Intramuscular sars-cov-2 vaccines to produce humoral igM and igG antibodies (and body serum resident T cells) based on a genetic sequence from 2+ years ago are now thrown away. That's unfortunate but a 4th dose has limited returns.
What we need is intranasal sars-cov-2 vaccine boosters to provide igM and igA antibodies, and more importantly trained tissue resident T cells, in the upper respiratory mucosa immune compartment where igG antibodies do not penetrate. That's where infection starts and replication goes (mostly) unchecked.
Even just updating the sequence to reflect current variants while remaining intramuscular only would be okay and that will happen this fall (too late). But if we really want to mitigate spread and mutation to complement the protection from hospitalization intramusculars give we're going to need continued funding for new vaccines.
What we need is a vaccine that works better. Everything else is just speculation until it’s tested in well-designed trials that test the right thing in actual humans.
Sure, you may think we need an intranasal vaccine and I may think we need an attenuated-virus vaccine stimulating a T cell response against ORF1ab peptides, but we could both be entirely wrong.
Keep in mind that the measles vaccine is injectable and produces excellent durable protection against the airborn measles virus. The chickenpox vaccine is an injected live virus vaccine that appears to provide excellent durable protection against chickenpox, which, while it sure looks like a virus that would be transmitted mainly by shedding from blisters, is apparently also airborn.
Meanwhile, a hypothetical intranasal vaccine that raised an awesome IgA response with the same affinity as the the IgG antibodies in people vaccinated with the current mRNA vaccines but did nothing else seems unlikely to be especially effective against BA.4 and BA.5.
Sad part I remember back in the beginning of the pandemic people mentioning this: we needed intranasal vaccines to properly stomp transmission. Feels like the initial success of Pfizer and Moderna stopped this development
I think what we need is trust, good faith communication, and actual science (rather than conjecture and bribes.) That's all gone now, possibly for a very long time.
I recently got Covid. My original vaccine was in April 2021, shot #2 in May 2021, and booster in December 2021. It really knocked me out for a solid week + persistent symptoms and very annoying cough for another two weeks. I would happily take another booster shot but apparently I'm not eligible yet (in California). Shame to hear that some doses are being thrown away - I'd take a shot every other month if it would prevent me from getting Covid again.
I know a dozen people that have had it in the last month, including my whole family, and everyone's symptoms were mild, less than the flu. Not trying to discredit, just wanted to share other points of view.
It seems to manifest in all kinds of ways. I got it a month ago (double boosted) and it was the worst illness I'd had since a big flu bout ca. 1990. Not fun. My symptoms were clinically mild, but were total ass-kickers.
That's what I was expecting. Makes me think I might've caught one of the new variants. I'm quite fit and healthy, so I don't think it's a matter of weak immune system.
What stops someone from going somewhere and just pretending they're unvaccinated and getting a shot? I was under the impression that a booster was just another dose.
> What stops someone from going somewhere and just pretending they're unvaccinated and getting a shot? I was under the impression that a booster was just another dose.
I don't know if they'd actually check it, but most (all?) US states have vaccine databases, and I assume COVID vaccinations would be entered into it.
I was shocked when I got a new doctor that he had all my vaccine records going back years. Things like flu shots and tetanus boosters that I didn't tell anyone about except the pharmacy and my insurance company.
Back in the day, your health record was like a criminal record. If it got a black mark, you couldn't buy insurance any longer. I hope we never go back to that.
> Back in the day, your health record was like a criminal record. If it got a black mark, you couldn't buy insurance any longer. I hope we never go back to that.
I'm honestly confused how this comment flowed from mine. Getting a vaccine isn't a health problem. These databases make it much easier to get your vaccination records, since you don't have to track down records from every health provider you may have visited (including ones from before you could talk).
> immune system does wise up to the virus with repeated exposures.
“Repeatedly catching Covid-19 appears to increase the chances that a person will face new and sometimes lasting health problems after their infection, according to the first study on the health risks of reinfection.”
People test for a lot of reasons (for ex: their employer requires routine screening, or they are going to be proximate with immunocompromised people, etc.). Testing positive is not an indicator of poor health.
> The article mentions that, as well as points out that the material it is based on is not peer reviewed.
The article says that even when controlling for prior existing conditions, age, sex, etc, that outcomes are still statistically worse with each infection. The material is also preprint and will be undergoing peer review.
Immune escape is not a binary. Natural infection produces t-cells trained on every viral protein rather than just ones on the surface, they don't prevent infections but get them under control. In the meantime memory b-cells accumulate and diversify with every exposure. Vaccine kick start was sure helpful, but natural adaptive immunity is not easy to outsmart.
Infections are bad because the virus transmits. The virus is capable of mutating to evade the immune response. Future variants may also attack different body systems. For example, it looks like BA.5 reverts back to the lungs vs the original omicron variant.
Also, it is quite unfortunate that we now have evidence that multiple acute covid infections may cause long lasting health problems.
Which to be honest is the wrong metric to look at. The right metric is whether you get sick from it. If previous infections or vaccinations downgrade the virus to just a cold, then it’s good enough. Clearly we have no mean to stop this virus, not even slow it down. But if it is mostly harmless, is that really a problem?
Interesting attitude, and I wonder how much you've been affected by the pro-vaccine fervor over the last few years. Vaccines are still a risky product; your immune system is a highly complex, tightly calibrated system, and every vaccine has a small probability of throwing that system out of order. New research is coming out to show that horrific chronic illnesses like post-viral syndrome and long covid are caused by autoantibodies--antibodies that attack healthy cells. There's a good reason why we're not recommended monthly vaccine doses, and it doesn't just have to do with the cost.
Because COVID changed (fortunately, I hope). Delta was bad, but Omicron was not so the pressure on people to pay attention was reduced/removed. Hopefully, the changes to Omicron don't return "strength" to go along with "transmissibility". The signal-to-noise ratio for COVID was terrible, and people just decided it was over. The last wave didn't end up in hospital and if they think about it at all they assume all future waves won't either. Hope so...
Endemic COVID, which is sorta the endgame that people want/expect, has it turning into somewhere between a cold and a bad flu in strength/effect. We'll see.
> Endemic COVID, which is sorta the endgame that people want/expect
Textbook case of a self-fulfilling prophecy. It was said from the beginning that would be the ultimate result and very little was done as a coordinated global effort to avoid it. And that inspired little confidence in regard to the next pandemic, whenever it may be.
There was much done, but to ill effect with a large percentage of people actively blocking any efforts. What do you suggest should have been done that wasn’t attempted?
A lot to unpack but off the top of my head, the US was wide open compared to UK/EU; the biggest mistake initially was the communication from WHO and CDC recommending that masks were not necessary, and subsequent backtrack that eroded public confidence leading to even less compliance; mask mandates were dropped everywhere; and the worst is this insistence of combatting fomite transmission—which is completely false—having hand sanitizers installed everywhere but nowhere do you find improvements to ventilation and air filtration, for instance.
edit: and I agree a lot was done, but certainly not in any unified manner. in this age of hyper-globalized economies, countries cannot effectively act as individual entities when dealing with pandemics.
You’ve seen how the public has reacted to mask mandates. When something requires cooperation of the entire world, it’s at that point more about risk mitigation than elimination.
We have seen similar or even worse numbers in UK/EU over time. Theres a notion of being open, and then there’s public conformance.
Totally agree masking and filtration could have been massively improved, but it wasn’t known for a while that masks were the right thing. Everyone needs to give the health officials some latitude when something is brand new and being studied in real time. Of course communication could be improved, but it didn’t help it was also politically inconvenient (along with all the false information) so the comms no matter what would be challenged.
> peoples initial state of extreme fear(that they were told to have)
Estimated US flu deaths[0] between 2010 and 2020 (i.e. 10 years): 359K.
Estimated US Covid-19 deaths[1] between January 2020 and today (i.e. 2.5 years): 1,044,557
Can we stop with this disingenuous narrative? People rightfully perceived a level of heightened risk, ahead of a working vaccine, and took reasonable precautions. If it was as dangerous as the flu, we would have seen 90K deaths not 1M+.
~75% of those deaths were among people of retirement age or older. I think it's fair to question whether it was "reasonable precaution" to shut down schools, people's workplace, and entire sectors of the economy. Simply showing the total body count doesn't even begin to describe the complexity of balanced risk assessment for younger people and what was allowed to be considered a "disingenuous narrative" or not.
Operation of our economy relies a lot on free or paid labor from old people, though. We can't isolate them and keep the economy running normally.
How do you think poor people get child care so they can go to work, for one thing?
I do think there's room to criticize what was done, but I don't think "just isolate old people" was ever a practical option, and I don't think the alternative of "we're keeping things open and not isolating old people, so make sure you say anything you've been meaning to to your elderly parents really soon, because... well, you know" was ever gonna go over well.
> I think it's fair to question whether it was "reasonable precaution" to shut down schools,
I know enough teachers and was privy to their thoughts and observations during the pandemic that I'm quite confident schools were going to shut down no matter what official policy was. Lots of teachers are married to higher earners, and they're basically all working because they want to. They'd have stopped wanting to, and the schools wouldn't have been able to remain open with normal hours and procedures, with their much-reduced staff. A couple districts I know for a fact faced near-revolt over measures that were regarded as insufficient and coupled with tone-deaf messaging, and had to adjust or the scenario above was definitely going to happen and they'd have lost 10+% of their staff all at once, which is enough to completely mess them up.
Whether their opinions were based on reality hardly matters: fact is, schools were going to shutdown, one way or another.
'Psychopathic' is a generous take, as it would assume some level of truth. The take is just wrong and mindlessly repeats the contrarian bullshit we've been hearing for the past two years. I'm very disappointed to be reading it on hackernews actually.
If it wasn't for the last two sentences I would have thought this wasn't satire.
Good god, from calling an order of magnitude in difference as only "a few" to the false equivalences, you really nailed the poor logic I saw at the beginning of the pandemic.
There used to be a time when young people challenged the government narrative. Now they are the most vociferous in repeating and amplifying it without an ounce of doubt or questioning.
I hope this means more will go to underdeveloped countries now. The African continent averages at 40 doses per 100 people while the rest of the world is at 154
"painfully clear " although it's quite unclear if (most of) those countries really need vaccines. Their fatality rate has always been orders of magnitude lower than in eur / us..
I'll take this one. The vast majority of COVID risk is stratified in the very elderly and/or those with diseases of modernity / metabolic syndrome type conditions. Both of those categories (age & diseases of modernity) are much more present in wealthy, fat first-world countries than they are 2nd and 3rd world countries. Thus the utility of reducing COVID mortality is much, much lower in those less "advanced" countries.
I'd also add that even if the absolute death weren't lower in the 3rd world, the relative death would. Being able to be freaked out about an average of .3% chance of dying of COVID if infected is a luxury that those countries struggling with malaria, rampant malnutrition, and insufficient non-COVID vaccination don't really have.
South African here: may be different in other African nations but we have had plenty of supply for a while: people simply don't want to get vaccinated.
It is not just the west that has "vaccine hesitancy".
Even in underdeveloped countries most have probably been exposed multiple times and built up natural immunity. Although AIDS and other comorbidities could be a problem in Africa and perhaps China needs lots of doses to mitigate consequences of zero COVID. If their official case stats are to be trusted that is.
now that ba.5 is the dominant variant, seriously, what is the efficacy of the original covid-19 vaccine? does it actually reduce spreading and by how much?
I take it that you're looking only at the "All Infection" efficacy? While the original vaccines are clearly less effective at totally preventing infection with the latest variants, their efficacy against symptomatic infection and hospitalization is nothing to sneeze at — ~50% and ~90% respectively with a booster, eyeballing the table.
yes, that is precisely what I was asking about. I dont have high expectations for the vaccine, we all know tons of vaxed people have gotten re-infected with later variants.
The protection afforded by intramusculars to the body against death is clear, well worth it, and long lasting. I am not talking about that here.
I tried to make this distinction clear by writing out the full "vaccine effectiveness against infection" every time. The entire point of my comments in this post's threads is to point out the intramuscular vaccines cannot and are not protective against you getting infected and spreading the disease.
That's bad. We need new intranasal vaccine boosters to augment the intramusculars and we need to keep wearing face fitting N95 or ffp2 or better masks indoors until then. Being intramuscularly vaccinated will not prevent you from spread sars-cov-2. It will keep you from dying for years and keep you from being hospitalized for ~6 months.
"High levels of protection (over 90%) are also seen against mortality with all 3 vaccines and against both the Alpha and Delta variants with relatively limited waning"
That's something. Remember the early days, when there was a shortage of body bags.
It varies from year to year. The traditional seasonal flu intramuscular contains 4 different variants it targets, and sometimes the predictions of which sequences to include are wrong. In those years you see sub 50% vaccine efficiencies against infection. Vaccine efficiency versus hospitalization is much better.
But the same situation re: igG humoral antibodies from intramuscular vaccination not getting in your nose/throat/etc mucosa apply to flu vaccines. Most people only get intramuscularly vaccinated and so get upper respiratory flu infections and spread but are mostly asymptomatic and unaware. Actual vaccine efficiency for flu intramusculars is probably lower than reported due to the asymptomatic cases.
I personally alternate between intramuscular flu vaccines and the Flu Mist intranasal flu vaccine (which you can get by request).
> I heard that the flu vaccine is also around 30% effective.
The flu vaccine is so ineffective that if we actually applied evidence-based medicine standards to it / actually looked at a real cost:benefit analysis, we would never be pushing the flu vaccine.
> Injected influenza vaccines probably have a small protective effect against influenza and ILI (moderate-certainty evidence), as 71 people would need to be vaccinated to avoid one influenza case, and 29 would need to be vaccinated to avoid one case of ILI. Vaccination may have little or no appreciable effect on hospitalisations (low-certainty evidence) or number of working days lost.
So: a miniscule reduction in actual flu cases (granted, a slightly-better-but-still-weak reduction in general ILI), with no appreciable difference on hospitalizations or working days lost, meaning that the economic benefit of giving the flu vaccine is basically zero.
It's pretty great that the first world (at least America) has been so heavily socialized to accept the flu vaccine as effective and necessary, because it makes arguing for the effectiveness of the COVID vaccine much easier, since the bar is so incredibly low.
Flu vaccine has zero side effects for many and if you do have side effects you are free to skip it. Otherwise, I like getting a little less sick statistically with no downside. Current COVID vaccines are different in that many have days of quite significant side effects. Absolutely worth it for initial 2-3 shots without preexisting immunity, not so much once one's immune system is already trained through vaccination and repeated exposure.
Was that really the intention? Pretty sure they intended for something better and just settled on this because it was the only feather left in the cap.
Well the original trials only tested if there were symptoms, they never even measured the ability to stop transmissions. So it never really said on the tin that it did. It the bullshit echochamber of journalists and politicians that ended up defining the vaccine “working” as stopping transmissions, rather than serious cases. But that was not a claim from the manufacturers of the vaccines.
> It the bullshit echochamber of journalists and politicians that ended up defining the vaccine “working” as stopping transmissions, rather than serious cases. But that was not a claim from the manufacturers of the vaccines.
Pfizer stated[0] on Jan 26, 2021 that their vaccine "has been authorized for emergency use to prevent COVID-19 in individuals 16+." [emphasis added]
I am the wrong person for this debate but I think we laymen refer to the virus as covid but in medical terms covid is the disease/symptoms caused by the virus, not the virus itself. So that statement may still be compatible with the vaccine stopping getting sick from it, not transmissions.
cm2187 is correct. It was, and is, incredibly frustrating to see the news media and laymen talking about sars-cov-2 by saying covid or covid-19. That's always been the disease that sars-cov-2 causes. You can be infected with sars-cov-2 without having covid-19. In fact, based on China's latest massive population wide PCR testing about 90% of people infected with sars-cov-2 are asymptomatic and will spread it without ever having covid-19.
I'm sorry the science communication during the pandemic has been so terrible but there's really nothing suspicious or disengenous going on here.
Here is someone who should certainly know what they're talking about:
CDC Director Dr. Rochelle Walensky, March 29, 2021:
"[O]ur data from the CDC today suggests, um, you know, that vaccinated people do not carry the virus, don't get sick, and that it's not just in the clinical trials but it's also in real world data."
> Which papers did the CDC rep cite in her speech?
Dr. Walensky is much more than a CDC "rep"; she is[1] "an American physician-scientist who is the director of the Centers for Disease Control and Prevention and the administrator of the Agency for Toxic Substances and Disease Registry. Prior to her appointment at the CDC, she was the Chief of the Division of Infectious Diseases at Massachusetts General Hospital and a professor of medicine at Harvard Medical School. Walensky is an expert on HIV/AIDS."
So Americans are supposed to not trust the imminently qualified head of the CDC unless she cites specific papers, which they should then go and read to "do their own research" and second guess her?
>So Americans are supposed to not trust the imminently qualified head of the CDC
Unfortunately, yes, name and status does not mean anything. Papers and replicable findings matter. Press conferences held by media figures don't. Arguments from authority require the authority figure to be talking in a non-laymen context. Video press conferences are for people that don't know science and, frankly, they're very dumbed down.
Scientists have known about immune compartmentalization and the how to evoke the different types of antibodies since the 1960s (and T-cell residence in 1980s). It just hasn't made it into public messaging about vaccines for aerosol spread viruses until recently because it wasn't a world stage issue.
There's no doubt intramuscular vaccination still does help against infection in other immune compartments. It's just not the best at it. This has been shown in large scale studies re: sars-cov-2 from Israel in terms of likelyhood of being infected if someone in your residence gets infected. ref: https://www.science.org/doi/10.1126/science.abl4292 "Vaccination with BNT162b2 reduces transmission of SARS-CoV-2 to household contacts in Israel"
To be honest at this stage vaccination policies have become little more than a bureaucratic process and a mean to enforce compliance for the sake of compliance. Forcing people to get vaccinated irrespective of whether they were infected or not, or whether the virus circulates or not, or whether they are in a demographics with near zero risk from the virus. It ceases to be a medical consideration. So the fact that we are many variants away from the original vaccine is lost on the political science graduates running the show.
what nonsense is this? why would you get vaccinated AFTER and infection? the point of the vaccine is to prevent, not to fix. I realize my comment begged someone to talk like this, to be honest I am glad that me and my whole family got vaxxed. It was the least we could do.
I think it's worth pulling out three points in particular from the article.
One is that packaging choices (vial size) made to optimize mass vaccination are now somewhat of a hindrance. This isn't exactly unsurprising that packaging should have to evolve with the type of demand. I know that changing vial sizes probably would require the manufacturers to re-run all of their shelf-life and shipping validations. I wonder where they are along that process. One would have hoped that these validations would have been run earlier - the change in consumption patterns was somewhat predictable.
The other is that other countries are -refusing- vaccine donations. As it turns out, infrastructure and logistics constraints, as well as vaccine hestitancy continue to be a problem. Here's another article about that from earlier in 2022 (https://www.politico.com/news/2022/02/22/africa-asks-covid-v...).
The article claims the US has a ~12% wastage rate. I'd argue that while that's not insignificant, if the rate can be held at 12% (big if to be fair...), that doesn't seem -that- bad. There's quite a lot of literature on vaccine wastage rates even prior to COVID. From what I've found, a 2.5%-5% wastage rate was considered normal for vaccines in steady-state use in developed countries, while flu vaccine wastage could potentially range from 5-40% (https://www.auditor.on.ca/en/content/annualreports/arreports... Figure 6).
One thing to remember is that the reason why these doses aren't going to countries that want them is that Bill "Open Source is Communism" Gates said so. Remember when Biden wanted to suspend COVID vaccine patents? Yeah, that got the entire rogues gallery of copyright and patent maximalists to circle the wagons and kill anything even remotely related to poorer countries being able to print their own mRNA.
The current situation we have now is what they wanted: rich countries buying up dose after dose long after they are needed while poor countries have to beg and plead for nearly-expired scraps. The end result of this is that vaccine immunity has a shelf-life because the virus has plenty of unexposed individuals to mutate in. No, this wasn't planned, but it is an example of how excessive focus on protecting "intellectual property" generates worse public outcomes.
Well, they are obsolete. If there was a vaccine that could bring Omicron to R < 1 among those who didn't yet have the latest variant, there would be plenty of demand. Especially if it had mild enough side effects for continued regular shots to be preferable to occasional reinfections. As it is, a second Omicron infection after 3 shots seems to be 1-2 days of sniffles while each additional shot is 3 solid days of fever/puking/misery. Common sense suggests not taking something that makes you quite sick again and again.
Mind you, someone with no preexisting immunity or one natural infection would do well to get 3 shots rather than risking severe disease or lingering after effects. But how many people in the world are in this position anymore? Everyone willing and able has got the shots and the rest have been exposed multiple times and either developed effective immunity or succumbed to the disease. I can see some corner cases like babies and immunocompromised, but that's not a lot of doses. Hopefully they will have access to stronger / less unpleasant vaccine before long.
Having had the vaccine and COVID, the vaccine has far fewer side effects and offers vetter protection than the virus. This should be pretty clear to anyone who has experienced the same, and the data we have shows that too.
How is that different from what I am saying? It's just that if you already had 3 shots and 2 COVIDs, and you had significant side effects from previous shots, the equation is different going forward. But new vaccines that are ahead of circulating variants / tend to not have noticeable side effects would be worth considering.
In all of Connecticut, less than 3,000 of the ~166k children under five have gotten vaccinated so far. Which is pretty crazy, given that Connecticut was consistently among the top three most vaccinated states, at least until the Omicron wave.
Is it really crazy that adults who are at risk would vaccinate themselves but not their children that have essentially zero/infinitesimal risk? I took the covid vaccine but there is not a chance in hell, mandated or not, that I would vaccinate my 5 year old for Covid. And yes, he has all of his other vaccines.
Lingering after effects risk is not really zero, I would go for initial doses but not necessarily indefinite boosters of current shot. However slight is your worry about kid catching COVID, it will be a little less with some protection, resulting in fuller enjoyment of life. All in exchange for at most 2-3 days of side effects after shots.
Kids could have more side effects from covid vaccine than from covid itself. I am not a kid but have long term, almost a year, side effects from Pfizer vaccine.
We are talking statistics, individual experiences can always be different. If you personally had bad reaction to shots, certainly seems reasonable to not get more at this stage. Whether such reactions are likely to be heritable is above my pay grade to tell. I personally had bad lingering effects from swine flu, if shots prevented that for COVID, I am grateful to be spared that experience.
Isn't long covid still a common issue for young kids? And doesn't vaccination reduce the chances of having long covid? Admittedly I haven't done a deep dive on the statistics, just a quick google search.
What we need is for more truth. Unfortunately many Republican and far-right followers think covid is just like the flu. Or worse, that the vaccines have nanochips that will control you. Worst is influential people like Musk who vote for Mayra Flores who is a qanon believer and is against the covid vaccine.
Misinformation is one of the worst problems for the future human race.
I don't see much formal policy/discussion of 2nd booster with the new variants around. Most people I know have boosted for 6+ months and wondering if it's worth getting 4th shot but there's no official guidance. Like if you can just walk into a pharmacy and get another shot like in US I'd probably do it.
Also, a significant number of doses are thrown away in the US because they still come in 5-dose vials. Just shipping single dose would prevent a lot of scenarios where giving one person a booster means throwing away the other four doses in the vial. (The vial is only good for a few hours after being opened.)
What we need is intranasal sars-cov-2 vaccine boosters to provide igM and igA antibodies, and more importantly trained tissue resident T cells, in the upper respiratory mucosa immune compartment where igG antibodies do not penetrate. That's where infection starts and replication goes (mostly) unchecked.
Even just updating the sequence to reflect current variants while remaining intramuscular only would be okay and that will happen this fall (too late). But if we really want to mitigate spread and mutation to complement the protection from hospitalization intramusculars give we're going to need continued funding for new vaccines.