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The most effective malaria vaccine yet discovered

blogs.sciencemag.org

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Re: The most effective malaria vaccine yet discovered

#51

Post by soperj »

fastball wrote: post #40
soperj wrote: post #38

Earlier quoted context omitted.

Because old people are worth less than children?

Yes but not in the way you're implying. A child dying robs them and the world of 60+ years of human life. An 80 year old dying of COVID-19 was not going to live much longer anyway, so the loss is less severe. Old people have already had the opportunity to live a "full" life. Imagine two societies – one where a disease kills 50% of 70s every year. Which society would do better? Which society would you rather live in?

In the US, more people in the 55-74 age range have died than the 85+. Those are people who are taking care of grand children, or are still working. These are people that society has spent decades making fully functioning parts of society. A child has had none of that investment.

A society of just children wouldn't work, just as a society without wouldn't work.

Re: The most effective malaria vaccine yet discovered

#52

Post by IG_Semmelweiss »

eloff wrote: post #5

What blows me away is in a study group of 734 infants, which benefited from maternal antibodies against malaria, 717 were infected by malaria in the first year of their life. That's nearly 100%, in the first year since birth. That's devastating. The vaccine is showing 77% efficacy in trials in Burkina Faso. That's an ongoing pandemic that makes covid-19 look like a case of the sniffles. Malaria deaths peaked around 9…

malaria vector is mosquitoes, which are particularly devastating in tropical areas with rainy seasons that end up with numerous stillwater deposits.

Stillwater deposits (i.e. no fish) are the perfect breeding grounds for mosquitoes. If you have a very wide area with poor transportation infrastructure, or if you don't have funds to fumigate for mosquitoes...you are toast.

The incidence rate should not be surprising for anyone that has lived in a tropical country with a rainy season.

You can't run and you can't hide. Mosquitos come out when you sleep, and use body heat and breathing to find their victims. You will be bit by mosquitoes. Many times. Sometimes multiple times a day. The question is whether you get enough bites that chance will deliver a malaria bite.

Re: The most effective malaria vaccine yet discovered

#53

Post by vtail »

jjeaff wrote: post #30
eloff wrote: post #5

What blows me away is in a study group of 734 infants, which benefited from maternal antibodies against malaria, 717 were infected by malaria in the first year of their life. That's nearly 100%, in the first year since birth. That's devastating. The vaccine is showing 77% efficacy in trials in Burkina Faso. That's an ongoing pandemic that makes covid-19 look like a case of the sniffles. Malaria deaths peaked around 9…

Except for the age difference of the victims, those numbers actually make covid seem pretty bad. Covid has hardly been around for a year and is killing 7x as many people a year.

Malaria affects far smaller population size.

Re: The most effective malaria vaccine yet discovered

#54

Post by eloff »

jefftk wrote: post #49
throwaway5752 wrote: post #34

Earlier quoted context omitted.

It's incorrect to say it looks like sniffles in comparison. This is basically severity / priority in software. If we left sars-covid-19 without mitigation for a century, it would catch up rapidly. You compare things over relevant intervals. There are far more influenza deaths over the last 3 decades than ebola, but ebola is far more severe and greater concern.

> If we left sars-covid-19 without mitigation for a century, it would catch up rapidly. I think that's probably wrong? The most likely outcome would be that after the initial pandemic subsided (with lots of deaths), most people would catch it when they were reasonably young and then be mostly protected. This is different from malaria, which is much more deadly.

Yes. Also evolution tends to favor making diseases better adapted to their hosts and note virulent, but less deadly.

We have a number of Coronaviruses endemic to humans that cause the common cold (among other viruses.) That's probably how covid19 would turn out, left to its own devices.

Re: The most effective malaria vaccine yet discovered

#55

Post by eloff »

soperj wrote: post #39
eloff wrote: post #36

Earlier quoted context omitted.

Yes, but over the course of history, there's no comparison. Which was my point. Covid-19 is hopefully going to be short-lived thanks to the vaccines, but even if it weren't for that it would likely become more virulent but less deadly over time like the other Coronaviruses that are endemic in humans. There is a also a big difference in lives lost at the end of life versus at the beginning.

>Covid-19 is hopefully going to be short-lived thanks to the vaccines, but even if it weren't for that it would likely become more virulent but less deadly over time like the other Coronaviruses that are endemic in humans. Over the last year it's be come more virulent and more deadly. We have no idea how well the vaccines are going to work. We have a situation right now where a country(india) with 100 million people…

> Over the last year it's be come more virulent and more deadly.

Evolution is a somewhat random process at its heart, but I stand by what I said as the likely outcome, because that's the path new diseases normally take. It's early days yet.

> We have no idea how well the vaccines are going to work

I think we have a petty good idea by now actually. A bigger question is how much will it be hampered by people afraid or unwilling to be vaccinated? I have never in my life seen such widespread and illogical fear of vaccines.

We may have to just accept that there will be an ongoing toll in the unvaccinated population that keeps the virus circulating in quantity and keeps the hospitals busy. Until sufficiently many develop natural antibodies through infection.

> We have a situation right now where a country(india) with 100 million people vaccinated is getting 350,000 cases a day, and it's doubling every 10 days. That's a scenario where the evolution around the protection a vaccine offers becomes a very real and distinct possibility.

Yes, that's a tail risk that's real and terrifying. I think the risk is small given such a mutation would possibly render the virus much less virulent. The vaccines tend to target the spike protein, without which it can't even infect humans. But nature finds a way. We can and will also adapt the vaccines in that case though. The money, motivation, and technical expertise are all there. But nobody knows how likely a risk that is.

Re: The most effective malaria vaccine yet discovered

#56

Post by ChrisMarshallNY »

Exmoor wrote: post #11
eloff wrote: post #5

What blows me away is in a study group of 734 infants, which benefited from maternal antibodies against malaria, 717 were infected by malaria in the first year of their life. That's nearly 100%, in the first year since birth. That's devastating. The vaccine is showing 77% efficacy in trials in Burkina Faso. That's an ongoing pandemic that makes covid-19 look like a case of the sniffles. Malaria deaths peaked around 9…

> Malaria deaths peaked around 930,000 a year in 2004, and is around 600,000 a year now Your link does a good job showing this, but for those who don't click and scroll down it's probably worth mentioning that the vast majority of those deaths are in central Africa. So it's not just a lot of deaths, but it's a really significant portion of the population and, as you said, mostly children.

I grew up in Africa. We weren't as scared of Ebola, as we were, of good old Malaria.

It's also the gift that keeps on giving. Once you get it, it does a reunion tour, every now and then, for the rest of your life.

At the dinner table, we (expats) used to have a bowl of quinine tablets, set out like a condiment.

I really hope this works out, because, thanks to climate change, the lower 48 may get a chance to find something in common with our neighbors to the south.

Re: The most effective malaria vaccine yet discovered

#57

Post by Vrondi »

stuff4ben wrote: post #46
User23 wrote: post #17

Earlier quoted context omitted.

The most successful measure was carpet bombing the USA with DDT for years[1]. Most people don't know this now, but malaria used to be endemic in the USA as far north as the border with Canada. DDT's environmental persistence is obviously a double-edged sword, but it made the eradication possible. [1] https://www.cdc.gov/malaria/about/history/elimination_us.htm...

I don't mean to be crass, but why wouldn't that have worked in Africa? Yes DDT is scary bad, but we seem to be doing ok in the US.

Weird as this seems, at the time, you had to be in a country that could _afford_ DDT. It wasn't free.

Re: The most effective malaria vaccine yet discovered

#58

Post by fastball »

soperj wrote: post #51
fastball wrote: post #40

Earlier quoted context omitted.

Yes but not in the way you're implying. A child dying robs them and the world of 60+ years of human life. An 80 year old dying of COVID-19 was not going to live much longer anyway, so the loss is less severe. Old people have already had the opportunity to live a "full" life. Imagine two societies – one where a disease kills 50% of 70s every year. Which society would do better? Which society would you rather live in?

In the US, more people in the 55-74 age range have died than the 85+. Those are people who are taking care of grand children, or are still working. These are people that society has spent decades making fully functioning parts of society. A child has had none of that investment. A society of just children wouldn't work, just as a society without wouldn't work.

Is your goal to just be as misleading as possible in this conversation?

Yes, of course more 55-74s have died – there are far, far more of them than there are >85s. Normalized, COVID is far more lethal (8x more lethal) for >85s than for your range. Here's the mortality rates:

55-74: 0.28%

85+: 2.5%

https://www.statista.com/statistics/241488/population-of-the...

https://www.cdc.gov/nchs/nvss/vsrr/covid_weekly/index.htm

Re: The most effective malaria vaccine yet discovered

#59

Post by renewiltord »

eloff wrote: post #5

What blows me away is in a study group of 734 infants, which benefited from maternal antibodies against malaria, 717 were infected by malaria in the first year of their life. That's nearly 100%, in the first year since birth. That's devastating. The vaccine is showing 77% efficacy in trials in Burkina Faso. That's an ongoing pandemic that makes covid-19 look like a case of the sniffles. Malaria deaths peaked around 9…

Ah, that's why GiveWell rates mosquito netting so high. To think I could save a child with a thousand dollars.

Re: The most effective malaria vaccine yet discovered

#60

Post by renewiltord »

soperj wrote: post #38
MongooseMan wrote: post #32

Earlier quoted context omitted.

Comparing the deaths side by side misses an important aspect: most malaria deaths are children, whereas Covid mostly affects older age groups.

Because old people are worth less than children?

In a QALY sense, yeah. The most valuable to society are the workforce but children are almost as valuable.

My parents are 60+ yr old surgeons. They work during the pandemic not because they have to. It's because you run the QALYs and the morality is clear. You participate or make way.

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