Developing the Covid-19 vaccine

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Millennie Al
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Re: Developing the Covid-19 vaccine

Post by Millennie Al » Fri Dec 31, 2021 2:26 am

Woodchopper wrote:
Thu Dec 30, 2021 11:38 pm
tl;dr effect of the third booster on being infectious wanes after a few months, at the same rate as the second dose.

IMHO we may be looking at biannual vaccinations indefinitely.
That would be ethically dubious. Such vaccinations would then be almost entirely administered to patients for the benefit of others. We don't do that. We currently administer vaccines either solely for the benefit of the patient (e.g. rabies) or for the benefit of patients with the desireable side-effect of reducing transmission and so benefiting others (e.g. measles). Since the Covid vaccines seem to continue to protect the vaccinated against severe illness even after they have lost their power to protect against catching the disease, repeated vaccination would be of little benefit to the vaccinated.

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Re: Developing the Covid-19 vaccine

Post by Woodchopper » Fri Dec 31, 2021 5:20 am

Millennie Al wrote:
Fri Dec 31, 2021 2:26 am
Woodchopper wrote:
Thu Dec 30, 2021 11:38 pm
tl;dr effect of the third booster on being infectious wanes after a few months, at the same rate as the second dose.

IMHO we may be looking at biannual vaccinations indefinitely.
That would be ethically dubious. Such vaccinations would then be almost entirely administered to patients for the benefit of others. We don't do that. We currently administer vaccines either solely for the benefit of the patient (e.g. rabies) or for the benefit of patients with the desireable side-effect of reducing transmission and so benefiting others (e.g. measles). Since the Covid vaccines seem to continue to protect the vaccinated against severe illness even after they have lost their power to protect against catching the disease, repeated vaccination would be of little benefit to the vaccinated.
It would be a problem to compel people who were very unlikely to be seriously ill to be vaccinated. I don’t see a problem if it’s voluntary. There is a difficult moral grey area between the two.

Millennie Al
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Re: Developing the Covid-19 vaccine

Post by Millennie Al » Sun Jan 02, 2022 12:45 am

Woodchopper wrote:
Fri Dec 31, 2021 5:20 am
It would be a problem to compel people who were very unlikely to be seriously ill to be vaccinated. I don’t see a problem if it’s voluntary. There is a difficult moral grey area between the two.
There's also an issue if it's voluntary but deceit over the benefit is used to encourage uptake.

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bob sterman
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Re: Developing the Covid-19 vaccine

Post by bob sterman » Sun Jan 02, 2022 7:30 am

Millennie Al wrote:
Fri Dec 31, 2021 2:26 am
Woodchopper wrote:
Thu Dec 30, 2021 11:38 pm
tl;dr effect of the third booster on being infectious wanes after a few months, at the same rate as the second dose.

IMHO we may be looking at biannual vaccinations indefinitely.
That would be ethically dubious. Such vaccinations would then be almost entirely administered to patients for the benefit of others. We don't do that. We currently administer vaccines either solely for the benefit of the patient (e.g. rabies) or for the benefit of patients with the desireable side-effect of reducing transmission and so benefiting others (e.g. measles). Since the Covid vaccines seem to continue to protect the vaccinated against severe illness even after they have lost their power to protect against catching the disease, repeated vaccination would be of little benefit to the vaccinated.
We do administer some vaccines where the main benefit is prevention of severe disease in others (where they only provide small benefits to the person vaccinated). E.g.

A major benefit of childhood flu vaccinations for school age kids is that they prevent transmission and severe disease in babies and the elderly.

HPV vaccines for teenage boys - main benefit is that it prevents transmission and hence cervical cancer in women. The benefits to boys are small.

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Re: Developing the Covid-19 vaccine

Post by Bird on a Fire » Mon Jan 03, 2022 11:00 am

The rubella component of MMR is also mainly to protect pregnant people IIRC.
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Re: Developing the Covid-19 vaccine

Post by Herainestold » Sun Jan 09, 2022 4:13 pm

A new protein subunit vaccine is approved and being manufactured in India. Is this similar to the Novavax vaccine?
A vaccine authorized in December for use in India may help solve one of the most vexing problems in global public health: How to supply lower-income countries with a COVID-19 vaccine that is safe, effective and affordable.

The vaccine is called CORBEVAX. It uses old but proven vaccine technology and can be manufactured far more easily than most, if not all, of the COVID-19 vaccines in use today.
"And it's cheap, a dollar, dollar fifty a dose," Hotez says. "You're not going to get less expensive than that."

Clinical trials showed they were right to be confident CORBEVAX would work. An unpublished study conducted in India involving 3,000 volunteers found the vaccine to be 90% effective in preventing disease cause by the original COVID-19 virus strain and 80% against the delta variant. It's still being tested against omicron.

But CORBEVAX is already entering the real world. Last month, the vaccine received emergency use authorization from regulators in India. An Indian vaccine manufacturer called Biological E Ltd is now making the vaccine. The company says it is producing 100 million doses per month and has already sold 300 million doses to the Indian government.

"The real beauty of the CORBEVAX vaccine that Drs. Hotez and Bottazzi created is that intellectual property of this vaccine will be available to everybody," Keith Martin says. "So you can get manufacturers in Senegal, and South Africa and Latin America to be able to produce this particular vaccine."
I doubt we will see this here, but a cheap easily manufactured vaccine will be good for global vaccine equity.

https://www.npr.org/sections/goatsandso ... ket-newtab
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Millennie Al
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Re: Developing the Covid-19 vaccine

Post by Millennie Al » Mon Jan 10, 2022 1:37 am

Herainestold wrote:
Sun Jan 09, 2022 4:13 pm
I doubt we will see this here, but a cheap easily manufactured vaccine will be good for global vaccine equity.
That doesn't seem very likely as there is already sufficient supply. The limits are elsewhere.

Story from February: https://economictimes.indiatimes.com/in ... 947580.cms
The South African government has denied that it has asked Serum Institute of India (SII) to take back the 1 million doses of Covid-19 vaccines that the company had sent in early February. The government said that it plans to share the vaccines with other african countries. ... it decided to halt the use of the AstraZeneca-Oxford vaccine, as a trial found that the jab provided only ‘minimal protection’ against mild and moderate cases of Covid-19 caused by the new variant that accounts for 90% of infections in that country. South Africa has paid $1million to procure the AZ/Oxford vaccines that SII is manufacturing.
So that's down to $1 per dose already.

And from April South Africa's Health Minister Zweli Mkhize said: https://economictimes.indiatimes.com/in ... 982170.cms
"We have now secured 51 million doses of vaccines with the agreements that have been signed - 31 million from Johnson and Johnson, which is a one-dose vaccine; and 20 million from Pfizer
, which is a two-dose vaccine.

"This means that we can now move forward with confidence as we finalise our plans for our mass rollout campaign, which is due to officially begin at the end of phase one on May 17," he said.
So South Africa is able to buy the vaccines they want on the open market at the current prices.

And from December: https://timesofindia.indiatimes.com/bus ... 156036.cms
Serum Institute of India (SII), the world’s largest vaccine manufacturer by volume, on Tuesday said it is slashing production of Covishield by at least 50% from next week as the company has no further orders from the Centre.
...
Serum has 500 million doses of Covishield—half of that is finished product and half of that is bulk, which can be filled and finished in a matter of two months, and it has a shelf life of nine months—and it is available on priority to the Indian government.
Pointing out that the export of Covishield is also slow currently, he said the export orders would pick up in the next quarter. “Over the eight months when we could not export, other countries managed supplies from donations from the US and elsewhere and we have lost a lot of share,” he said, adding that he is now going to try to claw the demand back in the first quarter of next year.
So it's now just a commercial operation with different suppliers competing for market share. Maybe the poorest countries need money to be donated to pay for doses, or help to adminster them, but the global supply is enough for everyone already.

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Re: Developing the Covid-19 vaccine

Post by Herainestold » Fri Jan 21, 2022 10:49 pm

Nordic countries are limiting the administration of Moderna vax.
COPENHAGEN, Denmark (AP) — Finland has joined other Nordic countries in suspending or discouraging the use of Moderna’s COVID-19 vaccine in certain age groups because of an increased risk of heart inflammation, a rare side effect associated with the shot.

The Finnish Institute for Health and Welfare said Thursday that authorities won’t give the shot to males under age 30. They will be offered the Pfizer/BioNTech vaccine instead. The government agency said it found that young men and boys were at a slightly higher risk of developing myocarditis.
https://www.wjhl.com/news/international ... rna-shots/
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Re: Developing the Covid-19 vaccine

Post by Herainestold » Wed Jan 26, 2022 4:22 am

Pfizer testing Omicron specific vaccine:
Pfizer and BioNTech have started a study comparing their Omicron-based Covid-19 vaccine to the original vaccine, the companies said in a statement on Tuesday.

If regulators were to decide to wait for data from such a study, it could mean it will be many months before an Omicron-specific vaccine would be available.

Pfizer said it expects initial findings from the study, which will enroll 1,420 volunteers, to be available during the first half of 2022.
The study will look at the safety, immunogenicity, and tolerability of the vaccine – meaning, essentially, whether it raises antibody levels and how frequently it causes side effects including fever and fatigue. The study will not be large enough that it would be expected to necessarily give data on how strategies compare in terms of how many people are infected or develop Covid symptoms.

The study will be split into three groups, or cohorts. One, of 615 people, already received two doses of the authorized Pfizer-BioNTech vaccine. They will receive either one or two doses of the Omicron-specific vaccine.

A second group of 600 already received three doses of the Pfizer-BioNTech vaccine. They will receive either another dose of the authorized vaccine, or a dose of the Omicron-specific vaccine. A third group of 205 volunteers have not yet been vaccinated, and will receive three doses of the Omicron-based vaccine.
By the time it is approved, Omichron will be long gone and there will be a new variant making us sick.

https://www.statnews.com/2022/01/25/pfi ... d-vaccine/
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Re: Developing the Covid-19 vaccine

Post by Grumble » Wed Jan 26, 2022 7:40 am

Who are these 205 volunteers who haven’t been vaccinated yet? Requires a combination of being willing to take a genuinely experimental vaccine but also not to have bothered going getting vaccinated previously.
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Re: Developing the Covid-19 vaccine

Post by tom p » Wed Jan 26, 2022 2:15 pm

Grumble wrote:
Wed Jan 26, 2022 7:40 am
Who are these 205 volunteers who haven’t been vaccinated yet? Requires a combination of being willing to take a genuinely experimental vaccine but also not to have bothered going getting vaccinated previously.
The country of the study was not mentioned, and may well be relevant

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Re: Developing the Covid-19 vaccine

Post by sTeamTraen » Thu Jan 27, 2022 12:56 am

Herainestold wrote:
Wed Jan 26, 2022 4:22 am
By the time it is approved, Omichron will be long gone and there will be a new variant making us sick.
Perhaps, but given that Omicron now utterly dominates the world, it is far more likely that the next successful variant will be more like Omicron than the original virus, which is what the vaccines were developed against.
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Re: Developing the Covid-19 vaccine

Post by Herainestold » Thu Jan 27, 2022 4:06 pm

sTeamTraen wrote:
Thu Jan 27, 2022 12:56 am
Herainestold wrote:
Wed Jan 26, 2022 4:22 am
By the time it is approved, Omichron will be long gone and there will be a new variant making us sick.
Perhaps, but given that Omicron now utterly dominates the world, it is far more likely that the next successful variant will be more like Omicron than the original virus, which is what the vaccines were developed against.
Who knows what the future will bring. All we know is most predictions are wrong. There will be another wave based on a new variant and it will likelier be more virulent than Omicron.
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Re: Developing the Covid-19 vaccine

Post by Trinucleus » Thu Jan 27, 2022 4:17 pm

Herainestold wrote:
Thu Jan 27, 2022 4:06 pm
sTeamTraen wrote:
Thu Jan 27, 2022 12:56 am
Herainestold wrote:
Wed Jan 26, 2022 4:22 am
By the time it is approved, Omichron will be long gone and there will be a new variant making us sick.
Perhaps, but given that Omicron now utterly dominates the world, it is far more likely that the next successful variant will be more like Omicron than the original virus, which is what the vaccines were developed against.
Who knows what the future will bring. All we know is most predictions are wrong. There will be another wave based on a new variant and it will likelier be more virulent than Omicron.
I presume it's got to be otherwise it wouldn't take hold

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Re: Developing the Covid-19 vaccine

Post by jdc » Thu Jan 27, 2022 6:33 pm

Trinucleus wrote:
Thu Jan 27, 2022 4:17 pm
Herainestold wrote:
Thu Jan 27, 2022 4:06 pm
sTeamTraen wrote:
Thu Jan 27, 2022 12:56 am


Perhaps, but given that Omicron now utterly dominates the world, it is far more likely that the next successful variant will be more like Omicron than the original virus, which is what the vaccines were developed against.
Who knows what the future will bring. All we know is most predictions are wrong. There will be another wave based on a new variant and it will likelier be more virulent than Omicron.
I presume it's got to be otherwise it wouldn't take hold
Nope. It would have to be more contagious and/or more immune escapey than Omicron. More virulent wouldn't be helpful.

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Re: Developing the Covid-19 vaccine

Post by bob sterman » Thu Jan 27, 2022 7:39 pm

Herainestold wrote:
Thu Jan 27, 2022 4:06 pm
Who knows what the future will bring. All we know is most predictions are wrong. There will be another wave based on a new variant and it will likelier be more virulent than Omicron.
Errrr.....in adjacent sentences????

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Re: Developing the Covid-19 vaccine

Post by Herainestold » Thu Jan 27, 2022 7:58 pm

bob sterman wrote:
Thu Jan 27, 2022 7:39 pm
Herainestold wrote:
Thu Jan 27, 2022 4:06 pm
Who knows what the future will bring. All we know is most predictions are wrong. There will be another wave based on a new variant and it will likelier be more virulent than Omicron.
Errrr.....in adjacent sentences????
Yup. Most predictions are wrong...especially mine. Doesn't mean I can't make them.
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Re: Developing the Covid-19 vaccine

Post by shpalman » Thu Jan 27, 2022 10:33 pm

It's probably semi obvious that it will continue to mutate in a generally more contagious direction, but nobody could meaningfully quantify either that or its eventually severity let alone suggest what it would mean in terms of case numbers or health service pressure.
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Re: Developing the Covid-19 vaccine

Post by Herainestold » Thu Jan 27, 2022 11:59 pm

shpalman wrote:
Thu Jan 27, 2022 10:33 pm
It's probably semi obvious that it will continue to mutate in a generally more contagious direction, but nobody could meaningfully quantify either that or its eventually severity let alone suggest what it would mean in terms of case numbers or health service pressure.
Just know that whatever happens it will be bad
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Re: Developing the Covid-19 vaccine

Post by shpalman » Fri Jan 28, 2022 9:36 am

Herainestold wrote:
Thu Jan 27, 2022 11:59 pm
shpalman wrote:
Thu Jan 27, 2022 10:33 pm
It's probably semi obvious that it will continue to mutate in a generally more contagious direction, but nobody could meaningfully quantify either that or its eventually severity let alone suggest what it would mean in terms of case numbers or health service pressure.
Just know that whatever happens it will be bad
This is meaningless; it's probably safe to assume that covid won't mutate into a form which makes people live longer.

More constructively, in the UK and especially in England, the strategy seems to have been to let it be as bad as tolerable so as not to cause slight inconvenience to people, so if the viral disease itself gets less bad by whatever metric (lower fatality rate or lower hospitalization rate) the government will order even fewer restrictions and non-pharmaceutical interventions than Plan B, until the overall death rate or hospitalization rate or hospital occupancy climbs to some level at which people start to care again. But people don't seem to care about the ~1800 deaths per week which you currently have in the UK and certainly didn't care about the ~800-1000 deaths per week you had since the summer.

OWID UK all-cause deaths: you can see it's been higher than "usual" since July.
molto tricky

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Re: Developing the Covid-19 vaccine

Post by raven » Sat Jan 29, 2022 6:25 pm

shpalman wrote:
Fri Jan 28, 2022 9:36 am
More constructively, in the UK and especially in England, the strategy seems to have been to let it be as bad as tolerable so as not to cause slight inconvenience to people, so if the viral disease itself gets less bad by whatever metric (lower fatality rate or lower hospitalization rate) [...]
Well, playing devil's advocate, you could make an argument that by allowing high-ish levels of community transmission you're not forcing the virus to rely on hospitalisation & nocosomial spread to get into all that juicy human lung tissue, and thus you've opened up the possibility of it evolving in a less virulent direction.

Similarly you could argue that by leaving kids unvaccinated and having schools open even when WFH is expected for lots of adults, you're also tempting it to evolve into being really good at infecting kids. This may be a less good thing.

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Re: Developing the Covid-19 vaccine

Post by shpalman » Sat Jan 29, 2022 6:39 pm

raven wrote:
Sat Jan 29, 2022 6:25 pm
shpalman wrote:
Fri Jan 28, 2022 9:36 am
More constructively, in the UK and especially in England, the strategy seems to have been to let it be as bad as tolerable so as not to cause slight inconvenience to people, so if the viral disease itself gets less bad by whatever metric (lower fatality rate or lower hospitalization rate) [...]
Well, playing devil's advocate, you could make an argument that by allowing high-ish levels of community transmission you're not forcing the virus to rely on hospitalisation & nocosomial spread to get into all that juicy human lung tissue, and thus you've opened up the possibility of it evolving in a less virulent direction.

Similarly you could argue that by leaving kids unvaccinated and having schools open even when WFH is expected for lots of adults, you're also tempting it to evolve into being really good at infecting kids. This may be a less good thing.
We've tended to see previous variants die out when new variants take over, rather than having parallel outbreaks in different groups, at least within a single country. So either the increased restrictions introduced to counteract the higher R0 of the new variants effectively suppresses the old ones - in which case couldn't we have just done those restrictions in the first place? - or the new variant actually outcompetes the old one by getting to people first such that they then have enough antibodies to not also get infected by the old one.

It's definitely been good at infecting kids since Alpha.
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Re: Developing the Covid-19 vaccine

Post by Herainestold » Sat Jan 29, 2022 11:21 pm

shpalman wrote:
Fri Jan 28, 2022 9:36 am
Herainestold wrote:
Thu Jan 27, 2022 11:59 pm
shpalman wrote:
Thu Jan 27, 2022 10:33 pm
It's probably semi obvious that it will continue to mutate in a generally more contagious direction, but nobody could meaningfully quantify either that or its eventually severity let alone suggest what it would mean in terms of case numbers or health service pressure.
Just know that whatever happens it will be bad
This is meaningless; it's probably safe to assume that covid won't mutate into a form which makes people live longer.

More constructively, in the UK and especially in England, the strategy seems to have been to let it be as bad as tolerable so as not to cause slight inconvenience to people, so if the viral disease itself gets less bad by whatever metric (lower fatality rate or lower hospitalization rate) the government will order even fewer restrictions and non-pharmaceutical interventions than Plan B, until the overall death rate or hospitalization rate or hospital occupancy climbs to some level at which people start to care again. But people don't seem to care about the ~1800 deaths per week which you currently have in the UK and certainly didn't care about the ~800-1000 deaths per week you had since the summer.

OWID UK all-cause deaths: you can see it's been higher than "usual" since July.
Delta was more virulent than alpha was more virulent than Wuhan strain. Omicron was less. Regression to the mean makes me think that the next variant will be more virulent. As well as more contagious and greater immune escape, otherwise it won't be the next variant.

I think the UK is heading for another 100 000 Covid deaths in 2022. Plus Long Covid, organ damage etc.

It will be interesting to compare life expectancy of UK (And Western Europe in general) with China and New Zealand who have held Covid at bay.
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Re: Developing the Covid-19 vaccine

Post by Herainestold » Sat Jan 29, 2022 11:42 pm

shpalman wrote:
Sat Jan 29, 2022 6:39 pm
raven wrote:
Sat Jan 29, 2022 6:25 pm
shpalman wrote:
Fri Jan 28, 2022 9:36 am
More constructively, in the UK and especially in England, the strategy seems to have been to let it be as bad as tolerable so as not to cause slight inconvenience to people, so if the viral disease itself gets less bad by whatever metric (lower fatality rate or lower hospitalization rate) [...]
Well, playing devil's advocate, you could make an argument that by allowing high-ish levels of community transmission you're not forcing the virus to rely on hospitalisation & nocosomial spread to get into all that juicy human lung tissue, and thus you've opened up the possibility of it evolving in a less virulent direction.

Similarly you could argue that by leaving kids unvaccinated and having schools open even when WFH is expected for lots of adults, you're also tempting it to evolve into being really good at infecting kids. This may be a less good thing.
We've tended to see previous variants die out when new variants take over, rather than having parallel outbreaks in different groups, at least within a single country. So either the increased restrictions introduced to counteract the higher R0 of the new variants effectively suppresses the old ones - in which case couldn't we have just done those restrictions in the first place? - or the new variant actually outcompetes the old one by getting to people first such that they then have enough antibodies to not also get infected by the old one.

It's definitely been good at infecting kids since Alpha.
Whatever societal or pharmaceutical interventions you make will cause the virus to mutate around them. That is just the way it works.
That is why Zero covid is so attractive. You stop engineering a virus to evade your control measures.

We have engineered a virus that infects children, when the original strain did not affects them as much. Good work.

China successfully suppressed Delta variant. We will see how they do with Omicron.
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Re: Developing the Covid-19 vaccine

Post by bob sterman » Sun Jan 30, 2022 9:52 am

Herainestold wrote:
Sat Jan 29, 2022 11:42 pm
Whatever societal or pharmaceutical interventions you make will cause the virus to mutate around them.
This isn't mere pedantry - but this is not how evolution works.

Interventions create selection pressures that make some mutations more successful than others. They can also, by allowing more cases to emerge - create more opportunities for mutations to arise (that could then be subject to selection).

But the interventions do not "cause" mutations (unless we really are talking about drugs designed to mess with viral replication!!).

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