Vaccine

[madires]

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?

AFAIK, someone is performing a study about combining two different viral vector vaccines. BTW, one vaccine is single-shot (Johnson & Johnson).

[jpanhalt]

That question has been asked often.  First, the J&J vaccine is a viral vector vaccine that uses a replication defective adenovirus. Moderna and Pfizer vaccines do not use a viral vector.  They use synthetic liposomes.  The latter two vaccines are quite similar and seem to differ mostly in the liposome. 

Some experts have opined that little harm would be expected by crossing between those two vaccines; however, since such studies have not been completed, no agency of which I am aware has approved doing that.   Even under emergency release approval, one must still comply with the conditions of approval, unless you have an approved research study.

[Zero999]

I doubt there would be any harm caused by mixing vaccines, so long as there's sufficient gap between doeses. If there was, then previously infected people would be at greater risk of harm by the vaccine and so far that doesn't seem to be the case, other than an increased incidence of side effects.

It's equally likely mixing vaccines could improve immunity to a greater range of strains, as the immune system will be exposed to different antigens, in each vaccine. On the other hand there isn't the reinforcement effect of being exposed to the same antigen again, which coulld make it less effective. Studies need to be done for each vaccine, before considering such an approach.

[JohnnyMalaria]

That question has been asked often.  First, the J&J vaccine is a viral vector vaccine that uses a replication defective adenovirus. Moderna and Pfizer vaccines do not use a viral vector.  They use synthetic liposomes.  The latter two vaccines are quite similar and seem to differ mostly in the liposome. 

The liposomal part is just a vehicle for the mRNA that protects the mRNA and enables it to survive the journey to into our cells. Once there, our cells use the genetic information encoded in the mRNA to synthesize proteins identical to those made by the virus. By choosing the correct protein to be made, it can trigger our immune response as if it were the virus itself that was present. The Moderna and Pfizer vaccines are not the same when it come to the mRNA but the concept is the same.

The stability of the liposome is important and a challenge. I worked on similar products about 10 years ago. I suspect Pfizer's difficulties with storage temperature lie with the structure of the liposome and the fact that Pfizer hadn't generated any data to support storage at less extreme temperatures. This has changed.

[Stray Electron]

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...

   I sort of doubt that that would happen, at least on it's own. All of the vaccine sights that I've seen are well manned by the police in order to keep order and prevent people from jumping in line preventing traffic jams, etc.  There are also usually dozens of paramedics and off duty police there to watch for possible allergic reactions as well.  Hell, some of the vaccine sites in the US are even being operated by active duty US Army personnel.

    But now that you're brought up the idea, it would be too surprising if someone read it and decided to do as you suggested, just for the sheer notoriety of it. Just like the copy-cat school shootings, people see one on the news and then decide that they want to be infamous too and ......

[madires]

There are already dangerous idiots among us, Two week ago: Dutch Covid test centre hit by suspected bomb attack (https://www.theguardian.com/world/2021/mar/03/dutch-covid-test-centre-hit-by-suspected-bomb-attack).

[DrG]

That question has been asked often.  First, the J&J vaccine is a viral vector vaccine that uses a replication defective adenovirus. Moderna and Pfizer vaccines do not use a viral vector.  They use synthetic liposomes.  The latter two vaccines are quite similar and seem to differ mostly in the liposome. 

The liposomal part is just a vehicle for the mRNA that protects the mRNA and enables it to survive the journey to into our cells. Once there, our cells use the genetic information encoded in the mRNA to synthesize proteins identical to those made by the virus. By choosing the correct protein to be made, it can trigger our immune response as if it were the virus itself that was present. The Moderna and Pfizer vaccines are not the same when it come to the mRNA but the concept is the same.

The stability of the liposome is important and a challenge. I worked on similar products about 10 years ago. I suspect Pfizer's difficulties with storage temperature lie with the structure of the liposome and the fact that Pfizer hadn't generated any data to support storage at less extreme temperatures. This has changed.

I am not a virologist, but I have probably spent 1000 hours with the literature / watching /discussing over the last year. Sadly, it has been consuming, but a fantastic story.

Re: The mRNA vaccines - Agree completely (see #45 in this thread). To me, these two represent a huge breakthrough and are likely to have a huge impact on future vaccines and particularly combo vaccines.

The similarity between the J&J approach and the Pfizer/Moderna approach is that they both use cells to manufacture the protein. The adenovirus approach has been around for a while (tried and true). The Pfizer/Moderna mRNA approach has also been tried for influenza and some others, but unsuccessfully. I think historically, the roots of the approach was probably in some cancer treatments.

The distinction are vaccines which do not instruct the cell to make anything but instead, contain fragments/deactivated virus and the like. I think that Novovax may have some advanced ways to synthesize the substance it uses, but that general approach is the oldest as I see the situation.

I don't know, but I think you are probably right about the stability and Pfizer. But, when you are out their first and the race is all-important, you do not want to risk a failure. I agree that this is changing.

In fact, I believe that we will be taking another covid vaccine in ~ a year, maybe sooner if a a variant becomes dominant. And it will be an mRNA vaccine.

[1xrtt]

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?

Not sure how it is done in other parts, but around here, you get a vaccination card with the brand, lot number and the date you should return for the second dose. Upon return, you present the card and you get a shot from the same brand.
AFAIK, it´s working, my grandfather and my mother already got two doses and the medical team  always show you the label, before.
There was an intense debate as if the vaccination centers should use all doses available, to spread as much population as possible, or keep stock for the second dose and ensure whoever is vaccinate got the full coverage. Eventually, keeping he stock was favored.

[DrG]

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?

Not sure how it is done in other parts, but around here, you get a vaccination card with the brand, lot number and the date you should return for the second dose. Upon return, you present the card and you get a shot from the same brand.
AFAIK, it´s working, my grandfather and my mother already got two doses and the medical team  always show you the label, before.
There was an intense debate as if the vaccination centers should use all doses available, to spread as much population as possible, or keep stock for the second dose and ensure whoever is vaccinate got the full coverage. Eventually, keeping he stock was favored.

Yes, similar situation (including the debate) in the US. As it is now clear that here we will have enough vaccine soon, the debate part has largely gone away.

As far as mix and match, right now, most place (all that I know about) have only one vaccine. As we get more and more, I am sure some intentional or unintentional mix and match will happen, but not likely with dire consequences.

One issue in the US is the small site vs. mass center. Right now, my state is favoring mass vaccination sites. There have been some problems ("entitled" folks cutting in line in their cars), but they are getting better.

Once I became eligible, I scored an appointment at a smaller Med Clinic. They did a great job! everything was smooth - triage outside - questions at station 1 - nurse at station 2 (filled out card after injection) - off to the anaphylaxis waiting room - out the door.

To get that appointment, I was searching for about an hour a day. 50-60 mile radius - registered with whomever I could - checking with sites (grocery stores and drug store chains) who had appointment software up but (as far as I can tell) no vaccine at this point. Even used browser refresh add-ons....and BTW: I am not happy that some drug stores here "say" you have to be a member of their pharmacy club to get the vaccine. Sure, you have to give a lot of info, including a consent form, as it should be, but at the time of vaccination -  but join your club - what is up with that?

[tooki]

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.

While I completely agree with you on factory farming, as someone currently in school, I could not disagree more on the online learning idea. We have to do that, and it’s simply no substitute for in-person instruction. It’s less effective, and it creates a lot more work for the teachers to boot.

[peter-h]

I was getting a connection to the chip using my S10 phone but after I cycled under some 400kV power lines, I never saw it again. Hopefully the 2nd dose will restore proper function.

It was slightly unusual in that it wasn't broadcasting an SSID - presumably to reduce the power consumption.

[Tomorokoshi]

I was getting a connection to the chip using my S10 phone but after I cycled under some 400kV power lines, I never saw it again. Hopefully the 2nd dose will restore proper function.

It was slightly unusual in that it wasn't broadcasting an SSID - presumably to reduce the power consumption.

With one dose you can only achieve 2.5G. You need both doses to get 5G.

[coppice]

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.

On line learning, as with traditional learning purely from books, works well for those who are very smart and very motivated. For the bulk of people its a poor substitute for face to face learning. MOOC was a hot topic a few years ago. Now its a topic of much disillusion.

[mathsquid]

I could not disagree more on the online learning idea. We have to do that, and it’s simply no substitute for in-person instruction. It’s less effective, and it creates a lot more work for the teachers to boot.

I agree completely. I've been teaching fully online for the past year due to covid, and in many ways it has been problematic. I don't know my students very well. I only get a tiny fraction of the feedback I'd normally get. Preparation takes way longer. Cheating seems to be more prevalent.  I can't wait to get back into a normal face-to-face classroom. But at the same time it has forced me to reassess how I do assignments and testing. I've learned how to shoot videos using multiple sources (camera, ipad, computer windows showing computations or graphs). And I've gotten much better at writing online assignments.

So (for me anyway) this huge disruption has had some definite benefits. I'm thinking that partially online classes might become a large part of what I do in the future. I am concerned, however, that snow days may become a thing of the past.

[gnuarm]

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).

You are a very wise man.

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

In viral replication this is not significant.  In higher lifeforms using DNA, changes to the nuclear information is detected and often repaired preventing it from becoming a mutation (i.e. being expressed).  Viruses have a very high replication factor and so can more easily tolerate a higher mutation rate, so there is less detection and correction involved resulting in a much higher mutation rate.   No need to induce mutations from outside affects.

The virus (SARS-CoV-2) is not alive.

I would debate that assertion, but it is of no consequence in this discussion.

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.

<Trimmed a tour of viral replication and processing...>

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.

Yes, we were probably on solid ground until the winter (Northern hemisphere) surge.  Those numbers were insane and we have not recovered from that back to August levels yet!  Higher rates of infection result in higher rates of mutation.  With the vaccine in wide distribution we will be letting our guard down paying less attention to spreading the disease.

Our response to the rate of infection is to shelter when it is on the upswing and to relax when it is on the down swing.  This acts like a control loop maintaining a high level of infection.  In the US we had not even dropped back to the peak levels from the two previous surges before opening up and relaxing the protective regulations.  Clearly we are a nation of idiots who can't understand simple math, being led by imbeciles who can't even understand a chart. 

https://xkcd.com/2278/

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!.

You mean like the router I am connected to the Internet with?  Which version of OpenWrt are you running?  Or is it Tomato or DD-WRT? 

[DrG]

/-- snipped lots of good civil discussion which I really do appreciate and would like to respond to or engage further (especially about the alive part) but I will stay in size /thread / policy bounds - but, sincerely, it really is refreshingly sane

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!.

You mean like the router I am connected to the Internet with?  Which version of OpenWrt are you running?  Or is it Tomato or DD-WRT?

Yes, that is the one - a V5 and when I used it, I used whatever software it came with or that I found and I did all sorts of crazy things with it, most of which are not retrievable without some pain. Long story / new provider equipment / old XP balking at it / np with newer machines and android devices / maybe failing XP wifi card / maybe something else. Gave me a headache last night - probably dig up an old pci wifi card from somewhere (no PCIe slot) and see if that works or find a very long Ethernet cable.....or just throw out old junk.

[Monkeh]

/-- snipped lots of good civil discussion which I really do appreciate and would like to respond to or engage further (especially about the alive part) but I will stay in size /thread / policy bounds - but, sincerely, it really is refreshingly sane

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!.

You mean like the router I am connected to the Internet with?  Which version of OpenWrt are you running?  Or is it Tomato or DD-WRT?

Yes, that is the one - a V5 used by me for many years and many years ago. Long story / new provider equipment / old XP balking at it / np with newer machines and android devices / maybe failing XP wifi card / maybe something else. Gave me a headache last night - probably dig up an old pci wifi card from somewhere (no PCIe slot) and see if that works or find a very long Ethernet cable.....or just throw out old junk.

Newer equipment is likely refusing to support outdated and known insecure standards. WRT54Gs should be long recycled along with the rest of the equipment of the era.

[TimFox]

To gnuarm:
 I am surprised that the media don’t mention that the daily graph of new cases in the US (appearing in newspapers) shows that the current rate, far down from the last peak, is only down to the previous local maximum.

[DrG]

/-- snipped lots of good civil discussion which I really do appreciate and would like to respond to or engage further (especially about the alive part) but I will stay in size /thread / policy bounds - but, sincerely, it really is refreshingly sane

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!.

You mean like the router I am connected to the Internet with?  Which version of OpenWrt are you running?  Or is it Tomato or DD-WRT?

Yes, that is the one - a V5 used by me for many years and many years ago. Long story / new provider equipment / old XP balking at it / np with newer machines and android devices / maybe failing XP wifi card / maybe something else. Gave me a headache last night - probably dig up an old pci wifi card from somewhere (no PCIe slot) and see if that works or find a very long Ethernet cable.....or just throw out old junk.

Newer equipment is likely refusing to support outdated and known insecure standards. WRT54Gs should be long recycled along with the rest of the equipment of the era.

Hey, what if we started substituting "old Farts" for "equipment" in your response? Then I would be in real trouble 

Your suspicion may be correct, which is why I wanted to attach the WTG to the newer equipment as an access point for the XP - kind of like a Senior Citizens Enter Here. Actually, the XP does connect but stops recieving after a time but does not drop the connection. Reconnecting will get it to work for a bit. I use that machine infrequently and it may have started to do that before the new equipment.

[gnuarm]

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.

We do need to get rid of it.  Letting this disease roam free is like a psychotic person with a gun.  Even if the gun is laying on the table, it can be picked up and fired at any time.  This virus is dangerous enough that a simple mutation could allow it to become much more deadly and at the same time resistant to every treatment to date.  We don't want it hanging around sniping at us like the crocodiles at the watering hole, waiting for the day they become agile, fast and able to pursue victims on land before we act.
 

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.

That is the sort of limited thinking I try to counter by reason.  But it is hard.  These disease is not rampant because of lack of border controls.  The population density of Australia is not a factor because the density is dominated by the vast areas with few people while the vast majority of people live in the same conditions as the rest of us. 

North and South Dakota in the US have the highest infection per population numbers, yet are very lightly populated, among the lowest in the US.  But in the populated areas the infection rates are high dominating the infection rate numbers.  Heck, South Dakota has the second highest vaccination number in the country!  You would think they'd have great infection numbers.  So clearly population density is not a useful metric when calculated over a region with widely varying demographics.

[Zero999]

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.

We do need to get rid of it.  Letting this disease roam free is like a psychotic person with a gun.  Even if the gun is laying on the table, it can be picked up and fired at any time.  This virus is dangerous enough that a simple mutation could allow it to become much more deadly and at the same time resistant to every treatment to date.  We don't want it hanging around sniping at us like the crocodiles at the watering hole, waiting for the day they become agile, fast and able to pursue victims on land before we act.

No one is talking about allowing the disease to roam freely. It's why so much time and money have been spent on developing vaccines.

It would be great to get rid of it, but the consensus of opinion is it's not possible.

Put it into perspective.

How many children have died from COVID-19? Very few.

How many people have been reinfected and suffered from severe disease? For a start, reinfection is comparatively rare and most cases of reinfection are minimally symptomatic, with severe disease due to reinfection being extremely rare.

Once everyone has been vaccinated or infected, the pandemic will end, as has been the case with every other pandemic. A new pathogen emerges, causes widespread death and severe illness, then after herd immunity is reached, it continues to kill a small number of vulnerable people each year. The same happened with the 1918 influenza and it's possible the 1889 - 1890 pandemic was a coronavirus, which is now a common cold.

If we do get rid of it. It will be due to herd immunity, rather than border control, quarantine, social distancing and track and trace.

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.

That is the sort of limited thinking I try to counter by reason.  But it is hard.  These disease is not rampant because of lack of border controls.  The population density of Australia is not a factor because the density is dominated by the vast areas with few people while the vast majority of people live in the same conditions as the rest of us. 

North and South Dakota in the US have the highest infection per population numbers, yet are very lightly populated, among the lowest in the US.  But in the populated areas the infection rates are high dominating the infection rate numbers.  Heck, South Dakota has the second highest vaccination number in the country!  You would think they'd have great infection numbers.  So clearly population density is not a useful metric when calculated over a region with widely varying demographics.

Now try to tell people they can't travel from South Dakota, to another state, with much lower infection figures? It's not possible to seal a US state off from the others, except for Hawaii and Alaska

In Australia, they managed to cut-off western Australia, from the rest of the country, because there's nothing but desert separating it from the other states.

[Syntax Error]

Never thought about this, but exactly why is the Russian vaccine called Sputnik? And Pitzer Biontech sounds a lot like bionic nano technology? Good job I've used telepathy to cancel my subscription to the Fortean Times. Or have I?

Seriously, don't be a Vacnik. Get jagged

[JohnnyMalaria]

Never thought about this, but exactly why is the Russian vaccine called Sputnik? And Pitzer Biontech sounds a lot like bionic nano technology? Good job I've used telepathy to cancel my subscription to the Fortean Times. Or have I?

Seriously, don't be a Vacnik. Get jagged

Etymology
From Russian спу́тник (spútnik, “satellite”, literally “fellow traveller”), from с- (s-, “with, together”) + пу́тник (pútnik, “traveller”), from путь (putʹ, “way, journey”) + agent suffix -ник (-nik).

Also, it was the first, just like the first artificial satellite.

BTW, Moderna is called Moderna to reflect its technology - mRNA.

[Syntax Error]

A proven side effect of the Moderna vaccine is, you can turn into Dolly Parton. And you won't look a day over 70 50 21.

The alt.truth is somewhere out there.

[LaserSteve]

This thread has been a blast and incredibly  informative.

Steve