Updated vaccines _have_ been developed and are in trials. Moderna created a beta variant vaccine last year that is the furthest along in any trial IIRC. Pfizer has an alpha variant specific booster with quite good results from trials too.

The problem as I understand it is that it isn't profitable for either company to take a risk on producing these boosters at scale. They have to take a bet that the variant they target for the booster will be the one to dominate in the next months, and right now with variants like omicron mutating and growing at astounding rates it is quite risky. If they target the wrong variant that's a whole lot of completely wasted vaccine doses and they have to start over again. As I understand it their production lines are limited too and can only produce one specific type of vaccine or booster at once (i.e. wild type or new variant, but not both).

Honestly we need operation warp speed again. It needs to just never stop, at least while we are in such a critical stage and massive amount of virus spread. We need the government and the billionaires/trillionaires to bankroll parallel development of all major variant boosters at once.

> Honestly we need operation warp speed again. It needs to just never stop, at least while we are in such a critical stage and massive amount of virus spread. We need the government and the billionaires/trillionaires to bankroll parallel development of all major variant boosters at once.

This makes sense defense-wise, as well, because the arms race in vaccine development is also an arms race in producing vaccines for diseases you intend to use as weapons. A disease a group has a vaccine or cure for, but no one else does, could be weaponized.

I agree. Someone please correct me if I’m wrong, but I imagine it’ll be a huge advantage to be able to produce new vaccines at the same rate that a weaponized virus can mutate.

It comes at the cost of reducing regulatory burden but also the oversight and safety rails required to make sure the "cure isn't worse than the disease".

For the initial wave of COVID-19, it was an absolute necessity, but unless our backs are pinned metaphorically to the wall, is it really worth taking a short cut? In the best case, COVID-19 will become endemic (prevalent every season, but not as harmful for the majority of the population)... so wiping it out by way of universal uptake of a given vaccine is not (and never was) on the tables.

A weaponized virus would inflict untold suffering, but there is nothing to stop another Operation Warpspeed. Having OW active all the time? I don't see that being a good thing.

IF I Understand Correctly; this could actually backfire on the entity using it as a weapon by constantly having new vaccines at the ready.

IIUC: This means that they would essentially be supplying the new pressure and stressors required for the virus to be forced into mutating more and more since its current environment is not suitable for its current arrangement. Every time it replicates there is a chance for mutation, but greater stressors increase that chance of mutation. Depending on the stressors, the mutation may or may not occur in tandem to that stressor. I.E. Vaccines increase immunity? Virus gains ability to breakthrough easier.

Now that may be a rather simplistic understanding of it, I admit; but this does seem to coincide with what is essentially happening so far this past couple years.

1. New variant emerges. 2. More people get vaccinated. 3. Old 'new' variant dies off 4. New 'new' variant picks up. 5. More people get vaccinated, or re-vaxxed. 6. Old 'new' variant dies off, again. 7. New variant emerges, or a subvariant, or double mutation. Repeat.

Eventually we will all be vaccinated 3 times or more, easily. Or at least a very large majority of us. What happens when some super variant emerges and has the capability to breakthrough all that resistance?

More vaccines?

You do see where this is going, right? Doctors and scientists were concerned about a very similar situation with anti-bacterial resistant bugs. Stuff like H.Pylori in hospitals if I remember correctly. Well, now we have the same situation potentially occurring on our hands.

We can only hope that the mRNA vaccines or something better is/are able to keep ahead of the game. The only way we are beating this thing out, is by completely snuffing it out. And that's going to require removing all its potential hosts.

That means we might have to vaccinate wild animals, because deer have been catching it for instance. And apparently spreading it in some cases. Once so far for sure is confirmed I believe. So yeah, Deer-vid is a thing now. Hooray?

It's going to be either a lot of animal vaccinations going on out there... or a huge culling. Of all sorts of animals. Or letting them catch it and suffer through it for better resistance for a time being; and then hoping to snuff out the virus finally at that point.

I'm sure you can see how hopeless this all is at this point. It's part of why the politicians are now saying "we need to learn to live with Covid."

And I agree, I guess. Not really much choice at this point. It's here to stay in its current forms, and further. For now at least.

So, huge advantage? Sure, maybe. Depends on your goals.

How about this : https://www.lesswrong.com/posts/niQ3heWwF6SydhS7R/making-vac....

> The large majority of the cost (about $850) was the peptides

If we could produce just the peptides at scale then everyone is free to produce local vaccines. Not sure if the peptides themselves have the same extreme storage requirements as the vaccines do. If we can give every country the techniques to build their own vaccines we wouldn't depend on mega-corps and some of the "anti-vax" arguments would become moot.

isn't omikron acting like a vaccine anyway ? with its astounding spread, everyone will have been contaminated anyway. And it seems that natural immunity is as good if not better than mrna induced immunity ( although i'm not sure if it's controversial or not).

Omikron is milder on average. I had it in February, was hit really hard for 4 days, and then I was more or less good again. But I still have lingering problems like short-breath and heart palpitations, which I am currently in the process of getting diagnosed. Could for example be a myocarditis, or just the typical unspecific "long covid" symptoms resulting from damage to nerves and tissue. Vaccines can have long-term side-effects, too, but in all likelihood at much lower levels.

And the hospitalisation rates for Omikron are still way too high compared to how fast it spreads, at least for most healthcare systems.

I got my result today morning +ve. Fever wasn’t breaking since last 3 days. It remained 102-103.5F. Today it came down to 99.5F. No other symptoms so far, except on and off body ache and headache.

I hope I get better without having to visit a hospital.

What should I get tested for after getting better?

Did you go for this as routine checkup or after some symptoms, or you wanted to see what damage was caused by COVID?

As is tradition, covid hit me at the absolute worst time, 2 weeks before the end of a project, so I was really stressed out while/after having it. At first I attributed the lingering symptoms like groggyness and irregular/loud heartbeat just to stress, but since it persisted now for 2+ weeks after the end of the most stressful time, I got a bit suspicious and contacted my GP.

I'm gonna do an electrocardiogram next week, and based on that the GP might do some other tests. So you should listen to your body and try to have little stress, no drinking, no hard sports for a few weeks, and contact your GP if you don't feel good.

My GP has already prescribed me a chest CT scan as my fever basically didn’t budge for 3.5 days with paracetamol and NISE as well. My CRP was elevated as well.

Now fever is down. My 5th day of symptoms today. I’m going to repeat CRP and then additionally do a chest CT scan today. She will see whether all is well or almost well with me or do I need specific care as of now or later as part of recovery. I think I technically I am still a covid patient.

And god, why is it difficult for every doctor out there to understand and accept that my “normal body temperature is below 98.6 F”!!

Even if surviving infection confers immunity similar to one vaccination dose, that's not enough. COVID is so virulent and severe that you want multiple vaccine doses.

1 covid + 1 vaccine seems to be the "best" exposure, since the vaccine only has spike, but the obvious downside is that you catch covid which you really should avoid if you can.

However, it does seem like it's not necessary to make people get 2-3 vaccines if they caught it.

"I don't have the study in front of me, so let me make some numbers up."

This is not even remotely true. If you'd like to read an actual study that shows the opposite, here you go from the CDC: https://www.cdc.gov/mmwr/volumes/71/wr/mm7104e1.htm?s_cid=mm...

Studying infections as they occur is extremely difficult. People who get vaccinated take greater precautions than those who don't. People who get infected take greater risks, and those who are unvaccinated and have been infected are the greatest risk takers of all. Breakthrough infection rate has more to do with cohort behavior than efficacy of natural vs vaccine.

The biggest advantage a vaccine has is repeated exposure to viral material without illness and risk of death. But ultimately the vaccine is just trying to trick your body into creating natural immunity.

Note that this study uses data from May-November 2021, so it doesn't cover Omicron. Data on omicron is scarce still.

As an anecdotal data point - my kid had the Covid twice, not a year apart between the infections. Both times very mild, but still.

Source?

No, the problem has been that the variant vaccines have not shown superior responses to variants vs. the original spike isolate in preclinical and small trials.

Incorrect, the beta variant vaccine for example showed quite good strength at stopping the beta variant vs. the wild type vaccine (which beta much more easily evaded). The problem is beta variant grew for a bit last year but is entirely gone now.

We sequenced covid 19 on January 11, 2020. Within 2 days, we have a vaccine. It took 2 months (March 2020) to get that vaccine into humans, and almost an entire year (December 2020) to get an emergency use authorization to use it outside of clinical trials.

Updated vaccines are being looked into, but the original ones still work well enough that there is not the push to expedite the process we saw with the original one. With the virus slowing down to herd immunity, it is likely we won't see another such a push for this pandemic.

reminds me code that takes 1 day to write, 1 week to write tests for, and 2 months to release safely

Or even the two lines of code you wrote after researching the problem/solution for a week.

Bottom of the stack rank for you, slacker.

And a lifetime to maintain.

that entire year was also spent doing process engineering to scale up manufacture and delivery from zero to millions and millions of doses.

my understanding is that going from something in the lab to something that is produced at scale requires significant chemical engineering work, similar to, but likely harder than hardware which is based on parts availability and cost.

all warp speed did was release money and allow process development and testing phases to overlap, is my understanding.

A couple of reasons

1. It's still pretty effective against COVID

2. Clinical trials showed variant specific versions weren't that much more effective

3. Protecting against the granddaddy strain has a much broader effect than protecting against a new strain.

Are you sure about #3? That vast majority of cases now are Omicron, so new variants are far more likely to branch off of Omicron than an earlier strain. Therefore I can't imagine how a vaccine targeting the original spike protein would be expected to be more effective than one targeting the spike protein from Omicron against new variants.

One other consideration is that Omicron is significantly milder than previous variants

Perhaps there's a fear that an Omicron targeted vaccine would allow a more deadly variant to take over again

Omicron branched off the original lineage IIRC, not Delta nor Beta. So, no, we can’t make that assumption.

I'm not saying it's a certainty, just a strong likelihood.

> Therefore I can't imagine how a vaccine targeting the original spike protein would be expected to be more effective than one targeting the spike protein from Omicron against new variants.

Well, besides imagining, we're also doing science, so what does the data that you've seen say?

Is there data out there comparing variant-specific vaccines to the original in their effectiveness against derivative variants? I haven't seen anything like that.

Perhaps there is a reason the original vaccine would be expected to be more broadly effective, as my parent said. It's not intuitive to me, but that doesn't mean it's wrong. Hence my question.

My point was that our human body doesn't work by rhetorical reasoning or intuition. There are often things we discover about our immune system that are counter intuitive - for e.g. Using specially developed & formulated vaccines to teach the body to suppress immune response towards antigens (via Treg cells), rather than to neutralize them which is what most vaccines aim to do.

Specifically I was objecting to "Given X, we wouldn't expect Y to happen" aspect of your argument. Its never so simple with the human body! It works in many other domains, and so as a former programmer myself I have to catch myself trying to apply such reasoning to biological systems which can't be modeled like that.

Let's say we wait until only 1 out of 10000 cases world-wide is caused by a non-Omicron strain. Then, an Omikron-specific booster would be worth it. Otherwise, we are just playing whack-a-mole with other strains.

What if we had multivalent mRNA vaccines like the HPV vaccine? Gardasil first covered three different strains, then later was bumped to nine, hence Gardasil-9. It doesn’t have to be all or nothing.

HPV viruses are DNA viruses, which means they evolve way slower than Corona viruses. This makes it easier to identify strains that are worth developing a vaccine against. Also, the mRNA technology and/or the production lines are probably not yet capable of producing multivalent vaccines.

A quick Google for "multivalent covid vaccine" shows trials in progress and articles from as early as 2021, so I'd say there's progress happening here.

Good news!!

There are some in development, but they don't use mRNA.

https://www.technologynetworks.com/vaccines/articles/the-hun...

It's really not effective at all anymore with 12% efficiency [1]. Boosters are only "good" for your own placebo thoughts.

[1] https://www.cnbc.com/2022/02/28/pfizer-covid-vaccine-was-jus...

Thanks for linking the article, if you had read the title it says "in kids 5 to 11". The 6th sentence notes that "kids 5 to 11" received a lower dosage. It goes on to reference a study that showed dosage matters.

Delete your comment to save face?

Boosters of the current vaccine are somewhat effective against hospitalization and death, though even that benefit wears off alarmingly quickly. There's not really any justification for vaccinating 5-11 year olds at this point though given the mediocre benefits and the risk of side effects.

In very young kids at considerably reduced dosage

> Yet after so many mutations of covid, all we have is still the original version of covid mRNA vaccine. Why?

Think of COVID as a human being. The mRNA vaccine teaches your immune system to recognize and destroy hands instead of a whole person. As a result your immune system can detect all shapes and sizes of people as long as they have hands. It is possible for the virus to mutate to use claws instead of hands, but then it isn't as effective at grabbing cells to infect them.

The point was that mRNA vaccines should be able to be quickly adapted to detect claws.

An mRNA vaccine could be designed tomorrow to target claws instead of hands, the issue is how long it takes to test them / get approval to use them, not how long it takes to develop them.

In the case of an incredibly rapidly mutating virus like COVID-19 it's just not worth it to go through that whole process every time it goes from hands to claws to hooves.

> it's just not worth it to go through that whole process every time it goes from hands to claws to hooves.

It's not that it's not worth it, it's that this approach doesn't work. Evolution is a remarkable force, and unless there's a good reason for the part of the virus/bacteria/amoeba you're targeting to stay that way, it will change to escape the selective pressure against it. We're more-or-less seeing this with SARS-CoV2, even though the virus is a relative amateur at genetic drift.

OK, you may say "let's target the vaccine against a part that doesn't change"...that's great, except that those parts tend to be so common -- so "evolutionarily conserved" -- that you see them all over the place, including, often enough...your own body. Train your immune system to (over)react against common antigens, and you're going to cause problems.

The primary reason that vaccine development is difficult is because you have an extremely high bar for effectiveness, coupled with an extremely low bar for side-effects. And even if you find such a unicorn target, you have to make sure it stays magical over time. The mRNA technologies are great and do accelerate things, but ultimately, the speed of the Covid vaccine development process was more about our willingness to throw huge money at the problem and eliminate all development and liability risk, than it was about any particular technology platform.

> The mRNA technologies are great and do accelerate things, but ultimately, the speed of the Covid vaccine development process was more about...

Nope, the Moderna vaccine was designed in 2 days after getting a full DNA sequencing of the virus. Very rapid design is a particular feature of mRNA vaccines (with the caveat that sequencing to find the right proteins is required).

Yes, as I said, the technology accelerates things somewhat. But to put it in a computer science context, it's like slightly reducing the constant on an O(n^3) algorithm. You're making things faster, sure, but you're not really going to affect the time to create a vaccine.

Said differently: the slow part of creating a vaccine is doing the trials to make sure you have safe and effective target.

Yes, that was literally the point I made in the first comment. Not sure what we're arguing about.

The vaccines can quickly adapt, but the process of proving each version safe to use takes time each time.

Because there is no need for an updated vaccine. The original vaccine (especially with a booster 6 months after the second dose) is extremely effective at preventing severe disease, hospitalization, and death for all variants of SARS-CoV-2. (Alpha, Beta, Delta, Omicron, etc)

Nope. See https://www.nejm.org/doi/full/10.1056/NEJMoa2200797

The conclusion said it is less effective.

The messenger RNA (mRNA) boosters were highly effective against symptomatic delta infection, but they were less effective against symptomatic omicron infection. However, with both variants, mRNA boosters led to strong protection against Covid-19–related hospitalization and death. (Funded by Weill Cornell Medicine–Qatar and others.)

Don't get me wrong, I believe in the vaccine, but I think we are still far away from one vaccine that kill all the the mutations.

From the link you posted:

In this study, mRNA boosters were highly effective against infection with the delta variant but were less effective against infection with the omicron variant. However, these boosters led to strong protection against Covid-19–related hospitalization and death due to both variants.

We vaccinate in order to prevent severe disease, hospitalization, and death. The original vaccines, per the link you shared, are extremely effective at this.

Originally, the plan was to vaccinate in order to obtain herd immunity and wipe out COVID.

Smart people adjust plans as they discover new information. Your original hopes for a solution at the start of a disaster will change drastically as you better understand the problem at hand.

There seems to be a pervasive thought that our leaders ought to somehow become superhuman and obtain clairvoyance about how to solve any problem we have. They are no different from any of us, who think a bug has a simple solution before we spend a lot of time figuring out more complicated things were happening under the hood.

"Smart people adjust plans as they discover new information."

The new information, that the world is globalized, with many countries not being able to afford vaccines and also many militant anti vaxxers around?

How was wiping out covid, a realistic goal in the first place?

The problem isn't really affording vaccines so much as being able to administer them. Africa is a big place; it is literally hard to get very cold mRNA vaccines to people even if we donate them.

Similarly, a lot of people have been claiming we're evilly withholding patents from the world, but that can't be a real issue or China and Russia would just have stolen the IP from us. They literally can't produce them any faster even with the rights.

We managed to keep SARS and MERS fairly contained.

But I believe that was a very different situation at that time, with it not already spread globally and being less infectious.

Actually originally the plan was to hope for 50% efficacy, even knowing that coronavirus immunity may wane after several months as is the case with seasonal coronaviruses

Less effective doesn’t mean it isn’t extremely effective. Lightbulbs are less effective at providing light than the sun but they’re still extremely effective providers of light.

This analogy made me smile :-)

There is no disagreement between your comments.

That's the wrong comparison though, you would need to compare a wild type booster vs an omicron specific booster.

Unfortunately the public was told last year that the vaccines were near perfect and vaccinated people wouldn't get sick. Here's the head of the CDC at the time saying vaccinated people "do not carry the virus" and were 90% protected against infection: https://www.businessinsider.com/cdc-director-data-vaccinated...

The CDC needs to be explicit and clearly admit that it was wrong or the data changed, and that vaccinated/boosted people can and will get sick or even spread disease to others. The new 'deal' is that they will likely not be hospitalized or suffer severe disease if infected.

Far too many people are still walking around thinking their shots and booster, now nearly 6 months old for some, are an impenetrable force field against any sickness.

Have you read your own article?

Yes, it says "On Monday, the CDC released a study finding mRNA vaccines __90% effective at preventing infection__."

I remember last year when this news hit, that bit about 90% effective *against infection* was amplified and played nonstop for the public. The message was clearly get vaccinated and you will not get sick.

It was not until July and the CDC MMWR report on the Providence, Rhode Island, bear week festivities that lead to unexpected breakthrough infections that the CDC admitted the vaccines were not 90% effective against infection anymore. Unfortunately this updated message has never been clearly told to the public, at least not as clearly or loudly as the original 90% protection against infection message.

From the Business Insider article you posted:

> Walensky was referring to a new CDC study of nearly 4,000 front-line workers, some vaccinated and some not, who tested themselves weekly for COVID-19 infections between December and March.

> But more data is still necessary to say so definitively, which is why researchers are recruiting thousands of college students across the country to find out more about the likelihood of asymptomatic spread of this virus among vaccinated people.

The article is explicit that the CDC was talking about the findings in a new study, and that more research still needed to be conducted before being sure of their findings.

> It was not until July and the CDC MMWR report on the Providence, Rhode Island, bear week festivities that lead to unexpected breakthrough infections that the CDC admitted the vaccines were not 90% effective against infection anymore.

Because of the new delta variant that those very same festivity goers helped the CDC with[1], and that changed the CDC's guidelines:

> The speed of the investigation — and the exceptional participation from the mostly gay men involved in the outbreak — helped the CDC learn new information about the delta variant. And it was that new information, in part, that prompted the agency to change its guidance for how vaccinated people should keep themselves safe at this stage of the pandemic — including a return to masking indoors.

[1] https://www.npr.org/sections/health-shots/2021/08/06/1025553...

Unfortunately, that would destroy the narrative that the CDC is infallible and everyone should unquestioningly follow their advice, always.

Btw, I’ve had both shots, had COVID and will get the booster.

Noone has ever thought the CDC was infallible; we traditionally ignore everything public health officials tell us to do, since it's mainly things like "never eat medium-rare hamburgers".

That is unfortunate that we switched to directly getting mask policies etc. from them, because it's not their job to consider tradeoffs and they aren't good at it.

I've never heard that narrative, except from people into anti-establishment attacks who are criticizing the narrative. It's a strawperson, IME.

is strawman so non inclusive and offensive in the US?

Come to think of it, I'm not sure I've ever seen a strawwoman. Maybe as part of a straw couple as decoration at a harvest market or something

Well ok they'll get sick. People get sick. They'll get way less sick, so that's good!

> that vaccinated/boosted people can and will get sick or even spread disease to others Are you under the impression this isn't what they've been telling people?

The article I posted has a quote and video of the director of the CDC explicitly saying in March of last year that vaccinated people "do not carry the virus" and were 90% protected __against infection__.

That's a direct quote from the head of the CDC, it does not get more official or more of a primary source than that IMHO.

It actually does get more official than a director's spoken words, but moot point. You are writing as if in the year since that largely pre-Delta point in time that the CDC's official guidance was that you won't carry the virus and are protected from infection — and it was never updated.

In randomized clinical trials, the original mRNA vaccines were just as effective as modified versions at preventing symptomatic disease and hospitalization due to SARS-CoV-2 infection

This isn't true. No RCTs have ever been performed on the original vaccines and the subsequent variants. And to the extent that other kinds of experiments (retrospective cohort studies, etc.) have been done, they've almost universally found diminished effectiveness against mild illness.

Effectiveness of the original vaccines against Omicron infection, in particular, is essentially zero after a few months:

https://www.medrxiv.org/content/10.1101/2021.12.20.21267966v...

It should be noted that the vaccines appear to remain highly effective against severe illness, even without boosting. The mRNA vaccines, in particular, seem to raise a robust, long-lasting cellular immune response, even though antibody levels rapidly fall. One of the downsides of the unusually rapid approval process for the Covid vaccine was that it was impossible to see this pattern in a randomized trial that lasted only a few months. This led "experts" -- people who really should have known better -- to oversell the shots as a form of sterilizing immunity. They are not.

There are good reasons vaccines take a long time to develop.

From the article I read[1], the nuance was along the line of this -- a person who was previously exposed to the original COVID vaccine or the virus itself (and had an immune response) getting the updated version of the vaccine ends up having the immune response for the _original_ antigen[2], rather than the new one.

Since the immune response is for the older versions of the virus, getting the updated vaccine still ends up having the same effectiveness of the original vaccine.

[1]: https://arstechnica.com/science/2022/02/monkey-study-casts-d...

[2]: https://en.wikipedia.org/wiki/Original_antigenic_sin

Yeah, an immune response specific to the Omicron variant would likely be more effective against Omicron for obvious reasons, but it's probably not possible to get one in people with immunity to older variants because their existing immunity gets in the way. This isn't too surprising - it's one of the things that seems to limit the effectiveness of the flu vaccine.

While it is easy to modify, it still takes time to test the modified vaccine. The vaccines were designed to target the spike protein which is shaped to allow it to enter human cells. If that protein evolved too much to evade the vaccine, it would also become less effective in entering human cells.

In the future they might prepare a wide number of vaccines targeting common coronavirus ahead of time so there can be quick response when an outbreak appears.

In monkeys, there wasn't much of a benefit of an omicron specific booster vs an original Wuhan strain booster. The main thing was just getting a third dose which generates the mature antibodies that are apparently similar enough between current variants.

Not exactly sure, but I think the original version of the covid vaccine has been good enough for the mutations and there has not been need for modified version.

We don't know if it's worth updating the covid vaccine, because updating it to be more like omicron would make it less like the original type, and we don't think that's a worthwhile tradeoff.

The answer is a "pancoronavirus" vaccine that'd work against all of them, but it seems that using mRNA or not doesn't actually help with that.

Previous to this the record for fastest vaccine was 4 years, so I'd say promise is kept (Zika vaccine was on a path to beat the 4 year mark but COVID vaccine would still be faster). Vaccines normally take years to develop

Without the initial covid urgency there is an insane red tape beurocracy on new vaccines. It takes 7 years for the average vaccine to be approved and its 90% avoidable busywork.

I'm not so sure it's busy-work.

There's a prioritisation issue. There are so many diseases, and many more proposed treatments. Without a good reason to jump the queue there are bound to be delays.

There's also the efficacy testing issue. Your phase 2/phase 3 test subjects are mostly young european males (Uni-students). Without deliberately exposing them, how likely are they (and the control group) get infected? It could take years for a statistically significant number of the control group to catch the disease.

When there's a pandemic on you might hit those numbers in a few weeks.

My cynical take: New versions of the mRNA vaccine were unable to change the first two vaccine's "original antigenic sin".

That's dengue. It doesn't appear that getting covid makes it even worse the next time you get it. (I have seen people say this, but they're also saying wild stuff like "everyone who gets covid ends up with dementia".)