5 ms·

If smallpox-as-a-bioweapon is even a slight possibility why don’t we start vaccinating for it again? It seems like it would be much easier to prevent the proble

If smallpox-as-a-bioweapon is even a slight possibility why don’t we start vaccinating for it again? It seems like it would be much easier to prevent the problem at all rather than to try to respond to it.

nyokodo 5y ago
> why don’t we start vaccinating for it again? Because vaccination isn’t 0% risk. Very few people are going to acquiesce to vaccination for a functionally extinct virus nor should they. Perhaps those who want to should be able to but that’s another discussion.
- deleted 5y ago
  [deleted]
TylerE 5y ago
Because it no longer exists in the wild. All vaccines have some risk of negative reactions. No matter how small x is, x is > 0, which is the current chance of being infected by smallpox.
kps 5y ago
The current smallpox vaccines stockpiled in the US use a live virus¹ and have a fairly high rate of serious side effects (1–2%) for a disease that doesn't currently exist. The vaccines are also still effective a few days after exposure to smallpox. ¹ https://en.wikipedia.org/wiki/Vaccinia https://en.wikipedia.org/wiki/Vaccinia
- ohazi 5y ago
  Also, the way the smallpox vaccine is administered is mildly gruesome: > A droplet of ACAM2000 is administered by the percutaneous route (scarification) using 15 jabs of a bifurcated needle. ACAM2000 should not be injected by the intradermal, subcutaneous, intramuscular, or intravenous route. (emphasis mine) https://en.wikipedia.org/wiki/Smallpox_vaccine https://en.wikipedia.org/wiki/Smallpox_vaccine https://en.wikipedia.org/wiki/Bifurcated_needle https://en.wikipedia.org/wiki/Bifurcated_needle
  - Vecr 5y ago
    If routine vaccination was re-started, the Modified Vaccinia Ankara – Bavarian Nordic strain would probably be used, it's a two-dose intramuscular injection, same scheduled as the Moderna vaccine, and is approved in the US under the name "Jynneos". No scarring either, I would assume. In an emergency, ACAM2000 is a single dose and there's a lot of it, so it would be used in people who's immune system is good enough.
  - asah 5y ago
    ...and a complex procedure: https://www.cdc.gov/smallpox/vaccine-basics/who-gets-vaccination.html https://www.cdc.gov/smallpox/vaccine-basics/who-gets-vaccina...
  - thebeardisred 5y ago
    It's not bad at all. Post 9/11 I had it done as a part of a trial on diluting the vaccine (result: you could). At the time it was just a shading tattoo needle. 5 points, 3 jabs. It was nothing.
  - ChrisRR 5y ago
    Is that like the BCG?
  - hn8788 5y ago
    I got the vaccine in the military, the needle isn't bad, it looks like a tiny lobster fork. The worst part about it is how the injection site turns into a dime-sized itchy blister that you can't scratch for a few days.
5co 5y ago
I think the main issue is that it’s not difficult to create a vaccine resistant variant, modifying smallpox is apparently quite easy. Also current vaccines are only effective for around 5 years. I read about this recently, his other book about Ebola is worth a read too: https://en.wikipedia.org/wiki/The_Demon_in_the_Freezer https://en.wikipedia.org/wiki/The_Demon_in_the_Freezer
nomel 5y ago
> If smallpox-as-a-bioweapon is even a slight possibility why don’t we start vaccinating for it again? Well this would not treat the problem, because smallpox is not the problem here. The fact that we're squishy fragile hosts/food, and bioweapons are getting easier and easier to make, is the problem. If there was a smallpox vaccination campaign, unless completely secret, the bad actors would simply move on to a different virus/variant/fungus/bacteria. The only real protection against any of this is to make sure the world has a similar vaccination regime, to ensure mutual destruction.
- ineedasername 5y ago
  The fact that we're squishy fragile hosts If that describes you then you really need to be putting out some serious DPS, glass-cannon style. Otherwise you need bulk up on CON and figure out your dump stats so you can tank effectively for the damage dealers/buffers/de-buffers.
ineedasername 5y ago
In this case, probably multiple reasons: A weaponized version might be designed to work around current vaccines. Though we do stockpile them, just in case. Also they're live vaccines with not so great risk profiles. Assuming the vaccines were still effective against a weaponized version, with an off-the-shelf (literally) vaccine ready to go we could aggressively vaccinate every sick and symptomatic person and everyone those people even looked at, and pretty effectively stop mini outbreaks as they occur. It's actually the method that was used in some developing countries during the eradication campaign. So we have a (likely) effective alternative to mass vaccination. Also the vaccination leaves a small scar, so there's that too. Then again, if you don't get vaccinated, get smallpox, and survive? You may be full of lots of little scars. There's also probably some societal/political/social problems (or some other better word to fit this) to starting up vaccinations: it would seem strange to do it if we didn't have specific knowledge of a threat. Look at COVID: we know it's a threat and people don't get vaccinated. So with smallpox vaccinations you'll get some people who panic thinking there must be a threat, others saying if there's no threat then it's pointless and won't do it. Also as we see from COVID (and if you look at the history of the polio vaccine along with the massive industrial complex around annual flu vaccines) it's clear that such efforts are truly & enormously massive and expensive and difficult. We can't really go around doing that for every potential threat. Notably, what was approved by the FDA does not appear to be a vaccine, and is instead an anti viral medication effective against smallpox. Also notably, we don't truly know it's safety profile: it would be tough (and unethical) to infect humans with smallpox to try out the drug, so it was tested on animals and approved on the basis of those results. I guess if you want to develop medications against potential-but-not-yet-realized threats, that's the best you can do.

nyokodo 5y ago

> why don’t we start vaccinating for it again? Because vaccination isn’t 0% risk. Very few people are going to acquiesce to vaccination for a functionally extinct virus nor should they. Perhaps those who want to should be able to but that’s another discussion.

deleted 5y ago
[deleted]

TylerE 5y ago

Because it no longer exists in the wild. All vaccines have some risk of negative reactions. No matter how small x is, x is > 0, which is the current chance of being infected by smallpox.

kps 5y ago

The current smallpox vaccines stockpiled in the US use a live virus¹ and have a fairly high rate of serious side effects (1–2%) for a disease that doesn't currently exist. The vaccines are also still effective a few days after exposure to smallpox. ¹ https://en.wikipedia.org/wiki/Vaccinia https://en.wikipedia.org/wiki/Vaccinia

ohazi 5y ago
Also, the way the smallpox vaccine is administered is mildly gruesome: > A droplet of ACAM2000 is administered by the percutaneous route (scarification) using 15 jabs of a bifurcated needle. ACAM2000 should not be injected by the intradermal, subcutaneous, intramuscular, or intravenous route. (emphasis mine) https://en.wikipedia.org/wiki/Smallpox_vaccine https://en.wikipedia.org/wiki/Smallpox_vaccine https://en.wikipedia.org/wiki/Bifurcated_needle https://en.wikipedia.org/wiki/Bifurcated_needle
- Vecr 5y ago
  If routine vaccination was re-started, the Modified Vaccinia Ankara – Bavarian Nordic strain would probably be used, it's a two-dose intramuscular injection, same scheduled as the Moderna vaccine, and is approved in the US under the name "Jynneos". No scarring either, I would assume. In an emergency, ACAM2000 is a single dose and there's a lot of it, so it would be used in people who's immune system is good enough.
- asah 5y ago
  ...and a complex procedure: https://www.cdc.gov/smallpox/vaccine-basics/who-gets-vaccination.html https://www.cdc.gov/smallpox/vaccine-basics/who-gets-vaccina...
- thebeardisred 5y ago
  It's not bad at all. Post 9/11 I had it done as a part of a trial on diluting the vaccine (result: you could). At the time it was just a shading tattoo needle. 5 points, 3 jabs. It was nothing.
- ChrisRR 5y ago
  Is that like the BCG?
- hn8788 5y ago
  I got the vaccine in the military, the needle isn't bad, it looks like a tiny lobster fork. The worst part about it is how the injection site turns into a dime-sized itchy blister that you can't scratch for a few days.

5co 5y ago

I think the main issue is that it’s not difficult to create a vaccine resistant variant, modifying smallpox is apparently quite easy. Also current vaccines are only effective for around 5 years. I read about this recently, his other book about Ebola is worth a read too: https://en.wikipedia.org/wiki/The_Demon_in_the_Freezer https://en.wikipedia.org/wiki/The_Demon_in_the_Freezer

nomel 5y ago

> If smallpox-as-a-bioweapon is even a slight possibility why don’t we start vaccinating for it again? Well this would not treat the problem, because smallpox is not the problem here. The fact that we're squishy fragile hosts/food, and bioweapons are getting easier and easier to make, is the problem. If there was a smallpox vaccination campaign, unless completely secret, the bad actors would simply move on to a different virus/variant/fungus/bacteria. The only real protection against any of this is to make sure the world has a similar vaccination regime, to ensure mutual destruction.

ineedasername 5y ago
The fact that we're squishy fragile hosts If that describes you then you really need to be putting out some serious DPS, glass-cannon style. Otherwise you need bulk up on CON and figure out your dump stats so you can tank effectively for the damage dealers/buffers/de-buffers.

ineedasername 5y ago

In this case, probably multiple reasons: A weaponized version might be designed to work around current vaccines. Though we do stockpile them, just in case. Also they're live vaccines with not so great risk profiles. Assuming the vaccines were still effective against a weaponized version, with an off-the-shelf (literally) vaccine ready to go we could aggressively vaccinate every sick and symptomatic person and everyone those people even looked at, and pretty effectively stop mini outbreaks as they occur. It's actually the method that was used in some developing countries during the eradication campaign. So we have a (likely) effective alternative to mass vaccination. Also the vaccination leaves a small scar, so there's that too. Then again, if you don't get vaccinated, get smallpox, and survive? You may be full of lots of little scars. There's also probably some societal/political/social problems (or some other better word to fit this) to starting up vaccinations: it would seem strange to do it if we didn't have specific knowledge of a threat. Look at COVID: we know it's a threat and people don't get vaccinated. So with smallpox vaccinations you'll get some people who panic thinking there must be a threat, others saying if there's no threat then it's pointless and won't do it. Also as we see from COVID (and if you look at the history of the polio vaccine along with the massive industrial complex around annual flu vaccines) it's clear that such efforts are truly & enormously massive and expensive and difficult. We can't really go around doing that for every potential threat. Notably, what was approved by the FDA does not appear to be a vaccine, and is instead an anti viral medication effective against smallpox. Also notably, we don't truly know it's safety profile: it would be tough (and unethical) to infect humans with smallpox to try out the drug, so it was tested on animals and approved on the basis of those results. I guess if you want to develop medications against potential-but-not-yet-realized threats, that's the best you can do.