One of these is for the little known Nipah virus. This virus is really scary. Like the Coronavirus, it jumps to humans from bats. Unlike the Coronavirus, it is extremely lethal. In the last outbreak, in 2018 [1], the case fatality rate was 89%. Fortunately, there were only 19 cases (17 died).
I’d be a bit careful with those numbers. Who knows how many people really had it. Maybe a good number of cases showed no symptoms and thus were not detected?
They made a movie about it : Virus[1] on Amazon Prime.
Unfortunately due to flashbacks, which introduce non-linearity, it may be difficult for those who are not native speakers to follow through the movie. The problem is no obvious visual highlighting indicating that a scene was a flashback (like going black and white). Otherwise a really solid watch.
Lyme disease has a simple antibiotic treatment. The Lyme serology test has high false-positive rate. There might be many people who believe they have Lyme disease therefore sadly miss out on their actual diagnosis.
>Even if CLD lacks biological legitimacy, its importance as a phenomenon can be monumental to the individual patient. This is because many if not most patients who believe they have this condition are suffering, in many cases for years. Many have undergone frustrating, expensive, and ultimately fruitless medical evaluations, and many have become quite disaffected with a medical system that has failed to provide answers, let alone relief.
>Many patients referred for Lyme disease are ultimately found to have a rheumatologic or neurologic diagnosis. Rheumatologic diagnoses commonly misdiagnosed as Lyme disease include osteoarthritis, rheumatoid arthritis, degenerative diseases of the spine, and spondyloarthropathies. Some patients are found to have neurologic diseases, including multiple sclerosis, demyelinating diseases, amyotrophic lateral sclerosis, neuropathies, and dementia. Some CLD advocates have argued that these various conditions are simply manifestations of Lyme disease, but these hypotheses are untenable.
We already have a Lyme disease vaccine. However, the manufacturer refuses to sell it for human use due to PR threats from conspiracy theorists. Unfortunately, creating vaccines is only half the battle.
I saw this right before I came here: "FANTASTIC NEWS—A potential vaccine for multiple sclerosis is now within sight on the horizon! And it’s an mRNA vaccine by BioNTech, maker of the Pfizer #COVID19 vaccine. Study in mice shows great promise for improving symptoms & stopping MS progression!"
Damn can you imagine? I never imagined that an HIV vaccine would be possible within my lifetime. Kind of reminds me of HepC. An older coworker told me how a friend killed himself back in the day for getting HepC from tainted blood (pretty much a death sentence at that time and it consumed him). But now it’s possible to CURE it and hopefully it’ll be the same for HIV soon. Fuck, science like this is amazing.
Sorry if this is a stupid question, and I'm sure this is very positive news. But one question I didn't find an answer to in the press release: what's the value of using mRNA for flu vaccine? Will it result in a safer or more effective vaccine? Be cheaper and easier to produce? Something else?
I (mostly) understand the mRNA process, just curious about why it'd be superior.
Cheaper, well, it depends. (Vaccines are already cheap, especially because they are mass produced.)
But I'm guessing - but I'm a total layman - that Moderna is betting big on their mRNA platform. The "beauty" of it is that you really need to just copy-paste some part of the virus (pick protein from the viral genome), and literally just paste it into their vaccine deliver platform. (See the link.) And this means R&D costs could go waaaaay down.
Sure, clinical trials are still needed to make sure it's safe and effective, but now they have a very good choice of nailing it on the first try, every try. (Basically unless they pick a wrong protein, it will work "every time". And it's already possible to get antibodies from folks who have "seroconverted" - that is they have become immune to something, because they have the antibodies against that thing. So, they sample a lot of people, look at what the human immune system did, and just pick the most common/stable protein target.)
The flu virus is problematic because it evolves/mutates fast, so old antibodies might not fit the new proteins. Yeah, sounds crazy, but some (!) small mutations lead to still functioning but sufficiently different proteins. (Of course we don't really see all the mutations that led to non-functioning proteins.)
It's also possible - super total speculation here - that the scientists/professionals/experts have a better guess on what to target than our immune system. (Relevant buzzwords: immunodominant / conserved epitope; epitope is the part of the target protein that the antibody/T-cell/B-cell actually matches/binds-to , and if the virus changes that part, boom, new virus, "doesn't look like anything to me", for example in case of HIV: https://pubmed.ncbi.nlm.nih.gov/21115730/ )
From what I understand, it gives more control over the immune trigger. Perhaps it's possible to sequence a small part that's common to many flu viruses and administer that?
Well, most flu vaccines today are made by infecting fertilized eggs, so an mRNA vaccine would have the advantage of being vegan. It may eventually become cheaper to manufacture.
Uninformed speculation: I would hypothesize the mRNA process could react faster to flu mutations, the current vaccines are kind of trying to guess which strains are going to be important in the next flu season. It is also possible the mRNA technology could cover a broader spectrum of flu antigens.
Clearly Flu, HIV, and Nipah are more pressing, but I found myself wondering last night what the odds are of a rhinovirus vaccine being in the cards thanks to rapid progress SARS-CoV-2 has pressed us to make w.r.t. RNA and protein-like vaccines.
Economics is the largest barrier in my mind. While my understanding is that these vaccines are less expensive to produce, it's hard to convince people to get the flu shot, let alone a common cold shot. What's more is that with hundreds of variants, it's efficacy would be hard to get right.
That said, I'd gladly pay a heft amount yearly if it meant I had a >60% chance of not catching a cold that year.
There is a Netflix documentary called Pandemic about couple that is trying to eradicate flu. They found vaccine that works on all flu viruses but it takes 6 shots to work. That’s not practical at all therefore it’s not on the market yet.
Not a virologist so I might butcher the explanation, but I think the strategy for universal flu is to target the “stalk” part of the virus since it’s similar across strains. We currently target the surface proteins since it’s easier to make a vaccine this way, but it differs more across the strains. Going after the stall would mean we don’t need to shove 100 different strains in there. I don’t know if this will be easier with mRNA technology.
I can see it going full steam ahead, myself, for a few reasons:
1) Do both, for additional safety.
2) PrEP has changed formulations, and may change again. This implies that the previous formulations were not completely optimal.
3) From what I understand, PrEP can be expensive, although your insurance may cover it. You can also get it overseas for much less but many are not comfortable with that.
4) It's a lifetime expense, even with insurance and a lifetime of having to take a drug versus one or more shots.
5) Not having to undergo kidney function tests on the regular might be nice.
There's a lot of places in the world that have not approved PrEP. And just like a birth control pill, it has to be taken daily -- and that is something that is hard for a lot of people to do consistently.
There are probably a lot of people who are willing to take a one-time vaccine but not an expensive, daily series of pills which aren't completely free of side effects.
The initial trials just need to establish that the vaccine is safe (no severe side effects) which could include those on PrEP and even those with no risk factor.
The larger, latter trial that needs to study efficacy could simply use a large population. While HIV transmission is much more rare outside of certain high risk groups, infection does occur through accidents or deviations in behavior (e.g an EMT gets a needle prick while trying to administer Narcan). It would take a larger population and longer study but it should still be able to reach statistical significance.
Can someone fill me in here. I have tried my best to read, and educate myself about these mRNA vaccines. But I have yet to see any conclusive evidence or proof that having the vaccine for COVID-19 prevents you from actually getting COVID-19. And i've seen many people debating this in the comments of other HN threads. It might mean you are asymptomatic, and _less_ likely to spread your symptoms - but it still means you can theoretically harbour the virus and spread it on to others (e.g. through kissing)
So, the question is, given we already have medication which works well as treatment for those with HIV - what exactly will this vaccine do for HIV - if not stop the transmission? My understanding is HIV is primarily spread through sex and sharing of needles. A vaccination program won't stop that.
Thanks in advance. I would love to read more about this.
(Caveat: amateur opinion based on mainstream broad understanding, not an actual scientist.)
This is interesting, but so far a weak first step on flu. Each year experts stare at numbers and perhaps read some tea leaves to choose 4 strains to cover, often missing somewhat.
The innovation I'd like to see: ignore the "choose 4" process, and instead aim to cover all known strains.
>amateur opinion based on mainstream broad understanding
I don’t think experts are reading tea leaves and it’s pretty wild to claim that. There are literally billions of dollars at stake. To bring it bag to software, that’s like me claiming I think machine learning people are just using fancy excel formulas.
The experts are not randomly choosing strains. A few years ago it was 3 strains, they recently added a 4th. They could add a 5th next year, or drop back down to 3 depending on what they are seeing actually happen.
The real problem they have is the flu mutates. They know what strains they see now and can add them all easily enough. In the few months between deciding on strains and manufacturing them the flu can mutate to some new strain that wasn't even seen before.
Even if we want to see a more innovative flu vaccine, choosing an iterative approach of getting a working one first, and then fine tuning it to protect against more variants is a good plan.
[+] [-] credit_guy|5 years ago|reply
[1] https://en.wikipedia.org/wiki/2018_Nipah_virus_outbreak_in_K...
[+] [-] alexpetralia|5 years ago|reply
[+] [-] throw0101a|5 years ago|reply
I just submitted about this:
* https://www.bbc.com/future/article/20210106-nipah-virus-how-...
* https://news.ycombinator.com/item?id=25741798
[+] [-] baxtr|5 years ago|reply
[+] [-] deskamess|5 years ago|reply
Unfortunately due to flashbacks, which introduce non-linearity, it may be difficult for those who are not native speakers to follow through the movie. The problem is no obvious visual highlighting indicating that a scene was a flashback (like going black and white). Otherwise a really solid watch.
[1] https://www.imdb.com/title/tt8941440/
[+] [-] chanmad29|5 years ago|reply
[+] [-] ed_balls|5 years ago|reply
[+] [-] tkinom|5 years ago|reply
[+] [-] throwarayes|5 years ago|reply
[+] [-] danfo|5 years ago|reply
I am not an expert, but I think it would be amiss to omit the Lyme disease controversy with these statements. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4477530/
Lyme disease has a simple antibiotic treatment. The Lyme serology test has high false-positive rate. There might be many people who believe they have Lyme disease therefore sadly miss out on their actual diagnosis.
>Even if CLD lacks biological legitimacy, its importance as a phenomenon can be monumental to the individual patient. This is because many if not most patients who believe they have this condition are suffering, in many cases for years. Many have undergone frustrating, expensive, and ultimately fruitless medical evaluations, and many have become quite disaffected with a medical system that has failed to provide answers, let alone relief.
>Many patients referred for Lyme disease are ultimately found to have a rheumatologic or neurologic diagnosis. Rheumatologic diagnoses commonly misdiagnosed as Lyme disease include osteoarthritis, rheumatoid arthritis, degenerative diseases of the spine, and spondyloarthropathies. Some patients are found to have neurologic diseases, including multiple sclerosis, demyelinating diseases, amyotrophic lateral sclerosis, neuropathies, and dementia. Some CLD advocates have argued that these various conditions are simply manifestations of Lyme disease, but these hypotheses are untenable.
[+] [-] elil17|5 years ago|reply
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2870557/
[+] [-] a-dub|5 years ago|reply
[+] [-] ideamotor|5 years ago|reply
https://twitter.com/DrEricDing/status/1348912741562667008
[+] [-] m3kw9|5 years ago|reply
[+] [-] m-ee|5 years ago|reply
https://www.aidsmap.com/news/jul-2020/novel-vaccine-induces-...
[+] [-] syntaxing|5 years ago|reply
[+] [-] CryptoPunk|5 years ago|reply
[+] [-] elicash|5 years ago|reply
I (mostly) understand the mRNA process, just curious about why it'd be superior.
[+] [-] pas|5 years ago|reply
Cheaper, well, it depends. (Vaccines are already cheap, especially because they are mass produced.)
But I'm guessing - but I'm a total layman - that Moderna is betting big on their mRNA platform. The "beauty" of it is that you really need to just copy-paste some part of the virus (pick protein from the viral genome), and literally just paste it into their vaccine deliver platform. (See the link.) And this means R&D costs could go waaaaay down.
Sure, clinical trials are still needed to make sure it's safe and effective, but now they have a very good choice of nailing it on the first try, every try. (Basically unless they pick a wrong protein, it will work "every time". And it's already possible to get antibodies from folks who have "seroconverted" - that is they have become immune to something, because they have the antibodies against that thing. So, they sample a lot of people, look at what the human immune system did, and just pick the most common/stable protein target.)
The flu virus is problematic because it evolves/mutates fast, so old antibodies might not fit the new proteins. Yeah, sounds crazy, but some (!) small mutations lead to still functioning but sufficiently different proteins. (Of course we don't really see all the mutations that led to non-functioning proteins.)
It's also possible - super total speculation here - that the scientists/professionals/experts have a better guess on what to target than our immune system. (Relevant buzzwords: immunodominant / conserved epitope; epitope is the part of the target protein that the antibody/T-cell/B-cell actually matches/binds-to , and if the virus changes that part, boom, new virus, "doesn't look like anything to me", for example in case of HIV: https://pubmed.ncbi.nlm.nih.gov/21115730/ )
[+] [-] Zeratoss|5 years ago|reply
You don't have to mess around with proteins.
Producing a new protein and especially purifying it is a ton of work. mRNA is comparatively simple to produce
[+] [-] tgv|5 years ago|reply
[+] [-] sleepydog|5 years ago|reply
[+] [-] alex_stoddard|5 years ago|reply
Influenza genetics are weird: https://www.cdc.gov/flu/about/viruses/change.htm
https://www.nature.com/articles/nature06945
https://www.nejm.org/doi/full/10.1056/nejmp0904819
[+] [-] jszymborski|5 years ago|reply
Economics is the largest barrier in my mind. While my understanding is that these vaccines are less expensive to produce, it's hard to convince people to get the flu shot, let alone a common cold shot. What's more is that with hundreds of variants, it's efficacy would be hard to get right.
That said, I'd gladly pay a heft amount yearly if it meant I had a >60% chance of not catching a cold that year.
[+] [-] hooloovoo_zoo|5 years ago|reply
[+] [-] e9|5 years ago|reply
[+] [-] MaxLeiter|5 years ago|reply
[+] [-] m-ee|5 years ago|reply
[+] [-] onlyrealcuzzo|5 years ago|reply
[+] [-] dhnajsjdnd|5 years ago|reply
[+] [-] MartianSquirrel|5 years ago|reply
https://www.who.int/news-room/spotlight/why-the-hiv-epidemic...
[+] [-] at_a_remove|5 years ago|reply
1) Do both, for additional safety.
2) PrEP has changed formulations, and may change again. This implies that the previous formulations were not completely optimal.
3) From what I understand, PrEP can be expensive, although your insurance may cover it. You can also get it overseas for much less but many are not comfortable with that.
4) It's a lifetime expense, even with insurance and a lifetime of having to take a drug versus one or more shots.
5) Not having to undergo kidney function tests on the regular might be nice.
[+] [-] greg5green|5 years ago|reply
Even in the West, isn't it really expensive?
[+] [-] heavyset_go|5 years ago|reply
[+] [-] morpheuskafka|5 years ago|reply
[+] [-] KingMachiavelli|5 years ago|reply
The larger, latter trial that needs to study efficacy could simply use a large population. While HIV transmission is much more rare outside of certain high risk groups, infection does occur through accidents or deviations in behavior (e.g an EMT gets a needle prick while trying to administer Narcan). It would take a larger population and longer study but it should still be able to reach statistical significance.
[+] [-] abiogenesis|5 years ago|reply
[+] [-] francilien|5 years ago|reply
[+] [-] cogman10|5 years ago|reply
Hopefully these get approved relatively quickly. I'm most excited about the seasonal flu vaccine. That could be a major game changer.
[+] [-] lemonspat|5 years ago|reply
[+] [-] vegetaone|5 years ago|reply
[deleted]
[+] [-] xiphias2|5 years ago|reply
Anyways, I really hope them to succeed, my mother didn't take the flu vaccine ,,because it's risky and not that useful anyways''.
Moderna can make it much more efficient with less side effects, so I'm looking forward to it.
[+] [-] deanc|5 years ago|reply
So, the question is, given we already have medication which works well as treatment for those with HIV - what exactly will this vaccine do for HIV - if not stop the transmission? My understanding is HIV is primarily spread through sex and sharing of needles. A vaccination program won't stop that.
Thanks in advance. I would love to read more about this.
[+] [-] gautamcgoel|5 years ago|reply
[+] [-] kylecordes|5 years ago|reply
This is interesting, but so far a weak first step on flu. Each year experts stare at numbers and perhaps read some tea leaves to choose 4 strains to cover, often missing somewhat.
The innovation I'd like to see: ignore the "choose 4" process, and instead aim to cover all known strains.
[+] [-] soared|5 years ago|reply
I don’t think experts are reading tea leaves and it’s pretty wild to claim that. There are literally billions of dollars at stake. To bring it bag to software, that’s like me claiming I think machine learning people are just using fancy excel formulas.
[+] [-] wbl|5 years ago|reply
[+] [-] bluGill|5 years ago|reply
The real problem they have is the flu mutates. They know what strains they see now and can add them all easily enough. In the few months between deciding on strains and manufacturing them the flu can mutate to some new strain that wasn't even seen before.
[+] [-] greg5green|5 years ago|reply
[+] [-] toomuchtodo|5 years ago|reply
https://www.nature.com/articles/s41591-020-1118-7 (“A chimeric hemagglutinin-based universal influenza virus vaccine approach induces broad and long-lasting immunity in a randomized, placebo-controlled phase I trial”)