove treatment will not be detrimental in all cases. Or perhaps you prioritise the group above the individual in all cases and think e.g. the Nuremberg Code is worthless historical artifact?
  - haltingproblem 5y ago
    You have packed two strawman arguments into one comment. I was talking about a moral obligation and not about informed consent or this: "The Nuremberg Code aimed to protect human subjects from enduring the kind of cruelty and exploitation the prisoners endured at concentration camps. The 10 elements of the code are: Voluntary consent is essential. The results of any experiment must be for the greater good of society." ;)
- claytongulick 5y ago
  This would require a degree of confidence in the benevolence of pharmaceutical companies that I do not currently have.
  - Diederich 5y ago
    > benevolence of pharmaceutical companies I get that sentiment. There's a question of alignment of incentives. Covid19 vaccinations are likely to be a thing for many years to come, and there are a number of entities that will be able to produce those future vaccinations. If one of the big vaccine providers produces something that's demonstrably less safe than the others, then the odds of them getting more money for future vaccines goes down. It's far from a perfect system, and there are a lot of holes, but in this case, things line up pretty well. In short, you can be confident that these companies are primarily focused on long-term profit, which often aligns with good short and long term outcomes for its customers.
- wintermutestwin 5y ago
  In the semi-rural area where I live we have 1/3 trumpsters who won't get it due to their political allegiances and 1/3 hippies who won't because woo woo reasons. I am assuming there will be a harsh reckoning in store for this and similar places.
  - vkou 5y ago
    The harsh reckoning will be for the urban areas who subsidize that stupidity, when variants will emerge from among these unvaccinated populations, and we are going to go through this song and dance all over again. It's also why I'm incensed that vaccine production is ramping up both too slowly, and will top out at too low a number. It can't take six months to vaccinate the first world, and eighteen to vaccinate the developing world against a variant.
    - call_me_dana 5y ago
      Or variants emerging from those vaccinated. It’s nonsense to assume “the unvaccinated are dirty Petri dishes where mutations come from!” Variants can come from vaccines themselves or mutating in the host and then spreading. If anyone think that’s impossible, such a phenomenon is happening right now in Africa with Polio. Wild Polio is declared to be eradicated. A vaccine derived strain is keeping the outbreak alive. https://www.npr.org/sections/goatsandsoda/2020/08/25/905884740/africa-declares-wild-polio-is-wiped-out-yet-it-persists-in-vaccine-derived-cases https://www.npr.org/sections/goatsandsoda/2020/08/25/9058847...
      - vkou 5y ago
        Sure, it can happen, and viruses spread even through a vaccinated population, but quantity is a quality all of its own. Vaccinate everyone, and the number of opportunities for the virus to mutate and spread drops by orders of magnitude. Vaccinate half the population, and all that you'll do is create a great amount of evolutionary selection pressure for a mutation.
  - splistud 5y ago
    It's hard when people you don't like won't do what you want them to do isn't it?
- what_happa_god 5y ago
  Regardless of your opinion of vaccination being a moral obligation, that does not sway my personal decision whether to take an experimental vaccine for an illness with a 99.5% survival rate. Collectivist ideals like "vaccinate everyone for the greater good!" does not trump my personal sovereignty and never will. I do not consent.
  - deleted 5y ago
    [deleted]
  - jcadam 5y ago
    There are people (not so much on HN, but definitely other places on the net) openly advocating for forced vaccinations and/or completely shunning the unvaccinated from society (to include employment). Oh, I'm with you on this, but I think it's only a matter of time before things get very uncomfortable.
- kokanator 5y ago
  Just an interesting question here, if you are saying vaccination is a moral obligation does this mean you are a moral realist [0]? My guess is not. You may mean to say for you vaccination is a moral obligation which if this is the case you are a moral relativist [1] and therefore your moral obligation does not necessarily apply to others. [0] https://plato.stanford.edu/entries/moral-realism/ https://plato.stanford.edu/entries/moral-realism/ [1] https://plato.stanford.edu/entries/moral-relativism/ https://plato.stanford.edu/entries/moral-relativism/
  - haltingproblem 5y ago
    Of course, my moral obligation only applies to me. But I can advocate for others to follow my line of reasoning through persuasion. Many moons ago, when I lived in a community where most residents were of the all-organic-no-vax types, I convinced the powers that be that vaccination was a moral obligation for the (mostly young) community due to the effects of infecting young and old and the resulting deaths. Everyone got a flu vaccine that year. I was not very popular after that ;(
- splistud 5y ago
  You keep saying we. There is no we in this CHOICE (your assumed moral obligation notwithstanding).
- dang 5y ago
  Please don't take HN threads into flamewar. It's tedious and evokes worse from others. We're trying for the opposite here. Especially please don't take HN threads on generic flamewar tangents like "Vaccination is a moral obligation". They're highly repetitive and don't lead any place interesting. https://hn.algolia.com/?dateRange=all&page=0&prefix=true&sort=byDate&type=comment&query=generic%20discussion%20by:dang https://hn.algolia.com/?dateRange=all&page=0&prefix=true&sor... https://hn.algolia.com/?dateRange=all&page=0&prefix=true&sort=byDate&type=comment&query=generic%20ideolog%20by:dang https://hn.algolia.com/?dateRange=all&page=0&prefix=true&sor... https://news.ycombinator.com/newsguidelines.html https://news.ycombinator.com/newsguidelines.html
  - haltingproblem 5y ago
    I posted what I thought was a very uncontroversial idea - "vaccination is a moral obligation for me", since Covid is surging again and vaccination rates have flatlined because vaccine hesitancy et.al. I don't know why this evoked such a negative response. I will just cool off posting comments on HN for a while.
vibrio 5y ago
They did a great job with the mRNA vaccines, but they have been prolific in research for nearly decade. In my opinion a intersting question is whether infectious disease vaccines now matter to the "wealthy world", as infectious disease has largely been an economic backwater for Pharma/VC,etc. How mRNA vaccines play a role in that maybe interesting, as their product profile is mostly 'wealthy world friendly' at this point.
- haltingproblem 5y ago
  I have been noting down pandemic silver linings, and this is one did not occur to me. To take your point further, given the workhorse industrialization the mRNA platform has been given during Covid, turning it on the other infectious diseases might mean millions or tens of millions lives saved over the coming decade or two. A (pseudo) black swan of a pandemic leads to a white swan!
  - cyberlurker 5y ago
    A Malaria vaccine would be awesome. I have no idea if that’s possible though. I’ve known people with Malaria and have personally taken the (expensive) pills to protect myself. It all sucks.
    - notriddle 5y ago
      Malaria is a parasite, not a virus. Doesn't it have to be a virus for mRNA vaccines to make sense?
      - rst 5y ago
        There are vaccines against bacterial infections (tuberculosis, for example).
        Vecr 5y ago
        The tuberculosis vaccine might not be the best example, it lacks efficacy in some places, for an unknown reason or reasons, such as the US and India.
NobodyNada 5y ago
(2018)
whatever1 5y ago
Given the antibiotic stagnation, could we possibly develop something similar to target bacteria? Aka inject instructions in their genome to self destroy?
- SketchySeaBeast 5y ago
  I wonder if that won't work as well given that we're not using this to cure COVID while we are currently sick with it. I don't know if Syphilis booster shots would make sense or if the range of things we could need to be regularly inoculated for would be far too broad for this to be useful.
- passivate 5y ago
  Even if you could do that, you'd only kill a handful of bacteria. The mRNA platform doesn't contain genetic code to recreate and repackage itself.
  - mmastrac 5y ago
    Obviously not a biologist, but if you could target a specific protein on the bacterial surface it might work. Alternatively you could CRISPR some human cells that generate the bacteria-killing RNA constantly.
    - passivate 5y ago
      Yes, that would be super cool. But also crazy-risky!! :) But the risk is not due to chance, its due to the unknowns. Once they're no longer unknowns we'll be able to engineer such a therapy. Alternatively, once we understand our biology so well, we might as well just patch all the "bugs" so that we don't get infected by harmful pathogens. Or maybe forsake our biology and move on to Silicon ?
  - bpodgursky 5y ago
    Neither do standard antibiotics.
    - 5y ago
candiddevmike 5y ago
Will mRNA tech eventually become something synthesized at point of care and possibly be used therapeutically?
- _joel 5y ago
  RNA therapies are being used to to target tumors, the next few years should be very interesting in this field. https://www.sciencedirect.com/science/article/pii/S0753332220301888 https://www.sciencedirect.com/science/article/pii/S075333222...
  - lofi_lory 5y ago
    I wonder, if mRNA tech offers the possibility of reintroducing lost of function for cells with mutations like p53 defects. E.g. maybe just do what p53 does, if it's present or not. Much harder to identify the misbehaving cells, DNA deletions, than making all cells behave, I assume.
- pkaye 5y ago
  I think that is what CureVac is working on. RNA printers. I think even custom therapy can be produced but safety and efficacy is something they can't easily determine.
IG_Semmelweiss 5y ago
I take this quote from the article: "considerations and challenges include scaling up good manufacturing practice (GMP) production" Then I think of J&J and its 15M ruined doses, and then wonder whether pharma co's should provide better access to rank & file managers into scientific journals, particularly stuff they are known to be building. https://www.dailymail.co.uk/health/article-9486801/Emergent-stop-making-new-COVID-19-vaccine-material-Baltimore-plant.html https://www.dailymail.co.uk/health/article-9486801/Emergent-...
symlinkk 5y ago
Am I crazy for being nervous about taking an mRNA COVID shot? Like all of you I’m not an expert in the field, but from what I’ve skimmed online it seems like mRNA vaccines have never been used widespread in humans before? This is making me want to take the J&J one instead. I’m totally open to other opinions though, I haven’t made up my mind on this.
- colinmcd 5y ago
  I'm no biologist, but mRNA is ephemeral by design - it's constantly being broken down in the body. The fact that mRNA is converted to proteins by ribosomes is one of the best understood processes in cellular biology, and synthesizing the mRNA for a new protein is not a new idea. Getting actual viral vectors injected into my arm seems much more concerning on the surface (though it's obviously also very safe).
  - yasp 5y ago
    Were that it was so simple. My understanding is the mRNA used in the vaccines was engineered to be more stable (less ephemeral). Not sure what that means in terms of half life, but AFAICT it's a mistake to assume that it will behave similarly to naturally occurring mRNA if this is true.
    - pkaye 5y ago
      They put a lipid coating around the mRNA to protect it. But as soon as that coating is removed, it will be quickly be broken down in the body by various enzymes.
      - yasp 5y ago
        How long does the coating take to be removed? Can the mRNA still be (reverse-)transcribed while in the presence of this coating?
        pkaye 5y ago
andred14 5y ago
Why did they skip animal trials for the "covid" vacc1nes? https://regenerativemc.com/thursday-4-8-2021-what-happened-in-the-animal-trials-for-mrna-vaccines/ https://regenerativemc.com/thursday-4-8-2021-what-happened-i...
jzer0cool 5y ago
Not knowledgable in the biology area so forgive any incorrect terminologies or assumptions in advance. mRNA sounds incredible. As I understand the vaccines work by injecting an mRNA sequence which produces a certain spike protein to defend against certain viruses. In contrast, cells here are not producing the mRNA. Do these injected mRNA eventually phase out and die out from the body? Typically what is the lifetime? Is there also some 'off' mode, or complementary vaccine to undo an injection say after learning of some serious affect?
- homero 5y ago
  mRNA don't last long at all. The challenge was making them last long enough to even work. https://www.mskcc.org/coronavirus/what-s-different-about-messenger-rna-vaccines-covid-19 https://www.mskcc.org/coronavirus/what-s-different-about-mes...
- Arelius 5y ago
  As I understand it, there are natural mechanisms that break down the mRNA. At least in the article about reverse engineering the vaccine, they state that that "The mRNA vaccines quickly degrade in the human body" https://berthub.eu/articles/posts/reverse-engineering-source-code-of-the-biontech-pfizer-vaccine/ https://berthub.eu/articles/posts/reverse-engineering-source... I think also the instability is a large component of why the vaccines must be stored at such low temperatures.
  - wolfi1 5y ago
    >I think also the instability is a large component of why the vaccines must be stored at such low temperatures. As I understand it, the low temperatures are partly required because of the liposomes the mRNA is "packed" into
    - danwills 5y ago
      As I understand the instability of mRNA in the general cell background cytoplasm is because of the presence of enzymatic molecules (produced by the cell) that attract and then break down (lyse) any mRNA that floats into their 'jaws'. Loads of different things get broken-down by this kind of background presence of some enzyme, and since mRNA is used by the cell itself, maybe not too surprising that it has a cleanup mechanism in-place already?
ackbar03 5y ago
This is a totally amateur and non professional question. As I understand some techniques are required to ensure that the mrna reaches the cell without being destroyed. What are the chances that these techniques have side effects and we end up with the back story to the movie "I am legend"?
trowindis 5y ago
The human body is like an alien computer. We don't actually understand it; we can only hack and reverse engineer it. Maybe mRNA delivery systems are as harmless as throwing a garbled CSS file into a repo that gets trashed before ever making it into a build. But what if it's not? Could be something bad.
abinaya_rl 5y ago
Hoping the progress made in COVID-19 vaccines makes some breakthrough in HIV vaccines.

211 points by elsewhen 5y ago

mRNA vaccines are not new, just newer than existing platforms. mRNA vaccine clinical trials which usually last years (or a decade), were completed in 2017, as per the nature article summary. The technology and its effects are well known in both in mice and human models. Is there residual risk that there were will be some unintended side-effect when billions of doses are administered? Yes, of course. There is no way to prove a vaccine is safe for everyone in all conditions, (see: Popper's falsification and the demarcation problem). Same goes for any other pharma formulation, food stuff or procedure. However, we have to weigh the residual risks against the risk of death from Covid and its variants and risk of long term damage to me or those around me who might be unwittingly in a higher risk category. Vaccination is a moral obligation and even if I would rather not, decency and civic duty to our fellow humans dictates that I must. And so should you.

deleted 5y ago
[deleted]
jeremyis 5y ago
> Vaccination is a moral obligation and even if I would rather not, decency and civic duty to our fellow humans dictates that I must. And so should you. Well put
- aeternum 5y ago
  By that logic, shouldn't you also through that same sense of decency and civic duty donate to prevent starvation? How is it morally decent to live in an expensive city while that money could prevent others from dying? In fact, instead of taking that vaccine shouldn't you give it to a school teacher or hospital worker in a country that doesn't yet have the vaccine? This 'moral obligation' nonsense sounds good at face value but really doesn't hold up in practice.
medicineman 5y ago
>[...]civic duty to our fellow humans dictates that I must. It appears you grew up with more privilege than I can even fathom.
lolbrels 5y ago
No thanks. If someone is high risk that is their responsibility to accommodate themselves and their surroundings. You have a twisted sense of morality.
Pompidou 5y ago
My fear with mRNA vaccine is that we place too much hope in this technology. Maybe it's much less efficient from what was expected.
- alexfromapex 5y ago
  My fear is that we still don’t fully understand genetic and epigenetic coding and there are probably latent dangers lurking with this class of vaccines that may not even be apparent until a new generation of posterity.
  - jcadam 5y ago
    I suppose there's always a (very) small chance that we're making a civilization-ending mistake with this new vaccine :) On the flip-side, while COVID can cause serious illness (and death), with a survival rate north of 99%, there's virtually no risk of societal collapse if we do nothing (OTOH, our response to it has been far more de-stabilizing).
- elicash 5y ago
  I think we probably place too much hope in improving technology, in general. It's a tremendous breakthrough, I'd say. But rather than focus on the tech, I'd rather see a rethinking of our governmental approach to issues concerning public health and how approval processes are set up. I'd rather focus on how we incentivize breakthroughs on issues that are most important, rather than developing another medicine that's 1% better at treating acne, for example. And I'd rather see cultural changes around adopting already existing technologies -- less than half of folks take flu shots! I'd argue that getting flu shot numbers way up would be more of a breakthrough than any benefits from mRNA, as incredible as it is. Not that we have to choose one or the other. I'm just saying I'd like these other issues to get more prominence.
seriousquestion 5y ago
> moral obligation and even if I would rather not, decency and civic duty to our fellow humans dictates that I must. And so should you. When people are not on stable scientific ground, they invoke morality. That's what priests and politicians do, not scientists. (edited)
- diegoperini 5y ago
  For someone who doesn't work in the field, deciding to take the vaccine is an act of faith.
  - ubercore 5y ago
    By that logic, doing anything you aren't expert in is an act of faith. It's pretty reductive.
    - diegoperini 5y ago
      I'm not reducing it to entirely faith, but faith takes part in it.
    - mnw21cam 5y ago
      That logic seems sound to me.
    - donw 5y ago
      You’re more correct than you realize. If I get on a Boeing aircraft, I am indeed engaging in an act of faith: that it was built properly, maintained well, and all the rest. When that faith is violated, say by the control systems having the RANDOMLY_FALL_OUT_OF_THE_SKY flag set to “true”, then society engages in faith-restoring rituals: grounds the aircraft, leads an inquiry, does a recall, that sort of thing. What you are seeing here is what happens when a large chunk of the population has lost faith in, and thus no longer trusts, its institutions.
      - throwawayboise 5y ago
traviswt 5y ago
> Vaccination is a moral obligation Only if the mechanism of its action contributes to herd immunity. If it provides symptom abatement without lowering infection and transmission, then vaccination of those not at risk can prove counterproductive due to asymptomatic spread.
- klyrs 5y ago
  Death isn't the only negative outcome of covid. We're seeing a relatively high rate of long-term damage caused by low-level symptoms. If we can reduce those symptoms with a (perhaps annual) shot, then covid turns into the "just a cold" that we were all hoping it would be
  - TheBlight 5y ago
    >We're seeing a relatively high rate of long-term damage caused by low-level symptoms. Source? I've seen it reported that this may actually be dubious. [1] [1] https://archive.ph/CConv https://archive.ph/CConv
    - klyrs 5y ago
      https://www.sciencedaily.com/releases/2021/03/210331204431.htm https://www.sciencedaily.com/releases/2021/03/210331204431.h...
      - mdorazio 5y ago
        I'm not saying COVID doesn't have long-term impacts in certain portions of the population, but this sentence is pretty important: "However, the findings are observational, and the authors cannot rule out the possibility that rates of diagnoses in general might have decreased indirectly because of the pandemic, particularly in people not admitted to hospital with covid-19." It's really hard to draw meaningful conclusions when COVID has completely changed all kinds of factors in healthcare ranging from people being stuck at home and eating poorly to opting not to visit the doctor because of overburdened hospitals and fear of infection. I'd like to see some studies a year from now before forming a strong opinion.
padobson 5y ago
This had me nodding my head: However, we have to weigh the residual risks against the risk of death from Covid But then this made me wonder if there was a paragraph I missed: Vaccination is a moral obligation I think it's a mistake to think the weighing process you endorse in the first quote will land everyone with the moral obligation you endorse in the second.
krona 5y ago
Informed consent, a cornerstone of medical ethics, has very little to do with the fact that we can't prove treatment will not be detrimental in all cases. Or perhaps you prioritise the group above the individual in all cases and think e.g. the Nuremberg Code is worthless historical artifact?
- haltingproblem 5y ago
  You have packed two strawman arguments into one comment. I was talking about a moral obligation and not about informed consent or this: "The Nuremberg Code aimed to protect human subjects from enduring the kind of cruelty and exploitation the prisoners endured at concentration camps. The 10 elements of the code are: Voluntary consent is essential. The results of any experiment must be for the greater good of society." ;)
claytongulick 5y ago
This would require a degree of confidence in the benevolence of pharmaceutical companies that I do not currently have.
- Diederich 5y ago
  > benevolence of pharmaceutical companies I get that sentiment. There's a question of alignment of incentives. Covid19 vaccinations are likely to be a thing for many years to come, and there are a number of entities that will be able to produce those future vaccinations. If one of the big vaccine providers produces something that's demonstrably less safe than the others, then the odds of them getting more money for future vaccines goes down. It's far from a perfect system, and there are a lot of holes, but in this case, things line up pretty well. In short, you can be confident that these companies are primarily focused on long-term profit, which often aligns with good short and long term outcomes for its customers.
wintermutestwin 5y ago
In the semi-rural area where I live we have 1/3 trumpsters who won't get it due to their political allegiances and 1/3 hippies who won't because woo woo reasons. I am assuming there will be a harsh reckoning in store for this and similar places.
- vkou 5y ago
  The harsh reckoning will be for the urban areas who subsidize that stupidity, when variants will emerge from among these unvaccinated populations, and we are going to go through this song and dance all over again. It's also why I'm incensed that vaccine production is ramping up both too slowly, and will top out at too low a number. It can't take six months to vaccinate the first world, and eighteen to vaccinate the developing world against a variant.
  - call_me_dana 5y ago
    Or variants emerging from those vaccinated. It’s nonsense to assume “the unvaccinated are dirty Petri dishes where mutations come from!” Variants can come from vaccines themselves or mutating in the host and then spreading. If anyone think that’s impossible, such a phenomenon is happening right now in Africa with Polio. Wild Polio is declared to be eradicated. A vaccine derived strain is keeping the outbreak alive. https://www.npr.org/sections/goatsandsoda/2020/08/25/905884740/africa-declares-wild-polio-is-wiped-out-yet-it-persists-in-vaccine-derived-cases https://www.npr.org/sections/goatsandsoda/2020/08/25/9058847...
    - vkou 5y ago
      Sure, it can happen, and viruses spread even through a vaccinated population, but quantity is a quality all of its own. Vaccinate everyone, and the number of opportunities for the virus to mutate and spread drops by orders of magnitude. Vaccinate half the population, and all that you'll do is create a great amount of evolutionary selection pressure for a mutation.
- splistud 5y ago
  It's hard when people you don't like won't do what you want them to do isn't it?
what_happa_god 5y ago
Regardless of your opinion of vaccination being a moral obligation, that does not sway my personal decision whether to take an experimental vaccine for an illness with a 99.5% survival rate. Collectivist ideals like "vaccinate everyone for the greater good!" does not trump my personal sovereignty and never will. I do not consent.
- deleted 5y ago
  [deleted]
- jcadam 5y ago
  There are people (not so much on HN, but definitely other places on the net) openly advocating for forced vaccinations and/or completely shunning the unvaccinated from society (to include employment). Oh, I'm with you on this, but I think it's only a matter of time before things get very uncomfortable.
kokanator 5y ago
Just an interesting question here, if you are saying vaccination is a moral obligation does this mean you are a moral realist [0]? My guess is not. You may mean to say for you vaccination is a moral obligation which if this is the case you are a moral relativist [1] and therefore your moral obligation does not necessarily apply to others. [0] https://plato.stanford.edu/entries/moral-realism/ https://plato.stanford.edu/entries/moral-realism/ [1] https://plato.stanford.edu/entries/moral-relativism/ https://plato.stanford.edu/entries/moral-relativism/
- haltingproblem 5y ago
  Of course, my moral obligation only applies to me. But I can advocate for others to follow my line of reasoning through persuasion. Many moons ago, when I lived in a community where most residents were of the all-organic-no-vax types, I convinced the powers that be that vaccination was a moral obligation for the (mostly young) community due to the effects of infecting young and old and the resulting deaths. Everyone got a flu vaccine that year. I was not very popular after that ;(
splistud 5y ago
You keep saying we. There is no we in this CHOICE (your assumed moral obligation notwithstanding).
dang 5y ago
Please don't take HN threads into flamewar. It's tedious and evokes worse from others. We're trying for the opposite here. Especially please don't take HN threads on generic flamewar tangents like "Vaccination is a moral obligation". They're highly repetitive and don't lead any place interesting. https://hn.algolia.com/?dateRange=all&page=0&prefix=true&sort=byDate&type=comment&query=generic%20discussion%20by:dang https://hn.algolia.com/?dateRange=all&page=0&prefix=true&sor... https://hn.algolia.com/?dateRange=all&page=0&prefix=true&sort=byDate&type=comment&query=generic%20ideolog%20by:dang https://hn.algolia.com/?dateRange=all&page=0&prefix=true&sor... https://news.ycombinator.com/newsguidelines.html https://news.ycombinator.com/newsguidelines.html
- haltingproblem 5y ago
  I posted what I thought was a very uncontroversial idea - "vaccination is a moral obligation for me", since Covid is surging again and vaccination rates have flatlined because vaccine hesitancy et.al. I don't know why this evoked such a negative response. I will just cool off posting comments on HN for a while.

vibrio 5y ago

They did a great job with the mRNA vaccines, but they have been prolific in research for nearly decade. In my opinion a intersting question is whether infectious disease vaccines now matter to the "wealthy world", as infectious disease has largely been an economic backwater for Pharma/VC,etc. How mRNA vaccines play a role in that maybe interesting, as their product profile is mostly 'wealthy world friendly' at this point.

haltingproblem 5y ago
I have been noting down pandemic silver linings, and this is one did not occur to me. To take your point further, given the workhorse industrialization the mRNA platform has been given during Covid, turning it on the other infectious diseases might mean millions or tens of millions lives saved over the coming decade or two. A (pseudo) black swan of a pandemic leads to a white swan!
- cyberlurker 5y ago
  A Malaria vaccine would be awesome. I have no idea if that’s possible though. I’ve known people with Malaria and have personally taken the (expensive) pills to protect myself. It all sucks.
  - notriddle 5y ago
    Malaria is a parasite, not a virus. Doesn't it have to be a virus for mRNA vaccines to make sense?
    - rst 5y ago
      There are vaccines against bacterial infections (tuberculosis, for example).
      - Vecr 5y ago
        The tuberculosis vaccine might not be the best example, it lacks efficacy in some places, for an unknown reason or reasons, such as the US and India.

NobodyNada 5y ago

(2018)

whatever1 5y ago

Given the antibiotic stagnation, could we possibly develop something similar to target bacteria? Aka inject instructions in their genome to self destroy?

SketchySeaBeast 5y ago
I wonder if that won't work as well given that we're not using this to cure COVID while we are currently sick with it. I don't know if Syphilis booster shots would make sense or if the range of things we could need to be regularly inoculated for would be far too broad for this to be useful.
passivate 5y ago
Even if you could do that, you'd only kill a handful of bacteria. The mRNA platform doesn't contain genetic code to recreate and repackage itself.
- mmastrac 5y ago
  Obviously not a biologist, but if you could target a specific protein on the bacterial surface it might work. Alternatively you could CRISPR some human cells that generate the bacteria-killing RNA constantly.
  - passivate 5y ago
    Yes, that would be super cool. But also crazy-risky!! :) But the risk is not due to chance, its due to the unknowns. Once they're no longer unknowns we'll be able to engineer such a therapy. Alternatively, once we understand our biology so well, we might as well just patch all the "bugs" so that we don't get infected by harmful pathogens. Or maybe forsake our biology and move on to Silicon ?
- bpodgursky 5y ago
  Neither do standard antibiotics.
  - 5y ago

candiddevmike 5y ago

Will mRNA tech eventually become something synthesized at point of care and possibly be used therapeutically?

_joel 5y ago
RNA therapies are being used to to target tumors, the next few years should be very interesting in this field. https://www.sciencedirect.com/science/article/pii/S0753332220301888 https://www.sciencedirect.com/science/article/pii/S075333222...
- lofi_lory 5y ago
  I wonder, if mRNA tech offers the possibility of reintroducing lost of function for cells with mutations like p53 defects. E.g. maybe just do what p53 does, if it's present or not. Much harder to identify the misbehaving cells, DNA deletions, than making all cells behave, I assume.
pkaye 5y ago
I think that is what CureVac is working on. RNA printers. I think even custom therapy can be produced but safety and efficacy is something they can't easily determine.

IG_Semmelweiss 5y ago

I take this quote from the article: "considerations and challenges include scaling up good manufacturing practice (GMP) production" Then I think of J&J and its 15M ruined doses, and then wonder whether pharma co's should provide better access to rank & file managers into scientific journals, particularly stuff they are known to be building. https://www.dailymail.co.uk/health/article-9486801/Emergent-stop-making-new-COVID-19-vaccine-material-Baltimore-plant.html https://www.dailymail.co.uk/health/article-9486801/Emergent-...

symlinkk 5y ago

Am I crazy for being nervous about taking an mRNA COVID shot? Like all of you I’m not an expert in the field, but from what I’ve skimmed online it seems like mRNA vaccines have never been used widespread in humans before? This is making me want to take the J&J one instead. I’m totally open to other opinions though, I haven’t made up my mind on this.

colinmcd 5y ago
I'm no biologist, but mRNA is ephemeral by design - it's constantly being broken down in the body. The fact that mRNA is converted to proteins by ribosomes is one of the best understood processes in cellular biology, and synthesizing the mRNA for a new protein is not a new idea. Getting actual viral vectors injected into my arm seems much more concerning on the surface (though it's obviously also very safe).
- yasp 5y ago
  Were that it was so simple. My understanding is the mRNA used in the vaccines was engineered to be more stable (less ephemeral). Not sure what that means in terms of half life, but AFAICT it's a mistake to assume that it will behave similarly to naturally occurring mRNA if this is true.
  - pkaye 5y ago
    They put a lipid coating around the mRNA to protect it. But as soon as that coating is removed, it will be quickly be broken down in the body by various enzymes.
    - yasp 5y ago
      How long does the coating take to be removed? Can the mRNA still be (reverse-)transcribed while in the presence of this coating?
      - pkaye 5y ago

andred14 5y ago

Why did they skip animal trials for the "covid" vacc1nes? https://regenerativemc.com/thursday-4-8-2021-what-happened-in-the-animal-trials-for-mrna-vaccines/ https://regenerativemc.com/thursday-4-8-2021-what-happened-i...

jzer0cool 5y ago

Not knowledgable in the biology area so forgive any incorrect terminologies or assumptions in advance. mRNA sounds incredible. As I understand the vaccines work by injecting an mRNA sequence which produces a certain spike protein to defend against certain viruses. In contrast, cells here are not producing the mRNA. Do these injected mRNA eventually phase out and die out from the body? Typically what is the lifetime? Is there also some 'off' mode, or complementary vaccine to undo an injection say after learning of some serious affect?

homero 5y ago
mRNA don't last long at all. The challenge was making them last long enough to even work. https://www.mskcc.org/coronavirus/what-s-different-about-messenger-rna-vaccines-covid-19 https://www.mskcc.org/coronavirus/what-s-different-about-mes...
Arelius 5y ago
As I understand it, there are natural mechanisms that break down the mRNA. At least in the article about reverse engineering the vaccine, they state that that "The mRNA vaccines quickly degrade in the human body" https://berthub.eu/articles/posts/reverse-engineering-source-code-of-the-biontech-pfizer-vaccine/ https://berthub.eu/articles/posts/reverse-engineering-source... I think also the instability is a large component of why the vaccines must be stored at such low temperatures.
- wolfi1 5y ago
  >I think also the instability is a large component of why the vaccines must be stored at such low temperatures. As I understand it, the low temperatures are partly required because of the liposomes the mRNA is "packed" into
  - danwills 5y ago
    As I understand the instability of mRNA in the general cell background cytoplasm is because of the presence of enzymatic molecules (produced by the cell) that attract and then break down (lyse) any mRNA that floats into their 'jaws'. Loads of different things get broken-down by this kind of background presence of some enzyme, and since mRNA is used by the cell itself, maybe not too surprising that it has a cleanup mechanism in-place already?

ackbar03 5y ago

This is a totally amateur and non professional question. As I understand some techniques are required to ensure that the mrna reaches the cell without being destroyed. What are the chances that these techniques have side effects and we end up with the back story to the movie "I am legend"?

trowindis 5y ago

The human body is like an alien computer. We don't actually understand it; we can only hack and reverse engineer it. Maybe mRNA delivery systems are as harmless as throwing a garbled CSS file into a repo that gets trashed before ever making it into a build. But what if it's not? Could be something bad.

abinaya_rl 5y ago

Hoping the progress made in COVID-19 vaccines makes some breakthrough in HIV vaccines.