Surely a vaccine may never happen?

[tangochutney]

I keep hearing family/friends saying stuff along the lines of ‘well until they sort out the vaccine’ but I was thinking of all the diseases that have been around forever that they’ve not managed to vaccinate. I’m sure I read they’ve been working on making a vaccination for chlamydia for 50 years with zero success plus so so many other infections and viruses- surely they can’t just work on it for a while and magic one up in a certain timeframe like people seem to think.

[F1ftyCents]

If we don’t carry on with lockdown restrictions surely it will be carnage. Such a tiny percentage has had it so far.

[Sunshinegirl82]

This might speed things up...

www.google.co.uk/amp/s/amp.theguardian.com/science/2020/may/08/who-conditionally-backs-covid-19-vaccine-trials-that-infect-people

[ErrolTheDragon]

I am very confident that they will find a treatment

The time to develop and test a new treatment is probably at least as long as vaccine development (some of the reasons are exactly the same). Manufacture and distribution may or may not be easier depending on what sort of molecules the drugs are.

The hope for quicker treatments is from existing drugs for which the safety, side effects, manufacturing and distribution parameters are already known.

[Sometimenever100]

@F1ftyCents ‘this is it for years’ what is it for years? Lockdown? No international or domestic travel? Not seeing loved ones?

[F1ftyCents]

Sometime yes I suspect life is going to be inconvenient and different. Without a vaccine they’re not going to let international travel without the 2 week quarantine either side so who will travel? Would you risk hugging and seeing your elderly parents? How can there not be years of social distancing?

[MarshaBradyo]

Having heard a fair bit of positivity from scientists on R4 I’m not sure it won’t happen. We have a chance.

Although I do wonder about countries who eliminated it early if there isn’t one.

[Hearhoovesthinkzebras]

The time to develop and test a new treatment is probably at least as long as vaccine development (some of the reasons are exactly the same).

They aren't trialling new treatments though. They are trialling existing drugs which have already been in use so safety profile is known.

Losartan for example is used for hypertension but is a possible treatment.

Leronlimab is an HIV drug that has shown early promising results too.

These are both drugs that have already been tested, not new drugs.

[ErrolTheDragon]

If there isn't a vaccine then at some point I think everywhere will gradually adjust their expectations and accept that there are still deadly communicable diseases which will reduce life expectancy. Of course scientists will continue to work on ways to mitigate them and public health policies will adjust but life - and death - will go on.
(I'm 59 and DH has a few health conditions so I'm not saying that at all lightly)

[Sometimenever100]

Thing is though 50 is that international travel for example, will need to start up again in the not to distant future. Every first world country including ours literally relies on it to keep it 1st world. If there was no international travel for example for 2 or more years for example then the effects of that would be far worse than simply letting the virus lose from the beginning and killing hundreds of thousands. Entire countries would collapse, their health system, economy, housing, building, business and infrastructure would be severely affected.
I have no idea when I am going to see my vulnerable father but for many people, after a certain time, they will take their changes and see their kids and grandkids. Life is too short esp if you are over 70. Many over 70’s given the option of not seeing their family’s and living in isolation for years would rather take their chance

[F1ftyCents]

Life isn’t going to be the same. We don’t need air travel to the level we had it. Zoom meetings cut the need for face to face. Obviously freight is different and easier than transporting people.

The numbers involved and subsequent carnage that would happen from an “oh let’s just wing it we’re bored with this” mean the NHS simply won’t cope. The percentage who have had this tiny. The perecentage left yo get it is immense. Winging it isn’t going to happen.

It was a stark realisation last night. In my nativity I thought well just gradually get back to normal with a few deaths hear and there until a vaccine done time next year. I understand now that isn’t reality.

We will cope and adapt because we’ll have to but life is going to be very different.

[F1ftyCents]

here not hear

[MinteeFresh]

I really don't see why there is suddenly so much pessimism about a vaccine for this SARS Cov 2? I do see why it will take time, as a new vaccine, to get to the point where they can say the test subjects are immune, it works on different people and doesn't have unacceptably high side effects etc. I can see that we won't be able to rely on it until well into next year, even the next. But I don't see why we are thinking it is unlikely to ever be available.

I say that as someone with a very relevant scientific degree and an understanding of how this and other viruses work at the molecular level, albeit I don't work in that area now. Coronaviruses are well understood, in general, even though this is a novel one in humans. it is fully sequenced and the background mutation and replication rate of this virus, and coronaviruses in general, appears low, unlike HIV, and even Flu, which makes vaccine development much harder. They also have a genetic fidelity checking mechanism which means that replication is more accurate than in HIV and Flu viruses, which again makes it easier, in theory, to develop a vaccine against it. It is genetically extremely similar to SARS Cov 1, the coronavirus that caused the original SARS outbreak (remarkably so in my book, it is basically SARS Mark 2, make of that what you will... ) and also the MERS coronavirus that caused the respiratory illness in parts of the ME. Both of these viruses had vaccine development programs, albeit not fully realised, before this happened, so there will be usable data from those studies. So out of all the types of virus that could be causing a global pandemic, it is far from the worse type in terms of challenges to developing a reliable vaccine.

Also on the positive side, the mechanism of infection and how the virus gets into cells is very well understood, which lends itself to both ways of stimulating an immune response with a vaccine, and a target for drugs which could compete with the virus and block it's entry int cells. OK, the effects of the virus on the body and the immune response of the host is less well understood, because it's new, but we have data now from multiple countries going back 5 months and, lets face it, every doctor, scientist and government in the world actively studying it and reporting findings.

I know the actual vaccine development process is hard and takes a lot of time, but we are highly motivated, as a species, in developing one. It's all about money remember. This virus is effecting global economies and individual politician's re-election chances so the motivation, and more crucially the funding, is there. This was not the case for HIV and Malaria say, that have traditionally been hard to develop a vaccine against, where both the biology and the economics were against it. Governments and pharmaceutical companies don't pour funding and effort into diseases that kill poor people in Africa and particular demographics in their own countries that don't cross infect other people (you can't get HIV or Malaria by standing next to someone on the Tube). They are doing so for this disease which is fucking up their economies and individual careers paths. Cynical, but more likely to produce a usable vaccine imo.

[F1ftyCents]

There was this odd analogy on BBC last night from a quite negative US expert saying finding a vaccine for this disease was like something to do with an umbrella over the skin( I missed some of it as found it too depressing). Do you know what he was on about?

[F1ftyCents]

Also do you think they’ll make over 70s self isolate until a vaccine? There was nothing re over 79s yesterday.

[MinteeFresh]

No :)

The latest article about vaccination on the BBC www.bbc.co.uk/newsround/52629252 was updated today and doesn't mention an umbrella analogy, but seems fairly upbeat. I think fellow scientists think the challenge of developing a vaccine could be a lot worse, in terms of type of virus and its characteristics, as well.

In terms of the over 70s, I'd have thought they would be first in the queue for any vaccine roll out, after key workers, just like they are for the seasonal flu vaccination. But as you say, there's a long way to go until then. I think vulnerable over 70s are unfortunately faced with a very stark choice. Continue to stay at home as much as possible, or risk the very real possibility of dying from Covid 19 if you choose to go into cities, cinemas, restaurants etc if and when they reopen. My mother is this category and I know how hard it is. TBH though, I am female, 40s, pretty fit, no underlying conditions and I feel the same way myself. I'm not going anywhere outside the local area anytime soon unless I'm forced to.

[F1ftyCents]

So when will you visit your mum? My mum is at the bottom of the road, widowed, lonely, doesn’t drive, in 70s no hideous health conditions ( high blood pressure maybe). We’ve been Uber strict. She hasn’t been to a single shop and we’ve sat at opposite ends of her garden once. Wave at door couple of times a week and chat across drive.Not sure how long we can keep this up. She’s really fed up and in winter is going to be even more isolated.

[MinteeFresh]

I have no plans to visit her TBH and am not local. We do weekly family zoom calls. We are lucky that my younger sister moved in just before lockdown so is self-isolating with her and keeping her company. I don't know what will happen when she has to go back to work. My other siblings are local and visit with their young children and stand in the garden and talk through the window. I think that is ok for now. Once they go back to work and kids go back to school though I think it might get too risky. I don't know what will happen. I'd rather everything stays as it is for a few more weeks.

[PaddyF0dder]

I think people are pinning all hopes on a vaccine. Which we may never have (what other human coronavirus Have we got a vaccine for? None). On the other hand, look what science has achieved when directed at a single goal - the Manhattan project and the Apollo program spring to mind.

I also think people need to get out of the dichotomy of “vaccine or years of social distancing”. That’s a false dichotomy. It’s entirely feasibly for us to effectively eradicate this disease in some countries purely by medium-term social distancing.

Eradication may be a more realistic resolution than vaccination.

Either way, things won’t always be this bad.

[MinteeFresh]

I agree with you but I don't think this point is valid:

Which we may never have (what other human coronavirus Have we got a vaccine for? None).

The reason we didn't have a vaccine for a human coronavirus up until now was that there are only 7 of them:

229E (alpha coronavirus)
NL63 (alpha coronavirus)
OC43 (beta coronavirus)
HKU1 (beta coronavirus)
MERS-CoV (the beta coronavirus that causes Middle East Respiratory Syndrome, or MERS)
SARS-CoV (the beta coronavirus that causes severe acute respiratory syndrome, or SARS)
SARS-CoV-2 (the novel coronavirus that causes coronavirus disease 2019, or COVID-19)

4 of them cause no bother in humans other than mild colds, so no real reason to pour time, money and effort into developing a vaccine. MERS and SARS did (and should have been our wake up call), but were contained to a relatively small geographical area/number of people and didn't cause much if any economic harm or significant amount of deaths over the normal rate. SARS 1 was very virulent (high death rate for those infected) but not very transmissible (not very good at infecting cells as the spike protein did not bind with high affinity, and anyway it was too deadly, killing its host too quickly before it could be passed on).

Even then, there were attempts to develop a vaccine for SARS CoV 1 and MERS CoV, just not very big or well funded programs due to it not affecting many people/countries. That background research/effort was still going on when this hit.

There are lots of similar coronaviruses that affect animals, and many do have successful veterinary vaccines against them, because they kill lots of pets and so pharmaceutical companies could make a lot of money selling them and so there was an impetus to develop them. Immunity doesnt last long and they need to be reapplied every year, like flu viruses, so lots of long term potential to make money too.

So I don't think the fact that we didn't have a vaccine for a human coronavirus has any real bearing on how pessimistic, or not, we should be about developing on for SARS Cov 2 / Covid19. There were only 2 fairly obscure ones that really affected humans badly, this did kick off vaccine development programs which were largely abandoned as the economics didn't stack up as those virues blew themselves out by being too severe and not very good at infecting people. This one is much better at transmitting itself (spike protein binds with higher affinity), doesn't immediately kill the people it infects but has eventually managed to kill what is it nearly 300,000 people and rising, can transmit through some people, and is causing mass unemployment, global economic damage and stopping hospitals functioning for anything else but Covid 19 infections. It has infected 4 million plus people and killed hundreds of thousands. MERS CoV infected 2000 odd people and killed 800 odd. SARS CoV 1 infected 8000 odd people and killed 700 odd. Entirely different scale and impact.

So the fact we don't have one is again down to economics and impact and lack of drive to create on. Not because there is something fundamentally more difficult about making one for this virus.

[Delta1]

Thank you @MinteeFresh
Finally someone posting actual fact and (I am inferring) informed opinion, as opposed to their feelings and stuff they've googled.

[F1ftyCents]

Yes thank you Mintee, might sleep tonight.😂

[Sunshinegirl82]

@MinteeFresh

My understanding was that the Oxford teams vaccine is based on the one they developed for MERS which is undergoing clinical trials in the Middle East? That is why they were able to move so quickly. They had also done some research into developing a vaccine for “disease X” so something like this was on their radar. It’s not quite the leap it might at first appear.

[tangochutney]

If a vaccine/treatment isn’t going to be available for some time then I just don’t understand the ‘easing lockdown’ stages? How on Earth could pubs and restaurants be allowed to open in a couple of months?

[onemorepringle]

Because some people think we should all just get on with it, tango, and how dare anyone object.

[MinteeFresh]

Yes, exactly, as I posted before:
and also the MERS coronavirus that caused the respiratory illness in parts of the ME. Both of these viruses had vaccine development programs, albeit not fully realised, before this happened, so there will be usable data from those studies.

And as you say, a vaccine for MERS is almost through the vaccine development cycle and is looking promising: www.sciencedaily.com/releases/2020/04/200422132600.htm
Remember, much of vaccine development (and drug treatments) is done on computers these days with molecular modelling so all that software and algorithms that were developed for MERS in that program will be useful and being used in the programs for SARS CoV 2. All science builds on previously published papers and studies and I imagine many of the individual scientists will be the same or collaborating, in conjunction with pharmaceutical companies with access to all that data as well. Plus the vectors they use for vaccine development will be useful across the board now including this one (they just slot in a different bit of DNA/RNA from SARS Cov 2 or whatever virus instead of MERS CoV) and that lepfrogs you ahead in terms of human tolerance to the overall vaccine etc

So not as bleak as many were saying is my informed/educated guess. No guarantees of course but, as you say, we are not starting from scratch.