[HN Gopher] FDA Approves First Respiratory Syncytial Virus (RSV)...
       ___________________________________________________________________
        
       FDA Approves First Respiratory Syncytial Virus (RSV) Vaccine
        
       Author : ourmandave
       Score  : 73 points
       Date   : 2023-05-03 19:44 UTC (3 hours ago)
        
 (HTM) web link (www.fda.gov)
 (TXT) w3m dump (www.fda.gov)
        
       | macinjosh wrote:
       | [flagged]
        
       | fsagx wrote:
       | Moderna presentation on the vaccine from ReSViNET Conference
       | (RSVVW 2023):
       | 
       | https://s29.q4cdn.com/435878511/files/doc_presentations/2023...
       | 
       | some commentary summarized from alexberenson.substack.com :
       | 
       |  _Nine people who received the shot got RSV. Fifty-five who
       | received the placebo did. Thus the 17,500 shots prevented 46
       | cases of RSV.
       | 
       | It shows people who received the jab instead of the placebo
       | reported an extra 10,156 side effects such as headache or
       | fatigue. Those side effects included an extra 455 severe effects,
       | rated as Grade 3 or worse.
       | 
       | Side effects are rated on a five-point scale, with Grade 5 being
       | death and Grade 4 usually requiring immediate medical treatment
       | and hospitalization. Grade 3 side effects are defined as "severe
       | or medically significant."
       | 
       | For example, a Grade 3 fever is usually defined as over about 102
       | degrees, while a Grade 4 is over 104.
       | 
       | In other words, a single Grade 3 side effect is likely to be
       | considerably more severe than a case of RSV for most adults.
       | Again, Moderna's shot caused 10 of those side effects for every
       | RSV infection it prevented._
       | 
       | https://alexberenson.substack.com/p/how-can-modernas-rsv-jab...
        
         | pastor_bob wrote:
         | No skin in the game, but a cursory look at this article
         | indicates it is bogus. Citing supposed death certifications is
         | a really disingenuous tactic IMO:
         | 
         | >A review of death certificates found that RSV kills about 35
         | American adults a year
         | 
         | National Foundation for Infectious Diseases claims it kills
         | 14,000[0]:
         | 
         | > RSV is second only to influenza as a cause of medically
         | significant respiratory tract illnesses in adults7,8 and is
         | estimated to cause 177,000 hospitalizations and 14,000 annual
         | deaths in US adults age 65 years and older
         | 
         | [0]https://www.nfid.org/wp-content/uploads/2019/08/rsv-
         | report.p...
        
         | evancox100 wrote:
         | (I vouched for this post because I think it's important to
         | actually address these issue head on with facts and not just
         | shout people down.)
         | 
         | Berenson's numbers based on the presentation you shared seem to
         | check out, but the interpretation seems odd.
         | 
         | Just looking at how many cases were averted doesn't tell you
         | what types of tail risks were averted. It may be a worthwhile
         | trade off to have 10x as many "severe side effects" in exchange
         | for having many many fewer severe, debilitating, or fatal
         | infections.
         | 
         | Also, Berenson is looking at the ratio of severe side effects
         | induced to RSV cases prevented. But the vaccine side effects
         | only happen once, at the time of injection, while the vaccine
         | may continue to confer long term benefits. So this ratio is
         | highly dependent on the time period in question.
        
           | detaro wrote:
           | ... it's numbers about a different vaccine, how are they
           | relevant here?
        
           | breck wrote:
           | > But the vaccine side effects only happen once, at the time
           | of injection, while the vaccine may continue to confer long
           | term benefits. So this ratio is highly dependent on the time
           | period in question.
           | 
           | One must be extremely skeptical of these kind of claims now,
           | though, given what we just went through as a society. The
           | side effects of the mRNA vaccines seemed to become uncapped
           | (some people I know have now received 4 shots), and the long
           | term benefits went to nil (if not negative), commonly thought
           | due to mutation.
           | 
           | So the question is what are the odds that it really will be
           | just "once" and what are the odds that it will really provide
           | protection against RSV, and future mutated strands.
           | 
           | It seems to me the vaccine industry should be put in a severe
           | category of "distrusted entities" until we have significant
           | improvements in our symbolic infrastructure to the point
           | where they could be trusted again.
        
             | arcticbull wrote:
             | You do know billions of doses of COVID vaccines were
             | delivered and the side effects were overwhelmingly
             | insignificant, right? Skepticism is good, but in the face
             | of data we should be willing to pivot. The COVID vaccines
             | are probably the single most studied and tested vaccine -
             | heck, medical product - of all time.
             | 
             | It's like the aspartame or MSG of the medical world. No
             | matter how much data you provide people will never get over
             | the idea that it must somehow be dangerous.
        
               | breck wrote:
               | I should have used a more precise term than "uncapped".
               | The comment I was responding to used the term "once". I
               | was saying that in most recent vaccine history, the term
               | "twice" was used, then "three times", then "four times",
               | then "up to date". Uncapped was a gross exaggeration. I
               | should instead said that there "once" could not be taken
               | seriously and the range should be "1 to a handful of
               | times", which is a significant factor increase of at
               | least 2x.
               | 
               | But anyway, in my dataset of about 1,000 acquaintances,
               | the only one under 50 hospitalized related to Covid was a
               | friend who was a 38 year mother of 2, in top shape, who
               | had a heart attack within a month after her second dose,
               | and to this day is still recovering. I do not think these
               | vaccines are that dangerous--I would say they probably
               | cause as much harm as one night of heavy binge drinking--
               | but I saw zero evidence of any benefit, and yes I saw one
               | very bad case of severe life threatening side effect.
        
               | arcticbull wrote:
               | > But anyway, in my dataset of about 1,000 acquaintances,
               | the only one under 50 hospitalized related to Covid was a
               | friend who was a 38 year mother of 2, in top shape, who
               | had a heart attack within a month after her second dose,
               | and to this day is still recovering.
               | 
               | There's a reason we don't use anecdotes as a substitute
               | for medical research. Not least because they're subject
               | to the post hoc fallacy. Just because one event follows
               | another doesn't mean there's a causal relationship.
               | 
               | There's every chance that mother of 2 was going to have a
               | heart attack anyways. It happens. The fact they had a
               | vaccine first likely isn't relevant, clinically speaking.
               | If you give a few billion people vaccines, you will find
               | literally every effect that follows. Car crashes. Broken
               | arms. Death by mauling. Syphilis. Turbo-cancer of the
               | elbow.
               | 
               | In that age group, a boundary group, your risk of having
               | a heart attack are somewhere between 17 and 97 per
               | 100,000. [1] The risk of a heart issue from the vaccine
               | is about two orders of magnitude lower than that.
               | 
               | > I do not think these vaccines are that dangerous--I
               | would say they probably cause as much harm as one night
               | of heavy binge drinking-- ...
               | 
               | You have no basis to arrive at that conclusion.
               | 
               | > ... but I saw zero evidence of any benefit ...
               | 
               | It's in the data.
               | 
               | > ... and yes I saw one very bad case of severe life
               | threatening side effect.
               | 
               | You saw one anecdotal report of a bad thing that happened
               | to someone after they took a COVID vaccine, without any
               | evidence they were connected. I'm sure more than once
               | someone took a tylenol and got hit by a bus. That doesn't
               | mean taking tylenol causes getting hit by a bus.
               | 
               | > The proportions of participants who reported at least 1
               | serious adverse event were 0.6% in the vaccine group and
               | 0.5% in the placebo group. [2]
               | 
               | [1] https://pubmed.ncbi.nlm.nih.gov/32111640/
               | 
               | [2] https://www.cdc.gov/vaccines/covid-19/info-by-
               | product/pfizer...
        
               | loeg wrote:
               | > If you give a few billion people vaccines, you will
               | find literally every effect that follows. Car crashes.
               | Broken arms. Death by mauling. Syphilis. Turbo-cancer of
               | the elbow.
               | 
               | Yeah. Lightning-induced arrhythmia was (amusingly) a
               | registered side effect (Serious Adverse Event) of
               | Moderna's covid vaccine.
               | https://metro.co.uk/2020/12/18/covid-vaccine-volunteer-
               | struc...
        
               | Eumenes wrote:
               | You could say the same thing about infections
        
               | arcticbull wrote:
               | You're going to have to explain because I can't see how
               | you could.
        
               | Eumenes wrote:
               | Virus is weak and has super low mortality rate (esp. if
               | you take care of yourself and are not old or fat).
               | Vaccine is new and w/o years of data behind it. I pick no
               | vaccine.
        
               | arcticbull wrote:
               | Well you pick wrong. But that's fine I guess, at this
               | point it's personal responsibility and if you want to
               | make a stupid decision, go with god.
               | 
               | The virus has a fairly low mortality rate for healthy
               | people, most people aren't healthy.
               | 
               | The fact the vaccine is new is irrelevant because
               | generally speaking you can substitute time with quantity.
               | Most effects are normally distributed in time, and so if
               | you have enough doses given, you can replace the fact it
               | hasn't been around too long with a high number of
               | administrations when making a safety assessment. And it's
               | been given literally billions of times. We've seen the
               | full gamut of consequences.
               | 
               | But anyways, 'long-term side effects' don't refer to
               | latent effects. It's not things that magically appear 10
               | years later. They're effects that last a long time but
               | usually onset almost immediately. There's no reason to
               | think that 5 years of data is better than 3 years of data
               | when administered billions of times.
               | 
               | And frankly if you think 3 years and billions of data
               | points are insufficient nothing's going to change your
               | mind. So you may as well stop pretending it's a data
               | issue.
               | 
               | As I said, irrationality is your prerogative. But you are
               | wrong.
        
               | Eumenes wrote:
               | Yeah I'm speaking for myself, and I'm very healthy and
               | fit. If I were not, I'd probably be on other prescription
               | drugs, so what's one more thing? I don't think I've taken
               | an OTC or prescription drug in 10-15 years. My medicine
               | cabinet is empty. I've smoked some weed though. Agreed on
               | the personal responsibility piece.
               | 
               | The long-term side effects piece is still undecided and
               | that's undebatable, simply because not enough time has
               | gone by. Maybe I'll be open to changing my mind in 5-10
               | years. Even then, I'd win, no?
        
               | arcticbull wrote:
               | > The long-term side effects piece is still undecided and
               | that's undebatable, simply because not enough time has
               | gone by. Maybe I'll be open to changing my mind in 5-10
               | years. Even then, I'd win, no?
               | 
               | Like I said long-term side effects doesn't mean latent
               | effects. It doesn't mean things that show up years after
               | administration. It means things that happen right after
               | administration but last a long time. If getting the COVID
               | vaccine caused your arm to fall off 30 seconds after
               | administration, that's a long-term side-effect because
               | last I checked arms don't re-grow.
               | 
               | Yes, we do know what the long-term side effects are.
               | You've confused 'long-term' and 'latent'.
               | 
               | Yes, it's decided. No, it's not debatable.
               | 
               | > ... simply because not enough time has gone by.
               | 
               | Again that (a) doesn't matter and (b) unless you're a
               | vaccineologist then your opinion about whether sufficient
               | time has passed is totally meaningless.
        
             | burnished wrote:
             | Are you suggesting that the limited duration of protection
             | and hence the need for followups (like flu shots) is.. the
             | result of a conspiracy? Its not clear why you think they
             | should be 'distrusted' which calls your judgement into
             | question.
        
               | breck wrote:
               | No I am saying that there was no protection and the
               | follow ups provided none either.
               | 
               | Yes, with 99% odds I am saying there was a conspiracy to
               | end the randomized placebo control group early to bury
               | any chance that someone could ever conclusively prove
               | these vaccines were ineffective.
               | 
               | The claim was they decided it was unethical to withhold a
               | "life-saving" vaccine from control participants and
               | that's why they ended it. I would bet with 99% odds that
               | if there was a funded investigation with subpoena power
               | you would find strong evidence that the primary reason
               | that control group was ended because of extreme financial
               | incentive to end it. If the control group were allowed to
               | continue and it were shown that the vaccines were
               | ineffective (which is what ended up being the case), tens
               | of billions would have been lost. I am counting on
               | someone being sloppy and letting the truth spill
               | somewhere internally.
               | 
               | Now if you are saying that I am showing bad judgement for
               | speaking truth to power, for caring about honesty, I
               | could see a valid argument there. But to me truth and
               | honesty is more important than money.
               | 
               | There is _zero_ scientific evidence that this thing saved
               | a single life. The _only_ randomized control group
               | experiment showed _zero_ lives saved.
        
               | stevehawk wrote:
               | the common argument I heard from the anti-vaxxers was
               | that the mRNA COVID vaccine was obviously
               | bad/fake/contrived because it required a booster and "no
               | other vaccine requires a booster!" And if you mention
               | tetanus, hepatitis or meningococcal, or other vaccines
               | that required a booster/multiple shots then you just get
               | ignored. Ignorant gonna ignorant.
        
               | breck wrote:
               | https://en.wikipedia.org/wiki/Straw_man
        
         | version_five wrote:
         | Like it or not, these sort of not-very-effective-vaccines-for-
         | mostly-mild-diseases are going to be a very tough sell for a
         | lot of people post-covid. I assume there will be ongoing
         | attempts to ride of covid's coattails to get them pushed or
         | mandated wherever possible.
         | 
         | The real concern is that if we ever get new effective vaccines
         | for bad diseases, there are going to be lots of people not
         | taking them after all the abuse of trust that's happened. At
         | this point, how do you even know who to belive?
        
           | Eumenes wrote:
           | 100%. I am in my late 30s and have not received a vaccine
           | since I was in middle school ... literally never sick, never
           | got covid. There'd have to be zombies or bubonic plague to
           | convince me, and even then, there'd be bigger fish to fry.
        
           | Spooky23 wrote:
           | Honestly, who cares.
           | 
           | If you think reducing likelihood of getting really sick by
           | 80%, especially if you're vulnerable is no big deal, and you
           | want to suffer or spend your life savings on unnecessary
           | medical care because some YouTuber told you so, that's your
           | problem.
        
             | peteradio wrote:
             | If you want to base your medical decisions on wildly
             | average data that's your problem.
        
             | burnished wrote:
             | I don't think I would agree broadly with the person you are
             | responding to (riding the coattails of covid is a phrase
             | that paints a picture), but this narrow point has merit due
             | to the way herd immunity works. It is genuinely a matter of
             | community health.
             | 
             | No idea what to do about it given all the absolutely
             | unhinged perspectives on the topic, but still, I care.
        
           | peteradio wrote:
           | Then one time, I believe it was July ... no August, there's a
           | knock on the door. Open the door and there's this cute little
           | girl scout. Ah she was so adorable with her little pigtails
           | and all. And she says to me "how would you like to buy some
           | cookies?" I said "well what kind do you have?" She had thin
           | mints, graham crunchy thins, oatmeal raisin... I said "we'll
           | take a graham crunchy. How much will that be?" She looks at
           | me says "I'll need about three fitty." WELL! IT WAS ABOUT
           | THAT TIME I NOTICED THIS LITTLE GIRL SCOUT WAS ABOUT 8
           | STORIES TALL CRUSTACEAN FROM THE PALEDOZOLIC ERA! THE
           | LOCHNESS MONSTER!
        
             | version_five wrote:
             | Is this a reference to something?
        
               | peteradio wrote:
               | Yes it's south park probably very random.
        
           | shrimp_emoji wrote:
           | The last panel of: https://www.qwantz.com/index.php?comic=14
        
         | markus92 wrote:
         | Note: OP posted about the GSK vaccine, not the Moderna one.
        
         | philjohn wrote:
         | This feels like something that will be of benefit to the
         | immunocompromised, or with conditions such as Asthma (RSV can
         | be super non fun with Asthma)
        
           | peteradio wrote:
           | I wish there was a way to determine more stratified outcomes
           | according to potential correlates... without having to
           | perform high statistics human trials. I imagine that kind of
           | detail is released after some time, I wonder how long that
           | usually is.
        
         | icegreentea2 wrote:
         | The approved vaccine (Arexvy) is a GSK vaccine. It's also not
         | an mRNA vaccine - it's recombinant subunit vaccine (ie, you
         | tinker with microbes to spew out relevant pieces of the virus
         | which you harvest and purify).
         | 
         | Edit: Also your linked commentary basically completely hinges
         | on what we believe the risk of RSV to actually be (fair). The
         | lower bound estimate provided by tallying up actual death
         | certificates is just that - a lower bound. The linked study for
         | that number dedicates a huge pile of its discussion section to
         | the very weakness of just using death certificates. I'm not
         | saying that the 14k number must be true, but it's also quite
         | unlikely that the 35 per year number is the right order of
         | magnitude as well.
        
         | tikkun wrote:
         | Does someone have the same stats re side effects for the
         | approved vaccine?
        
         | Spooky23 wrote:
         | If you look at the actual data (
         | https://s29.q4cdn.com/435878511/files/doc_presentations/2023...
         | ), 0.6% with the vaccine had a grade 3 fever, compared to 0.4%
         | of placebo.
         | 
         | The population in question is 60+ or 70+. RSV can be very
         | significant in that population, even in young kids, it is a
         | virus that shuts down schools. The author is a well known anti-
         | vax guy, so I'd assume he's presenting the most negative
         | scenario possible.
        
       | version_five wrote:
       | Turn on showdead or you're missing the actual conversation. This
       | is one of the most egregious examples of people using flagging to
       | shut down a discussion that I've seen here. Either the whole
       | thread should be closed as off-topic or the substantive flagged
       | posts should stand.
        
         | RC_ITR wrote:
         | I did exactly that and I saw was anecdotes and unsupported
         | claims.
         | 
         | This is supposed to be a data-driven discussion forum - people
         | correctly flagging content you like != censorship.
        
           | version_five wrote:
           | You got to decide for yourself, that sounds like a win
        
             | RC_ITR wrote:
             | No - why participate in a forum if you fundamentally
             | disagree with the way it's run.
             | 
             | There's plenty of places online to do _whatever_ you want,
             | people like it _here_ because we at least sort of try to
             | follow some rules to encourage a fragile thing (informed
             | debate).
             | 
             | Like I said, happy to look at _data_ about this, but not
             | random stray stories.
        
               | RoyGBivCap wrote:
               | > _No - why participate in a forum if you fundamentally
               | disagree with the way it 's run._
               | 
               | The forum is useful _because of_ its users _in spite of_
               | how it 's run. Just like reddit.
        
               | version_five wrote:
               | Thanks for using italics to drive home how much you value
               | data. Unfortunately, this is is a discussion forum,
               | thankfully not a citation-fest, so some people will give
               | opinions, some will refer to other sites, etc. Everyone
               | doesn't have to agree.
        
             | mustacheemperor wrote:
             | And showdead is a feature available to everyone who wants
             | to decide for themselves. I leave it on, and I'd agree
             | people should be made aware of it. But for me this was just
             | another example that what gets downvoted to grey here often
             | is speculative, conspiratorial, and/or hostile to the
             | detriment of making a meaningful point.
             | 
             | As pointed out in its replies, the article linked in that
             | comment includes some basic mistakes like attributing to
             | death certificates that RSV kills 35 American adults every
             | year, when NFID claims 14k. Launching a conspiratorial
             | discussion from the platform of an article with such
             | rudimentary errors is always going to result in downvotes
             | on this community, so nothing seems unusual about this
             | instance to me.
             | 
             | And it's not like they linked a review of the paper by any
             | kind of medical doctor. Anyone who recognizes the name Alex
             | Berenson would reasonably assume the article is bogus,
             | especially in the context of infectious diseases.
             | https://en.wikipedia.org/wiki/Alex_Berenson
        
           | JumpCrisscross wrote:
           | > _supposed to be a data-driven discussion forum_
           | 
           | Anecdotes are fine. Flags should really be for violations of
           | the guidelines [1] or stuff that's blatantly illegal that the
           | mods should know about, though that's just my opinion.
           | 
           | [1] https://news.ycombinator.com/newsguidelines.html
        
         | m463 wrote:
         | thank you for helping me understand how showdead works.
         | 
         | If you enable it in your profile, dead articles appear, which
         | means
         | 
         | "The post was killed by software, user flags, or moderators."
         | 
         | In this case, a downvoted(?) thread appears at the bottom with
         | 28 replies.
        
           | detaro wrote:
           | your comment made me double-check if this changed: the thread
           | is still be there with showdead off, just its (flagged) top
           | comment is replaced with the [flagged] placeholder.
        
         | detaro wrote:
         | You really think trying to argue about safety data _for a
         | different vaccine_ , while pretending you are talking about the
         | submission topic is an important substantive post and not
         | horribly derailing the discussion? Or what substantive flagged
         | post do you mean?
        
           | JumpCrisscross wrote:
           | > _trying to argue about safety data for a different vaccine_
           | 
           | I turned on showdead and promptly reenabled it. Referencing
           | Covid and mRNA vaccines in response to a non-Covid non-MRNA
           | vaccine seems like using "Hacker News for political or
           | ideological battle" and pursuing "generic tangents" [1].
           | 
           | [1] https://news.ycombinator.com/newsguidelines.html
        
         | [deleted]
        
       | teslabox wrote:
       | [flagged]
        
         | phkahler wrote:
         | >> What's the point in vaccinating for RSV when effective
         | treatments already exist?
         | 
         | Standard answer: your 1 case is an anecdote, not data. I would
         | argue that it is actually 1 data point, but that you can't even
         | say it didn't clear up on its own.
         | 
         | The next problem is that nobody will fund clinical trials of
         | anything they can't patent and milk for money.
         | 
         | I cured my asthma with non-accepted stuff. I have before and
         | after test data to prove it too. Can't say it will work for
         | everyone though ;-)
        
         | [deleted]
        
         | ceejayoz wrote:
         | Most RSV infections last a week or two. 10-12 days is right
         | where it goes away on its own.
         | 
         | Time is more likely your "effective treatment" in this case.
        
       | XorNot wrote:
       | Looking forward to this landing in Australia and widening it's
       | approved usage.
       | 
       | Giving my son a chance of not catching RSV from daycare would be
       | be great.
        
         | nvahalik wrote:
         | > not catching RSV
         | 
         | These only lessen the effects. To my knowledge, there is not
         | (nor ever has been) any respiratory "vaccine" that prevents you
         | from getting it. It just makes your body better at fighting it.
        
           | [deleted]
        
       | jwineinger wrote:
       | My preemie daughter got 3 rounds (monthly, IIRC) of injections to
       | prevent RSV ten years ago. Was that some sort of antibody then?
        
         | icegreentea2 wrote:
         | Yes, looks to be the case:
         | https://en.wikipedia.org/wiki/Palivizumab
        
           | ceejayoz wrote:
           | Yep. My kids got that a bit over a decade ago.
        
       | NDizzle wrote:
       | [flagged]
        
       | tikkun wrote:
       | *Approved for individuals age 60 and older.
        
         | [deleted]
        
       | [deleted]
        
       ___________________________________________________________________
       (page generated 2023-05-03 23:00 UTC)