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>It's true that South Africa is largely unvaccinated, but seroprevalence is over 70%, making it one of the most immunized places on earth. OP was suggesting in

by yyyk 5y ago

>It's true that South Africa is largely unvaccinated, but seroprevalence is over 70%, making it one of the most immunized places on earth. OP was suggesting intentionally limiting vaccination. If 'natural' immunity can also allow for antibody-evading mutations, than we get nothing from limiting vaccinations - my point exactly. >Considering that even the most highly vaccinated places on earth are shattering records of infection rates, it seems implausible that vaccinating the rest of the world would somehow fix this issue. We cannot make mutation never happen, but we can limit the damage by vaccinating more. This will help us gain time to get more effective medications.

incrudible 5y ago
> If 'natural' immunity can also allow for antibody-evading mutations, than we get nothing from limiting vaccinations - my point exactly. No, that doesn't follow. Vaccines target a spike protein specifically, hence selecting for a variant that defeats that particular kind of immunity, making vaccines obsolete for those that need them the most. This is a hypothetical vaccine-escape variant, not this Omicron variant. We know nothing about its actual capability for vaccine-escape. Natural immunity targets the whole virus, so whatever immune-escape such a virus evolves, it would have to be far more comprehensive to have a significant effect. We may or may not have that in this particular variant and we're still at the very beginning of that wave: https://pbs.twimg.com/media/FFGNLl3XMAsNQXE?format=jpg&name=medium https://pbs.twimg.com/media/FFGNLl3XMAsNQXE?format=jpg&name=...
- yyyk 5y ago
  >Vaccines target a spike protein specifically... Natural immunity targets the whole virus, so whatever immune-escape such a virus evolves, it would have to be far more comprehensive A virus avoiding spike antibodies would have an advantage whether these antibodies were 'natural' or not, so it's far from clear natural immunity wouldn't lead to the same mutations - all the VOCs hail from mostly unvaxed countries, which leads to the suspicion that it does. Sure, the 'naturally immune' sick people having extra N-targeting antibodies would be in an advantage vs the virus, but the cost of that is having a real corona infection earlier on, with all the risk simply being frontloaded. * EDIT: the Chinese vaccines are inactivated virus vaccines. One wonders whether they fare better or worse vs this variant. Then again, maybe this variant will fail to transmit effectively and will just kill itself off like Beta did.
  - incrudible 5y ago
    All previous VOCs hail from a timeframe when there weren't any vaccines rolled out yet. The highly vaccinated countries made up for a small share of the world population over the entire timeframe in which mutations have arisen. In other words, there's no good control group here. > Sure, the 'naturally immune' sick people having extra N-targeting antibodies would be in an advantage vs the virus, but the cost of that is having a real corona infection earlier on, with all the risk simply being frontloaded. It's not a binary, when people get vaccinated and then infected (or vice versa), they do develop broader immunity. Frontloading the risk of infection versus vaccination may well be justified in the young and healthy population, but that opinion has been ostracized from the mainstream. > the Chinese vaccines are inactivated virus vaccines. One wonders whether they fare better or worse vs this variant. Not all of them are, but CoronaVac is. This[1] suggests that while efficacy of CoronVac against wild-type infection was modest (51%), the reduction when confronted with Gamma was very small (49.6%). > Then again, maybe this variant will fail to transmit effectively and will just kill itself off like Beta did. Beta didn't "kill itself off", it led to wave that rivaled Delta/Gamma in some cases. It ended up being outcompeted by Delta/Gamma. [1] https://www.who.int/news-room/feature-stories/detail/the-sinovac-covid-19-vaccine-what-you-need-to-know https://www.who.int/news-room/feature-stories/detail/the-sin...
    - yyyk 5y ago
      >In other words, there's no good control group here. There isn't. We have to theorize on the move, so to speak. >Frontloading the risk of infection versus vaccination may well be justified in the young and healthy population, but that opinion has been ostracized from the mainstream. The problem is that people took the wrong assumptions when calculating the risk of disease. All our calculations of risk are based on hospital treatment being available: providing Oxygen, Dexamethasone and ECMO treatment to critically ill patients, and no extra deaths due to healthcare overload. No scenario when we 'let it rip' involves being able to give Oxygen to all young people who need it, and there will be extra deaths due to overload. The clever people suggesting intentional infection assumed risk factors dependent on current policies without understanding that under their policies risk would shoot up. >Beta didn't "kill itself off", it led to wave that rivaled Delta/Gamma in some cases. It ended up being outcompeted by Delta/Gamma. That's functionally equivalent to 'killing itself off', or at least being much less of a threat. I recall Beta's transmission factor was lower than Alpha? Was it because it missed some key mutations, or because mutating to avoid immunity came with a cost?
- EMM_386 5y ago
  > Natural immunity targets the whole virus, so whatever immune-escape such a virus evolves, it would have to be far more comprehensive to have a significant effect. I never thought about it that way. That would mean, if the virus evolves a more efficient ACE-2 binding domain that the mRNA vaccines fail to recognize, the vaccinated population would be more at risk than the unvaccinated population who has been previously exposed.

by yyyk 5y ago

incrudible 5y ago

> If 'natural' immunity can also allow for antibody-evading mutations, than we get nothing from limiting vaccinations - my point exactly. No, that doesn't follow. Vaccines target a spike protein specifically, hence selecting for a variant that defeats that particular kind of immunity, making vaccines obsolete for those that need them the most. This is a hypothetical vaccine-escape variant, not this Omicron variant. We know nothing about its actual capability for vaccine-escape. Natural immunity targets the whole virus, so whatever immune-escape such a virus evolves, it would have to be far more comprehensive to have a significant effect. We may or may not have that in this particular variant and we're still at the very beginning of that wave: https://pbs.twimg.com/media/FFGNLl3XMAsNQXE?format=jpg&name=medium https://pbs.twimg.com/media/FFGNLl3XMAsNQXE?format=jpg&name=...

yyyk 5y ago
>Vaccines target a spike protein specifically... Natural immunity targets the whole virus, so whatever immune-escape such a virus evolves, it would have to be far more comprehensive A virus avoiding spike antibodies would have an advantage whether these antibodies were 'natural' or not, so it's far from clear natural immunity wouldn't lead to the same mutations - all the VOCs hail from mostly unvaxed countries, which leads to the suspicion that it does. Sure, the 'naturally immune' sick people having extra N-targeting antibodies would be in an advantage vs the virus, but the cost of that is having a real corona infection earlier on, with all the risk simply being frontloaded. * EDIT: the Chinese vaccines are inactivated virus vaccines. One wonders whether they fare better or worse vs this variant. Then again, maybe this variant will fail to transmit effectively and will just kill itself off like Beta did.
- incrudible 5y ago
  All previous VOCs hail from a timeframe when there weren't any vaccines rolled out yet. The highly vaccinated countries made up for a small share of the world population over the entire timeframe in which mutations have arisen. In other words, there's no good control group here. > Sure, the 'naturally immune' sick people having extra N-targeting antibodies would be in an advantage vs the virus, but the cost of that is having a real corona infection earlier on, with all the risk simply being frontloaded. It's not a binary, when people get vaccinated and then infected (or vice versa), they do develop broader immunity. Frontloading the risk of infection versus vaccination may well be justified in the young and healthy population, but that opinion has been ostracized from the mainstream. > the Chinese vaccines are inactivated virus vaccines. One wonders whether they fare better or worse vs this variant. Not all of them are, but CoronaVac is. This[1] suggests that while efficacy of CoronVac against wild-type infection was modest (51%), the reduction when confronted with Gamma was very small (49.6%). > Then again, maybe this variant will fail to transmit effectively and will just kill itself off like Beta did. Beta didn't "kill itself off", it led to wave that rivaled Delta/Gamma in some cases. It ended up being outcompeted by Delta/Gamma. [1] https://www.who.int/news-room/feature-stories/detail/the-sinovac-covid-19-vaccine-what-you-need-to-know https://www.who.int/news-room/feature-stories/detail/the-sin...
  - yyyk 5y ago
    >In other words, there's no good control group here. There isn't. We have to theorize on the move, so to speak. >Frontloading the risk of infection versus vaccination may well be justified in the young and healthy population, but that opinion has been ostracized from the mainstream. The problem is that people took the wrong assumptions when calculating the risk of disease. All our calculations of risk are based on hospital treatment being available: providing Oxygen, Dexamethasone and ECMO treatment to critically ill patients, and no extra deaths due to healthcare overload. No scenario when we 'let it rip' involves being able to give Oxygen to all young people who need it, and there will be extra deaths due to overload. The clever people suggesting intentional infection assumed risk factors dependent on current policies without understanding that under their policies risk would shoot up. >Beta didn't "kill itself off", it led to wave that rivaled Delta/Gamma in some cases. It ended up being outcompeted by Delta/Gamma. That's functionally equivalent to 'killing itself off', or at least being much less of a threat. I recall Beta's transmission factor was lower than Alpha? Was it because it missed some key mutations, or because mutating to avoid immunity came with a cost?
EMM_386 5y ago
> Natural immunity targets the whole virus, so whatever immune-escape such a virus evolves, it would have to be far more comprehensive to have a significant effect. I never thought about it that way. That would mean, if the virus evolves a more efficient ACE-2 binding domain that the mRNA vaccines fail to recognize, the vaccinated population would be more at risk than the unvaccinated population who has been previously exposed.