[HN Gopher] Considerations in boosting Covid-19 vaccine immune r...
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Considerations in boosting Covid-19 vaccine immune responses
Author : curmudgeon22
Score : 21 points
Date : 2021-09-15 18:47 UTC (4 hours ago)
(HTM) web link (www.thelancet.com)
(TXT) w3m dump (www.thelancet.com)
| bananabiscuit wrote:
| Interesting how much of a double standard there is in the media
| when it comes to promoting booster shots before the effects of
| doing so are adequately studied, but then pre-maturely shutting
| down other potential treatments (ivermectin, fluvoxamine, hcq),
| when there isn't really a consensus for either thing.
|
| Shooting from the hip seems to be fine as long as it has the
| effect of administering more vaccine doses, but everything else
| is to be ridiculed and held to much stricter standards of
| scientific proof.
| titzer wrote:
| Ivermectin was invented to combat parasites--worms. Not
| viruses. It is not an anti-viral or even anti-antirheumatic. It
| is the latest in a class of ignorant folk remedies emerging
| from who-knows-what dark place on the internet, and it will
| join Hydroxychloroquine as a total failure at treating COVID.
|
| The only double standard here is that, for once, the media
| isn't suffering the latest idiotic conspiracies with "both
| sides" nonsense but is appropriately putting them in the
| "eating crayons" box. For once, the media is actually taking
| public health seriously.
|
| As for proof, you know, propose a treatment, get approvals, run
| trials, analyze data. Zero people are doing that with
| Ivermectin. It's flat-Earther crackhead territory and I have
| absolutely no qualms about dismissing it out of hand.
| Meanwhile, vaccines have billions of data points that aren't
| just correlations, they are causative, and there's an entire
| sum of human knowledge of biology behind them, instead of some
| vague superstitious belief that magic potion kills one bad
| thing in your body, therefore it must kill other bad things.
| Also, people are eating tubes of _topical_ Ivermectin. You have
| got to be freaking kidding me. What a shitshow.
| hunterb123 wrote:
| Not so fast, like many drugs, it has multiple uses, not just
| what it was invented for.
|
| Ivermectin, like HCQ, has antiviral properties and prevents
| binding of some viruses, like the dengue virus and covid-19.
|
| You use it as a prophylactic to prevent replication of the
| virus.
|
| Details how Ivermectin prevents Covid19 from binding:
| https://www.nature.com/articles/s41429-021-00430-5/figures/1
|
| There have been many studies showing it's effective at
| preventing serious infections of Covid-19.
|
| https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7539925/
|
| https://covid19criticalcare.com/ivermectin-in-covid-19
| titzer wrote:
| Well, given it's from Nature, I actually gave your link a
| fair shake to see what it's about. This is not a "details
| on how it works" article. It's an article that is basically
| "brainstorming on how it might work". There is no
| epidemiological study, no controlled trial here, no
| proposed specific mode of action. A _huge_ shotgunning of
| potential pathway interactions that _might_ affect some
| portion of the virus 's interaction with host cells.
|
| In fact, the conclusion from TFA itself:
|
| > Considering the urgency of the ongoing COVID-19 pandemic,
| simultaneous detection of various new mutant strains and
| future potential re-emergence of novel coronaviruses,
| repurposing of approved drugs such as Ivermectin could be
| worthy of attention.
|
| This is _their_ conclusion. Not a sample of their
| conclusion. Their _entire_ conclusion. Not "It is
| effective." Not "It works like this." Not "Here are studies
| that show it works". This article is "hey, some drugs have
| crossover effects, we should look at them." I mean, they
| literally wrote that.
|
| I will repeat, _again_. Ivermectin is not an approved anti-
| viral medication. There are all kinds of things that have
| "anti-viral properties". Like UV light and bleach. These
| are not treatments for COVID.
|
| Meanwhile there is a _fricking vaccine_. It 's a
| scientifically designed, as-close-to-perfectly engineered
| solution to active your own immune response to respond to
| _exactly_ the spike protein, has been administered to
| _billions_ of people worldwide and has _overwhelming_ data
| that it _fucking works_. They 're not even in the same
| league. People who are taking Ivermectin, and people who
| are advocating it widely can be dismissed without further
| evidence. Otherwise, just show up to a pharmacy and pick a
| random drug off a back shelf. Drugs do weird things,
| sometimes they interact with viruses! Ship it? No.
|
| Please do Science, not whatever the fuck is behind the
| Ivermectin craze right now. Should it be studied? I mean,
| sure. But it is so clearly _not_ even a _decent_ treatment,
| we should probably move on from it.
| hunterb123 wrote:
| > There are all kinds of things that have "anti-viral
| properties". Like UV light and bleach.
|
| From "TFA":
|
| In principle, a molecule can act as an anti-viral drug if
| it "inhibits some stage of the virus replication cycle,
| without being too toxic to the body's cells [21]."
|
| Bleach doesn't quite meet that standard. Ivermectin helps
| according to the clinical trials, and that lines up
| according this study. It's not their opinion, it's backed
| by evidence.
|
| Yes we have the "fricking vaccine", but the spike protein
| is the problem as its toxic. Whether the vaccine's spike
| protein is toxic is up in the air, like Covid, the long
| term effects of mRNA "vaccines" are unknown entirely.
|
| If something works better that we've been putting in
| humans for a lot longer, why not look into it? Why
| dismiss it as dewormer?
|
| Calm down and stop running to the opposite side of the
| ring.
| robbiep wrote:
| > the long term effects of mRNA "vaccines" are unknown
| entirely.
|
| This is just such an absurd scientific and
| immunologically ignorant answer that I see get trotted
| out again and again that I need to respond.
|
| The mRNA vaccine is literally a scientific miracle. We
| introduce a piece of RNA, which is basically in the form
| of the RNA that viruses use to hijack the protein
| generating machinery of our cells, in order to produce an
| antigen our immune system can respond to without the
| runaway potential of an actual infection.
|
| The mRNA is broken down, antigen production stops, and
| our immune system is primed against a new foreign and
| potentially deadly pathogen.
|
| There is no conceivable mechanism for long term effects
| (and here I am responding to claims around impotence,
| infertility, 'changing your Genome') - you're literally
| just getting the immunological benefits of antigen
| stimulation without having to go through an infection.
| It's Nobel prize winning. Just because it's new doesn't
| mean it isn't highly well understood and characterised.
| It's such an ignorant statement it literally hurts
| Izkata wrote:
| > As for proof, you know, propose a treatment, get approvals,
| run trials, analyze data. Zero people are doing that with
| Ivermectin.
|
| Here's an aggregate of 63 studies, almost all of which show
| benefit to using Ivermectin: https://c19ivermectin.com/
| [deleted]
| javagram wrote:
| > then pre-maturely shutting down other potential treatments
| (ivermectin, fluvoxamine, hcq), when there isn't really a
| consensus for either thing.
|
| You listed 1 drug proven to work, Fluvoxamine, with two that
| have repeatedly failed in well designed RCTs...
|
| The problem with HCQ and Ivermectin are they are both being
| oversold as a near-certain cure. They've been politicized and
| you see the media reacting to that. Traditional media by
| debunking, social media by ineffectively trying to slow the
| spread of the false claims that you don't need a vaccine or
| masks or social distancing because of HCQ and Ivermectin.
|
| HCQ is pretty clearly a dud. Ivermectin has a chance of having
| a small effect like 10% or 20%.
|
| Fluvoxamine is the real deal but why are you complaining about
| media censorship here? Google News for "Fluvoxamine" shows
| plenty of positive coverage e.g. https://www.vox.com/future-
| perfect/22619137/fluvoxamine-covi...
|
| > The limited, promising literature around fluvoxamine prompted
| its inclusion in the large-scale study of treatments for
| Covid-19 run by Ed Mills at McMaster University and primarily
| conducted in Brazil. Dubbed the TOGETHER study after other
| prominent mega-clinical trials like RECOVERY and SOLIDARITY by
| other organizations, it randomized patients across eight
| prospective treatments, including metformin (a diabetes
| medication), hydroxychloroquine (an antimalarial), and
| ivermectin (an antiparasite).
|
| > The team announced their results at an August 6 symposium
| that was sponsored by the National Institutes of Health. Most
| of the treatments failed: Their study couldn't detect an
| effect. "A lot of drugs against Covid just don't work very
| well," Mills told me. Two other treatments were still in
| progress, and it was too early to rule out the chance that
| they'll work.
|
| > But fluvoxamine was a different story. In the trial, it
| improved patient outcomes substantially -- and while it's not
| the first drug to do that, ease of delivery and price give it
| the potential to have an outsized impact on patient care,
| especially outside the rich world
| dragontamer wrote:
| I can only assume you're talking about Ivermectin?
|
| https://www.covid19treatmentguidelines.nih.gov/tables/table-...
|
| Because the treatments that work (ie: Monoclonal Antibodies)
| are being hugely invested into right now. IIRC, the government
| just spent a few billion dollars buying more doses of them.
|
| --------
|
| The thing about COVID19 vaccine boosters is that the CDC has
| basically blessed them, but the FDA has not yet. As such,
| there's a vigorous debate going on right now whether the 3rd
| dose is needed. (Immunocompromised individuals are already
| allowed to get the 3rd dose however. The only questions with
| regards to the booster is the general public). Yes, different
| agencies will disagree on things. CDC is most focused on public
| health, FDA is most focused on safety. Their goals / purposes
| are different, and therefore will lead to situations where they
| disagree like this. The White House then has to resolve the
| difference and make a stance. Since the White House is having
| meetings on the subject, it makes the news a lot.
|
| For some "alternative treatments", like Ivermectin, there's no
| major body who believes it works in the USA. CDC says it
| doesn't work. FDA says it doesn't work. NIH doesn't have any
| research showing any reasonable degree of efficacy.
| daxfohl wrote:
| Yeah but you're forgetting this is all lies because
| government has no other way of extracting $31 or whatever
| from each citizen. /s
| dragontamer wrote:
| If we're bringing up costs... what actually bothers me
| rather severely is the $2100 price tag per Monoclonal
| Antibodies treatment.
|
| But it works. And people are freaking out about COVID19 so
| much that its free. Maybe we should start a debate about
| the moral hazards of giving highly expensive (though
| effective) COVID19 treatments to population centers who
| have refused to take the $20 vaccine?
|
| -------
|
| If people want the "cheap miracle drug that works", that
| was dexamethasone, at a price tag of like $15 or so. And
| the vaccine of course. I don't know why they're going for
| IVM.
|
| As a steroid, its an innately risky treatment (steroids
| suppress your immune system). But its been shown that the
| cheap steroid dexamethasone, when used in correct doses,
| can greatly decrease mortality rates. So yeah, take with
| assistance of a doctor (to make sure your situation is the
| right use case), but we already have a "cheap miracle drug"
| success story here if people just want some hope or
| optimism in their lives. Dexamethasone was credited for
| cutting out 50% of deaths or something along that
| magnitude.
| listless wrote:
| This is basically the conservative argument that you
| don't have a basic right to health care. If you can't
| afford it, you don't get it.
|
| I'm not saying that logic is flawed, but we should at
| least be consistent. If healthcare is a human right, you
| can't then judge my life choices that got me there.
| dragontamer wrote:
| I lean conservative.
|
| Numerous hospitals have reached triage of care. We now
| have to talk about how to conserve scarce resources. We
| need to pick "winners and losers". No one likes this
| discussion, but it must happen.
|
| * https://www.washingtonpost.com/health/2021/08/16/joel-
| valdez...
|
| * https://s3.documentcloud.org/documents/21062484/signed-
| mec-l...
|
| Now that we're reaching this level of crisis, hospitals
| are beginning to ration off care. I know the ethicists
| have theorized the proper ethics to this situation over
| the past year, but as citizens / voting members of the
| public, its our job to form an opinion about these ethics
| think-tanks, and whether or not we should support certain
| viewpoints or not.
|
| Health care cannot "be a right" if we cannot afford said
| health care for everyone. If we cannot afford health care
| for everyone (literally not enough hospital beds), some
| mechanism needs to be used to prioritize who gets care or
| not. No amount of policy can squeeze blood from a stone:
| if we don't have enough hospital beds anymore, then we
| must systematically deny care in some regards. (And
| whatever system we choose will hopefully be fair)
|
| Money, for all of its problems, is an effective
| prioritization methodology... and simple to understand.
| You give care to those who can afford it. People always
| criticize the methodology but in the absence of better
| choices, I'm going to default to it.
|
| I think there's some hypotheticals saying that maybe the
| vaccinated should have priority (since the unvaccinated
| are the group who is causing the crisis, we should
| "punish" the unvaccinated in this regards). I think I can
| accept that as an answer as a higher priority.
| somewhereoutth wrote:
| Meanwhile back in civilisation, healthcare is allocated
| by need.
| nradov wrote:
| Methylprednisolone is more effective than dexamethasone
| for treating COVID-19 lung injuries. Cost is similar.
|
| https://journals.plos.org/plosone/article?id=10.1371/jour
| nal...
|
| https://bmcinfectdis.biomedcentral.com/articles/10.1186/s
| 128...
| Tuna-Fish wrote:
| Wait, it costs money to get vaccinated in the USA? That is
| such an ridiculously shortsighted and stupid policy.
| dragontamer wrote:
| Vaccines and even monoclonal antibodies are free (though
| treatment may cost money still: the price of the hospital
| beds and whatnot).
|
| The $31 joke is about IVM: lice / parasite remover that
| people are taking because they think it cures COVID19. At
| least, that was my interpretation of the joke.
| Izkata wrote:
| > CDC says it doesn't work.
|
| The CDC's stance is "we don't know, there's trials ongoing",
| not "it doesn't work".
| nradov wrote:
| The NIH is currently sponsoring a large scale clinical trial
| of ivermectin and several other drugs to see whether they're
| effective. We'll have to give them time to complete the
| study.
|
| https://www.nih.gov/research-training/medical-research-
| initi...
| dragontamer wrote:
| NIH is _always_ sponsoring clinical trials. That's
| literally their job.
|
| We also happen to have months worth of studies of IVM
| already. Given what has happened in literally the last
| dozen studies, we have a good idea of what will probably
| happen in that study.
|
| That's 16 high quality studies on IVM already in the link I
| posted above. Do you think the results of study #17 will
| change things?
|
| ------
|
| I mean, maybe it will. But I wouldn't bet on it. Studies in
| science have this thing where they usually replicate
| results.
| nradov wrote:
| I wouldn't describe any of the ivermectin studies
| conducted so far as "high quality". All were relatively
| small and most had other flaws or limitations. The link
| you posted above is missing recent studies, some of which
| show statistically significant positive results.
|
| https://www.mdpi.com/1999-4915/13/6/989
|
| https://www.medrxiv.org/content/10.1101/2021.07.21.212602
| 23v...
|
| https://journals.lww.com/americantherapeutics/fulltext/20
| 21/...
|
| So we just don't know, and it's too early to place any
| bets one way or the other. That's how science works.
| allturtles wrote:
| It's not at all too early to place bets; if there is no
| good data showing that Ivermectin works, we should assume
| the null hypothesis, that it does nothing.
|
| Otherwise we would have to maintain the same sort of
| equipose about literally ever possible substance - peanut
| butter could be an effective COVID treatment, until
| someone does a proper study, we just don't know.
| winocm wrote:
| Be aware that quite a few of the ivermectin studies
| contain fraud or dodgy data.
|
| https://www.buzzfeednews.com/article/stephaniemlee/iverme
| cti...
|
| https://gidmk.medium.com/is-ivermectin-for-
| covid-19-based-on...
|
| Not to even mention that the only realistic effect it
| would have is blunting the effects of IL-6. There's
| better options for antagonizing IL-6 with less of a side
| effect profile, specifically tocilizumab and sarilumab.
|
| If you refer to blocking nuclear import, ORF6 in SARS-CoV
| and other sarbecoviruses already does that to begin with.
| Adding SARS-CoV ORF6 to a MHV model actually made it
| _more pathogenic_ , so there is little benefit to not
| blocking nuclear import.
|
| Here are some associated material on the topic:
|
| https://journals.asm.org/doi/10.1128/JVI.01012-07
|
| https://journals.asm.org/doi/10.1128/jvi.01308-07
|
| https://journals.asm.org/doi/full/10.1128/JVI.79.17.11335
| -11...
|
| https://www.sciencedirect.com/science/article/pii/S221112
| 472...
| nradov wrote:
| We can generalize that a bit and say that most medical
| research on all topics contains some dodgy data.
|
| https://journals.plos.org/plosmedicine/article?id=10.1371
| /jo...
|
| The quality of COVID-19 research has been pretty bad
| across the board with researchers racing to publish and
| journals doing weak reviews. But I haven't seen any
| credible allegations of fraud against the specific
| studies that I linked above.
|
| There are multiple other hypothesized mechanisms of
| action beyond antagonizing IL-6. It's not completely
| clear what, if anything, is actually happening in vivo.
|
| https://journals.lww.com/americantherapeutics/fulltext/20
| 21/...
| xyzzy21 wrote:
| It's almost as if "follow the science" actually means "follow
| the demagoguery". It's certainly NOT science in any way, shape
| or form!
| standardUser wrote:
| All of the vaccines in use have gone through massive and
| extensive trials specifically for the prevention of COVID-19.
| Trials started over 18 months ago. Have hydroxychloroquine or
| ivermectin completed such rigorous testing, specifically for
| the treatment of COVID-19? The answer is an unqualified "no".
| dragontamer wrote:
| More accurately: both Hydroxychloroquine and ivermectin have
| been tested. And in both cases, they suck at treating COVID19
| (roughly equivalent to placebo and/or weaker than current
| standard of care).
|
| I listed the ivermectin review in my post earlier. HCQ is
| reviewed here by the NIH: https://www.covid19treatmentguideli
| nes.nih.gov/tables/table-...
|
| The fact of the matter is: HCQ and IVM have been extensively
| studied. They've been fully rejected based off of evidence.
| When a treatment works (ex: cheap corticosteroids like
| dexamethasone), the NIH announces and the hospitals start
| using it immediately.
|
| ----------
|
| Vaccines, dexamethasone, and monoclonal antibodies all work.
| So all hospitals are offering these services to any COVID19
| patient.
|
| IVM, HCQ and other "alternative treatments" are snake-oil
| bullshit.
| winocm wrote:
| Correct. HCQ only works in vitro with Vero cells that do
| not express TMPRSS2. It stops working once you start
| expressing the gene.
| bananabiscuit wrote:
| Obviously the vaccines weren't studied enough if we are only
| finding out now that certain age groups might be at more risk
| from vaccine side effects than from covid itself
| (https://www.theguardian.com/world/2021/sep/10/boys-more-
| at-r...)
|
| OPs Lancet article shows there is not a consensus on
| effectivity of boosters, but you will never hear that from
| the left media.
|
| I understand science is a process, and things that we might
| think are true/false/undetermined now might change based on
| new evidence. My complaint isn't that scientist aren't
| magically getting everything right first try, but that there
| is clear bias in the media towards some narrative and while
| most people happily will take that for granted with right
| wing news sources, they think left wing news sources are
| somehow immune to spreading misinformation.
| Covzire wrote:
| Why is Israel having such a hard time with the pandemic
| despite their relatively high vaccination rate?
|
| https://www.newsweek.com/israel-world-leader-vaccine-
| booster...
|
| Shouldn't we be seeing the exact opposite if the current crop
| of vaccines were the best solution?
| bhickey wrote:
| From the article: because children are unvaccinated.
| standardUser wrote:
| Israel has a moderately higher vaccination rate than the US
| and currently has close to 50% fewer deaths per capita from
| COVID.
|
| I wish the US was doing as well a Israel right now!
| Hundreds and hundreds of Americans would not be dying
| _every single day_ if we were.
| prox wrote:
| They were the first to vaccinate, and because of the
| relatively first two shots being close together, a third
| booster is needed. They see good results from that. Studies
| show having the vaccines wider apart gives longer and
| stronger immune response.
|
| I believe this effect is not exclusive to covid vaccines.
| platonis wrote:
| Have you ever considered the possibility that some of these
| shots may contain custom mRNAs with a different purpose?
| Because, if there was a genuine push to prevent ICU patients,
| then the general population would have been required to be
| tested for vitamin D deficiency and given supplements
| accordingly. Specially because it has been shown that not
| being deficient cuts the ICU risk in half. What about NAC to
| counter act the oxidative stress early on when symptoms
| start?
| jdhn wrote:
| There also would've been a concerted push for obese people
| to lose weight. My hot take is that the deaths in the US
| have been higher than in other countries due to obesity,
| and that many lives could've been saved if they weren't
| fat.
| platonis wrote:
| The obese tend to have have vitamin D deficiency and
| higher oxidative stress
| robbiep wrote:
| Rather than just posing an open ended conspiratorial
| hypothesis that has no evidence (it is trivial for anyone
| to get hold of a vial and sequence the mRNA to actually
| test your absurd hypothesis) do you have a proposed endgame
| for 'custom mRNAs' to what must be a vast conspiracy
| involving thousands of scientists?
| kmlevitt wrote:
| This argument for caution against boosters is badly flawed. They
| are using pre-delta data to argue it's inconclusive if boosters
| are needed against the delta-
|
| https://mobile.twitter.com/michaelzlin/status/14380883906967...
|
| A lot of these arguments seem to be strategic rather than
| scientific. Many people want to see wider vaccinations worldwide
| before anyone gets a booster, so they downplay evidence boosters
| are effective in order to steer people toward their preferred
| policies.
| zarkov99 wrote:
| Exactly, its plain as day. It is amazing to me how many noble
| lies have been told in the Pandemic. Even more amazing is that
| the people lying cannot see a direct line from the lying to the
| complete loss of faith in the institutions thy represent.
| crazy1van wrote:
| Exactly. The noble lies have crushed their credibility
| because no one knows until later whether a particular comment
| was a well intentioned lie or the truth.
|
| Everyone I personally know who is skeptical about
| institutional guidance advocating the vaccine or protective
| measures like mask mandates and lockdowns can cite a litany
| of previous lies or half truths by the same institutions.
| They did not start as medical institution skeptics -- the
| last 18 months turned them into skeptics.
| decebalus1 wrote:
| > Many people want to see wider vaccinations worldwide before
| anyone gets a booster, so they downplay evidence boosters are
| effective in order to steer people toward their preferred
| policies.
|
| While giving ammo to conspiracy theorists and eroding trust in
| public health institutions. Worst of both worlds, same as the
| CDC no-mask-necessary bullshit right at the start of the
| pandemic.
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