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When mRNA vaccines were invented, I was told that it had the advantage that a mRNA vaccine can be easily modified so as to be effective against a mutated virus.

When mRNA vaccines were invented, I was told that it had the advantage that a mRNA vaccine can be easily modified so as to be effective against a mutated virus. Yet after so many mutations of covid, all we have is still the original version of covid mRNA vaccine. Why?

JamesBarney 5y ago
A couple of reasons 1. It's still pretty effective against COVID 2. Clinical trials showed variant specific versions weren't that much more effective 3. Protecting against the granddaddy strain has a much broader effect than protecting against a new strain.
- tempestn 5y ago
  Are you sure about #3? That vast majority of cases now are Omicron, so new variants are far more likely to branch off of Omicron than an earlier strain. Therefore I can't imagine how a vaccine targeting the original spike protein would be expected to be more effective than one targeting the spike protein from Omicron against new variants.
  - samus 5y ago
    Let's say we wait until only 1 out of 10000 cases world-wide is caused by a non-Omicron strain. Then, an Omikron-specific booster would be worth it. Otherwise, we are just playing whack-a-mole with other strains.
    - jagger27 5y ago
      What if we had multivalent mRNA vaccines like the HPV vaccine? Gardasil first covered three different strains, then later was bumped to nine, hence Gardasil-9. It doesn’t have to be all or nothing.
      - samus 5y ago
        HPV viruses are DNA viruses, which means they evolve way slower than Corona viruses. This makes it easier to identify strains that are worth developing a vaccine against. Also, the mRNA technology and/or the production lines are probably not yet capable of producing multivalent vaccines.
        jagger27 5y ago
        A quick Google for "multivalent covid vaccine" shows trials in progress and articles from as early as 2021, so I'd say there's progress happening here.
        samus 5y ago
        Good news!!
        astrange 5y ago
        There are some in development, but they don't use mRNA. https://www.technologynetworks.com/vaccines/articles/the-hunt-for-a-pan-coronavirus-vaccine-358132 https://www.technologynetworks.com/vaccines/articles/the-hun...
  - passivate 5y ago
    > Therefore I can't imagine how a vaccine targeting the original spike protein would be expected to be more effective than one targeting the spike protein from Omicron against new variants. Well, besides imagining, we're also doing science, so what does the data that you've seen say?
    - tempestn 5y ago
      Is there data out there comparing variant-specific vaccines to the original in their effectiveness against derivative variants? I haven't seen anything like that. Perhaps there is a reason the original vaccine would be expected to be more broadly effective, as my parent said. It's not intuitive to me, but that doesn't mean it's wrong. Hence my question.
      - passivate 5y ago
        My point was that our human body doesn't work by rhetorical reasoning or intuition. There are often things we discover about our immune system that are counter intuitive - for e.g. Using specially developed & formulated vaccines to teach the body to suppress immune response towards antigens (via Treg cells), rather than to neutralize them which is what most vaccines aim to do. Specifically I was objecting to "Given X, we wouldn't expect Y to happen" aspect of your argument. Its never so simple with the human body! It works in many other domains, and so as a former programmer myself I have to catch myself trying to apply such reasoning to biological systems which can't be modeled like that.
  - orra 5y ago
    Omicron branched off the original lineage IIRC, not Delta nor Beta. So, no, we can’t make that assumption.
    - tempestn 5y ago
      I'm not saying it's a certainty, just a strong likelihood.
  - shawabawa3 5y ago
    One other consideration is that Omicron is significantly milder than previous variants Perhaps there's a fear that an Omicron targeted vaccine would allow a more deadly variant to take over again
- k4rli 5y ago
  It's really not effective at all anymore with 12% efficiency [1]. Boosters are only "good" for your own placebo thoughts. [1] https://www.cnbc.com/2022/02/28/pfizer-covid-vaccine-was-just-12percent-effective-against-omicron-in-kids-5-to-11-study-finds.html https://www.cnbc.com/2022/02/28/pfizer-covid-vaccine-was-jus...
  - flipbrad 5y ago
    In very young kids at considerably reduced dosage
  - makomk 5y ago
    Boosters of the current vaccine are somewhat effective against hospitalization and death, though even that benefit wears off alarmingly quickly. There's not really any justification for vaccinating 5-11 year olds at this point though given the mediocre benefits and the risk of side effects.
  - statop 5y ago
    Thanks for linking the article, if you had read the title it says "in kids 5 to 11". The 6th sentence notes that "kids 5 to 11" received a lower dosage. It goes on to reference a study that showed dosage matters. Delete your comment to save face?
beebmam 5y ago
In randomized clinical trials, the original mRNA vaccines were just as effective as modified versions at preventing symptomatic disease and hospitalization due to SARS-CoV-2 infection
- coobird 5y ago
  From the article I read[1], the nuance was along the line of this -- a person who was previously exposed to the original COVID vaccine or the virus itself (and had an immune response) getting the updated version of the vaccine ends up having the immune response for the _original_ antigen[2], rather than the new one. Since the immune response is for the older versions of the virus, getting the updated vaccine still ends up having the same effectiveness of the original vaccine. [1]: https://arstechnica.com/science/2022/02/monkey-study-casts-doubt-on-need-for-an-omicron-specific-booster/ https://arstechnica.com/science/2022/02/monkey-study-casts-d... [2]: https://en.wikipedia.org/wiki/Original_antigenic_sin https://en.wikipedia.org/wiki/Original_antigenic_sin
  - makomk 5y ago
    Yeah, an immune response specific to the Omicron variant would likely be more effective against Omicron for obvious reasons, but it's probably not possible to get one in people with immunity to older variants because their existing immunity gets in the way. This isn't too surprising - it's one of the things that seems to limit the effectiveness of the flu vaccine.
- timr 5y ago
  This isn't true. No RCTs have ever been performed on the original vaccines and the subsequent variants. And to the extent that other kinds of experiments (retrospective cohort studies, etc.) have been done, they've almost universally found diminished effectiveness against mild illness. Effectiveness of the original vaccines against Omicron infection, in particular, is essentially zero after a few months: https://www.medrxiv.org/content/10.1101/2021.12.20.21267966v2 https://www.medrxiv.org/content/10.1101/2021.12.20.21267966v... It should be noted that the vaccines appear to remain highly effective against severe illness, even without boosting. The mRNA vaccines, in particular, seem to raise a robust, long-lasting cellular immune response, even though antibody levels rapidly fall. One of the downsides of the unusually rapid approval process for the Covid vaccine was that it was impossible to see this pattern in a randomized trial that lasted only a few months. This led "experts" -- people who really should have known better -- to oversell the shots as a form of sterilizing immunity. They are not. There are good reasons vaccines take a long time to develop.
juahan 5y ago
Not exactly sure, but I think the original version of the covid vaccine has been good enough for the mutations and there has not been need for modified version.
cm2012 5y ago
Without the initial covid urgency there is an insane red tape beurocracy on new vaccines. It takes 7 years for the average vaccine to be approved and its 90% avoidable busywork.
- NickNameNick 5y ago
  I'm not so sure it's busy-work. There's a prioritisation issue. There are so many diseases, and many more proposed treatments. Without a good reason to jump the queue there are bound to be delays. There's also the efficacy testing issue. Your phase 2/phase 3 test subjects are mostly young european males (Uni-students). Without deliberately exposing them, how likely are they (and the control group) get infected? It could take years for a statistically significant number of the control group to catch the disease. When there's a pandemic on you might hit those numbers in a few weeks.
rubatuga 5y ago
My cynical take: New versions of the mRNA vaccine were unable to change the first two vaccine's "original antigenic sin".
- astrange 5y ago
  That's dengue. It doesn't appear that getting covid makes it even worse the next time you get it. (I have seen people say this, but they're also saying wild stuff like "everyone who gets covid ends up with dementia".)
gizmo686 5y ago
We sequenced covid 19 on January 11, 2020. Within 2 days, we have a vaccine. It took 2 months (March 2020) to get that vaccine into humans, and almost an entire year (December 2020) to get an emergency use authorization to use it outside of clinical trials. Updated vaccines are being looked into, but the original ones still work well enough that there is not the push to expedite the process we saw with the original one. With the virus slowing down to herd immunity, it is likely we won't see another such a push for this pandemic.
- foolfoolz 5y ago
  reminds me code that takes 1 day to write, 1 week to write tests for, and 2 months to release safely
  - bladegash 5y ago
    Or even the two lines of code you wrote after researching the problem/solution for a week.
    - kevin_thibedeau 5y ago
      Bottom of the stack rank for you, slacker.
  - sph 5y ago
    And a lifetime to maintain.
- a-dub 5y ago
  that entire year was also spent doing process engineering to scale up manufacture and delivery from zero to millions and millions of doses. my understanding is that going from something in the lab to something that is produced at scale requires significant chemical engineering work, similar to, but likely harder than hardware which is based on parts availability and cost. all warp speed did was release money and allow process development and testing phases to overlap, is my understanding.
pkaye 5y ago
While it is easy to modify, it still takes time to test the modified vaccine. The vaccines were designed to target the spike protein which is shaped to allow it to enter human cells. If that protein evolved too much to evade the vaccine, it would also become less effective in entering human cells. In the future they might prepare a wide number of vaccines targeting common coronavirus ahead of time so there can be quick response when an outbreak appears.
mike_d 5y ago
> Yet after so many mutations of covid, all we have is still the original version of covid mRNA vaccine. Why? Think of COVID as a human being. The mRNA vaccine teaches your immune system to recognize and destroy hands instead of a whole person. As a result your immune system can detect all shapes and sizes of people as long as they have hands. It is possible for the virus to mutate to use claws instead of hands, but then it isn't as effective at grabbing cells to infect them.
- colordrops 5y ago
  The point was that mRNA vaccines should be able to be quickly adapted to detect claws.
  - fastball 5y ago
    An mRNA vaccine could be designed tomorrow to target claws instead of hands, the issue is how long it takes to test them / get approval to use them, not how long it takes to develop them. In the case of an incredibly rapidly mutating virus like COVID-19 it's just not worth it to go through that whole process every time it goes from hands to claws to hooves.
    - deleted 5y ago
      [deleted]
    - timr 5y ago
      > it's just not worth it to go through that whole process every time it goes from hands to claws to hooves. It's not that it's not worth it, it's that this approach doesn't work. Evolution is a remarkable force, and unless there's a good reason for the part of the virus/bacteria/amoeba you're targeting to stay that way, it will change to escape the selective pressure against it. We're more-or-less seeing this with SARS-CoV2, even though the virus is a relative amateur at genetic drift. OK, you may say "let's target the vaccine against a part that doesn't change"...that's great, except that those parts tend to be so common -- so "evolutionarily conserved" -- that you see them all over the place, including, often enough...your own body. Train your immune system to (over)react against common antigens, and you're going to cause problems. The primary reason that vaccine development is difficult is because you have an extremely high bar for effectiveness, coupled with an extremely low bar for side-effects. And even if you find such a unicorn target, you have to make sure it stays magical over time. The mRNA technologies are great and do accelerate things, but ultimately, the speed of the Covid vaccine development process was more about our willingness to throw huge money at the problem and eliminate all development and liability risk, than it was about any particular technology platform.
DogOfTheGaps 5y ago
Because there is no need for an updated vaccine. The original vaccine (especially with a booster 6 months after the second dose) is extremely effective at preventing severe disease, hospitalization, and death for all variants of SARS-CoV-2. (Alpha, Beta, Delta, Omicron, etc)
- phantomathkg 5y ago
  Nope. See https://www.nejm.org/doi/full/10.1056/NEJMoa2200797 https://www.nejm.org/doi/full/10.1056/NEJMoa2200797 The conclusion said it is less effective. The messenger RNA (mRNA) boosters were highly effective against symptomatic delta infection, but they were less effective against symptomatic omicron infection. However, with both variants, mRNA boosters led to strong protection against Covid-19–related hospitalization and death. (Funded by Weill Cornell Medicine–Qatar and others.) Don't get me wrong, I believe in the vaccine, but I think we are still far away from one vaccine that kill all the the mutations.
  - cko 5y ago
    There is no disagreement between your comments.
  - DogOfTheGaps 5y ago
    From the link you posted: In this study, mRNA boosters were highly effective against infection with the delta variant but were less effective against infection with the omicron variant. However, these boosters led to strong protection against Covid-19–related hospitalization and death due to both variants. We vaccinate in order to prevent severe disease, hospitalization, and death. The original vaccines, per the link you shared, are extremely effective at this.
    - vanviegen 5y ago
      Originally, the plan was to vaccinate in order to obtain herd immunity and wipe out COVID.
godelski 5y ago
Previous to this the record for fastest vaccine was 4 years, so I'd say promise is kept (Zika vaccine was on a path to beat the 4 year mark but COVID vaccine would still be faster). Vaccines normally take years to develop
qbasic_forever 5y ago
Updated vaccines _have_ been developed and are in trials. Moderna created a beta variant vaccine last year that is the furthest along in any trial IIRC. Pfizer has an alpha variant specific booster with quite good results from trials too. The problem as I understand it is that it isn't profitable for either company to take a risk on producing these boosters at scale. They have to take a bet that the variant they target for the booster will be the one to dominate in the next months, and right now with variants like omicron mutating and growing at astounding rates it is quite risky. If they target the wrong variant that's a whole lot of completely wasted vaccine doses and they have to start over again. As I understand it their production lines are limited too and can only produce one specific type of vaccine or booster at once (i.e. wild type or new variant, but not both). Honestly we need operation warp speed again. It needs to just never stop, at least while we are in such a critical stage and massive amount of virus spread. We need the government and the billionaires/trillionaires to bankroll parallel development of all major variant boosters at once.
- heavyset_go 5y ago
  > Honestly we need operation warp speed again. It needs to just never stop, at least while we are in such a critical stage and massive amount of virus spread. We need the government and the billionaires/trillionaires to bankroll parallel development of all major variant boosters at once. This makes sense defense-wise, as well, because the arms race in vaccine development is also an arms race in producing vaccines for diseases you intend to use as weapons. A disease a group has a vaccine or cure for, but no one else does, could be weaponized.
  - nusaru 5y ago
    I agree. Someone please correct me if I’m wrong, but I imagine it’ll be a huge advantage to be able to produce new vaccines at the same rate that a weaponized virus can mutate.
    - jimmydorry 5y ago
      It comes at the cost of reducing regulatory burden but also the oversight and safety rails required to make sure the "cure isn't worse than the disease". For the initial wave of COVID-19, it was an absolute necessity, but unless our backs are pinned metaphorically to the wall, is it really worth taking a short cut? In the best case, COVID-19 will become endemic (prevalent every season, but not as harmful for the majority of the population)... so wiping it out by way of universal uptake of a given vaccine is not (and never was) on the tables. A weaponized virus would inflict untold suffering, but there is nothing to stop another Operation Warpspeed. Having OW active all the time? I don't see that being a good thing.
kuhewa 5y ago
In monkeys, there wasn't much of a benefit of an omicron specific booster vs an original Wuhan strain booster. The main thing was just getting a third dose which generates the mature antibodies that are apparently similar enough between current variants.
astrange 5y ago
We don't know if it's worth updating the covid vaccine, because updating it to be more like omicron would make it less like the original type, and we don't think that's a worthwhile tradeoff. The answer is a "pancoronavirus" vaccine that'd work against all of them, but it seems that using mRNA or not doesn't actually help with that.

JamesBarney 5y ago

A couple of reasons 1. It's still pretty effective against COVID 2. Clinical trials showed variant specific versions weren't that much more effective 3. Protecting against the granddaddy strain has a much broader effect than protecting against a new strain.

tempestn 5y ago
Are you sure about #3? That vast majority of cases now are Omicron, so new variants are far more likely to branch off of Omicron than an earlier strain. Therefore I can't imagine how a vaccine targeting the original spike protein would be expected to be more effective than one targeting the spike protein from Omicron against new variants.
- samus 5y ago
  Let's say we wait until only 1 out of 10000 cases world-wide is caused by a non-Omicron strain. Then, an Omikron-specific booster would be worth it. Otherwise, we are just playing whack-a-mole with other strains.
  - jagger27 5y ago
    What if we had multivalent mRNA vaccines like the HPV vaccine? Gardasil first covered three different strains, then later was bumped to nine, hence Gardasil-9. It doesn’t have to be all or nothing.
    - samus 5y ago
      HPV viruses are DNA viruses, which means they evolve way slower than Corona viruses. This makes it easier to identify strains that are worth developing a vaccine against. Also, the mRNA technology and/or the production lines are probably not yet capable of producing multivalent vaccines.
      - jagger27 5y ago
        A quick Google for "multivalent covid vaccine" shows trials in progress and articles from as early as 2021, so I'd say there's progress happening here.
        samus 5y ago
        Good news!!
      - astrange 5y ago
        There are some in development, but they don't use mRNA. https://www.technologynetworks.com/vaccines/articles/the-hunt-for-a-pan-coronavirus-vaccine-358132 https://www.technologynetworks.com/vaccines/articles/the-hun...
- passivate 5y ago
  > Therefore I can't imagine how a vaccine targeting the original spike protein would be expected to be more effective than one targeting the spike protein from Omicron against new variants. Well, besides imagining, we're also doing science, so what does the data that you've seen say?
  - tempestn 5y ago
    Is there data out there comparing variant-specific vaccines to the original in their effectiveness against derivative variants? I haven't seen anything like that. Perhaps there is a reason the original vaccine would be expected to be more broadly effective, as my parent said. It's not intuitive to me, but that doesn't mean it's wrong. Hence my question.
    - passivate 5y ago
      My point was that our human body doesn't work by rhetorical reasoning or intuition. There are often things we discover about our immune system that are counter intuitive - for e.g. Using specially developed & formulated vaccines to teach the body to suppress immune response towards antigens (via Treg cells), rather than to neutralize them which is what most vaccines aim to do. Specifically I was objecting to "Given X, we wouldn't expect Y to happen" aspect of your argument. Its never so simple with the human body! It works in many other domains, and so as a former programmer myself I have to catch myself trying to apply such reasoning to biological systems which can't be modeled like that.
- orra 5y ago
  Omicron branched off the original lineage IIRC, not Delta nor Beta. So, no, we can’t make that assumption.
  - tempestn 5y ago
    I'm not saying it's a certainty, just a strong likelihood.
- shawabawa3 5y ago
  One other consideration is that Omicron is significantly milder than previous variants Perhaps there's a fear that an Omicron targeted vaccine would allow a more deadly variant to take over again
k4rli 5y ago
It's really not effective at all anymore with 12% efficiency [1]. Boosters are only "good" for your own placebo thoughts. [1] https://www.cnbc.com/2022/02/28/pfizer-covid-vaccine-was-just-12percent-effective-against-omicron-in-kids-5-to-11-study-finds.html https://www.cnbc.com/2022/02/28/pfizer-covid-vaccine-was-jus...
- flipbrad 5y ago
  In very young kids at considerably reduced dosage
- makomk 5y ago
  Boosters of the current vaccine are somewhat effective against hospitalization and death, though even that benefit wears off alarmingly quickly. There's not really any justification for vaccinating 5-11 year olds at this point though given the mediocre benefits and the risk of side effects.
- statop 5y ago
  Thanks for linking the article, if you had read the title it says "in kids 5 to 11". The 6th sentence notes that "kids 5 to 11" received a lower dosage. It goes on to reference a study that showed dosage matters. Delete your comment to save face?

beebmam 5y ago

In randomized clinical trials, the original mRNA vaccines were just as effective as modified versions at preventing symptomatic disease and hospitalization due to SARS-CoV-2 infection

coobird 5y ago
From the article I read[1], the nuance was along the line of this -- a person who was previously exposed to the original COVID vaccine or the virus itself (and had an immune response) getting the updated version of the vaccine ends up having the immune response for the _original_ antigen[2], rather than the new one. Since the immune response is for the older versions of the virus, getting the updated vaccine still ends up having the same effectiveness of the original vaccine. [1]: https://arstechnica.com/science/2022/02/monkey-study-casts-doubt-on-need-for-an-omicron-specific-booster/ https://arstechnica.com/science/2022/02/monkey-study-casts-d... [2]: https://en.wikipedia.org/wiki/Original_antigenic_sin https://en.wikipedia.org/wiki/Original_antigenic_sin
- makomk 5y ago
  Yeah, an immune response specific to the Omicron variant would likely be more effective against Omicron for obvious reasons, but it's probably not possible to get one in people with immunity to older variants because their existing immunity gets in the way. This isn't too surprising - it's one of the things that seems to limit the effectiveness of the flu vaccine.
timr 5y ago
This isn't true. No RCTs have ever been performed on the original vaccines and the subsequent variants. And to the extent that other kinds of experiments (retrospective cohort studies, etc.) have been done, they've almost universally found diminished effectiveness against mild illness. Effectiveness of the original vaccines against Omicron infection, in particular, is essentially zero after a few months: https://www.medrxiv.org/content/10.1101/2021.12.20.21267966v2 https://www.medrxiv.org/content/10.1101/2021.12.20.21267966v... It should be noted that the vaccines appear to remain highly effective against severe illness, even without boosting. The mRNA vaccines, in particular, seem to raise a robust, long-lasting cellular immune response, even though antibody levels rapidly fall. One of the downsides of the unusually rapid approval process for the Covid vaccine was that it was impossible to see this pattern in a randomized trial that lasted only a few months. This led "experts" -- people who really should have known better -- to oversell the shots as a form of sterilizing immunity. They are not. There are good reasons vaccines take a long time to develop.

juahan 5y ago

Not exactly sure, but I think the original version of the covid vaccine has been good enough for the mutations and there has not been need for modified version.

cm2012 5y ago

Without the initial covid urgency there is an insane red tape beurocracy on new vaccines. It takes 7 years for the average vaccine to be approved and its 90% avoidable busywork.

NickNameNick 5y ago
I'm not so sure it's busy-work. There's a prioritisation issue. There are so many diseases, and many more proposed treatments. Without a good reason to jump the queue there are bound to be delays. There's also the efficacy testing issue. Your phase 2/phase 3 test subjects are mostly young european males (Uni-students). Without deliberately exposing them, how likely are they (and the control group) get infected? It could take years for a statistically significant number of the control group to catch the disease. When there's a pandemic on you might hit those numbers in a few weeks.

rubatuga 5y ago

My cynical take: New versions of the mRNA vaccine were unable to change the first two vaccine's "original antigenic sin".

astrange 5y ago
That's dengue. It doesn't appear that getting covid makes it even worse the next time you get it. (I have seen people say this, but they're also saying wild stuff like "everyone who gets covid ends up with dementia".)

gizmo686 5y ago

We sequenced covid 19 on January 11, 2020. Within 2 days, we have a vaccine. It took 2 months (March 2020) to get that vaccine into humans, and almost an entire year (December 2020) to get an emergency use authorization to use it outside of clinical trials. Updated vaccines are being looked into, but the original ones still work well enough that there is not the push to expedite the process we saw with the original one. With the virus slowing down to herd immunity, it is likely we won't see another such a push for this pandemic.

foolfoolz 5y ago
reminds me code that takes 1 day to write, 1 week to write tests for, and 2 months to release safely
- bladegash 5y ago
  Or even the two lines of code you wrote after researching the problem/solution for a week.
  - kevin_thibedeau 5y ago
    Bottom of the stack rank for you, slacker.
- sph 5y ago
  And a lifetime to maintain.
a-dub 5y ago
that entire year was also spent doing process engineering to scale up manufacture and delivery from zero to millions and millions of doses. my understanding is that going from something in the lab to something that is produced at scale requires significant chemical engineering work, similar to, but likely harder than hardware which is based on parts availability and cost. all warp speed did was release money and allow process development and testing phases to overlap, is my understanding.

pkaye 5y ago

While it is easy to modify, it still takes time to test the modified vaccine. The vaccines were designed to target the spike protein which is shaped to allow it to enter human cells. If that protein evolved too much to evade the vaccine, it would also become less effective in entering human cells. In the future they might prepare a wide number of vaccines targeting common coronavirus ahead of time so there can be quick response when an outbreak appears.

mike_d 5y ago

> Yet after so many mutations of covid, all we have is still the original version of covid mRNA vaccine. Why? Think of COVID as a human being. The mRNA vaccine teaches your immune system to recognize and destroy hands instead of a whole person. As a result your immune system can detect all shapes and sizes of people as long as they have hands. It is possible for the virus to mutate to use claws instead of hands, but then it isn't as effective at grabbing cells to infect them.

colordrops 5y ago
The point was that mRNA vaccines should be able to be quickly adapted to detect claws.
- fastball 5y ago
  An mRNA vaccine could be designed tomorrow to target claws instead of hands, the issue is how long it takes to test them / get approval to use them, not how long it takes to develop them. In the case of an incredibly rapidly mutating virus like COVID-19 it's just not worth it to go through that whole process every time it goes from hands to claws to hooves.
  - deleted 5y ago
    [deleted]
  - timr 5y ago
    > it's just not worth it to go through that whole process every time it goes from hands to claws to hooves. It's not that it's not worth it, it's that this approach doesn't work. Evolution is a remarkable force, and unless there's a good reason for the part of the virus/bacteria/amoeba you're targeting to stay that way, it will change to escape the selective pressure against it. We're more-or-less seeing this with SARS-CoV2, even though the virus is a relative amateur at genetic drift. OK, you may say "let's target the vaccine against a part that doesn't change"...that's great, except that those parts tend to be so common -- so "evolutionarily conserved" -- that you see them all over the place, including, often enough...your own body. Train your immune system to (over)react against common antigens, and you're going to cause problems. The primary reason that vaccine development is difficult is because you have an extremely high bar for effectiveness, coupled with an extremely low bar for side-effects. And even if you find such a unicorn target, you have to make sure it stays magical over time. The mRNA technologies are great and do accelerate things, but ultimately, the speed of the Covid vaccine development process was more about our willingness to throw huge money at the problem and eliminate all development and liability risk, than it was about any particular technology platform.

DogOfTheGaps 5y ago

Because there is no need for an updated vaccine. The original vaccine (especially with a booster 6 months after the second dose) is extremely effective at preventing severe disease, hospitalization, and death for all variants of SARS-CoV-2. (Alpha, Beta, Delta, Omicron, etc)

phantomathkg 5y ago
Nope. See https://www.nejm.org/doi/full/10.1056/NEJMoa2200797 https://www.nejm.org/doi/full/10.1056/NEJMoa2200797 The conclusion said it is less effective. The messenger RNA (mRNA) boosters were highly effective against symptomatic delta infection, but they were less effective against symptomatic omicron infection. However, with both variants, mRNA boosters led to strong protection against Covid-19–related hospitalization and death. (Funded by Weill Cornell Medicine–Qatar and others.) Don't get me wrong, I believe in the vaccine, but I think we are still far away from one vaccine that kill all the the mutations.
- cko 5y ago
  There is no disagreement between your comments.
- DogOfTheGaps 5y ago
  From the link you posted: In this study, mRNA boosters were highly effective against infection with the delta variant but were less effective against infection with the omicron variant. However, these boosters led to strong protection against Covid-19–related hospitalization and death due to both variants. We vaccinate in order to prevent severe disease, hospitalization, and death. The original vaccines, per the link you shared, are extremely effective at this.
  - vanviegen 5y ago
    Originally, the plan was to vaccinate in order to obtain herd immunity and wipe out COVID.

godelski 5y ago

Previous to this the record for fastest vaccine was 4 years, so I'd say promise is kept (Zika vaccine was on a path to beat the 4 year mark but COVID vaccine would still be faster). Vaccines normally take years to develop

qbasic_forever 5y ago

Updated vaccines _have_ been developed and are in trials. Moderna created a beta variant vaccine last year that is the furthest along in any trial IIRC. Pfizer has an alpha variant specific booster with quite good results from trials too. The problem as I understand it is that it isn't profitable for either company to take a risk on producing these boosters at scale. They have to take a bet that the variant they target for the booster will be the one to dominate in the next months, and right now with variants like omicron mutating and growing at astounding rates it is quite risky. If they target the wrong variant that's a whole lot of completely wasted vaccine doses and they have to start over again. As I understand it their production lines are limited too and can only produce one specific type of vaccine or booster at once (i.e. wild type or new variant, but not both). Honestly we need operation warp speed again. It needs to just never stop, at least while we are in such a critical stage and massive amount of virus spread. We need the government and the billionaires/trillionaires to bankroll parallel development of all major variant boosters at once.

heavyset_go 5y ago
> Honestly we need operation warp speed again. It needs to just never stop, at least while we are in such a critical stage and massive amount of virus spread. We need the government and the billionaires/trillionaires to bankroll parallel development of all major variant boosters at once. This makes sense defense-wise, as well, because the arms race in vaccine development is also an arms race in producing vaccines for diseases you intend to use as weapons. A disease a group has a vaccine or cure for, but no one else does, could be weaponized.
- nusaru 5y ago
  I agree. Someone please correct me if I’m wrong, but I imagine it’ll be a huge advantage to be able to produce new vaccines at the same rate that a weaponized virus can mutate.
  - jimmydorry 5y ago
    It comes at the cost of reducing regulatory burden but also the oversight and safety rails required to make sure the "cure isn't worse than the disease". For the initial wave of COVID-19, it was an absolute necessity, but unless our backs are pinned metaphorically to the wall, is it really worth taking a short cut? In the best case, COVID-19 will become endemic (prevalent every season, but not as harmful for the majority of the population)... so wiping it out by way of universal uptake of a given vaccine is not (and never was) on the tables. A weaponized virus would inflict untold suffering, but there is nothing to stop another Operation Warpspeed. Having OW active all the time? I don't see that being a good thing.

kuhewa 5y ago

In monkeys, there wasn't much of a benefit of an omicron specific booster vs an original Wuhan strain booster. The main thing was just getting a third dose which generates the mature antibodies that are apparently similar enough between current variants.

astrange 5y ago

We don't know if it's worth updating the covid vaccine, because updating it to be more like omicron would make it less like the original type, and we don't think that's a worthwhile tradeoff. The answer is a "pancoronavirus" vaccine that'd work against all of them, but it seems that using mRNA or not doesn't actually help with that.