3 ms·

Dengue is a disease that vaccination actually makes worse, at least with the ones we have now. I'm wondering how they sidestep those issues.

by esyir 5y ago

sjmm1989 5y ago
> As Drew Weissman, one of the physician-scientists who helped develop mRNA vaccine technology put it, “mRNA vaccines are essentially plug and play. We believe you can change the part of the mRNA that encodes a protein, plugging in new code specific to the virus we hope to protect against, and cause one’s body to produce proteins that match that virus’ proteins. We do not have to develop and manufacture an entirely new formula.” I think this quote sufficiently answers your curiosity slightly. Not a lot, but slightly.
- zpeti 5y ago
  I don’t think it does. With dengue fever the issue is once you develop antibodies the first time, the second time you get infected the antibodies actually increase the viruses chances of binding to whatever it binds to, so the effectiveness of the virus increases. I’m not sure how mRNA vaccines get around that, but I imagine they have a plan, it would be interesting to hear it.
- esyir 5y ago
  Unfortunately not, I'm aware of how the mrna vaccines work. The issue with dengue in particular is a bit of a special case. Infection with a single serotype weakens the body against infection with other serotypes. Now. This poses a challenge to vaccination, as you need to find a way to get all four. Currently, we have dengvaxia, which does do that. However, an interesting effect is that the vaccination is only useful if you already have a history of dengue. If you're dengue naive, the vaxx increases the risk of severe disease instead.
  - sjmm1989 5y ago
    > However, an interesting effect is that the vaccination is only useful if you already have a history of dengue. If you're dengue naive, the vaxx increases the risk of severe disease instead. I was concerned about this potentially being a thing with Covid at one point. Thankfully not the case, but yeah...
unlikelymordant 5y ago
There were early vaccines for SARS in the early 2000s that also made it worse if you actually caught SARS. I dont think this is a disease specific property, hopefully the Moderna approach will work as it does with COVID.
techas 5y ago
A statement like this one requires a proper reference. Otherwise looks like anti vaccine ad.
- allisdust 5y ago
  It's a commonly known limitation of all Dengue vaccines. You can look it up in Wikipedia. This is also why there are no dengue vaccines widely used today.
- Zerverus 5y ago
  Very simplified Dengue has multiple strains. The initial infection with one strain tends to be not so bad and you may acquire immunity to it. However, it triggers a much worse, often hemorrhagic outcome if you acquire one of the other strains. Vaccines, afaik mirror that property, changing the risk calculation by removing the less risky first infection.
- esyir 5y ago
  Man, I hate the way that anything about vaccine side effects gets flanderized into "ANTIVAXXERS!". However I hate the "educate yourself" movement more, so here I am. (I missed out the "can" though, that's on me) First a WHO link.: https://www.who.int/news-room/questions-and-answers/item/dengue-vaccines https://www.who.int/news-room/questions-and-answers/item/den... >There is an increased risk of hospitalized and severe dengue in seronegative individuals starting about 30 months after the first dose. TL;DR vaxx good if you've been infected before, but if you're dengue naive, it might raise the risk of severe side effects Now, on the topic of an actual immunological phenomenon with a name out of /pol/'s fever dreams: An In-Depth Analysis of Original Antigenic Sin in Dengue Virus Infection https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3014204/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3014204/ TL;DR: Original antigenic sin describes a situation where the body's first exposure to an antigen shapes it's future response. This ends tragically in the case of dengue, where the response trained on a serotype is unfortunately overfit. Upon exposure to a different dengue serotype, the immune system defaults the response fit to the original infection, resulting in a response dominated by an inferior antibody. The outcomes are thus worse. From what I'm seeing in more recent publications this model of dengue infection still seems to be the general consensus. As to why I dug into this area in the first place, I live somewhere where dengue was quite the bugbear, and the "second time kills you" story was mentioned quite a bit. Turns out it's a pretty interesting area, since it clashes with the layman concept of immunity. I'm no expert in this domain though, so if I've missed out some progression on the science here, I'd really like to know. Edit: As others have also pointed out, there's also the case where the antibodies even enhance the infection process.

Dengue is a disease that vaccination actually makes worse, at least with the ones we have now. I'm wondering how they sidestep those issues.

by esyir 5y ago

Dengue is a disease that vaccination actually makes worse, at least with the ones we have now. I'm wondering how they sidestep those issues.

sjmm1989 5y ago

> As Drew Weissman, one of the physician-scientists who helped develop mRNA vaccine technology put it, “mRNA vaccines are essentially plug and play. We believe you can change the part of the mRNA that encodes a protein, plugging in new code specific to the virus we hope to protect against, and cause one’s body to produce proteins that match that virus’ proteins. We do not have to develop and manufacture an entirely new formula.” I think this quote sufficiently answers your curiosity slightly. Not a lot, but slightly.

zpeti 5y ago
I don’t think it does. With dengue fever the issue is once you develop antibodies the first time, the second time you get infected the antibodies actually increase the viruses chances of binding to whatever it binds to, so the effectiveness of the virus increases. I’m not sure how mRNA vaccines get around that, but I imagine they have a plan, it would be interesting to hear it.
esyir 5y ago
Unfortunately not, I'm aware of how the mrna vaccines work. The issue with dengue in particular is a bit of a special case. Infection with a single serotype weakens the body against infection with other serotypes. Now. This poses a challenge to vaccination, as you need to find a way to get all four. Currently, we have dengvaxia, which does do that. However, an interesting effect is that the vaccination is only useful if you already have a history of dengue. If you're dengue naive, the vaxx increases the risk of severe disease instead.
- sjmm1989 5y ago
  > However, an interesting effect is that the vaccination is only useful if you already have a history of dengue. If you're dengue naive, the vaxx increases the risk of severe disease instead. I was concerned about this potentially being a thing with Covid at one point. Thankfully not the case, but yeah...

unlikelymordant 5y ago

There were early vaccines for SARS in the early 2000s that also made it worse if you actually caught SARS. I dont think this is a disease specific property, hopefully the Moderna approach will work as it does with COVID.

techas 5y ago

A statement like this one requires a proper reference. Otherwise looks like anti vaccine ad.

allisdust 5y ago
It's a commonly known limitation of all Dengue vaccines. You can look it up in Wikipedia. This is also why there are no dengue vaccines widely used today.
Zerverus 5y ago
Very simplified Dengue has multiple strains. The initial infection with one strain tends to be not so bad and you may acquire immunity to it. However, it triggers a much worse, often hemorrhagic outcome if you acquire one of the other strains. Vaccines, afaik mirror that property, changing the risk calculation by removing the less risky first infection.
esyir 5y ago
Man, I hate the way that anything about vaccine side effects gets flanderized into "ANTIVAXXERS!". However I hate the "educate yourself" movement more, so here I am. (I missed out the "can" though, that's on me) First a WHO link.: https://www.who.int/news-room/questions-and-answers/item/dengue-vaccines https://www.who.int/news-room/questions-and-answers/item/den... >There is an increased risk of hospitalized and severe dengue in seronegative individuals starting about 30 months after the first dose. TL;DR vaxx good if you've been infected before, but if you're dengue naive, it might raise the risk of severe side effects Now, on the topic of an actual immunological phenomenon with a name out of /pol/'s fever dreams: An In-Depth Analysis of Original Antigenic Sin in Dengue Virus Infection https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3014204/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3014204/ TL;DR: Original antigenic sin describes a situation where the body's first exposure to an antigen shapes it's future response. This ends tragically in the case of dengue, where the response trained on a serotype is unfortunately overfit. Upon exposure to a different dengue serotype, the immune system defaults the response fit to the original infection, resulting in a response dominated by an inferior antibody. The outcomes are thus worse. From what I'm seeing in more recent publications this model of dengue infection still seems to be the general consensus. As to why I dug into this area in the first place, I live somewhere where dengue was quite the bugbear, and the "second time kills you" story was mentioned quite a bit. Turns out it's a pretty interesting area, since it clashes with the layman concept of immunity. I'm no expert in this domain though, so if I've missed out some progression on the science here, I'd really like to know. Edit: As others have also pointed out, there's also the case where the antibodies even enhance the infection process.