[HN Gopher] How scientists across three continents produced an E...
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How scientists across three continents produced an Ebola vaccine
Author : bookofjoe
Score : 197 points
Date : 2020-01-08 12:36 UTC (10 hours ago)
(HTM) web link (www.statnews.com)
(TXT) w3m dump (www.statnews.com)
| sneak wrote:
| It's the cynic in me that notices that over a thousand poor brown
| deaths is a nonstarter for human trials to move the vaccine
| forward, but when the white researcher lady might die, suddenly
| the machinery all kicks into gear.l
| hinkley wrote:
| One, because a new vaccine hasn't been proven safe to
| administer yet. And even 'proven safe' just means that the vast
| majority of recipients won't experience permanent side effects.
| You're intentionally triggering an immune response in the
| patient. What if you triggered an autoimmune response? Now you
| have a created a whole new autoimmune disease (and I dunno if
| you've noticed, but we mostly treat symptoms and not that
| well).
|
| That said, a few people react even to approved vaccines badly.
| Unfortunately this fact feeds the anti-vax people, who don't
| seem to understand how to model risks. Just going to the
| drugstore to pick up antibiotics that will save your life has a
| larger chance of death (due to a car accident). It's more
| dangerous to drive to the doctor to get vaccinated than it is
| to get vaccinated.
|
| Just living is dangerous. I'm running out of fingers on one
| hand to count the number of times I've tried to choke to death
| eating or drinking something, and I've got half a billion years
| of evolution trying to keep me from killing myself just trying
| to absorb nutrients.
|
| Nothing is guaranteed. Anything can kill you. Better to get on
| with life rather than wait for Death to find you.
|
| Where was I? Medical ethics.
|
| Medical ethics has some opinions on how 'informed' a person can
| be to volunteer for experiments. A peer who is in your field is
| presumed to know the consequences of their choices better than
| just about anybody. So yes, a medical researcher experimenting
| essentially on themselves is quite different than the same
| person doing trials on others.
|
| See also the doctor who gave himself an ulcer to prove that
| ulcers were of bacterial origin. Won a Nobel Prize for that
| discovery. If he'd done it on someone else he'd have been in
| big trouble.
| robocat wrote:
| > white researcher lady
|
| How do you know she was white?
| emiliobumachar wrote:
| It's a balancing act, the vaccine might have killed her too.
| Experimental drugs sometimes do that. Presumably she could
| understand the risks better than any layman.
| Pigo wrote:
| The account of the German researcher pricking her finger with a
| needle containing the Ebola virus... Oh man, that's terrifying.
| It's very reassuring to hear the vaccine worked out for her.
| bookofjoe wrote:
| Reminds me of the first week of my internship at Los Angeles
| County-University of Southern California Medical Center in July
| 1974. I needed to get an arterial blood gas from one of my
| patients -- a drug addict with hepatitis and so-called
| "cannonball" fungal lesions in both lungs. I couldn't find the
| radial artery in either of his wrists, so I took the syringe
| and needle and moved down to his groin and tried a femoral
| stick. He was really obese and I couldn't feel his femoral
| pulse, so I tried to separate his abdominal fat pannus from his
| thigh with my right hand while plunging the needle into what I
| hoped would be his femoral triangle. The blind stick impaled my
| right index finger. My heart sank. I was sure I was gonna get
| hepatitis and/or his fungal infection, and spent the next month
| or so on tenterhooks waiting to wake up one day feeling sick.
| By some good fortune, I didn't get either of his illnesses.
| gear54rus wrote:
| I don't get it. Wasn't the needle sterile? You pricked
| yourself but not him, how could have you contacted anything?
| fermenflo wrote:
| Sounds like they already pricked the patient when they
| couldn't find a vein in the arm, maybe?
| bookofjoe wrote:
| Precisely. The multiple radial artery puncture failures
| left needle puncture wounds.
| bookofjoe wrote:
| I used the same needle for the femoral stick that I'd used
| for the radial artery attempts. Standard procedure then and
| now.
| agumonkey wrote:
| Happy for you.
|
| How often do hospital employees suffer these kind of
| accidents ?
| bookofjoe wrote:
| Inadvertent needle sticks? Every now and then. I'm not
| trying to avoid your question or be funny. It's one of the
| unavoidable risks of being a health care worker.
| agumonkey wrote:
| No worries it's just a seemingly simple context I/we
| forget it can backfire
| chenning wrote:
| Call me crazy, but I felt like this story was perhaps a
| little too specific.
| joshgel wrote:
| Can confirm the thrust of this story. And I trained in the
| last 10 years in NYC. Modern healthcare is little
| different.
| bookofjoe wrote:
| You can't please everyone!
| hammock wrote:
| Better to stay in the dark about what the average American
| experience is like! (?)
| behringer wrote:
| Haha reminds me of a story a psychiatrist once told about
| how he/she would generalize people's problems that happen
| to all sorts of patients and yet would routinely be accused
| of sharing a unique and deeply embarrassing story by their
| patients, who don't realize it but all face the same
| problems.
| mercora wrote:
| if it happens to all or just almost all or even just some
| of the patients it would still be sharing a somewhat
| private story from all of them, no? Being accused of
| sharing this (not so) unique story tells me it was even
| told to somebody that knew both people. I think you
| should refrain from that in this profession...
| behringer wrote:
| Psychiatrists have to tell these stories in order to
| train new psychiatrists. The only thing they cannot share
| is personally identifiable information. Sadly, so many
| people think they are struggling alone and their
| situation is completely unique, which is rarely ever the
| case.
| Pigo wrote:
| When I hear what you medical guys go through, I realize how
| not cut out I am for it. I wish I was, because it is very
| fascinating and important to all of us. But I almost got
| faint just picturing what you described.
|
| Would you describe your motivation to help that man as being
| a factor of great empathy for his situation or cold
| detachment from him as a person? I'm not trying to degrade
| him as a person, but I'm curious how you learn to cope with
| the realities of certain people's bodies.
| bookofjoe wrote:
| Neither. It was my job, and I did it to the best of my
| ability. Period.
| Pigo wrote:
| So you just learn, or have the ability, to not think
| about it?
| bookofjoe wrote:
| Exactly. I think it's some of each.
| toomuchtodo wrote:
| Courage is an acquired skill.
| amelius wrote:
| Did you tell your supervisor? (Not sure how easy it is to be
| open about accidents as a student)
| bookofjoe wrote:
| No.
| sansnomme wrote:
| Were you allowed vein finder?
| bookofjoe wrote:
| In 1974 there was no such thing.
| robbiep wrote:
| Those things are basically useless. Especially on fat
| people
| williesleg wrote:
| Nice! Now Obama can fly more ebolas to the united stares!
| crmrc114 wrote:
| This article is an awesome write-up. I love how it walks through
| the process of discovery from the beginning- or as close to it as
| readers will bear. Its insane to think that we are at a point
| where we can just swap a coating on a virus as easily as I can
| un-solder a component from a motherboard. Its also scary as hell
| to think about what plagues could be created in these labs for
| biological war.
|
| Like sure we get atomic power its super clean- but now we also
| have nukes. Tasty yummy nukes.
|
| Where is the biological nuke equivalent here? I don't want to
| spread Microsoft style FUD about such exciting news but it does
| make me wonder what classified work is being done in Andromeda
| strain style labs.
|
| I am both excited and scared as hell about what we can do these
| days.
| lebuffon wrote:
| In light of this research, I find it strange that after almost 40
| years we still don't have a commercially available HIV vaccine.
| Could it be because charging people $1000++ a month for drugs,
| for the rest of their life, is a better business model?
| ravenstine wrote:
| What's with all the downvotes? HN has gotten ridiculously
| polarized in the last few years.
| Someone1234 wrote:
| It is an unfounded conspiracy theory that has nothing really
| to do with this topic. It also shows a great deal of
| ignorance around how HIV invades the body (and why it is so
| difficult to completely eradicate e.g. [0]).
|
| I didn't downvote it, but it isn't exactly hard to see why
| some might. It is less that HN is "ridiculously polarized"
| and more that the signal:noise on that specific comment is
| exceptionally low.
|
| [0] https://labblog.uofmhealth.org/lab-report/cells-stand-
| way-of...
| [deleted]
| Angostura wrote:
| No, it's just that the difficulties surrounding the
| development of an HIV vaccine are well established.
| Unwarranted suggestions of a global conspiracy suppressing
| The Truth tend to get downvoted as daft.
|
| "Could it be because charging people $1000++ a month for
| drugs, for the rest of their life, is a better business
| model?" Or could it be that the poster hadn't bothered to
| look at the reasons.
|
| https://www.historyofvaccines.org/content/articles/developme.
| ..
|
| https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2572109/
| ravenstine wrote:
| I get what you're saying. I just think it's hyperbolic to
| downvote someone making that kind of speculation. It seems
| as if you're reading a lot into that one sentence. I didn't
| see anything about a "global conspiracy"; he's just asking
| if the economics around HIV drugs are discouraging research
| into an HIV vaccine which, even if it's not correct, isn't
| totally outrageous or unrelated to the thread. Ebola, in
| contrast to HIV, doesn't have the same economic pressure
| that could dissuade drug companies from developing a
| vaccine. As far as I'm aware, there's no expensive drug
| that suppresses Ebola symptoms.
|
| A better thing for people to do would have been to just
| reply with the kind of information that you provided.
| bsanr2 wrote:
| I think the economic lens is the way to go. It clearly
| applies to ebola itself. How come there wasn't a vaccine
| before now? Because it's a virus endemic to a poor
| continent that kills its host quickly. And the sudden
| effort over the past few years? Spurred by Western
| medicine's realization of the grave potential of an ebola
| pandemic, because of experience with the epidemics of the
| past few years.
|
| I find it hard to believe that we couldn't moonshot an
| HIV/AIDS vaccine or cure, but it's also clear that the
| incentive isn't there. That doesn't take a conspiracy,
| just the people who could fund an organize a concerted,
| focused global effort simply not caring enough about a
| disease that is still stigmatized by its infection rate
| among "gays, druggies, and blacks" (particularly when
| they can rent-seek on bodies that have historically been
| commodified anyway).
| Angostura wrote:
| It requires all drug companies to have at least an
| internal conspiracy to suppress the results if HIV
| vaccine research - we know that they are investing plenty
| of money into the research from publicly available
| figures, so the implication is that they will be either
| suppressing the results or tampering with research to
| make it fail.
|
| > As far as I'm aware, there's no expensive drug that
| suppresses Ebola symptoms.
|
| "In the light of this I find it very surprising that drug
| companies haven't developed a drug that allows them to
| charge people $1000++ a month for drugs, for the rest of
| their life, isn't that a better business model? How on
| earth did the companies allow this vaccine research to
| escape?!!
| ravenstine wrote:
| Dude, what's with the snark? Can't we have a civilized
| discussion? You had a point there, but I'm not really
| inclined to engage with you after the last thing you
| said.
| warent wrote:
| It's a nice attempt to spin this as an economics argument
| but that's definitely not what this is. There's not even
| any evidence to reinforce their hypothesis.
|
| I could just as well say something like "it's interesting
| that the WTC collapsed the way it did in 9/11. Could it
| be because if it toppled over then the damage would have
| been too catastrophic? I'm just making an economics
| argument!"
| ravenstine wrote:
| > It's a nice attempt to spin this as an economics
| argument
|
| Stop right there. I'm not attempting to "spin" anything.
| refurb wrote:
| It's being downvoted because it's such an incredibly ignorant
| statement that is doing nothing but perpetrating conspiracy
| theories.
|
| If the OP had done even a little bit of research, they would
| have quickly realized that AIDS has unique properties that
| makes making a vaccine incredibly complicated despite a ton
| of effort that has gone into it so far.
| natechols wrote:
| In my experience the people who make claims like the OP's
| almost invariably know nothing about either biology, drug
| development, or big pharma. But the amount of
| disinformation circling the whole drug price debate has
| always been epic.
| headcanon wrote:
| The first firm to make an HIV vaccine will print money selling
| to various NGO and world governments so I think there's plenty
| of incentive to develop one.
|
| HIV is a different animal from most viruses since it targets
| the immune cells, the very thing that allows vaccines to work,
| so I imagine its a lot more complicated than other vaccines to
| develop.
| lebuffon wrote:
| In the short term they will make money yes, but someone used
| to make money selling smallpox vaccine. :-)
|
| Having spent some time at a Fortune 500 company I cannot
| imagine a day where someone voluntarily creates a plan to
| eliminate billions of dollars of sales in monthly doses of
| medicine in exchange for a single or double dose per patient
| product. Corporations just don't think like that. Some might
| say it's even illegal for them to value the patients over the
| shareholders under current regulations.
|
| I take your point on the complexity of HIV. However there are
| creative strategies that can be used like targeting surface
| proteins (?) perhaps. There are a great many intelligent
| people in the field. I have dim memories of work showing
| promise in the early years of the disease. It seems to have
| gone silent after the introduction of the drug cocktail
| approach. Coincidence? Perhaps...
| headcanon wrote:
| Perhaps, but I can certainly imagine a day where someone
| voluntarily creates a plan to create a new product that is
| extraordinarily valuable to a lot of deep-pocketed
| customers, that competitors cannot match for years
| potentially, and even reduces customers for the current
| product on the market that their competitors _can_ match
| (cocktail). Not to mention that 1) new vaccines will need
| to be created to match virus mutation, and 2) thousands of
| new customers will enter the market daily by sheer virtue
| of population expansion, especially in areas hit hard by
| HIV [1].
|
| I'm sorry but there isn't a global conspiracy to stop
| development of an HIV vaccine. Much of what big pharma does
| is incredibly cyncial and deserves scrutiny, but even
| viewing it within that lens, there is a clear business case
| here.
|
| [1]: https://en.wikipedia.org/wiki/Projections_of_populatio
| n_grow...
| faitswulff wrote:
| > In the short term they will make money
|
| This is generally reason enough for companies to do what
| they will, consequences be damned.
| dmix wrote:
| Yes. This is literally the business model of tons of
| successful billion dollar companies in bio and pharma who
| continually find new revenue streams by attracting talent
| and acquiring new "exciting firms".
|
| The OPs conspiracies don't hold any water to reality.
|
| The reason for drug prices are randomly spiking in the US
| (for a small minority of drugs lucky enough to be in FDA
| backlogs) is mostly unrelated to the R&D side:
| https://slatestarcodex.com/2016/08/29/reverse-
| voxsplaining-d...
| emiliobumachar wrote:
| Not all of Big Pharma is in on AIDS treatment. Are there
| any such restrictions to "eliminate billions of dollars of
| sales" of a competitor?
| alecst wrote:
| From my college years I remember that vaccination was hard
| because the outer shell of the virus is capable of mutating
| so rapidly that it's hard to make antibodies specific to it.
| lebuffon wrote:
| I am not an expert but I notice that we seem to manage
| variability with Influenza by creating a new vaccine every
| year.
| markus92 wrote:
| There efficacy is debated though. Every other year you
| hear that the vaccine is not for the right strain of it.
| InitialLastName wrote:
| The difference, as I (also not an expert) understand it
| is that HIV is unique in that it's so variable that the
| host never develops immunity to the disease. In most
| viruses, the immune system eventually develops an
| immunity and eliminates the disease. Influenza is an
| example of this; your immune system learns to fight off
| the strain that you get. The new vaccine every year is
| for the new strains.
|
| The HIV vaccine mutates quickly enough that the host
| never develops immunity themselves, which makes
| triggering immunity with a vaccine very difficult.
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