PlagueWatch 2020-23 - Coronavirus

[OldPhiKap]

1. The FDA can mull all it wants, but they don't have enough data to be completely confident.

What's the possibility that these vaccines induce serious autoimmune reactions that won't show after only a few months of experience with only tens of thousands of patients?

2. Assuming things roll out fairly smoothly, the average person may not be wearing masks in a year, but there will still be covid.

What's the possibility that the higher "dose" of virus inhaled by non-mask wearers will reduce the efficacy of the vaccine?

Did I read of some concern that it can cause infertility in women by interfering with the formation/establishment of the placenta?

I’m all for the vaccine, but I would like assurance that the long-term impacts are not worse than the current risk for me and my family.

[Bluedog]

Did I read of some concern that it can cause infertility in women by interfering with the formation/establishment of the placenta?

I’m all for the vaccine, but I would like assurance that the long-term impacts are not worse than the current risk for me and my family.

https://fullfact.org/health/vaccine-covid-fertility/
"This claim has no basis. The spike protein on the Covid-19 virus and a protein that makes up the placenta have only a small amount in common, almost certainly not enough for the immune system to attack the placenta."

Of course, "no evidence" doesn't mean it's been proven it doesn't, but you can't test every possible long-term impact on the negative side...

[tbyers11]

1. The FDA can mull all it wants, but they don't have enough data to be completely confident. Agree there is no 100% sure fire guarantee in biology

What's the possibility that these vaccines induce serious autoimmune reactions that won't show after only a few months of experience with only tens of thousands of patients?

Extremely unlikely, IMO. The executive summary of this work edited by Paul Offit states that there is no consistent evidence that vaccines cause autoimmune disease. One of the most prominent cases linking autoimmune disease with vaccination involved people getting Guillain-Barre syndrome from a swine flu vaccination in 1976. It was found to occur in 1 per million vaccine recipients while natural infection with influenza leads to 17 cases of GBS per million

2. Assuming things roll out fairly smoothly, the average person may not be wearing masks in a year, but there will still be covid.

What's the possibility that the higher "dose" of virus inhaled by non-mask wearers will reduce the efficacy of the vaccine?

The point of the vaccine is that you have pre-primed immune memory that is able to more quickly and strongly respond to exposure to virus. I am not an infectious disease physician but if you have a primed immune system the marginally higher dose encountered while not wearing a mask versus wearing a mask should not make a big difference in vaccine efficacy or at least efficacy against severe symptoms.
2 caveats to this: 1) very high dose exposure situations (say health care workers) could be more likely to overwhelm immunity. These people will still being wearing PPE. 2) The immunity provided by vaccinations does wane over time. As we study the immune response to COVID we may find that we need a booster vaccination periodically to prime the immune system

The hope (and early signs are very promising) is that vaccination will slow transmission enough to greatly lessen the epidemic spread of the disease and eventually lead to herd immunity. However, COVID vaccines are not going to provide sterilizing immunity and eradicate the disease. However, if the death and hospitalization rates drop 10-100 fold due to people having significant immunity to SARS-CoV-2 we lessen the severe strain on our healthcare system and we can manage the disease via potential treatments or periodic vaccination programs such as we have for other respiratory viruses

[OldPhiKap]

https://fullfact.org/health/vaccine-covid-fertility/
"This claim has no basis. The spike protein on the Covid-19 virus and a protein that makes up the placenta have only a small amount in common, almost certainly not enough for the immune system to attack the placenta."

Of course, "no evidence" doesn't mean it's been proven it doesn't, but you can't test every possible long-term impact on the negative side...

Thanks!

[tbyers11]

https://fullfact.org/health/vaccine-covid-fertility/
"This claim has no basis. The spike protein on the Covid-19 virus and a protein that makes up the placenta have only a small amount in common, almost certainly not enough for the immune system to attack the placenta."

Of course, "no evidence" doesn't mean it's been proven it doesn't, but you can't test every possible long-term impact on the negative side...

"You must spread some Comments around before commenting on Bluedog again"

Much better link regarding this claim than I provided about 20 posts upthread

Key quote

Professor Jonathan Stoye, Virologist at the Francis Crick Institute, told Full Fact these proteins are not identical, as some have claimed.

On whether the vaccine could cause an immune reaction to the syncytin-1 protein vital for placenta formation, he said: “I would never say never, but the possibility is vanishingly small.”

When you are dealing with proteins of hundreds or thousands of amino acids long there are bound to be stretches of 5 aa (like synctin-1 and SARS-CoV-2 Spike) in common. There are only 20 amino acids after all. This concept is called molecular mimicry and has been studied in the induction of autoimmune diseases. However, as pointed out, you likely need much longer stretches of similarity (~10 aa for T cells and ~15-20 aa for antibody) for even the potential of aberrant immunity due to the mimicry

[JasonEvans]

https://fullfact.org/health/vaccine-covid-fertility/
"This claim has no basis. The spike protein on the Covid-19 virus and a protein that makes up the placenta have only a small amount in common, almost certainly not enough for the immune system to attack the placenta."

Of course, "no evidence" doesn't mean it's been proven it doesn't, but you can't test every possible long-term impact on the negative side...

So, you are telling me that Clive Owen's career is not about to make a comeback?

[JasonEvans]

More good vaccine news...

The UAE says its phase 3 trials of the vaccine developed by China's Sinopharm have been completed and the drug produces 86% efficacy against Covid-19: https://www.reuters.com/article/heal...-idUSL1N2IP09V

While it seems quite unlikely that the US ever uses the Chinese vaccine, the way the world comes out of this is that the whole world gets the disease under control. The more effective treatments that are out there, the better!

[Phredd3]

What's the possibility that these vaccines induce serious autoimmune reactions that won't show after only a few months of experience with only tens of thousands of patients?

Extremely unlikely, IMO. The executive summary of this work edited by Paul Offit states that there is no consistent evidence that vaccines cause autoimmune disease. One of the most prominent cases linking autoimmune disease with vaccination involved people getting Guillain-Barre syndrome from a swine flu vaccination in 1976. It was found to occur in 1 per million vaccine recipients while natural infection with influenza leads to 17 cases of GBS per million

It's probably also useful to mention that there's good evidence to believe that there is a high incidence of autoimmune reactions to natural COVID - far more than from swine flu. As posted upthread, around 10% of COVID survivors have symptoms longer than two months, some for much longer, and the evidence suggests that what may be causing the long-duration symptoms is actually an autoimmune response. If it's autoimmunity you are worried about, natural COVID is probably the real risk.

[budwom]

Note that President to be Joe has moderated Azar's prediction of 50 million does of vaccine/month at the beginning of next year, down to (a more realistic I would guess) goal of 100 million doses in his first 100 days...seems much more reasonable.

[mph]

Canada approves the Pfizer vaccine. This will surely increase pressure on the FDA to move things along.

[budwom]

Yo rsvman and other virus gurus, word has it that Sinovac is 86% effective. So...is there any typical derating adjustment we should apply for this Chinese vaccine, or should it be accepted at face value?

[YmoBeThere]

Yo rsvman and other virus gurus, word has it that Sinovac is 86% effective. So...is there any typical derating adjustment we should apply for this Chinese vaccine, or should it be accepted at face value?

I believe the trial was conducted in the UAE, so that might factor into the adjustment.

[Mike Corey]

Canada approves the Pfizer vaccine. This will surely increase pressure on the FDA to move things along.

This is good news but I disagree that this will place any pressure on the FDA.

[rsvman]

Yo rsvman and other virus gurus, word has it that Sinovac is 86% effective. So...is there any typical derating adjustment we should apply for this Chinese vaccine, or should it be accepted at face value?

insert shrug emoji here

[duke79]

https://www.studyfinds.org/children-...vessel-damage/

Another scary study (if true) about potential long-term damage from Covid, for even infected children.

[MarkD83]

I am not sure where to put this item so I will out it in the Pandemic thread.

https://www.espn.com/college-footbal...an-2020-season

So LSU self imposes a ban in a year where there may not be many bowl games because of covid. This is almost like a self-pardon. Let me take a penalty in a year where there may not be a reward.

Now is the time for all football and basketball teams who think they may be or may get into trouble with the NCAA to take a self-imposed penalty.

So should this be in a football thread, the pandemic thread or the presidential election thread.

[throatybeard]

Certain aspects of the NYT's "Find Your Place in the Vaccine Line" calculator seem a bit odd to me.

As far as I can tell, here is the prioritization from the article.

Priority	Group	Percent of Population	Percent with Higher Priority
1	Healthcare workers	5.0%	0.0%
2	Nursing home residents	1.0%	5.0%
3	First Responders	0.8%	6.0%
4	Individuals with Covid-related health risks	30.0%	6.8%
5	Other elderly (ages 65+)	2.5%	36.8%
6	Essential workers	2.5%	39.3%
7	Teachers	2.0%	41.8%
8	Homeless	0.3%	43.8%
9	Prisoners	0.5%	44.0%
10	Young adults (ages 18-30)	12.5%	44.5%
11	Children (ages 0-17)	22.5%	57.0%
12	Other essential workers	3.5%	79.5%
13	Others (ages 31-64)	17.0%	83.0%

Priorities 1-8 seem pretty straightforward, even if reasonable minds could make a case for shuffling the order a bit. The article points out that vaccinating prisoners before average risk, non-elderly adults will likely be controversial. However, this group makes up less than 1% of the population, so changing the priority of this group is unlikely to affect the overall timeline by more than a week or so.

However, the relative priorities for groups 10, 11, and 13, seem odd to me. First of all, as tbyers points out, the vaccine hasn't been tested in children, so I wouldn't expect kids to be vaccinated before 20% of the population. Addtionally, I am not sure what group 10 would (adults 18-30 without risk factors) would be prioritized ahead of group 13 (adults 31-64 without risk factors). Is there really a chance that healthy 25 year olds will be prioritized ahead of 64 year olds? The only rationale I can imagine for vaccinating young adults ahead of others is that their (casual) behavior towards the virus has driven a lot of the spread.

Finally, the NYT list doesn't include people with a previously confirmed infection. Shouldn't we expect this group, which will probably be 10-20% of the population within a few months, to be at or very near the bottom of the priority list?

Are college professors 7)teachers ?

[bundabergdevil]

US surpasses 3,000 COVID deaths in a day for first time.

[mph]

The positivity rate in my area is 11% against relatively robust testing numbers. Went into a local store to purchase a Big Green Egg yesterday. (yay!). I had already visited the other dealer in our area and stopped by the 2nd store to compare prices. The governor's mask order was posted on the entrance. Inside, there were 3 customers in the showroom, all wearing masks along with 5-6 maskless employees. Not a single employee was wearing masks. One tried to approach me and I stopped him before he could get any closer than 6 feet. My wife and I politely excused ourselves from the store and went back to the first retailer to make our purchase.

Even if someone disagrees with the mask mandate, for the life of me I don't understand why a business would adopt a policy that they know will make a significant percentage of their customers uncomfortable even being in the store. Ideology over economic self-interest.

[rsvman]

https://www.studyfinds.org/children-...vessel-damage/

Another scary study (if true) about potential long-term damage from Covid, for even infected children.

Interesting, and the biomarker was an activated complement component; again, this would be blocked by my colleague's new drug that is currently under investigation.