Coronavirus week 121: Vaccine losers — and new Platonic noble lies?

I remember that, more than a year ago, people more knowledgeable than me in fields like immunlogy and even more importantly, warned there would be vaccine losers as well as winners as the race narrowed and government funding and other support picked winners and losers.

Well, as the not-quite-omni but more widely targeted anti-Omicron boosters that Pfizer and Moderna roll out ...

Where's Johnson and Johnson? Ever since the US government paused the administration of the J and J adenovirus based vaccine in April 2021 over what were likely overstated concerns about blood clotting, it's scrambled to stay in the game. And, the FDA since then largely shunted J and J aside. As a result, it had no incentive to work on a COVID booster and instead turned its primary factory in Europe into working on a new experimental non-COVID vaccine.

As a result, we're left only with mRNA vaxxes for boosters. (For the first of a set of updates to this piece, now almost as long as the original, that talk about why this is an issue, go here, though the whole thing isn’t that long.)

Yes, Novavax exists, and it, like older antiviral vaccines against other viruses, directly targets a COVID spike protein. That said, right now, there's not official approval for a one-dose booster, nor do we have information yet on how Novavax performs against Omicron.

I'm not a nutter who believes mRNA vaxxes alter my RNA, or DNA.

I am someone who notes the relatively rapid falloff in mRNA protection. And, while J and J allegedly had less degree of protection, there's been no reports about the same degree of falloff.

I got it, the first chance I had in my rural area, both because it was a one-shot vax and because it was based on more traditional vaccine technology.

IF I were to want a booster (not old, but not young, either, and I've gotten none so far), I would go Novavax. It and the mRNA vaxxes both themselves have rare coronary side effects, it seems. But, Novavax is a more traditional technology, like J and J, and I venture it has a slower dropoff period than the mRNA vaxxes, like J and J. And, eventually, the more times you get shot, even if they remain very low, the more your chances of some side effect.

AstraZenica is also an adenovirus vax. It, like Johnson and Johnson, also known as Janssen from its Euro subsidiary, has also had very small numbers reported of people with clotting. But, it was never shelved, here or abroad. It and Novavax both have the down side of being two-dose vaxxes in non-booster situations. Other adenovirus vaxxes are Russia's Sputnix and a newer kid, Convidecia. It's one-shot; Sputnik is two. Convidecia, like Sinopharm, which uses dead virus, is Chinese.

There are other "viral vector vaccines" that use vector viruses besides an adenovirus.

And, there's the Indian nasal vaccine (China and others have similar in the pipeline) but based on attempts at nasal flu vaccines here in the US, William Haseltine is highly skeptical.

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Update: Another version of "vaccine loser" is going to be "we the people." Per recent reporting, new subvariants have popped up since the start of work on the bivalent booster that was originally billed as an omnivariant. It looks pretty lokely that the booster won't have full effect against them. That will likely further undermine public trust in mRNA vaxxes, which in turn will bring up further questioning of Biden's COVID policies, questions from his left and his non-wingnut right as well as wingers. And, he'll have "earned" them. Between a focus on mRNA vaxxes as boosters being the latest version of COVID Status Quo Joe putting most of his eggs in one basket, and "we the people" being on the hook for these new vaxxes ourselves, he's richly earned skeptical questioning and more.

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Update 2: Per Pro Publica, it ain't just me saying this. When a Paul Offit raises questions, you know you have problems. Offit cites bad framing over "breakthrough" infections as the cornerstone issue early on. But, on the new bivalent boosters? He's a skeptic and bases it on scientific, empirical evidence, or rather, lack thereof. More here from one of the links in the Pro Publica article. Interestingly, neither it nor any of its links talk about the delay in non-mRNA vax boosters, only the possible rush in mRNA boosters.

For the “Platonic noble lies” expansion of the subheader, as reflected by the latest of these updates, go here.

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Update 3: Tweeted by Offit, this piece from Science Mag pretty much says that mRNA vaxxes by themselves aren't the long-term answer. They need another approach added to their mix. Could be in-vaccine, as the story indicates, but by themselves? Not the best answer. And, the issue of T-cell immunity may tie to the issue of mRNA vax falloff.

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Update 4: Walker Bragman keeps tweeting about various actual or alleged failures of Biden's vaccine policy, but I have yet to see him talk about this. Is he afraid of giving fuel to vax deniers? Offit wasn't. I wonder if, in addition to tribalism, that's why Orac won't talk about the lab leak. Wonder what he'll do if enough people bring up the likes of Offit.

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Update 5: Your Local Epidemilogist hasn't read Offit. And thus, saying "science update"? Kuff, didn't run her in the roundup.

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Update 6: Here's my COVID next post from a week later, following up on some of these issues, mainly the issue of whether we're at least getting nearer to post-pandemic. More to the point, here's my piece from the week after that, more explicitly tackling mRNA vaxxes again and taking a first small look at whether tribalism isn't involved with the likes of Bragman. And, I'm going to keep doing it.

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Update 7: I think it's a new version of Fauci's Platonic Noble Lie for people like Tom Frieden and Peter Hotez, who know better, to be telling all Americans, whether over 50 or under 50, contra Updates 2 and 3, to "go get your bivalent boosters," as both were on Twitter over Thanksgiving weekend.

I quote-tweeted Hotez with this post, and he quote-tweeted me back.

I’m confused by this tweet: 1) actually at our @TexasChildrens vaccine center we developed one of the most commonly used non-mRNA primary immunization and boosters globally. Also 2) the bivalent mRNA is indeed indicated for both adults and children in the US? https://t.co/ElrO8V4E6e

— Prof Peter Hotez MD PhD (@PeterHotez) November 27, 2022

I in turn did another quote-tweet, which noted that's "global" not American and there's no non-mRNA vax here in the USofA, and added that I was aware of his global work. (Either Pro Publica or the Trib, or the two together, wrote about it several months ago.) We'll see if he does another quote-tweet back talking about WHY we don't have this in the US. And, that's the issue, Dr. Hotez, is that we don't have it here. And, that's true of initial-line shots as well as boosters. We're pretty much being peddled mRNA and nothing but. AND, you're connected enough to DC insiders on this issue, that you could, in my opinion, "push" more on this issue yourself. Saying, "oh, look, we've got non mRNA boosters globally is not the US.)

As far as the last part? Maybe CDC finally indicated it, but that was NOT its original plan, Dr. Hotez, and I have no doubt that you, like Offit, know that CDC originally planned to "indicate" the bivalent booster for only those 50-plus.

I should add that Hotez has gone Twitter radio silent since my last quote tweet.

AND ... proof that he's a tribalist and twosider? He's also a tribalist and twosider on the lab leak. Bigly, starting with attacking non-wingnut Richard Burr over the Senate minority committee report by Pro Publica over the lab leak theory, which it has now reviewed and strongly defended, despite the pushback by #BlueMAGA like Hotez, who comes off as a kinder, gentler Orac:

Bottom line: the lab leak GOF is all political theater, designed to cripple our national biomedical infrastructure. All so a few uneducated chuckleheads in the US Congress can flex their muscles, exercise authoritarian control. It will make us more vulnerable to future pandemics

— Prof Peter Hotez MD PhD (@PeterHotez) November 1, 2022

And this isn't new from Hotez, as his Twitter feed and stories will show.

Not at all. As I said in quote-Tweeting that first tweet, he's lost some serious credibility in my book. I noted that Alina Chan, Scott Gottlieb and Jaime Metzl, among others, are not members of Congress (and by extension, not chuckleheads or uneducated). May blog just about that.

And, I DID just blog about that, calling him a gaslighter.

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Update 7, Jan 1, 2023: STAT talks about lessons from COVID so far. One is how public health measures have both been imposed, and to some degree, opposed, without nuance either way. It also notes the rapid dropoff of mRNA effectiveness.

In that piece, re the one big issue above, Nancy Messionier notes there's still no accepted definition of Long COVID. That's one of many science-tentative issues around COVID, she says.