4 ms·

Why use vaccines in a highly targeted way instead of giving it to everyone?

criticaltinker 5y ago
Because mass vaccination combined with a vaccine that does not necessarily prevent infection and transmission creates selective pressure that is likely to further enhance the fitness of the virus and will lead to variants that escape the immune response in both vaccinated and naturally infected individuals. Excerpts from [1]: - "The spike protein receptor-binding domain (RBD) of SARS-CoV-2 is the molecular target for many vaccines and antibody-based prophylactics aimed at bringing COVID-19 under control." - "Such a narrow molecular focus raises the specter of viral immune evasion as a potential failure mode for these biomedical interventions. With the emergence of new strains of SARS-CoV-2 with altered transmissibility and immune evasion potential, a critical question is this: how easily can the virus escape neutralizing antibodies (nAbs) targeting the spike RBD?" - "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." - "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 (April 2021) https://pubmed.ncbi.nlm.nih.gov/33909660/ https://pubmed.ncbi.nlm.nih.gov/33909660/
- HeroOfAges 5y ago
  Glad to see you're not getting downvoted for this. This line of thought and information will be dismissed as a conspiracy theory and will follow the same arc as the lab leak hypothesis. Meaning there will be attempts to discredit it with no more than appeals to authority until the truth becomes impossible to ignore.
- vkou 5y ago
  > Because mass vaccination combined with a vaccine that does not necessarily prevent infection and transmission creates selective pressure that is likely to further enhance the fitness of the virus and will lead to variants that escape the immune response in both vaccinated and naturally infected individuals. And yet, the Delta variant evolved in an 100% unvaccinated population - and is quite happily punching through some of the protections afforded by vaccines, despite not having any evolutionary pressure to do so. > "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" Doesn't this mean that the problem is in having a large number of infected individuals? Which is exactly what happens when a virus sweeps through the unvaccinated population - see, delta. Also, since Covid and its variants seems to happily re-infect people who have already had it, the same evolutionary pressures will still be present, as long as there's a large reservoir of sick people, regardless of whether they are rubbing shoulders with vaccinated individuals, or 'caught it eight months ago' individuals. We have two broad options for reducing the number of dangerous COVID mutations. 1. Harsh lockdowns, Australia/NZ/China style, to bring cases down. It works, but everyone hates it. 2. Mass vaccination, that gets us to herd immunity against the most prevalent strains of COVID, so that we no longer have millions of active cases. We're not there with 50% of the population vaccinated. We might be there if we were at 85%. Since you seem to think that #2 is not the solution, what is your plan for stopping the evolution of the virus? #1?
  - walterbell 5y ago
    Why should already-immune, recovered people be vaccinated?
    - munk-a 5y ago
      Vaccination has shown better health outcomes even in already infected persons[1] - getting both is the best protection and there is no rational reason to refuse the vaccine. 1. https://jamanetwork.com/journals/jama/fullarticle/2782139 https://jamanetwork.com/journals/jama/fullarticle/2782139
- bertil 5y ago
  That’s an argument for alternative measures than vaccines (isolation, disinfection) but not against population-wide vaccination. If you can’t identify all cases, you want as many people as possible vaccinated to limit the overall spread.
sethammons 5y ago
Same reason why antibacterial soap has led to the rise of antibiotic resistant infections

Because mass vaccination combined with a vaccine that does not necessarily prevent infection and transmission creates selective pressure that is likely to further enhance the fitness of the virus and will lead to variants that escape the immune response in both vaccinated and naturally infected individuals. Excerpts from [1]: - "The spike protein receptor-binding domain (RBD) of SARS-CoV-2 is the molecular target for many vaccines and antibody-based prophylactics aimed at bringing COVID-19 under control." - "Such a narrow molecular focus raises the specter of viral immune evasion as a potential failure mode for these biomedical interventions. With the emergence of new strains of SARS-CoV-2 with altered transmissibility and immune evasion potential, a critical question is this: how easily can the virus escape neutralizing antibodies (nAbs) targeting the spike RBD?" - "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." - "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 (April 2021) https://pubmed.ncbi.nlm.nih.gov/33909660/ https://pubmed.ncbi.nlm.nih.gov/33909660/

HeroOfAges 5y ago
Glad to see you're not getting downvoted for this. This line of thought and information will be dismissed as a conspiracy theory and will follow the same arc as the lab leak hypothesis. Meaning there will be attempts to discredit it with no more than appeals to authority until the truth becomes impossible to ignore.
vkou 5y ago
> Because mass vaccination combined with a vaccine that does not necessarily prevent infection and transmission creates selective pressure that is likely to further enhance the fitness of the virus and will lead to variants that escape the immune response in both vaccinated and naturally infected individuals. And yet, the Delta variant evolved in an 100% unvaccinated population - and is quite happily punching through some of the protections afforded by vaccines, despite not having any evolutionary pressure to do so. > "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" Doesn't this mean that the problem is in having a large number of infected individuals? Which is exactly what happens when a virus sweeps through the unvaccinated population - see, delta. Also, since Covid and its variants seems to happily re-infect people who have already had it, the same evolutionary pressures will still be present, as long as there's a large reservoir of sick people, regardless of whether they are rubbing shoulders with vaccinated individuals, or 'caught it eight months ago' individuals. We have two broad options for reducing the number of dangerous COVID mutations. 1. Harsh lockdowns, Australia/NZ/China style, to bring cases down. It works, but everyone hates it. 2. Mass vaccination, that gets us to herd immunity against the most prevalent strains of COVID, so that we no longer have millions of active cases. We're not there with 50% of the population vaccinated. We might be there if we were at 85%. Since you seem to think that #2 is not the solution, what is your plan for stopping the evolution of the virus? #1?
- walterbell 5y ago
  Why should already-immune, recovered people be vaccinated?
  - munk-a 5y ago
    Vaccination has shown better health outcomes even in already infected persons[1] - getting both is the best protection and there is no rational reason to refuse the vaccine. 1. https://jamanetwork.com/journals/jama/fullarticle/2782139 https://jamanetwork.com/journals/jama/fullarticle/2782139
bertil 5y ago
That’s an argument for alternative measures than vaccines (isolation, disinfection) but not against population-wide vaccination. If you can’t identify all cases, you want as many people as possible vaccinated to limit the overall spread.

sethammons 5y ago

Same reason why antibacterial soap has led to the rise of antibiotic resistant infections