Vaccine

[Nominal Animal]

Particularly funny/weird/sad is that the most effective way to stop the spread of pandemics is to restrict human movement, drastically: no exceptions, even for the super rich or politicians.

So simple, yet so costly and difficult.  Proven to save lives, but how do you calculate potential losses, or how much is a single avoidable death worth?  How do you balance the near-term loss of life with the long-term loss of life due to increased statistical financial hardships?  It is not easy.

I'm not suggesting any particular policy, either.  Just pointing out how difficult the answers are even when we have some of them.  We humans need things to be easy and cheap; but sometimes they just aren't.  Sometimes medicine and vaccines have drawbacks: just consider thalidomide, which causes horrible birth defects if taken during pregnancy.  Yet, it is an essential medicine, among the 460 medications WHO considers essential, with important life-saving use cases.

With money, it's a much easier calculation.  When it is a person suffering in front of you, and you have the tools that might help, it is basically inhuman to deny that help because of the long-term statistical repercussions.  Typical humans just don't work that way.

[LaserSteve]

I took my cell phone with me to the vaccination center. Mom's eighty-nine, so I knew we would get the longer observation hold post injection. I was reading EEV blog so the technician told security to  let me keep it on while secretly  calibrating each patient's implant  transceiver. Wasn't that cool!
Mom is griping about her 5G reception being poor, and like everything else in her life, I'm to blame. Not my fault the lizards went lowest bidder and used a front end on the chip  with poor IMD performance.

IN reality,  they forgot to post signs, and the center was in a public atrium. So  they just watched to make sure I wasn't taking photos. That way they had their HIPAA compliance. After listening to Mom babble for five minutes, they knew why I needed the phone. In my case, for sanity. .  I did read EEV while waiting. :-)

What really worried me was hundreds of seniors with a few family members  in one place with little to no temperature screening on entry.

Steve

[Zero999]

I took my cell phone with me to the vaccination center. Mom's eighty-nine, so I knew we would get the longer observation hold post injection. I was reading EEV blog so the technician told security to  let me keep it on while secretly  calibrating each patient's implant  transceiver. Wasn't that cool!
Mom is griping about her 5G reception being poor, and like everything else in her life, I'm to blame. Not my fault the lizards went lowest bidder and used a front end on the chip  with poor IMD performance.

IN reality,  they forgot to post signs, and the center was in a public atrium. So  they just watched to make sure I wasn't taking photos. That way they had their HIPAA compliance. After listening to Mom babble for five minutes, they knew why I needed the phone. In my case, for sanity. .  I did read EEV while waiting. :-)

What really worried me was hundreds of seniors with a few family members  in one place with little to no temperature screening on entry.

Steve

Sounds fun. You could have put a sticker over the camera, if they were funny about you having your phone on. Temperature screening is of little use because COVID-19 mostly spreads in healthy people and many don't get a fever. Were there any other precautions: good ventilation, keeping everyone 2m apart, masks? Those other measures are far more important, especially ventilation and distance. Think: if I farted, would the nearest person to me, be able to smell it and if so, for how long? If the person would hardly smell the fart, or only briefly, then the risk of transmission is low.

[Benta]

@Zero999, you break me up!

Next Corona risk management strategy: force people to eat baked beans, and if you smell something get out of there fast.

Much simpler, cheaper and probably more effective than what's going on right now.

[TimFox]

I had both my shots at a large community hospital, where they had re-purposed areas for the vaccination process (a different area for each time; the instructions mentioned two possible locations).  It was well-organized, with 6-foot markers on the floor of the corridor leading to the check-in, and separate small examining rooms for the actual shot.  The recovery room was a re-purposed lounge area, where the chairs were carefully located for distancing.  All in all, it went very smoothly (with friendly staff) and I had negligible reaction (only slight arm soreness).  As mentioned above, there were wall postings reminding of the camera ban, due to patient privacy.

[NiHaoMike]

I do agree we need to cut our use of antibiotics and develop new ones. It's possible the next pandemic could be caused by an antibiotic resistant bacterium.

Antibiotics are meant to deal with bacteria, not viruses. But it's true that we use way too much antibiotics, not just in human and veterinary medicine but also in industrial livestock farming which is possibly the larger threat.

Indeed, they should rapidly phase out factory farming. I hope that if factory farming causes another pandemic, it would be one that decimates factory farms but cause little or no harm to humans or sustainably raised animals.

Particularly funny/weird/sad is that the most effective way to stop the spread of pandemics is to restrict human movement, drastically: no exceptions, even for the super rich or politicians.

So simple, yet so costly and difficult.  Proven to save lives, but how do you calculate potential losses, or how much is a single avoidable death worth?  How do you balance the near-term loss of life with the long-term loss of life due to increased statistical financial hardships?  It is not easy.

Hence why I'm strongly against reopening schools early, since school has become bloated and overpriced. In its place, we could have online learning services instead. Hands on activities (e.g. science experiments) could be done by sending kits to the students or small workshops could be opened if that's not practical, done in such a way that possible spread would be very limited.

[Circlotron]

I wonder what would happen if you got the first dose of one brand of vaccine and the second does of a different brand? Would it still work? Would it cause any harm?

[Circlotron]

For example, if we use antibacterial detergents everywhere, and antibiotics for every bacterial and/or viral infection, then we actually provide evolutionary pressure for bacteria and viruses to evolve protection against them.  Superbugs (antibiotic-resistant bacteria) didn't just appear out of nowhere; we forced bacteria to evolve that way.

I've heard some say that the above situation, rather than cause a new entity to evolve, instead wipes out all the weak versions and leaves the previously minority but very strong and therefore unaffected versions with the entire environment all to themselves so now they can multiply unchecked. Disclaimer - I have no particular understanding of these things.

[JohnnyMalaria]

I wonder what would happen if you got the first dose of one brand of vaccine and the second does of a different brand? Would it still work? Would it cause any harm?

It would be less likely to work because the optimum time between first and second doses is different. The clinical trials determined the optimum time as defined by the maximum reduction in hospitalizations. (Sorry, that's a fugly word but I've lived in the US long enough...) If you get the second dose too early or too late, then its likely efficacy will be reduced.

As for harm? That hasn't been tested. Some of the vaccines are mRNA-based, some aren't. In the former case, it would depend on which proteins found in the coronavirus your body has been fooled into synthesizing in order to stimulate an immune response. And, harm, in such case, would be insufficient protection rather than direct damage to your health.

I'd be much more concerned about how your particular healthcare system would screw that up, though.

[langwadt]

For example, if we use antibacterial detergents everywhere, and antibiotics for every bacterial and/or viral infection, then we actually provide evolutionary pressure for bacteria and viruses to evolve protection against them.  Superbugs (antibiotic-resistant bacteria) didn't just appear out of nowhere; we forced bacteria to evolve that way.

I've heard some say that the above situation, rather than cause a new entity to evolve, instead wipes out all the weak versions and leaves the previously minority but very strong and therefore unaffected versions with the entire environment all to themselves so now they can multiply unchecked. Disclaimer - I have no particular understanding of these things.

isn't that basically the evolve in evolution?

[tszaboo]

I wonder what would happen if you got the first dose of one brand of vaccine and the second does of a different brand? Would it still work? Would it cause any harm?

We have no idea. Basically the current vaccination strategy is this way, because they tested it and it worked. And then we have stupid results, like this:
https://www.openaccessgovernment.org/astrazeneca-vaccine-2/98616/
where half dose works better, they could give it to twice as many people, but it's not tested.

[gnuarm]

Going forward, I hope that we can make progress on anti-viral medication, since vaccines can take a long time when a new virus appears.

Going forward I hope we can make progress in people treating deadly diseases like they are deadly diseases and not talking about them as "fake" or whining about not being able to get a haircut or claiming they will simply "vanish".

[gnuarm]

AstraZeneca is now on hold in many countries because some receivers have had unsual cases of blood clots some of them dying

afaiu if you had it and get unusual bruising you should see a doctor

With 37 clotting events across the 17 million doses given, I would not be in the least worried about getting the AstraZenica vaccine. In fact I find it surprising that so few have been reported, given that you'd expect something like 1/1000 people to experience a clotting event in a given year. If clots within a week of the vaccine were reported you'd expect to see 17e6/(1e3*52) =~ 300.

But you need to add to those 37 cases the number who were involved in a fatal auto accident on their way to the vaccination site.  In the US each day 1 in about 3.5 million die in auto accidents.  That would be roughly 2.5 deaths in 17 million, so the blood clots are about 10 times worse than auto risk.  I wonder how it compares to deaths due to falling down stairs or slipping in the bathtub.  Those numbers are pretty scary too.

I'm wondering how long it will be before there is a mass shooting at a vaccination site.  Just when you thought you were safe...

[gnuarm]

Come on. If you keep it serious, and talk about covid and vaccines, they will close this thread. Mods said several times it is not thematically fitting to an engineering forum.

Ok, being retired this virus has kept me at home nearly all the time.  That has allowed me to do a lot more work on electronics and FPGAs.  In fact, that is why I found this group.  I mainly posted in newsgroups before, but this group is MUCH betterer. 

A nice, supportive and reasonable bunch.  :-)

[gnuarm]

The best strategy for a new pathogen is to become less lethal and more infectious, thus increasing their numbers without killing off their hosts.

Unfortunately the less lethal part doesn't apply to pathogens which spread in a/presymptomatic people, or via a third party. For example, HIV has a 100% mortality rate, without treatment and spreads rapidly in healthy people, so it has no incentive to become less deadly. The same is true with SARS-Cov 2, which whilst fortunately is several orders of magnitude less deadly, also spreads in healthy people. Unfortunately there's mounting evidence to suggest the B1525 variant discovered in the UK, is not only more transmissible, but more deadly, than the original one. A pattern which seems to be repeated in other new variants.

I know it's only wackypedia (I'm lazy) so check the references.
https://en.wikipedia.org/wiki/Variants_of_SARS-CoV-2#Overview_table

If you think about the mechanics for a moment, you will realize most increases in transmissibility will also make a given infection more serious or lethal.  The most likely change that improves transmissibility is to more readily invade a cell or reproduce in larger numbers or faster so that lower initial numbers of viruses are more likely to create an infection.  They will also make the disease more serious and deadly.  So, no surprise.

[Circlotron]

For example, if we use antibacterial detergents everywhere, and antibiotics for every bacterial and/or viral infection, then we actually provide evolutionary pressure for bacteria and viruses to evolve protection against them.  Superbugs (antibiotic-resistant bacteria) didn't just appear out of nowhere; we forced bacteria to evolve that way.

I've heard some say that the above situation, rather than cause a new entity to evolve, instead wipes out all the weak versions and leaves the previously minority but very strong and therefore unaffected versions with the entire environment all to themselves so now they can multiply unchecked. Disclaimer - I have no particular understanding of these things.

isn't that basically the evolve in evolution?

I would have called it Natural Selection. That is to say, nothing new is produced. Instead, certain properties of an existing organism enable it's survival and consequent domination of it's environment.

[langwadt]

For example, if we use antibacterial detergents everywhere, and antibiotics for every bacterial and/or viral infection, then we actually provide evolutionary pressure for bacteria and viruses to evolve protection against them.  Superbugs (antibiotic-resistant bacteria) didn't just appear out of nowhere; we forced bacteria to evolve that way.

I've heard some say that the above situation, rather than cause a new entity to evolve, instead wipes out all the weak versions and leaves the previously minority but very strong and therefore unaffected versions with the entire environment all to themselves so now they can multiply unchecked. Disclaimer - I have no particular understanding of these things.

isn't that basically the evolve in evolution?

I would have called it Natural Selection. That is to say, nothing new is produced. Instead, certain properties of an existing organism enable it's survival and consequent domination of it's environment.

the new was produced when some turned out stronger than others

[gnuarm]

I wonder what would happen if you got the first dose of one brand of vaccine and the second does of a different brand? Would it still work? Would it cause any harm?

The multiple vaccines are not likely to interact at all as they target different, even if only slightly antigens. 

The Pfizer and Moderna vaccines provide mRNA that once inside the cell produce a protein fragment that is a portion of the virus spike.  Your cells use this mRNA to make copies of this protein which your immune systems then reacts to by creating antibodies and T-cells.  Once your immune system has reacted, it retains the ability to respond more quickly in the future. 

The second vaccine helps to boost the level of response to the presence of the COVID virus.  As such, it is unlikely that one vaccine will help to boost the other since they create different antibodies for different antigens.

[gnuarm]

For example, if we use antibacterial detergents everywhere, and antibiotics for every bacterial and/or viral infection, then we actually provide evolutionary pressure for bacteria and viruses to evolve protection against them.  Superbugs (antibiotic-resistant bacteria) didn't just appear out of nowhere; we forced bacteria to evolve that way.

I've heard some say that the above situation, rather than cause a new entity to evolve, instead wipes out all the weak versions and leaves the previously minority but very strong and therefore unaffected versions with the entire environment all to themselves so now they can multiply unchecked. Disclaimer - I have no particular understanding of these things.

isn't that basically the evolve in evolution?

Evolution consists of two separate things, mutation and selection.  There is no guiding force causing mutations.  They happen randomly and constantly resulting in a genome population with variation.  When these mutations result in poor performance in the environment those organisms reproduce less often and the frequency of the genes they carry are reduced.  When the mutations result in better survivability in the environment the frequency of the gene increases. 

In a disease population that is not wide spread (no where near herd immunity numbers) there is no competition.  Many strains of the disease can spread without influence on one another.  There is no real competition.  Once herd immunity levels are approached only a significant mutation that prevents existing antibodies from attacking the virus will be able to spread widely.  That is why we need to continue to take all precautions to minimize the spread of the disease; so the disease can be brought to Australian levels where it can be tracked and traced out of existence.

[Circlotron]

When these mutations result in poor performance in the environment those organisms reproduce less often and the frequency of the genes they carry are reduced.  When the mutations result in better survivability in the environment the frequency of the gene increases.

If we substitute the word "humans" for "organisms", from a purely logical point of view, by vaccinating ourselves it would appear we are interfering with evolution's efforts to refine the human race. Note I said logical, not ethical.

[DrG]

For example, if we use antibacterial detergents everywhere, and antibiotics for every bacterial and/or viral infection, then we actually provide evolutionary pressure for bacteria and viruses to evolve protection against them.  Superbugs (antibiotic-resistant bacteria) didn't just appear out of nowhere; we forced bacteria to evolve that way.

I've heard some say that the above situation, rather than cause a new entity to evolve, instead wipes out all the weak versions and leaves the previously minority but very strong and therefore unaffected versions with the entire environment all to themselves so now they can multiply unchecked. Disclaimer - I have no particular understanding of these things.

isn't that basically the evolve in evolution?

Evolution consists of two separate things, mutation and selection.  There is no guiding force causing mutations.  They happen randomly and constantly resulting in a genome population with variation.  When these mutations result in poor performance in the environment those organisms reproduce less often and the frequency of the genes they carry are reduced.  When the mutations result in better survivability in the environment the frequency of the gene increases. 

In a disease population that is not wide spread (no where near herd immunity numbers) there is no competition.  Many strains of the disease can spread without influence on one another.  There is no real competition.  Once herd immunity levels are approached only a significant mutation that prevents existing antibodies from attacking the virus will be able to spread widely.  That is why we need to continue to take all precautions to minimize the spread of the disease; so the disease can be brought to Australian levels where it can be tracked and traced out of existence.

I certainly agree with your final sentence – completely, but if I can add some other information (as I see it).

We can cause mutations – chemicals and radiation, for example.

The virus (SARS-CoV-2) is not alive. It requires a living cell to reproduce. It binds to the cell and hijacks the cell to follow its RNA instructions, which includes making copies. Unabated, enough cells get hijacked and you are in trouble.

When a copy is made, it can have an error in the sense that the newly made virus is not identical to the first one – that is the mutation. The more copies that are made, the more mutations will occur. The mutated virus has to be able to continue to make copies and those copies include the error. That’s how we get a “variant”.

Many mutations have little biological significance. Some can, potentially, make it much more lethal. In fact, they can fade out because they kill the host so quickly, there is little chance to transmit to another host.

Some mutations can be more transmissible (more contagious). The virus binds to a site on the cell and some mutations can make that bond stronger or easier to bind to the cell. In an evil sense, the worst case scenario is a very transmissible and very lethal virus, but slowly lethal, or lethal in only some people.

A vaccine can be less effective against a variant, but it is really the immune system activation by the vaccine that is not recognizing the variant as well as the “original” – that is the thinking.

This is expected to happen the longer the virus is active and the counter is to change the vaccine so that what is produced by the vaccine – that is the immune stimulation, is better targeted against the variant.

The two mRNA vaccines are little more than mRNA and some lipids to get it into your cells. There, the mRNA instructs the cells to make a compound that stimulates our immune system in a way that produces antibodies that can neutralize the virus. Even when the antibodies are gone the immune system has a “memory” such that it can recognize the virus can produce more of those antibodies quickly.

If they need to be tuned up, you can change the mRNA. Moderna has already done that and has requested a clinical trial for a new formulation that is designed to be more effective against variants.

The J&J vaccine (the one-shot, no big cooling needed) uses a modified adenovirus (harmless and can’t reproduce) to get into the cells to have them make a substance that will stimulate the same kinds of immune response.

Novovax (nearly approved) actually contains bits of harmless virus-like spikes. Again, these get recognized by the immune system and it outputs antibodies.

In each case, the vaccine can be tuned to produce an immune response better targeting a variant. The big fear, however, is that we don’t get it under control with vaccination; we could end up in a whack-a-mole situation.

If we don’t screw up, we will overcome this one and be better prepared for the next one. But that is a big “if”. Even though in the US we are up to some 2 million shots / day, and increasing, I worry. Moreover, it is absolutely a global situation that requires global eradication/control.

Sorry to go on and on but I am trying to set up an old Linksys WRT54G router - remember those? Well, I feel like I have forgotten whatever I once knew about the $!#@ things!.

[gnuarm]

When these mutations result in poor performance in the environment those organisms reproduce less often and the frequency of the genes they carry are reduced.  When the mutations result in better survivability in the environment the frequency of the gene increases.

If we substitute the word "humans" for "organisms", from a purely logical point of view, by vaccinating ourselves it would appear we are interfering with evolution's efforts to refine the human race. Note I said logical, not ethical.

Not sure what you mean by "interfering".  Creating and using vaccines is part of our survival process.  That's perfectly natural in the context of our own evolution.

BTW, evolution is not a thing and doesn't have "efforts".  It just happens.

[Zero999]

I do agree we need to cut our use of antibiotics and develop new ones. It's possible the next pandemic could be caused by an antibiotic resistant bacterium.

Antibiotics are meant to deal with bacteria, not viruses. But it's true that we use way too much antibiotics, not just in human and veterinary medicine but also in industrial livestock farming which is possibly the larger threat.

Indeed, they should rapidly phase out factory farming. I hope that if factory farming causes another pandemic, it would be one that decimates factory farms but cause little or no harm to humans or sustainably raised animals.

Factory farming is generally bad, as disease can spread rapidly and pathogens have plenty of opportunties to mutate, but there is one benifit of keeping animals indoors: it helps to keep them away from pathogen reservoirs in wild animals. We need lower density farming and stricter controlls of antibiotics used on livestock.

Particularly funny/weird/sad is that the most effective way to stop the spread of pandemics is to restrict human movement, drastically: no exceptions, even for the super rich or politicians.

So simple, yet so costly and difficult.  Proven to save lives, but how do you calculate potential losses, or how much is a single avoidable death worth?  How do you balance the near-term loss of life with the long-term loss of life due to increased statistical financial hardships?  It is not easy.

Hence why I'm strongly against reopening schools early, since school has become bloated and overpriced. In its place, we could have online learning services instead. Hands on activities (e.g. science experiments) could be done by sending kits to the students or small workshops could be opened if that's not practical, done in such a way that possible spread would be very limited.

I agree that the school is pretty crappy these days, but it's not just about academia, but socialising and learning to obey rules. It also negatively impacts parents who can't work from home. Here in the UK we opened schools last, after the first lockdown, but this time they've been the first thing to open, whilst restaurants, hair dressers, non-essential retail are still closed. Lots of it is political and this isn't the place for that discussion.

The best strategy for a new pathogen is to become less lethal and more infectious, thus increasing their numbers without killing off their hosts.

Unfortunately the less lethal part doesn't apply to pathogens which spread in a/presymptomatic people, or via a third party. For example, HIV has a 100% mortality rate, without treatment and spreads rapidly in healthy people, so it has no incentive to become less deadly. The same is true with SARS-Cov 2, which whilst fortunately is several orders of magnitude less deadly, also spreads in healthy people. Unfortunately there's mounting evidence to suggest the B1525 variant discovered in the UK, is not only more transmissible, but more deadly, than the original one. A pattern which seems to be repeated in other new variants.

I know it's only wackypedia (I'm lazy) so check the references.
https://en.wikipedia.org/wiki/Variants_of_SARS-CoV-2#Overview_table

If you think about the mechanics for a moment, you will realize most increases in transmissibility will also make a given infection more serious or lethal.  The most likely change that improves transmissibility is to more readily invade a cell or reproduce in larger numbers or faster so that lower initial numbers of viruses are more likely to create an infection.  They will also make the disease more serious and deadly.  So, no surprise.

It's not certain either way. If the virus evolves to infect the upper respitory tract, rather than the lungs, it'll be less lethal.

I think in this case, with the newer variants of COVID-19, your statement is correct: it's more readily invades cells and reproduces faster, so the minimum infectious dose is lower, which also makes it more lethal.

For example, if we use antibacterial detergents everywhere, and antibiotics for every bacterial and/or viral infection, then we actually provide evolutionary pressure for bacteria and viruses to evolve protection against them.  Superbugs (antibiotic-resistant bacteria) didn't just appear out of nowhere; we forced bacteria to evolve that way.

I've heard some say that the above situation, rather than cause a new entity to evolve, instead wipes out all the weak versions and leaves the previously minority but very strong and therefore unaffected versions with the entire environment all to themselves so now they can multiply unchecked. Disclaimer - I have no particular understanding of these things.

isn't that basically the evolve in evolution?

Evolution consists of two separate things, mutation and selection.  There is no guiding force causing mutations.  They happen randomly and constantly resulting in a genome population with variation.  When these mutations result in poor performance in the environment those organisms reproduce less often and the frequency of the genes they carry are reduced.  When the mutations result in better survivability in the environment the frequency of the gene increases. 

In a disease population that is not wide spread (no where near herd immunity numbers) there is no competition.  Many strains of the disease can spread without influence on one another.  There is no real competition.  Once herd immunity levels are approached only a significant mutation that prevents existing antibodies from attacking the virus will be able to spread widely.  That is why we need to continue to take all precautions to minimize the spread of the disease; so the disease can be brought to Australian levels where it can be tracked and traced out of existence.

We don't need to completely get rid of it, to get life back to normal. Fortunately serious illness due to reinfection is rare, so once we have herd immunity, the number of deaths will drastically fall. It's also rarely fatal in the young, so it's highly likely it'll just become like flu, or perhaps even milder, since it doesn't mutate quite so rapidly.

I doubt the US or Europe will be able to do as the Australians have done. Australia is quite well isoleted from the rest of the world and has a very low population density. People here in the UK often say we should have done what Australia did, but even through we're geographically an island, we're not really, since there's a tunnel linking us to Europe and we're too dependant on people crossing the border to completely close it.

[Nominal Animal]

For example, if we use antibacterial detergents everywhere, and antibiotics for every bacterial and/or viral infection, then we actually provide evolutionary pressure for bacteria and viruses to evolve protection against them.  Superbugs (antibiotic-resistant bacteria) didn't just appear out of nowhere; we forced bacteria to evolve that way.

I've heard some say that the above situation, rather than cause a new entity to evolve, instead wipes out all the weak versions and leaves the previously minority but very strong and therefore unaffected versions with the entire environment all to themselves so now they can multiply unchecked. Disclaimer - I have no particular understanding of these things.

Yes, but bacteria can exchange DNA "horizontally" ("horizontal DNA transfer" and "horizontal gene transfer" in literature), across different types, when in close proximity (in the same patient).  This means that to get a new drug-resistant strain of bacteria, all you need is a patient with two or more bacterial infections, one of which is a drug-resistant strain.  (Obviously, it does not always happen, you need some bad luck too.)

Viruses exchange RNA, if two different types infect the same cell.

This is a major way how viruses and bacteria evolve.

There are some very interesting scientific papers on this, for example Juhas, M. "Horizontal gene transfer in human pathogens", Crit Rev Microbiol. 2015 Feb;41(1):101-8.  Not my field, but the abstracts tell pretty well what the researchers are investigating.

[jpanhalt]

@Nominal Animal

That ability to promiscuously pick up DNA from its environment was well know for the Neisseriaceae, which includes Neisseria gonorrhoea, of course.  Easy to remember.