[HN Gopher] Pfizer vaccine appears effective against mutation in...
       ___________________________________________________________________
        
       Pfizer vaccine appears effective against mutation in new
       coronavirus variants
        
       Author : awnird
       Score  : 614 points
       Date   : 2021-01-09 03:48 UTC (19 hours ago)
        
 (HTM) web link (www.cbc.ca)
 (TXT) w3m dump (www.cbc.ca)
        
       | noncoml wrote:
       | Slightly off-topic, but I don't have any other good forum to ask
       | that.
       | 
       | Once we are done with COVID, will the new vaccine methods enable
       | us to develop vaccines for virus that we couldn't do before. E.g.
       | maybe HIV?
        
         | kdps wrote:
         | That's what BioNTech has been researching for years. BNT162b2
         | is, slightly exaggerated, a by-product.
         | 
         | From https://en.wikipedia.org/wiki/BioNTech:
         | 
         |  _It develops pharmaceutical candidates based on messenger
         | ribonucleic acid (mRNA) for use as individualized cancer
         | immunotherapies, as vaccines against infectious diseases and as
         | protein replacement therapies for rare diseases, and also
         | engineered cell therapy, novel antibodies and small molecule
         | immunomodulators as treatment options for cancer._
        
         | jojobas wrote:
         | HIV is hard as it attacks the very immune cells that come to
         | get it.
        
           | raducu wrote:
           | It's not just that. People do develop neutralizing antibodies
           | against HIV.
           | 
           | HIV, like other retroviruses, embedds itself in the cell DNA.
           | 
           | Some cells remain dormant for weeks and then start producing
           | virions.
           | 
           | So the other problem with HIV, even if it didn't attack
           | immune cells, is the hidden virus reservoir, I guess, just
           | like other incurable viruses, like herpes and some hepatitis.
        
             | fastball wrote:
             | Right but if you're vaccinated, you'd hope the immune
             | system could attack HIV before it could take hold.
        
               | raducu wrote:
               | I really don't know enough about immunology to answer
               | that -- but I presume most neutralizing antibodies wane
               | over time.
               | 
               | If you take antiretrovirals you're very unlikely to
               | become infected with HIV, even if you take it after
               | initial exposure (but do your own research on that), but
               | as soon as you stop, you lose that protection -- same
               | with antibodies (not sure how a vaccine would help T-cell
               | immunity if HIV infects T-cells).
        
             | inglor_cz wrote:
             | CRISPR can edit herpes simplex virus out of cells, so maybe
             | it can do the same for HIV.
             | 
             | https://www.globenewswire.com/news-
             | release/2019/11/18/194889...
        
               | raducu wrote:
               | Wow, thanks, that's really interesting!
        
         | tachyonbeam wrote:
         | Maybe? The nice thing about mRNA vaccines is that the formula
         | can be adjusted very rapidly (weeks). I feel like if there was
         | a way to tweak the formula fast enough, we could react as fast
         | as the different viral strains mutate. We would need to change
         | the regulatory framework though. Having to do 3 phases of
         | clinical trial involving tens of thousands of participants
         | makes it hard to adapt fast enough.
        
           | mrtesthah wrote:
           | > we could react as fast as the different viral strains
           | mutate
           | 
           | The number of mutations is proportional to the number of
           | people currently infected. The faster the virus spreads the
           | more variants will be created. The fact that the N501 variant
           | spreads faster seems to imply that the rate of mutations is
           | already in the process of accelerating.
           | 
           | It may make more sense to use evolutionary modeling and
           | analysis of existing SARS-type viruses to create antigens
           | robust to all expected mutations. Here's one such bit of
           | research:
           | https://www.biorxiv.org/content/10.1101/2020.11.17.387092v2
        
           | rtx wrote:
           | So we will see weekly news about new strains and new vaccines
           | to prevent them from spreading. This might be a long drawn
           | process.
        
           | gurleen_s wrote:
           | Is the risk that's being assessed by these trials coming from
           | the delivery method of the vaccine? Perhaps maybe there's a
           | way to get around some of those regulations.
        
           | BillyTheKing wrote:
           | doesn't the regulatory framework allow such changes though?
           | afaik we aren't doing any phase 3 trials for the annual flu
           | shot, or are we? (genuine question) But if we aren't,
           | couldn't we just expand this to also take into account the
           | Covid-shot?
        
             | bluGill wrote:
             | The flu shot gets a special exception to the process. They
             | study safety every year, but not effectiveness. This takes
             | months off the development time.
        
         | lvs wrote:
         | While this is indeed a new vaccine modality, it doesn't change
         | the dynamics of vaccinology appreciably. Things that were
         | challenging vaccine targets in the past will likely remain
         | challenging.
        
           | hobofan wrote:
           | Doesn't it change the dynamics insofar as that you have a
           | straightforward path from virus -> its mRNA blueprint,
           | without more specialized and likely costly engineering of
           | e.g. a adenovirus? This should then allow for broader
           | protection against viruses with many strains e.g. a HPV
           | vaccine cocktail that protects against all ~100 known strains
           | vs. just the 9 it currently does.
        
             | raducu wrote:
             | Some influenza antibodies destroy certain neurons in your
             | brain and you develop narcolepsy.
             | 
             | This is both true for natural infection and first
             | generation vacines.
             | 
             | Later generation vaccines avoid this by not presenting
             | certain proteins.
             | 
             | My point is, you can't just include hundreds of protein
             | variants without a lot of trials.
        
               | beagle3 wrote:
               | Do you have a reference for this? It was my assumption
               | too, reading about the Pandemrix vaccine, but I didn't
               | find any dependable references for this.
        
               | bluGill wrote:
               | Even if he is wrong about how it works, because of the
               | potential for unknowns they need to study it in a trial.
               | There is a lot we don't know about biology.
        
               | hobofan wrote:
               | I'm not suggesting to include new strains on the fly
               | while they are discovered without trials. The same way
               | they had to do trials for Gardasil-9 after already having
               | Gardasil, they could do the same just with a wider
               | cocktail.
               | 
               | In the optimal case you would attempt the 100+ cocktail
               | and don't have any unreasonable side effects from them.
               | Of course if there is a single variant in there that
               | causes side effects you would need a ton of trials to
               | triangulate which one causes them, but there is no
               | guarantee that that is necessary or that you wouldn't run
               | into that variant when you just adding 5 new variants in
               | an iteration.
        
       | AhmedHassan2027 wrote:
       | Thanks to pfizer to take affective medicine to open the world
        
         | allendoerfer wrote:
         | Also thanks to BioNtech for developing said medicine.
        
       | phreeza wrote:
       | What I haven't seen widely discussed regarding the new variant is
       | whether the higher infectiousness means herd immunity will be
       | achieved later. From my amateur understanding of the SIR model,
       | this should be the case.
       | 
       | So ultimately we may not achieve herd immunity except with
       | mandatory vaccination campaigns.
        
       | 7OVO7 wrote:
       | good for all those suppressed people
        
       | alevskaya wrote:
       | Sadly, note that the study talked about here [1] is investigating
       | the effect of the N501Y mutation, not the more worrying E484K
       | mutation found in the South African 501.v2 strain that likely
       | does escape antibody drugs and reduces neutralization by
       | convalescent sera from past infections. [2]
       | 
       | [1]: https://www.biorxiv.org/content/10.1101/2021.01.07.425740v1
       | 
       | [2]: https://www.biorxiv.org/content/10.1101/2020.12.31.425021v1
        
         | jb1991 wrote:
         | I wonder why it says:
         | 
         | > works against a key mutation in the highly transmissible new
         | variants of the coronavirus discovered in Britain and South
         | Africa
        
           | dmix wrote:
           | Both the South African and UK variant seem to be under the
           | name 501Y.V2 but the South African version has a mutation not
           | seen in the UK strain:
           | 
           | > The variant in South Africa carries two other mutations in
           | the spike protein (E484K and K417N, among others) which are
           | not present in the U.K. strain
           | 
           | This three day old article also anticipated this study
           | results:
           | 
           | > While scientists believe the U.K. variant is not likely to
           | affect the efficacy of the vaccines currently being rolled
           | out in the West, there is more uncertainty regarding the
           | other strain.
           | 
           | https://www.cnbc.com/2021/01/06/south-africa-covid-
           | strain-a-...
           | 
           | I'm guessing they are both of the same "strain" but of
           | different "variant". But I don't know enough about how virus
           | taxonomy works to validate that. Sounds like two levels of
           | mutation...
        
         | zebrafish wrote:
         | Discussion of [2] on /r/covid19:
         | https://www.reddit.com/r/COVID19/comments/kqz7y5/comprehensi...
        
         | TheRealSteel wrote:
         | Does this mean there's now a variant that is immune to all the
         | vaccines, and we're basically back at square one with the
         | pandemic?!?! :( or am I misunderstanding? Is it still protected
         | against from mRNA vaccines, but just not prevented by immunity
         | from past infections?
         | 
         | I have no knowledge of biology whatsoever.
        
           | mckirk wrote:
           | From what I've gathered, it's more like: It's likely that the
           | vaccine will have reduced efficacy (seen over the whole
           | population) against this new strain. That's because your
           | immune system essentially learns to recognize a random part
           | of the virus, and if it ends up "training" itself using that
           | part of the spike protein that's changed in this strain, it
           | won't detect the virus.
        
           | graeme wrote:
           | Not square one. It's unlikely there would be 0% efficacy. But
           | it could be less.
           | 
           | But also not square one because it takes literally a day to
           | redesign mrna vaccines for new variants. Then hopefully they
           | can be approved faster the second go and
           | manufactured/distributed more quickly.
           | 
           | But I'd say all northern hemisphere countries should do their
           | best to focus on local elimination in summer 2021. Most of
           | europe had it in reach summer 2020 but decided to reopen
           | early and keep the virus at a low level.
           | 
           | That was an abject failure. It probably only would have taken
           | another month of heavy restrictions to eliminate.
           | 
           | The mutations we're seeing in the winter of high case volumes
           | caution against doing another cycle like this.
        
             | TheRealSteel wrote:
             | Great, thanks for the info. mRNA tech really is amazing!!
             | 
             | I agree. Everywhere should've pursued elimination strategy
             | like Australia and New Zealand, and even at this late stage
             | would be the best option.
        
               | Mediterraneo10 wrote:
               | > Everywhere should've pursued elimination strategy like
               | Australia and New Zealand
               | 
               | Australia and New Zealand were very unusual in having
               | that possibility, not everyone could have followed such a
               | strategy. The EU had to move thousands and thousands of
               | migrant agricultural workers from Eastern Europe to
               | Western Europe for the harvests, otherwise there would
               | have been scarcities of common foodstuffs. Also goods
               | move through Europe largely through freight trucks that
               | mean drivers moving about, not container shipping like
               | the two island nations you mention.
        
               | graeme wrote:
               | I'm in Atlantic Canada, where we had eliminated it
               | locally. We moved in agricultural workers, it was fine.
               | We just had an isolation requirement and testing.
               | 
               | We have freight trucks from the US too! A lot of
               | obstacles are not, in fact, insurmountable. The actual
               | issue is that most places weren't aiming at elimination.
        
               | Mediterraneo10 wrote:
               | > We moved in agricultural workers, it was fine. We just
               | had an isolation requirement and testing.
               | 
               | As you might remember, there was a shortage of tests the
               | first time that the EU needed to move its agricultural
               | workers en masse (which happened already in the spring -
               | harvests in Spain are more or less continuous, unlike
               | Atlantic Canada where it is much more restricted
               | seasonally). Also, many of those agricultural laborers
               | live in precarious working conditions that the state has
               | little insight into, and arranging any kind of isolation
               | on short notice was not possible.
               | 
               | The EU was not aiming at total elimination because the
               | virus had already spread throughout the bloc practically
               | before the authorities were even aware of it and again,
               | these are not island nations.
        
               | graeme wrote:
               | Sure but you had until the end of August to end it.
               | Spring was the early days. And it would have been
               | conceivable to try to eliminate it locally in sectors
               | _other_ than agriculture. Deal with the easy buts first
               | and then the hard bits after. Often the hard bits become
               | easier in so doing.
               | 
               | You could have kept internal border controls except for
               | essential work. We did that in Atlantic Canada.
               | Australian states did that. We're just as integrated as
               | the EU is! We never had a border at any point in our
               | history. So we set one up.
               | 
               | There are non islands that more or less eliminated it.
               | China, vietnam for example.
               | 
               | Harder in the EU? More complicated? Absolutely. But the
               | policy the EU pursued was an abject failure, so merely
               | saying "there would have been difficulties" doesn't show
               | that elimination would have been worse. The places that
               | reduced covid better generally saw better economic
               | results too.
        
               | Mediterraneo10 wrote:
               | > You could have kept internal border controls except for
               | essential work.
               | 
               | Lack of internal borders in the EU is one of the most
               | important features of the bloc, both in terms of
               | maintaining close integration that could prevent more
               | intra-European wars and in terms of mere everyday
               | convenience. I would gladly sacrifice the demographic
               | most at risk of COVID (about half of all deaths in the EU
               | so far have been in care homes) in order to avoid
               | internal borders.
               | 
               | Also, China has been able to eliminate COVID (and even
               | that is subject to doubt) only through civil-rights
               | violations that the West would not tolerate. Pointing to
               | China and saying "They did it, so the EU could too"
               | misses the point. Vietnam was able to avoid a surge in
               | COVID cases only because they hadn't yet got the huge
               | number of cases that the EU had first without even being
               | aware of it; of course if somewhere else is already
               | suffering, and you aren't, you can close the borders and
               | avoid the problems from the start.
        
             | FuckButtons wrote:
             | That was very much the opinion of the immunologists I have
             | been reading the opinions of recently. Giving this virus
             | opportunity to mutate through allowing circulation is
             | playing with fire next to a dynamite factory.
        
             | Mediterraneo10 wrote:
             | > But I'd say all northern hemisphere countries should do
             | their best to focus on local elimination in summer 2021.
             | 
             | This isn't realistic. Fatigue with COVID restrictions has
             | already set in across Europe: people are wearing masks in
             | sloppy ways (not covering the nose, or even just putting
             | the mask over their chin) and returning to socializing or
             | even leisure travel. The authorities know this, and while
             | they can do things like keep restaurants and theatres
             | closed, they appear to feel little democratic mandate for
             | using the police to enforce strict social separation
             | between individuals. And that is in the winter: once the
             | warm weather comes back, expect even more flaunting of
             | restrictions.
        
               | graeme wrote:
               | That happened summer 2020 and look where things ended up.
               | There are a few factors I think you're missing:
               | 
               | 1. The virus is seasonal. Substantially less restrictions
               | are needed over the summer. Outdoor socialization really
               | isn't high risk
               | 
               | 2. School is out. This naturally lowers spread
               | 
               | 3. A bunch of people will be vaccinated. This will surely
               | make it easier
               | 
               | 4. We'll probably have new rapid tests by the summer.
               | They go a long way to reducing spread without much
               | inconvenience. Michael Mina has been banging his head
               | against the wall for months to get people to listen:
               | these can be as effective as lockdowns and much less
               | burdensome.
               | 
               | 5. At least some countries will figure this out, go for
               | elimination, and require a vaccine/negative test for
               | entry and make travel arrangements with other covid zero
               | areas
               | 
               | Now it might be the vaccines work perfectly, no mutant
               | strains escape them, and we won't have a repeat of this
               | in fall/winter 2021/22.
               | 
               | But if that scenario does seem likely them elimination is
               | overwhelmingly the best option. And society that can't
               | pull itself together to do that will live in a purgatory.
        
         | pageandrew wrote:
         | Does the 501.v2 strain resist vaccine antibodies as well, or
         | only things like the antibody cocktail / convalescent plasma
         | therapy?
        
           | whoisburbansky wrote:
           | The first paper describes the effect of mRNA based vaccine
           | derived serum on both variants, showing that both variants
           | are affected about equally by the vaccine, if I'm not
           | horribly mistaken?
        
             | alevskaya wrote:
             | The first study is only studying the effect of the N501Y
             | mutation as found in several emergent strains, not the
             | E484K mutation.
        
               | whoisburbansky wrote:
               | Yes, sorry, I phrased that badly. I meant N501 and Y501
               | when I said both variants here.
        
           | alevskaya wrote:
           | What I meant by sera above was general adaptive immunity.
           | It's likely to partially resist past immunity from both
           | vaccines (esp. from the spike-only vaccines: moderna, pfizer,
           | etc) and natural infections from older strains. We'll
           | probably know a lot more about it soon, but we may need to
           | update our vaccines to include this mutant class.
        
         | f430 wrote:
         | > does escape antibody drugs and reduces neutralization by
         | convalescent sera from past infections
         | 
         | what does this mean in plain words? this SA variant has a
         | totally new evasion system?
         | 
         | what exactly are we dealing with here? what causes it to
         | rapidly mutate like this?
        
           | jonplackett wrote:
           | It's just evolution - we put social distancing and masks in
           | place, so variants that can overcome those emerged and
           | spread.
           | 
           | Think of it like antibiotic resistance - our crappy attempt
           | at lockdown was like not finishing the course. We gave it
           | loads of places to multiply but didn't finish it off so it
           | just adapted
        
             | FuckButtons wrote:
             | The mutations don't arise because of selection pressure
             | against masks and social distancing, that is dangerously
             | wrong. They arise in an individual patient who has a poor
             | immune response who can't clear the virus for a long time.
             | As their immune response tries to clear the virus it adapts
             | to be more effective over many generations inside that
             | patient. That's why we have distinct lineages, each of
             | these variants with multiple distinct mutations probably
             | arose in a single person.
        
           | esyir wrote:
           | It's a virus. Mutation to avoid detection is par the course.
           | 
           | Essentially, each replication means mutation, and over time,
           | variants emerge. Think of why you need a seasonal flu vaccine
           | and not one flu vaccine.
        
           | dnautics wrote:
           | Viruses are typically rapidly mutating so you should consider
           | them to be a fuzzy statistical ensemble around the "official"
           | sequence, even in one patient. Therefore these viruses can
           | facilely jump over hills in the gradient descent of
           | optimization; but keep in mind optimization is not just a
           | one-factor thing. If you are interested in this the keyword
           | is "viral metagenome"
           | 
           | An E to K mutation converts a surface negative charge to a
           | surface positive charge. So if your antibodies were expecting
           | a negative charge and therefore putting positive charges near
           | that place when they attach to the virus, the polarity on the
           | mutant has now shifted and the antibodies will be repelled
           | from the mutant virus.
        
             | Erlich_Bachman wrote:
             | > Therefore these viruses can facilely jump over hills in
             | the gradient descent of optimization
             | 
             | It warms to see that the similarities of some aspects of
             | biological life to the current AI/ML terms has entered the
             | lexicon, well at least on HN crowd. The fact that it makes
             | a lot of sense to use those terms hints that we might
             | indeed be on the right track to building AGI and
             | understnding the life itself in general.
        
               | hutzlibu wrote:
               | "The fact that it makes a lot of sense to use those terms
               | hints that we might indeed be on the right track to
               | building AGI "
               | 
               | But there is also the danger of false analogies doing
               | damage, by creating the illusion of understanding
               | something because the wording feels familiar.
               | 
               | There are no doubts similarities, but that does not mean,
               | it is the same.
               | 
               | That happened a couple of times already with progess in
               | technology and then simplified applied technical models
               | to biological life.
               | 
               | So sure, I think so too, that we are on the right track,
               | I am just a bit more hesistant.
        
               | mvanaltvorst wrote:
               | Gradient descent is a subset of survival of the fittest,
               | described by Darwin in 1800-1900, and has been in applied
               | in computer science since the 70's. An AGI will probably
               | use some form of gradient descent during its training,
               | yes, but I wouldn't argue that this has brought us even
               | close to an AGI.
        
               | dnautics wrote:
               | This is wrong. Gradient descent derives from multivariate
               | calculus, not evolution.
        
               | dnautics wrote:
               | Objective cost surfaces have been around way longer than
               | ml. It's been in the genetic algorithm lexicon for a long
               | time, and more true to form, in stuff like actual
               | potential energy diagrams of high dimensional degrees of
               | freedom spaces in enzymology. Also having been a
               | professional biochemist and worked in AI infrastructure,
               | I know the commonalities well and know how to avoid faux-
               | amis.
               | 
               | Note that this process is NOT backpropagation.
               | 
               | "The fact that it makes a lot of sense to use those terms
               | hints that we might indeed be on the right track to
               | building AGI and understnding the life itself in general"
               | 
               | Nope, it's a residual of the fact that AI stole ideas
               | from other fields, and ran with the terminology as
               | marketing. Sometimes even to the point of extreme
               | divergence from the original ("neural" nets).
        
               | quonn wrote:
               | How is there gradient descent or even a gradient in
               | biological mutations? If anything there could be an
               | analogy to undirected trial & error as in genetic
               | algorithms.
        
               | RobertoG wrote:
               | I think that they are using "gradient descend" when they
               | should be using "space of the problem". Otherwise is a
               | good comment.
        
               | Erlich_Bachman wrote:
               | It's directed by the survival and spreading of the virus.
        
               | jsinai wrote:
               | meta, what if it was just GPT-3 commenting and there was
               | just leakage from the ML community
        
             | martin_bech wrote:
             | Afaik not all rapidly mutating, HIV seems to be mutating at
             | a rapid pace, yet measels apparently largely never mutates.
        
               | dnautics wrote:
               | That's why I said typically, not always.
        
               | sudosysgen wrote:
               | The majority of viruses do not mutate rapidly enough to
               | evade immunity. The exceptions are virus with chronic
               | infections because they can mutate much more easily, and
               | some viruses like Influenza that can use antigenic
               | shifts.
               | 
               | It's really not typical. Even in all of the human cold
               | coronaviruses, only one seems to be evolving its spike
               | protein, and it does so quite slowly.
               | 
               | If it was typical, we wouldn't see the amazing efficacy
               | of vaccines against endemic diseases.
        
         | whoisburbansky wrote:
         | Am I reading the second paper correctly when I say this was
         | conducted on a sample size of 11, and they found that the E484K
         | mutation had saw no reduction in neutralization in some of
         | those subjects? I'm trying to get a better sense of the numbers
         | involved to figure out how much credence to lend to the dangers
         | posed by the second mutation.
        
           | alevskaya wrote:
           | It's unlikely to _completely_ escape immunity - humans will
           | raise antibodies against different regions of the spike
           | protein, but it does seem to confer a pretty significant
           | average resistance to patient sera. There's another study
           | looking specifically at several different monoclonal
           | antibodies against this mutation at:
           | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7723407/
        
             | whoisburbansky wrote:
             | When you say average here, is that in the sense of average
             | resistance over time for a given patient or average
             | resistance across a population? The paper seemed to imply a
             | great deal of heterogeneity in individual responses to the
             | variant, so significant average would just be something
             | like part of the population affected very badly, another
             | part not at all, vs everyone affected mildly?
        
               | alevskaya wrote:
               | Averaged over a population - some people will have
               | resistant sera and others not depending on the parts of
               | sars-cov-2 targeted by their polyvalent antibody
               | response. Note that this is only looking at antibodies,
               | not T-cell responses... so the clinical consequences are
               | harder to predict, but it's certainly a bit concerning.
        
               | whoisburbansky wrote:
               | Ah, I see. Thanks, that clears things up quite a bit.
               | It's potentially mildly bad news but not the end of the
               | world, is what it sounds like then.
        
             | robbiep wrote:
             | No idea why the downvotes here (at initial time of
             | writing), that's literally how the immune system functions,
             | it's a random process and everybody's antibody DNA will be
             | different to someone else's antibody sequence against the
             | same antigen.
             | 
             | No vaccine is training the body on the exact antibody to
             | raise, it's training it to (hopefully, because sometimes
             | the stochastic process missed) recognise particular
             | epitopes.
             | 
             | Important to also note that generally (and particularly
             | during early infection) there will be many antibodies that
             | recognise parts of an antigen.
             | 
             | Affinity Maturation through somatic hypermutation is one of
             | the most amazing processes the body does - look it up or
             | for a very brief summary look at my notes on page 32 (or
             | the whole mechanism of adaptive immunity from 27) with a
             | little diagram on page 28
             | 
             | https://www.dropbox.com/s/4ldgs4v9y99anm8/BCHM%203072%20Not
             | e...
        
               | l33tman wrote:
               | It truly is. In early medschool we had a group student
               | session on the adaptive immune system where we had to
               | brainstorm on antibody generation and nobody in the group
               | even came up with an idea remotely close to how it
               | actually works. Robust and amazing. Talk about brute-
               | force searching.
               | 
               | Still, at this day my hope is that we'll be able to do
               | the body's work even better at some point using computer
               | designed antibodies (or similar) at least for therapies.
               | There are some notable bottlenecks in the adaptive system
               | where antigen fragments have to be broken down and shown
               | to potential antibodies and this is a bit different
               | between humans etc. The human antibody molecule is also
               | very large and it's particular design doesn't fit some
               | epitopes you'd want to hit (not an expert on it but I
               | remember one of the HIV proteins having an area you'd
               | want to train on but that can't accommodate the antibody
               | variable fragments well).
        
         | dnautics wrote:
         | An N to Y mutation is associated with tighter specificity in
         | binding protein protein interfaces. An E to K mutation is
         | changing the surface charge from negative to positive so it
         | shouldn't be surprising that it reduces antibody's ability to
         | recognize, assuming it's in the most recognized pocket.
         | Hopefully this will be a relatively easy cut and paste into the
         | existing vaccine cassette if it turns out to spread really
         | widely.
        
           | JamesBarney wrote:
           | I'm far more worried about the FDA and logistics than
           | technical limitations.
           | 
           | Even if you could make this fix in a day, it'll take months
           | to get FDA approval, and then you still have to manufacture
           | and distribute it. And by that time the populous will have
           | gotten immunity the old fashion way.
        
             | dnautics wrote:
             | Indeed. And the likelihood of escape are worse the greater
             | the infected population x time to new vaccine. I'm
             | increasingly worried that covid-19 is the slow loris of
             | viruses. Too slow and mild to warrant panic-mode measures
             | (I don't mean lockdowns), just gonna be an annual
             | millimation of the population.
        
               | howlgarnish wrote:
               | Aren't we in panic mode measures already? I'm not sure
               | there's much more most countries can realistically
               | implement even if there's a 10x more lethal variant.
        
               | the8472 wrote:
               | During initial containment china welded apartments shut
               | and organized essentials deliveries by dedicated couriers
               | for each city block. And then there's the option of
               | military-enforced cordons. There are multiple levels of
               | panic left untapped.
        
               | howlgarnish wrote:
               | That's why I said "most countries", because in (say) the
               | US the government couldn't pull that off even if they
               | tried. (For one thing, it's hard to weld shut suburban
               | housing.)
        
               | nicoburns wrote:
               | Perhaps, but if the virus was as transmissible as sars-
               | cov-2, but had a much higher fatality rate (say 60% like
               | Ebola). Then you would get a lot more support for strict
               | measures amongst the general population.
        
               | dnautics wrote:
               | I said "not lockdowns". I meant things like "strip down
               | the phase testing" etc.
               | 
               | I see no evidence we are doing that.
        
               | meddlepal wrote:
               | I think Parents point was that eventually we will have to
               | give up on panic mode and accept deaths from this each
               | year.
        
         | partingshots wrote:
         | For the vaccine to lose effectiveness, the mutation would have
         | to drastically alter the spike protein of the virus.
         | 
         | This is effectively impossible as the virus is dependent on a
         | functioning spike protein in order to infect cells, and the
         | machinery involved with the mechanics of the spike are
         | extremely delicate. Errant mutations that would cause
         | compositional changes to the shape of the protein are almost
         | guaranteed to cause functional failure. Using terminology, this
         | is what we call a highly conserved area.
         | 
         | In both cases for the South African or UK strain, if you take a
         | look at the areas where mutations have occurred, you'll see
         | that the code responsible for generating the spike protein is
         | basically completely unaffected. This will generally hold true
         | for any successive future strains.
        
           | [deleted]
        
           | enchiridion wrote:
           | While that may be true, I think that scale plays a role here.
           | 
           | The ancestors of this virus were bouncing around between a
           | relatively small set of humans and animals for a while before
           | becoming SARS-CoV-2.
           | 
           | Now with a significant portion of the world infected, it does
           | not seem unreasonable that it would mutate. Although at that
           | point it probably would not be considered the same virus
           | anymore.
        
           | hn_throwaway_99 wrote:
           | This doesn't make much sense to me, given that coronaviruses,
           | with spike proteins, have existed for eons, and humans have
           | had lots of time to build up immunity to previous
           | coronaviruses (ones that cause colds, for example). So there
           | was something about the Covid-19 coronavirus spike proteins
           | that was different enough where it didn't look like
           | "familiar" coronaviruses, so I see no reason why it couldn't
           | evolve further to evade whatever antibodies humans are able
           | to build up to the vaccines.
        
             | sudosysgen wrote:
             | You can make multiple spike proteins that target the same
             | receptor.
             | 
             | This generally happens when a virus from another animal
             | (and thus with a slightly different version of the
             | receptor) adapts to humans.
             | 
             | Basically, a gradient descent from a very different
             | starting point ending up in a different local minima.
             | 
             | The question is, is the spike protein at a local minima
             | (very probably quite close to it), and could it jump to
             | another local minima then? Most likely not.
             | 
             | It's possible it will evolve to make our antibodies
             | slightly less effective, likely as a trade off for
             | infectiousness, but incredibly unlikely the spike protein
             | would evolve to be unrecognizable to our immune systems.
             | Historically, this doesn't happen all that often, except
             | for viruses with chronic infections over years that can do
             | a deeper search over the gradient, but even then it
             | generally takes years to decades.
        
               | dimgl wrote:
               | This is extremely interesting. Thanks for this context.
               | Detailed and thoughtful explanations like this help to
               | understand the news.
        
               | lawrenceyan wrote:
               | Given the non-linear dynamics that proteins must live
               | under, I like the usage of local minima as an analogy. It
               | feels apt.
               | 
               | Generally though, within the context of machine learning,
               | one of the benefits of gradient descent, especially when
               | stochastic, is that we can get past those local minima
               | humps. Does this hold less true with respect to the
               | process of sequence mutation that viruses go through?
        
           | rolph wrote:
           | you are speaking about a general case scenario, there is
           | conservation of sequence region and variation of sequence
           | region. to wit one protien encoding sequence has separate
           | regions corresponding to regions of the product protien, the
           | receptor binding domain[RBD] is a moderately conserved region
           | ; the ImmunoAntigenic regions are not tightly linked to the
           | protiens receptor binding function thus may vary at a greater
           | rate than the RBD regions
        
           | alevskaya wrote:
           | This isn't correct. The constraints placed upon epitopes by
           | the cell receptor vs antibodies aren't the same. Rhinoviruses
           | and Influenza viruses escape past immunity without
           | fundamentally altering their biology all the time! The 2nd
           | paper cited does in fact show functional virus with a charge-
           | shifting E->K mutation in its receptor binding domain that
           | escape many antibodies raised against earlier strains. I used
           | to engineer viruses and human immune cells for a living -
           | maybe read a little more virology/immunology.
        
         | mvanaltvorst wrote:
         | Say that Pfizer were able to simulate 50 possible mutations and
         | put all of them into a single vaccine, would there be any risk
         | that the antibodies could interact with each other in some way
         | that makes the vaccines less effective?
         | 
         | Also another scenario: say that we get yearly Covid shots that
         | contain the latest strains, would these accumulate over the
         | years and start interacting with each other?
        
           | Retric wrote:
           | As I understand it, the second isn't an issue so 50 vaccines
           | over 50 years would be fine, that's how seasonal flu vaccines
           | are done.
           | 
           | The first is mostly a question of how similar they are. Best
           | case original vaccine covers all strains without
           | modification, worst case you need 50 different vaccines. But
           | the most likely combination is a mix where you might need say
           | 5 vaccines, each of which over an overlapping subset of the
           | 50 strains to various degrees of effectiveness.
        
             | danarmak wrote:
             | The immune system presumably has a limited capacity of
             | circulating antibodies. By introducing new antibodies, do
             | we reduce the amount of previous antibodies, and does this
             | reduce their immune response? Is there a concept or metric
             | of "antibody dilution"?
        
               | Retric wrote:
               | Antibody production ramps up and down rapidly, it's
               | memory cells that get altered by vaccines.
               | https://en.wikipedia.org/wiki/Immunological_memory
               | 
               | That said the immune system is extremely complex, but
               | here is a simplified version, which gives a reasonable
               | overview: https://microbenotes.com/cells-of-the-immune-
               | system/
        
               | dannyw wrote:
               | While correlation is not causation, I find it interesting
               | that the human immune system only remembers the common
               | cold and seasonal influenza for several months, but
               | diseases like the polio for much longer.
               | 
               | https://biology.stackexchange.com/a/21802
        
               | TylerE wrote:
               | "The common cold" is a loose nebula of hundreds of
               | different, unrelated, virus strains. They're not even all
               | the same TYPE of virus.
        
         | ksk wrote:
         | The pfizer vaccine also elicits T Cell response/cell mediated
         | immunity. I'm guessing there are a few more studies in the
         | pipeline..
        
       | williesleg wrote:
       | Calm down, it's a cold virus.
        
       | qwerty456127 wrote:
       | Does this suggest that immunity against some ordinary old
       | pre-2019 coronaviruses also applies against the current strains?
        
         | zaroth wrote:
         | There is clearly something that prevents certain people
         | (particularly kids) from contracting COVID to the point where
         | they will not test PCR positive even if they are heavily
         | exposed and have not had it before.
         | 
         | I know several families in my town who have gotten COVID. All
         | of these families had 2 or more kids and in 3 of the families
         | there was at least one kid who never had any symptoms and never
         | tested positive despite being PCR tested repeatedly.
         | 
         | It's theorized that there is some cross-immunity that some
         | people have from other coronaviruses.
        
         | [deleted]
        
         | TylerE wrote:
         | No.
         | 
         | Coronavirus is a generic term for a type of virus.
         | 
         | For example, a few of the more common strains of the common
         | cold, representing perhaps 15% of cases, are coronavirus - but
         | they have no real relation to _the_ coronavirus, as term is
         | typically used.
        
           | qwerty456127 wrote:
           | That's what I meant.
        
           | nradov wrote:
           | It depends what you mean by real relation. Both OC43 and HKU1
           | are betacoronaviruses, in the same genera as SARS-CoV-2. So
           | they're genetically very similar, but there's no reliable
           | evidence of significant cross immunity.
        
         | bpodgursky wrote:
         | There is some anecdotal evidence of prior immunity, but is
         | tangental to this development.
        
       | Capira wrote:
       | I hope it isn't mandatory?
        
       | jerzyt wrote:
       | >>> appears effective I'm not knocking the vaccine, but that's a
       | pretty low scientific standard. The public is so polarized that
       | we have crazy conspiracy theories on one side, and complete
       | acceptance with very little questioning on the other side. A
       | typical drug takes about 5 years to develop and another 5-7 for
       | clinical trials, and for good reasons. It takes time to discover
       | side effects. This vaccine has been developed in less than a year
       | from virus discovery to production. I really hope this vaccine
       | works, but I can understand the skepticism.
        
         | fsh wrote:
         | This is incorrect. Vaccines take forever to develop for
         | economic reasons. Big studies are very expensive, so companies
         | are typically quite hesitant to move to the next step. Vaccine
         | side effects are usually quite rare, so you wouldn't see them
         | in a Phase-3 trial, even if you waited for decades. This is why
         | any drug is studied after approval in Phase-4 trials.
         | Furthermore, vaccines side effects have historically pretty
         | much always shown up at most weeks after the vaccination.
        
         | rimliu wrote:
         | To develop mRNA vaccine took what, ~10 years? It's about how
         | long it takes to develop the printing press vs. how long does
         | it take to print a book.
        
       | luikore wrote:
       | We still need Continuous Integration/Continuous Deployment in
       | vaccine development.
        
         | jimbokun wrote:
         | The question is whether or not we're confident enough to
         | administer the latest vaccine variants without clinical trials.
        
       | zaroth wrote:
       | The bigger question I have is when will we be ready to
       | confidently claim that the vaccine doesn't just prevent symptoms
       | but also prevents spread? (Edit: at the same or nearly the same
       | 95% rate)
       | 
       | I can't see a human trial being able to show this, and contact
       | tracing is overall so poor how long will we have to wait to _not_
       | see a case that can be tracked back to a vaccinated individual
       | before we are willing to agree that the vaccine is highly
       | effective at stopping transmission?
       | 
       | For example, by Feb 1 we will have millions of people who are
       | effectively protected at least from symptoms due to vaccine. So
       | e.g. by March 1, if we have no, or single digit, reported cases
       | of 2-week post-jab transmission?
       | 
       | The corollary is how durable is the effect?
       | 
       | To fully reopen the economy you need some kind of consensus on
       | where the truth lies to these two questions.
       | 
       | I wonder if public health agencies will never really admit, but
       | just the case count will start to dwindle and mitigations will
       | start to lessen, without ever really coming out and admitting
       | vaccinated people don't need mitigations 2-weeks-post-jab.
       | 
       | Similar to how we've never really admitted that people who've had
       | COVID are immune and can no longer spread it.
       | 
       | I think fundamentally gov't is too afraid of having two classes
       | of citizens, and mainly, that one class (the antibody negative
       | class) lying that they are actually the other.
        
         | anonytrary wrote:
         | These vaccines do _not_ prevent spread! They decrease the
         | probability of symptoms, and with any coronavirus, the main
         | vector of spread is going to be through symptoms (coughing,
         | sneezing, etc.). This means that if you are vaccinated, you
         | will be less likely to spread the virus, but you must still
         | wear a mask in order to protect those around you!
        
           | mancerayder wrote:
           | That intuitively doesn't make sense for the fact that
           | vaccines help produce antibodies which prevent the virus from
           | spreading within the body and reproducing within the body.
           | The spike protein is detected as something bad, and the body
           | becomes furious and destroys the whole shebang, but not
           | before binding to the spike protein as well and preventing it
           | from infecting cells. If there's a lower viral load in the
           | body, then it reduces the chance of spread (hint, because
           | viral shedding is what causes spread across people).
           | 
           | Put away your exclamation points and have a glance at
           | https://www.nytimes.com/interactive/2020/health/pfizer-
           | biont...
        
           | nradov wrote:
           | Please don't spread misinformation. We don't yet have any
           | reliable evidence on that one way or the other.
        
             | anonytrary wrote:
             | This is not true, the Pfizer vaccine does not prevent you
             | from carrying the virus and spreading it to others who do
             | not have the vaccine. This is what a medical professional
             | told me who was required to get the vaccine. Their entire
             | department had to get vaccinated (Pfizer, _not_ Moderna)
             | and they are still required to wear masks for this very
             | reason. Do your research.
        
               | enchiridion wrote:
               | Your tone is somewhat hostile.
               | 
               | As far as I can tell, we just don't know yet. Until we
               | know, some preventative measures would be prudent.
               | 
               | So yes, the scenario you layout is possible. However, it
               | is also possible that it does stop spread.
        
               | anonytrary wrote:
               | Even if it's unknown, my advice is still the correct
               | advice, and this is what is recommended by medical
               | professionals. Wear a mask after you got the vaccine.
        
               | Nabati wrote:
               | > is what a medical professional told me.
               | 
               | > Do your research.
               | 
               | I don't mean this abrasively but, referring to an unknown
               | third party for credibility and then telling people to do
               | their research does not seem overly convincing to me.
        
               | anonytrary wrote:
               | Is my conclusion wrong? Best to err on the side of
               | caution -- wear a mask, even if you got the vaccine.
               | Period.
        
               | feanaro wrote:
               | This is the right conclusion, but for the wrong reasons.
               | A vaccine which induces antibodies should prevent spread
               | because it will prevent your body from producing large
               | quantities of the virus and hence prevent viral shedding.
               | 
               | The remaining factors which still require masks are the
               | non-perfect efficiency (~5% of people will still get it),
               | social factors (related to creating two classes of
               | people; the immune and non-immune) and perhaps some
               | others I forgot.
        
               | sokoloff wrote:
               | While I think I agree with you high-level, you and GP may
               | be talking past each other when you use "prevent" when
               | you more precisely mean "dramatically reduce [possibly to
               | the point where you _effectively_ prevent]".
        
               | feanaro wrote:
               | You're right. I also just found out about research
               | (mentioned somewhere downthread) on differences between
               | antibody expression in different tissue types (some IgA
               | subtypes predominantly found in mucosa while other IgG
               | types being dominantly systemic and/or in the lower
               | respiratory system). The discussion there is on a whole
               | other level of precision and points toward a mechanism
               | which might indeed make it possible for vaccinated people
               | to transmit the disease with some degree so it's not
               | quite as clear cut as I presented it.
               | 
               | Though, intuitively, I'd still bet that vaccination will
               | reduce viral shedding and the total load shedded, thus
               | also reducing transmission.
        
               | netsec_burn wrote:
               | Why do you say not Moderna? Are they not equally
               | effective?
        
               | zwily wrote:
               | You cannot say definitively "this is not true". The
               | advice to wear a mask after vaccination is still the best
               | advice with the data we have, but you made a statement of
               | fact that is currently unknown.
        
             | NiekvdMaas wrote:
             | Source? This is ongoing research but the hypothesis is that
             | vaccinated people spread the same rate as asymptonic
             | COVID-19 carriers.
             | 
             | For example: https://globalnews-
             | ca.cdn.ampproject.org/v/s/globalnews.ca/n...
        
               | anonytrary wrote:
               | Your link 404'd for me. Here is the direct link:
               | https://globalnews.ca/news/7559408/health-matters-
               | covid-19-v...
               | 
               | As I said, my contacts in the medical field have the same
               | opinion as the article. It's "unknown" officially, but
               | apparently people on HN don't know anyone in the field
               | who is literally on the front lines researching this. The
               | overwhelming opinion (articles aren't being written yet,
               | expect some in a few weeks) is that the Pfizer vaccine
               | does not actually prevent spread of the virus, _only
               | symptoms_ which decreases the probability of spread, but
               | does not completely prevent spread.
        
               | prox wrote:
               | The right term would be sterilization vaccine, at least
               | thats what a epidemiologist recently called it, if I
               | remember the term correctly?
        
               | ro-_-b wrote:
               | So for the vaccination it seems that:
               | 
               |  _It does not prevent the virus from spreading_ It does
               | not protect against certain variations that we are seeing
               | like in South Africa
               | 
               | This means that the pandemic will still be there next
               | winter some how. Likely not as bad as it is now. But it
               | won't be over yet as a thread for societies. Remember
               | most emerging/developing countries are not expected to
               | receive vaccinations any time soon.
               | 
               | They'll be able to update the vaccination but many people
               | will lose trust in them unfortunately
               | 
               | Means that our economies & currencies will be in trouble
               | 
               | Remote work will break through. After 2 years nobody is
               | used to anything else anymore
               | 
               | Many people will permanently lose their job/business, but
               | software companies will continue to do extremely well
               | (although there will be some regulatory crack down on the
               | largest companies)
        
               | frabcus wrote:
               | Another option would be for Europe and the US to get
               | people from Asia and Australia/NZ to teach us how to
               | track and trace.
        
               | morsch wrote:
               | The article is asking the wrong question ( _Immune but
               | infectious: Can someone vaccinated against COVID-19 still
               | spread the virus?_ ). The question is not whether or not,
               | but to which degree. That is, how likely are they to
               | spread the disease, how many people do they infect on
               | average, how much virus do they shed...
        
           | JamesBarney wrote:
           | Source?
           | 
           | Most other vaccines prevent spread. Why don't these?
        
             | zkms wrote:
             | tl;dr per this Nature article, there's different type of
             | antibody responses, intramuscular vaccines are better at
             | inducing the flavor of antibody that works in the lower
             | respiratory tract (which is excellent at attenuating
             | disease severity) but not the kind that works in the upper
             | respiratory tract. Also afaict, sars 2.0 reproduces in the
             | upper respiratory tract, and it's this type of reproduction
             | that allows for disease spread.
             | 
             | i'm not a virologist nor an immunologist but this is my
             | understanding of the situation.
             | 
             | https://www.nature.com/articles/s41586-020-2798-3
             | 
             | > it is important to note that natural infection induces
             | both mucosal antibody responses (secretory immunoglobulin A
             | (IgA)) and systemic antibody responses (IgG). The upper
             | respiratory tract is thought to be mainly protected by
             | secretory IgA, whereas the lower respiratory tract is
             | thought to be mainly protected by IgG27,28,29. Vaccines
             | that are administered intramuscularly or intradermally
             | induce mainly IgG, and no secretory IgA30. It is therefore
             | possible that most vaccines currently in development induce
             | disease-preventing or disease-attenuating immunity, but not
             | necessarily sterilizing immunity (Fig. 2).
             | 
             | > The lower human respiratory tract is thought to be mostly
             | protected by IgG (IgG1 is most prevalent), the main type of
             | antibody in serum, which is transported into the lung. The
             | upper respiratory tract is thought to be mostly protected
             | by secretory IgA1 (sIgA1). a, Natural infection with
             | respiratory viruses induces both a systemic immune
             | response, dominated by IgG1, as well as a mucosal immune
             | response in the upper respiratory tract that is dominated
             | by sIgA1. This process can lead to sterilizing immunity for
             | many respiratory viruses. b, Intramuscular or intradermal
             | vaccination leads in many cases to a strong induction of
             | serum IgG but not to an induction of mucosal IgA. Although
             | some IgG can also be found on the mucosal surfaces of the
             | upper respiratory tract, the lack of sIgA often leaves an
             | individual vulnerable to infection of the upper respiratory
             | tract. c, Intranasal vaccination can efficiently induce
             | mucosal antibody responses, thereby potentially providing
             | sterilizing immunity in the upper respiratory tract.
             | However, systemic immune responses are often lower after
             | this type of vaccination. Currently, all SARS-CoV-2 vaccine
             | candidates in clinical development are administered
             | intramuscularly, and very few of the more than 180 vaccine
             | candidates in development are designed to induce mucosal
             | immunity. Although mucosal immunity might not be required
             | to protect from severe or even symptomatic disease, it
             | could be required to achieve optimal protection from
             | infection and onward transmission of SARS-CoV-2.
        
               | raducu wrote:
               | How about intranasal flu vaccines?
               | 
               | If we developed intranasal covid vaccines, would those
               | also produce IgA antibodies?
        
             | Exmoor wrote:
             | It's been covered well in other comments, so read the whole
             | thread, but basically it's expected that the vaccine would
             | greatly decrease your ability to spread if not completely
             | eliminate it. It's just pending hard data which is a bit
             | complicated to study.
        
         | toast0 wrote:
         | None of the data you'd need to have policies based on
         | calculated immunity is going to come quickly, if at all.
         | 
         | I don't think it's reasonable to try to run an open economy for
         | those who are likely immune and a parallel economy for those
         | who are unknown. There's no way anyone can verify any of that
         | in a day to day setting.
         | 
         | I would expect that some international borders might reduce
         | quarantine requirements if you can show evidence of probable
         | immunity, but not right away.
        
         | nradov wrote:
         | Reopening the economy or not is a political choice and doesn't
         | necessarily depend on vaccine effectiveness. The economy in
         | Florida has been pretty much open since September. We can argue
         | about whether that is wise but the reality is they are open
         | today.
        
           | elicash wrote:
           | There's truth to this, but it's more complicated. In my
           | neighborhood, even if our mayor "opened" things back up, very
           | few would be willing to, say, dine indoors. I can say this
           | confidently because we were less locked down in the late
           | summer.
           | 
           | It's not just a political choice.
        
             | bzb6 wrote:
             | Are you sure of this? Here every time restrictions are
             | lifted all restaurants are crowded the very same day.
        
           | fsflover wrote:
           | The question was not about wrong political choices, but about
           | the right ones.
        
             | newsclues wrote:
             | But how do you evaluate right?
             | 
             | Public health, economic, liberty, community cohesion?
        
               | fsflover wrote:
               | Those compatible with the scientific research.
        
               | sonotmyname wrote:
               | Which scientific research? That which only takes the
               | virus related deaths into account, or that which balances
               | other factors such as depression, suicide, substance and
               | spousal abuse, and long term economic factors?
        
         | iso1210 wrote:
         | Israel has managed to give the first shot to 20% of its
         | population, and at this rate will be into herd immunity
         | territory by the end of the month.
         | 
         | As far as pressures on healthcare systems though, once over 65s
         | have been vaccinated (and the northern winter ends) the
         | pressures pretty much vanish.
         | 
         | > Similar to how we've never really admitted that people who've
         | had COVID are immune and can no longer spread it.
         | 
         | Well we don't know that. In many cases the virus reproduces and
         | spreads without any symptoms. If the spread occurs before the
         | immune system kicks in you could still be a carrier even though
         | the vaccine makes your symptoms pretty much zero.
        
           | zaroth wrote:
           | > _Well we don 't know that. In many cases the virus
           | reproduces and spreads without any symptoms._
           | 
           | We know that asymptomatic people who are not immune can
           | possibly spread the virus. But that's a slightly different
           | question.
           | 
           | We know that it's very rare for someone with antibodies to be
           | symptomatically reinfected with COVID. That's also a slightly
           | different question.
           | 
           | The specific question on the likelihood of someone with
           | natural immunity to be able to later _spread_ COVID without a
           | symptomatic infection;
           | 
           | I've never heard of a single confirmed case of this
           | happening. And the point is not that it _never_ happens, the
           | point is it's a negligible risk. Smaller than, for example,
           | someone who isn't immune who is wearing a mask.
           | 
           | But from a public policy perspective, we'll never actually
           | admit this, just because the second order effects -- where
           | some people can rightfully walk around without a mask and are
           | rightfully not subject to mitigations and lockdowns - are
           | political untenable.
        
             | selimthegrim wrote:
             | Well more the idea that immunity passports bring back
             | memories of really bad old societal sequelae from the
             | yellow fever days
        
               | iso1210 wrote:
               | Yellow fever days? You mean before international travel
               | mostly stopped?
               | 
               | I have to show my yellow piece of paper with the stamp
               | from my jab when I travel to several countries, most
               | recently Nigeria
        
               | selimthegrim wrote:
               | In antebellum New Orleans, people would often try to get
               | infected with yellow fever as soon as they got here to
               | get it over with so if they survived they could claim
               | immunity.
        
           | Aachen wrote:
           | "once winter ends" I've been wondering about that. In June
           | things were just great, but at the same time our health
           | agency (RIVM) claims COVID-19 is not affected by seasons. Are
           | they lying (since they're saying "is not" instead of "might
           | not" / "unknown"), or was what happened around June a
           | coincidence?
        
             | gomjabbar wrote:
             | Hello from summer in Australia right now
        
             | GuB-42 wrote:
             | I can't believe it is not a bit seasonal, whatever the
             | reason is.
             | 
             | First wave ended in June in the northern hemisphere and
             | started in the southern hemisphere at about the same time.
             | We are seeing a similar shift in the second wave.
             | 
             | It can be a coincidence but since people are more likely to
             | stay inside when it is cold outside, and transmission is
             | more likely inside, it makes sense.
        
               | hutzlibu wrote:
               | "It can be a coincidence"
               | 
               | Since the cold season is usually when it is cold outside,
               | yeah. Might be more than coincidence.
        
             | iso1210 wrote:
             | More non-covid hospital pressure in winter. More people
             | inside.
        
             | graeme wrote:
             | On what basis are they saying it? Every single other
             | coronavirus is seasonal, so I don't see why this one
             | wouldn't be.
             | 
             | Have a look at hcov's seasonality in figure 2 here:
             | https://www.annualreviews.org/doi/10.1146/annurev-
             | virology-0...
             | 
             | "It's not seasonal" is one of the mantras health agencies
             | repeated in february, along with "masks aren't shown to
             | work" and "it doesn't" spread by aerosol.
             | 
             | My guess is your health agency simply hasn't re-examined
             | their beliefs as evidence came in.
        
         | maxerickson wrote:
         | From the phase 3 trials you'd absolutely expect cases to occur
         | after vaccinations. That's what the 95% efficacy after 2 doses
         | means, that 5% of people had symptomatic infections.
         | 
         | Hopefully it is the case that the 5% are people that have a
         | weak response to the vaccine and the remainder mostly aren't
         | infectious. They can study this by monitoring for asymptomatic
         | infections (I don't know if they are going to or not).
        
           | doktorhladnjak wrote:
           | 95% effectiveness does not mean 5% of people had symptomatic
           | infections. It means there were 20 times more infections in
           | the placebo group compared to control.
           | 
           | If you gave the vaccine to 1000 people and placebo to 1000
           | people, and 100 of the placebo and 5 of the treatment group
           | got sick, that's 95% effective, as is if all 1000 in the
           | control group got COVID and only 50 in the treatment group.
        
             | maxerickson wrote:
             | Yep, thanks for clarifying.
        
             | TheGallopedHigh wrote:
             | You're saying the same thing as the parent comment.
        
               | dtech wrote:
               | Parent said 5% had symptomatic infections, 50 in this
               | example, while the correct number is 0.5% percent or 5
               | people.
        
       | GistNoesis wrote:
       | What worries me is that there doesn't seem to be some global
       | coordination in the distribution of the vaccines. It looks more
       | like an individual race, than a synchronized collective effort.
       | 
       | In the scenario where only the old accept to get vaccinated, and
       | the vaccine doesn't reach the required threshold to stomp the
       | virus. The virus become manageable, the economy reopen but the
       | virus run rampant in the asymptotic population slowly mutating
       | over-time until it finds a variant that is resistant to the
       | vaccine by successfully infecting a vaccinated person.
       | 
       | And it just needs for this to happen in a large population
       | cluster where the vaccination doesn't reach the threshold, either
       | because they do not have access to the vaccine yet or because
       | some fraction of the population decide to not get vaccinated, for
       | everyone to get screwed-up again.
       | 
       | Then we get a new vaccine every year.
        
         | Thorentis wrote:
         | Congratulations, you discovered the flu.
        
           | GistNoesis wrote:
           | Touche ! What is so sad is that it can still be avoided.
           | 
           | But the current situation where we simultaneously have a high
           | number of active case and high number of vaccinated people
           | over a sufficiently long time because of slow vaccination
           | schedule, is a recipe for creating vaccine resistant
           | variants.
           | 
           | As soon as we start vaccinating we are giving the virus
           | opportunities to pressure-select against the vaccine. The
           | more active case we have and the longer it takes the better
           | for the virus.
           | 
           | I'm no epidemiologist, but with the apparition in a short
           | amount of time of 2 variants which affects the spike protein,
           | it seems the current level of active case we are entering a
           | red-zone, where the virus is given too many opportunities to
           | mutate. And we should try to contain it via the current
           | measures (masks, tracking and lock-downs), before sabotaging
           | our best card.
        
         | [deleted]
        
       | m3kw9 wrote:
       | How effective is it to use one of those molecular simulation
       | tools to quickly calculate if the antigens created still have
       | high affinity to bind to the mutated spike?
        
       | corona-research wrote:
       | Does the vaccine cure hypochondria?
        
       | anonthinker wrote:
       | I know some of you are following this closely and I have some
       | questions I haven't seen any proper answer. I am hoping one of
       | you can shine some light.
       | 
       | How long will the mod-RNA express the spike proteins? (where is
       | the actual 'protein expression'/time plot?)
       | 
       | The poly(A) tail isn't just A (which would give a mechanic answer
       | to my first question?), there is also a 10-nucleotide linker
       | (GCAPsAPsGACPs). I wonder if this could be there to trigger some
       | sort of self-amplification. Can someone point me to the relevant
       | paper?
        
       | jakub_jo wrote:
       | It's not the "Pfizer" vaccine. It's either the "Biontech" vaccine
       | or the "Biontech/Pfizer" vaccine. Please fix the title.
        
         | mseidl wrote:
         | AFAIK, Biontech developed the vaccine and had successful tests
         | in mice/monkeys, then they asked Pfizer help for bigger scaled
         | testing/manufacturing?
        
       | jonplackett wrote:
       | Pfizer have said it will only take a few weeks to tweak their Rna
       | vaccine, if it does need to be changed.
       | 
       | Anyone know how long it would take AstraZeneca with a more
       | traditional vaccine?
        
         | libertine wrote:
         | The problem is that we're turning this into a cat and mouse -
         | Pfizer has nowhere near the capacity to ramp up production to
         | make a positive impact after all.
         | 
         | If we enter a cycle of new variants every 9-6 months that
         | require new vacines, simply because the volume of people infect
         | allows the virus to have enough diversity, then it's pointless.
         | 
         | It's basically a "weird flex" from Pfizer, because what they
         | should say is: even though we can make a new vaccine easily, we
         | will have nowhere near the production capacity to make a
         | difference, so global governments need to get their shit
         | together.
        
           | iguy wrote:
           | Manufacturing capacity is going to be a big constraint this
           | year, but surely whatever factory was going to make the old
           | variant, could equally well make some new variant of the
           | vaccine.
           | 
           | Longer-term, if we need a new vaccine every 9 months, that
           | doesn't sound like a huge manufacturing problem. We
           | manufacture many high-tech things on a scale of 1 per person
           | per year, like the flu vaccine. The difficulty is ramping up
           | fast (especially when you think that demand may only last a
           | year).
        
             | libertine wrote:
             | It's the whole chain, manufacturing is just a portion of it
             | - the logistics required for this vacine, and the volume of
             | people that needs to be vaccinated.
        
               | iguy wrote:
               | Sure, and the logic is pretty similar for the whole
               | chain.
        
           | bluGill wrote:
           | Pfizer can develop more capacity if they see a need. Right
           | now it isn't looking useful, as several other competitors are
           | expected to be approved in the near future before they can
           | bring more production online. If they need to develop a new
           | vaccine every few months, the speed they can make new
           | variations would make more investment in manufacturing worth
           | it.
        
         | phreeza wrote:
         | Will a tweaked vaccine have to go through the full approval
         | process again?
        
           | lame-robot-hoax wrote:
           | I believe only phase 1 and phase 2.
        
             | jonplackett wrote:
             | How long do phase 1/2 take?
             | 
             | I wonder if, under some potential circumstances (eg. the
             | virus turns out to escape current vaccine & be much more
             | contagious) exceptions will be made.
        
               | bluGill wrote:
               | A few months. Though we don't have enough understanding
               | of mRNA to skip phase 3 yet. That dull take time. How
               | much time is a question of tradeoffs.
        
       | iridium_core wrote:
       | Is there any evidence that this new 'variant' has any impact to
       | infectiousness or death?
       | 
       | Or is it simply genetic drift?
        
         | avl999 wrote:
         | No evidence that it is deadlier than other variants. Some
         | evidence that it is more infectious.
        
           | sbinthree wrote:
           | It's been rapidly becoming the dominant variant in places
           | with various different kinds of measures so I think it's for
           | sure more infectious at this point.
        
             | iridium_core wrote:
             | So incessant, and seemingly ineffective, lockdowns have
             | succeeded - in selecting for a variant of COVID which is
             | resistant to lockdown? What biological or physical
             | mechanism could allow it to spread more than the original?
        
               | sbinthree wrote:
               | Yes
        
               | wwweston wrote:
               | On one hand, it may be plausible that taking any measure
               | that makes it harder to spread... favors a variant that
               | can spread more easily.
               | 
               | On the other hand, spreading more easily means higher
               | reproductive fitness under _any_ circumstance. And _not_
               | taking measures to reduce spread probably just means more
               | infections faster, which is more opportunity for
               | reproduction and mutation, which means you probably get
               | higher fitness variations sooner.
               | 
               | Also I'm trying to think of anywhere in US/UK society for
               | which "incessant lockdown" could possibly be an accurate
               | description of policy much less behavior.
        
               | nmca wrote:
               | Imperial study was in the context of a tiered UK system
               | that keeps schools, so increased infection from young
               | people _is my personal and ill-informed_ hypothesis of
               | how the new variant achieved 50-70% increased r0 under
               | restrictions.
        
           | JamesBarney wrote:
           | Just a reminder that greater infectiousness is worse than
           | greater lethality.
           | 
           | Say you have two variants, variant S-spreader and variant
           | L-lethal. S kills 1 in 100 people and has a doubling time of
           | 3.5 days L kills 2 in 100 people and has a doubling time of a
           | week.
           | 
           | First week L kills twice as many people of S. Week 2 they
           | kill the same number of people. Week 3 S kills twice as many
           | people as L Week 4 S kills 4x as many people as L.
        
             | lazyjones wrote:
             | This is plain wrong. You have 2 variables there and can't
             | claim that one has greater effect based on 2 examples. It
             | can be refuted by a suitably chosen 3rd example, e.g.
             | N-nonlethal kills 1 in 10000000000000 people and has a
             | doubling time of 1 day.
        
           | fpgaminer wrote:
           | It should be noted that increased infectiousness will
           | inherently result in a larger number of deaths, even if it is
           | not "deadlier". i.e. the new strain may still only be fatal
           | in 0.5% of cases, but if it infects more people that's more
           | rolls of the dice. The original strain was only projected to
           | infect 60-70% of the population (if left unchecked). A new
           | strain being 70% more infectious drastically changes that
           | figure.
           | 
           | Not to mention a similar uptick in serious cases and even
           | just more people presenting to the hospital. Imagine the
           | current situation, where some cities are already at 0%
           | capacity, but 70% worse...
           | 
           | Just something worth noting when we say that a new strain is
           | _just_ more infectious.
        
             | Erlich_Bachman wrote:
             | Yep, but at the same time if they would have said that it
             | is "more infectious and more deadly" - that would have even
             | more incorrect (without clarification), given that those
             | terms usually refer to specific properties.
        
             | lazyjones wrote:
             | > _It should be noted that increased infectiousness will
             | inherently result in a larger number of deaths, even if it
             | is not "deadlier"._
             | 
             | That's wrong if this virus, like many other viruses, is
             | mutating to become simultaneously more infectious and less
             | lethal.
             | 
             | https://www.reuters.com/article/us-health-coronavirus-
             | mutati...
        
               | graeme wrote:
               | Actually it isn't wrong. A 70% increase in an
               | _exponential_ gain leads to many multiples more cases.
               | 
               | You could halve the death rate in that scenario and still
               | have 10x the number of deaths or more.
               | 
               | Run two exponential series: one at 1.1x, one at 1.7x.
               | Start at 1,000 cases each. Death rate 1% for the first,
               | 0.5% for the second. Assume doubling in a week. Check new
               | cases and thus new deaths after eight weeks.
               | 
               | 2143 new cases on week eight fir the second one, 21.4
               | deaths.
               | 
               | 110,199 new cases on week eight for second one, resulting
               | in 550.5 deaths.
               | 
               | 20x worse. And unfortunately the new strain doesn't seem
               | to be less deadly, so it would be 40x worse if death rate
               | the same.
        
               | lazyjones wrote:
               | You are wrong on principle because you stopped thinking
               | after you calculated the death rate after week eight. The
               | virus doesn't stop spreading in either of the
               | hypothetical cases and the population is a finite number.
               | Keep calculating!
               | 
               | Also, your numbers are arbitrarily picked. Why don't you
               | pick 1.8x and 1% vs. 1.9x and 0.999%?
        
               | graeme wrote:
               | Because 1.1x is about the r pre-existing restrictions had
               | most western societies at. And it's estimated the new
               | variant is 70% more transmissible.
               | 
               | >You are wrong on principle because you stopped thinking
               | after you calculated the death rate after week eight. The
               | virus doesn't stop spreading in either of the
               | hypothetical cases and the population is a finite number.
               | Keep calculating!
               | 
               | This only applies if the plan was to let literally
               | everyone get infected. That wasn't the plan. We have
               | vaccines now. It should be possible to end things by the
               | end of summer, so excess deaths now are needless deaths.
               | 
               | Also you're ignoring speed. 200,000 hospitalizations in a
               | week is much much worse than 200,000 in a year. Get too
               | many people needing to be hospitalized at once and the
               | death rate goes up because you can't treat them as well.
               | You also get more deaths from other conditions as
               | hospitals can no longer serve cancer patients, heart
               | attack victims past a certain point etc.
        
               | lazyjones wrote:
               | You keep introducing more variables and more arbitrary
               | numbers, we won't get to agree on anything this way.
               | 
               | It's well known that harmless viruses exist, they infect
               | a lot of people and kill nobody (or almost nobody).
               | Claiming that more infectious = generally more lethal is
               | just not based on facts. If Covid-19 mutates into a
               | mostly harmless variant, we will easily treat the few
               | more severe infections and nobody will die.
        
               | graeme wrote:
               | > You keep introducing more variables and more arbitrary
               | numbers
               | 
               | These variables are the ones that are relevant to deaths
               | and have been talked about since the beginning of the
               | pandemic: hospital overwhelm, total percent of populace
               | infected, etc
               | 
               | To refuse to deal with the complexities of the situation
               | doesn't make them go away. I didn't introduce any factors
               | apart from the common ones.
               | 
               | > It's well known that harmless viruses exist, they
               | infect a lot of people and kill nobody (or almost
               | nobody).
               | 
               | We're not talking about those viruses though. Most
               | viruses that we don't have a vaccine for are either
               | orders of magnitude less lethal or substantially less
               | contagious.
               | 
               | > Claiming that more infectious = generally more lethal
               | is just not based on facts.
               | 
               | I didn't say that. I said that at the level of lethality
               | coronavirus is at, an increase in contagiousness is worse
               | than an increase in lethality. Very different claim.
               | 
               | > If Covid-19 mutates into a mostly harmless variant, we
               | will easily treat the few more severe infections and
               | nobody will die.
               | 
               | This would be true if it mutated into something maybe
               | 100x less contagious. An entirely theoretical
               | possibility. That's how much more lethal covid is
               | compared to stuff like the cold.
        
         | maxerickson wrote:
         | What does 'evidence' mean in the question?
         | 
         | There is certainly something going on in the UK and Ireland,
         | but it's not a randomized controlled study designed to measure
         | the infectiousness of the variants that have recently been
         | sampled there.
         | 
         | (because it's exponential, higher infectiousness can be quite a
         | lot worse than higher lethality)
        
         | graeme wrote:
         | Yes. Denmark has studied it and the new variant is doubling its
         | prevalence in denmark every week too.
        
         | aqme28 wrote:
         | The British variant is estimated to be about 40-70% more
         | infectious, which is pretty bad of course.
         | 
         | https://www.who.int/csr/don/21-december-2020-sars-cov2-varia...
        
         | elij wrote:
         | https://www.imperial.ac.uk/mrc-global-infectious-disease-ana...
         | 
         | It's very important, specifically in the UK, to put N501Y in
         | the context of political decisions that impact the R index.
         | 
         | https://twitter.com/dgurdasani1/status/1344774576371335175
        
         | JamesBarney wrote:
         | There is. In the UK you are seeing a huge spike in infections
         | at the same time the percentage of coronaviruses attributed to
         | the new variant sky rocket.
         | 
         | Look here for how one of the lines is not like the others. (UK)
         | 
         | https://ourworldindata.org/coronavirus-data-explorer?zoomToS...
        
       | ashtonkem wrote:
       | Oh yes, pandemic. I feel like I was forgetting something.
       | 
       | That's good news at least.
        
       | johndoe42377 wrote:
       | Why should it be not? It will be effective as long as the core
       | protein against which the immune system response is to be
       | triggered will remain the same.
        
         | lrossi wrote:
         | This is like saying that your input schema has changed a
         | little, but you still want to push the code to production
         | without retesting it.
        
           | rimliu wrote:
           | It is nothing like that.
        
       | UltimateBallR wrote:
       | Extremely good news!
        
       | PurpleFoxy wrote:
       | What worries me is the chance that we will see another super
       | virus in a few years except one country already has vaccines
       | developed on day one and will not share the information on them.
        
         | duxup wrote:
         | I feel like in this economically connected world, that would be
         | a sort of global politics suicide. It would be one of the few
         | acts that would likely galvanize... everyone. The leaders of
         | those nations would be pariahs in a way that even a nation like
         | N. Korea is not.
         | 
         | For the nation's without a vaccine, the leaders there likely
         | would be quite motivated to act and enjoy a great deal of
         | support at home.
        
         | ggm wrote:
         | Remember China and the USA were in a full bore trade war and
         | despite some mud flinging and half-truths,essentially the
         | global health system was kept informed.
         | 
         | The genome was shared. At least four competitors in global
         | economic terms (China, Russia, the EU and the USA) all
         | developed vaccines.
         | 
         | This is not like pre-hydrogen bomb information hoarding. The
         | techniques behind mRNA are taught worldwide. Most medicines
         | come from India, which was a leading non-aligned economy for
         | years and years.
        
           | bluGill wrote:
           | In general sharing vaccine information with your enemy is
           | considered a good thing by generals. No good army wants to
           | get involved in biological warfare at this time as it is too
           | risky as to turning against you.
           | 
           | The above does leave room for bad armies. Some tiny
           | insignificant nation might do this. China isn't
           | insignificant, and not stupid. Even in an all out war they
           | would still share virus and vaccine information with their
           | enemies as there is nothing to lose and goodwill to gain.
        
         | f430 wrote:
         | As long as it's not a communist country then we are fine.
         | 
         | They still not letting WHO scientists into Wuhan to study it's
         | origins and we are being told to take CCP's word at face value.
        
         | JamesBarney wrote:
         | Developing vaccines are easy. The cost is all testing. Other
         | countries could easily reverse engineer the vaccine and make
         | it.
        
         | newsbinator wrote:
         | That's part of the reason every major country in the world has
         | a well-funded department of espionage.
        
       | zelly wrote:
       | Why does the vaccine for SARS-CoV-2 work so well but there was no
       | vaccine at all and still isn't for SARS?
        
         | CorrectHorseBat wrote:
         | Hard to test the efficacy of a vaccine on an eradicated
         | disease.
        
         | hobofan wrote:
         | Because mRNA tech for rapid vaccine development wasn't
         | available back then and it didn't spread so far that there was
         | political pressure for expedited trials. Now it is eradicated
         | anyway.
        
         | QuesnayJr wrote:
         | Part of why these vaccines were developed so quickly is that
         | much of the preliminary work was done for SARS.
        
         | bluGill wrote:
         | The is/was several SARS vaccines. They never got to phase 3
         | trials, because of various problems. We learned enough from
         | them to skip all the issues this time around.
        
       | meekmockmook wrote:
       | Another social media panic for no reason. Big Tech is the
       | ultimate superspreader.
        
         | [deleted]
        
         | eclipxe wrote:
         | Nope, you are incorrect.
        
           | meekmockmook wrote:
           | The vaccine works on the new variants. The variant spreads
           | faster than previous ones, but in the end the rules don't
           | change: Wear a mask, wash your hands, don't go inside with
           | people if possible.
           | 
           | People were sharing on a Facebook and tweeting that the new
           | strain was being spread through touching surfaces and farts
           | and that masks no longer work.
           | 
           | Big Tech is poison and many thousands would still be alive
           | today if they had never logged on. These companies are no
           | longer defensible.
        
             | SpicyLemonZest wrote:
             | The problem is that, because the variant spreads faster
             | than previous ones, rules which were sufficient to keep
             | previous ones in check will likely be insufficient to keep
             | the new one in check. We'll have to get stricter about the
             | rules, get vaccine rollout accelerated quite a bit, or find
             | ways to handle a lot more disease than currently exists. I
             | have no doubt some people shared weird falsehoods about it,
             | but there's still a true reason for concern.
        
               | corona-research wrote:
               | Lol
        
               | meekmockmook wrote:
               | Speaking from California, the only change we could make
               | is convincing law enforcement to enforce the rules (they
               | won't) and changing the bizarre vaccine restrictions that
               | are leaving 75 percent of our doses in a freezer while
               | thousands who are offered it say no thanks.
               | 
               | A massive percentage of the public has decided to give up
               | on safety protocols and if Thanksgiving and Christmas
               | didn't change any minds, why would this?
               | 
               | What good did terrorizing the people who are already
               | following the rules with this variant panic do? "THE
               | VACCINE MIGHT NOT WORK NOW!" only scares people who want
               | the vaccine. The media frenzy around the variant did
               | absolutely no good.
        
               | SpicyLemonZest wrote:
               | What you're saying is probably true. But I don't think
               | the media should refrain from reporting true, relevant
               | information just because they don't think it will do any
               | good if it's known.
        
               | meekmockmook wrote:
               | Oh, of course news should be reported. But a week
               | straight of panic mongering headlines? That does people a
               | disservice and spreads fear for $. Big Tech and corporate
               | media have a profit incentive in spreading terror.
        
               | SpicyLemonZest wrote:
               | Fair, I certainly can't endorse a lot of the headlines
               | I've seen. Headlines are just very bad and we as a
               | society have got to find a way to fix them.
        
               | wwweston wrote:
               | What's bizarre about the vaccine restrictions? The
               | publicized plans I'm aware of start with healthcare
               | workers and long-term care residents, which is pretty
               | much what I expected. I've heard there are about 3
               | million of those people and 1 million doses, so even if
               | over half of those people for some reason are refusing
               | doses, there's no reasons to expect that we're through
               | that crowd yet.
               | 
               | I've got several acquaintances who work in both areas and
               | what I'm hearing that there _are_ challenges: not ones
               | that have to do with  "rules", but actual supply and
               | logistics. Still, among these are people who've received
               | their first dose.
        
               | meekmockmook wrote:
               | There's been a serious problem im CA with Healthcare
               | workers rejecting vaccines which are then either
               | discarded or put away in a freezer. Only 25 percent of
               | the supply has been used, including the ones reserved for
               | dose 2.
        
               | jeofken wrote:
               | Any CA health care worker on HN? Why do most of you
               | reject these vaccines?
        
               | syspec wrote:
               | Many of them simply do not want to be "the first ones to
               | get this untested vaccine".
               | 
               | That is the consensus, and even within medical community
               | misinformation about the vaccine has footing.
        
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