Are vaccines the light at the end of the tunnel?

[markeb]

40 minutes ago, Doris&Nereus said:

BP99, you say that the mAb will not kill the current infection.  So they just drop off , and the same infection just comes back after the 4 months or so. I thought that the person who got the treatment could get another infection, but not the same one would get back into the cells. That is why I was hoping for mAbs to work on sick people and those at very high risk until we can get the vaccine to work. Also, there are some people who have poor immune response to vaccines, and they could benefit.

 

You can at least theoretically use mAbs a couple of ways. Using them in high risk settings prior to infection is essentially the same as the old days of using Gamma Globulin as protection against hepatitis A. As long as it's on board and can bind the virus, it will provide some protection. They'll have a limited lifespan in the body, and unlike an active immunization, you won't make more. It's hard to say where that would be most useful; maybe an outbreak in a high risk population, or preprocedure? It's hard to imagine more widespread use.

 

For treatment, the big challenge with most respiratory viruses is by the time you know what you've got, they've done most of their damage, and you're now fighting the body's own immune response. That's why most folks advocate for early use of mAb or convalescent serum, which sounds counterintuitive, and why the concerns that using mAbs later in the disease won't stop the current disease (they'll bind the virus, but the inflammatory response to dead and infected cells is causing the pathology). And I think that's what BP99 is saying.

 

In theory, if there's enough virus (or SPIKE in this case), someone infected with the virus and treated, either before or after infection, with a mAb should mount their own immune response, which would last a lot longer.

 

As with most things with this virus (and immunology!), it's complicated.

 

 

[BP99]

36 minutes ago, Doris&Nereus said:

BP99, you say that the mAb will not kill the current infection.  So they just drop off , and the same infection just comes back after the 4 months or so. I thought that the person who got the treatment could get another infection, but not the same one would get back into the cells. That is why I was hoping for mAbs to work on sick people and those at very high risk until we can get the vaccine to work. Also, there are some people who have poor immune response to vaccines, and they could benefit.

The mAb WILL remove and kill the virus in infected people. This is a "treatment".

If given in high enough doses (and long enough) it should theoretically cure most

infected people. Although this has to be tested. This also greatly depends

on how much damage the virus has already caused prior to using the mAbs.

There are treatments for other infections using mAb that are approved. 

However, if given to people that are NOT infected it will only prevent getting the

virus for a short term. This is a "preventative" treatment. A vaccine is

also a  "preventative" method that is usually better/cheaper/longer lasting method

 without giving the virus a chance to cause damage.

 

[BP99]

25 minutes ago, markeb said:

 

You can at least theoretically use mAbs a couple of ways. Using them in high risk settings prior to infection is essentially the same as the old days of using Gamma Globulin as protection against hepatitis A. As long as it's on board and can bind the virus, it will provide some protection. They'll have a limited lifespan in the body, and unlike an active immunization, you won't make more. It's hard to say where that would be most useful; maybe an outbreak in a high risk population, or preprocedure? It's hard to imagine more widespread use.

 

For treatment, the big challenge with most respiratory viruses is by the time you know what you've got, they've done most of their damage, and you're now fighting the body's own immune response. That's why most folks advocate for early use of mAb or convalescent serum, which sounds counterintuitive, and why the concerns that using mAbs later in the disease won't stop the current disease (they'll bind the virus, but the inflammatory response to dead and infected cells is causing the pathology). And I think that's what BP99 is saying.

 

In theory, if there's enough virus (or SPIKE in this case), someone infected with the virus and treated, either before or after infection, with a mAb should mount their own immune response, which would last a lot longer.

 

As with most things with this virus (and immunology!), it's complicated.

 

 

Yes, you are correct with what I was trying to explain earlier. I was actually 

typing my response when your reply was posted. Sorry for the repeat info.

There are MANY FDA approve mAbs but mostly for cancer treatments.

There are a few against other diseases. To make enough mAbs for

a "preventable" world wide pandemic would be excessively expensive. 

[K.T.B.]

18 hours ago, Ken the cruiser said:

I can't seem to find where he said this in the article you referenced. 

 

It's an assumption.  And you know what they say when you assume...

[Marla07860]

On 9/2/2020 at 7:52 PM, Babr said:

Is anyone else uncomfortable or questioning the timing of this? November 1? Really?

I say don't rush it as someone with Lupus I want something safe or something possibly like flu vaccine at least.

[mimbecky]

20 hours ago, npcl said:

Pfizer is expanding their trial to include down to age 16, and some additional pre existing conditions.

 

I also just read they are expanding Phase 3 to 44,000 subjects.

[TeeRick]

We are just confusing some folks (mAb vs vaccine).  I will try to summarize:

 

- An effective vaccine is the preferred preventative approach worldwide.  One that is cheap, easy to manufacture (100's of millions of doses) and distribute.  And simple, quick inoculation to healthy people of all ages (at a pharmacy or clinic).  Life long immunity but might need booster doses maybe even once a year (like influenza vaccine).

 

- The mAb drugs as all drugs are used primarily for therapy.  A mAB against a COVID protein (like SPIKE) might help with a current infection in an individual. Remains to be seen.  It might possibly be used as a temporary short lived preventative approach but this is in theory at this stage.  It would not last more than a few months at best.  The body will not make more.  One and done. The mAb is very expensive, not easy to manufacture or distribute for widespread use.  Needs to be administered in a hospital or clinic setting by iv drip. 

 

- No real comparison using a vaccine vs. a mAb for worldwide prevention.  Only a true vaccine will suffice.

[Ken the cruiser]

9 minutes ago, mimbecky said:

 

I also just read they are expanding Phase 3 to 44,000 subjects.

I just found this article regarding this development - https://www.ibtimes.com/pfizer-has-covid-19-vaccine-production-says-rejecting-federal-funding-gave-scientists-3045017

[Homosassa]

55 minutes ago, TeeRick said:

 

 

- The mAb drugs as all drugs are used primarily for therapy.  A mAB against a COVID protein (like SPIKE) might help with a current infection in an individual. Remains to be seen.  It might possibly be used as a temporary short lived preventative approach but this is in theory at this stage.  It would not last more than a few months at best.  The body will not make more.  One and done. The mAb is very expensive, not easy to manufacture or distribute for widespread use.  Needs to be administered in a hospital or clinic setting by iv drip. 

 

 

Not all mAb drugs are short lived in the body.

I know I was given one as part of my treatment for breast cancer. It is known to take 4-5 years to clear the body. It was only after that point that recurrence risk when back to the hormonal status of the cancer.

[cangelmd]

Not sure who,I’m responding to because I’ve been MIA the last week, and now we’re having a hurricane - 2020 just keeps getting better!

 

 I never pictured monoclonal as anything but a therapy for very ill hospitalized patients - think of it as a concentrated version of convalescent plasma, but instead of giving a person a cocktail of whatever antibodies another individual produced in response to the virus, you are giving the sick person a very specific antibody that will have an effect on the virus OR on the immune response.

You can’t exactly compare monoclonal Abs used in different diseases or extrapolate, because while they each bind to a specific protein, what happens after that step varies depending on type protein is bound and what the mechanism of disease is. I think that would also affect the duration of the effect that the antibody (drug in this case) is trying to produce.

 

 

[BP99]

3 hours ago, cangelmd said:

Not sure who,I’m responding to because I’ve been MIA the last week, and now we’re having a hurricane - 2020 just keeps getting better!

 

 I never pictured monoclonal as anything but a therapy for very ill hospitalized patients - think of it as a concentrated version of convalescent plasma, but instead of giving a person a cocktail of whatever antibodies another individual produced in response to the virus, you are giving the sick person a very specific antibody that will have an effect on the virus OR on the immune response.

You can’t exactly compare monoclonal Abs used in different diseases or extrapolate, because while they each bind to a specific protein, what happens after that step varies depending on type protein is bound and what the mechanism of disease is. I think that would also affect the duration of the effect that the antibody (drug in this case) is trying to produce.

 

 

Hi,

Normally mAb's when given to people last in high enough levels for 1-4 weeks.

However by altering them (FC region, glycosylation, combing them with

carriers etc) can increase their half life. AstraZeneca reported that they are

planing a Phase 1 study with their mAb that  their modified antibody

that "should be" protective for 6 months (see below). Also a review of mAbs.

https://www.contagionlive.com

August 25, 2020

AstraZeneca Begins Phase 1 Trial for Monoclonal Antibody Combination for COVID-19

AstraZeneca announced this morning it has started its phase 1 clinical trial for AZD7442, its investigational therapy which is in development for the prevention and treatment of coronavirus 2019 (COVID-19).

This therapeutic could afford at least 6 months of protection from COVID-19, according to a statement released by the company.

 

June 15, 2020

Monoclonal Antibodies for Prevention and Treatment of COVID-19

Mary Marovich, MD¹; John R. Mascola, MD¹; Myron S. Cohen, MD²

Author Affiliations Article Information

JAMA. 2020;324(2):131-132. doi:10.1001/jama.2020.10245

[Ken the cruiser]

Always enjoy reading good news about the development of the COVID vaccine. 

 

https://www.usatoday.com/story/news/health/2020/09/15/covid-19-vaccine-pfizer-positive-update/5808960002

[K.T.B.]

41 minutes ago, Ken the cruiser said:

Always enjoy reading good news about the development of the COVID vaccine. 

 

https://www.usatoday.com/story/news/health/2020/09/15/covid-19-vaccine-pfizer-positive-update/5808960002

 

Some real good news.

 

IF everything plays out as the article says, there's a very good possibility that by 1st quarter of 2021 that vaccine with be available.

[npcl]

Lilly just released some information on its MAB trial. While its medium dose met endpoints,  the high and low dose did not.

 

The results do not seem to be a game changer. the article says that it appears to reduce hospitalizations in new patients with mild to moderate symptoms.

 

Article is from CNBC. Am traveling and unable to post link with the device I am using.

[Ken the cruiser]

23 minutes ago, npcl said:

Lilly just released some information on its MAB trial. While its medium dose met endpoints,  the high and low dose did not.

 

The results do not seem to be a game changer. the article says that it appears to reduce hospitalizations in new patients with mild to moderate symptoms.

 

Article is from CNBC. Am traveling and unable to post link with the device I am using.

I believe this is the link you are referring to.

 

https://www.cnbc.com/video/2020/09/16/eli-lilly-covid-19-phase-2-antibody-drug-trial.html

[npcl]

1 hour ago, Ken the cruiser said:

I believe this is the link you are referring to.

 

https://www.cnbc.com/video/2020/09/16/eli-lilly-covid-19-phase-2-antibody-drug-trial.html

related there is a more detailed article out there also from cnbc linked from google news

[Ken the cruiser]

8 minutes ago, npcl said:

related there is a more detailed article out there also from cnbc linked from google news

Can't find that one, but here's a more in-depth one from PR Newswire.

 

https://www.prnewswire.com/news-releases/lilly-announces-proof-of-concept-data-for-neutralizing-antibody-ly-cov555-in-the-covid-19-outpatient-setting-301131785.html

[ECCruise]

CDC's Redfield just testified today that he expects to have full availability of vaccine in the 3rd Quarter, 2021, even though there may be some very limited availability at the very end of this year.

 

He also said that, in his opinion, face coverings are more effective than vaccines, where the efficacy will likely be in the the 70% range, e.g.  Face masks, when worn properly and by all, have a higher efficacy than that. 

[Porky55]

CDC's Redfield:

He also said that, in his opinion, face coverings are more effective than vaccines, where the efficacy will likely be in the the 70% range, e.g.  Face masks, when worn properly and by all, have a higher efficacy than that. 

 

There is the 70% efficacy in HIS comment:

 

Face masks - “when worn properly and by all”.

 

This would NEVER happen IMHO, people just won’t wear face masks properly, or at all. 🧐

[ECCruise]

21 minutes ago, Porky55 said:

 

There is the 70% efficacy in HIS comment:

 

Face masks - “when worn properly and by all”.

 

This would NEVER happen IMHO, people just won’t wear face masks properly, or at all. 🧐

That's why we will still be battling this virus months fro.m now.  Ignorant selfish people. 

[Crazy planning mom]

So, the CDC director said it will take 6-9 months after it is approved before it can be widely available.  If they are already working on production, why does it take that long?  So, if it’s approved in November which is optimistic, it will be May at the earliest or as late as August before it’s widely available.
https://www.npr.org/sections/coronavirus-live-updates/2020/09/16/913560563/cdc-director-says-covid-vaccine-likely-wont-be-widely-available-until-next-year?utm_medium=social&utm_campaign=npr&utm_term=nprnews&utm_source=facebook.com&fbclid=IwAR0fk1PfqJRK8LFZy_JLALL3P4zu882RwcYcx5E0RDBQZV45L19mInrJQVs&fbclid=IwAR0ygkE1RT7X4RlnjvuuANKLRbF4tL_yNpLWs99AB9HvmBREmhfcjTSFrO0

[UnorigionalName]

31 minutes ago, Crazy planning mom said:

So, the CDC director said it will take 6-9 months after it is approved before it can be widely available.  If they are already working on production, why does it take that long?  So, if it’s approved in November which is optimistic, it will be May at the earliest or as late as August before it’s widely available.
https://www.npr.org/sections/coronavirus-live-updates/2020/09/16/913560563/cdc-director-says-covid-vaccine-likely-wont-be-widely-available-until-next-year?utm_medium=social&utm_campaign=npr&utm_term=nprnews&utm_source=facebook.com&fbclid=IwAR0fk1PfqJRK8LFZy_JLALL3P4zu882RwcYcx5E0RDBQZV45L19mInrJQVs&fbclid=IwAR0ygkE1RT7X4RlnjvuuANKLRbF4tL_yNpLWs99AB9HvmBREmhfcjTSFrO0

 

Because there are 7.6 billion people in the world who may benefit from the vaccine.  Who should get it first?

 

The WHO says those at highest risk of dying.

 

The US says whoever paid for it.

 

The timing will eventually will come down to which specific vaccine candidate(s) gets approved

[Crazy planning mom]

10 minutes ago, UnorigionalName said:

 

Because there are 7.6 billion people in the world who may benefit from the vaccine.  Who should get it first?

 

The WHO says those at highest risk of dying.

 

The US says whoever paid for it.

 

The timing will eventually will come down to which specific vaccine candidate(s) gets approved

 

10 minutes ago, UnorigionalName said:

 

Because there are 7.6 billion people in the world who may benefit from the vaccine.  Who should get it first?

 

The WHO says those at highest risk of dying.

 

The US says whoever paid for it.

 

The timing will eventually will come down to which specific vaccine candidate(s) gets approved

Guess, I am just impatient.

[Oville]

48 minutes ago, Crazy planning mom said:

So, the CDC director said it will take 6-9 months after it is approved before it can be widely available.  If they are already working on production, why does it take that long?  So, if it’s approved in November which is optimistic, it will be May at the earliest or as late as August before it’s widely available.
https://www.npr.org/sections/coronavirus-live-updates/2020/09/16/913560563/cdc-director-says-covid-vaccine-likely-wont-be-widely-available-until-next-year?utm_medium=social&utm_campaign=npr&utm_term=nprnews&utm_source=facebook.com&fbclid=IwAR0fk1PfqJRK8LFZy_JLALL3P4zu882RwcYcx5E0RDBQZV45L19mInrJQVs&fbclid=IwAR0ygkE1RT7X4RlnjvuuANKLRbF4tL_yNpLWs99AB9HvmBREmhfcjTSFrO0

This has become such a political hot potato in the US it is mind-boggling.

[Crazy planning mom]

Just now, Oville said:

This has become such a political hot potato in the US it is mind-boggling.

Agree, that it’s crazy that everything is political here.  Not to sound like an old fart but I miss the old days.