10 ms·

This has been a known problem for years. There are three issues at play: 1. Overuse of antibiotics in non-theraputic settings (e.g. agriculture) 2. Lack of in

This has been a known problem for years. There are three issues at play: 1. Overuse of antibiotics in non-theraputic settings (e.g. agriculture) 2. Lack of interest in developing new classes of antibiotics 3. Insufficient interest in vaccine development The last one is particularly interesting because a somewhat-effective vaccine[0] for Neisseria gonorrhoeae was discovered several years ago, but GlaxoSmithKline doesn't want to conduct the trials and submit it for approval until they find one that would be more effective and more profitable for them, so in the meantime it can only be used off-label, which means adoption is next to zero, because most physicians and patients don't even know it's an option. It's also only covered by insurance for its on-label use, which makes it difficult and expensive ($300 for the full series) even for people who want to get it. Although GSK is at least ahead of Pfizer, who owns the patent for a nearly-identical vaccine that is also shown to be comparably effective against gonorrhea, and as far as I can tell has not even bothered to try using that as the basis for developing another. [0] about 40%, which for comparison is higher than the effectiveness of the flu vaccine for every year in the past decade except one

ceejayoz 4y ago
You can't use an entirely unapproved drug off-label (with rare and individual exceptions; https://www.fda.gov/news-events/public-health-focus/expanded-access https://www.fda.gov/news-events/public-health-focus/expanded...). Off-label use is using an approved drug for a different medical purpose than the one it was approved for.
- chimeracoder 4y ago
  > You can't use an entirely unapproved drug off-label I know how drug development works, but thank you. The vaccine is approved for use against another bacterium in the same genus. It is not approved for use against gonorrhea. That means it can be used off-label.
  - mmmmmkouff 4y ago
    > I know how drug development works, but thank you. No reason to get angry, nobody knows you from Adam. If you don't want to be treated like you're an idiot, post to a different website. The whole point of Hacker News comment sections is to see who can pretentiously promote their own alleged genius at the expense of everyone else
Scoundreller 4y ago
> until they find one that would be more effective and more profitable for them If I’ve learned anything over the past few years, the less effective the vaccine, the more profitable it is.
- nerdponx 4y ago
  The most profitable vaccine would be highly effective, but wears off over time.
- gus_massa 4y ago
  The mRNA vaccines have an effectiveness of approximately 90%. The inactivated virus vaccines have a "low" effectiveness like approximately 60% (that is not negligible!). Are the inactivated virus vaccine more profitable than the mRNA vaccines?
  - Scoundreller 4y ago
    Depends on production costs, can make the inactivated virus vaccine easily. mRNA vaccines were about 95% effective against symptomatic disease, but only against the targeted strain.
mfer 4y ago
All 3 of these are related to optimizing for income. Even the first. They use so much antibiotics due to optimizing for income when it comes to the meat industry. Speaks to priorities
nerdponx 4y ago
#2 and #3 seems like obvious places to direct public funds via government, being investments in public goods. In the USA, this can be done either through executive agencies, or by Congress. Is Congress unaware of the issue, or is there some political jockeying that prevents it? It seems like maybe it's worth redirecting funds from other basic research (medical or otherwise) into this area for at least a few years.
- chimeracoder 4y ago
  > #2 and #3 seems like obvious places to direct public funds via government, being investments in public goods. In the USA, this can be done either through executive agencies, or by Congress. Is Congress unaware of the issue, or is there some political jockeying that prevents it? It seems like maybe it's worth redirecting funds from other basic research (medical or otherwise) into this area for at least a few years. This problem disproportionately affects gay men and sex workers (of any gender/orientation), and the government's track record with public health issues that affect gay men is... pretty bad. The HIV epidemic began in 1981, and the first FDA-approved condom for anal sex didn't appear until 2022. Heck, there wasn't even an FDA-approved gonorrhea test for gay men until 2019. Or if you want something more recent, look at how badly the US government botched the Mpox epidemic. The US literally had Jynneos vaccines ready to go, and at multiple points either failed to arrange for the logistics of using them or (in more egregious displays) simply refused to administer them altogether. The US government's mishandling of Mpox response has been so egregious that unless you were following it closely, you'd think sounds like satire or a conspiracy theory. https://www.nytimes.com/2022/05/29/opinion/monkeypox-covid-and-hiv.html https://www.nytimes.com/2022/05/29/opinion/monkeypox-covid-a... https://www.nytimes.com/2022/07/25/nyregion/nyc-monkeypox-vaccine-doses-denmark.html https://www.nytimes.com/2022/07/25/nyregion/nyc-monkeypox-va... https://www.nytimes.com/2022/08/01/nyregion/monkeypox-vaccine-jynneos-us.html https://www.nytimes.com/2022/08/01/nyregion/monkeypox-vaccin...
- sjsdaiuasgdia 4y ago
  I think there's a few factors that contribute to there not being much political attention on gonorrhea treatment and prevention in the US. 1) Only about 0.2% of the US population contracts gonorrhea annually [0] 2) Many people see gonorrhea as a consequence of risky sex, which then butts up against religious beliefs and the like. The Religious Right would not generally be in favor of anything that makes sex less dangerous, and it would almost certainly become a culture war issue. 3) Until pretty recently, gonorrhea was not that big a deal because we had multiple antibiotics that worked against it. Public perception has not yet caught up with the science, thus there's not that many people clamoring for action. [0] https://www.statista.com/statistics/626863/rate-of-cases-of-gonorrhea-in-us/ https://www.statista.com/statistics/626863/rate-of-cases-of-...
rjzzleep 4y ago
The effectiveness of the flu vaccine is kind of odd, but somewhat makes sense since it seems more like a moneymaking machine than something that actually has some worthwhile results(some people will probably jump on this statement). Most places don't even seriously market them for that very reason. 40% is terrible for something like gonorrhea, so unless it becomes much better you're better off being more diligent in your sexual escapades.
- nerdponx 4y ago
  There has been a huge push for annual flu vaccination in the last ~10 years in the USA. It was a favorite target of anti-vax conspiracy theorists long before Covid.
- chimeracoder 4y ago
  > it seems more like a moneymaking machine than something that actually has some worthwhile results The flu vaccine is absolutely not a moneymaking enterprise (unless you define "money-making" as "spending less money on treating serious flu cases and sequelae", at which point you might as well leverage that same logic to argue against all preventive care). > 40% is terrible for something like gonorrhea, so unless it becomes much better you're better off being more diligent in your sexual escapades. This is a common attitude amongst the public, but it is completely at odds with how public health officials operate, because it's incredibly harmful and counterproductive. Shaming people for sexual activity might feel good and "moral", but not only does it not actually reduce incidence, but it increases the rate of STI transmission. 40% is not perfect, and it's insufficient to merit mass public vaccination, but it's more than adequate for protecting high-risk groups.
  - rjzzleep 4y ago
    > This is a common attitude amongst the public, but it is completely at odds with how public health officials operate, because it's incredibly harmful and counterproductive. That's an ABSURD statement. Your statement is completely at odds with how public health operates in most countries. I've worked in it both in the US and in Germany, and worked with two more countries' health systems. In Germany at a leadership level, that is actually very close to the layer that decides what gets covered by public health insurance. Most public health insurance only covers older treatments because the new treatments are too risky for them with too little data on successful treatments. Things such as shockwave treatment that performance athletes frequently use or mothers use for their thumb after breastfeeding are completely out of pocket, because not enough longterm studies show statistical significance on the treatment. I understand that public health officials in the RECENT years(ten years is considered recent in public health or healthcare in general by the way) are trying to completely change the way public health works, because they want more direct control, but it is absolutely not YET how it works.
legutierr 4y ago
So you are saying this functional vaccine exists, and has been approved by the FDA for another use, so that it can be used off-label, but that people do not use it because people don't know about it... ...and you don't name the vaccine or provide any specific information about it. I'm sure you see the irony! What is this vaccine called, and for what other purpose has it been approved? Do you have a link to a study indicating that it is somewhat affective against Neisseria gonorrhoeae?
- vamin 4y ago
  They may be referring to the meningitis vaccine: https://www.bmj.com/content/377/bmj.o997 https://www.bmj.com/content/377/bmj.o997
  - raylad 4y ago
    This is not paywalled and has more info: https://www.cidrap.umn.edu/studies-highlight-meningitis-vaccines-potential-against-gonorrhea https://www.cidrap.umn.edu/studies-highlight-meningitis-vacc...
- kemayo 4y ago
  Googling "Neisseria gonorrhoeae vaccine" turned up... honestly, a lot of papers that're above my educational level. That said, this[1] WHO article from halfway down the results says that "observational studies indicating that vaccines developed for serogroup B Neisseria meningitidis might offer some protection against gonorrhoea, providing promise that gonococcal vaccines are biologically feasible", which I'd suspect is referring to the development that the OP is talking about. Please, feel free to follow up on that article if you have higher scientific literacy than I do. :D [1]: https://www.who.int/teams/immunization-vaccines-and-biologicals/diseases/neisseria-gonorrhoeae https://www.who.int/teams/immunization-vaccines-and-biologic...
- chimeracoder 4y ago
  > What is this vaccine called, and for what other purpose has it been approved? The GlaxoSmithKline version is called Bexsero, but Pfizer has the patent on Trumenba, which is functionally the same thing. Both are used against bacterial meningitis serogroup B. Note that this is different from the standard meningitis vaccine required in most public schools and universities. Isomeone says they've been vaccinated against meningitis, they almost certainly are referring to the vaccine for serogroups A, C, Y, and W-135, which is different and not effective against gonorrhea. There are tons of studies demonstrating the effectiveness of both against gonorrhea - it's almost a running joke that every 3-6 months a new one gets published, prompting a slew of articles expressing surprise and amazement, as if this hasn't happened so many times over the last decade that we've lost track. Pretty much all of them point to the range of 40% real-world effectiveness, which is actually quite good from a public health standpoint. Knowing about it isn't really the main hurdle, though. Even if you know it exists, it's incredibly difficult logistically to get it, because your insurance company won't pay for it unless you've been provably in the vicinity of a MenB outbreak (which is rare in the US), and pharmacies will order it but generally not administer it, so even if you are fine paying for it yourself and manage to get your doctor to prescribe it to you, you'll end up in a weird logistical catch-22 where you can obtain it from a pharmacy but have to self-administer it (do not do this, unless you are trained) or find a not-so-kosher way to get it administered.
binarycrusader 4y ago
Would it be this GSK Vaccine that just started a clinical study relatively recently? https://www.clinicaltrials.gov/ct2/show/NCT05630859 https://www.clinicaltrials.gov/ct2/show/NCT05630859
- chimeracoder 4y ago
  > Would it be this GSK Vaccine that just started a clinical study relatively recently? That's the vaccine that GSK is developing as a candidate with the hopes that it will be superior (and also more lucrative) than Bexsero (the existing vaccine). It's not inherently a bad thing that this might be an option, especially if it turns out to be effective, but keep in mind that GSK has been working on this for years, and that Bexsero's effectiveness has been widely known for years before that. So having a candidate that may be approved in 2026 or later is... not very reassuring given the threats of treatment resistance..
onlyrealcuzzo 4y ago
Do you have a link to this vaccine data? Are there different types of gonorrhea, or is it 40% effective against all strains? And how long does the effectiveness last?
devmunchies 4y ago
Those are scientific issues, but STD spread is also a by-product of social changes. The median age of female's first marriage was less than 22 for 100 years and rose to 28 in the last few decades[1]. I would assume this results in a higher number of partners and more opportunities for an STD to spread. [1]: https://www.census.gov/content/dam/Census/library/visualizations/time-series/demo/families-and-households/ms-2.pdf https://www.census.gov/content/dam/Census/library/visualizat...
- zwkrt 4y ago
  Why is this women’s fault somehow?
  - slingnow 4y ago
    Why do you assume OP was blaming women? Nothing they said implies blame.
  - Cuuugi 4y ago
    Noone passed blame, simply noting the sexual revolution has made STD's more common-place.
  - sbaiddn 4y ago
    How do you infer that op is blaming women? They merely stated a fact and didn't assign any blame.
    - Avshalom 4y ago
      >" median age of female's first marriage "
      - Volundr 4y ago
        The mere mention of a statistic involving a gender does not blame that gender. The point of noting the increase in marriage age is to point out that presumably the number of sexual partners increase as well, which can lead to more spread. Presumably women having more sexual partners ALSO means men having more, it takes two to tango and all that. That said I had initially assumed that the reason for using women specifically was probably that the male median age didn't increase in the same time-frame, but it looks like it's pretty much been in lockstep (https://www.census.gov/content/dam/Census/library/visualizations/time-series/demo/families-and-households/ms-2.pdf https://www.census.gov/content/dam/Census/library/visualizat...) so it's an odd choice to not just mention the median age of marriage instead of women specifically.
fsckboy 4y ago
> 1. Overuse of antibiotics in non-theraputic settings (e.g. agriculture) > 2. Lack of interest in developing new classes of antibiotics > 3. Insufficient interest in vaccine development you left out 4. Underuse of antibiotics in people so at risk they already have it, and then among those, them who will catch it again within the same social group. We have subpopulations and particular communities who engage in "way more than their share" of risky sexual behavior, many of whom also use drugs and alcohol liberally, and in the worst cases (like say drug addiction/mental illness) don't generally seek medical care or otherwise take care of themselves. I think the overuse of antibiotics on cattle has had much less to do with drug resistant human gonorrhea than giving populations humans who have gonorrhea insufficient quantities of inadequate antibiotics, particularly incomplete courses or treatment of cases without followthrough.That creates a perfect informal laboratory for developing strains of drug resistant bugs.
- chimeracoder 4y ago
  > I think the overuse of antibiotics on cattle has had much less to do with drug resistant human gonorrhea than giving populations humans who have gonorrhea insufficient quantities of inadequate antibiotics, particularly incomplete courses or treatment of cases without followthrough.That creates a perfect informal laboratory for developing strains of drug resistant bugs. This is provably incorrect. The standard treatment protocol for gonorrhea is a single IM dose. There's no such thing as an "incomplete" treatment for gonorrhea. > We have subpopulations and particular communities who engage in "way more than their share" of risky sexual behavior, many of whom also use drugs and alcohol liberally, and in the worst cases (like say drug addiction/mental illness) don't generally seek medical care or otherwise take care of themselves. It's common and perhaps tempting to lump "people who have a lot of sex" together with "people who use drugs and alcohol" and "people who don't seek medical care or take care of themselves", but the data shows that that's not actually the case. Particularly for the subpopulations most affected by gonorrhea, where the data very clearly and unambiguously shows the opposite relationship.
  - inglor_cz 4y ago
    "Particularly for the subpopulations most affected by gonorrhea, where the data very clearly and unambiguously shows the opposite relationship." People who tend to be sober and care about prophylactic care are the most afflicted with gonorrhoea?
SoftTalker 4y ago
> 1. Overuse of antibiotics in non-theraputic settings (e.g. agriculture) How is agricultural use of antibiotic fueling antibiotic-resistant gonorrhea? Are people having sex with animals, picking up STDs from them, and then passing them along to other people? Is there some other common repositiory of gonorrhea that both people and animals are coming into contact with to a degree that it's causing selection for antibiotic resistance?
telotortium 4y ago
$300 doesn't sound like that much to me, if we're talking about the price in the developed world. Did you mean $3000? In the US, $300 sounds like what you might pay as coninsurance on a non-particularly-generous health care plan for treatments for much less harmful diseases - I would have paid for it out of HSA when I was on a high-deductible health plan, since that insurance only starts covering anything besides an annual physical and flu shots if you spend more than $2000 a year.

ceejayoz 4y ago

You can't use an entirely unapproved drug off-label (with rare and individual exceptions; https://www.fda.gov/news-events/public-health-focus/expanded-access https://www.fda.gov/news-events/public-health-focus/expanded...). Off-label use is using an approved drug for a different medical purpose than the one it was approved for.

chimeracoder 4y ago
> You can't use an entirely unapproved drug off-label I know how drug development works, but thank you. The vaccine is approved for use against another bacterium in the same genus. It is not approved for use against gonorrhea. That means it can be used off-label.
- mmmmmkouff 4y ago
  > I know how drug development works, but thank you. No reason to get angry, nobody knows you from Adam. If you don't want to be treated like you're an idiot, post to a different website. The whole point of Hacker News comment sections is to see who can pretentiously promote their own alleged genius at the expense of everyone else

Scoundreller 4y ago

> until they find one that would be more effective and more profitable for them If I’ve learned anything over the past few years, the less effective the vaccine, the more profitable it is.

nerdponx 4y ago
The most profitable vaccine would be highly effective, but wears off over time.
gus_massa 4y ago
The mRNA vaccines have an effectiveness of approximately 90%. The inactivated virus vaccines have a "low" effectiveness like approximately 60% (that is not negligible!). Are the inactivated virus vaccine more profitable than the mRNA vaccines?
- Scoundreller 4y ago
  Depends on production costs, can make the inactivated virus vaccine easily. mRNA vaccines were about 95% effective against symptomatic disease, but only against the targeted strain.

mfer 4y ago

All 3 of these are related to optimizing for income. Even the first. They use so much antibiotics due to optimizing for income when it comes to the meat industry. Speaks to priorities

nerdponx 4y ago

#2 and #3 seems like obvious places to direct public funds via government, being investments in public goods. In the USA, this can be done either through executive agencies, or by Congress. Is Congress unaware of the issue, or is there some political jockeying that prevents it? It seems like maybe it's worth redirecting funds from other basic research (medical or otherwise) into this area for at least a few years.

chimeracoder 4y ago
> #2 and #3 seems like obvious places to direct public funds via government, being investments in public goods. In the USA, this can be done either through executive agencies, or by Congress. Is Congress unaware of the issue, or is there some political jockeying that prevents it? It seems like maybe it's worth redirecting funds from other basic research (medical or otherwise) into this area for at least a few years. This problem disproportionately affects gay men and sex workers (of any gender/orientation), and the government's track record with public health issues that affect gay men is... pretty bad. The HIV epidemic began in 1981, and the first FDA-approved condom for anal sex didn't appear until 2022. Heck, there wasn't even an FDA-approved gonorrhea test for gay men until 2019. Or if you want something more recent, look at how badly the US government botched the Mpox epidemic. The US literally had Jynneos vaccines ready to go, and at multiple points either failed to arrange for the logistics of using them or (in more egregious displays) simply refused to administer them altogether. The US government's mishandling of Mpox response has been so egregious that unless you were following it closely, you'd think sounds like satire or a conspiracy theory. https://www.nytimes.com/2022/05/29/opinion/monkeypox-covid-and-hiv.html https://www.nytimes.com/2022/05/29/opinion/monkeypox-covid-a... https://www.nytimes.com/2022/07/25/nyregion/nyc-monkeypox-vaccine-doses-denmark.html https://www.nytimes.com/2022/07/25/nyregion/nyc-monkeypox-va... https://www.nytimes.com/2022/08/01/nyregion/monkeypox-vaccine-jynneos-us.html https://www.nytimes.com/2022/08/01/nyregion/monkeypox-vaccin...
sjsdaiuasgdia 4y ago
I think there's a few factors that contribute to there not being much political attention on gonorrhea treatment and prevention in the US. 1) Only about 0.2% of the US population contracts gonorrhea annually [0] 2) Many people see gonorrhea as a consequence of risky sex, which then butts up against religious beliefs and the like. The Religious Right would not generally be in favor of anything that makes sex less dangerous, and it would almost certainly become a culture war issue. 3) Until pretty recently, gonorrhea was not that big a deal because we had multiple antibiotics that worked against it. Public perception has not yet caught up with the science, thus there's not that many people clamoring for action. [0] https://www.statista.com/statistics/626863/rate-of-cases-of-gonorrhea-in-us/ https://www.statista.com/statistics/626863/rate-of-cases-of-...

rjzzleep 4y ago

The effectiveness of the flu vaccine is kind of odd, but somewhat makes sense since it seems more like a moneymaking machine than something that actually has some worthwhile results(some people will probably jump on this statement). Most places don't even seriously market them for that very reason. 40% is terrible for something like gonorrhea, so unless it becomes much better you're better off being more diligent in your sexual escapades.

nerdponx 4y ago
There has been a huge push for annual flu vaccination in the last ~10 years in the USA. It was a favorite target of anti-vax conspiracy theorists long before Covid.
chimeracoder 4y ago
> it seems more like a moneymaking machine than something that actually has some worthwhile results The flu vaccine is absolutely not a moneymaking enterprise (unless you define "money-making" as "spending less money on treating serious flu cases and sequelae", at which point you might as well leverage that same logic to argue against all preventive care). > 40% is terrible for something like gonorrhea, so unless it becomes much better you're better off being more diligent in your sexual escapades. This is a common attitude amongst the public, but it is completely at odds with how public health officials operate, because it's incredibly harmful and counterproductive. Shaming people for sexual activity might feel good and "moral", but not only does it not actually reduce incidence, but it increases the rate of STI transmission. 40% is not perfect, and it's insufficient to merit mass public vaccination, but it's more than adequate for protecting high-risk groups.
- rjzzleep 4y ago
  > This is a common attitude amongst the public, but it is completely at odds with how public health officials operate, because it's incredibly harmful and counterproductive. That's an ABSURD statement. Your statement is completely at odds with how public health operates in most countries. I've worked in it both in the US and in Germany, and worked with two more countries' health systems. In Germany at a leadership level, that is actually very close to the layer that decides what gets covered by public health insurance. Most public health insurance only covers older treatments because the new treatments are too risky for them with too little data on successful treatments. Things such as shockwave treatment that performance athletes frequently use or mothers use for their thumb after breastfeeding are completely out of pocket, because not enough longterm studies show statistical significance on the treatment. I understand that public health officials in the RECENT years(ten years is considered recent in public health or healthcare in general by the way) are trying to completely change the way public health works, because they want more direct control, but it is absolutely not YET how it works.

legutierr 4y ago

So you are saying this functional vaccine exists, and has been approved by the FDA for another use, so that it can be used off-label, but that people do not use it because people don't know about it... ...and you don't name the vaccine or provide any specific information about it. I'm sure you see the irony! What is this vaccine called, and for what other purpose has it been approved? Do you have a link to a study indicating that it is somewhat affective against Neisseria gonorrhoeae?

vamin 4y ago
They may be referring to the meningitis vaccine: https://www.bmj.com/content/377/bmj.o997 https://www.bmj.com/content/377/bmj.o997
- raylad 4y ago
  This is not paywalled and has more info: https://www.cidrap.umn.edu/studies-highlight-meningitis-vaccines-potential-against-gonorrhea https://www.cidrap.umn.edu/studies-highlight-meningitis-vacc...
kemayo 4y ago
Googling "Neisseria gonorrhoeae vaccine" turned up... honestly, a lot of papers that're above my educational level. That said, this[1] WHO article from halfway down the results says that "observational studies indicating that vaccines developed for serogroup B Neisseria meningitidis might offer some protection against gonorrhoea, providing promise that gonococcal vaccines are biologically feasible", which I'd suspect is referring to the development that the OP is talking about. Please, feel free to follow up on that article if you have higher scientific literacy than I do. :D [1]: https://www.who.int/teams/immunization-vaccines-and-biologicals/diseases/neisseria-gonorrhoeae https://www.who.int/teams/immunization-vaccines-and-biologic...
chimeracoder 4y ago
> What is this vaccine called, and for what other purpose has it been approved? The GlaxoSmithKline version is called Bexsero, but Pfizer has the patent on Trumenba, which is functionally the same thing. Both are used against bacterial meningitis serogroup B. Note that this is different from the standard meningitis vaccine required in most public schools and universities. Isomeone says they've been vaccinated against meningitis, they almost certainly are referring to the vaccine for serogroups A, C, Y, and W-135, which is different and not effective against gonorrhea. There are tons of studies demonstrating the effectiveness of both against gonorrhea - it's almost a running joke that every 3-6 months a new one gets published, prompting a slew of articles expressing surprise and amazement, as if this hasn't happened so many times over the last decade that we've lost track. Pretty much all of them point to the range of 40% real-world effectiveness, which is actually quite good from a public health standpoint. Knowing about it isn't really the main hurdle, though. Even if you know it exists, it's incredibly difficult logistically to get it, because your insurance company won't pay for it unless you've been provably in the vicinity of a MenB outbreak (which is rare in the US), and pharmacies will order it but generally not administer it, so even if you are fine paying for it yourself and manage to get your doctor to prescribe it to you, you'll end up in a weird logistical catch-22 where you can obtain it from a pharmacy but have to self-administer it (do not do this, unless you are trained) or find a not-so-kosher way to get it administered.

binarycrusader 4y ago

Would it be this GSK Vaccine that just started a clinical study relatively recently? https://www.clinicaltrials.gov/ct2/show/NCT05630859 https://www.clinicaltrials.gov/ct2/show/NCT05630859

chimeracoder 4y ago
> Would it be this GSK Vaccine that just started a clinical study relatively recently? That's the vaccine that GSK is developing as a candidate with the hopes that it will be superior (and also more lucrative) than Bexsero (the existing vaccine). It's not inherently a bad thing that this might be an option, especially if it turns out to be effective, but keep in mind that GSK has been working on this for years, and that Bexsero's effectiveness has been widely known for years before that. So having a candidate that may be approved in 2026 or later is... not very reassuring given the threats of treatment resistance..

onlyrealcuzzo 4y ago

Do you have a link to this vaccine data? Are there different types of gonorrhea, or is it 40% effective against all strains? And how long does the effectiveness last?

devmunchies 4y ago

Those are scientific issues, but STD spread is also a by-product of social changes. The median age of female's first marriage was less than 22 for 100 years and rose to 28 in the last few decades[1]. I would assume this results in a higher number of partners and more opportunities for an STD to spread. [1]: https://www.census.gov/content/dam/Census/library/visualizations/time-series/demo/families-and-households/ms-2.pdf https://www.census.gov/content/dam/Census/library/visualizat...

zwkrt 4y ago
Why is this women’s fault somehow?
- slingnow 4y ago
  Why do you assume OP was blaming women? Nothing they said implies blame.
- Cuuugi 4y ago
  Noone passed blame, simply noting the sexual revolution has made STD's more common-place.
- sbaiddn 4y ago
  How do you infer that op is blaming women? They merely stated a fact and didn't assign any blame.
  - Avshalom 4y ago
    >" median age of female's first marriage "
    - Volundr 4y ago
      The mere mention of a statistic involving a gender does not blame that gender. The point of noting the increase in marriage age is to point out that presumably the number of sexual partners increase as well, which can lead to more spread. Presumably women having more sexual partners ALSO means men having more, it takes two to tango and all that. That said I had initially assumed that the reason for using women specifically was probably that the male median age didn't increase in the same time-frame, but it looks like it's pretty much been in lockstep (https://www.census.gov/content/dam/Census/library/visualizations/time-series/demo/families-and-households/ms-2.pdf https://www.census.gov/content/dam/Census/library/visualizat...) so it's an odd choice to not just mention the median age of marriage instead of women specifically.

fsckboy 4y ago

> 1. Overuse of antibiotics in non-theraputic settings (e.g. agriculture) > 2. Lack of interest in developing new classes of antibiotics > 3. Insufficient interest in vaccine development you left out 4. Underuse of antibiotics in people so at risk they already have it, and then among those, them who will catch it again within the same social group. We have subpopulations and particular communities who engage in "way more than their share" of risky sexual behavior, many of whom also use drugs and alcohol liberally, and in the worst cases (like say drug addiction/mental illness) don't generally seek medical care or otherwise take care of themselves. I think the overuse of antibiotics on cattle has had much less to do with drug resistant human gonorrhea than giving populations humans who have gonorrhea insufficient quantities of inadequate antibiotics, particularly incomplete courses or treatment of cases without followthrough.That creates a perfect informal laboratory for developing strains of drug resistant bugs.

chimeracoder 4y ago
> I think the overuse of antibiotics on cattle has had much less to do with drug resistant human gonorrhea than giving populations humans who have gonorrhea insufficient quantities of inadequate antibiotics, particularly incomplete courses or treatment of cases without followthrough.That creates a perfect informal laboratory for developing strains of drug resistant bugs. This is provably incorrect. The standard treatment protocol for gonorrhea is a single IM dose. There's no such thing as an "incomplete" treatment for gonorrhea. > We have subpopulations and particular communities who engage in "way more than their share" of risky sexual behavior, many of whom also use drugs and alcohol liberally, and in the worst cases (like say drug addiction/mental illness) don't generally seek medical care or otherwise take care of themselves. It's common and perhaps tempting to lump "people who have a lot of sex" together with "people who use drugs and alcohol" and "people who don't seek medical care or take care of themselves", but the data shows that that's not actually the case. Particularly for the subpopulations most affected by gonorrhea, where the data very clearly and unambiguously shows the opposite relationship.
- inglor_cz 4y ago
  "Particularly for the subpopulations most affected by gonorrhea, where the data very clearly and unambiguously shows the opposite relationship." People who tend to be sober and care about prophylactic care are the most afflicted with gonorrhoea?

SoftTalker 4y ago

> 1. Overuse of antibiotics in non-theraputic settings (e.g. agriculture) How is agricultural use of antibiotic fueling antibiotic-resistant gonorrhea? Are people having sex with animals, picking up STDs from them, and then passing them along to other people? Is there some other common repositiory of gonorrhea that both people and animals are coming into contact with to a degree that it's causing selection for antibiotic resistance?

telotortium 4y ago

$300 doesn't sound like that much to me, if we're talking about the price in the developed world. Did you mean $3000? In the US, $300 sounds like what you might pay as coninsurance on a non-particularly-generous health care plan for treatments for much less harmful diseases - I would have paid for it out of HSA when I was on a high-deductible health plan, since that insurance only starts covering anything besides an annual physical and flu shots if you spend more than $2000 a year.