What? HIV mutates so fast and effectively that it’s better thought of as a constellation of genomes always exploring a huge fitness space than just one thing and we haven’t even been able to make one good vaccine yet despite throwing huge sums of money at the problem. It simply escapes the immune response that was developed for a previous variant, all within your own body!
Which is not at all the case with coronaviruses, and especially not with Covid. The main reason there is no HIV vaccine isn't even the mutation rate. There is a number of reasons vaccines are really ineffective for HIV that have nothing to do with mutation rates. It's kind of a perfect storm really, you can't even test them on animals because there are no good HIV analogues in animals to test the vaccines on, and people just seem incapable of having a decent immune reaction to HIV in general so typical techniques won't be effective since the vaccine will just be ignored by your immune system. If the only issue with an HIV vaccine was the mutation rate there would probably already be vaccines covering a wide spectrum which are constantly refreshed and are at least somewhat efficient, but with HIV it's just extremely hard to make an effective vaccine for it in the first place, even if it didn't mutate at all.
Bacteria and antibiotics are different for various reasons. As you said, there are a lot more options for them to mutate, and mutations are very often passed from one to the other horizontally. But also when you take an antibiotic, you already have a large bacterial load, and you're directly throwing a selective "net" on them. Vaccines deprive the virus of available hosts and even when a vaccinated person contracts the disease, they typically have a much lower viral load and less chance of a mutation. In both cases there is selective pressure, but the difference is that antibiotics come AFTER the infection, whereas vaccines come before, and that tends to be better.
And the fact that bacteria have more options for evasion on average… doesn’t actually matter. We don’t need to compare the rates. All that is necessary is that immune escaping variants arise, something that anyone who’s taken pop gen can tell you is proportional to population size (infection rates).
The rates absolutely do matter. It's a function of both rates and population size.
We have barely started the very long period where the selective pressure of vaccines is being applied and we’re already seeing widespread natural infection immune response escape.
Yes, because between the time the vaccines in use now were developed and, well, now, it's getting close to a year, and hundreds of millions of infections. . My point is, there is no reason why it should be as long with the next set of vaccines. Also note that there HAS been strong selective pressure in many places, including Brazil which you brought up. Places such as Manaus had like 75% of the population infected. That's a STRONG pressure on the vaccines to mutate such that reinfection is possible. And honestly something similar is probably true in many places in the UK or South Africa. Thing is, what I can't find at all anywhere and there probably isn't good enough data on it yet, is how severe reinfection is. Reinfection being as severe as the first illness on average would be pretty unexpected.
This is something that you absolutely do not know. It is a fairly unknown risk that cannot be reasonably estimated right now. We can only say that the vaccines will probably work for now.
Again, you are talking about the vaccines we have NOW, there will have to be a second set, that's more or less a given.
That is actually bad news…
Why is escape mutations being covered by current vaccines bad news?
Already-approved vaccines are still taking 6-12+ months to roll out in the richest countries on the planet. Lag time (will the new vaccine work against potential new variants?) and productive capacity (and the political capacity to maintain it) is a serious limiting factor.
Remember how rare PPE was at first? There is no real shortage now in most countries. The thing is, vaccination has to be so widespread that there has to be a large shift in production. And it's not just shots that you have to manufacture, but also dry ice, refrigerators, the distribution system, etc. So an initial lag should have been expected. But again, for the second round all these things won't have to happen from scratch, and there won't have to be as big a delay in testing, since usually regulators don't require equally extensive trials for small modifications of vaccines, and mRNA vaccines are apparently easy to modify. I heard someone from Moderna say that they could literally shift to producing a new vaccine within two days. Yeah, alright. Whatever. But still, it shouldn't take way too long.
This is why the bacterial reference is relevant… that’s my point.
The thing is, while of course I agree that this should have been contained long ago so that vaccines can just come in and largely eradicate COVID, it's still not really as bad as the bacteria issue we're facing. I think it's fair to expect that by the time summer is over, we won't be seeing the massive daily death tolls any more. In some countries at least.
One thing that is interesting is that cases in the US are falling, but I haven't heard anything about new measures being instituted, and more infectious strains are supposed to be already widespread. Why are cases falling then? Could it be partial herd immunity combined with social distancing? Idk but it is good to see that at least something is happening.
Not really. It is really hard to create a vaccine that causes immunity in the first place.
If it successfully escapes the immune system well enough, which many human pathogens do, they could be treated as a 100% new infection by the body.
If it mutated into an entirely new thing then yeah I guess. But that definitely hasn't happened yet.
The thing that is bad news is that many vaccines already won’t be effective. The status quo is that they all work. The new development is that some don’t. That’s bad news.
All the vaccines that have been tested so far show decreased effectiveness but none of them show no effectiveness. That's not bad news.
I have a bad habit of exaggerating what I say sometimes. Yes, it doesn't have to stop being covid to become completely undetectable. Although the thing with flu is that flu is not one thing. Influenza A has lots and lots of subtypes, and each subtype has lots and lots of strains. Additionally, immune response and memory isn't usually just monoclonal antibodies, which is why even when a strain "should" be undetectable, we still see the immune system responding much better. Where I was getting at is that as you said, covid doesn't have the variety to completely elude and none of the strains so far seem to be an insurmountable problem for current vaccines.
Decreased effectiveness is bad. It means more spreading, more people be getting sick, more dying. I think those things are bad. Do you not?
Since we already have escape mutations and that's been known for some time now, I don't see why you are framing it as bad news that vaccines are still effective against them. The news is that they are still effective, not that there are escape mutations.
And the vaccines based on folded spike protein should have a pretty bad time with some of the new variants, they should be similar to native immune response
The thing is I can't find any studies yet about the severity of reinfection, neither are there extensive studies about the performance of most vaccines on these strains. That's the important question here, it's not whether or not they are as capable at addressing the new strains as they are with the old strain, they aren't, the question is, the question is, how much worse are they? So far there has been some evidence they are still at least partially effective. That's the good news.
Incidentally I just saw that apparently AZ says they want to roll out a new vaccine by autumn.
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Which is not at all the case with coronaviruses, and especially not with Covid. The main reason there is no HIV vaccine isn't even the mutation rate. There is a number of reasons vaccines are really ineffective for HIV that have nothing to do with mutation rates. It's kind of a perfect storm really, you can't even test them on animals because there are no good HIV analogues in animals to test the vaccines on, and people just seem incapable of having a decent immune reaction to HIV in general so typical techniques won't be effective since the vaccine will just be ignored by your immune system. If the only issue with an HIV vaccine was the mutation rate there would probably already be vaccines covering a wide spectrum which are constantly refreshed and are at least somewhat efficient, but with HIV it's just extremely hard to make an effective vaccine for it in the first place, even if it didn't mutate at all.
Bacteria and antibiotics are different for various reasons. As you said, there are a lot more options for them to mutate, and mutations are very often passed from one to the other horizontally. But also when you take an antibiotic, you already have a large bacterial load, and you're directly throwing a selective "net" on them. Vaccines deprive the virus of available hosts and even when a vaccinated person contracts the disease, they typically have a much lower viral load and less chance of a mutation. In both cases there is selective pressure, but the difference is that antibiotics come AFTER the infection, whereas vaccines come before, and that tends to be better.
The rates absolutely do matter. It's a function of both rates and population size.
Yes, because between the time the vaccines in use now were developed and, well, now, it's getting close to a year, and hundreds of millions of infections. . My point is, there is no reason why it should be as long with the next set of vaccines. Also note that there HAS been strong selective pressure in many places, including Brazil which you brought up. Places such as Manaus had like 75% of the population infected. That's a STRONG pressure on the vaccines to mutate such that reinfection is possible. And honestly something similar is probably true in many places in the UK or South Africa. Thing is, what I can't find at all anywhere and there probably isn't good enough data on it yet, is how severe reinfection is. Reinfection being as severe as the first illness on average would be pretty unexpected.
Again, you are talking about the vaccines we have NOW, there will have to be a second set, that's more or less a given.
Why is escape mutations being covered by current vaccines bad news?
Remember how rare PPE was at first? There is no real shortage now in most countries. The thing is, vaccination has to be so widespread that there has to be a large shift in production. And it's not just shots that you have to manufacture, but also dry ice, refrigerators, the distribution system, etc. So an initial lag should have been expected. But again, for the second round all these things won't have to happen from scratch, and there won't have to be as big a delay in testing, since usually regulators don't require equally extensive trials for small modifications of vaccines, and mRNA vaccines are apparently easy to modify. I heard someone from Moderna say that they could literally shift to producing a new vaccine within two days. Yeah, alright. Whatever. But still, it shouldn't take way too long.
The thing is, while of course I agree that this should have been contained long ago so that vaccines can just come in and largely eradicate COVID, it's still not really as bad as the bacteria issue we're facing. I think it's fair to expect that by the time summer is over, we won't be seeing the massive daily death tolls any more. In some countries at least.
One thing that is interesting is that cases in the US are falling, but I haven't heard anything about new measures being instituted, and more infectious strains are supposed to be already widespread. Why are cases falling then? Could it be partial herd immunity combined with social distancing? Idk but it is good to see that at least something is happening.
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Not really. It is really hard to create a vaccine that causes immunity in the first place.
If it mutated into an entirely new thing then yeah I guess. But that definitely hasn't happened yet.
All the vaccines that have been tested so far show decreased effectiveness but none of them show no effectiveness. That's not bad news.
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Well you kinda did.
I have a bad habit of exaggerating what I say sometimes. Yes, it doesn't have to stop being covid to become completely undetectable. Although the thing with flu is that flu is not one thing. Influenza A has lots and lots of subtypes, and each subtype has lots and lots of strains. Additionally, immune response and memory isn't usually just monoclonal antibodies, which is why even when a strain "should" be undetectable, we still see the immune system responding much better. Where I was getting at is that as you said, covid doesn't have the variety to completely elude and none of the strains so far seem to be an insurmountable problem for current vaccines.
Since we already have escape mutations and that's been known for some time now, I don't see why you are framing it as bad news that vaccines are still effective against them. The news is that they are still effective, not that there are escape mutations.
The thing is I can't find any studies yet about the severity of reinfection, neither are there extensive studies about the performance of most vaccines on these strains. That's the important question here, it's not whether or not they are as capable at addressing the new strains as they are with the old strain, they aren't, the question is, the question is, how much worse are they? So far there has been some evidence they are still at least partially effective. That's the good news.
Incidentally I just saw that apparently AZ says they want to roll out a new vaccine by autumn.
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