11 ms·

Ignoring WHO call, major nations stick to vaccine booster plans

42 points by bryan0 5y ago

danuker 5y ago
In Romania where I'm from, people no longer want vaccines. The authorities had to sell them before they spoil. I say let everyone do whatever they want, including letting the doctors go home when they are tired.
- croes 5y ago
  That will lead to more variants and some of them will render the current vaccines and efforts useless.
  - beerandt 5y ago
    No- designing and depending on a vaccine based on a single gene is what will (has already) lead to variants. It's no coincidence that lambda has 3 separate mutations on the spike protein targeted by the mrna vaccine.
    - majormajor 5y ago
      The immune system doesn't lead to variants, randomness + time does. Selection pressure to see what variants become dominant happens later. They aren't being actively "designed" in any sense. That's why anything that would make real progress has to happen quickly and broadly, without large left-out pockets (not that rejecting a vaccine is any worse than not being offered one in the first place, here - that's the issue that is mostly being ignored for now, since we have no current solution).
      - newbamboo 5y ago
        How do antibiotic resistant infections work? I ask as a lay person.
        criticaltinker 5y ago
        Here are very accessible peer-reviewed primary sources that will answer your question and give historical examples [1][2]. [1] Why does drug resistance readily evolve but vaccine resistance does not? https://royalsocietypublishing.org/doi/pdf/10.1098/rspb.2016.2562 https://royalsocietypublishing.org/doi/pdf/10.1098/rspb.2016... [2] The adaptive evolution of virulence: a review of theoretical predictions and empirical tests https://www.cambridge.org/core/services/aop-cambridge-core/content/view/30EC8AB1717BF7A173CF5E051DBB498F/S003118201500092Xa_hi.pdf/_div_class__title__The_adaptive_evolution_of_virulence__a_review_of_theoretical_predictions_and_empirical_tests__div_.pdf https://www.cambridge.org/core/services/aop-cambridge-core/c...
        newbamboo 5y ago
        Second link was really helpful. I found this part interesting and potentially relevant, “reducing the risk of death for infected hosts reduces the cost of virulence, causing an evolutionary increase in virulence (Gandon et al. 2003, 2001b). Vaccines that either block infection or block transmission, on the other hand, have no effect on virulence evolution” Especially considering Dr Fauci’s recent statements on how the COVID vaccines do not block transmission. https://m.youtube.com/watch?v=AuO_OfjlPUI https://m.youtube.com/watch?v=AuO_OfjlPUI Putting these together then it seems like we should expect the result of our vaccination efforts to be increased virulence in strains such as Delta variant. Is it possible the Delta variant itself was somehow the result of our intrepid and swift vaccination efforts? I’m having a hard time understanding why more people aren’t talking about this given the obviously well established scientific literature you’ve cited.
        criticaltinker 5y ago
        I'm glad you found the reference helpful. > Is it possible the Delta variant itself was somehow the result of our intrepid and swift vaccination efforts? The variants can arise under neutral genetic drift, ie pure random chance via naturally occurring mutation. But the widespread dominance of these variants is very plausibly connected to the mass vaccination efforts. Here is another good paper on the subject, in case you haven't already seen it [1]. > I’m having a hard time understanding why more people aren’t talking about this Me too, but to be fair these are complex second and third order effects that only gained traction in the scientific literature within the past decade or so. Right now everyone is mostly focused on first order effects - eg "will the vaccination help/harm me?" Quotes from [1]: - "Our modeling suggests that SARS-CoV-2 mutants with one or two mildly deleterious mutations are expected to exist in high numbers due to neutral genetic variation, and consequently resistance to vaccines or other prophylactics that rely on one or two antibodies for protection can develop quickly -and repeatedly- under positive selection." - "Our work suggests that it is likely that standing genetic variation alone has already produced a substantial population of viruses with single and double nucleotide changes that confer nAb resistance. These variants will establish quickly in the population under selection pressure. In fact, there is already a precedent for this behavior, as one such selective sweep occurred early on in the SARS-CoV-2 pandemic when the D614G mutation rose to nearly 80% frequency in under 6 months [33]." [1] Risk of rapid evolutionary escape from biomedical interventions targeting SARS-CoV-2 spike protein https://pubmed.ncbi.nlm.nih.gov/33909660/ https://pubmed.ncbi.nlm.nih.gov/33909660/
      - criticaltinker 5y ago
        > They aren't being actively "designed" in any sense The point made by GP is that the current mRNA vaccines are actively designed to illicit a highly targeted immune response targeted towards the spike protein [1]. > That's why anything that would make real progress has to happen quickly and broadly, without large left-out pockets Assuming you mean 100% vaccine coverage, this is the opposite conclusion that the authors of this paper came to [1]. Citing [1]: - "The speed at which nAb resistance develops in the population increases substantially as the number of infected individuals increases, suggesting that complementary strategies to prevent SARS-CoV-2 transmission that exert specific pressure on other proteins (e.g., antiviral prophylactics) or that do not exert a specific selective pressure on the virus (e.g., high-efficiency air filtration, masking, ultraviolet air purification) are key to reducing the risk of immune escape" - "Strategies for viral elimination should therefore be diversified across molecular targets and therapeutic modalities" [1] Risk of rapid evolutionary escape from biomedical interventions targeting SARS-CoV-2 spike protein https://pubmed.ncbi.nlm.nih.gov/33909660/ https://pubmed.ncbi.nlm.nih.gov/33909660/
      - Banyonite 5y ago
        >> The immune system doesn't lead to variants, randomness + time does. I disagree. It has been shown over many years of research that viral mutations may be driven by both antigenic drift as well as selective immunological pressures, with the question being more the degree to which these factors influence mutation in different viral species. Not to present an argument against vaccination, rather an argument against making blanket statements that fail to accurately represent the current state of collective knowledge on the subject, to wit: We do not know with any certainty the degree to which either of these factors drive SARS-CoV-2 mutations. A naked statement that the un-vaccinated population drives the mutation rate of this virus is nothing more than speculation; issues surrounding a field of study as incredibly complex as this may not ever be definitively put to bed through analysis of (conflicting?) study outcomes- let alone through arguments made in the commons of popular science. I don't argue that emerging SARS-CoV-2 mutations are driven more by one factor or the other, I argue that we do not know the degree to which mutations are driven by 'random' antigenic drift vs selective pressures. Unfortunately, the issue has been politicized to the point where study outcomes that suggest dominance of one over the other are likely to be attacked or even ignored, regardless of the strength of study. Citations? Efforts to find evidence here prioritized time invested over strength- this may not represent the best arguments out there, however it took only a scant few moments to gather, and points to a much larger body of literature supporting the position that both antigenic drift and selective immunological pressures drive viral mutations (SARS-CoV-2 being no exception) and that we do not know the degree to which each is a factor... and therefore stating OR implying that the un-vaccinated population drives the viral mutation rate in this pandemic is inaccurate. Once again- we simply do not know. CF "Given that the antibody response to the spike protein is so focused, could mutations in these restricted sequences lead to a less efficacious vaccine, if the human immune response is specific to the vaccine sequence? These mutations might be driven by antigenic drift, or by selection, either during natural infection or due to the vaccine itself. When a virus is grown under the selective pressure of a single monoclonal antibody that targets a single epitope on a viral protein, mutations in that protein sequence will lead to the loss of neutralisation, and the generation of escape mutants. This sequence of events has been shown in the laboratory for polio, measles, and respiratory syncytial virus,7 and in 2020 for SARS-CoV-2.8" https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(21)00075-8/fulltext https://www.thelancet.com/journals/lanres/article/PIIS2213-2... McCarthy, K. R. et al. Recurrent deletions in the SARS-CoV-2 spike glycoprotein drive antibody escape. Science 371, 1139–1142 (2021). Plante, J. A. et al. The variant Gambit: COVID’s next move. Cell Host Microbe 29, 508–515 (2021). Ravindra Gupta, Steven Kemp, William Harvey et al. Recurrent independent emergence and transmission of SARS-CoV-2 Spike amino acidH69/V70 deletions, PREPRINT (Version 1) available at Research Square https://doi.org/10.21203/rs.3.rs-136937/v1(2021) https://doi.org/10.21203/rs.3.rs-136937/v1(2021).
    - treis 5y ago
      The vaccine elicits a response to many different sites on the virus. It's extremely unlikely that the vaccine ever becomes useless.
      - criticaltinker 5y ago
        Some experts from highly regarded institutions across the country would disagree. See this peer-reviewed paper for introduction to their reasoning [1]. [1] Risk of rapid evolutionary escape from biomedical interventions targeting SARS-CoV-2 spike protein https://pubmed.ncbi.nlm.nih.gov/33909660/ https://pubmed.ncbi.nlm.nih.gov/33909660/
        treis 5y ago
        That's talking about 1-2 sites. The vaccine elicits a response to a dozen or more.
        criticaltinker 5y ago
        Did you read the paper I linked to (at least the abstract)? It directly contradicts your claims. Please cite primary sources to support your claim, otherwise it must be regarded as uninformed opinion.
        treis 5y ago
        It says: >Our modeling suggests that SARS-CoV-2 mutants with one or two mildly deleterious mutations are expected to exist in high numbers due to neutral genetic variation, and consequently resistance to vaccines or other prophylactics that rely on one or two antibodies for protection can develop quickly -and repeatedly- under positive selection. 1 or 2 mutations isn't enough. It would need an order of magnitude more. It's very unlikely for that to happen. I don't wish to get into a cite duel with what appears to be a Covid troll account.
        criticaltinker 5y ago
    - sudosysgen 5y ago
      This is highly misleading. All variants right now are significantly more effective at transmission in unvaccinated individuals. The reason the mutations are on the spike protein is because it's the part of the virus that matters the most for infectivity. The more effective the spike protein, the more easily other people are affected and the faster the virus is produced. The Delta variant itself rose in India, which has really low vaccination rates.
      - criticaltinker 5y ago
        This is not misleading at all, GP's point is well founded and backed by peer-reviewed literature, see [1]. I have more references if you're interested. > All variants right now are significantly more effective at transmission in unvaccinated individuals. Please cite your primary source(s). [1] Risk of rapid evolutionary escape from biomedical interventions targeting SARS-CoV-2 spike protein https://pubmed.ncbi.nlm.nih.gov/33909660/ https://pubmed.ncbi.nlm.nih.gov/33909660/
        sudosysgen 5y ago
        The article you linked does not say what you think it says. It says that mutation for immune escape is possible. There has been zero mutations for immune escape, so far all mutations were for higher infectivity. Beyond that, we do know that all variants are more infective in unvaccinated individuals : http://weekly.chinacdc.cn/fileCCDCW/journal/img/cover/ffd464f2-ff7e-4bcf-8210-e7fb781fbb50.pdf#page=18 http://weekly.chinacdc.cn/fileCCDCW/journal/img/cover/ffd464... If it wasn't, it would never have out-competed the ancestral type in unvaccinated India. The OP's point was that vaccines drove mutations. So far, that has not happened. There is no variant that is more infective in vaccinated individuals but not in unvaccinated individuals, all variants are simply more effective across the board.
        criticaltinker 5y ago
        > There has been zero mutations for immune escape, so far all mutations were for higher infectivity. You're making very broad claims here that are again contradicted by the literature, see [1]. The very short paper you linked to "Transmission Dynamics of an Outbreak of the COVID-19 Delta Variant B.1.617.2" does not even discuss vaccination status. I'm inclined to believe you linked to the wrong paper - or you haven't thoroughly reviewed it yourself. I'm not interested in arguments based on logical deductions. Show me the peer-reviewed sources backing your point and I will happily read them with an open mind. [1] SARS-CoV-2 immune evasion by the B.1.427/B.1.429 variant of concern https://science.sciencemag.org/content/early/2021/06/30/science.abi7994 https://science.sciencemag.org/content/early/2021/06/30/scie...
    - croes 5y ago
      It's no coincidence the variants come from areas with lower vaccination rates. If your claim were true the variants would come from Israel , Europe or the US. And most variants don't get a own name because they don't differ enough from known viruses, so only the variants with certain mutations get the attention and a name at all.
      - pbak 5y ago
        >If your claim were true the variants would come from Israel, >Europe or the US. Except for the UK variant, b.1.1.7, also called Alpha, the deadliest since the beginning...
        rsynnott 5y ago
        First detected in November, becoming dominant by end December. The first vaccine wasn't approved in the UK until December.
        pbak 5y ago
        I should have been longer. Exactly : Location of emergence of a variant has nothing to do with vaccination or not. All of the current variants raging around appeared before there were vaccines, as were all current and past variants of interest.
        croes 5y ago
        Pre vaccination and not really deadlier just faster spreading.
        sudosysgen 5y ago
        The UK had a full vaccination rate of approximately 0.0% when B.1.1.7 was detected, and a first dose rate of 1.5%.
        rsynnott 5y ago
        Even earlier than that; it was detected in November, though it didn't become dominant til late December.
    - croes 5y ago
      Like majormajor already said, evolution is not targeted conscious process, it's randomness plus time and as long the result doesn't lead to extinction a species remains existent even if it needs very special conditions to survive.
- majormajor 5y ago
  Does "do whatever they want" extend even to something like doctors saying "you've declined to get vaccinated and acted like there's not to be concerned about, so we're going to not admit you to the hospital"?
  - sjwalter 5y ago
    Does your logic extend to "you've declined to lose weight and acted like being obese is nothing to be concerned about, so we're going to not admit you to the hospital"?
    - majormajor 5y ago
      Well, it's 'danuker's logic, not my own. I just want to know if they fully extend "do what you want" to everybody or if it's a situation of "do what you want for me, do what I want for thee." If they do, then the answer would clearly be: yes. As an aside, some of this is already done when resources are scarce today. The alcoholic who can't stop drinking isn't going to make it on the liver transplant recipient list. One of the biggest dangers of Covid has consistently been that it risks overwhelming hospital capacity, which so far fortunately has been minor (though has resulted in some tragic outcomes) but not something anyone should want to continue.
    - treis 5y ago
      You can't solve obesity with two shots.
      - pbak 5y ago
        You can, in the US. /s
    - johnchristopher 5y ago
      On one hand there's a clear pressure from governments, WHO, etc. to get vaccinated (which is still a higher pressure than from smallest groups but with a bigger voice, aka anti-sthg) for a positive outcome and on the other hand there is a strong pressure from junk food industries to eat unhealthy diet. There's also a lot of obese people who are concerned about their weight (but I don't know the proportions). So it's oranges to apples.
- penultimatename 5y ago
  It's in very poor taste to conflate the issues of social distancing and vaccination acceptance with treatment of medical staff. If everyone social distanced and got a vaccine, there would be no issues with medical staff being overworked. If everyone did what they wanted, what would the medical staff do? Go home and let them die on the sidewalk? Kids dying in the streets by no fault of their own wouldn't go over well.
  - sjwalter 5y ago
    >Kids dying in the streets... Uh, wat? Which kids are dying from covid? This level of hyperbole is insane.
    - deleted 5y ago
      [deleted]
    - penultimatename 5y ago
      Children account for 1.3% to 4% of all US hospitalizations for COVID, depending on the US state. What do you suggest is done when everyone throws their hands up and medical demand exceeds supply? I fail to see how being unable to admit patients is some impossible scenario.
      - lijogdfljk 5y ago
        Acceptable losses from the sounds of it. I find these conversations difficult to discuss because we all have different ideas of what is acceptable losses.
      - sjwalter 5y ago
        Hospitals have been built and staffed for estimated peak capacity forever. Slack capacity is extremely expensive. Here's an article from 2018 about LA County's makeshift flu hospital tent, which they built because the flu season was so bad then: https://www.latimes.com/local/lanow/la-me-ln-flu-demand-20180116-htmlstory.html https://www.latimes.com/local/lanow/la-me-ln-flu-demand-2018... So, what I suggest is done, is what hospitals have always done, which is do their best to make it work. "Two weeks to flatten the curve" was all about giving hospitals a chance and not be overwhelmed, and presumably, get better prepared. It's been 1.5 years. How long do you think it's reasonable to extend that 2 weeks to?
- Tepix 5y ago
  We've seen what happens when restrictions are loosened. Just look at what happened in the Netherlands in the last few months. It just doesn't work.
  - pbak 5y ago
    Sweden enters the chat.
simonh 5y ago
I suppose the surge of infections from the Delta variant have made developed world governments re-think their approach to vaxing younger citizens. In the UK a fifth of hospital admissions with covid are 18-34 years old and we're extending vaccination to 16-17 year olds. I'm sure it's true these vaccines would save more lives in developed nations, but politically governments are still accountable to their own citizens first. It's an ugly situation. Delta has seriously thrown a spanner in the works, and I'm sure there are more variants to come. Suppose a variant pops up that's deadly to children, but the current vaccines protect against it. How would governments explain shipping vaccines abroad instead of vaxing children then?
- sjg007 5y ago
  How are the younger patients faring? I see the UK as a canary to the USA for the upcoming school year but have no sense of it from the news.
  - mschuster91 5y ago
    In Germany we vaccinate from 12 years old, to my knowledge there haven't been any newsworthy incidents. The only thing we have is the (political) squabble if it is officially recommended by the vaccine commission, and the debate on how we are going to protect the young children - especially those at high risk - when ignorant unvaccinated adults will be spreading COVID around.
- alimw 5y ago
  > Suppose a variant pops up that's deadly to children, but the current vaccines protect against it. How would governments explain... All sorts of mad things could happen. But this fantasy scenario is really quite unlikely.
  - randompwd 5y ago
    > But this fantasy scenario is really quite unlikely Based on what exactly. The delta variant was unlikely. The COVID-19 was unlikely. I think I'll back governments taking precautions against the possible rather than somebody thinking it's a fantasy(def: the faculty or activity of imagining impossible or improbable things) scenario, ignoring the last 18 months of world life.
throwaway894345 5y ago
Is the bottleneck in deploying vaccine to poor countries strictly the amount of vaccine? Or is it logistics? If the former then rich countries should send more vaccine to poor countries before administering their own booster programs, but if it's logistics, then I don't see the point in holding off on booster campaigns.
- JohnJamesRambo 5y ago
  My Walmart is begging people to come get vaccinated for free in my 40% fully vaccinated state. I say send the vaccines where they will be used and cherished.
  - probablyexists 5y ago
    I think this probably falls to the normal debate of the balance between "but who will pay for them?" and "it costs every nation to not have all nations vaccinated"
  - vorpalhex 5y ago
    Have you talked to anyone not getting vaccinated in your state to try and gather why? Despite sort of the popular media push that there's some huge contingent of never-vaxxers, that actually appears to be a small proportion of the unvaccinated[1]. Are the remainder having doubts? Is it a transport/scheduling issue? Is there a misunderstanding about it being a multiple dose vaccine? [1] - https://www.kff.org/coronavirus-covid-19/issue-brief/latest-data-on-covid-19-vaccinations-race-ethnicity/ https://www.kff.org/coronavirus-covid-19/issue-brief/latest-...
    - TingPing 5y ago
      In my experience they are just anxious about getting something they don't understand, doing nothing is super easy/comfortable, and some media scares the last bit of uncertainty out of them.
      - sjwalter 5y ago
1helloworld1 5y ago
The western greed might actually backfire. What are the chances that if we let the virus spread unchecked in the poorer countries for a few more years, the virus accumulates more mutations on the spike protein making the existing vaccines ineffective?
- minikites 5y ago
  >if we let the virus spread unchecked in the poorer countries It's spreading unchecked now in the USA because people are refusing the vaccine. The scenario you describe is absolutely going to happen, but it won't be because of poorer nations, it will be because of selfish people in rich nations.
  - leesec 5y ago
    Pretty baseless to assume where a variant is going to spread or why. It's not like every country other than USA would have 100% vaccine uptake either.
    - minikites 5y ago
      I think it's reasonable to place more of the blame on people who choose not to help (refusing the vaccine) instead of the people who don't have the means to help (unable to get a vaccine).
      - __s 5y ago
        The original comment was laying blame on the cause of people unable to get a vaccine, not the people themselves. Incidentally that puts them in agreement with you: selfish people in richer nations
- libertine 5y ago
  This has been a period of constant backfires on a global scale - starting from WHO themselves right at the start of this whole thing when dealing with the first breakout in China, especially having experience with dealing with China (SARS). They knew information was being withheld. So will this backfire be worst then all the other backfires, or other potential backfires? Honestly we have no idea. I'm still baffled why the leadership of WHO hasn't been renewed yet... I get that in times of crises leadership shouldn't be changed, but they are stretching it. WHO lost a lot of their soft power during this pandemic.
minikites 5y ago
It's clear that a large portion of the USA will never get vaccinated, so we should be sending our vaccines to people who want them instead of letting them go to waste here.
- wayoutthere 5y ago
  Or just fill tranquilizer darts with vaccine and don’t give people the choice
  - jboggan 5y ago
    I wouldn't advocate assault on an open forum.
    - wayoutthere 5y ago
      I’m advocating for it as government policy; I have no desire to go out and deal with those morons myself.
      - Gibbon1 5y ago
        I kind of roll my eyes at the mah freedom tech bro libertarian types. When I was kid they were drafting young men and sending them to Vietnam. Seriously people don't want to do their duty? Why should society care at all what they think?
- nradov 5y ago
  That is happening. The US has already exported 110M vaccine doses. https://www.wsj.com/articles/u-s-says-it-has-shared-110-million-covid-19-vaccine-doses-overseas-11627981201 https://www.wsj.com/articles/u-s-says-it-has-shared-110-mill...
bingohbangoh 5y ago
What's the guidance on booster shots? How often are we to get them? Example: I got vaccinated in June, fairly late. Am I to get a booster shot now? Will the booster shots be the same vaccine formula as the original?
- testplzignore 5y ago
  https://www.cnbc.com/2021/08/05/moderna-covid-vaccine-booster-produces-robust-response-against-delta.html https://www.cnbc.com/2021/08/05/moderna-covid-vaccine-booste... has some details released by Moderna this morning. Important bit: In a phase two trial, Moderna is testing a 50-microgram dose of three vaccine booster candidates in previously vaccinated individuals. The booster shots produced a promising immune response against three variants, including delta, with antibody levels approaching those seen in previously unvaccinated people who received two 100-microgram doses, the company said. I'm interested to know if just getting another dose of the original vaccine has any effect. If so, I'd love to get it now.
- MurMan 5y ago
  Both Pfizer and Moderna have stated that boosters will be needed this Fall. Pfizer says that immunity drops from 96% to 84% at the six month point. The good news is that the vaccine continues to protect against severe disease due to its effects on T-cells and memory B-cells.
forcry 5y ago
All this, while the essential systems to capture vaccine safety signal appear to be apparently broken and based on "voluntary reporting", and the world does not give a single fuck about it... https://roundingtheearth.substack.com/p/defining-away-vaccine-safety-signals/comments https://roundingtheearth.substack.com/p/defining-away-vaccin... https://tinyurl.com/CovidvFluReport https://tinyurl.com/CovidvFluReport
andi999 5y ago
Government acting in the interest of its own people?
theptip 5y ago
I think the WHO is right on this one; we really need to be thinking more about how to prevent an Omega variant that can break through our existing vaccines. Unfortunately even complete elimination of Covid in a single country would be useless, as long as it's rampant elsewhere -- we have already shown that we're not willing or able to lock down international travel enough to prevent the spread of Covid. Maybe this is a "yes and" situation, but I think we're not doing enough to get the rest of the world vaccinated.

42 points by bryan0 5y ago

In Romania where I'm from, people no longer want vaccines. The authorities had to sell them before they spoil. I say let everyone do whatever they want, including letting the doctors go home when they are tired.

croes 5y ago
That will lead to more variants and some of them will render the current vaccines and efforts useless.
- beerandt 5y ago
  No- designing and depending on a vaccine based on a single gene is what will (has already) lead to variants. It's no coincidence that lambda has 3 separate mutations on the spike protein targeted by the mrna vaccine.
  - majormajor 5y ago
    The immune system doesn't lead to variants, randomness + time does. Selection pressure to see what variants become dominant happens later. They aren't being actively "designed" in any sense. That's why anything that would make real progress has to happen quickly and broadly, without large left-out pockets (not that rejecting a vaccine is any worse than not being offered one in the first place, here - that's the issue that is mostly being ignored for now, since we have no current solution).
    - newbamboo 5y ago
      How do antibiotic resistant infections work? I ask as a lay person.
      - criticaltinker 5y ago
        Here are very accessible peer-reviewed primary sources that will answer your question and give historical examples [1][2]. [1] Why does drug resistance readily evolve but vaccine resistance does not? https://royalsocietypublishing.org/doi/pdf/10.1098/rspb.2016.2562 https://royalsocietypublishing.org/doi/pdf/10.1098/rspb.2016... [2] The adaptive evolution of virulence: a review of theoretical predictions and empirical tests https://www.cambridge.org/core/services/aop-cambridge-core/content/view/30EC8AB1717BF7A173CF5E051DBB498F/S003118201500092Xa_hi.pdf/_div_class__title__The_adaptive_evolution_of_virulence__a_review_of_theoretical_predictions_and_empirical_tests__div_.pdf https://www.cambridge.org/core/services/aop-cambridge-core/c...
        newbamboo 5y ago
        Second link was really helpful. I found this part interesting and potentially relevant, “reducing the risk of death for infected hosts reduces the cost of virulence, causing an evolutionary increase in virulence (Gandon et al. 2003, 2001b). Vaccines that either block infection or block transmission, on the other hand, have no effect on virulence evolution” Especially considering Dr Fauci’s recent statements on how the COVID vaccines do not block transmission. https://m.youtube.com/watch?v=AuO_OfjlPUI https://m.youtube.com/watch?v=AuO_OfjlPUI Putting these together then it seems like we should expect the result of our vaccination efforts to be increased virulence in strains such as Delta variant. Is it possible the Delta variant itself was somehow the result of our intrepid and swift vaccination efforts? I’m having a hard time understanding why more people aren’t talking about this given the obviously well established scientific literature you’ve cited.
        criticaltinker 5y ago
        I'm glad you found the reference helpful. > Is it possible the Delta variant itself was somehow the result of our intrepid and swift vaccination efforts? The variants can arise under neutral genetic drift, ie pure random chance via naturally occurring mutation. But the widespread dominance of these variants is very plausibly connected to the mass vaccination efforts. Here is another good paper on the subject, in case you haven't already seen it [1]. > I’m having a hard time understanding why more people aren’t talking about this Me too, but to be fair these are complex second and third order effects that only gained traction in the scientific literature within the past decade or so. Right now everyone is mostly focused on first order effects - eg "will the vaccination help/harm me?" Quotes from [1]: - "Our modeling suggests that SARS-CoV-2 mutants with one or two mildly deleterious mutations are expected to exist in high numbers due to neutral genetic variation, and consequently resistance to vaccines or other prophylactics that rely on one or two antibodies for protection can develop quickly -and repeatedly- under positive selection." - "Our work suggests that it is likely that standing genetic variation alone has already produced a substantial population of viruses with single and double nucleotide changes that confer nAb resistance. These variants will establish quickly in the population under selection pressure. In fact, there is already a precedent for this behavior, as one such selective sweep occurred early on in the SARS-CoV-2 pandemic when the D614G mutation rose to nearly 80% frequency in under 6 months [33]." [1] Risk of rapid evolutionary escape from biomedical interventions targeting SARS-CoV-2 spike protein https://pubmed.ncbi.nlm.nih.gov/33909660/ https://pubmed.ncbi.nlm.nih.gov/33909660/
    - criticaltinker 5y ago
      > They aren't being actively "designed" in any sense The point made by GP is that the current mRNA vaccines are actively designed to illicit a highly targeted immune response targeted towards the spike protein [1]. > That's why anything that would make real progress has to happen quickly and broadly, without large left-out pockets Assuming you mean 100% vaccine coverage, this is the opposite conclusion that the authors of this paper came to [1]. Citing [1]: - "The speed at which nAb resistance develops in the population increases substantially as the number of infected individuals increases, suggesting that complementary strategies to prevent SARS-CoV-2 transmission that exert specific pressure on other proteins (e.g., antiviral prophylactics) or that do not exert a specific selective pressure on the virus (e.g., high-efficiency air filtration, masking, ultraviolet air purification) are key to reducing the risk of immune escape" - "Strategies for viral elimination should therefore be diversified across molecular targets and therapeutic modalities" [1] Risk of rapid evolutionary escape from biomedical interventions targeting SARS-CoV-2 spike protein https://pubmed.ncbi.nlm.nih.gov/33909660/ https://pubmed.ncbi.nlm.nih.gov/33909660/
    - Banyonite 5y ago
      >> The immune system doesn't lead to variants, randomness + time does. I disagree. It has been shown over many years of research that viral mutations may be driven by both antigenic drift as well as selective immunological pressures, with the question being more the degree to which these factors influence mutation in different viral species. Not to present an argument against vaccination, rather an argument against making blanket statements that fail to accurately represent the current state of collective knowledge on the subject, to wit: We do not know with any certainty the degree to which either of these factors drive SARS-CoV-2 mutations. A naked statement that the un-vaccinated population drives the mutation rate of this virus is nothing more than speculation; issues surrounding a field of study as incredibly complex as this may not ever be definitively put to bed through analysis of (conflicting?) study outcomes- let alone through arguments made in the commons of popular science. I don't argue that emerging SARS-CoV-2 mutations are driven more by one factor or the other, I argue that we do not know the degree to which mutations are driven by 'random' antigenic drift vs selective pressures. Unfortunately, the issue has been politicized to the point where study outcomes that suggest dominance of one over the other are likely to be attacked or even ignored, regardless of the strength of study. Citations? Efforts to find evidence here prioritized time invested over strength- this may not represent the best arguments out there, however it took only a scant few moments to gather, and points to a much larger body of literature supporting the position that both antigenic drift and selective immunological pressures drive viral mutations (SARS-CoV-2 being no exception) and that we do not know the degree to which each is a factor... and therefore stating OR implying that the un-vaccinated population drives the viral mutation rate in this pandemic is inaccurate. Once again- we simply do not know. CF "Given that the antibody response to the spike protein is so focused, could mutations in these restricted sequences lead to a less efficacious vaccine, if the human immune response is specific to the vaccine sequence? These mutations might be driven by antigenic drift, or by selection, either during natural infection or due to the vaccine itself. When a virus is grown under the selective pressure of a single monoclonal antibody that targets a single epitope on a viral protein, mutations in that protein sequence will lead to the loss of neutralisation, and the generation of escape mutants. This sequence of events has been shown in the laboratory for polio, measles, and respiratory syncytial virus,7 and in 2020 for SARS-CoV-2.8" https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(21)00075-8/fulltext https://www.thelancet.com/journals/lanres/article/PIIS2213-2... McCarthy, K. R. et al. Recurrent deletions in the SARS-CoV-2 spike glycoprotein drive antibody escape. Science 371, 1139–1142 (2021). Plante, J. A. et al. The variant Gambit: COVID’s next move. Cell Host Microbe 29, 508–515 (2021). Ravindra Gupta, Steven Kemp, William Harvey et al. Recurrent independent emergence and transmission of SARS-CoV-2 Spike amino acidH69/V70 deletions, PREPRINT (Version 1) available at Research Square https://doi.org/10.21203/rs.3.rs-136937/v1(2021) https://doi.org/10.21203/rs.3.rs-136937/v1(2021).
  - treis 5y ago
    The vaccine elicits a response to many different sites on the virus. It's extremely unlikely that the vaccine ever becomes useless.
    - criticaltinker 5y ago
      Some experts from highly regarded institutions across the country would disagree. See this peer-reviewed paper for introduction to their reasoning [1]. [1] Risk of rapid evolutionary escape from biomedical interventions targeting SARS-CoV-2 spike protein https://pubmed.ncbi.nlm.nih.gov/33909660/ https://pubmed.ncbi.nlm.nih.gov/33909660/
      - treis 5y ago
        That's talking about 1-2 sites. The vaccine elicits a response to a dozen or more.
        criticaltinker 5y ago
        Did you read the paper I linked to (at least the abstract)? It directly contradicts your claims. Please cite primary sources to support your claim, otherwise it must be regarded as uninformed opinion.
        treis 5y ago
        It says: >Our modeling suggests that SARS-CoV-2 mutants with one or two mildly deleterious mutations are expected to exist in high numbers due to neutral genetic variation, and consequently resistance to vaccines or other prophylactics that rely on one or two antibodies for protection can develop quickly -and repeatedly- under positive selection. 1 or 2 mutations isn't enough. It would need an order of magnitude more. It's very unlikely for that to happen. I don't wish to get into a cite duel with what appears to be a Covid troll account.
        criticaltinker 5y ago
  - sudosysgen 5y ago
    This is highly misleading. All variants right now are significantly more effective at transmission in unvaccinated individuals. The reason the mutations are on the spike protein is because it's the part of the virus that matters the most for infectivity. The more effective the spike protein, the more easily other people are affected and the faster the virus is produced. The Delta variant itself rose in India, which has really low vaccination rates.
    - criticaltinker 5y ago
      This is not misleading at all, GP's point is well founded and backed by peer-reviewed literature, see [1]. I have more references if you're interested. > All variants right now are significantly more effective at transmission in unvaccinated individuals. Please cite your primary source(s). [1] Risk of rapid evolutionary escape from biomedical interventions targeting SARS-CoV-2 spike protein https://pubmed.ncbi.nlm.nih.gov/33909660/ https://pubmed.ncbi.nlm.nih.gov/33909660/
      - sudosysgen 5y ago
        The article you linked does not say what you think it says. It says that mutation for immune escape is possible. There has been zero mutations for immune escape, so far all mutations were for higher infectivity. Beyond that, we do know that all variants are more infective in unvaccinated individuals : http://weekly.chinacdc.cn/fileCCDCW/journal/img/cover/ffd464f2-ff7e-4bcf-8210-e7fb781fbb50.pdf#page=18 http://weekly.chinacdc.cn/fileCCDCW/journal/img/cover/ffd464... If it wasn't, it would never have out-competed the ancestral type in unvaccinated India. The OP's point was that vaccines drove mutations. So far, that has not happened. There is no variant that is more infective in vaccinated individuals but not in unvaccinated individuals, all variants are simply more effective across the board.
        criticaltinker 5y ago
        > There has been zero mutations for immune escape, so far all mutations were for higher infectivity. You're making very broad claims here that are again contradicted by the literature, see [1]. The very short paper you linked to "Transmission Dynamics of an Outbreak of the COVID-19 Delta Variant B.1.617.2" does not even discuss vaccination status. I'm inclined to believe you linked to the wrong paper - or you haven't thoroughly reviewed it yourself. I'm not interested in arguments based on logical deductions. Show me the peer-reviewed sources backing your point and I will happily read them with an open mind. [1] SARS-CoV-2 immune evasion by the B.1.427/B.1.429 variant of concern https://science.sciencemag.org/content/early/2021/06/30/science.abi7994 https://science.sciencemag.org/content/early/2021/06/30/scie...
  - croes 5y ago
    It's no coincidence the variants come from areas with lower vaccination rates. If your claim were true the variants would come from Israel , Europe or the US. And most variants don't get a own name because they don't differ enough from known viruses, so only the variants with certain mutations get the attention and a name at all.
    - pbak 5y ago
      >If your claim were true the variants would come from Israel, >Europe or the US. Except for the UK variant, b.1.1.7, also called Alpha, the deadliest since the beginning...
      - rsynnott 5y ago
        First detected in November, becoming dominant by end December. The first vaccine wasn't approved in the UK until December.
        pbak 5y ago
        I should have been longer. Exactly : Location of emergence of a variant has nothing to do with vaccination or not. All of the current variants raging around appeared before there were vaccines, as were all current and past variants of interest.
      - croes 5y ago
        Pre vaccination and not really deadlier just faster spreading.
      - sudosysgen 5y ago
        The UK had a full vaccination rate of approximately 0.0% when B.1.1.7 was detected, and a first dose rate of 1.5%.
        rsynnott 5y ago
        Even earlier than that; it was detected in November, though it didn't become dominant til late December.
  - croes 5y ago
    Like majormajor already said, evolution is not targeted conscious process, it's randomness plus time and as long the result doesn't lead to extinction a species remains existent even if it needs very special conditions to survive.
majormajor 5y ago
Does "do whatever they want" extend even to something like doctors saying "you've declined to get vaccinated and acted like there's not to be concerned about, so we're going to not admit you to the hospital"?
- sjwalter 5y ago
  Does your logic extend to "you've declined to lose weight and acted like being obese is nothing to be concerned about, so we're going to not admit you to the hospital"?
  - majormajor 5y ago
    Well, it's 'danuker's logic, not my own. I just want to know if they fully extend "do what you want" to everybody or if it's a situation of "do what you want for me, do what I want for thee." If they do, then the answer would clearly be: yes. As an aside, some of this is already done when resources are scarce today. The alcoholic who can't stop drinking isn't going to make it on the liver transplant recipient list. One of the biggest dangers of Covid has consistently been that it risks overwhelming hospital capacity, which so far fortunately has been minor (though has resulted in some tragic outcomes) but not something anyone should want to continue.
  - treis 5y ago
    You can't solve obesity with two shots.
    - pbak 5y ago
      You can, in the US. /s
  - johnchristopher 5y ago
    On one hand there's a clear pressure from governments, WHO, etc. to get vaccinated (which is still a higher pressure than from smallest groups but with a bigger voice, aka anti-sthg) for a positive outcome and on the other hand there is a strong pressure from junk food industries to eat unhealthy diet. There's also a lot of obese people who are concerned about their weight (but I don't know the proportions). So it's oranges to apples.
penultimatename 5y ago
It's in very poor taste to conflate the issues of social distancing and vaccination acceptance with treatment of medical staff. If everyone social distanced and got a vaccine, there would be no issues with medical staff being overworked. If everyone did what they wanted, what would the medical staff do? Go home and let them die on the sidewalk? Kids dying in the streets by no fault of their own wouldn't go over well.
- sjwalter 5y ago
  >Kids dying in the streets... Uh, wat? Which kids are dying from covid? This level of hyperbole is insane.
  - deleted 5y ago
    [deleted]
  - penultimatename 5y ago
    Children account for 1.3% to 4% of all US hospitalizations for COVID, depending on the US state. What do you suggest is done when everyone throws their hands up and medical demand exceeds supply? I fail to see how being unable to admit patients is some impossible scenario.
    - lijogdfljk 5y ago
      Acceptable losses from the sounds of it. I find these conversations difficult to discuss because we all have different ideas of what is acceptable losses.
    - sjwalter 5y ago
      Hospitals have been built and staffed for estimated peak capacity forever. Slack capacity is extremely expensive. Here's an article from 2018 about LA County's makeshift flu hospital tent, which they built because the flu season was so bad then: https://www.latimes.com/local/lanow/la-me-ln-flu-demand-20180116-htmlstory.html https://www.latimes.com/local/lanow/la-me-ln-flu-demand-2018... So, what I suggest is done, is what hospitals have always done, which is do their best to make it work. "Two weeks to flatten the curve" was all about giving hospitals a chance and not be overwhelmed, and presumably, get better prepared. It's been 1.5 years. How long do you think it's reasonable to extend that 2 weeks to?
Tepix 5y ago
We've seen what happens when restrictions are loosened. Just look at what happened in the Netherlands in the last few months. It just doesn't work.
- pbak 5y ago
  Sweden enters the chat.

simonh 5y ago

I suppose the surge of infections from the Delta variant have made developed world governments re-think their approach to vaxing younger citizens. In the UK a fifth of hospital admissions with covid are 18-34 years old and we're extending vaccination to 16-17 year olds. I'm sure it's true these vaccines would save more lives in developed nations, but politically governments are still accountable to their own citizens first. It's an ugly situation. Delta has seriously thrown a spanner in the works, and I'm sure there are more variants to come. Suppose a variant pops up that's deadly to children, but the current vaccines protect against it. How would governments explain shipping vaccines abroad instead of vaxing children then?

sjg007 5y ago
How are the younger patients faring? I see the UK as a canary to the USA for the upcoming school year but have no sense of it from the news.
- mschuster91 5y ago
  In Germany we vaccinate from 12 years old, to my knowledge there haven't been any newsworthy incidents. The only thing we have is the (political) squabble if it is officially recommended by the vaccine commission, and the debate on how we are going to protect the young children - especially those at high risk - when ignorant unvaccinated adults will be spreading COVID around.
alimw 5y ago
> Suppose a variant pops up that's deadly to children, but the current vaccines protect against it. How would governments explain... All sorts of mad things could happen. But this fantasy scenario is really quite unlikely.
- randompwd 5y ago
  > But this fantasy scenario is really quite unlikely Based on what exactly. The delta variant was unlikely. The COVID-19 was unlikely. I think I'll back governments taking precautions against the possible rather than somebody thinking it's a fantasy(def: the faculty or activity of imagining impossible or improbable things) scenario, ignoring the last 18 months of world life.

throwaway894345 5y ago

Is the bottleneck in deploying vaccine to poor countries strictly the amount of vaccine? Or is it logistics? If the former then rich countries should send more vaccine to poor countries before administering their own booster programs, but if it's logistics, then I don't see the point in holding off on booster campaigns.

JohnJamesRambo 5y ago
My Walmart is begging people to come get vaccinated for free in my 40% fully vaccinated state. I say send the vaccines where they will be used and cherished.
- probablyexists 5y ago
  I think this probably falls to the normal debate of the balance between "but who will pay for them?" and "it costs every nation to not have all nations vaccinated"
- vorpalhex 5y ago
  Have you talked to anyone not getting vaccinated in your state to try and gather why? Despite sort of the popular media push that there's some huge contingent of never-vaxxers, that actually appears to be a small proportion of the unvaccinated[1]. Are the remainder having doubts? Is it a transport/scheduling issue? Is there a misunderstanding about it being a multiple dose vaccine? [1] - https://www.kff.org/coronavirus-covid-19/issue-brief/latest-data-on-covid-19-vaccinations-race-ethnicity/ https://www.kff.org/coronavirus-covid-19/issue-brief/latest-...
  - TingPing 5y ago
    In my experience they are just anxious about getting something they don't understand, doing nothing is super easy/comfortable, and some media scares the last bit of uncertainty out of them.
    - sjwalter 5y ago

1helloworld1 5y ago

The western greed might actually backfire. What are the chances that if we let the virus spread unchecked in the poorer countries for a few more years, the virus accumulates more mutations on the spike protein making the existing vaccines ineffective?

minikites 5y ago
>if we let the virus spread unchecked in the poorer countries It's spreading unchecked now in the USA because people are refusing the vaccine. The scenario you describe is absolutely going to happen, but it won't be because of poorer nations, it will be because of selfish people in rich nations.
- leesec 5y ago
  Pretty baseless to assume where a variant is going to spread or why. It's not like every country other than USA would have 100% vaccine uptake either.
  - minikites 5y ago
    I think it's reasonable to place more of the blame on people who choose not to help (refusing the vaccine) instead of the people who don't have the means to help (unable to get a vaccine).
    - __s 5y ago
      The original comment was laying blame on the cause of people unable to get a vaccine, not the people themselves. Incidentally that puts them in agreement with you: selfish people in richer nations
libertine 5y ago
This has been a period of constant backfires on a global scale - starting from WHO themselves right at the start of this whole thing when dealing with the first breakout in China, especially having experience with dealing with China (SARS). They knew information was being withheld. So will this backfire be worst then all the other backfires, or other potential backfires? Honestly we have no idea. I'm still baffled why the leadership of WHO hasn't been renewed yet... I get that in times of crises leadership shouldn't be changed, but they are stretching it. WHO lost a lot of their soft power during this pandemic.

minikites 5y ago

It's clear that a large portion of the USA will never get vaccinated, so we should be sending our vaccines to people who want them instead of letting them go to waste here.

wayoutthere 5y ago
Or just fill tranquilizer darts with vaccine and don’t give people the choice
- jboggan 5y ago
  I wouldn't advocate assault on an open forum.
  - wayoutthere 5y ago
    I’m advocating for it as government policy; I have no desire to go out and deal with those morons myself.
    - Gibbon1 5y ago
      I kind of roll my eyes at the mah freedom tech bro libertarian types. When I was kid they were drafting young men and sending them to Vietnam. Seriously people don't want to do their duty? Why should society care at all what they think?
nradov 5y ago
That is happening. The US has already exported 110M vaccine doses. https://www.wsj.com/articles/u-s-says-it-has-shared-110-million-covid-19-vaccine-doses-overseas-11627981201 https://www.wsj.com/articles/u-s-says-it-has-shared-110-mill...

bingohbangoh 5y ago

What's the guidance on booster shots? How often are we to get them? Example: I got vaccinated in June, fairly late. Am I to get a booster shot now? Will the booster shots be the same vaccine formula as the original?

testplzignore 5y ago
https://www.cnbc.com/2021/08/05/moderna-covid-vaccine-booster-produces-robust-response-against-delta.html https://www.cnbc.com/2021/08/05/moderna-covid-vaccine-booste... has some details released by Moderna this morning. Important bit: In a phase two trial, Moderna is testing a 50-microgram dose of three vaccine booster candidates in previously vaccinated individuals. The booster shots produced a promising immune response against three variants, including delta, with antibody levels approaching those seen in previously unvaccinated people who received two 100-microgram doses, the company said. I'm interested to know if just getting another dose of the original vaccine has any effect. If so, I'd love to get it now.
MurMan 5y ago
Both Pfizer and Moderna have stated that boosters will be needed this Fall. Pfizer says that immunity drops from 96% to 84% at the six month point. The good news is that the vaccine continues to protect against severe disease due to its effects on T-cells and memory B-cells.

forcry 5y ago

All this, while the essential systems to capture vaccine safety signal appear to be apparently broken and based on "voluntary reporting", and the world does not give a single fuck about it... https://roundingtheearth.substack.com/p/defining-away-vaccine-safety-signals/comments https://roundingtheearth.substack.com/p/defining-away-vaccin... https://tinyurl.com/CovidvFluReport https://tinyurl.com/CovidvFluReport

andi999 5y ago

Government acting in the interest of its own people?

theptip 5y ago

I think the WHO is right on this one; we really need to be thinking more about how to prevent an Omega variant that can break through our existing vaccines. Unfortunately even complete elimination of Covid in a single country would be useless, as long as it's rampant elsewhere -- we have already shown that we're not willing or able to lock down international travel enough to prevent the spread of Covid. Maybe this is a "yes and" situation, but I think we're not doing enough to get the rest of the world vaccinated.