[conspire] 2 Virology professors explain why bivalent vaccine won't stop transmission

[Les Faby]

2 shots and a booster. They do not make the original booster so your new
booster has to be the bivalent one.



On Fri, Nov 18, 2022, 10:15 AM paulz at ieee.org <paulz at ieee.org> wrote:

> San Mateo Public Health refers to CDC for vaccination information.
> https://www.cdc.gov/coronavirus/2019-ncov/vaccines/stay-up-to-date.html
>
> For 18 and older, CDC:
>   2 doses of Pfizer-BioNTech 3 to 8 weeks apart
>   or
>   2 doses of Moderna 4 to 8 weeks apart
>
> The 2 shots followed 2 months later by a bivalent booster of either Pfizer
> or Moderna.  It's OK to have the other brand of booster.
>
>
> On Thursday, November 17, 2022 at 04:49:01 PM PST, Rick Moen <
> rick at linuxmafia.com> wrote:
>
>
> Quoting Les Faby (lfaby2018 at gmail.com):
>
> > Thanks for responding. The only thing important in requiring a vaccine is
> > ***transmission***
>
> See, this stuff is tricky, Les.
>
> I try to write my mailing list postings quite carefully, even when
> rushed, so as to be comprehensive and fair, and also trying to be
> thoughtful -- which is difficult indeed when writing extemporaneously,
> so one tends to get all the spontaneity of oral speech with all the
> you-said-it-on-the-record problems of written speech.  Anyhow, I'm
> rushed again at the moment, so apologies in advance for not being able
> to take a _slow, careful_ time on this one.
>
> Remember I said there were a number of questions a person worried about
> an infectious disease could worry about, and that it's crucial in
> science to pick the correct question to investigate?  Here were the
> person-worried-about-infection-disease questions I listed:
>
> "Will X make it less likely to become infected if exposed?"
> "Will X affect my likelihood of symptomatic disease?"
> "Will X affect my period of infectiousness to others?"
> "Will X affect my probable time to recovery?"
>
> (I should have added "Will X affect my likelihood of severe disease?",
> but the above was the list.)
>
> Ask yourself what we mean when we speak of risk of "transmission".
>
> We mean the risk of a hypothetical person who is _infected_ being the
> vector for transmission to another person.  So, we're talking about two
> things in sequence:  1. Person A contracts the pathogen, which has
> likelihood P1.  2.  Person A then infects person B, which has likelihood
> P2.  The composite likelihood, from the viewpoint of justifiably peeved
> person B, is P1 * P2.
>
> But here's the thing, Les:  You seem to be asserting a view about
> probability P2.  (Remember, because of the high, high incidence of
> asymptomatic infections, one must consider anyone a potential vector.)
>
> And, actually, it's somewhat more complicated.  Again, a framing
> question:  What is _my_ objective?  My objective, as part of
> Scandinavian standards of hospitality, is to assure Guest B that I've
> done what I can to reasonably eliminate risks from the statistical
> average Guest A.  But is that the multiplicative product of P1 and P2?
> No.  The actual composite risk to Guest B starts with that
> multiplication, but then logically it also matters whether factor X
> (where X is, say, some particular booster) makes the average period of
> viral shedding longer, and/or the average viral titer of someone
> shedding.
>
> Now, as my 1980s boss David Carroll used to say when we started to
> diagnose a technical problem, "What do we know?"  As Dr. Offit was
> quick to point out, we didn't have, at the time of adopting the
> bivalent booster, clinical data proving that it was better than the
> earlier booster against current strains -- but that doesn't mean we knew
> nothing about that.  There are sound scientific reasons to think that
> the second portion, which IIRC is mRNA coding for the Omicron BA.2
> "spike" protein, does successfully train B memory cells in the patient's
> adaptive immune system in a way that _does_ create better-targeted
> neutralising antibodies, both during the 3 month immediate horizon and,
> if needed to be re-generated after the infamous antibody fade, will
> be ramped up.
>
> Dr. Offit is correct that we also need clinical confirmation that this
> actually happens as expected.  A couple of weeks ago, I had in hand
> preprints that appeared to show that.  I don't have them now.
>
> > Why I asked about transmission 2 months after vaccination:
> > There are 12 months in a year and if it is only even somewhat effective
> > less than 17% of the time then an annual booster is close to useless.
>
> Non sequitur.  This assumes, for starters, that the only point of a
> booster is to supercharge over a 3 month (not 2, IIRC) period a set of
> neutralising antibodies, which is _not_ true.  If, as expected, a useful
> revised recipe for memory B cells gets encoded into the adaptive immune
> system, then that is a significant advantage.
>
> Some people say "But that's useless because without a full stock of
> neutralising antibodies, you will get ill while your memory B cells
> start cranking out a fresh set of neutralising antibodies."  Again,
> this is non-sequitur argumentation.  The advantage of having the
> _recipe_ for making appropriate neutralising antibodies has value
> _particularly_ to the Guest A, but there are very probably also
> benefits to Guest B.  Why?  There is, to the best of my understanding,
> based on general principles and past, similar matters, reasonable
> expectation that Guest A will tend to have a shorter period of viral
> shedding than without variable X (in this case, the bivalent vaccine).
> Again, no, last I heard, we don't have solid clinical data on this,
> because (as usual) not enough time has passed.  As usual, intelligent
> people are obliged to do rational planning as best they can using what
> data _are_ available.
>
> > Also, I read Katherine Wu's paper. Good choice of authors, BTW. She is
> > recommending the vaccine because it keeps you from getting seriously
> > ill. She does NOT say it will keep you from transmitting the disease
> > or you should take it for that purpose.
>
> That question is, as I'm sure you saw, simply not the focus of the
> referenced article at all -- for starters.  Ms. Wu has written a lot, a
> lot, a lot, on the subject, more than I have any intention of delving
> through at this moment.  As I said, I'm rushed, for which, I'm sorry,
> but that's life.
>
> The referenced article's gravamen was simply that our language should
> now change from "has had N doses" to "is up to date for the season" --
> and why.
>
> In the current piece, Wu doesn't flog the previously done-to-death
> rational for exactly what benefits one gets from having booster N --
> which makes me disappointed in seeing you say "Wu doesn't say in that
> article that you should get a certain booster for XYZ reason".  No,
> she doesn't -- in that it's not an article trotting out reasons.
>
> Nor is Ms. Wu's article's focus on "Are you a danger to others if you
> haven't done XYZ?"  Instead, it contains layman-accessible advice
> about how to judge, going forward, "how long it’s been since your last
> immunity-conferring event" (to quote the article) and when it might be
> prudent to schedule the currently appropriate booster-du-jour.
>
> Wu quotes several credible parties (fortunately _not_ just Unc'a Joe
> Biden, who is not known for his epidemiological genius) as saying that
> we're probably headed towards an annual booster every fall for the
> foreseeable future.  Because, as you say in your helpful and kindly
> effort to teach grandma to suck eggs ;-> , SARS-CoV-2 has evolved --
> and, I will add as long as we're piling on tedious platitudes, is
> continuing to do so.
>
> > Which of your papers, if any, say it has a big effect on you
> > transmitting the virus?
>
> Talk to me after you have read the above about the problems with your
> overly reductionist probabilistic concept of "transmitting" in the
> context of my hospitality.  Because otherwise we are not communicating,
> and you are just talking at me.
>
> Also, I currently have no time to go re-find science papers for you.
> Maybe after work, Deirdre will be interested in that.
>
>
> > The Other people on the committee disagreeing with Dr. Offit are NOT
> saying
> > it will keep you from infection because they know that is an impossible
> > standard.
>
> Wrong question.
>
> As I said, in science, one must to be very careful that you are
> investigating the correct question.
>
> Which is also true in computer hardware and software debugging.
>
> At this point, I'm sorry, but I'm not just out of time on this, but have
> just gobbled up the second overtime.
>
>
>
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