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Possible vaccines/treatment(s) for Coronavirus

I can just see it in 5 years' time - most of the world will be Covid-free, with just a few plague-ridden outposts remaining, thanks to governments not acting soon enough, dicking around with vaccine delivery, and creating superstrains of the damn thing that means the rest of the world will regard us as something equivalent to a leper colony...
 
Similar concerns here:



The question of whether giving single or more spaced out vaccine doses leading to partial immunity increases the selection pressure for the virus to evolve the avoid the vaccine is far from clear. As has also been pointed out, leaving more of the population for longer without even a single dose while the virus is uncontrollably spreading also leads to even more people fighting the virus with a partial immune response. This is very different to the concerns about untested convalescent plasma/monoclonal antibody treatments and the like.

 
The question of whether giving single or more spaced out vaccine doses leading to partial immunity increases the selection pressure for the virus to evolve the avoid the vaccine is far from clear. As has also been pointed out, leaving more of the population for longer without even a single dose while the virus is uncontrollably spreading also leads to even more people fighting the virus with a partial immune response. This is very different to the concerns about untested convalescent plasma/monoclonal antibody treatments and the like.


Only, if we do end up creating a situation where the virus is able to evolve past the current vaccine, we're going to be right back to square one.
 
Only, if we do end up creating a situation where the virus is able to evolve past the current vaccine, we're going to be right back to square one.

Not quite square one, both the IC and mRNA vaccine methodologies are capable of very fast turnaround of new sequences (ie to target the mutant domains) - in theory these could be added into the mix in a matter of weeks, and might not require re-approval for rollout. It would mean that we could be in for a rolling vaccination program for a year or more, and considerable resources would have to be brought to bear, but it’s not square one. Bottom of a snake on square 11 maybe.
 
Not quite square one, both the IC and mRNA vaccine methodologies are capable of very fast turnaround of new sequences (ie to target the mutant domains) - in theory these could be added into the mix in a matter of weeks, and might not require re-approval for rollout. It would mean that we could be in for a rolling vaccination program for a year or more, and considerable resources would have to be brought to bear, but it’s not square one. Bottom of a snake on square 11 maybe.
That did occur to me, but I felt that the acknowledging of it would dilute the vitriol of my polemic.
 

University of Miami Miller School of Medicine researchers led a unique and groundbreaking randomized controlled trial showing umbilical cord derived mesenchymal stem cell infusions safely reduce risk of death and quicken time to recovery for the severest COVID-19 patients, according to results published in STEM CELLS Translational Medicine in January 2021.
The study’s senior author, Camillo Ricordi, M.D., director of the Diabetes Research Institute (DRI) and Cell Transplant Center at the University of Miami Miller School of Medicine, said treating COVID-19 with mesenchymal stem cells makes sense.

Results: treatment group vs. control group
The paper describes findings from 24 patients hospitalized at University of Miami Tower or Jackson Memorial Hospital with COVID-19 who developed severe acute respiratory distress syndrome. Each received two infusions given days apart of either mesenchymal stem cells or placebo.
“It was a double-blind study. Doctors and patients didn’t know what was infused,” Dr. Ricordi said. “Two infusions of 100 million stem cells were delivered within three days, for a total of 200 million cells in each subject in the treatment group.”
Researchers found the treatment was safe, with no infusion-related serious adverse events.
Patient survival at one month was 91% in the stem cell treated group versus 42% in the control group. Among patients younger than 85 years old, 100% of those treated with mesenchymal stem cells survived at one month.
Dr. Ricordi and colleagues also found time to recovery was faster among those in the treatment arm. More than half of patients treated with mesenchymal stem cell infusions recovered and went home from the hospital within two weeks after the last treatment. More than 80% of the treatment group recovered by day 30, versus less than 37% in the control group.
“The umbilical cord contains progenitor stem cells, or mesenchymal stem cells, that can be expanded and provide therapeutic doses for over 10,000 patients from a single umbilical cord. It’s a unique resource of cells that are under investigation for their possible use in cell therapy applications, anytime you have to modulate immune response or inflammatory response,” he said. “We’ve been studying them with our collaborators in China for more than 10 years in Type 1 Diabetes, and there are currently over 260 clinical studies listed in clinicaltrials.gov for treatment of other autoimmune diseases.”
Mesenchymal stem cells potential to restore normal immune response
Mesenchymal cells not only help correct immune and inflammatory responses that go awry, they also have antimicrobial activity and have been shown to promote tissue regeneration.
"Our results confirm the powerful anti-inflammatory, immunomodulatory effect of UC-MSC. These cells have clearly inhibited the 'cytokine storm', a hallmark of severe COVID-19,” said Giacomo Lanzoni, Ph.D, lead author of the paper and assistant research professor at the Diabetes Research Institute. “The results are critically important not only for COVID-19 but also for other diseases characterized by aberrant and hyperinflammatory immune responses, such as autoimmune Type 1 Diabetes.”
When given intravenously, mesenchymal stem cells migrate naturally to the lungs. That’s where therapy is needed in COVID-19 patients with acute respiratory distress syndrome, a dangerous complication associated with severe inflammation and fluid buildup in the lungs.
“It seemed to me that these stem cells could be an ideal treatment option for severe COVID-19,” said Dr. Ricordi, Stacy Joy Goodman Professor of Surgery, Distinguished Professor of Medicine, and professor of biomedical engineering, microbiology and immunology. “It requires only an intravenous (IV) infusion, like a blood transfusion. It’s like smart bomb technology in the lung to restore normal immune response and reverse life-threatening complications.”

Early success with mesenchymal stem cells
When the pandemic emerged, Dr. Ricordi asked collaborators in China if they had studied mesenchymal stem cell treatment in COVID-19 patients. In fact, they and Israeli researchers reported great success treating COVID-19 patients with the stem cells, in many cases with 100% of treated patients surviving and recovering faster than those without stem cell treatment.
But there was widespread skepticism about these initial results, because none of the studies had been randomized, where patients randomly received treatment or a control solution (placebo), to compare results in similar groups of patients.
“We approached the FDA and they approved our proposed randomized controlled trial in one week,and we started as quickly as possible,” Dr. Ricordi said.
Dr. Ricordi worked with several key collaborators at the Miller School, the University of Miami Health System, Jackson Health System, and collaborated with others in the U.S. and internationally, including Arnold I. Caplan, Ph.D., of Case Western Reserve University, who first described mesenchymal stem cells.

Next steps
The next step is to study use of the stem cells in COVID-19 patients who have not yet become severely ill but are at risk of having to be intubated, to determine if the infusions prevent disease progression.
The findings have implications for studies in other diseases, too, according to Dr. Ricordi.
Hyper-immune and hyper-inflammatory responses in autoimmune diseases might share a common thread with why some COVID-19 patients transition to severe forms of the disease and others don’t.

“Autoimmunity is a big challenge for healthcare, as is COVID-19. Autoimmunity affects 20% of the American population and includes over 100 disease conditions, of which Type 1 Diabetes can be considered just the tip of the iceberg. What we are learning is that there may be a common thread and risk factors that can predispose to both an autoimmune disease or to a severe reaction following viral infections, such as SARS-CoV-2,” he said.
The DRI Cell Transplant Center is planning to create a large repository of mesenchymal stem cells that are ready to use and can be distributed to hospitals and centers in North America, he said.
“These could be used not only for COVID-19 but also for clinical trials to treat autoimmune diseases, like Type 1 Diabetes,” Dr. Ricordi said. “If we could infuse these cells at the onset of Type 1 Diabetes, we might be able to block progression of autoimmunity in newly diagnosed subjects, and progression of complications in patients affected by the disease long-term. We are planning such a trial specifically for diabetes nephropathy, a kidney disease that is one of the major causes of dialysis and kidney transplantation. We are also planning to do a study on umbilical cord mesenchymal stem cell transplantation in combination with pancreatic islets to see if you can modulate the immune response to an islet transplant locally.”
Funding by The Cure Alliance made launching the initial trial possible, while a $3 million grant from North America’s Building Trades Unions (NABTU) allowed Dr. Ricordi and colleagues to complete the clinical trial and expand research with mesenchymal stem cells.
“North America’s Building Trades Unions (NABTU) has been a major supporter of the Diabetes Research Institute since 1984, when they started a campaign to fund, and build, our state-of-the-art research and treatment facility. NABTU has continued to support our work through the years, including our mesenchymal stem cell research that helped lead the way to this clinical trial,” he said.

All the organizations funding the research are nonprofit entities, including the Barilla Group and Family, The Fondazione Silvio Tronchetti Provera, the Simkins Family Foundation and the Diabetes Research Institute Foundation. The National Center for Advancing Translational Sciences also provided funding.
 
Only, if we do end up creating a situation where the virus is able to evolve past the current vaccine, we're going to be right back to square one.
Perhaps but all the current crop are focused exclusively on the spike protein. More traditional forms of inactivated or attenuated vaccine will likely be more effective against these and future mutations by provoking a response to multiple proteins. It may be quicker to just cut out the old spike and insert the new one in some RNA mind.
 
Perhaps but all the current crop are focused exclusively on the spike protein. More traditional forms of inactivated or attenuated vaccine will likely be more effective against these and future mutations by provoking a response to multiple proteins. It may be quicker to just cut out the old spike and insert the new one in some RNA mind.
There are three vaccine candidates each of inactivated (Covaxin, BBIBP-CorV, CoronaVac) and at least one live attenuated (COVI-VAC), naturally targeting all proteins.
 
There are three vaccine candidates each of inactivated (Covaxin, BBIBP-CorV, CoronaVac) and at least one live attenuated (COVI-VAC), naturally targeting all proteins.
Yeah, I was aware of that hence not starting at square one.
 
Right. I hope i get some sensible answers here. Had a discussion with my 18year old neice yesterday. She is the main carer for her mum who is a vulnerable person (also goes to college or rather doesn't go atm..) Although she is young, fit and well because of her caring responsibilities she will be offered the vaccine sooner rather than later.

Her concern, which I couldn't definitively allay was the possibility of effects on future fertility. She wants to have the vaccine because of the risk to her mum specifically, but she's a young woman and wants kids at some point and I understand her concerns.

I m doing vaccination training this afternoon and tomorrow which may answer my question but wondered if any of our resident science nerds may be able to answer sooner?
 
The immune response from vaccines or natural invaders happens hundreds or thousands of times. If it affected fertility we wouldn't exist as a species. That's my non doctor response anyway.
 
Right. I hope i get some sensible answers here. Had a discussion with my 18year old neice yesterday. She is the main carer for her mum who is a vulnerable person (also goes to college or rather doesn't go atm..) Although she is young, fit and well because of her caring responsibilities she will be offered the vaccine sooner rather than later.

Her concern, which I couldn't definitively allay was the possibility of effects on future fertility. She wants to have the vaccine because of the risk to her mum specifically, but she's a young woman and wants kids at some point and I understand her concerns.

I m doing vaccination training this afternoon and tomorrow which may answer my question but wondered if any of our resident science nerds may be able to answer sooner?

I don't think that the vaccine training will address that concern.

TBH I think the totally honest answer is 'nobody knows' but the pragmatic one is that it's very likely there won't be a problem at all with that. Point out she's already had loads of vaccinations as well, as have millions of people all around the world, and no such issue with any other has come to light.
 
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I don't think that the vaccine training will address that concern.

TBH I think the totally honest answer is 'nobody knows' but the pragmatic one is that there won't be a problem at all with that. Point out she's already had loads of vaccinations as well, as have millions of people all around the world, and no such issue with any other has come to light.
Shes a sensible kid and she'll have the vaccine because of the risk to her mum but this is pretty much what I said. That there's no indication that this would be the case and given the way the vaccines work its unlikely but there's no proof as yet
Cheers LynnDoyleCooper
 
Right. I hope i get some sensible answers here. Had a discussion with my 18year old neice yesterday. She is the main carer for her mum who is a vulnerable person (also goes to college or rather doesn't go atm..) Although she is young, fit and well because of her caring responsibilities she will be offered the vaccine sooner rather than later.

Her concern, which I couldn't definitively allay was the possibility of effects on future fertility. She wants to have the vaccine because of the risk to her mum specifically, but she's a young woman and wants kids at some point and I understand her concerns.

I m doing vaccination training this afternoon and tomorrow which may answer my question but wondered if any of our resident science nerds may be able to answer sooner?

I don’t know if I count as a science nerd, but some thoughts on this:

The IC vaccine (which she is most likely to get I would have thought) is an adenovirus vectored subunit system vaccine [this means that an adenovirus is used to introduce code for some of the subunits of the coronavirus into our cells, which then express those units and the immune system gets trained against them]. This vaccination methodology has been developed and used for something like 15+ years, for a number of different therapies (HIV, malaria, some anti-tumour agents) and so is pretty well tested and there is no sign of any effect on fertility or germ-line cells (these are the cells in ones ovaries or testicles that produce the eggs or sperm - they are the 'pure' copies of your DNA as it were, and as such are strongly protected from interference) - and nor would there be expected to be (ie from what we understand of its mode of action and human biology).

The mRNA vaccines (which is what the other 2 in use at the moment are) are newer technology, and I think this may the first time they've been used in anger as it were, but the methodology has been in development for several years and undergone extensive animal model testing, which won't have revealed any effects on fertility (or they wouldn't be using it) - and again, the mode of action wouldn't be expected to do so [it's similar to the adenovirus vectored method, except that the code is introduced directly rather than using another virus to carry it in]. Given it's newer I would say that the uncertainty regarding the risks for these types of vaccine is higher than the vectored vaccine, but the actual risk is probably about the same - ie negligible.

Nothing is certain of course, and there could be unknown effects particular to these specific vaccines, so the risk is not actually zero - but I would say it is low enough to be considered zero in practice (as clearly do the medical regulatory authorities, or they wouldn't license them).

FWIW I have two teenage children (one boy one girl) and I would have no hesitation in getting them vaccinated with either vaccine on this basis (or any other) - I wouldn't even give the fertility question a second thought.
 
Thats very helpful prunus. I've just started the online vaccination training and that has also given me information in a form I can understand ( :oops: )and can translate into teenspeak.
Good. I feel much better equipped to put forward an informed point of view. I need to understand the science to be able to do that and my eyes glaze over sometimes at all the acronyms and stats!
 
A very general rule of thumb is that RNA vaccines and those using viral vectors are at the safer end of the vaccine spectrum. To again generalise they bring speed and safety to the table but are less efficacious than other types of vaccine.
 
Just saw a report on bbc news that two rheumatoid arthritis drugs have been shown in trials to save lives and improve recovery by dampening the immune response. They will be rolled out immediately for use in icu's. More good news from science :thumbs:
 
This nurse didnt get the result she and everyone else was hoping for:


'Bethan' - not her real name - said: "I feel a huge amount of guilt - the fact that I made my family unwell. It's heartbreaking. I feel deflated, angry and upset at how frontline workers are being treated."
Working on the NHS frontline, she was initially relieved to be offered the chance of a vaccine and despite difficulties getting an appointment, she received her first dose of the Pfizer-BioNtech vaccine last month.
"It gave me peace of mind. It made me feel safer and that I was doing the right thing for my family... but it gives a false sense of security," she said.
The nurse, from west Wales, said she was told it would take 10 days for the vaccine to offer some protection and reduce the risk of transmission.
However three weeks after the jab, she began to feel unwell and was "shocked" when she tested positive for coronavirus.
 
It's going to be a problem, right? People getting the vaccine and then changing their behaviour under mistaken beliefs about what it means in terms of reduction of risk.
 
This nurse didnt get the result she and everyone else was hoping for:


If she did actually say she's 'angry and heartbroken' then sorry, but she's a fucking idiot, doubly so if she started behaving differently after having the vaccine. It doesn't provide 100% protection and she should know that.
 
Sigh. We are literally going to have to spend all year explaining to people who don't like thinking about numbers that 5% of a big number can still be quite a big number aren't we? And that the 95% figure is for people not getting it seriously. This is going to get very tedious.

Incidentally that reporting by the BBC is fucking irresponsible. They need to explain that plenty of vaccinated people will get the virus, it's not something to be 'angry' about, and they need to explain that until we have BOTH high vaccine uptake AND low prevalence in the population, people should not be changing their behaviour.
 
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And that the 95% figure is for people not getting it seriously.
No. ~95% (Pfizer) is for people not developing any symptoms (AstraZeneca may be as low as ~70%, or lower, though clearly depends on the degree the government is determined to undermine their own vaccination programme).
~5% (~30%) will be for people experiencing symptoms but not developing disease so serious that they require hospitalisation.
 
No. ~95% (Pfizer) is for people not developing any symptoms (AstraZeneca may be as low as ~70%, or lower, though clearly depends on the degree the government is determined to undermine their own vaccination programme).
~5% (~30%) will be for people experiencing symptoms but not developing disease so serious that they require hospitalisation.
Ah sorry, you're right, was getting confused. Memory failure rather than maths failure...
 
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