What we need is intranasal sars-cov-2 vaccine boosters to provide igM and igA antibodies, and more importantly trained tissue resident T cells, in the upper respiratory mucosa immune compartment where igG antibodies do not penetrate. That's where infection starts and replication goes (mostly) unchecked.

Even just updating the sequence to reflect current variants while remaining intramuscular only would be okay and that will happen this fall (too late). But if we really want to mitigate spread and mutation to complement the protection from hospitalization intramusculars give we're going to need continued funding for new vaccines.

What we need is a vaccine that works better. Everything else is just speculation until it’s tested in well-designed trials that test the right thing in actual humans.

Sure, you may think we need an intranasal vaccine and I may think we need an attenuated-virus vaccine stimulating a T cell response against ORF1ab peptides, but we could both be entirely wrong.

Keep in mind that the measles vaccine is injectable and produces excellent durable protection against the airborn measles virus. The chickenpox vaccine is an injected live virus vaccine that appears to provide excellent durable protection against chickenpox, which, while it sure looks like a virus that would be transmitted mainly by shedding from blisters, is apparently also airborn.

Meanwhile, a hypothetical intranasal vaccine that raised an awesome IgA response with the same affinity as the the IgG antibodies in people vaccinated with the current mRNA vaccines but did nothing else seems unlikely to be especially effective against BA.4 and BA.5.

I'm sure there's still plenty of places that haven't gotten access to a first shot yet

https://www.bloomberg.com/news/articles/2022-01-11/repeat-bo...

Raw data from the UK seems to support this. https://www.ons.gov.uk/peoplepopulationandcommunity/birthsde...

I don't know if they'd actually check it, but most (all?) US states have vaccine databases, and I assume COVID vaccinations would be entered into it.

Back in the day, your health record was like a criminal record. If it got a black mark, you couldn't buy insurance any longer. I hope we never go back to that.

I'm honestly confused how this comment flowed from mine. Getting a vaccine isn't a health problem. These databases make it much easier to get your vaccination records, since you don't have to track down records from every health provider you may have visited (including ones from before you could talk).

“Repeatedly catching Covid-19 appears to increase the chances that a person will face new and sometimes lasting health problems after their infection, according to the first study on the health risks of reinfection.”

https://www.cnn.com/2022/07/05/health/covid-reinfection-risk...

The article says that even when controlling for prior existing conditions, age, sex, etc, that outcomes are still statistically worse with each infection. The material is also preprint and will be undergoing peer review.

More likely these people always had a less-effective immune system, which is why they catch Covid repeatedly.

Classic correlation mixup of attributing cause to the result.

https://www.science.org/content/article/bad-news-paxlovid-co...

Also, it is quite unfortunate that we now have evidence that multiple acute covid infections may cause long lasting health problems.

Flagging this comment is also pretty ridiculous. Here's the source. https://www.science.org/content/article/rare-cases-coronavir...

Endemic COVID, which is sorta the endgame that people want/expect, has it turning into somewhere between a cold and a bad flu in strength/effect. We'll see.

Textbook case of a self-fulfilling prophecy. It was said from the beginning that would be the ultimate result and very little was done as a coordinated global effort to avoid it. And that inspired little confidence in regard to the next pandemic, whenever it may be.

edit: and I agree a lot was done, but certainly not in any unified manner. in this age of hyper-globalized economies, countries cannot effectively act as individual entities when dealing with pandemics.

We have seen similar or even worse numbers in UK/EU over time. Theres a notion of being open, and then there’s public conformance.

Totally agree masking and filtration could have been massively improved, but it wasn’t known for a while that masks were the right thing. Everyone needs to give the health officials some latitude when something is brand new and being studied in real time. Of course communication could be improved, but it didn’t help it was also politically inconvenient (along with all the false information) so the comms no matter what would be challenged.

Estimated US flu deaths[0] between 2010 and 2020 (i.e. 10 years): 359K.

Estimated US Covid-19 deaths[1] between January 2020 and today (i.e. 2.5 years): 1,044,557

Can we stop with this disingenuous narrative? People rightfully perceived a level of heightened risk, ahead of a working vaccine, and took reasonable precautions. If it was as dangerous as the flu, we would have seen 90K deaths not 1M+.

[0] https://www.cdc.gov/flu/about/burden/past-seasons.html

[1] https://www.worldometers.info/coronavirus/country/us/

https://www.statista.com/statistics/1191568/reported-deaths-...

How do you think poor people get child care so they can go to work, for one thing?

I do think there's room to criticize what was done, but I don't think "just isolate old people" was ever a practical option, and I don't think the alternative of "we're keeping things open and not isolating old people, so make sure you say anything you've been meaning to to your elderly parents really soon, because... well, you know" was ever gonna go over well.

> I think it's fair to question whether it was "reasonable precaution" to shut down schools,

I know enough teachers and was privy to their thoughts and observations during the pandemic that I'm quite confident schools were going to shut down no matter what official policy was. Lots of teachers are married to higher earners, and they're basically all working because they want to. They'd have stopped wanting to, and the schools wouldn't have been able to remain open with normal hours and procedures, with their much-reduced staff. A couple districts I know for a fact faced near-revolt over measures that were regarded as insufficient and coupled with tone-deaf messaging, and had to adjust or the scenario above was definitely going to happen and they'd have lost 10+% of their staff all at once, which is enough to completely mess them up.

Whether their opinions were based on reality hardly matters: fact is, schools were going to shutdown, one way or another.

Good god, from calling an order of magnitude in difference as only "a few" to the false equivalences, you really nailed the poor logic I saw at the beginning of the pandemic.

I hope this means more will go to underdeveloped countries now. The African continent averages at 40 doses per 100 people while the rest of the world is at 154

https://www.statista.com/statistics/1245573/covid-19-vaccina...

The NYT’s visualization makes this painfully clear: https://www.nytimes.com/interactive/2021/world/covid-vaccina...

Their reported fatality rate.

In the most developed and transparent countries cause of death data leave a lot to be desired.

Is that because of superior health care and strong leadership, like in North Korea?

You might like to look at the life-expectancy figures for those Countries.

I'd also add that even if the absolute death weren't lower in the 3rd world, the relative death would. Being able to be freaked out about an average of .3% chance of dying of COVID if infected is a luxury that those countries struggling with malaria, rampant malnutrition, and insufficient non-COVID vaccination don't really have.

https://www.cdc.gov/coronavirus/2019-ncov/covid-data/investi...

You might like to explain why they don't, given the death-rate exponentially increases with age.

It is not just the west that has "vaccine hesitancy".

Cold-chain transport, storage, distribution, staff to inject, syringes and sundries.

The current vaccine effectiveness against infection for either Moderna's, BioNTech/Pfizers, or AstroZeneca's against BA.4/BA.5 is 0-30%.

followed by effectiveness against hospitalisation mid-percentage,

followed by effectiveness against death the highest percentage.

I tried to make this distinction clear by writing out the full "vaccine effectiveness against infection" every time. The entire point of my comments in this post's threads is to point out the intramuscular vaccines cannot and are not protective against you getting infected and spreading the disease.

That's bad. We need new intranasal vaccine boosters to augment the intramusculars and we need to keep wearing face fitting N95 or ffp2 or better masks indoors until then. Being intramuscularly vaccinated will not prevent you from spread sars-cov-2. It will keep you from dying for years and keep you from being hospitalized for ~6 months.

That's something. Remember the early days, when there was a shortage of body bags.

But the same situation re: igG humoral antibodies from intramuscular vaccination not getting in your nose/throat/etc mucosa apply to flu vaccines. Most people only get intramuscularly vaccinated and so get upper respiratory flu infections and spread but are mostly asymptomatic and unaware. Actual vaccine efficiency for flu intramusculars is probably lower than reported due to the asymptomatic cases.

I personally alternate between intramuscular flu vaccines and the Flu Mist intranasal flu vaccine (which you can get by request).

The flu vaccine is so ineffective that if we actually applied evidence-based medicine standards to it / actually looked at a real cost:benefit analysis, we would never be pushing the flu vaccine.

https://www.cochrane.org/CD001269/ARI_vaccines-prevent-influ...

> Injected influenza vaccines probably have a small protective effect against influenza and ILI (moderate-certainty evidence), as 71 people would need to be vaccinated to avoid one influenza case, and 29 would need to be vaccinated to avoid one case of ILI. Vaccination may have little or no appreciable effect on hospitalisations (low-certainty evidence) or number of working days lost.

So: a miniscule reduction in actual flu cases (granted, a slightly-better-but-still-weak reduction in general ILI), with no appreciable difference on hospitalizations or working days lost, meaning that the economic benefit of giving the flu vaccine is basically zero.

It's pretty great that the first world (at least America) has been so heavily socialized to accept the flu vaccine as effective and necessary, because it makes arguing for the effectiveness of the COVID vaccine much easier, since the bar is so incredibly low.

People could be forgiven for thinking otherwise: https://tinyapps.org/blog/202201040700_gaslighting.html

Pfizer stated[0] on Jan 26, 2021 that their vaccine "has been authorized for emergency use to prevent COVID-19 in individuals 16+." [emphasis added]

[0] https://web.archive.org/web/20210126223727/https://twitter.c...

I'm sorry the science communication during the pandemic has been so terrible but there's really nothing suspicious or disengenous going on here.

CDC Director Dr. Rochelle Walensky, March 29, 2021:

"[O]ur data from the CDC today suggests, um, you know, that vaccinated people do not carry the virus, don't get sick, and that it's not just in the clinical trials but it's also in real world data."

Video: https://tinyapps.org/screenshots/20220104-walensky.mp4

Dr. Walensky is much more than a CDC "rep"; she is[1] "an American physician-scientist who is the director of the Centers for Disease Control and Prevention and the administrator of the Agency for Toxic Substances and Disease Registry. Prior to her appointment at the CDC, she was the Chief of the Division of Infectious Diseases at Massachusetts General Hospital and a professor of medicine at Harvard Medical School. Walensky is an expert on HIV/AIDS."

So Americans are supposed to not trust the imminently qualified head of the CDC unless she cites specific papers, which they should then go and read to "do their own research" and second guess her?

[1] https://en.wikipedia.org/wiki/Rochelle_Walensky

Unfortunately, yes, name and status does not mean anything. Papers and replicable findings matter. Press conferences held by media figures don't. Arguments from authority require the authority figure to be talking in a non-laymen context. Video press conferences are for people that don't know science and, frankly, they're very dumbed down.

There's no doubt intramuscular vaccination still does help against infection in other immune compartments. It's just not the best at it. This has been shown in large scale studies re: sars-cov-2 from Israel in terms of likelyhood of being infected if someone in your residence gets infected. ref: https://www.science.org/doi/10.1126/science.abl4292 "Vaccination with BNT162b2 reduces transmission of SARS-CoV-2 to household contacts in Israel"

One is that packaging choices (vial size) made to optimize mass vaccination are now somewhat of a hindrance. This isn't exactly unsurprising that packaging should have to evolve with the type of demand. I know that changing vial sizes probably would require the manufacturers to re-run all of their shelf-life and shipping validations. I wonder where they are along that process. One would have hoped that these validations would have been run earlier - the change in consumption patterns was somewhat predictable.

The other is that other countries are -refusing- vaccine donations. As it turns out, infrastructure and logistics constraints, as well as vaccine hestitancy continue to be a problem. Here's another article about that from earlier in 2022 (https://www.politico.com/news/2022/02/22/africa-asks-covid-v...).

The article claims the US has a ~12% wastage rate. I'd argue that while that's not insignificant, if the rate can be held at 12% (big if to be fair...), that doesn't seem -that- bad. There's quite a lot of literature on vaccine wastage rates even prior to COVID. From what I've found, a 2.5%-5% wastage rate was considered normal for vaccines in steady-state use in developed countries, while flu vaccine wastage could potentially range from 5-40% (https://www.auditor.on.ca/en/content/annualreports/arreports... Figure 6).

The current situation we have now is what they wanted: rich countries buying up dose after dose long after they are needed while poor countries have to beg and plead for nearly-expired scraps. The end result of this is that vaccine immunity has a shelf-life because the virus has plenty of unexposed individuals to mutate in. No, this wasn't planned, but it is an example of how excessive focus on protecting "intellectual property" generates worse public outcomes.

Mind you, someone with no preexisting immunity or one natural infection would do well to get 3 shots rather than risking severe disease or lingering after effects. But how many people in the world are in this position anymore? Everyone willing and able has got the shots and the rest have been exposed multiple times and either developed effective immunity or succumbed to the disease. I can see some corner cases like babies and immunocompromised, but that's not a lot of doses. Hopefully they will have access to stronger / less unpleasant vaccine before long.

>15 million Covid vaccine doses thrown away in the U.S. since March, new data shows

As countries across the world clamor for vaccine doses,

U.S. pharmacy chains and state health departments have thrown millions away.<

NOTE the Date on this Article >Sept. 1, 2021, 3:26 PM UTC / Updated Sept. 1, 2021, 9:23 PM UTC

Unsold and now EOL Vaccines are destroyed. For new Vaccines for Fall release see;

Covid-19 Vaccines Candidates in Clinical Trials : https://covid19.trackvaccines.org/vaccines/

Misinformation is one of the worst problems for the future human race.

Pair that with the efficacy of a 4th dose, and it is not surprising what is happening to the demand.