15 ms·

Vaccination blunts, but does not defeat Delta

102 points by sohkamyung 5y ago

jdhn 5y ago
Is this necessarily a bad thing? If it protects the vast majoriy of people from going into the hospital and they gain additional immunity from covid, then I don't really see a downside.
- anyfoo 5y ago
  A less effective vaccination keeps COVID around longer and farther than a more effective one, though, giving the virus more time and population surface to mutate into further variants. (But still less than no vaccination.) I'm not an expert in this, so I cannot say how significant that issue is, but this is at least one potential downside that I am seeing to the vaccination being weaker for that variant. EDIT: To clarify since some have misunderstood: I did not assert that the vaccination causes higher mutation, quite the opposite. I asserted that the absence of vaccination (entirely or effectively) gives more opportunity for mutation. I understand now that there are higher order effects that make this more complex.
  - jdhn 5y ago
    That's a fair critique. I feel like I've heard concerns about the potential for the virus to mutate because of the high level of vaccinations, but like you, I don't know how significant of an issue that is.
    - tunesmith 5y ago
      I think the parent was talking about the lack of vaccinations yielding more time to mutate, not the vaccinations themselves. Viruses aren't like bacteria; they don't mutate in direct response to vaccines.
      - anyfoo 5y ago
        That is correct. My premise was that the more virus exists in absolute numbers (if the vaccine is weaker for the Delta variant), the more virus has the opportunity to mutate.
    - listless 5y ago
      I also have this concern. I haven’t seen it addressed anywhere and I am but a mere layperson.
    - smt88 5y ago
      What you've heard is misinformation. Vaccines reduce potential for mutation, which is both intuitive and borne out by data.
      - AndrewBissell 5y ago
        That's neither intuitive nor true in all cases. https://www.quantamagazine.org/how-vaccines-can-drive-pathogens-to-evolve-20180510/ https://www.quantamagazine.org/how-vaccines-can-drive-pathog...
    - addicted 5y ago
      The virus will not mutate because of the high level of vaccinations. The virus will mutate because of the high level of unvaccinated people. The risk is when the high level of unvaccinated are in the same population with a high level of vaccinated, of the many mutations in the unvaccinated there is a greater chance that a mutation that randomly has greater tolerance to the vaccines will be naturally selected and flourish. Vaccination does not lead to more mutations, but in the absence of vaccination, resistance to vaccines does not give a mutation any advantage, so whether it flourishes or not is based entirely on other attributes. It’s only when you do have a significant population of vaccinated does the mutations created in the unvax population benefit from resistance to vaccines.
      - velcii 5y ago
        >mutations created in the unvax population benefit from resistance to vaccines. I cannot see how this is correct. Because it should be the mutations created in the vaccinated that will help the virus to survive in similar vaccinated hosts..because first of all, the mutated virus need to survive in the vaccinated host, and become the dominant one in that host and thus giving it a better chance to jump to another host... So this mutations must be happening in Vaccinated hosts. In unvaccinated as you said, any mutations that gives the virus immune escape capability does not give it an advantage over the other mutations in the same host, simply because there is no vaccine generated antibodies to kill the other mutations, for it to gain dominance.
      - tunesmith 5y ago
        I haven't been able to get a straight answer to this even from scientists on science threads... Given the following: 1. Virus mutations do not directly react to the vaccine. These are simply random mutations. 2. If a mutation occurs that has a higher probability of escaping an existing vaccine, then in one unvaccinated person, that mutation has an identical chance of occurring whether that person is part of a 0% vaccinated community, a 50% vaccinated community, or a 99% vaccinated community. 3. Natural selection just means its ability to reproduce. Let's say that the mutation can escape the vaccine at 100% probability. Then: Can that virus spread equally regardless of whether it's a 0% vaccinated community, a 50% vaccinated community, or a 99% vaccinated community? Because it sure sounds like people are saying that in that scenario, the mutation spreads less in a 0% community, and more in a 50% community. Are they saying that in a "mostly unvaccinated" community, the other variants (that the vaccine protects against) that are more prevalent somehow serve to "crowd out" the mutation? Because I don't know if that's true - at least, I've seen reports that suggest that people can catch more than one variant at one time.
    - anyfoo 5y ago
      Just to clarify: That is not my concern.
  - MisterBastahrd 5y ago
    It's going to mutate regardless of how many people are vaccinated. The entire point is to make it so that people don't have the runaway immune system responses that are melting lungs and brains.
    - anyfoo 5y ago
      Is that true? Intuitively, the more virus exists (in absolute numbers, even), the more virus may potentially mutate into worse variants. More infected people -> more individual virus instances, each with a given chance to mutate, and more time for that mutation to occur (because expired virus is replenished with fresh virus in available hosts; though you can probably fold this into higher virus numbers instead with the same result). I'm gladly corrected if I missed something!
      - totony 5y ago
        Variant that achieve immune escape from vaccine-induced immunity are bound to propagate at a faster rate if most people are vaccinated. Even if that variant is more lethal (from which you might expect a smaller R0), it might be prevalent because of an augmentation in R0 from vaccination (which might be lesser had people developed a more complete natural immunity).
    - suchire 5y ago
      The likelihood of mutation is directly proportional to how widespread a virus is multiplied by the amount of time it stays that way (more specifically, the area under the curve for infections over time). Vaccination and control of spread is critical to preventing further variants
      - totony 5y ago
        Likehood of mutation might be, but spread of variants is a more complicated function. Vaccination for sure might affect how likely one variant predominates against others. Considering cross-immunization between variants with natural immunity, it might be more efficient to refrain from vaccines to give cross-immunity with a weaker variant.
  - weaksauce 5y ago
    the fact that the delta variant came from a country that didn't have widespread vaccines dispels this notion.
    - anyfoo 5y ago
      Seems perfectly in line with what I said? More virus, more time to mutate -> more mutations? I now understand that there are second order effects that make this more complex, but I don't see the contradiction right here.
      - weaksauce 5y ago
        I suppose either you edited it to change the text or the more likely event was that I misread it. yeah you're mostly correct and there are those second order effects too.
  - jfoster 5y ago
    Is it analogous to flu? Do flu vaccines cause mutations as well? One interesting thing about covid is that it seems to be the first time humanity has collected so much data (eg. contact tracing, phylogenetics through genome sequencing, etc.) about this kind of virus, and applied modern medical knowledge in trying to combat it. It's very apparent that the overall response hasn't been nearly good enough, but it's probably also the best response there's ever been. (perhaps not the best ROI, though?)
    - anyfoo 5y ago
      > Do flu vaccines cause mutations as well? That is not what I have written, please reread!
  - velcii 5y ago
    >But still less than no vaccination.. Can you share why you think the current vaccines will reduce the mutations when we already know that they only prevent symptoms (not even reduce viral load for some variants). So given that, why do you think the current vaccines will reduce the chances for virus to mutate. To me, it appears that the current vaccines will give the exact same chance for the virus to mutate, without the vaccine, but in addition also apply selection pressure to guide the evolution to gain immune escape. So the worst of both worlds.
- pizza 5y ago
  People are still dying from breakthrough cases. Children (w/o vaccine) are dying of delta. Not to go full scaremonger but we don't know that much about long covid at this point. Plus the CDC admits that there is likely an undercount of people who got COVID post-vaccination https://www.cdc.gov/vaccines/covid-19/health-departments/breakthrough-cases.html https://www.cdc.gov/vaccines/covid-19/health-departments/bre... It's an "ounce of prevention, pound of cure" type of situation
  - jdhn 5y ago
    >Children (w/o vaccine) are dying of delta The number of children who are dying of covid has been ridiculously low for a virus that spreads so easily. Hasn't covid deaths for children under the age of 12 been under 1000 since the pandemic started?
    - koolba 5y ago
      It’s even lower if you factor in that the vast majority of those that died had existing underlying health issues. The level of social isolation the elderly have unilaterally imposed on the youth is a travesty.
      - themaninthedark 5y ago
        It's not the elderly that have been imposing isolation, they have all been sent to long term care homes to die. Our leaders however are not letting this crisis go to waste.
      - mikeyjk 5y ago
        Is this not a bit confused? The children being referred to would need supervision wouldn't they? They are also totally capable at spreading it to older people. I find a lot of the discourse / antilockdown sentiment to be really confusing. I understand lockdowns are a bad experience but are we not agreed that they save lives, and the quality of life (long covid)?
    - bob33212 5y ago
- brodouevencode 5y ago
  The pretense all along as far as I can tell from most countries has been one of "zero COVID". Meaning a total removal/extermination of the virus. Whether or not this was ever realistic is really the underlying debate that hasn't yet fully surfaced.
  - hcknwscommenter 5y ago
    Of course it was realistic. China basically achieved it (I am not a China fan or defender), but the rest of the world failed. The whole world achieved it for the first SARS. However, that ship sailed a long time ago. Probably before the first surge in Italy of COVID-19.
    - deleted 5y ago
      [deleted]
    - brodouevencode 5y ago
      You have a lot more faith in the data coming out of China than I do. The CCP has lied from the beginning and attempted (successfully in most cases) to silence the researchers from the Wuhan lab that attempted to report early on.
    - jdminhbg 5y ago
      China didn’t really achieve Zero Covid if they exported it to the rest of the world. They may have stamped out some local outbreaks.
    - dragonwriter 5y ago
      > China basically achieved it No, it didn't. > (I am not a China fan or defender) Then why are you making B.S. “rah rah China” claims that even Chinese state media doesn't?
  - legerdemain 5y ago
    Europeans learned to live with the bubonic plague, which has never been eradicated, and Native Americans, over time, overcame the smallpox that was introduced among them. The people of today can do the same with Covid. It is the only way.
danielodievich 5y ago
I am good friends with 3 doctors, and talk to them a lot about the amazing science behind the vaccines and the incredible speed with which those were designed and developed. All agree it was done at pretty much the software speed - custom designed on the computer in weeks and then built to order - and both them and I think it's pretty neat. It is very refreshing to talk to them because they, being good doctors, deal calmly and reasonably with probabilities rather than absolutes. Very early, even before general public could get vaccines, all 3 of them told me to expect something like that - the virus mutates, it is expected to develop, the mutation for reproductive number going up is likely to occur - and it did - and the vaccines will likely be needing to adjust. Even the highest levels of vaccination are no protection, and I am pretty tiny Israel in a sea of the largely unvaccinated is going to be swamped.
- graderjs 5y ago
  I don't know if we have this, but it would be good if we had a technology that enhanced your body's immune system to identify and kill viruses, rather than prime it to respond to a particular viral signal, that then may need to be updated as the virus changes (that's how I understand how vaccines work, but that could be false). You might think it's a subtle difference, but I think the former technology would be leaning into the body's existing ability to form a variety of antigens for viruses it encounters, and boosting its defense/offense against those, rather than 'handing out a series of police composite sketches', and saying 'Be On the Look Out for this specific guy, he might be coming through here.' The former could be more alike to enhancing predictive policing and profiling abilities, and beefing up response and enforcement capabilities.
  - thatguy0900 5y ago
    Beefing up the immune system without garunteeing it something to do seems like a recipe for autoimmune disorders, no?
    - graderjs 5y ago
      Yeah, agree. It would be tricky. I'm hoping that by 'enhancing' the immune system you lean into its natural self-regulation equilibrium system and avoid that mostly--but then again autoimmune disorders seemingly emerge from those stasis systems going haywire, maybe without external poking...so it would be tricky for sure. I guess the intuition is that the human immune system is an incredibly sophisticated, evolving capability that over time, and over the mass population, can respond to become resilient against a wide array of pathogens. So if you could somehow capture the best of that (like, for illustration, take the immune system of the healthiest, most resilient person, 30 generations from now in the future) and convey that benefit to many other people, that would be truly awesome. Sort of like an idea of training an AI, more iterations are better, the immune system of any one person at any one point in time, might not be so great, but the best immune system of the population after encountering many pathogens, is going to be really great. How can we short circuit that "natural training" process and enhance the immune system? But I agree that attempts to do so might run the risk of creating or exacerbating autoimmune diseases...But I still think it's worth it.
refurb 5y ago
There were several prominent epidemiologists who said early on “Covid will end up like the flu, you’ll need a yearly vaccine, we’ll have new variants and we’ll get waves of infections through out the year”. And here we are.
- smt88 5y ago
  Except that it is still much more dangerous for unvaccinated people than the flu, which is an important distinction.
  - bob33212 5y ago
    The original strain of the flu was also more deadly. But it eventually mutated and became less
    - ashildr 5y ago
      With that high number of young people dying of the flu back then you may say that the host mutated and became less susceptible to the original strain of the flu. Since SARS-CoV-2 seems to be especially dangerous for people after reproductive age I don‘t expect the same pressure as with flu. It may influence our inverted age pyramid, though. And it may have influence on the number of highly educated people >50 and older people with disposable income. (I belong in this group)
- landemva 5y ago
  I havent (needed) a flu shot in a couple decades. I'm not interested in yearly jabs. Better to lose the waist inches and high BMI. Few want the self-responsibility of healthy living. And I don't agree with headline of "grim", as it was obvious a year ago this was coming. Who lost any excess weight in the past year?
  - brodouevencode 5y ago
    Not sure why you're getting downvoted. Comorbidity is a fundamental driving factor in whether or not you survive this virus. We've not heard any recommendations from any health agency suggesting a healthier lifestyle would help - it most certainly would statistically speaking. And 18 months in I doubt we'll see anything like that because it has proven to not be politically expedient. (FWIW Ive been intermittent fasting with some pretty good success)
loteck 5y ago
If we had effective treatments and OTC therapies for this illness, the pressure to vaccinate against every resurgence and new mutation would basically disappear. With so much social difficulty with vaccines, this seems like the most likely long term path. Where's my cherry flavored Covidquil?
- smt88 5y ago
  This is absolutely wrong. A vaccine is a fraction of the cost of treatment, and it has no long-term side effects. Even better, a vaccine reduces the chance for a virus to mutate. Treatments, even if they work, are going to have side effects, and there are still unknown risks from a severe (unvaccinated) infection anyway. Vaccines are a miracle of proactivity, and there's no reason to try to replace them with something expensive, risky, and reactive.
  - cickpass_broken 5y ago
    the cost of these vaccines is largely hidden, no? Each country made deals behind closed doors AFAIK. I've seen some estimates of $12-$30 a shot, but have no idea the validity of this. How much do the treatments cost? Is it vastly different? > No long term side effects. How do you know? I thought the only study/data from Pfizer covered 6 months. That's not very long term? https://www.medrxiv.org/content/10.1101/2021.07.28.21261159v1.full-text https://www.medrxiv.org/content/10.1101/2021.07.28.21261159v... I don't think we need to replace vaccines, but large swathes of the population still don't have access. It seems very likely that a multi-modal approach would allow us to treat more people, faster. Even Pfizer sees vaccination as well as treatment as the path forward: https://www.pfizer.com/science/coronavirus/antiviral-efforts https://www.pfizer.com/science/coronavirus/antiviral-efforts
    - smt88 5y ago
      > How much do the treatments cost? Is it vastly different? An average hospitalization costs $73,000 in the US, according to data collected from insurance claims[1]. That means that a single hospitalization costs the same as vaccinating 2,400 people (using your $30/shot estimate). > How do you know? I thought the only study/data from Pfizer covered 6 months. That's not very long term? Although I'm not an expert, a friend of mine is getting his PhD studying the immune system and explained it to me this way: Any additional risk of mRNA vaccines would (with almost 100% certainty) occur shortly after vaccination[2], theorized to be as a result of a strong(er) immune response. After the immune response has subsided, the vaccinated person's immune system would be hard to distinguish from someone who received a traditional vaccine because the goal of the vaccines is the same: to teach the immune system what the virus looks like[3][4] without actually requiring an active virus. So to put that together, we can be fairly confident in an mRNA vaccine's long-term safety because its long-term effects are similar to other vaccines that we've studied for more than 100 years and because the mechanism of action subsides within a few months[5]. 1. https://www.fairhealth.org/article/costs-for-a-hospital-stay-for-covid-19 https://www.fairhealth.org/article/costs-for-a-hospital-stay... 2. https://www.muhealth.org/our-stories/how-do-we-know-covid-19-vaccine-wont-have-long-term-side-effects https://www.muhealth.org/our-stories/how-do-we-know-covid-19... 3. https://www.health.harvard.edu/blog/why-are-mrna-vaccines-so-exciting-2020121021599 https://www.health.harvard.edu/blog/why-are-mrna-vaccines-so... 4. https://www.vumc.org/viiii/infographics/how-does-mrna-vaccine-compare-traditional-vaccine https://www.vumc.org/viiii/infographics/how-does-mrna-vaccin... 5. https://www.uab.edu/news/health/item/12143-three-things-to-know-about-the-long-term-side-effects-of-covid-vaccines https://www.uab.edu/news/health/item/12143-three-things-to-k...
berkut 5y ago
There seems to be some evidence that having a longer duration between the first and second doses provides better long-term protection, i.e. gaps of 7+ weeks, compared to the 3+ weeks the US and Israel have generally done. NZ is currently thinking about increasing the gap to > 6 weeks because of this. I wonder how much that would affect things.
- graderjs 5y ago
  I heard that as well. My feeling is that with all the treatments we are deploying against the virus, one thing we are doing is creating a selective pressure, forcing it to evolve to promote more resistant and transmissible variants. Whether those transmissible variants also contain higher mortality might be a crapshoot game of chance, but I don't hear this sort of idea spouted a lot and I think it's worth considering. It might be similar to the way that antibiotics have helped select for 'treatment-resistant' 'superbugs'.
  - sneak 5y ago
    Increased transmission is worse than increased fatality rate, counterintuitively, as it's the same percentage deaths of a much much higher number infected - resulting in higher numbers of absolute deaths than if the CFR increased without an increase of transmissibility.
    - graderjs 5y ago
      Ah, that's a great and simple and direct explanation of that. Thanks, I'm gonna try to remember that.
  - hcknwscommenter 5y ago
    Vaccines are very different from antibiotics. Antibiotics are single molecules that bind a very specific target. A single mutation of a single protein can render an antibiotic useless. Vaccines induce the immune system to generate a repertoire of antibodies, each of which binds in a different way and each of which is then selected and "evolved" (hypermutation) for increased efficacy. And each individual person creates a different starting and ending repertoire of antibodies. A single mutation, or even a large group of mutations, does not so easily side step all this diversity of antibody types/binding modes. Moreover, we have evidence that the idea that vaccines increase the likelihood of variants is just wrong. We do not see that effect for mumps, polio, smallpox, or any other virus. Moreover, delta appears to have arisen in India, which at the time had vaccination rates very close to zero. Again, providing strong evidence that vaccines are not applying selective pressure for more virulent strains.
djmips 5y ago
One thing to ponder is that Israel used Pfizer and apparently Moderna, has a significantly better protection against Delta.
- bogomipz 5y ago
  That has not been established. You are referring to a preliminary study that has not been peer reviewed. See: https://www.independent.co.uk/news/world/americas/us-politics/fauci-moderna-pfizer-delta-variant-b1903301.html https://www.independent.co.uk/news/world/americas/us-politic...
oliv__ 5y ago
What I'm curious about is: what happens now? When everyone starts realizing that vaccines and masks can't fully contain a spread, what's the next logical step to take? Are people going to insist that you keep wearing your mask, take booster shots and live in fear for the next 50 years or are we going to collectively change our mindset from "Zero COVID" to accepting that COVID is just another risk factor in the world and move on?
- maxerickson 5y ago
  Getting booster shots to lessen the risk to people that are at greater risk from the virus isn't a huge imposition. We should make it easier for more people to do it (people that don't have sick leave or aren't sure they can take it and so on).
  - oliv__ 5y ago
    > Getting booster shots to lessen the risk to people that are at greater risk from the virus isn't a huge imposition. You may think so. I politely disagree.
    - cdrini 5y ago
      Care to contribute to the conversation and explain why? At risk populations do get eg the flu shot.
      - Gibbon1 5y ago
        I used to joke that I gotten so many tetanus shots that I can cure it by laying on of hands. But consider women, they have all sort of intrusive health related stuff imposed on them. They get pap smears, mammograms, then consider all the things that happen with pregnancy. And they just roll with it. Thing though, when I was reading about potential vaccines spring so 2020 people that knew what they were talking about were unsure if a third dose would be needed. Because there are a number of vaccines that require three doses. Also I've come to be suspicious of any argument that includes the demand that we not 'panic' or 'live in fear'. I'm beginning to see nothing but masculine anxiety/panic in that.
georgeplusplus 5y ago
Natural immunity also blunts delta but isn’t talked about in this article. I don’t understand why both can’t be allowed to work.
perryizgr8 5y ago
Isn't that kind of true even for the earlier variants? I personally know fully vaccinated people who got infected. Their symptoms were mild, and recovery was smooth. So yes, vaccination "blunted" but didn't defeat.
0xdeadb00f 5y ago
Vaccination doesn't "defeat" regular COVID as well (right?). You can still get COVID when vaccinated. The symptoms you get are less intense, and therefore transmission is less likely (though definitely still possible).
oseityphelysiol 5y ago
I wonder what is the mutation mode of viruses regarding vaccines? Does harsher environment (more people with immunity) spur mutation, or is mutation frequency correlating with number of infected people?
- gilbetron 5y ago
  The latter. Vaccines just affect the pathway variants take, but not the rate at which they mutate (they aren't bacteria and other life forms). And argument can be made that the vaccines create pathways to variants that wouldn't have been as viable without the existence of the vaccine, but that's relatively academic. A large population is what increases variant creation.
hestefisk 5y ago
Argh, this news is so exhausting it’s almost unbearable :(

102 points by sohkamyung 5y ago

jdhn 5y ago

Is this necessarily a bad thing? If it protects the vast majoriy of people from going into the hospital and they gain additional immunity from covid, then I don't really see a downside.

anyfoo 5y ago
A less effective vaccination keeps COVID around longer and farther than a more effective one, though, giving the virus more time and population surface to mutate into further variants. (But still less than no vaccination.) I'm not an expert in this, so I cannot say how significant that issue is, but this is at least one potential downside that I am seeing to the vaccination being weaker for that variant. EDIT: To clarify since some have misunderstood: I did not assert that the vaccination causes higher mutation, quite the opposite. I asserted that the absence of vaccination (entirely or effectively) gives more opportunity for mutation. I understand now that there are higher order effects that make this more complex.
- jdhn 5y ago
  That's a fair critique. I feel like I've heard concerns about the potential for the virus to mutate because of the high level of vaccinations, but like you, I don't know how significant of an issue that is.
  - tunesmith 5y ago
    I think the parent was talking about the lack of vaccinations yielding more time to mutate, not the vaccinations themselves. Viruses aren't like bacteria; they don't mutate in direct response to vaccines.
    - anyfoo 5y ago
      That is correct. My premise was that the more virus exists in absolute numbers (if the vaccine is weaker for the Delta variant), the more virus has the opportunity to mutate.
  - listless 5y ago
    I also have this concern. I haven’t seen it addressed anywhere and I am but a mere layperson.
  - smt88 5y ago
    What you've heard is misinformation. Vaccines reduce potential for mutation, which is both intuitive and borne out by data.
    - AndrewBissell 5y ago
      That's neither intuitive nor true in all cases. https://www.quantamagazine.org/how-vaccines-can-drive-pathogens-to-evolve-20180510/ https://www.quantamagazine.org/how-vaccines-can-drive-pathog...
  - addicted 5y ago
    The virus will not mutate because of the high level of vaccinations. The virus will mutate because of the high level of unvaccinated people. The risk is when the high level of unvaccinated are in the same population with a high level of vaccinated, of the many mutations in the unvaccinated there is a greater chance that a mutation that randomly has greater tolerance to the vaccines will be naturally selected and flourish. Vaccination does not lead to more mutations, but in the absence of vaccination, resistance to vaccines does not give a mutation any advantage, so whether it flourishes or not is based entirely on other attributes. It’s only when you do have a significant population of vaccinated does the mutations created in the unvax population benefit from resistance to vaccines.
    - velcii 5y ago
      >mutations created in the unvax population benefit from resistance to vaccines. I cannot see how this is correct. Because it should be the mutations created in the vaccinated that will help the virus to survive in similar vaccinated hosts..because first of all, the mutated virus need to survive in the vaccinated host, and become the dominant one in that host and thus giving it a better chance to jump to another host... So this mutations must be happening in Vaccinated hosts. In unvaccinated as you said, any mutations that gives the virus immune escape capability does not give it an advantage over the other mutations in the same host, simply because there is no vaccine generated antibodies to kill the other mutations, for it to gain dominance.
    - tunesmith 5y ago
      I haven't been able to get a straight answer to this even from scientists on science threads... Given the following: 1. Virus mutations do not directly react to the vaccine. These are simply random mutations. 2. If a mutation occurs that has a higher probability of escaping an existing vaccine, then in one unvaccinated person, that mutation has an identical chance of occurring whether that person is part of a 0% vaccinated community, a 50% vaccinated community, or a 99% vaccinated community. 3. Natural selection just means its ability to reproduce. Let's say that the mutation can escape the vaccine at 100% probability. Then: Can that virus spread equally regardless of whether it's a 0% vaccinated community, a 50% vaccinated community, or a 99% vaccinated community? Because it sure sounds like people are saying that in that scenario, the mutation spreads less in a 0% community, and more in a 50% community. Are they saying that in a "mostly unvaccinated" community, the other variants (that the vaccine protects against) that are more prevalent somehow serve to "crowd out" the mutation? Because I don't know if that's true - at least, I've seen reports that suggest that people can catch more than one variant at one time.
  - anyfoo 5y ago
    Just to clarify: That is not my concern.
- MisterBastahrd 5y ago
  It's going to mutate regardless of how many people are vaccinated. The entire point is to make it so that people don't have the runaway immune system responses that are melting lungs and brains.
  - anyfoo 5y ago
    Is that true? Intuitively, the more virus exists (in absolute numbers, even), the more virus may potentially mutate into worse variants. More infected people -> more individual virus instances, each with a given chance to mutate, and more time for that mutation to occur (because expired virus is replenished with fresh virus in available hosts; though you can probably fold this into higher virus numbers instead with the same result). I'm gladly corrected if I missed something!
    - totony 5y ago
      Variant that achieve immune escape from vaccine-induced immunity are bound to propagate at a faster rate if most people are vaccinated. Even if that variant is more lethal (from which you might expect a smaller R0), it might be prevalent because of an augmentation in R0 from vaccination (which might be lesser had people developed a more complete natural immunity).
  - suchire 5y ago
    The likelihood of mutation is directly proportional to how widespread a virus is multiplied by the amount of time it stays that way (more specifically, the area under the curve for infections over time). Vaccination and control of spread is critical to preventing further variants
    - totony 5y ago
      Likehood of mutation might be, but spread of variants is a more complicated function. Vaccination for sure might affect how likely one variant predominates against others. Considering cross-immunization between variants with natural immunity, it might be more efficient to refrain from vaccines to give cross-immunity with a weaker variant.
- weaksauce 5y ago
  the fact that the delta variant came from a country that didn't have widespread vaccines dispels this notion.
  - anyfoo 5y ago
    Seems perfectly in line with what I said? More virus, more time to mutate -> more mutations? I now understand that there are second order effects that make this more complex, but I don't see the contradiction right here.
    - weaksauce 5y ago
      I suppose either you edited it to change the text or the more likely event was that I misread it. yeah you're mostly correct and there are those second order effects too.
- jfoster 5y ago
  Is it analogous to flu? Do flu vaccines cause mutations as well? One interesting thing about covid is that it seems to be the first time humanity has collected so much data (eg. contact tracing, phylogenetics through genome sequencing, etc.) about this kind of virus, and applied modern medical knowledge in trying to combat it. It's very apparent that the overall response hasn't been nearly good enough, but it's probably also the best response there's ever been. (perhaps not the best ROI, though?)
  - anyfoo 5y ago
    > Do flu vaccines cause mutations as well? That is not what I have written, please reread!
- velcii 5y ago
  >But still less than no vaccination.. Can you share why you think the current vaccines will reduce the mutations when we already know that they only prevent symptoms (not even reduce viral load for some variants). So given that, why do you think the current vaccines will reduce the chances for virus to mutate. To me, it appears that the current vaccines will give the exact same chance for the virus to mutate, without the vaccine, but in addition also apply selection pressure to guide the evolution to gain immune escape. So the worst of both worlds.
pizza 5y ago
People are still dying from breakthrough cases. Children (w/o vaccine) are dying of delta. Not to go full scaremonger but we don't know that much about long covid at this point. Plus the CDC admits that there is likely an undercount of people who got COVID post-vaccination https://www.cdc.gov/vaccines/covid-19/health-departments/breakthrough-cases.html https://www.cdc.gov/vaccines/covid-19/health-departments/bre... It's an "ounce of prevention, pound of cure" type of situation
- jdhn 5y ago
  >Children (w/o vaccine) are dying of delta The number of children who are dying of covid has been ridiculously low for a virus that spreads so easily. Hasn't covid deaths for children under the age of 12 been under 1000 since the pandemic started?
  - koolba 5y ago
    It’s even lower if you factor in that the vast majority of those that died had existing underlying health issues. The level of social isolation the elderly have unilaterally imposed on the youth is a travesty.
    - themaninthedark 5y ago
      It's not the elderly that have been imposing isolation, they have all been sent to long term care homes to die. Our leaders however are not letting this crisis go to waste.
    - mikeyjk 5y ago
      Is this not a bit confused? The children being referred to would need supervision wouldn't they? They are also totally capable at spreading it to older people. I find a lot of the discourse / antilockdown sentiment to be really confusing. I understand lockdowns are a bad experience but are we not agreed that they save lives, and the quality of life (long covid)?
  - bob33212 5y ago
brodouevencode 5y ago
The pretense all along as far as I can tell from most countries has been one of "zero COVID". Meaning a total removal/extermination of the virus. Whether or not this was ever realistic is really the underlying debate that hasn't yet fully surfaced.
- hcknwscommenter 5y ago
  Of course it was realistic. China basically achieved it (I am not a China fan or defender), but the rest of the world failed. The whole world achieved it for the first SARS. However, that ship sailed a long time ago. Probably before the first surge in Italy of COVID-19.
  - deleted 5y ago
    [deleted]
  - brodouevencode 5y ago
    You have a lot more faith in the data coming out of China than I do. The CCP has lied from the beginning and attempted (successfully in most cases) to silence the researchers from the Wuhan lab that attempted to report early on.
  - jdminhbg 5y ago
    China didn’t really achieve Zero Covid if they exported it to the rest of the world. They may have stamped out some local outbreaks.
  - dragonwriter 5y ago
    > China basically achieved it No, it didn't. > (I am not a China fan or defender) Then why are you making B.S. “rah rah China” claims that even Chinese state media doesn't?
- legerdemain 5y ago
  Europeans learned to live with the bubonic plague, which has never been eradicated, and Native Americans, over time, overcame the smallpox that was introduced among them. The people of today can do the same with Covid. It is the only way.

danielodievich 5y ago

I am good friends with 3 doctors, and talk to them a lot about the amazing science behind the vaccines and the incredible speed with which those were designed and developed. All agree it was done at pretty much the software speed - custom designed on the computer in weeks and then built to order - and both them and I think it's pretty neat. It is very refreshing to talk to them because they, being good doctors, deal calmly and reasonably with probabilities rather than absolutes. Very early, even before general public could get vaccines, all 3 of them told me to expect something like that - the virus mutates, it is expected to develop, the mutation for reproductive number going up is likely to occur - and it did - and the vaccines will likely be needing to adjust. Even the highest levels of vaccination are no protection, and I am pretty tiny Israel in a sea of the largely unvaccinated is going to be swamped.

graderjs 5y ago
I don't know if we have this, but it would be good if we had a technology that enhanced your body's immune system to identify and kill viruses, rather than prime it to respond to a particular viral signal, that then may need to be updated as the virus changes (that's how I understand how vaccines work, but that could be false). You might think it's a subtle difference, but I think the former technology would be leaning into the body's existing ability to form a variety of antigens for viruses it encounters, and boosting its defense/offense against those, rather than 'handing out a series of police composite sketches', and saying 'Be On the Look Out for this specific guy, he might be coming through here.' The former could be more alike to enhancing predictive policing and profiling abilities, and beefing up response and enforcement capabilities.
- thatguy0900 5y ago
  Beefing up the immune system without garunteeing it something to do seems like a recipe for autoimmune disorders, no?
  - graderjs 5y ago
    Yeah, agree. It would be tricky. I'm hoping that by 'enhancing' the immune system you lean into its natural self-regulation equilibrium system and avoid that mostly--but then again autoimmune disorders seemingly emerge from those stasis systems going haywire, maybe without external poking...so it would be tricky for sure. I guess the intuition is that the human immune system is an incredibly sophisticated, evolving capability that over time, and over the mass population, can respond to become resilient against a wide array of pathogens. So if you could somehow capture the best of that (like, for illustration, take the immune system of the healthiest, most resilient person, 30 generations from now in the future) and convey that benefit to many other people, that would be truly awesome. Sort of like an idea of training an AI, more iterations are better, the immune system of any one person at any one point in time, might not be so great, but the best immune system of the population after encountering many pathogens, is going to be really great. How can we short circuit that "natural training" process and enhance the immune system? But I agree that attempts to do so might run the risk of creating or exacerbating autoimmune diseases...But I still think it's worth it.

refurb 5y ago

There were several prominent epidemiologists who said early on “Covid will end up like the flu, you’ll need a yearly vaccine, we’ll have new variants and we’ll get waves of infections through out the year”. And here we are.

smt88 5y ago
Except that it is still much more dangerous for unvaccinated people than the flu, which is an important distinction.
- bob33212 5y ago
  The original strain of the flu was also more deadly. But it eventually mutated and became less
  - ashildr 5y ago
    With that high number of young people dying of the flu back then you may say that the host mutated and became less susceptible to the original strain of the flu. Since SARS-CoV-2 seems to be especially dangerous for people after reproductive age I don‘t expect the same pressure as with flu. It may influence our inverted age pyramid, though. And it may have influence on the number of highly educated people >50 and older people with disposable income. (I belong in this group)
landemva 5y ago
I havent (needed) a flu shot in a couple decades. I'm not interested in yearly jabs. Better to lose the waist inches and high BMI. Few want the self-responsibility of healthy living. And I don't agree with headline of "grim", as it was obvious a year ago this was coming. Who lost any excess weight in the past year?
- brodouevencode 5y ago
  Not sure why you're getting downvoted. Comorbidity is a fundamental driving factor in whether or not you survive this virus. We've not heard any recommendations from any health agency suggesting a healthier lifestyle would help - it most certainly would statistically speaking. And 18 months in I doubt we'll see anything like that because it has proven to not be politically expedient. (FWIW Ive been intermittent fasting with some pretty good success)

loteck 5y ago

If we had effective treatments and OTC therapies for this illness, the pressure to vaccinate against every resurgence and new mutation would basically disappear. With so much social difficulty with vaccines, this seems like the most likely long term path. Where's my cherry flavored Covidquil?

smt88 5y ago
This is absolutely wrong. A vaccine is a fraction of the cost of treatment, and it has no long-term side effects. Even better, a vaccine reduces the chance for a virus to mutate. Treatments, even if they work, are going to have side effects, and there are still unknown risks from a severe (unvaccinated) infection anyway. Vaccines are a miracle of proactivity, and there's no reason to try to replace them with something expensive, risky, and reactive.
- cickpass_broken 5y ago
  the cost of these vaccines is largely hidden, no? Each country made deals behind closed doors AFAIK. I've seen some estimates of $12-$30 a shot, but have no idea the validity of this. How much do the treatments cost? Is it vastly different? > No long term side effects. How do you know? I thought the only study/data from Pfizer covered 6 months. That's not very long term? https://www.medrxiv.org/content/10.1101/2021.07.28.21261159v1.full-text https://www.medrxiv.org/content/10.1101/2021.07.28.21261159v... I don't think we need to replace vaccines, but large swathes of the population still don't have access. It seems very likely that a multi-modal approach would allow us to treat more people, faster. Even Pfizer sees vaccination as well as treatment as the path forward: https://www.pfizer.com/science/coronavirus/antiviral-efforts https://www.pfizer.com/science/coronavirus/antiviral-efforts
  - smt88 5y ago
    > How much do the treatments cost? Is it vastly different? An average hospitalization costs $73,000 in the US, according to data collected from insurance claims[1]. That means that a single hospitalization costs the same as vaccinating 2,400 people (using your $30/shot estimate). > How do you know? I thought the only study/data from Pfizer covered 6 months. That's not very long term? Although I'm not an expert, a friend of mine is getting his PhD studying the immune system and explained it to me this way: Any additional risk of mRNA vaccines would (with almost 100% certainty) occur shortly after vaccination[2], theorized to be as a result of a strong(er) immune response. After the immune response has subsided, the vaccinated person's immune system would be hard to distinguish from someone who received a traditional vaccine because the goal of the vaccines is the same: to teach the immune system what the virus looks like[3][4] without actually requiring an active virus. So to put that together, we can be fairly confident in an mRNA vaccine's long-term safety because its long-term effects are similar to other vaccines that we've studied for more than 100 years and because the mechanism of action subsides within a few months[5]. 1. https://www.fairhealth.org/article/costs-for-a-hospital-stay-for-covid-19 https://www.fairhealth.org/article/costs-for-a-hospital-stay... 2. https://www.muhealth.org/our-stories/how-do-we-know-covid-19-vaccine-wont-have-long-term-side-effects https://www.muhealth.org/our-stories/how-do-we-know-covid-19... 3. https://www.health.harvard.edu/blog/why-are-mrna-vaccines-so-exciting-2020121021599 https://www.health.harvard.edu/blog/why-are-mrna-vaccines-so... 4. https://www.vumc.org/viiii/infographics/how-does-mrna-vaccine-compare-traditional-vaccine https://www.vumc.org/viiii/infographics/how-does-mrna-vaccin... 5. https://www.uab.edu/news/health/item/12143-three-things-to-know-about-the-long-term-side-effects-of-covid-vaccines https://www.uab.edu/news/health/item/12143-three-things-to-k...

berkut 5y ago

There seems to be some evidence that having a longer duration between the first and second doses provides better long-term protection, i.e. gaps of 7+ weeks, compared to the 3+ weeks the US and Israel have generally done. NZ is currently thinking about increasing the gap to > 6 weeks because of this. I wonder how much that would affect things.

graderjs 5y ago
I heard that as well. My feeling is that with all the treatments we are deploying against the virus, one thing we are doing is creating a selective pressure, forcing it to evolve to promote more resistant and transmissible variants. Whether those transmissible variants also contain higher mortality might be a crapshoot game of chance, but I don't hear this sort of idea spouted a lot and I think it's worth considering. It might be similar to the way that antibiotics have helped select for 'treatment-resistant' 'superbugs'.
- sneak 5y ago
  Increased transmission is worse than increased fatality rate, counterintuitively, as it's the same percentage deaths of a much much higher number infected - resulting in higher numbers of absolute deaths than if the CFR increased without an increase of transmissibility.
  - graderjs 5y ago
    Ah, that's a great and simple and direct explanation of that. Thanks, I'm gonna try to remember that.
- hcknwscommenter 5y ago
  Vaccines are very different from antibiotics. Antibiotics are single molecules that bind a very specific target. A single mutation of a single protein can render an antibiotic useless. Vaccines induce the immune system to generate a repertoire of antibodies, each of which binds in a different way and each of which is then selected and "evolved" (hypermutation) for increased efficacy. And each individual person creates a different starting and ending repertoire of antibodies. A single mutation, or even a large group of mutations, does not so easily side step all this diversity of antibody types/binding modes. Moreover, we have evidence that the idea that vaccines increase the likelihood of variants is just wrong. We do not see that effect for mumps, polio, smallpox, or any other virus. Moreover, delta appears to have arisen in India, which at the time had vaccination rates very close to zero. Again, providing strong evidence that vaccines are not applying selective pressure for more virulent strains.

djmips 5y ago

One thing to ponder is that Israel used Pfizer and apparently Moderna, has a significantly better protection against Delta.

bogomipz 5y ago
That has not been established. You are referring to a preliminary study that has not been peer reviewed. See: https://www.independent.co.uk/news/world/americas/us-politics/fauci-moderna-pfizer-delta-variant-b1903301.html https://www.independent.co.uk/news/world/americas/us-politic...

oliv__ 5y ago

What I'm curious about is: what happens now? When everyone starts realizing that vaccines and masks can't fully contain a spread, what's the next logical step to take? Are people going to insist that you keep wearing your mask, take booster shots and live in fear for the next 50 years or are we going to collectively change our mindset from "Zero COVID" to accepting that COVID is just another risk factor in the world and move on?

maxerickson 5y ago
Getting booster shots to lessen the risk to people that are at greater risk from the virus isn't a huge imposition. We should make it easier for more people to do it (people that don't have sick leave or aren't sure they can take it and so on).
- oliv__ 5y ago
  > Getting booster shots to lessen the risk to people that are at greater risk from the virus isn't a huge imposition. You may think so. I politely disagree.
  - cdrini 5y ago
    Care to contribute to the conversation and explain why? At risk populations do get eg the flu shot.
    - Gibbon1 5y ago
      I used to joke that I gotten so many tetanus shots that I can cure it by laying on of hands. But consider women, they have all sort of intrusive health related stuff imposed on them. They get pap smears, mammograms, then consider all the things that happen with pregnancy. And they just roll with it. Thing though, when I was reading about potential vaccines spring so 2020 people that knew what they were talking about were unsure if a third dose would be needed. Because there are a number of vaccines that require three doses. Also I've come to be suspicious of any argument that includes the demand that we not 'panic' or 'live in fear'. I'm beginning to see nothing but masculine anxiety/panic in that.

georgeplusplus 5y ago

Natural immunity also blunts delta but isn’t talked about in this article. I don’t understand why both can’t be allowed to work.

perryizgr8 5y ago

Isn't that kind of true even for the earlier variants? I personally know fully vaccinated people who got infected. Their symptoms were mild, and recovery was smooth. So yes, vaccination "blunted" but didn't defeat.

0xdeadb00f 5y ago

Vaccination doesn't "defeat" regular COVID as well (right?). You can still get COVID when vaccinated. The symptoms you get are less intense, and therefore transmission is less likely (though definitely still possible).

oseityphelysiol 5y ago

I wonder what is the mutation mode of viruses regarding vaccines? Does harsher environment (more people with immunity) spur mutation, or is mutation frequency correlating with number of infected people?

gilbetron 5y ago
The latter. Vaccines just affect the pathway variants take, but not the rate at which they mutate (they aren't bacteria and other life forms). And argument can be made that the vaccines create pathways to variants that wouldn't have been as viable without the existence of the vaccine, but that's relatively academic. A large population is what increases variant creation.

hestefisk 5y ago

Argh, this news is so exhausting it’s almost unbearable :(