India approves first DNA Covid vaccine

https://www.bbc.co.uk/news/world-asia-india-57774294

by vijayr02 • 5 years ago

63 73 5 years ago

bbc.co.uk

yread• 5 years ago

3 dose, 66% efficient against symptomatic delta variant, injection free, can be kept at 25C for 3 months.Not bad!

Yajirobe• 5 years ago

Vaccine that's injection free?

avnigo• 5 years ago

It is administered with a disposable needle-free injector, which uses a narrow stream of the fluid to penetrate the skin and deliver the jab to the proper tissue.

I've never heard of something like this [0],[1]. It's not injector-free, but rather needle-free.

[0] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4675000/

[1] https://theconversation.com/a-covid-19-vaccine-may-come-with...

evgen• 5 years ago

Very cool if the efficacy numbers turn out to be true. No reason to doubt them, but a few of the vaccines have turned out to have wildly worse efficacy numbers in the real world compared to what was reported by the manufacturer. 28K trial pool (including children) is good, let's see if the numbers hold up over time.

avodonosov• 5 years ago

is 66% good, comparing to other vaccines?

unmole• 5 years ago

But not particularly great compared to Covishield (Oxford-AZ) and Covaxin which are the main vaccines in use in India. The fancy needle free injector is almost certainly going to be more expensive than a normal syringe and will make logistics more difficult. While the thermal stability is great, I don't think it will be a game changer. The one thing it has going for it is that it can be given to children above 12.

throw3849• 5 years ago

Perhaps it is easier to apply than injections. Rural India may not have qualified medical personnel.

akrain• 5 years ago

I couldn't find the effectiveness of Covishield against Delta but for Covaxin the claimed efficacy is in the same ballpark at 65%. So this is not bad at all.

Ref: https://www.hindustantimes.com/india-news/covaxin-65-efficie...

aguacate6• 5 years ago

My very limited understanding tells me that the human body is a very complex system not fully understood.

I only have engineering analogies, but deploying bad software in a complex distributed system can appear fine until latent effects are discovered literally years later (e.g. all data in a specific column for a subset of users was overwritten for records within 6 months in 2008).

My understanding with some debilitating, fatal conditions are that the causes are not well known.

Fundamentally, it seems that most science is a result of abductive, deductive reasoning etc but ultimately, tinkering and observation i.e. if you don't analyse something over 10 years, you don't know its effect over 10 years.

By using a variety of different vaccines all over the world the expression of humanity is that we are spreading the risk among various vaccine types or contracting COVID itself.

So for a mostly self-interested individual in a rural area with a low chance of catching COVID, would it follow that the safest (but maybe selfish) bet is to wait many years?

Or is my premise or conclusion flawed, especially because I missing prerequisite knowledge?

AussieWog93• 5 years ago

Or is my premise or conclusion flawed, especially because I missing prerequisite knowledge?

Pharmaceutical-risk-based arguments aside, India is in a pretty bad spot COVID-wise. A massive proportion of the population is dirt poor (<$1/hr) and the broader society in general don't give a damn about their plight.

They cannot afford to lock down. If they do so, millions will starve to death.

They were literally begging, fighting and worse to get access to oxygen tanks earlier this year. The unlucky ones watched their parents and grandparents asphyxiate in their homes with no access to treatment of any kind.

If this stuff can be produced cheaply, locally and quickly, then it will be lapped up gratefully by the hundreds of millions of poor people who would be dead and buried before they got the opportunity to receive Pfizer or Moderna.

What could or might happen 10 years down the track will be the least of their worries if we see another flare up.

aguacate6• 5 years ago

No argument against that & my argument definitely comes from a privileged position than your average Indian.

wizardofmysore• 5 years ago

if you don't analyse something over 10 years, you don't know its effect over 10 years

Yes, that is why long term studies are done. Vaccine as a methodology has been proven effective. Many diseases are non-existent now thanks to it.

My knowledge is limited with respect to COVID vaccines but if they are any thing like the vaccines developed for flu strains then they will not have any adverse impact.

By using a variety of different vaccines all over the world the expression of humanity is that we are spreading the risk among various vaccine types or contracting COVID itself.

"spreading the risk among various vaccine types" could you elaborate on this?

hutzlibu• 5 years ago

"Yes, that is why long term studies are done. Vaccine as a methodology has been proven effective. Many diseases are non-existent now thanks to it."

But aren't the new vaccines of a different kind? Genetically engeneered?

So I too had my doubts, before getting the shot. And I still do. But what I do know for example is, that I had strong side effects after the first dose. And also strong side effects just before my second shot of Astra. In other words, the mind is a strong factor here and the body is used to deal with alien dna all the time, so I do not worry too much about long term effects.

icegreentea23• 5 years ago

If you truly believe that you can wait out a few years without being at reasonable risk of getting COVID, you're logic isn't off. You are ultimately correct, we can't actually really know what the 5+ year side effects are until we actually witness them, though I believe the data at hand indicates that they should be long-term safe.

Pretty much any type of reasoning + data at hand would indicate that any type of "years past" risks that would occur with vaccines would also be present with COVID itself (especially along the inactivated virus and mRNA vaccine routes). And if the magnitude of the risks scale with exposure (they probably do), then getting straight up COVID would still yield higher long-term risk than getting vaccinated (and either successfully not getting infected, or getting infected).

Basically, if you really think your choice is between not getting COVID, and not getting COVID and getting vaccinated, then obviously not getting COVID at all yields the lowest possible risk. I would challenge anyone's risk assessment on thinking they can just... not get COVID over a 10 year window however.

Perhaps one change to your analogy is that the intention of these vaccines doesn't map well to new software into a distributed system. It's more like providing a specifically crafted input to a system. Long-term there is supposed to be no distinct "vaccine" sub-unit that you can point to in the human body, there's only the human bodies persisted long-term memory and response to a vaccine. I dunno if that's meaningfully changes your thinking at all, but maybe worth thinking about.

aguacate6• 5 years ago

This seems like a good assessment. Personally I don't plan on avoiding COVID for the next 10 years nor do I even live in a rural area. Hypothetical.

I don't fully agree with the last paragraph. I mean I think if you're charitable you can alter the analogy a little bit to make it fit. I agree that there is no "vaccine" sub-unit, but let's say the equivalent is temporarily changing a data structure that is read by service A, not thinking about service B. Or not fully examining the flow on effects from service A etc.

yonaguska4• 5 years ago

if you really think your choice is between not getting COVID, and not getting COVID and getting vaccinated,

Getting vaccinated, then getting COVID is always an option.

Either way, from my personal anecdotes, aka friends and family- I now know at least a handful of people with permanent life altering reactions to the vaccine, and one death from the vaccine. These are all younger people that were previously in good health. Given my age, health, and natural immunity- it makes zero sense for me to incur additional risk from the vaccine.

JohnJamesRambo2• 5 years ago

I think your premise is greatly flawed. The risk from getting a little piece of Covid mRNA is infinitesimal compared to the risk of getting Covid and having the whole genome replicated, all the proteins, and actually maybe dying to Covid or suffering long Covid after.

I don’t know of any risks that have been shown to be associated with the vaccine.

aguacate6• 5 years ago

If I had to argue against your assessment of the risk, I would reframe or reiterate part of my premise which is really that you cannot measure the risk of what you don't know.

That being said, if I'm a betting man, I suspect someone strictly avoiding vaccines through my original line of reasoning would end up like a prepper who never lives through doom's day.

jtbayly2• 5 years ago

Are you claiming the vaccine has zero known risks? Surely not.

sureglymop2• 5 years ago

I agree with you. The one thing I will say though is, it is necessary to look at the vaccines more in depth to make a judgement.

For example, I would vastly prefer the Moderna and Pfizer-BioNTech mRNA based vaccines over the AstraZeneca DNA based vaccine.

That is because the AstraZeneca vaccine uses a "harmless" carrier virus to carry the DNA. The problem I see with that is that your immune system also builds resilience against said carrier virus, rendering future shots of the vaccine more ineffective. Because of that, they might have to "update" the vaccine if more booster shots in the future are required.

antattack• 5 years ago

"So for a mostly self-interested individual in a rural area with a low chance of catching COVID, would it follow that the safest (but maybe selfish) bet is to wait many years?"

It would be fine strategy for Hepatatis B, for example, however delta COVID is so infectious that most people will get it, vaccinated or unvaccinated (with currently available vaccines). The only difference will be severity of the disease.

aguacate6• 5 years ago

Ok fair, "a rural area with a low chance of catching COVID" may be a bit too much like never-never land over a 10 year period.

XorNot5• 5 years ago

If you've ever cut yourself in a non-sterile environment, then you have been exposed to thousands of times more genetic material and invading pathogens then a vaccine contains, bent on doing much more serious damage.

For some reason people worry about "what vaccines might do" but not "what the virus that invades your cells, co-opts the replication machinery, and then invades more cells uncontrolled" will do. The virus that literally did not exist in nature till 1.5 years ago when it started infecting humans and killing them.

Like it does not only produce more viruses either - that's the goal but it's a stochastic process. You also get filled with bits of viral RNA from sheared up viruses, or ones that run into an enzyme, or from viruses where the cell shuts down or dies early and it blows fragments of viral protein into your blood stream.

tim333• 5 years ago

the virus invades your cells, splices it's DNA into the replication machinery

I don't think covid has any DNA - it's made of RNA - or does that.

fragileone• 5 years ago

It seems the newer variants like delta are more contagious yet vastly less lethal, so if it continues this trend then yes, we're past the optimal time period for vaccinations.

BobJackienine• 5 years ago

I know several people that almost died from the vaccination I'm one of them and I never heard anything about any problems with the vaccination until I had problems and that seems to be the normal. The behavioral health center forced me to get it never asked me never told me just jabbed me and then all the sudden I had a ton of tubes and hoses coming out of me. I'll get reparations if I have to get them myself. Hardly any doctor will even entertain the fact that the vaccine did damage to my body. The few that do are baffled, even though I'm not the only patient they're seeing with the same exact problems that won't go away.

selimthegrim• 5 years ago

There’s a federal vaccine injury program you realize

webmobdev5• 5 years ago

I am sorry you had to go through that experience. But you are one those 1 or 2% rare and unlucky cases that are known to happen, who have some severe reaction to the vaccines. That said, I am shocked that you were vaccinated without your knowledge. I am very pro-vaccine, but would never support someone being vaccinated against their will.

webmobdev5• 5 years ago

Or is my premise or conclusion flawed, especially because I missing prerequisite knowledge?

One obvious flaw I can point out in your reasoning is that you are mixing tried and tested technology with new ones. While mRNA and DNA based COVID-19 vaccines are based on new technology and perhaps their long-term impact is not yet fully known or understood (and need to be studied), there are many other vaccines based on the older, more widely used and studied bio-technology (e.g. vaccines using inactivated virus). The older vaccine biotech have been studied for, and perfected over, more than half a century. So even if the efficacy of vaccines created with older tech maybe purportedly lower (not really) than the vaccines based on newer biotech, you can be relatively sure that they are safe.

Your concern about the long term impact of newer mRNA and DNA based vaccines may be justified. But that shouldn't extend to the vaccines based on the old, tried and tested and well-understood popular tech that has successfully been used in other older vaccines for decades now. (Yes, even the COVID-19 vaccines based on older biotech need to be studied. But because of the decades of data we already have, we can be reasonably predict that nothing biologically unexpected will happen. And so most of the long-term studies of these older biotech vaccines are more focused, with fewer parameters, to determine how long their efficacy lasts. With the newer mRNA and DNA vaccines though, the long-term study will have more parameters to study and more diligently observe if some thing unexpected may occur in the future.)

So all said and done, even if the prevalence of the epidemic is low in your rural area, it is much better and safer for you and your community to get vaccinated, than remain unvaccinated. It just takes one undetected case to spread it to others.

tzs• 5 years ago

It is helpful to consider the four prior coronaviruses that are in widespread circulation among humans.

They are believed to have causes pandemics when they first crossed over into humans, but like SARS-CoV-2 they caused very little death in children even though children are easily infected. Once someone caught them and survived, that person had some immunity. Immunity against reinfection fades, but immunity against serious illness lasts longer.

So what happened with them is that you got a terrible pandemic that did a number on adults but while widely infecting children didn't harm them much. People who caught it and survived would get reinfected as their immunity against infection faded, but would not get seriously ill, so the pandemic would eventually end with everyone eventually having been infected, and the virus regularly in circulation. Everyone gets infected every year or so, for the most part getting only mildly ill at worst.

Children born after this point all catch these viruses when they are young. They don't yet have any immunity, but these viruses only very rarely cause serious illnesses in children. They then get reinfected every year or so just like adults, but now they have the immunity against serious illness too so remain fine when they get older.

Now, hundreds of years after those viruses crossed over and caused their pandemics they are so routine that we generally don't specifically track them and don't even have a specific name for the illnesses they cause. We just lump the illness in with the illnesses caused by several other respiratory viruses and call it the "common cold". Those four coronaviruses are responsible for about 20% of the common colds in the US.

It looks like SARS-CoV-2 is heading toward becoming another common cold virus. Look at infection rates, hospitalization rates, and death rates by age group (US, through May 2021, rates per 100k):

    Age  Infect  Hosp  Death
   0-17     37k   287      0.5
  18-49     44k  1100     25
  50-64     32k  2600     85
  65+       22k  5200   1140

Children get it, but very rarely die from it. For comparison, the death rate for children 0-12 per year in car accidents is a little over 1.3 per 100k. For kids, COVID is about as risky as taking about 50% more car trips.

If it is indeed heading down the path of the other four then it is extremely likely that you will get COVID-19 at some point, despite living in a rural area. Vaccination makes it so that when you do get your first COVID-19 infection, it will almost certainly act more like a second or third infection. Without vaccination, you go into that first infection with your immune system totally unprepared.

As far as the risks of vaccination go, yes, there is a lot we don't know about how the body works. (Ask me sometime about the mysterious lump that showed up on my ass one day, baffled all the doctors that looked at it, and a few years later just went away on its own).

But we do know a lot about vaccination in general. We've been doing that a long time. For all vaccinations so far if there was going to be a side effect it showed up within something like 6 months.

For new vaccines for new diseases the things that go into them are all things that have been well tested before, except for whatever is specific to the new disease. In the case of the mRNA vaccines, that new thing is the mRNA, but mRNA is broken down in cells in a few days.

All the COVID-19 vaccines in use in the US and Europe have been given to enough people long enough ago that we can be confident that if there are any side effect that we do not yet know about it is because they are extremely rare rather than because they take longer to develop.

Bottom line: Waiting it out perhaps made sense when it seemed like there was a chance we could eradicate SARS-CoV-2, but too many people were not willing to do what that it would have taken to do that. With it heading toward becoming the fifth common cold coronavirus that is no longer the case. Get vaccinated with one of the vaccines that has been widely deployed for at least six months.

aguacate6• 5 years ago

Appreciate the perspective re. the common cold and the previous 4 coronaviruses. Some good arguments here.

mabbo• 5 years ago

The two big advantages here:

administered with a disposable needle-free injector, which uses a narrow stream of the fluid to penetrate the skin and deliver the jab to the proper tissue.
They can also be stored at higher temperatures - 2 to 8C. Cadila Healthcare claims that their vaccine had shown "good stability" at 25C for at least three months

No needles means, ideally, less training needed to administer. This can keep medical staff working hospitals, where they are needed. And high temperature storage means easier handling, less spoilage.

Even if efficacy is lower with this vaccine, it's still going to save millions of lives of people who don't live in wealthy cities.

Filligree• 5 years ago

DNA is remarkably stable. I’m not sure if it’s true, but I’ve heard reports of separating it from proteins by boiling the stuff, which will certainly destroy the proteins but apparently leaves DNA largely intact.

The second it’s inside your body the enzymes in your bloodstream will start tearing it apart, but that’s also true for practically anything else you can inject. Until then, refrigeration is far more than enough.

guilhas• 5 years ago

It is amazing how experimental treatments keep getting approved. And traditional proven and effective vaccine like Novavax keeps getting pushed behind

thoughty2• 5 years ago

Coaxin is a transitional vaccine already approved in India (I took it). But yes they haven’t got EUA in US and WHO still hasn’t approved it yet.

webmobdev5• 5 years ago

I too see some corporate competitive politics behind Novavax - Serum Institute of India (SII), one of the largest manufacturer of vaccines in the world, had been licensed to manufacture Novavax in India last year, but apparently the US administration held it up by preventing exports of the raw material with their "US first" policy. That's kind of understandable, but even in the US, I don't think Novavax is so easily available (or perhaps it is but the US media is excessively giving attention to only the mRNA vaccines from Pfizer and Moderna?). Even recently, SII said they are in talks to start production of Novavax this year, but it's still not available. It's not clear what is going on behind the scene with this particular vaccine.

gregwebs• 5 years ago

The company started with zero manufacturing capacity. It’s now slated for fourth quarter in the US but earlier for Europe. I wish they would have been able to partner with big pharma much like the Pfizer vaccine.

DrAwdeOccarim• 5 years ago

This is really cool to see. Just to help people with some context, this vaccine is 2 milligrams per shot (which is equal to 2000 micrograms). I am unsure if they use an adjuvant or not (seems like they don't).

The reason they need to use so much material is the immune activation doesn't line up with spike protein expression and presentation. This is because the plasmid has to be turned into mRNA by the cell that takes it up. By the time the mRNA is being read to make the protein, the initial immune activation by the DNA itself is already waning.

The concomitant signalling (immune activation to trick the body to think it's an actual infection, and detection of the foriegn spike protein at the time and place) is essential for robust immune response against the target. This is why the mRNA vaccines can use 100 micrograms and 30 micrograms (Moderna and Pfizer/BioNTech, respectively)--the innate immune activation caused by the mRNA itself occurs in at the time and space as antigen (spike protein) expression and presentation.

I wish them luck with this, but I don't believe outside of an emergency this technology will be robust enough compared to mRNA, viral-vector, and traditional vaccines.

One more thing, they detect plasmid for a month at the injection site (in non-clinical study) and nearly a month in the blood. That is a concern to me, but not a huge concern. (https://www.biorxiv.org/content/10.1101/2021.01.26.428240v1)

India approves first DNA Covid vaccine

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