We need to do better on vaccines!

I almost feel like, big picture, it might have been some bad luck that the mRNA vaccine initially worked so damn well.  It allowed us to relax and say, “problem solved” and lose our sense of urgency on better, next generation vaccines.  How do we not have a vaccine based on the Omicron spike yet– it’s been here since late November?  I get that mucosal vaccines are hard and we’re making progress, but what if we had pushed these at a warp speed pace– would they be here now?  Also, the spike protein mutates a lot.  Way back in 2020 I remember Michael Mina saying we needed whole virus vaccines.  Well, the Chinese made some and they sucked, relatively speaking.  But not all inactivated virus vaccines are the same.  India made one, Covaxin, and it’s awesome (better adjuvant, for those of you into such things).  Since it presents the whole virus, and not just the highly mutagenic spike, there’s much less immune escape.   Why the hell aren’t we scaling this up like mad here in the US?  Where’s the damn urgency?

Short version: there’s lots of good stuff in the works from Omicron specific vaccines, to multi-valent vaccines, to mucosal vaccines all of which should really, really help.  But we’re just taking our damn time (not to mention the whole kids under 5 issue!).  

So, yes, more urgency!  But, also very frustrating is “we’re doomed” takes like this which completely ignore all the progress we are (if too slowly) making:

A virus that shows no signs of disappearing, variants that are adept at dodging the body’s defenses, and waves of infections two, maybe three times a year — this may be the future of Covid-19, some scientists now fear.

The central problem is that the coronavirus has become more adept at reinfecting people. Already, those infected with the first Omicron variant are reporting second infections with the newer versions of the variant — BA.2 or BA2.12.1 in the United States, or BA.4 and BA.5 in South Africa.

Those people may go on to have third or fourth infections, even within this year, researchers said in interviews. And some small fraction may have symptoms that persist for months or years, a condition known as long Covid.

“It seems likely to me that that’s going to sort of be a long-term pattern,” said Juliet Pulliam, an epidemiologist at Stellenbosch University in South Africa.

“The virus is going to keep evolving,” she added. “And there are probably going to be a lot of people getting many, many reinfections throughout their lives.”…

This is not how it was supposed to be. Earlier in the pandemic, experts thought that immunity from vaccination or previous infection would forestall most reinfections.

The Omicron variant dashed those hopes. Unlike previous variants, Omicron and its many descendants seem to have evolved to partially dodge immunity. That leaves everyone — even those who have been vaccinated multiple times — vulnerable to multiple infections.

“If we manage it the way that we manage it now, then most people will get infected with it at least a couple of times a year,” said Kristian Andersen, a virologist at the Scripps Research Institute in San Diego. “I would be very surprised if that’s not how it’s going to play out.” …

Instead, the coronavirus is behaving more like four of its closely related cousins, which circulate and cause colds year round. While studying common-cold coronaviruses, “we saw people with multiple infections within the space of a year,” said Jeffrey Shaman, an epidemiologist at Columbia University in New York.

Okay, Kristian Andersen knows a helluva lot more than me, but…. that’s not how it’s going to play out! We’re not going to “manage it the way we manage it now.”  We’re going to manage it better.  Yes, the virus is evolving.  But so are we damnit!  We will have multi-valent vaccines.  We will have whole virus vaccines.  We may well have better therapeutics, too.  We wouldn’t get common colds multiple times per year if we had vaccines for them.  

So, yeah, short-term, too many re-infections and the whole thing isn’t great.  But the NYT (and Apoorva Mandilli really does love to play up the negatives in so many of her stories) does not need to spread this doomerism without even acknowledging the ongoing biotechnological improvements which will almost surely be coming online in the next year or two.  But, hey…. faster!