I encountered yesterday someone who said omicron is “just a cold” and “people aren’t dying from it.” When I brought up hospitalization rates and death of vacc vs unvacc ppl I got the line about complications and other underlying health problems that caused the death meaning that the deaths were misrepresented as caused by COVID. This is that old argument of course, and in conversation I didn’t have the numbers at my mental fingertips. Very frustrating. And then there is another discussion I have been having with a family member about getting their 3 children ages 8, 6 and 6 to be vaccinated. The fact that they are on the “low end” of acceptable ages has been that argument. I tried to say that the issue with the under 5 group was vaccine response not side effects but that didn’t help the discussion. Thank you for your insights. I often use your arguments when dealing with the nay sayers in my sphere. Sigh.
All the misinformation out there is really frustrating, I'm right there with you. It feels like a giant game of whack-a-mole, and the truth can only smack down so many lies at once. Thank you for doing the work in your own circle to try and clear up some of these misconceptions. It's hard; as humans we get emotionally committed to certain viewpoints even when reality contradicts them. There's a tendency to think that doing this makes a person less intelligent, but the reality is that the very intelligent are even better at the motivated reasoning that it takes to stick to false beliefs that are emotionally-based.
In personal conversations, for this reason, I tend to focus on personal stories. People who I personally know who had bad experiences from making the wrong choice--even better if it's someone we both know. For example, I have an uncle who was duped into believing lies about the vaccines. He spent a week in the hospital alone, unable to see his wife, hooked up to high-flow oxygen and constantly afraid that he would die. He asked for the vaccine when in the hospital, but of course, it was far too late. Thankfully he pulled through, but he may never be the same. He looks like he's been through hell, and everyone in our family was terrified for him. He had the choice to fight COVID-19 with the vaccine, or fight it without the vaccine, and he chose wrong. I wish that story had never happened, but it did. So, at least I can use it to improve things for other people. I want to help as many people as I can make better choices.
Now, I like to make arguments with data, because it's better to have evidence than not, but that story has a compelling narrative and emotional appeal. Telling a story like that--but also being able to answer data-driven questions--can really make a huge difference in helping someone make the choice to protect themselves through vaccination.
It may seem like a small detail: the antigenic target isn't the spike, it's the regional binding domain (that is unique). Will it have the same efficacy as spike-based vaccines when used at commercial scale?
The RBD (receptor binding domain) of the spike protein is usually the best target for generating neutralizing antibodies because it blocks virus attachment to cells if it is occupied by an antibody. I don't anticipate any differences from marketed vaccines that target the full-length spike; the key neutralizing antibodies that they generate often target the RBD anyway.
Biological E is not *that* small. Their reported revenue was around $125 million as of 2019, presumably substantially higher post-pandemic since they're mostly a vaccine maker. They now produce four approved COVID-19 vaccines: Novavax's entry, Janssen's, A-Zs, and Corbevax. Their total production is in the billions of doses(!).
EDIT: does NYC break out numbers for those who have already had COVID-19, but not been vaccinated? I'd love to compare the protection from symptomatic disease vs. vaccination vs. both (for folks like yourself and your bride).
Here's something that got zero coverage in the USA (that I saw): Turkey has approved its homegrown TURKOVAC COVID-19 vaccine. Apparently, it's yet another inactivated virus vaccine. No data has been published about their phase 3 trial, according to https://clinicaltrials.gov/ct2/show/NCT04942405
Based on Chinese and Russian precedent, you'd think it will be less effective than (to tie it together) any of the ones Biological E is making. Since CORBEVAX isn't patented, they could start working on a production line tomorrow.
I worry about inactivated virus vaccines against COVID-19. They were never very good, and that's without variants escaping the immunity they induce. I'm concerned about how they'll perform against such variants. Something to keep an eye on.
Still, more vaccines is better and this is good to have on my radar.
If you ever run short of topics for this column (ha!) you could maybe supply whatever is known about this: why are inactivated virus vaccines not as effective as the various other types? Surely the non-active virions have spike proteins, along with other components of the virus, so why don't they produce as good an immunity as pure spike protein (as with Corbevax or Novavax) or "homegrown" spike protein from the mRNA and virus-carrier vaccines?
It's a great question. My first guess would be that they don't provoke enough of an inflammatory/innate immune reaction early on, so the adaptive immune response is not recruited well. But I don't know for sure.
It could help. No adjuvant is going to be perfect, and the fact that it's a large inactivated particle may also be causing issues with cellular uptake that, say, the subunit vaccines (which are generally adjuvanted) don't have.
There's some element of art here still, I don't think our science is sophisticated enough to explain this offhand without a lot of data collection. But ultimately my feeling is that this big useless particle doesn't easily get into innate immune cells and doesn't adequately turn on innate immunity, leading to poor recruitment of adaptive immune responses.
$125 million revenue is...pretty small. But then again, it's impressive to have any revenue at all in the biotech business! I'm sure they'll be far from small by the time this is all over, but I largely used that characterization because it appeared in the Washington Post story I'd linked.
RE: NYC numbers on the previously infected, I don't think the city has access to those data. I'm not sure. It would be interesting, definitely, but I've never seen it reported anywhere.
On the other hand in my own case, where we went for the order of get vaccinated before getting infected (IMO, the ideal order), I now expect that in addition to having had milder COVID-19, I (and my wife as well) have some really impressively diverse antibodies, and a substantial IgA response as well. I'll have resident memory T cells in my upper respiratory tract, too. I feel pretty confident that I've now got diverse anti-spike capabilities that cover multiple variants--I want to say "from alpha to omega" but we're not quite there yet--and will set me up to be even better protected in the future.
It would be great to see that expectation borne out in data. I do think it'll come eventually. Just maybe not specifically from NYC's public health apparatus.
I just found out that my niece and her partner have just recovered (or nearly) from COVID-19. Both had two doses of an mRNA vaccine, but neither got a booster ... yeah. Young and immortal. Now I get to worry about two more people.
I encountered yesterday someone who said omicron is “just a cold” and “people aren’t dying from it.” When I brought up hospitalization rates and death of vacc vs unvacc ppl I got the line about complications and other underlying health problems that caused the death meaning that the deaths were misrepresented as caused by COVID. This is that old argument of course, and in conversation I didn’t have the numbers at my mental fingertips. Very frustrating. And then there is another discussion I have been having with a family member about getting their 3 children ages 8, 6 and 6 to be vaccinated. The fact that they are on the “low end” of acceptable ages has been that argument. I tried to say that the issue with the under 5 group was vaccine response not side effects but that didn’t help the discussion. Thank you for your insights. I often use your arguments when dealing with the nay sayers in my sphere. Sigh.
All the misinformation out there is really frustrating, I'm right there with you. It feels like a giant game of whack-a-mole, and the truth can only smack down so many lies at once. Thank you for doing the work in your own circle to try and clear up some of these misconceptions. It's hard; as humans we get emotionally committed to certain viewpoints even when reality contradicts them. There's a tendency to think that doing this makes a person less intelligent, but the reality is that the very intelligent are even better at the motivated reasoning that it takes to stick to false beliefs that are emotionally-based.
In personal conversations, for this reason, I tend to focus on personal stories. People who I personally know who had bad experiences from making the wrong choice--even better if it's someone we both know. For example, I have an uncle who was duped into believing lies about the vaccines. He spent a week in the hospital alone, unable to see his wife, hooked up to high-flow oxygen and constantly afraid that he would die. He asked for the vaccine when in the hospital, but of course, it was far too late. Thankfully he pulled through, but he may never be the same. He looks like he's been through hell, and everyone in our family was terrified for him. He had the choice to fight COVID-19 with the vaccine, or fight it without the vaccine, and he chose wrong. I wish that story had never happened, but it did. So, at least I can use it to improve things for other people. I want to help as many people as I can make better choices.
Now, I like to make arguments with data, because it's better to have evidence than not, but that story has a compelling narrative and emotional appeal. Telling a story like that--but also being able to answer data-driven questions--can really make a huge difference in helping someone make the choice to protect themselves through vaccination.
It may seem like a small detail: the antigenic target isn't the spike, it's the regional binding domain (that is unique). Will it have the same efficacy as spike-based vaccines when used at commercial scale?
The RBD (receptor binding domain) of the spike protein is usually the best target for generating neutralizing antibodies because it blocks virus attachment to cells if it is occupied by an antibody. I don't anticipate any differences from marketed vaccines that target the full-length spike; the key neutralizing antibodies that they generate often target the RBD anyway.
Biological E is not *that* small. Their reported revenue was around $125 million as of 2019, presumably substantially higher post-pandemic since they're mostly a vaccine maker. They now produce four approved COVID-19 vaccines: Novavax's entry, Janssen's, A-Zs, and Corbevax. Their total production is in the billions of doses(!).
Smaller than the giants, surely.
Forbes India reports they're also working on both an mRNA vaccine and a viral vector vaccine: https://www.forbesindia.com/article/innovation/hyderabads-biological-e-the-dark-horse-in-indias-vaccine-race/64733/1
EDIT: does NYC break out numbers for those who have already had COVID-19, but not been vaccinated? I'd love to compare the protection from symptomatic disease vs. vaccination vs. both (for folks like yourself and your bride).
Here's something that got zero coverage in the USA (that I saw): Turkey has approved its homegrown TURKOVAC COVID-19 vaccine. Apparently, it's yet another inactivated virus vaccine. No data has been published about their phase 3 trial, according to https://clinicaltrials.gov/ct2/show/NCT04942405
Based on Chinese and Russian precedent, you'd think it will be less effective than (to tie it together) any of the ones Biological E is making. Since CORBEVAX isn't patented, they could start working on a production line tomorrow.
I worry about inactivated virus vaccines against COVID-19. They were never very good, and that's without variants escaping the immunity they induce. I'm concerned about how they'll perform against such variants. Something to keep an eye on.
Still, more vaccines is better and this is good to have on my radar.
If you ever run short of topics for this column (ha!) you could maybe supply whatever is known about this: why are inactivated virus vaccines not as effective as the various other types? Surely the non-active virions have spike proteins, along with other components of the virus, so why don't they produce as good an immunity as pure spike protein (as with Corbevax or Novavax) or "homegrown" spike protein from the mRNA and virus-carrier vaccines?
It's a great question. My first guess would be that they don't provoke enough of an inflammatory/innate immune reaction early on, so the adaptive immune response is not recruited well. But I don't know for sure.
Would that not mean that using an adjuvant (or more of the adjuvant, or a different adjuvant) would fix the problem?
It could help. No adjuvant is going to be perfect, and the fact that it's a large inactivated particle may also be causing issues with cellular uptake that, say, the subunit vaccines (which are generally adjuvanted) don't have.
There's some element of art here still, I don't think our science is sophisticated enough to explain this offhand without a lot of data collection. But ultimately my feeling is that this big useless particle doesn't easily get into innate immune cells and doesn't adequately turn on innate immunity, leading to poor recruitment of adaptive immune responses.
$125 million revenue is...pretty small. But then again, it's impressive to have any revenue at all in the biotech business! I'm sure they'll be far from small by the time this is all over, but I largely used that characterization because it appeared in the Washington Post story I'd linked.
RE: NYC numbers on the previously infected, I don't think the city has access to those data. I'm not sure. It would be interesting, definitely, but I've never seen it reported anywhere.
On the other hand in my own case, where we went for the order of get vaccinated before getting infected (IMO, the ideal order), I now expect that in addition to having had milder COVID-19, I (and my wife as well) have some really impressively diverse antibodies, and a substantial IgA response as well. I'll have resident memory T cells in my upper respiratory tract, too. I feel pretty confident that I've now got diverse anti-spike capabilities that cover multiple variants--I want to say "from alpha to omega" but we're not quite there yet--and will set me up to be even better protected in the future.
It would be great to see that expectation borne out in data. I do think it'll come eventually. Just maybe not specifically from NYC's public health apparatus.
I just found out that my niece and her partner have just recovered (or nearly) from COVID-19. Both had two doses of an mRNA vaccine, but neither got a booster ... yeah. Young and immortal. Now I get to worry about two more people.