health

Why COVID boosters weren't tweaked to better match variants

15 Comments
By LAURAN NEERGAARD

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As the article describes, the main point to make the decision is if the immunity from the vaccine acts or not against the variant. If it has neutralizing activity then it is useful and protective, even if in a lesser degree, and do not need the extra time and resources to test for safety and efficacy as a new formulation would.

Some people that have no idea about how immunity works mistakenly think the vaccines could be making the variants more likely to appear (even if we are seeing the complete opposite) but that is plainly false. Some even say that soon after vaccination, when the immunity is not yet completely developed, the variants could be selected more easily than in unvaccinated people, which is of course nonsense, because any partial immunity conferred by the vaccination represents an advantage over unvaccinated people, that have to begin from zero and therefore let the virus propagate for longer and increase the chances of variants appearing and being selected.

Yearly boosters are another possibility, but at this point no data points to them being necessary except for specially vulnerable people (the same as with other vaccines), it is still perfectly possible that being vaccinated provides enough protection to make the risk from COVID in the following years just as high as the common cold human coronaviruses, making extra boosters not necessary.

1 ( +11 / -10 )

Being able to read and having access to the internet makes one an expert in virology.

-3 ( +8 / -11 )

Being able to read and having access to the internet makes one an expert in virology.

Of course not, but it makes you able to read what experts in virology write, like this article. Unfortunately some people actively try to pretend this is above their capacity. And when confronted with an experts opinion they don't like (and can't demonstrate as false) their only "resource" is trying to pretend that opinion was expressed by commenters and not the experts.

3 ( +12 / -9 )

Reading what the experts have to say can make you an expert in virology too.

-3 ( +7 / -10 )

Reading experts can make you an expert? It might, after many years, proving it may be a problem, why don't you try asking for proof when someone try to push things or make predictions about what the future will be based only in their personal opinions?

Also, what does this have to do with the article?

2 ( +4 / -2 )

One the one hand, updated vaccines would be better. But they would (they should, but might not bother) need to do new clinical trials for the updated version since it might have greater adverse reactions or might not be as effective.

But by the time they get any new vaccine version out, it might already be outdated. Each new variant comes and goes within a few (3-4?) months.

Natural immunity on the other hand is broad, stable and long lived....

-4 ( +6 / -10 )

Natural immunity on the other hand is broad, stable and long lived....

That is not true, natural immunity can be less broad, and short lived, specially if the infected person was never symptomatic enough to be hospitalized. Even if you count

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)00575-4/fulltext

Even with the very important bias of considering infection mostly on people that were symptomatic enough to be tested the protection after 6 months droped between 20 to 50%.

This is complicated with the fact that natural infection is much more risky than vaccinating, which means the people would get limited protection against risks of COVID... by getting those risks in the first place.

Vaccines still protect from those risks even with low level of circulating antibodies

https://www.nature.com/articles/s41586-021-03738-2

And studies indicate the recognition of neutralizing epitopes is even broader than what is found on natural immunity.

https://www.jci.org/articles/view/149335

So the choice is not about getting infected once or getting multiple boosters, if boosters become necessary for the general population the option would be to be reinfected (and risking complications and death) multiple times.

1 ( +7 / -6 )

Some months ago there was much more optimism and they told into every microphone how easy to adapt or tweak the mRNA vaccines and quickly producing them wit only slightly altered methods. Personally, I guess it’s a rowing back as those voices became more silent.

3 ( +6 / -3 )

Natural immunity on the other hand is broad, stable and long lived....

And death is forever.

2 ( +5 / -3 )

Natural immunity on the other hand is broad, stable and long lived....

That is not true, natural immunity can be less broad, and short lived, specially if the infected person was never symptomatic enough to be hospitalized. 

But if they were never symptomatic enough, wouldn't that be thanks to their immune system?

-1 ( +1 / -2 )

But if they were never symptomatic enough, wouldn't that be thanks to their immune system?

No necessarily not, if they were exposed to a low viral load, or a less virulent variant (specially compared with Delta, that is the standard of the pathogen right now) that can cause abortive infections even with subpar immunity. If the next exposure is stronger, with a variant that is more infective or just during the normal low peaks of immunity that can produce serious disease, complications or death.

https://jim.bmj.com/content/69/6/1253

-1 ( +1 / -2 )

“It’s less churn and burn on the manufacturing” to only switch formulas when it’s really necessary, said FDA vaccine chief Dr. Peter Marks.

What sort of doctor sprouts such unintelligible nonsense?

This is why there is a mistrust of big pharma and medical practice

1 ( +2 / -1 )

This is why there is a mistrust of big pharma and medical practice

Because someone say something true? would be be better according to you if he said switching unnecessarily at every new variant identified was fine? that is obviously much worse.

-2 ( +0 / -2 )

Great article about a Delta specific booster or a Beta/Delta booster.

The advantage of using an "ancestral" vaccine is that it is related to all variants. But, if 99% of the current infections are Delta, it is likely that he next variant will be related to the Delta variant.

So, I would like to see one or two doses of the ancestral vaccine followed by a Delta booster, or a Beta/Delta booster. While it may not be necessary today, it may help with the next dominant strain. We also need to work on increasing the speed of conception to production.

I partly disagree with @virusrex above.

[quote]"Some people that have no idea about how immunity works mistakenly think the vaccines could be making the variants more likely to appear (even if we are seeing the complete opposite) but that is plainly false. Some even say that soon after vaccination, when the immunity is not yet completely developed, the variants could be selected more easily than in unvaccinated people"[/quote]The background mutation rate is independent of the vaccination status, and thus, there are more unvaccinated people getting the disease, and likely are infectious longer spreading the virus more, and thus more chances of developing significant mutations.

HOWEVER, as a greater percent of the population is vaccinated, we are getting significant numbers of breakthrough infections. Here in the Western USA we are getting about 20% breakthrough infections (more people vaccinated than unvaccinated). These breakthrough infections have the potential of selecting vaccine resistant mutations, either with the primary infection, or developing in vivo.

There is a chance of spreading these potential new mutations to more individuals, either vaccinated or not, or bouncing between vaccinated and unvaccinated individuals, selecting additional vaccine resistant mutations.

So, developing something like the highly infectious Delta variant would be independent of the vaccine. However, developing a vaccine resistant strain may depend on breakthrough infections among vaccinated.

Ultimately, we are better off reducing the number of carriers through vaccination, masking, social distancing, etc.

-2 ( +0 / -2 )

HOWEVER, as a greater percent of the population is vaccinated, we are getting significant numbers of breakthrough infections. Here in the Western USA we are getting about 20% breakthrough infections (more people vaccinated than unvaccinated). These breakthrough infections have the potential of selecting vaccine resistant mutations, either with the primary infection, or developing in vivo.

That would be true if the breakout infections were indistinguishable from naive infections, which clearly they are not. The potential is there for any kind of infection (including in naive people) but if breakout infections are milder and last for a shorter time that still means the risk is much lower than if the people were not vaccinated.

There is a chance of spreading these potential new mutations to more individuals, either vaccinated or not, or bouncing between vaccinated and unvaccinated individuals, selecting additional vaccine resistant mutations.

This chance again is reduced in vaccinated people which still means the more people are vaccinated the lower the possibility any variant is transmitted from whatever source it came. The most important part is that immunity from vaccines is still neutralizing against all variants identified until now (even if not at 100%) which means by definition that anybody vaccinated has lower chances of originating or propagating a variant.

-2 ( +0 / -2 )

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