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> We could be getting even closer to stopping the spread of HIV/AIDS. Not if it's anything like the Covid-19 vaccines that don't stop someone from contracting

> We could be getting even closer to stopping the spread of HIV/AIDS. Not if it's anything like the Covid-19 vaccines that don't stop someone from contracting or spreading it.

echelon 5y ago
70% prevention is better than 0%, and something tells me that it will see a much higher rate of adoption than the Covid vaccine.
- dogma1138 5y ago
  PREP already gives you good prevention for this to work it needs to be both a therapeutic vaccine at least at stages at which PEP is no longer effective as well and or as being at least as effective as PREP whilst being more cost effective as an overall treatment. Also there is no chance that this would have a higher adoption rate than COVID unless it turns out to give 100% life time immunity and would end up being part of the National vaccination program world wide. This likely would have the same usage as PREP/PEP today so at risk individuals and a post exposure treatment.
- adamrezich 5y ago
  what makes you think so? how could the market for this be greater than the market for the covid vaccine? the number of people susceptible to covid is much greater than the number of people susceptible to HIV.
  - yakshaving_jgt 5y ago
    I think the general public’s perception of the consequences of infection are different depending on the disease. I think most people see it as “covid = bad cold; HIV = death”.
    - adamrezich 5y ago
      but surely more people would say "my lifestyle choices mean that I'm never going to be exposed to HIV so I don't need a vaccine for it" than ditto for covid?
      - yakshaving_jgt 5y ago
        I think unprotected sex is more common than many people in wealthy countries realise.
        adamrezich 5y ago
        sure but the set of all people who engage in frequent unprotected sex so as to be possibly susceptible to HIV is strictly smaller than the set of all people who could be possibly affected by covid.
        yakshaving_jgt 5y ago
        Yes, it is. I'm not sure how we're lost in translation here, so I'll try to express this another way. I think the majority of sexually promiscuous adults aren't particularly concerned about COVID infection, because the likelihood that they'll die from it is low. If they do catch it, they will most likely recover without long-term damage. I think those same adults however are indeed concerned about HIV infection, because it is [so far] incurable, and has an enormous social stigma attached to it, and without constant treatment will eventually kill you. The number of people who would benefit from a drug against COVID is larger than those who would benefit from a drug against HIV, however, of those who would buy either drug, I think the latter drug is the one that would have much higher market demand because of just how consequential an infection with that disease is.
        adamrezich 5y ago
        well, hopefully that market demand results in getting a drug that is more than adequate at what it's supposed to do, because I'd imagine the consequences would be much worse.
- iqanq 5y ago
gameswithgo 5y ago
The covid-19 vaccines were very effective at preventing disease and spread until the omicron mutation, which perhaps wouldn't have happened if not for vaccine hesitancy. (but that is an inevitable human nature thing, so you have to accept it and deal with) Fortunately the vaccines were still very effective at preventing death and hospitalization with omicron, I wonder how many lives were saved overall, so far? It is really quite remarkable. Given the slower way HIV spreads we have a much better chance at actually getting rid of it. Its not flying around in the air mutating in a billion people at once every day.
- Vrondi 5y ago
  But, HIV mutates super easily, which is why we do not already have a more traditional vaccine that works. It will be a greater challenge in this regard than COVID-19/Omicron, not an easier one.
  - woodruffw 5y ago
    Two observations: 1. Given the continued efficacy of the COVID-19 vaccines against severe illness, it stands to (lay-)reason that a similar outcome might occur with HIV. A world in which HIV is roughly as transmissible as it currently is (and is still responsive to other avenues of treatment/prevention, like PrEP) but where it does not cause fatal immunocompromization is an extremely preferable world. 2. We have no particular reason to believe that HIV's mutation vectors are more or less susceptible to the vectors that mRNA vaccines target, versus "traditional" vaccines.
- pokot0 5y ago
  As much as I'd like to blame them, the number of people who willingly refused the vaccine are irrelevant compared to those who do not have access to it.
  - tamcap 5y ago
    This is a valid point, but I think ignores amount of public health resources "spent" on trying to address vaccine hesitancy and healthcare resources addressing "unnecessary" hospitalization and complications. Now imagine we could cut the above in half, and then use some fraction of those savings (as a nation) promoting wider adoption of vaccines globally. If we've reached higher levels of vaccination earlier (in the USA), more people without access to the vaccine currently would've been able to get it.
thesis 5y ago
Not sure why you’re being downvoted all much… well actually no it’s pretty obvious. I think you’re right though. The current Covid-19 vaccines are proven to lose efficacy over time. Will the same thing happen with this one as well? It’s a good question.
- luckydata 5y ago
  because the point he's making is wrong. Vaccines are doing a fantastic job at slowing down the progression of the virus which is key to keep mutations at bay. No vaccine is 100% effective, but even 80% effectiveness radically changes the dynamic of a pandemic, it's so easy to see that I don't understand what can lead someone to deny this fact besides bad faith.
  - hn_throwaway_99 5y ago
    I wholeheartedly agree, I downvoted the comment because it appeared to be made in bad faith (and from another comment I posted on this topic, I obviously share the concern that this HIV vaccine may lose efficacy over time). Also, it's not hard to see how a vaccine for HIV would be much more effective at slowing pandemic progression than a vaccine for an airborne virus, even if the vaccines conferred the same benefits. Right now, if you get HIV, you are essentially contagious for life until you get on antiretrovirals that can bring your viral load to undetectable (and, you also need to be on those antiretrovirals for life). If an HIV vaccine prevented you from having a long term infection, it could potentially fully end the pandemic.
  - kbos87 5y ago
    Exactly. The COVID vaccines have been proven over and over again to reliably prevent serious illness across the original strain and every variant of concern we’ve seen since then. The fact that they initially also largely prevented infection against the original strain was a bonus that scientists were never counting on. Now, just because omicron is better at driving breakthrough infections, that fact is being used in bad faith by some who now say the vaccines “don’t work”, even though they are still as effective at preventing serious illness
  - 5y ago
luckydata 5y ago
There's a difference between "someone" and "no one" and "everyone". Someone with an engineering education should be able to understand that very easily, it's a shame you don't.
megaman821 5y ago
The Covid-19 vaccines were made against the original strain in which it was 95% effective. Let's see how the updated Omicron vaccine goes. I am guessing we are going to see above 90% effectiveness. mRNA vaccines are looking pretty promising at neutralizing the specific virus they are targeting. How effective that is for mutated and related viruses is what remains to be seen.
- marcosdumay 5y ago
  > How effective that is for mutated and related viruses is what remains to be seen. I imagine that depends much more on the virus than on the vaccine.
  - megaman821 5y ago
    Wouldn't it depend more on how well-chosen the target protein is? If it mutates too fast the vaccine won't be as effective. This says nothing about the effectiveness of the mRNA technique though, which seems to reliable induce an immune response to the target protein.
_6hmp 5y ago
it's defense in depth. if someone has HIV, they can be treated and if they are consistent with treatment they can have such a low (undetectable) viral load that it is not transmittable. (aka U=U) additionally, high risk populations (transactional sex, msm, intravenous drug users) can take the same drugs and be protected from the virus. (aka PREP) also people with known exposures or likely exposures can have post exposure prophylaxis with the same drugs (e.g. in the case of an accidental needle stick in a healthcare worker). These defenses have already radically slowed the spread and increased the lifespan and quality of life of those who become HIV positive. Now we will hopefully have a an additional defense that will be even easier (no daily dosing required for negative at-risk population) and probably much more broadly administered. I love the progress we are making with vaccines.
perardi 5y ago
…or it totally could, if it primes T-cells to fully clear the infection, or keep it to such a low level that the viral load is minimized. HIV has a tremendous latency period. It lurks for a long time before symptom onset. If a vaccine doesn't provide sterilizing immunity, but does prime T-lymphocytes to clear the virus, or keep it to an extremely low viral load, it would make people substantially less likely to spread the virus, or have symptomatic progression to AIDS. This is, of course, easier said than done. https://www.aidsmap.com/about-hiv/search-hiv-prevention-vaccine https://www.aidsmap.com/about-hiv/search-hiv-prevention-vacc...
solarkraft 5y ago
Car brakes are also ineffective because they don't prevent 100% of collisions, huh?
tehjoker 5y ago
No one in this thread knows anything about vaccines or infectious disease. Each organism is different and requires a detailed understanding to see what the potential for the vaccine is. You can't just take COVID-19's performance and project that onto another disease. mRNA allows the targeting of specific proteins. The efficacy of the T-cell and B-cell responses are going to be highly dependent on that protein's structure, its importance and level of conservation in the pathogen, and other factors. COVID-19 seems to require a persistently high level of neutralizing anti-bodies and the T-cell response seems to be less important (and also plays a role in auto-immunity). On the plus side, the wild-type vaccine has continued to be fairly effective against even highly mutated Omicron which is surprisingly good even if strategically, it is suboptimal that the virus has continued to mutate and evade the vaccine to ever greater degrees.
Ekaros 5y ago
I would be really worried with false sense of security when dealing with HIV/AIDS... Covid in the end is a mild thing, same can't really be said about HIV/AIDS. And if the protection is only temporary and partially it might be worse than having nothing at all if it leads to lot more risk taking.
erglkjklrh 5y ago
silver-arrow 5y ago
Why did you get flagged when you are absolutely correct. Why would you think that mRNA vaccines, which failed for so many years in testing, would presto work this time. and they clearly didn’t work this time, unless you drone around mumbling how thank god your symptoms would have been worse without it. As a matter of fact, the “trials’ during warp speed were so flawed to show efficacy it is pathetic. But these tech geeks here know better.

> We could be getting even closer to stopping the spread of HIV/AIDS. Not if it's anything like the Covid-19 vaccines that don't stop someone from contracting or spreading it.

echelon 5y ago

70% prevention is better than 0%, and something tells me that it will see a much higher rate of adoption than the Covid vaccine.

dogma1138 5y ago
PREP already gives you good prevention for this to work it needs to be both a therapeutic vaccine at least at stages at which PEP is no longer effective as well and or as being at least as effective as PREP whilst being more cost effective as an overall treatment. Also there is no chance that this would have a higher adoption rate than COVID unless it turns out to give 100% life time immunity and would end up being part of the National vaccination program world wide. This likely would have the same usage as PREP/PEP today so at risk individuals and a post exposure treatment.
adamrezich 5y ago
what makes you think so? how could the market for this be greater than the market for the covid vaccine? the number of people susceptible to covid is much greater than the number of people susceptible to HIV.
- yakshaving_jgt 5y ago
  I think the general public’s perception of the consequences of infection are different depending on the disease. I think most people see it as “covid = bad cold; HIV = death”.
  - adamrezich 5y ago
    but surely more people would say "my lifestyle choices mean that I'm never going to be exposed to HIV so I don't need a vaccine for it" than ditto for covid?
    - yakshaving_jgt 5y ago
      I think unprotected sex is more common than many people in wealthy countries realise.
      - adamrezich 5y ago
        sure but the set of all people who engage in frequent unprotected sex so as to be possibly susceptible to HIV is strictly smaller than the set of all people who could be possibly affected by covid.
        yakshaving_jgt 5y ago
        Yes, it is. I'm not sure how we're lost in translation here, so I'll try to express this another way. I think the majority of sexually promiscuous adults aren't particularly concerned about COVID infection, because the likelihood that they'll die from it is low. If they do catch it, they will most likely recover without long-term damage. I think those same adults however are indeed concerned about HIV infection, because it is [so far] incurable, and has an enormous social stigma attached to it, and without constant treatment will eventually kill you. The number of people who would benefit from a drug against COVID is larger than those who would benefit from a drug against HIV, however, of those who would buy either drug, I think the latter drug is the one that would have much higher market demand because of just how consequential an infection with that disease is.
        adamrezich 5y ago
        well, hopefully that market demand results in getting a drug that is more than adequate at what it's supposed to do, because I'd imagine the consequences would be much worse.
iqanq 5y ago

gameswithgo 5y ago

The covid-19 vaccines were very effective at preventing disease and spread until the omicron mutation, which perhaps wouldn't have happened if not for vaccine hesitancy. (but that is an inevitable human nature thing, so you have to accept it and deal with) Fortunately the vaccines were still very effective at preventing death and hospitalization with omicron, I wonder how many lives were saved overall, so far? It is really quite remarkable. Given the slower way HIV spreads we have a much better chance at actually getting rid of it. Its not flying around in the air mutating in a billion people at once every day.

Vrondi 5y ago
But, HIV mutates super easily, which is why we do not already have a more traditional vaccine that works. It will be a greater challenge in this regard than COVID-19/Omicron, not an easier one.
- woodruffw 5y ago
  Two observations: 1. Given the continued efficacy of the COVID-19 vaccines against severe illness, it stands to (lay-)reason that a similar outcome might occur with HIV. A world in which HIV is roughly as transmissible as it currently is (and is still responsive to other avenues of treatment/prevention, like PrEP) but where it does not cause fatal immunocompromization is an extremely preferable world. 2. We have no particular reason to believe that HIV's mutation vectors are more or less susceptible to the vectors that mRNA vaccines target, versus "traditional" vaccines.
pokot0 5y ago
As much as I'd like to blame them, the number of people who willingly refused the vaccine are irrelevant compared to those who do not have access to it.
- tamcap 5y ago
  This is a valid point, but I think ignores amount of public health resources "spent" on trying to address vaccine hesitancy and healthcare resources addressing "unnecessary" hospitalization and complications. Now imagine we could cut the above in half, and then use some fraction of those savings (as a nation) promoting wider adoption of vaccines globally. If we've reached higher levels of vaccination earlier (in the USA), more people without access to the vaccine currently would've been able to get it.

thesis 5y ago

Not sure why you’re being downvoted all much… well actually no it’s pretty obvious. I think you’re right though. The current Covid-19 vaccines are proven to lose efficacy over time. Will the same thing happen with this one as well? It’s a good question.

luckydata 5y ago
because the point he's making is wrong. Vaccines are doing a fantastic job at slowing down the progression of the virus which is key to keep mutations at bay. No vaccine is 100% effective, but even 80% effectiveness radically changes the dynamic of a pandemic, it's so easy to see that I don't understand what can lead someone to deny this fact besides bad faith.
- hn_throwaway_99 5y ago
  I wholeheartedly agree, I downvoted the comment because it appeared to be made in bad faith (and from another comment I posted on this topic, I obviously share the concern that this HIV vaccine may lose efficacy over time). Also, it's not hard to see how a vaccine for HIV would be much more effective at slowing pandemic progression than a vaccine for an airborne virus, even if the vaccines conferred the same benefits. Right now, if you get HIV, you are essentially contagious for life until you get on antiretrovirals that can bring your viral load to undetectable (and, you also need to be on those antiretrovirals for life). If an HIV vaccine prevented you from having a long term infection, it could potentially fully end the pandemic.
- kbos87 5y ago
  Exactly. The COVID vaccines have been proven over and over again to reliably prevent serious illness across the original strain and every variant of concern we’ve seen since then. The fact that they initially also largely prevented infection against the original strain was a bonus that scientists were never counting on. Now, just because omicron is better at driving breakthrough infections, that fact is being used in bad faith by some who now say the vaccines “don’t work”, even though they are still as effective at preventing serious illness
- 5y ago

luckydata 5y ago

There's a difference between "someone" and "no one" and "everyone". Someone with an engineering education should be able to understand that very easily, it's a shame you don't.

megaman821 5y ago

The Covid-19 vaccines were made against the original strain in which it was 95% effective. Let's see how the updated Omicron vaccine goes. I am guessing we are going to see above 90% effectiveness. mRNA vaccines are looking pretty promising at neutralizing the specific virus they are targeting. How effective that is for mutated and related viruses is what remains to be seen.

marcosdumay 5y ago
> How effective that is for mutated and related viruses is what remains to be seen. I imagine that depends much more on the virus than on the vaccine.
- megaman821 5y ago
  Wouldn't it depend more on how well-chosen the target protein is? If it mutates too fast the vaccine won't be as effective. This says nothing about the effectiveness of the mRNA technique though, which seems to reliable induce an immune response to the target protein.

_6hmp 5y ago

it's defense in depth. if someone has HIV, they can be treated and if they are consistent with treatment they can have such a low (undetectable) viral load that it is not transmittable. (aka U=U) additionally, high risk populations (transactional sex, msm, intravenous drug users) can take the same drugs and be protected from the virus. (aka PREP) also people with known exposures or likely exposures can have post exposure prophylaxis with the same drugs (e.g. in the case of an accidental needle stick in a healthcare worker). These defenses have already radically slowed the spread and increased the lifespan and quality of life of those who become HIV positive. Now we will hopefully have a an additional defense that will be even easier (no daily dosing required for negative at-risk population) and probably much more broadly administered. I love the progress we are making with vaccines.

perardi 5y ago

…or it totally could, if it primes T-cells to fully clear the infection, or keep it to such a low level that the viral load is minimized. HIV has a tremendous latency period. It lurks for a long time before symptom onset. If a vaccine doesn't provide sterilizing immunity, but does prime T-lymphocytes to clear the virus, or keep it to an extremely low viral load, it would make people substantially less likely to spread the virus, or have symptomatic progression to AIDS. This is, of course, easier said than done. https://www.aidsmap.com/about-hiv/search-hiv-prevention-vaccine https://www.aidsmap.com/about-hiv/search-hiv-prevention-vacc...

solarkraft 5y ago

Car brakes are also ineffective because they don't prevent 100% of collisions, huh?

tehjoker 5y ago

No one in this thread knows anything about vaccines or infectious disease. Each organism is different and requires a detailed understanding to see what the potential for the vaccine is. You can't just take COVID-19's performance and project that onto another disease. mRNA allows the targeting of specific proteins. The efficacy of the T-cell and B-cell responses are going to be highly dependent on that protein's structure, its importance and level of conservation in the pathogen, and other factors. COVID-19 seems to require a persistently high level of neutralizing anti-bodies and the T-cell response seems to be less important (and also plays a role in auto-immunity). On the plus side, the wild-type vaccine has continued to be fairly effective against even highly mutated Omicron which is surprisingly good even if strategically, it is suboptimal that the virus has continued to mutate and evade the vaccine to ever greater degrees.

Ekaros 5y ago

I would be really worried with false sense of security when dealing with HIV/AIDS... Covid in the end is a mild thing, same can't really be said about HIV/AIDS. And if the protection is only temporary and partially it might be worse than having nothing at all if it leads to lot more risk taking.

erglkjklrh 5y ago

silver-arrow 5y ago

Why did you get flagged when you are absolutely correct. Why would you think that mRNA vaccines, which failed for so many years in testing, would presto work this time. and they clearly didn’t work this time, unless you drone around mumbling how thank god your symptoms would have been worse without it. As a matter of fact, the “trials’ during warp speed were so flawed to show efficacy it is pathetic. But these tech geeks here know better.