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The science against mass vaccination during a pandemic (viral immune escape) (mcusercontent.com)
6 points by SQL2219 28 days ago | hide | past | favorite | 5 comments

This really needs a simpler summary that I can digest -- I think I understand but there where many points that I couldn't wrap my head around. I get the comparison with the overuse of antibacterials ... can someone dumb this down for me?

It's an open letter, which contains zero data or even references for the claims being made. Looks like nothingburger to me (a non-epidemiologist)

So has anyone else with the requisite background engaged with this argument? It sounds somewhat dubious to me but I can't pretend to have sophistication on this subject.

I think highly of this concern about selecting vaccine-escaping variants due to exposing a lot of immunized people to a lot of infected people, to the extent that I've posted about it myself[0].

However, the author is wrong about there being no attention given to these issues, it's a very active research topic in general (although AFAIK not some specifics he mentions like NK vaccines). Vaccine escaping, its consequences, and how to beat it are not obscure topics, but seem to be considered and explored on virtually every scientific endeavor in the last months.

Vaccination efforts aren't necessarily informed by those, and more attention to real world risks is warranted IMO. But that effort should build on the growing awareness and datasets about vaccine escaping. And probably it should avoid presenting a solution (NK vaccines) to a problem (vaccines actually making the immune response weaker when escaping happens) that is AFAICS construed from first principles as opposed to experimental data.

I have issues with this particular effort, but welcome it if it's a way to foment evidence based, non-alarmist discussion on possible vaccine-escaping and what can be done to avoid it. It might result in opposite decisions to what the author argues, like for instance we may have to massively speed up vaccination in key countries, maybe funded by other countries, or escaping becomes much more likely. There are many ideas around, and fortunately there's a lot of science being made on this.

[0] https://news.ycombinator.com/item?id=26071768

what you have hit on is the idea that this virus is not a static code but changes as a consequence of reproducing.

this is not a phenomenon limited to vaccine based selection but can also occur as a result of naturally aquired immunity.

it goes like this, original viral character passes among a population each replication carries a crap shoot of variation. initially a novel host is often free fare and any variant moves to infect very easily. as individuals develop naturally aquired immunity OR vaccination aquired immunity, the variants that change enough to have shifted antigen profile are the ones that occur in greatest frequency.

the really bad part is that other mutations or variations can occur or recombine to a character that makes the present look like a dry run.

as an individual, vaccination is good in the face of this virus, the big problem is the human behaviour that allows the virus to transmit, have more chances at replicating and chance at becoming high morbidity and or mortality incurring pathogen. as an individual you should still endeavor to prevent yourself from transmitting or receiving the virus.

if things go fairly well for us as a species, the coronavirus will exhaust its repetoire of variability, and take its place among the human endemic coronavirus that we all experience on a regular basis.

this is the route that the influenza virus has taken and you can see how that works well for us most of the time, but via sequence surviellance we can predict most bad turns of the pathogen and choose a vaccine that is representative of the character of concern.

this whole intention of squelching generation of variants by reducing reproductive cycling is the best we have along side vaccination.

the formulation of polyvalent vaccines, effective vs more then one variant or strain is a major avenue to explore.

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