Submitted by number1dork t3_120rixo in askscience
PHealthy t1_jdin3el wrote
We really don't know much about serotype specific waning immunity, it's likely we'll have robust long term immunity from the earlier variants like alpha and delta.
The whole issue of "re-infections" is that new serotypes keep emerging not that people keep getting reinfected with the same variant.
If anyone is interested in infectious disease news: r/ID_News
yofomojojo t1_jdjj3fe wrote
Just to follow up on the re-emergence question. Here's a fun fact about the original Influenza epidemic we call the Spanish Flu; H1N1: It actually died out, once.
Partially from its own mortality rate, partially from built up immunities over time and evolving variants, but by the time we understood what viruses really were and how to approach them, there was no known surviving sample of it.
Before it died out, though, it passed on, first into the birds as H1N2, swapping out one bit for another, and again into pigs as H3N1, which themselves eventually crossed and produced H3N2, but enough mutations and variations kept the base nodes on infrequent rotation over the years. And eventually they met and hot swapped again, giving us the "Novel" influenza virus we called Swine Flu, H1N1.
And at some point, someone found an inexplicably well preserved vial of blood containing the Spanish Flu from back in the early 1900s, and tested it, confirming suspicions that yes indeed, through a series of exchanged hands, swine flu was a perfect re-assembly of the original Spanish Flu strain of influenza.
Tl;Dr - re-emergence is entirely possible even when the given strain has already gone extinct. Blind mutation and hot swapped component parts can always put Humpty Dumpty back together again.
im_thatoneguy t1_jdjlrq0 wrote
Out of curiosity if H1N1 Spanish Flu == H1N1 Swine Flu, why was Swine Flu so much less virulent? The Spanish Flu was particularly deadly among younger people and no young people would have been exposed to the extinct Spanish Flu.
(I Had H1N1 and it was awwwwwffullll, but didn't shut the world down like Covid or Spanish Flu).
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EDIT: They're not the same:
>The Centers for Disease Control and Prevention said Friday the swine flu virus appears to be about as contagious as the average seasonal flu. In examining the virus, it also did not find the genes they think made the infamous 1918 flu so deadly.
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>https://www.npr.org/templates/story/story.php?storyId=103728922
Edit edit:
>Model to Explain the 1918 Mortality Patterns.
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>Elderly individuals may have been protected from the 1918 virus by childhood exposure to an H1N1-like virus (5). We estimate that H1 and the H2 + H5 lineage diverged from a common ancestor near the time of the 1830 pandemic (SI Appendix, SI Text and Figs. S13 and S14). Moreover, protection was clearly greatest in those born before 1834 (5) (Fig. 3A), implicating the 1830–1833 pandemic virus, which would have primed the majority of that age group. If an H1-like virus emerged in 1830, it would likely have been positioned near one of the orange stars close to the root of the tree in SI Appendix, Fig. S13. Those primed as children between 1830 and 1889 by this HA lineage would likely have had considerable protection against the 1918 HA, comparable to that exhibited during the 2009 H1N1 pandemic by those born before 1957 (32), based on the similar genetic distances separating the childhood and pandemic virus HA in each case
https://www.pnas.org/doi/10.1073/pnas.1324197111#supplementary-materials
The tree here would indicate that H1N1 like Covid just continued to evolve and become endemic, it didn't die out. Nowhere is it claimed that the genomes are the same. In fact as the CDC mentions, we had a full sequence by 2005 of the 1918 flu and it didn't match.
hayalci t1_jdjswfg wrote
In addition to r/brown_felt_hat's answer, Spanish Flu was around World War I, ravaged economies, poverty, illness, and a general lack of resources probably would have confounded its effects.
brown_felt_hat t1_jdjn0u2 wrote
We are definitely a lot better at recognizing and treating illnesses these days. We have drugs to mitigate infection vectors (eg cough syrup prevents coughing, a massive transmission vector, decongestants limit mucus production so you're not sneezing snot everywhere), we have drugs to treat dangerous symptoms (anti pyretic drugs to prevent high fevers, repository drugs to prevent failure), and just much better overall awareness of how viral infections work and spread.
im_thatoneguy t1_jdjx0hg wrote
So if you didn't take any medication, you had pretty much the experience you would have in 1918--except you would probably take Paracetamol for fever and if your condition worsened you could receive tamiflu and other stronger medications?
Or like the difference between Alpha and Delta Omicron, they're the "same" but probably exhibited substantially different mortality?
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Atechiman t1_jdk1y5e wrote
HXNX is a way of indentfying large families of Orthomyxoviridae in particular alphainfluenza betainfluenza gammainfluenza and deltainfluenza, the four 'families' of bird/mammalian flus (often just called a,b,c,d) I forget off hand the exact proteins it refers to, but all of the viruses have one of four of them so H1N3 viruses tend to behave similar to each other but different from H1N2.
H1N1 is an alpha virus, that different strains have caused several major pandemics including the Swine Flu. It is an avian virus usually, but some strains are endemic in humans and it is often the flu-a vaccine for a year.
1918 flu is an outlier as was the '83? '82? Russian pandemic novel. The 2008 was slightly more lethal than normal but not more contagious.
mystlurker t1_jdk8n7n wrote
This article is pretty interesting:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3734171/
I found potential explanation #4 to be of particular interest. There is a theory that exposure to another flu strain in ~1890 may have caused a dysregulated immune response.
byerss t1_jdjw4rg wrote
H1N1/09 did hit younger people harder than older folks. I remember reading that one theory was that for 2009 older folks may have had more natural immunity because they were exposed to flu variants based on Spanish Flu.
Look up the death vs age graphs for swine flu.
yofomojojo t1_jdk0chr wrote
Re: your edit - I'm open to being rebutted here but, I think that clip might be a bit outdated. H1N1 is Swine Flu and Spanish Flu. If we're doing podcast links, RadioLab covered this topic again during early Covid. Current scientific papers and articles on the topic all seem to understand and accept that H1N1 is the virus in question in both cases.
im_thatoneguy t1_jdk1ror wrote
https://pubag.nal.usda.gov/download/26795/PDF
That radiolab is discussing the basis of a 2005 paper which included the entire genome. So a 2009 CDC analysis (which NPR cites) should be based on the fully sequenced H1N1-1918 genome from 2005.
Edit:
https://www.pnas.org/doi/10.1073/pnas.1324197111#supplementary-materials
This states that H1N1 didn't go away, it continued to evolve into a seasonal H1N1. And that likely the 1918 H1N1 branched off into the H1N1 in pigs prior to the human outbreak.
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namenumberdate t1_jdjz9iv wrote
That’s scary. Thank you.
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jinxjar t1_jdk7b1k wrote
it's like that time when i did the math problem wrongly but got the correct result.
i failed that test, but H1N1 passes.
no fair
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phred14 t1_jdirlwl wrote
I was under the impression that Omicron and later were better at evading immunity and that nothing worked in a lasting fashion against them - everything wanes fairly quickly.
PHealthy t1_jdiztvk wrote
Omicron isn't a single serotype (immune recognition), it's actually a ton:
https://covid.cdc.gov/covid-data-tracker/#variant-proportions
So this isn't waning immunity, it's serotype emergence that escapes immunity.
ELI5: we get a great pitcher versus the first batter but they keep changing batters as we strike them out until eventually our pitcher is terrible. Then we bring in a new pitcher to match against the best batter we've seen so far and it starts all over again.
phred14 t1_jdj1pe4 wrote
Thank you for that perspective, it makes me feel much better about things. Not enough better to quit being careful, but still better than I had been.
chimpfunkz t1_jdj2jfy wrote
The other half of it is, Even though the batters started hitting instead of striking out, they're mostly hitting singles or doubles instead of home runs. So it's easier to prevent runs from being scored (in this analogy, runs are deaths)
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northatlanticdivide t1_jdjwo1o wrote
I’ve followed mutations on nextstrain for a while and those of you who are more visual learners like me may find it interesting. It was particularly fascinating watching the rise of delta and it’s being overtaken by omicron. You can also track flu, Ebola, measles, etc.
kurai_tori t1_jdjboh1 wrote
This is why the latest booster is based on the mRNA of two variants. Both to increase your immunity to an increased number of variants (there is some cross protection from related variants, depends on how similar the spike protein/antigen is to the original that the antibodies previously produced (e.g. via vaccination).) as well as to increase your "standing army" of antibodies (specific antibodies levels drop after a while, leaving memory cells that will "activate" when reexposed to the Covid antigen (variant-specfic spike protein). Problem is the memory cell response might be too slow, hence the need for boosters of the same variant.
Flu shots are a good example of this and we will likely be moving to a similar approach with COVID.
fakeittil_youmakeit t1_jdjbodw wrote
Question for you - I couldn't get the most recent booster due to some health issues at the time. I'm doing much better now and could probably be in a good enough place to do it in the next couple of months or so, at that point, is it even worth it or will the serotypes have changed so much it's not effective anymore? If that's the case are there going to be annual boosters and should I just wait for the next one in October or something? TIA!
Tephnos t1_jdk617u wrote
You should still get the bivalent booster now if you can. In the US, it is based off of BA.5, which isn't too far removed from the current circulating XBB 1.5 and BQ1.1 strains.
It is likely that later this year we'll get an updated booster again, possibly targeting XBB if it still sticks around.
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KruppeTheWise t1_jdk9j3q wrote
Is the fact we vaccinated during the pandemic likely to have put evolutionary pressure on selecting serotypes that can defeat vaccine protection?
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Psyc3 t1_jdj1meq wrote
You have to take into account what evading immunity can mean. It means it can infect people and they can spread it, it however doesn't mean they have a serious disease or need hospitalisation.
The issue with COVID-19 was lack of any immunity at all, while early variants infected the lungs, later, more infectious variants started to infect the upper airway more seriously, but the reality is while this allows more effective spread, the upper airway is largely irrelevant, it isn't what absorbs your Oxygen supply, it is just causes a really bad cough instead.
Then you have to take into account this issue isn't a disease existing, it is everyone getting it at the same time, and then a significant percentage needing hospitalisation at the same time. Imagine everyone broken their arm at the same time, A+E would collapse, orthopaedics would collapse, any requirement for surgery would be overwhelmed (it is needed in 2 weeks), there would be no ability to get people effective rehabilitation, and people would start dying from complications of broken arms.
That is essentially what happened in COVID, with "a broken arm" being an unknown disease with an unknown treatment pathway, which once again is a massive problem. It is fine if you can treat 95% of your patients with X known treatment, it is another thing when you are trying to work out what treatment is needed, then when you do, don't have the equipment to implement it, or the specialists to manage it.
NutDraw t1_jdjtgv0 wrote
>Imagine everyone broken their arm at the same time, A+E would collapse, orthopaedics would collapse, any requirement for surgery would be overwhelmed (it is needed in 2 weeks), there would be no ability to get people effective rehabilitation, and people would start dying from complications of broken arms.
Excellent example. The biggest risk with something like COVID are the huge waves of cases that overwhelm response systems. Sure, the vast majority of hospitalized people will survive with some supplemental oxygen, but if you only have enough tanks and masks for half of them the death rate skyrockets.
kurai_tori t1_jdjcc0h wrote
This is why I've been sure to get the lastest booster and am still relatively careful. I don't want to be a cog in the damn viruses' mechanisms. I want my immune system to be able to say "this isn't free real estate".
Cause if you get infected, even if it's asymptomatic, you are a carrier/vector at that point. And you give the virus a chance to thrive, and mutate, and possible mutate to a worse form (viruses can be fatal as long as that still allows them to thrive, and direction of mutation is not always to safer, less fatal forms. Really it's whatever features allow them to outcompete their competitors).
mikmckn t1_jdjh59d wrote
If more people took that approach it might have helped early on but eventually it was going to come down to a couple different end games.
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We eradicate COVID-19 (sars-cov_2). The fact that there are many different coronaviruses out there would indicate this isn't likely to work. The willingness of this thing to mutate would also seem to be a big speedbump in this road. It's not smallpox.
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We beat it back so it's uncommon in this country, like polio or mumps. We'd measure outbreaks in the hundreds and it makes the occasional news report instead of being among the leading causes of death. This MIGHT have been possible with an earlier response that was more restrictive and heavier vaccine use. However, other nations did this and still didn't manage to beat it back before it moved into the 3rd option. China is still trying for zero COVID-19.
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Endemic. COVID-19 is here for the long haul. It's in the population. Mothers are going to pass their immunity onto new children. Survivors built antibodies. Vaccinated people built antibodies. Less deadly variants managed to sneak under the radar. We'll be stuck with this long term and probably forever. Coronaviruses are adaptable little jerks. Some just cause cold symptoms. Others cause SARS. Like it or not, we are here.
fang_xianfu t1_jdj48aq wrote
"Omicron and later" has huge variation. The variants people are getting now are as different to Omicron as the initial variant was from Omicron. They get named based on how concerning they are - they're Variants of Concern - not how different they are. So when they say "nothing works in a lasting fashion against them" it's because there are many of them.
WaitForItTheMongols t1_jdiz0hx wrote
It's important what "immunity" you're referring to.
At this point with the number of variants, it's more helpful to think of COVID as a family of illnesses, rather than an illness. Immunity to other variants won't work against Omicron very well. But if you have immunity to Omicron, it works against Omicron.
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Nicolay77 t1_jdjaxs7 wrote
I was under the impression Omicron was so contagious and so not-deadly that getting it actually was like getting vaccinated against most variants of Covid.
Bone-Wizard t1_jdke1nv wrote
That’s the sub where I first read about Covid in mid-December 2019… back when it was a case series of 20ish people with pneumonia in Wuhan. Great sub.
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dannymurz t1_jdj0pjq wrote
Transmission wasn't halted because the vaccine doesn't produce great mucosal immunity since so the virus easily and quickly replicates and is able to be spread, vaccine does great against more moderate and severe disease, which takes days and weeks to develop.
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StickySnacks t1_jdjb3s6 wrote
What are the chances the vaccine is actually ineffective?
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