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Could there be a vaccine that stops transmission?

23 replies

fluffyugg · 23/01/2021 10:19

I don't know much about vaccines but wouldn't a vaccine that stops you getting it at all be a better outcome? Is this something that will be developed? Just wondering as obviously current spreading and new mutations are going to keep us in lockdown for some time. If vaccinated people can still spread it then new strains are always going to be a potential problem?

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Zogstart · 23/01/2021 11:08

We already have two vaccines that might stop transmission - Pfizer and Oxford. The trials can’t prove this as how can you prove whether a person passed it on to anyone. Just because it’s not been proven doesn’t mean they definitely don’t stop transmission.

fluffyugg · 23/01/2021 11:19

@Zogstart yes I hope they do stop transmission but all the talk at the moment is assuming they won't. Just wondered if there is the possibility of developing a vaccine solely for that purpose? ie stopping transmission

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raviolidreaming · 23/01/2021 11:22

I don't know much about vaccines but wouldn't a vaccine that stops you getting it at all be a better outcome?

Do you honestly think the research scientists etc etc haven't thought of this?!

ProudAuntie76 · 23/01/2021 11:24

There’s pretty decent emerging research that the Pfizer Biontech’s second dose reduces transmission.

The third stage of the clinical trials of the AstraZeneca suggested it MAY stop transmission. Everyone in the this trial also had two doses of course.

Too early to say for definite.

PurpleDaisies · 23/01/2021 11:25

[quote fluffyugg]@Zogstart yes I hope they do stop transmission but all the talk at the moment is assuming they won't. Just wondered if there is the possibility of developing a vaccine solely for that purpose? ie stopping transmission[/quote]
Confused

I really don’t know where you’re coming from here. What would be the point of a vaccine that stopped transmission but didn’t prevent severe illness or death?

As others have said, the aim would always be to minimise transmission and protect individuals. The hope is these vaccines will do that.

Cookerhood · 23/01/2021 11:26

I think most experts think it should prevent transmission, they just can't say so. No-one suggests that we pass on flu, measles etc after vaccination & I can't see why this would be different, unless it's something to do with the way the infection occurs and how the vaccine works, but I have no idea (& I used to work in this sort of area but just don't know enough of the details!).

Busygoingblah · 23/01/2021 11:31

No vaccine is 100% effective. They rely on lots of people having them. The more people we can vaccinate the harder it will be for covid to spread and then cases will reduce hugely.

As PPs have said it’s very hard to prove a vaccine reduces transmission in the time scientists have had.

They test vaccines by giving a real vaccine to a certain number of people and a ‘fake’ vaccine to a certain number of people. The two groups don’t know which they’ve had so their behaviour should be the same. Scientists then measure illness and hospitalisation and compare the two groups. That tells us how effective a vaccine is.

Have a think about the logistics and how you would measure the effectiveness in stopping transmission in a similar way without purposefully exposing people to covid?

fluffyugg · 23/01/2021 11:43

@raviolidreaming nope, didn't say that. Was just wondering if anyone who knew anything about this area knew if this was something that would be following on from the current vaccines we have, that's all.

Like others have said, most other vaccines do stop transmission so was thinking that this one hopefully does too but the talk of lockdown/restrictions remaining after vaccinations made me wonder.

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fluffyugg · 23/01/2021 11:43

@ProudAuntie76 thanks for that

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fluffyugg · 23/01/2021 11:45

@PurpleDaisies I suppose the point of that would be it eventually eradicates the virus? Also greatly reduces the problem of mutations? As they occur when transmission is high

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ProudAuntie76 · 23/01/2021 11:53

www.scientificamerican.com/article/vaccines-need-not-completely-stop-covid-transmission-to-curb-the-pandemic1/

You might find this article informative.

It’s not true that most other vaccinations completely prevent any transmission of illness.

InterfectoremVulpes · 23/01/2021 11:59

My understanding is that with any vaccine, stopping transmission is just a happy side effect of a vaccine fulfilling its primary function - priming a person's immune system to recognise and overcome a virus before it has a chance to make someone ill.

The reduction in transmission stems from a person not having enough of the virus to pass it on as their immune system has kicked in but it is not the intended purpose of the vaccine itself.

fluffyugg · 23/01/2021 12:04

@ProudAuntie76 that's an interesting article, thanks. It looks as though even if these vaccines don't stop transmission then the prevalence will reduce over the coming years anyway

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Motorina · 23/01/2021 12:11

As others have said, the likelyhood is that the vaccine will stop or reduce transmission. We simply don't know yet.

It would be rare for a vaccine not to do so, but there are examples of this. The reason for this is that our immune system is really a series of interlocking systems. There are innate systems - our skin and stomach acids, and immune cells that attack anything that looks alien. And adaptive systems, which learn how to respond to threats, and which are what vaccines trigger. But the adaptive system in itself divides down into compartments. The mucosal immune system (the system in the linings of the mouth, nose and gut) in particular is slightly seperate from the central system.

Which compartment you trigger depends on where you get an immune response. If the vaccine (or disease) is swallowed, you get good immunity in the bowels. If it's squirted up the nose, you get good immunity in the nose, throat and lungs. If you inject it, you get good internal immunity.

There is some overlap between the chunks of the immune system, but an exposure to one section of the immune system won't necessarily trigger much of a response in the others. In particular, injected vaccines don't tend to trigger much of a response in the mucosal or gut immune systems.

This is why the inactivated polio vaccine doesn't stop transmission. Polio is mostly a disease which lives in the gut - it transmits when the faeces of an infected person contaminates the food or water that someone else drinks or eats. And it does no great harm there. People get ill with polio when the organism leaves their gut and invades their nervous system. The inactivated polio vaccine is an injection, which creates an immune response carried by the blood. Those defences are triggered when the organism tries to spread into someone from their gut. It works really well to stops people from getting sick. But it doesn't attack the organism when it is living in the gut, so it doesn't stop people from carrying or transmitting the virus. The oral polio vaccine, on the other hand, is swallowed and creates a good immune response in the gut and so does stop the disease from spreading.

Covid enters the body and lives in the linings of the nose and throat. You only get really ill if it enters into your body from there. We know the vaccine is really good at stopping that. But the nose linings are mucosal immunity - a different system - and we don't yet know to what extent the covid vaccine injection will trigger immunity there. The virus may continue to reproduce in and spread from the nose/throat. The likelyhood is it will reduce the amount of virus hanging around in the nose and being coughed or sneezed out, and so will reduce spread, but this remains an unknown.

As with everything, more research needed.

(And as with everything I'm open to criticism/correction from the people who understand this stuff much better than I.)

Motorina · 23/01/2021 12:15

(more at www.nature.com/articles/nm1213 but it's moderately heavy going.)

fluffyugg · 23/01/2021 12:16

@Motorina really interesting, thanks 😊

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Dilbertian · 23/01/2021 12:26

This is why the inactivated polio vaccine doesn't stop transmission. Polio is mostly a disease which lives in the gut - it transmits when the faeces of an infected person contaminates the food or water that someone else drinks or eats. And it does no great harm there. People get ill with polio when the organism leaves their gut and invades their nervous system. The inactivated polio vaccine is an injection, which creates an immune response carried by the blood. Those defences are triggered when the organism tries to spread into someone from their gut. It works really well to stops people from getting sick. But it doesn't attack the organism when it is living in the gut, so it doesn't stop people from carrying or transmitting the virus. The oral polio vaccine, on the other hand, is swallowed and creates a good immune response in the gut and so does stop the disease from spreading.

So why was the polio vaccine changed from an oral vaccine to an injected one? Wouldn't the oral one have been better because of the double-whammy: protecting both the infected individual and their community?

Motorina · 23/01/2021 12:31

@Dilbertian pros and cons. Largely that the OPV can cause polio symptoms (rare) and, as it's a live-attenuated virus that reproduces before immunity kicks in, can re-mutate back to a more virulent form.

Lots at polioeradication.org/polio-today/polio-prevention/the-vaccines/

Dilbertian · 23/01/2021 13:14

Thanks Motorina Smile

Dilbertian · 23/01/2021 13:15

Very interesting and informative link.

Cookerhood · 23/01/2021 15:31

Great explanations Motoring, thank you.

titchy · 23/01/2021 15:41

Interesting Motorina. Would it therefore make sense to develop a vaccine that is inhaled, similar to the flu one small kids get?

PinkSparklyPussyCat · 23/01/2021 15:42

On the subject of nasal vaccines, why can't adults have the nasal flu one?

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