Moderna Is About to Begin Trials for HIV Vaccine

I am no expert but my understanding is that AIDS occurs when a variant targeting receptors more specific to CD4 T-cells begins replicating (or begins replicating at too high a rate), which results in T-cell counts falling below some threshold. So a person will go through an extended period without feeling any symptoms, possibly transmitting the virus to others (hence the importance of widespread, easy access to testing), only to be incapacitated by AIDS later when the "balance" of the variants changes (assuming they do not receive HIV-suppressing medications).

Compared to having a sore arm for a couple of days? Or even getting sick for a day or two - at a time I can choose - to just not deal with getting sick later on? Sure. And I'm awfully sure that the flu kills more than the vaccine for it. So many complications for so many people.

And to be fair: The folks you knew in their 60's had an unusual reaction. Older people with their aging immune systems are actually more likely to get little to know side effects to vaccines - younger folks tend to get more. The same goes for folks that are genetically female: You tend to get more side effects (they think this is because so many immune genes are on sex chromosomes, and women have more genes here.).

And to be fair: Taking a day off of work when you are sick isn't such a big deal if you live somewhere with labor protection laws that allow you sick days. It is a little less of a big deal if you live in the US and get paid sick time, but a lot of folks just don't have this so it makes being sick after a vaccine a bigger deal that it should be.

With the second phizer shot, I mild symptoms for a day.

I would say a couple of days of flu is vastly better than some of the other side effects I've seen with other medications. Take for instance:

- Suicidal thoughts - Abnormal heart rhythms - Internal bleeding - Cancer

At the end of the day, we rely on medical professionals to help us with these decisions and weigh the treatment of said ailments against the side effects we may incur if we do or don't take treatment. For what it's worth I've seen the opposite, most folks took the day off just in case there was a side effect, but ultimately everyone was fine. I know I scheduled my vaccine shots for a Thursday so I could have a 3 day weekend assuming I wasn't feeling ill, and I felt fine so I enjoyed my 3 day weekend.

I'm sure a second shot of the traditional flu vaccine wouldn't feel great.

Well, using that analogy, I would say, it took us indeed great efforts to reach it, but now we have vast land to colonize - meaning applying all that groundbreaking research into everything. There are so many more technologies avaiable, than just what you can buy on the market.

Sci-Fi is very possible.

edit: oh and about FTL:

I know I do not really understand quantum physics and co. but I think I understand, that no one really understands it yet - so I do not expect FTL in my lifetime, but I would not rule it out.

There is so much to learn about the world around us without even hitting physics limits.

And then so much to do with that knowledge.

I am not worried we will run out of problems to solve.

wtf are you talking about? SpaceX is going to Mars in 3 years and is designed to go past it with extra fuel transport ships.

And despite President-level dismissal of HIV/AIDS at the time, significant resources were devoted to it in the 80s, such that even though we didn't make huge progress against HIV at the time, the research on HIV progressed the rest of the field.

And a lot of our anti-viral drugs have come out of HIV research as well.

A modern Project Warpspeed probably wouldn't be quite as successful as a Covid19 Warpspeed, because a lot of the first ideas have already been attempted. But with the new sorts of designs that mRNA vaccines allow, there's a lot more that's possible now.

but.. it's still not a polyvalent vaccine, it's only targeting one such highly-conserved region, and there's HIV out there that evades BNAbs (5% of HIV+ patients have BNAbs after all, and they eventually progress.. though maybe after changing tropism or something.)

so it may not be all that effective as a strategy, but there's at least some monkey data suggesting it delays or sometimes prevents infection.

More info here: https://www.aidsmap.com/news/mar-2020/hiv-vaccine-generates-...

That's not necessarily a given.

Even in EU countries (former HIV researcher, had MD colleagues in a country with budget issues).

No, it wouldn't necessarily.

While it's true that a vaccine would apply selection pressure and create a fitness gradient for HIV to evolve against, the virus is still bound by its genetics.

The rate at which we're developing vaccines is increasing dramatically. If our new methods are good enough to quickly adapt, then HIV may have a limited state space left to explore. A single remarkable vaccine could even do this on its own if we're lucky.

The virus can't easily descend down a fitness well to make a jump to a new gradient (ie. dramatic change of receptor bindings).

If you're talking about novel viruses, that's a wholly unrelated issue. There's of course a giant reservoir of zoonotic viruses that may one day make a leap to humans, but if anything, our work to rapidly develop vaccines may give us an increased advantage against new viruses if and when they arise.

Finally, if you're talking "hygiene hypothesis", that under-stimulation of the immune system creates auto immune disorders, has increased interaction with gut flora, or changes the dynamics with which cancer clearance happens, then you may be onto something. But this is a huge unknown where we have a lot of study left to do.

(On a personal note, I left my pursuit of biochem because when I studied it, the prospects looked to be moving at glacial pace and the tools felt akin to using punch cards and truth tables. The problems are massive, dynamical, and it looked too daunting. After the last decade and a half of bio discoveries and innovations, I've changed my outlook completely and am incredibly bullish on biotech. We are going to make incredible strides in the next few decades that will in many ways mirror the rise of tech. I want to find my way back to the field someday.)

But a vaccine, especially if it is affordable and works for a long time will go even further in ending this pandemic that has gone one for 40+ years.

As long as there’s no antiviral therapy resistance.

What you said applies to most viruses (flu, corona, ...), but not to HIV.

There is a reason we failed to create a HIV vaccine for 30 years, and that reason is that simply presenting the virus just doesn't work.

So this vaccine uses a new quite amazing methodology, instead of presenting the virus, it presents something else designed to trigger the 1 in the million B cell from our bodies which are actually capable of producing a neutralizing antibody. Regular vaccine trigger randomly the other 999999 B cells which produce useless antibodies.

Typically that process takes 10 years for a HIV infected person, after which they produce the proper antibodies.

This approach is called germ-line targeting, and tries to accelerate that 10 year process in 2-3 shots.

This is different from other disease where the immune system doesn't have enough time to response before the disease kills/damages the body.

If the vaccine can prevent HIV signature evasion, it may very well help control/treat the disease, I think.

I'd say, from sexual perspective, the better protection is to have a long term partner (not talking about marriage here).

Also you can get HIV from other sources than sexual intercourse too, so having a vaccine that is proved by medical science is a huge relief.

Here is personal story of mine: Last year, while vacationing, I was walking on the beach and I felt a slight sting and when I looked down a hypodermic needle was piercing my finger. Took it up and barely a single drop of blood formed, so the penetration barely went below the skin but that was enough to make me feel afraid. After 3 weeks took the test, found out I was HIV negative and talked with the doctor. She said that salty water is great at dismantling DNA/RNA and asked me what the needle looked like. It was all clean except for the tip where my blood was. Told me to not worry, just test again in 6 months which I did and for my great relief I was still HIV negative. Nevertheless during this entire time, in the back of my head black thoughts were daily there, worrying about "what if".

If the initial stage is already 2 years, I don't see a Phase 3 trial taking less than 3 times that amount of time. It will be super difficult to test. The R0 value of HIV is relatively low.

"This is also why social conservatives don't like it when scientific progress makes sex safer or better. Sex outside of their ideal scenario (in marriage, at the husband's wish, for reproduction) should be punished, and steps to mitigate that punishment (STD prevention, pregnancy prevention) should be discouraged or lambasted as immoral."

https://www.theguardian.com/commentisfree/2012/oct/16/conser...

https://www.washingtonpost.com/local/dc-politics/why-the-pol...