Coronavirus Discussion Thread

Peak

ED/Prehospital Registered Nurse
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The studies we have on the vaccines are mostly all by the manufacturers (who stand to gain billions but will be sheltered if it goes bad) in which most of them are still in Phase 1 or barely into Phase 2.

In the case of these vaccines manufacturers were allowed to run multiple trial phases concurrently to speed up development. Phase III trials are really about better understanding clinical efficacy and when to use a drug in practice once it is Phase IV (which is just post market surveillance).

Also it is important to remember that most trial drugs don’t make it out of phase 0 or I, drugs often don’t show the promise that we hope for and we stop their trials early. Not making it to phase III or IV doesn’t mean that category of drug isn’t possible, it means that a specific formulation isn’t efficacious but that doesn’t necessarily make it dangerous.

It is not uncommon to have drugs given outside of trial anyway. We give compassionate exception drugs frequently even though they are still in phase II or III.
 

Mufasa556

Forum Captain
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Dan Aykroyd has webbed feet. He danced pretty good in the Blues Brothers and wrote Ghostbusters. Having webbed feet doesn’t seem all that bad. Maybe we’re just setting ourselves up for a future undefeatable Olympic swim team? USA! USA!
 

Summit

Critical Crazy
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The reason the mRNA vaccines were the first through phase 3 is that mRNA is way faster to get out of preclinical development.
 

Summit

Critical Crazy
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I just think that if this is supposedly the extinction level event so many believe it is
So many believe that? Nobody believes that! 1918 level event? Yes many believe it could have been that. Despite all of our folly, we've managed this much better than 1918 and prevented a 1918 level event.
 

SandpitMedic

Crowd pleaser
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SandpitMedic

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So many believe that? Nobody believes that! 1918 level event? Yes many believe it could have been that. Despite all of our folly, we've managed this much better than 1918 and prevented a 1918 level event.
1918... ELE... take your pick at vocabulary. We’re talking past each other on this point.
 

SandpitMedic

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Dan Aykroyd has webbed feet. He danced pretty good in the Blues Brothers and wrote Ghostbusters. Having webbed feet doesn’t seem all that bad. Maybe we’re just setting ourselves up for a future undefeatable Olympic swim team? USA! USA!
Hell yeah! USA! USA!
Hey look- we are all free to make our own medical decisions. I’m not anti-Vax, I just want to see what happens. As I said- cautiously optimistic skeptic.
 
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Akulahawk

Akulahawk

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mRNA vaccines are a relatively new technology. The safety profile of this vaccine is not fully understood. In the most layman’s terms I can think of right now... It is artificial chromosomes that go in to cells to copy the chromosomal data and pump out proteins for the body to recognize the “not self” and mount an immune response.
There's this other method which uses a replication-disabled live virus that puts genetic material into cells to get the ribosomes in them to pump out proteins so the body can recognize the "not self" and mount an immune response... That method has been used for years. The mRNA method just skips using a live virus. The trick is getting the mRNA into the cells and both Pfizer/BioIntech and Moderna have figured out ways to do this without using a live virus. I suspect that since they now have developed a carrier for mRNA, I think we're going to see mRNA vaccines much more commonly soon. The lead time for an influenza vaccine is pretty long. Imagine doing the surveillance of the circulating strains, getting mRNA vaccine candidates for all those strains ready, then actually determining the actual influenza strains that have started circulating in humans and doing mass production of the mRNA vaccines for those strains just a few months before influenza season hits. You'd likely have a VERY effective vaccine against the actively circulating flu every year. Given the right info, it might be easier to produce a universal influenza vaccine this way too.

I'd say mRNA is actually pretty well understood, it just hasn't been utilized in humans because other vaccine tech is a known quantity and people like going with what they know vs what they haven't tried before.
 

Summit

Critical Crazy
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All of what akulak said. MRNA is very well understood. The technology is 30 years old. The problem has been getting the mRNA to survive long enough to get in the cell. There were mRNA cancer treatments that were tested and found to be safe but not efficacious due to the problem of the MRNA not lasting long enough. There were mRNA vaccines developed but not tested because the vaccines were not needed. Pfizerbiontech and moderna have created phospholipid envelopes for the MRNA to allow it long enough to enter into the cytoplasm where it can hook up with ribosomes for some protein making fun. Moderna has more experience and was able to use sugars to temperature stabilize.
 

Summit

Critical Crazy
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1918... ELE... take your pick at vocabulary. We’re talking past each other on this point.
Maybe. Maybe you are speaking in hyperbole. Otherwise there's quite a stratum between our current mitigated covid experience, 1918 paninfluenza, the European medieval plague depopulation, the poly pathogen civilization ending pandemics following Americas' contact with European diseases, and an ELE.
 

SandpitMedic

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All of what akulak said. MRNA is very well understood. The technology is 30 years old. The problem has been getting the mRNA to survive long enough to get in the cell. There were mRNA cancer treatments that were tested and found to be safe but not efficacious due to the problem of the MRNA not lasting long enough. There were mRNA vaccines developed but not tested because the vaccines were not needed. Pfizerbiontech and moderna have created phospholipid envelopes for the MRNA to allow it long enough to enter into the cytoplasm where it can hook up with ribosomes for some protein making fun. Moderna has more experience and was able to use sugars to temperature stabilize.
CDC info on mRNA COVID vaccine:

2012 study on mRNA use a medical "disruptive technology": Good stuff here.

I have heard of the glycogen capsules and synthetic phospholipids they are using to stabilize the particles for cell entry, although I have not researched that to any extent. I am not sure if that is proprietary information or open source. You are spot on that this technology was first theorized for medical use in 1989 (according to this study). I consider that relatively new.

However, and I am not arguing with you, I'm just saying, cancer/HIV/etc has killed, maimed, and otherwise destroyed more lives to the nth degree than COVID, yet they couldn't figure it out to "cure" cancer? HIV? Ebola? The common cold? The answer to that is a puzzling one, because mRNA as a vaccine and/or cancer treatment was theorized in 1989, and because they couldn't get it into the cell to do it's ribosomal dance as you noted. I guess those things just weren't as pressing.
Here is a quote, which demonstrates the initial hurdles which have apparently been figured out.

"For instance, in addition to the previously mentioned nucleotide modifications, novel delivery modes may severely affect vaccine adjuvanticity. While direct delivery into the cytosol would certainly enhance antigen expression, the lack of interaction with endosomal RNA receptors may severely weaken immunostimulation by the vaccine and this issue would likely have to be addressed."

What remains true is that it has only been used in vivo and in insects in vitro successfully in limited studies with the exception of the current COVID studies. This will be the first mRNA vaccine for humans (that works, so they say). The down stream effects are unknown- does it prevent or does it lessen, side effects, etc? The argument there is the risk of COVID is greater, some would say. We've already debated that and we all landed where we landed. CFR similar to influenza... some say its not.

I get you're fully bought in to it, and that is fine. I want it to work too; in fact, I want it to usher in more treatments and cures for longtime viruses. I still have my misgivings about the way it’s been done, down range effects, who stands to gain what from this, and the idea everyone needs the vaccine.
 
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SandpitMedic

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Maybe. Maybe you are speaking in hyperbole. Otherwise there's quite a stratum between our current mitigated covid experience, 1918 paninfluenza, the European medieval plague depopulation, the poly pathogen civilization ending pandemics following Americas' contact with European diseases, and an ELE.
Yeah, maybe you just want to take it too literal and argue about it. In my opinion, over the past ~9 months the news media has portrayed this pandemic as the end of the world ad nauseam as a plague, and it's been compared to 1918, etc etc... causing many to believe that... If you missed that, then I envy you.

Lets keep talking vaccines, the virus, and response, this is a good conversation we are having. Let's not bog it down with semantics that aren't worth the bandwidth.
 
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PotatoMedic

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Well scheduled to get the first jab on Tuesday.
 

PotatoMedic

Has no idea what I'm doing.
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And my date is getting moved. So hopefully next week. Either way it will be soon.
 

Summit

Critical Crazy
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Got mine and no... side... brains.... BRAAAAAAAAAAAAAAAAAAIIIINSSS!
 

ffemt8978

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