11 ms·

One reason is that mRNA vaccines can be developed much faster than traditional vaccines. So the idea is you have a better chance of "outrunning" a strain.

Vrondi 5y ago
- ausudhz 5y ago
  So you think for other vaccine you know the "long term effects" What you define as "long term"? Because in my definition, in the "long term" we're all dead. The "long term" effects of many pathologies is also death for example.
  - ceejayoz 5y ago
    > Because in my definition, in the "long term" we're all dead. My wife's studio got a "everyone who takes the vaccine will die!" pamphlet pushed under the door, which gave us a good chuckle.
- mlyle 5y ago
  Three things: - This isn't really the reason why mRNA is attractive here (see my other comment above). (Though, ability to iterate/try many protein combinations quickly in animal models was helpful). - Almost no drugs or treatments do we really know the long term picture of. Running studies in a way that lets you detect effects far later in life isn't practical. - When we're talking about treatments to prevent severe disease, bounding the consequences to be very, very likely to be well below the consequences of the virus times the likely infection chance is "good enough".
  - ausudhz 5y ago
    Not to mention the long term effects of COVID are known and way worst that what a vaccine can give you. Vaccine are building an immune response, they're not drugs that try to cope the symptoms (eg. Panadol) and they are the safest drugs out there. Is so interesting how people eat Panadol and many other drugs like candies (without reading the KNOWN side effects - which are also nasty), while they focus so much on things they know nothing about thinking that has mysterious "long term effects"
    - epgui 5y ago
      Exactly this. I would rather take the "most unsafe" vaccine of the last 30 years than take an Advil. (I am a biochemist)
      - abletonlive 5y ago
        Could you elaborate on why you wouldn't take advil?
        mlyle 5y ago
        Not the poster. Advil is pretty safe, but sometimes has horrific effects (e.g. Stevens Johnson Syndrome, catastrophic stomach bleeding, etc.) Also, NSAIDs are shown to slow healing from injury in most cases. Ibuprofen is terrifically useful but also a little scary for something we use so routinely. e.g. some parents gave their 7 year old a motrin, and all her skin sloughed off her body and she had brain damage and lost 80% of her lung function. https://www.cbsnews.com/news/jury-awards-63m-to-samantha-reckis-girl-who-lost-skin-after-taking-motrin/#:~:text=Samantha%20was%207%20when%20she,and%20was%20blinded%2C%20he%20said https://www.cbsnews.com/news/jury-awards-63m-to-samantha-rec....
        refurb 5y ago
        That’s ridiculous since SJS and TENS can happen with pretty much any drug. And fatal anaphylactic reactions to vaccines aren’t atypical.
        wolverine876 5y ago
        How is atypical defined? They are very rare for the COVID-19 vaccines.
        refurb 5y ago
        So is SJS and TENS.
- vmception 5y ago
  mRNA treatments likely will accelerate the trial process because their purview is so limited, compared to other molecule based treatments. So more likely you’ll just get over a shorter release cycle and the longer one gets deprecated, relegated to certain style of treatment that mRNA based investment and research will run laps around anyway, further pushing people to evaluate and prioritize mRNA versions. You can try to hold out for an arbitrary threshold of “long term” for your own comfort level. Its accurate that the state wont be helping you. mRNA is like a file for a 3D printer, telling the body what to print for. Other styles of treatments were showing the body the payload. We will definitely learn how often we can get the body to do this, but I wouldn't call it an inferior beta status. Its just as good (or bad) as the longer process for different kinds of treatment. Same efficacy, which allows me personally to not focus on that.
- epgui 5y ago
  You're vastly overestimating the potential harms caused by vaccines.
- tylerhou 5y ago
  Knowing long-term effects (1+ years) is not a precondition of approval for most vaccines. It just so happens that vaccines usually take a long time for approval, so we end up knowing long-term effects as a side effect. This is because there generally isn't a known mechanism for vaccines to have long term effects. Not ruling out the possibility, but we understand how vaccines work pretty well. Also, most vaccines are subject to a cost/benefit analysis anyway (we don't give the rabies vaccine out to everyone) so the miniscule chance of having long term effects has to be weighed against the much more likely long term effects of the disease.
  - ifyoubuildit 5y ago
    > This is because there generally isn't a known mechanism for vaccines to have long term effects. I know a lot of people believe this, but as a developer who regularly deploys code to production, this mindset blows me away. I'm not saying that being a developer means I know anything about this. I'm well aware of my (our? I don't know what you do) peoples habit of thinking being good at our craft means we're also somehow suddenly good at others. But if I told someone that I don't need to know the effects of v7.1.3 before patching it because I can't think of a mechanism for it going wrong, and besides, we already released all those other versions and they were fine, I'd hopefully be fired. I get it, software and medicine are different things, and some things just aren't practical in meat space, but the mindset around testing is something that I think will always be difficult for me to understand after being in this occupation for so long.
    - copperx 5y ago
      I'm pretty sure understanding the biology behind it all can help make predictions about the outcome in the same way that you know that merging a pull request isn't going to bring the entire internet down. I mean, it could. But there's no known mechanism that will trigger such an event. That reminds me of the first atomic bomb test. We weren't 100% sure that the atmosphere wasn't going to ignite with an atomic bomb, but those that knew the physics knew it was almost impossible. > "If, after calculation, [Compton] said, it were proved that the chances were more than approximately three in one million that the earth would be vaporized by the atomic explosion, he would not proceed with the project. Calculation proved the figures slightly less -- and the project continued." https://www.insidescience.org/manhattan-project-legacy/atmosphere-on-fire https://www.insidescience.org/manhattan-project-legacy/atmos...
- Jenk 5y ago
  you'd rather the long term effects of HIV? What a bizzarely banal thing to post.
- arcticbull 5y ago
  Generally the long pole in vaccine approval is showing that it works - not that it's safe. If there's only a handful of cases worldwide, say for Ebola, then you have to vaccinate a few thousand people and wait for a period where a statistically significant portion would have caught the disease and then didn't. This can be years. There's only a few cases per year, you can't just give a bunch of people Ebola to see if the vaccine works. They're not waiting for 'long-term side effects' to show up, they know they don't exist. However, with HIV as with COVID, there's a pretty significant installed base around the country so showing that it works isn't really a challenge. Usually only a few thousand or tens of thousands of folks participate in basically any drug trial, btw. We very well understand the risk profile of mRNA vaccines at this point, having deployed billions of them and studied the technology for 40+ years. And having studied vaccines for upwards of 300 years.
- glitchc 5y ago
  Seems to be an okay strategy for software…
- AussieWog93 5y ago
  This is such an out of touch comment. I ask that you please speak to some people in South Africa or Botswana where almost 20% of the population live with HIV, including children (both victims of rape - there was and still is the belief that having sex with a virgin can cure AIDS - and children of HIV-positive mothers who were born with the condition). It's beyond inhuman, and if such a vaccine were to work it would be as impactful as the eradication of Polio (yes, I know it still exists in some places) or Smallpox.
f6v 5y ago
I think slowly will come the realization that mRNA vaccines aren’t as fast to develop as people thought. Sputnik/AstraZeneca vaccines were released almost at the same time as Moderna/Pfizer. Yes, the latter were first commercial mRNA vaccines, but the technology is nevertheless rather mature. I watched a lecture by the people credited with creating mRNA vaccines and it turns out people have been working on the technology for decades. Now, the thing is that you can’t just sequence a virus, do bioinformatics, synthesize mRNA and package it into a nano particle. I mean, you can, but chances are it’s going to fail like the CureVac vaccine. The mRNA that gets packaged needs to be modified (I believe with alternative bases) to achieve desired effect. If mRNA vaccine was as magical as it was marketed, we wouldn’t be getting 3-4(and soon 5?) doses of the same vaccine with the emergence of new variants. Rather, there would be delta- and omicron-specific vaccine.
- glial 5y ago
  > Rather, there would be delta- and omicron-specific vaccine. I think there are -- they just haven't made it through the trials and approval processes yet. These are press releases from Pfizer for whatever it's worth: Omicron: https://www.pfizer.com/news/press-release/press-release-detail/pfizer-and-biontech-initiate-study-evaluate-omicron-based https://www.pfizer.com/news/press-release/press-release-deta... Mentions delta: https://cdn.pfizer.com/pfizercom/2021-07/Delta_Variant_Study_Press_Statement_Final_7.8.21.pdf?IPpR1xZjlwvaUMQ9sRn2FkePcBiRPGqw https://cdn.pfizer.com/pfizercom/2021-07/Delta_Variant_Study...
  - f6v 5y ago
    Yes, but what I meant was those would be already approved.
    - copperx 5y ago
      What's the rationale behind your assertion?
    - jsharpe 5y ago
      Regulation will take time to catch up. We manage to create and approve a flu vaccine every year, and that's likely because the general process has been approved, and so each iteration is fast tracked. I don't think that's the case with mRNA vaccines yet.
mpalczewski 5y ago
We get a new flu vaccine every year, is this much different?
- driverdan 5y ago
  Yes. It takes a long time to generate the flu vaccine. The strains need to be selected long before the season starts so it's a bit of guess work. That's why effectiveness varies from year to year. mRNA vaccines can be produced in high volumes much faster than traditional vaccines. It would allow the flu vaccine strains to be selected at a better time.
  - trompetenaccoun 5y ago
    Works great with the sars-cov-2 vaccine so far. That's why there are fewer symptomatic infections since the vaccines are out. /s
    - selcuka 5y ago
      Why the /s? I don't think there is a sure way to estimate what the number of total symptomatic infections would be if there weren't any vaccines, but the fact that unvaccinated are overrepresented in case statistics indicate that the vaccines are working as expected.
    - driverdan 5y ago
      There are far fewer symptomatic infections and deaths than there would have been otherwise.
xienze 5y ago
> One reason is that mRNA vaccines can be developed much faster than traditional vaccines. So the idea is you have a better chance of "outrunning" a strain. Is that why the response to Delta was "just take another dose of the original formulation" and the response to Omicron was "just take another dose of the original formulation until we have the new one made up in a few months"? And who doesn't see another strain taking over in the next few months, rendering this new formulation less effective than originally promised? My math may be off but there's been exactly one new Covid vaccine formulation in a little over a year, which is about how fast we crank out new flu vaccine formulations. Why exactly did we need to use mRNA tech to crank out new vaccines at the same speed as we did with traditional vaccines?
- SideburnsOfDoom 5y ago
  > Why exactly did we need to use mRNA tech to crank out new vaccines at the same speed as we did with traditional vaccines? mRNA tech is a lot newer than "traditional vaccines". I do not expect that the mRNA process is run at the same speed with the same degree of confidence at the same number of facilities. Yet.
- asveikau 5y ago
  I suspect the fact that we're in the middle of a pandemic has something to do with this, though. In particular, the demand is such that we urgently need hundreds of millions (or billions?) of doses. That takes a lot of effort to roll out. Most vaccines probably don't see use at that scale and speed. An HIV vaccine, for example, would probably initially only go out to communities with higher risk.
- selcuka 5y ago
  They have trialled variant specific vaccines for both Delta and Omicron. It turned out that the original vaccine is as effective for Delta, so that work was shelved. Omicron, on the other hand, seems to be evading the immunity created by the Alpha vaccine, so they are actually planning to start producing an Omicron specific booster (or more correctly Alpha+Omicron) after FDA approval.
  - 5y ago

Vrondi 5y ago

ausudhz 5y ago
So you think for other vaccine you know the "long term effects" What you define as "long term"? Because in my definition, in the "long term" we're all dead. The "long term" effects of many pathologies is also death for example.
- ceejayoz 5y ago
  > Because in my definition, in the "long term" we're all dead. My wife's studio got a "everyone who takes the vaccine will die!" pamphlet pushed under the door, which gave us a good chuckle.
mlyle 5y ago
Three things: - This isn't really the reason why mRNA is attractive here (see my other comment above). (Though, ability to iterate/try many protein combinations quickly in animal models was helpful). - Almost no drugs or treatments do we really know the long term picture of. Running studies in a way that lets you detect effects far later in life isn't practical. - When we're talking about treatments to prevent severe disease, bounding the consequences to be very, very likely to be well below the consequences of the virus times the likely infection chance is "good enough".
- ausudhz 5y ago
  Not to mention the long term effects of COVID are known and way worst that what a vaccine can give you. Vaccine are building an immune response, they're not drugs that try to cope the symptoms (eg. Panadol) and they are the safest drugs out there. Is so interesting how people eat Panadol and many other drugs like candies (without reading the KNOWN side effects - which are also nasty), while they focus so much on things they know nothing about thinking that has mysterious "long term effects"
  - epgui 5y ago
    Exactly this. I would rather take the "most unsafe" vaccine of the last 30 years than take an Advil. (I am a biochemist)
    - abletonlive 5y ago
      Could you elaborate on why you wouldn't take advil?
      - mlyle 5y ago
        Not the poster. Advil is pretty safe, but sometimes has horrific effects (e.g. Stevens Johnson Syndrome, catastrophic stomach bleeding, etc.) Also, NSAIDs are shown to slow healing from injury in most cases. Ibuprofen is terrifically useful but also a little scary for something we use so routinely. e.g. some parents gave their 7 year old a motrin, and all her skin sloughed off her body and she had brain damage and lost 80% of her lung function. https://www.cbsnews.com/news/jury-awards-63m-to-samantha-reckis-girl-who-lost-skin-after-taking-motrin/#:~:text=Samantha%20was%207%20when%20she,and%20was%20blinded%2C%20he%20said https://www.cbsnews.com/news/jury-awards-63m-to-samantha-rec....
        refurb 5y ago
        That’s ridiculous since SJS and TENS can happen with pretty much any drug. And fatal anaphylactic reactions to vaccines aren’t atypical.
        wolverine876 5y ago
        How is atypical defined? They are very rare for the COVID-19 vaccines.
        refurb 5y ago
        So is SJS and TENS.
vmception 5y ago
mRNA treatments likely will accelerate the trial process because their purview is so limited, compared to other molecule based treatments. So more likely you’ll just get over a shorter release cycle and the longer one gets deprecated, relegated to certain style of treatment that mRNA based investment and research will run laps around anyway, further pushing people to evaluate and prioritize mRNA versions. You can try to hold out for an arbitrary threshold of “long term” for your own comfort level. Its accurate that the state wont be helping you. mRNA is like a file for a 3D printer, telling the body what to print for. Other styles of treatments were showing the body the payload. We will definitely learn how often we can get the body to do this, but I wouldn't call it an inferior beta status. Its just as good (or bad) as the longer process for different kinds of treatment. Same efficacy, which allows me personally to not focus on that.
epgui 5y ago
You're vastly overestimating the potential harms caused by vaccines.
tylerhou 5y ago
Knowing long-term effects (1+ years) is not a precondition of approval for most vaccines. It just so happens that vaccines usually take a long time for approval, so we end up knowing long-term effects as a side effect. This is because there generally isn't a known mechanism for vaccines to have long term effects. Not ruling out the possibility, but we understand how vaccines work pretty well. Also, most vaccines are subject to a cost/benefit analysis anyway (we don't give the rabies vaccine out to everyone) so the miniscule chance of having long term effects has to be weighed against the much more likely long term effects of the disease.
- ifyoubuildit 5y ago
  > This is because there generally isn't a known mechanism for vaccines to have long term effects. I know a lot of people believe this, but as a developer who regularly deploys code to production, this mindset blows me away. I'm not saying that being a developer means I know anything about this. I'm well aware of my (our? I don't know what you do) peoples habit of thinking being good at our craft means we're also somehow suddenly good at others. But if I told someone that I don't need to know the effects of v7.1.3 before patching it because I can't think of a mechanism for it going wrong, and besides, we already released all those other versions and they were fine, I'd hopefully be fired. I get it, software and medicine are different things, and some things just aren't practical in meat space, but the mindset around testing is something that I think will always be difficult for me to understand after being in this occupation for so long.
  - copperx 5y ago
    I'm pretty sure understanding the biology behind it all can help make predictions about the outcome in the same way that you know that merging a pull request isn't going to bring the entire internet down. I mean, it could. But there's no known mechanism that will trigger such an event. That reminds me of the first atomic bomb test. We weren't 100% sure that the atmosphere wasn't going to ignite with an atomic bomb, but those that knew the physics knew it was almost impossible. > "If, after calculation, [Compton] said, it were proved that the chances were more than approximately three in one million that the earth would be vaporized by the atomic explosion, he would not proceed with the project. Calculation proved the figures slightly less -- and the project continued." https://www.insidescience.org/manhattan-project-legacy/atmosphere-on-fire https://www.insidescience.org/manhattan-project-legacy/atmos...
Jenk 5y ago
you'd rather the long term effects of HIV? What a bizzarely banal thing to post.
arcticbull 5y ago
Generally the long pole in vaccine approval is showing that it works - not that it's safe. If there's only a handful of cases worldwide, say for Ebola, then you have to vaccinate a few thousand people and wait for a period where a statistically significant portion would have caught the disease and then didn't. This can be years. There's only a few cases per year, you can't just give a bunch of people Ebola to see if the vaccine works. They're not waiting for 'long-term side effects' to show up, they know they don't exist. However, with HIV as with COVID, there's a pretty significant installed base around the country so showing that it works isn't really a challenge. Usually only a few thousand or tens of thousands of folks participate in basically any drug trial, btw. We very well understand the risk profile of mRNA vaccines at this point, having deployed billions of them and studied the technology for 40+ years. And having studied vaccines for upwards of 300 years.
glitchc 5y ago
Seems to be an okay strategy for software…
AussieWog93 5y ago
This is such an out of touch comment. I ask that you please speak to some people in South Africa or Botswana where almost 20% of the population live with HIV, including children (both victims of rape - there was and still is the belief that having sex with a virgin can cure AIDS - and children of HIV-positive mothers who were born with the condition). It's beyond inhuman, and if such a vaccine were to work it would be as impactful as the eradication of Polio (yes, I know it still exists in some places) or Smallpox.

f6v 5y ago

I think slowly will come the realization that mRNA vaccines aren’t as fast to develop as people thought. Sputnik/AstraZeneca vaccines were released almost at the same time as Moderna/Pfizer. Yes, the latter were first commercial mRNA vaccines, but the technology is nevertheless rather mature. I watched a lecture by the people credited with creating mRNA vaccines and it turns out people have been working on the technology for decades. Now, the thing is that you can’t just sequence a virus, do bioinformatics, synthesize mRNA and package it into a nano particle. I mean, you can, but chances are it’s going to fail like the CureVac vaccine. The mRNA that gets packaged needs to be modified (I believe with alternative bases) to achieve desired effect. If mRNA vaccine was as magical as it was marketed, we wouldn’t be getting 3-4(and soon 5?) doses of the same vaccine with the emergence of new variants. Rather, there would be delta- and omicron-specific vaccine.

glial 5y ago
> Rather, there would be delta- and omicron-specific vaccine. I think there are -- they just haven't made it through the trials and approval processes yet. These are press releases from Pfizer for whatever it's worth: Omicron: https://www.pfizer.com/news/press-release/press-release-detail/pfizer-and-biontech-initiate-study-evaluate-omicron-based https://www.pfizer.com/news/press-release/press-release-deta... Mentions delta: https://cdn.pfizer.com/pfizercom/2021-07/Delta_Variant_Study_Press_Statement_Final_7.8.21.pdf?IPpR1xZjlwvaUMQ9sRn2FkePcBiRPGqw https://cdn.pfizer.com/pfizercom/2021-07/Delta_Variant_Study...
- f6v 5y ago
  Yes, but what I meant was those would be already approved.
  - copperx 5y ago
    What's the rationale behind your assertion?
  - jsharpe 5y ago
    Regulation will take time to catch up. We manage to create and approve a flu vaccine every year, and that's likely because the general process has been approved, and so each iteration is fast tracked. I don't think that's the case with mRNA vaccines yet.

mpalczewski 5y ago

We get a new flu vaccine every year, is this much different?

driverdan 5y ago
Yes. It takes a long time to generate the flu vaccine. The strains need to be selected long before the season starts so it's a bit of guess work. That's why effectiveness varies from year to year. mRNA vaccines can be produced in high volumes much faster than traditional vaccines. It would allow the flu vaccine strains to be selected at a better time.
- trompetenaccoun 5y ago
  Works great with the sars-cov-2 vaccine so far. That's why there are fewer symptomatic infections since the vaccines are out. /s
  - selcuka 5y ago
    Why the /s? I don't think there is a sure way to estimate what the number of total symptomatic infections would be if there weren't any vaccines, but the fact that unvaccinated are overrepresented in case statistics indicate that the vaccines are working as expected.
  - driverdan 5y ago
    There are far fewer symptomatic infections and deaths than there would have been otherwise.

xienze 5y ago

> One reason is that mRNA vaccines can be developed much faster than traditional vaccines. So the idea is you have a better chance of "outrunning" a strain. Is that why the response to Delta was "just take another dose of the original formulation" and the response to Omicron was "just take another dose of the original formulation until we have the new one made up in a few months"? And who doesn't see another strain taking over in the next few months, rendering this new formulation less effective than originally promised? My math may be off but there's been exactly one new Covid vaccine formulation in a little over a year, which is about how fast we crank out new flu vaccine formulations. Why exactly did we need to use mRNA tech to crank out new vaccines at the same speed as we did with traditional vaccines?

SideburnsOfDoom 5y ago
> Why exactly did we need to use mRNA tech to crank out new vaccines at the same speed as we did with traditional vaccines? mRNA tech is a lot newer than "traditional vaccines". I do not expect that the mRNA process is run at the same speed with the same degree of confidence at the same number of facilities. Yet.
asveikau 5y ago
I suspect the fact that we're in the middle of a pandemic has something to do with this, though. In particular, the demand is such that we urgently need hundreds of millions (or billions?) of doses. That takes a lot of effort to roll out. Most vaccines probably don't see use at that scale and speed. An HIV vaccine, for example, would probably initially only go out to communities with higher risk.
selcuka 5y ago
They have trialled variant specific vaccines for both Delta and Omicron. It turned out that the original vaccine is as effective for Delta, so that work was shelved. Omicron, on the other hand, seems to be evading the immunity created by the Alpha vaccine, so they are actually planning to start producing an Omicron specific booster (or more correctly Alpha+Omicron) after FDA approval.
- 5y ago