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Prevention of HIV 2 years ago

Maybe when on treatment, otherwise superinfections are a thing and associated with poorer outcomes.

Post exposure vaccination alone is not sufficient to prevent death for all cases. Immunoglobulins (HRIG) must also be administered. HRIG is not commonly available in many developing countries or rural areas. This is why preexposure vaccination is recommended for vulnerable groups (children) when traveling to such areas.

The mutation rate for proofreading ssRNA viruses is, affair, about 10^-7 per nt per replication. If we don’t see a particular variant nt it is (from the top of my head) because it didn’t “survive” the drift events or that there is strong positive selection on the sequence.

(Preemptive) Synonymous mutations are able to be selected, as they affect speed of translation and protein folding due to stalled ribosomes.

It depends. It’s hard to model and even think about the selection pressures accurately. West Nile virus showed a marked increase in virulence in corvids recently as did rabbit hemorrhagic disease.

And let’s not forget about Mareks disease, where a non-sterilizing vaccine is thought to have contributed to a massive increase in virulence, killing nearly 100% of unvaccinated chickens now vs causing mild disease decades ago.