[HN Gopher] Sputnik V vaccine-neutralization escape by SARS-CoV-...
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       Sputnik V vaccine-neutralization escape by SARS-CoV-2 Spike
       variants
        
       Author : pabo
       Score  : 59 points
       Date   : 2021-04-04 14:25 UTC (8 hours ago)
        
 (HTM) web link (www.medrxiv.org)
 (TXT) w3m dump (www.medrxiv.org)
        
       | phreack wrote:
       | The president of Argentina has just been diagnosed with Covid,
       | with mild symptoms, after being vaccinated with both doses of
       | Sputnik for over a month or two.
        
         | m0llusk wrote:
         | There is speculation that Argentina may have failed to keep
         | Sputnik V cold enough during distribution, so it is quite
         | possible that the president and others recently vaccinated
         | received degraded vaccine.
        
           | mromanuk wrote:
           | No, that's just speculation or fake news [1]: the Sputnik V
           | boxes can last up to 60hs without refrigeration
           | 
           | 1: https://factual.afp.com/las-cajas-con-vacunas-sputnik-v-
           | mant...
        
           | mrkramer wrote:
           | So how we should know is vaccine good or is it degraded? Any
           | way of testing?
           | 
           | Not all batches should or could be tested but you could do
           | random sample testing.
        
         | sz4kerto wrote:
         | Completely expected. That's why the efficacy is not 100%.
         | 
         | We have people in hospital after 2 rounds of Pfizer.
        
       | ainar-g wrote:
       | > [...], we determined that 8 out of 12 (75%) of serum samples
       | from 12 recipients [...] showed dose response curve slopes
       | indicative of failure to neutralize rcVSV-CoV2-S: B.1.351.
       | 
       | I may be misreading this, as English is not my native language,
       | but 8/12 is 66 % and not 75 %, no? Or does the "(75 %)" refer to
       | something else?
        
         | qzw wrote:
         | Off-by-one errors, they're not just for programmers anymore.
        
       | amluto wrote:
       | Someone needs to do exactly the same study (same methods, ideally
       | same lab) on sera from people vaccinated with all the major
       | vaccines. The lack of a valid comparison study is ridiculous.
        
         | ObscureScience wrote:
         | I wouldn't say it's ridiculous. This is generally how a
         | scientific study is done. One "object" per study. An article
         | like this is not made to stand alone and should in general not
         | be used for non-science purposes, such as policy-making. First
         | order comparative studies (such as experiments) of course
         | exists, but comparisons are generally done to my knowledge in
         | meta-studies.
         | 
         | For laypeople and policy makers we of course need comparisons
         | and validations before we let them guide our choices.
        
       | nerdponx wrote:
       | At this point, what is the cost-benefit of further vaccine
       | development versus heavier investment in drugs and other
       | therapies to reduce the severity of disease?
       | 
       | There are a couple doctors in the US (particularly Peter
       | McCullough) who make a case that we haven't invested enough in
       | the latter and too much in the former. Naturally the anti-vax
       | people seem to love these guys, so it's hard to find any kind of
       | balanced analysis on it.
       | 
       | Or do the numbers still work out to be "more pandemic, more full
       | hospitals, many more dead" no matter how good the drug treatment
       | gets?
        
         | maxerickson wrote:
         | How recent are these arguments?
         | 
         | Deploying the vaccines is very cheap compared to
         | hospitalization.
         | 
         | And like a sibling comment has already said, we should just be
         | spending money anywhere it even seems to make sense.
        
         | kurthr wrote:
         | There's lots of work on anti-virals and other drugs, but unless
         | you happen to hit a pre-approved drug showing both efficacy and
         | safety will take so long that it probably won't matter until
         | the next epidemic. Drug treatments are much harder to develop
         | without significant side-effects and also likely less effective
         | than a well targeted vaccine.
         | 
         | Watch around 1hr into this TWiV, if you're interested in what
         | targets there are for anti-virals, who's working on them, and
         | why they're hard.
         | 
         | https://www.youtube.com/watch?v=7dL-ll8dSmY
        
         | hannob wrote:
         | A lot has been invested in drugs. Most of them don't work. The
         | best that was found was Dexamethasone, which reduces mortality
         | in severe cases significantly.
         | 
         | Generally medication for viral infections seems to be hard.
         | There isn't much good medication for other respiratory viral
         | diseases. It doesn't look like a major breakthrough in drug
         | treatment will happen.
         | 
         | A vaccine can make the difference between "you get the disease"
         | and "you don't get the disease and can't spread it to others".
         | No drug comes remotely close to that.
        
           | amluto wrote:
           | A lot of very competent coordinated studies of drugs have
           | been done. Oh wait, no it hasn't.
           | 
           | We had a mishmash of variously competent and incompetent
           | studies of AZ/HCQ. We have anecdotal data on ivermectin. We
           | have some preliminary studies of fluvoxamine (excellent
           | results, needs follow up); the large scale expedited follow
           | up is MIA. It's been over six months from the original study
           | -- there is no fundamental reason it should take more than
           | two months to test it on a few tens of thousands of people.
           | Ditto for anti-androgens. Camistat ought to have at least
           | some effect (famous last words); this has been known for
           | something like a year with no meaningful followup.
           | 
           | What's needed here is IMO public health department
           | coordination on studies, which isn't quite the same thing as
           | money.
        
             | entee wrote:
             | To be clear, almost all of these studies showed very small
             | effect sizes. The best therapeutics we have are remdesevir
             | (small but real effect on severity, unclear effect on
             | hospitalization and death), dexamethosone (moderate to
             | large effect on death when hospitalized), and antibody
             | drugs for which Lilly's has already been remove because
             | ineffective against variants though Regeneron's cocktail
             | seems quite good. Fluvoxamine is I'm sure under
             | investigation, we'll get a readout eventually but that's a
             | relatively new result.
             | 
             | The best drugs we have are either:
             | 
             | 1.) treat the virus with a novel entity (Regeneron, the
             | other antibodies)
             | 
             | 2.) treat the inflammation (dexamethosone, possibly
             | eventually fluvoxamine)
             | 
             | The repurposing and general antivirals (including
             | remdesevir) have little effect and likely won't make a
             | difference. There are novel drugs being developed (Pfizer
             | just started a protease inhibitor trial) but that's the
             | only place I'd expect to see real impact, with fluvoxamine
             | as a treat the symptoms wildcard. People have been trying
             | to find drugs or repurpose, and academic medical centers
             | have been working on it. It's that almost nothing works
             | when subjected to the hard trials.
        
               | maxerickson wrote:
               | There's likely room to pick better monoclonal antibodies
               | to use. There was an antibody identified that smashed
               | variants, for instance.
               | 
               | https://www.medrxiv.org/content/10.1101/2021.01.26.212502
               | 24v...
               | 
               | Some contextualization at https://twitter.com/K_G_Anderse
               | n/status/1367592606641704961
        
         | amluto wrote:
         | The cost vs benefit analysis is: do all of the above. The total
         | amount spent on biotech related to Covid is negligible compared
         | to the cost of Covid. Israel seems to understand this. Many
         | other countries are orders of magnitude off in their analysis.
        
           | [deleted]
        
       | codeulike wrote:
       | Most of these studies just look at antibodies (because they are
       | easiest to study) but all the indications are that T-cells from
       | all vaccines will continue to work well (thus preventing serious
       | disease) because T-cells are much more comprehensive in their
       | recognition abilities.
       | 
       | So covid will try and evolve to keep spreading but it will become
       | less deadly as vaccination and natural immunity increase. So its
       | destiny is to become a cold virus like the other human
       | coronaviruses.
       | 
       | https://twitter.com/Coronavirusgoo1/status/13769286914738135...
       | 
       | https://twitter.com/Coronavirusgoo1/status/13667086756797644...
       | 
       | https://twitter.com/profshanecrotty/status/13552620195622092...
        
         | __blockcipher__ wrote:
         | SARS-2 was always destined to become yet another endemic
         | seasonal respiratory virus, just to be clear.
         | 
         | Also, it basically _is_ a cold virus already. For the majority
         | of the population it's a mild respiratory virus. For the very
         | elderly it is quite deadly. I wish more people appreciated this
         | fact.
         | 
         | Interestingly OC43, one of the already-extant human CoVs, seems
         | pretty comparable in mortality for the elderly last time I
         | checked.
        
           | NicoJuicy wrote:
           | 3 months ago, a friend of mine got it and he couldn't even
           | walk the stairs.
           | 
           | He's 34 and does a lot of sports. So, i wouldn't say that
           | it's a cold virus already... Not deadly for younger people,
           | doesn't mean it has no consequences.
        
             | tunnuz wrote:
             | As anecdotal as it can be, I also know people in their mid-
             | thirties workout complicating pathologies and in good shape
             | that ended up being treated in ICUs and on ventilation (one
             | with a collapsed lung, pneumonia and a bacterial
             | infection).
        
               | NicoJuicy wrote:
               | Well, i did mention it because it's not the only one I
               | know.
               | 
               | A friend of mine is a nurse and she also mentioned lots
               | of young and fit collegues getting it pretty bad.
               | 
               | But correct, no research. But mostly people i know they
               | got infected. Sure, some have nothing or only lose smell
               | and taste.
        
           | Jeema101 wrote:
           | >For the majority of the population it's a mild respiratory
           | virus
           | 
           | I know someone in her 40s who got it and is not overweight.
           | She said it was terrible and that she's definitely getting
           | the vaccine because she never wants to get it again.
           | 
           | What exactly would you consider a non-mild respiratory virus?
        
           | codeulike wrote:
           | _SARS-2 was always destined to become yet another endemic
           | seasonal respiratory virus, just to be clear._
           | 
           | People were certainly saying that from the start, but lots of
           | people were saying lots of things from the start. Now that we
           | know that natural immunity lasts a decent while, and now that
           | we know that its possible to vaccinate for it, and now that
           | we know that the T-cells are going to be robust, then the
           | likely future paths are becoming much clearer. One year ago,
           | none of that was clear.
        
         | somewhereoutth wrote:
         | That is just speculation I'm afraid. There is much evidence
         | that newer variants are more contagious, more virulent, and
         | affect younger people more severely. Brazil's experience is
         | instructive.
         | 
         | Thankfully the fantastic results of the mRNA vaccines mean that
         | we should be able to suppress Covid down to the levels of
         | measles, if not eradicate it like smallpox.
         | 
         | As ever we should be wary of those who seek to deny the
         | seriousness of Covid, or suggest it cannot be defeated. We
         | should try to understand any agenda they may have, perhaps
         | including:
         | 
         | 1. Having previously decided Covid was not serious, they are
         | trying to justify their actions/lack of actions that put others
         | in danger.
         | 
         | 2. They have financial interests threatened by the necessary
         | non pharmaceutical interventions.
         | 
         | 3. Covid attitude has become a partisan political act.
         | 
         | 4. They are influenced by certain philosophies around notions
         | of 'survival of the fittest', 'culling the herd' and such like.
        
       | devit wrote:
       | How bad is this result and the similar result on the AstraZeneca
       | vaccine?
       | 
       | Does it mean that the South African variant will almost certainly
       | cause another pandemic in countries vaccinated with those (thus
       | requiring a revaccination with an mRNA vaccine) or is there
       | somehow a chance that the variant won't be prevalent?
        
         | throwaway4good wrote:
         | I believe az had similar (bad) results which caused south
         | africa to pause the rollout.
        
           | petre wrote:
           | Yup, except none of the recipients in the AZ study had severe
           | cases.
        
             | amluto wrote:
             | IIRC no one in either arm of that study had a serious case.
             | The study was nearly useless.
        
             | Barrin92 wrote:
             | the problem is of course that even if that's true, if the
             | virus spreads asymptomatically the same mutation risk
             | applies to the variant itself and at some point then we
             | might up with something that again completely escapes
             | immunity and vaccination.
             | 
             | It's just evolution in action. Any variant that dodges the
             | vaccine starts a new game of dice.
        
         | throwaway4good wrote:
         | I don't think it is the vaccine technology rather what part of
         | the virus the vaccine causes the immune system to react on.
        
         | newdude116 wrote:
         | If I may point to a comment of mine that got heavily downvoted:
         | https://news.ycombinator.com/item?id=26664839
        
       | Kliment wrote:
       | This study is not particularly interesting as a measurement of
       | vaccine effectiveness (because of the extremely low sample count
       | of 12 patients). So don't read too much into the particular
       | numbers. Instead, there's two useful and valuable results in it:
       | 
       | 1. It gives us information on the mechanism that the variants are
       | using for vaccine evasion - the E484K substitution which was the
       | suspected mechanism for B.1.351 ("south african variant") was
       | tested on its own and did not evade the vaccine-induced
       | antibodies as effectively as the full B.1.351 mutation set. This
       | tells us that there is some other mechanism in B.1.351 that makes
       | it more successful at evading antibodies. This is important and
       | valuable information.
       | 
       | 2. It demonstrates a really fast, safe, and clever method of
       | testing vaccine effectiveness against a new variant - what they
       | did was to take an entirely unrelated virus, graft a modified S
       | protein on it, expose it to blood serum from vaccinated patients,
       | and then try to infect a cell culture with it. By counting
       | infected cells compared to the same count without the serum
       | exposure, you can measure how effective the neutralization is,
       | without having to measure infection counts in a large population.
       | This is awesome and can easily be done with other vaccines and
       | any new variant that shows up, as long as it's sequenced, even if
       | it doesn't have much prevalence in the population. In fact, you
       | can use this method to test hypothetical variants that only exist
       | in animal viruses or not at all, and be able to redeploy vaccines
       | that are particularly effective against those in regions where
       | they happen to emerge. This, to me, is the absolute highlight of
       | this paper, and I suspect it will be extremely useful.
        
       | wrongdonf wrote:
       | If the herpes virus were new, spread around the entire world and
       | infected 2/3 of people and resisted all of our efforts to
       | eradicate it, would we panic? Should we panic? The idea of
       | coexisting with a virus is not pleasant but it wouldn't be the
       | first time I guess.
        
       | rediguanayum wrote:
       | More commentary on reddit:
       | https://www.reddit.com/r/COVID19/comments/milxvy/qualitative...
       | It basically echoes comments here, that there's a significant
       | reduction in neutralization (and paper says several instances of
       | no neutralization in some sera). Comments also says that the pre-
       | fusion spike stabilization used on the mRNA vaccine and J&J
       | (which otherwise similar to Sputnik as both use Adenovirus
       | vector) seems to be the difference.
        
         | kurthr wrote:
         | If you're interested in a fairly long discussion with the(?!)
         | guy who developed the stabilized spike protein substitutions.
         | Have a look at this TWiV.
         | https://www.youtube.com/watch?v=P9S28_5AqUA
        
       | abdullahkhalids wrote:
       | What is the effect of taking multiple vaccines, with a few months
       | of gap? Sputnik is available to me starting yesterday. If I take
       | it now, will taking a different vaccine that is effective against
       | the variants later on, give me immunity? Or will the new vaccines
       | not do anything because the immune response has already happened?
        
         | mensetmanusman wrote:
         | No one knows, it hasn't happened before and it would probably
         | be hard in the past to just test continuous vaccinations
         | indefinitely.
        
         | raducu wrote:
         | The only issue could be if you take Sputnik now and Sputnik V2
         | too soon, if they use the same viral vector in the future (you
         | could develop antibodies to the adenovirus itself, afik Sputnik
         | uses 2 adenoviruses for dose 1 and dose 2 for this exact
         | reason) if the vector is different, they will both work(in the
         | case of mRNA the vector is not an issue, afik).
         | 
         | So if you're allowed to get another vaccine in a couple of
         | months, take Sputnik now.
        
         | amluto wrote:
         | It's unknown. There is a phenomenon called "original antigenic
         | sin" that may or may not apply.
         | 
         | There's also a potential issue with immunity to the vector.
        
         | kurthr wrote:
         | Multiple vaccines have not been tested, but immunology suggests
         | they would be safe (using the same adeno-virus would likely be
         | less effective since your body would pre-empt spike
         | production). One possible hypothesis for why Sputnik (which it
         | self is a succession of two different adeno-virus laden spike
         | protein generators) is less effective is that it (unlike
         | Moderna, Pfizer, J&J) does not appear to use a stabilized Spike
         | protein, which makes the immune response it generates more
         | susceptible to this substitution. They key is what parts of the
         | artificial vaccine spike you develop antibodies for, as to how
         | effective the vaccine is for a variant since much of the active
         | portion of the protein is unchanged.
         | 
         | However, since both Moderna and Pfizer are testing mRNA
         | "booster" vaccines specifically for the SA variant, you might
         | just wait for that. They don't have an adeno-virus vector that
         | could be pre-empted by immune response.
        
       | randomopining wrote:
       | So essentially Sputnik is most likely useless against the South
       | African variant?
        
         | monocasa wrote:
         | My amateur reading of the paper: They say that there's a chance
         | still it can reduce some of the symptoms and reduce the need
         | for hospitalization of the South African variant (B.1.351), but
         | it doesn't do a great job at preventing infections in the first
         | place.
         | 
         | > we determined that 8 out of 12 (75%) of serum samples from 12
         | recipients of the Russian Sputnik V Ad26 / Ad5 vaccine showed
         | dose response curve slopes indicative of failure to neutralize
         | rcVSV-CoV2-S: B.1.351.
         | 
         | > Furthermore, we acknowledge that in vivo protective efficacy
         | can be derived from Fc effector functions of antibodies that
         | bind but do not neutralize.
        
         | konart wrote:
         | Useless? No. Less efficient? Likely.
         | 
         | I guess they will have to produce an updated version in nearest
         | future.
        
           | [deleted]
        
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       (page generated 2021-04-04 23:01 UTC)