As we approach the possible availability of vaccines -- though it could be a number of months away from many of us -- I had some questions about vaccines that I imagine many people share.
1) On the issue of Antigen-Dependent Enhancement -- are we out of the woods yet? In the past cases where ADE arose, did they always occur soon after vaccination, or is there precedent of ADE arising as immunity fades or as the virus mutates? Are there any past cases of ADE that happened 6 months, a year, or even years after vaccination? Or, in the past has it always been something you see relatively quickly? Also, for past instances where ADE was a problem, was it dependent on the disease, on the particular vaccine, or on the particular type of vaccine?
2) I have read many times that the first vaccines may not be the best vaccines, and that we may need boosters, but you might be "stuck" with the vaccine you take first. IE, if you take Pfizer now, but this fall we realize some other vaccine (that isn't even in Phase III now) is the "best", why might you be "stuck" continuing to take the vaccine you took first? In the past, what scenarios required this?
3) 90% or 95%+ efficacy is considered a brobdingnagian success, but I was wondering, what are the causes for that 5-10% of people not being immune, and would it be detectable? For example, what percent of cases is due to some kind of error like a vaccine not being stored properly (so it loses potency) or not being administered properly (like they injected too little or in the wrong place)? Is there a significant % of people who would *not* be immune, but it would be detectable using a blood antigen test taken after the vaccination course is completed (like 1 month after the second shot)? Could an antigen test be revealing, or, would you expect everyone would show antibodies, but just some people (due to quirks of their immune system or their own body) just aren't completely immune even if they showed a ton of antibodies?
4) What are people's expectations for vaccinations for teens (12-18) and young children (under 12). When do people imagine college, high school, middle school and elementary students will be required to be vaccinated?
I know the answer to all of these is "we don't know yet". But that's why I've just framed each one as "what has happened with past precedents?" or, what data do we have for a speculative answer.
1) On the issue of Antigen-Dependent Enhancement -- are we out of the woods yet? In the past cases where ADE arose, did they always occur soon after vaccination, or is there precedent of ADE arising as immunity fades or as the virus mutates? Are there any past cases of ADE that happened 6 months, a year, or even years after vaccination? Or, in the past has it always been something you see relatively quickly? Also, for past instances where ADE was a problem, was it dependent on the disease, on the particular vaccine, or on the particular type of vaccine?
2) I have read many times that the first vaccines may not be the best vaccines, and that we may need boosters, but you might be "stuck" with the vaccine you take first. IE, if you take Pfizer now, but this fall we realize some other vaccine (that isn't even in Phase III now) is the "best", why might you be "stuck" continuing to take the vaccine you took first? In the past, what scenarios required this?
3) 90% or 95%+ efficacy is considered a brobdingnagian success, but I was wondering, what are the causes for that 5-10% of people not being immune, and would it be detectable? For example, what percent of cases is due to some kind of error like a vaccine not being stored properly (so it loses potency) or not being administered properly (like they injected too little or in the wrong place)? Is there a significant % of people who would *not* be immune, but it would be detectable using a blood antigen test taken after the vaccination course is completed (like 1 month after the second shot)? Could an antigen test be revealing, or, would you expect everyone would show antibodies, but just some people (due to quirks of their immune system or their own body) just aren't completely immune even if they showed a ton of antibodies?
4) What are people's expectations for vaccinations for teens (12-18) and young children (under 12). When do people imagine college, high school, middle school and elementary students will be required to be vaccinated?
I know the answer to all of these is "we don't know yet". But that's why I've just framed each one as "what has happened with past precedents?" or, what data do we have for a speculative answer.