Covid endless variants and RA immune suppression

Arthuritis

This is a concerning article from the journal Nature:

https://www.nature.com/articles/d41586-022-01613-2

Just when I thought it was safe to go back out…

For our community having multiple jabs each with the potential to trigger a flare up is already unwelcome. We really need vaccination against the parts that don’t mutate so much.

Has anyone heard of any progress in this direction?

frogmorton

Hello @Arthuritis where have you been? I hope all is going well for you?

Here in staffordshire our figures are rising for definite. Best keep our masks on I 🤔 think.

Take care

Toni x

stickywicket

I'm sure I read something of the kind ages ago ie that, because we are immunosuppressed to start off with, we are liable to have covid for longer than other (NB. Covid, ie still infected, not 'long covid' where the infection goes but health problems remain) the disease may well mutate inside us. That seems logical but, on the plus side, there are lots of mutations occurring regularly which are not significant. Also, I think all that was before the advent of antivirals.

jamieA

Hi @Arthuritis

There's an interesting CNN article I read last week that looks at the search for longer lasting vaccines.

https://edition.cnn.com/2022/05/20/health/mrna-vaccine-technology-covid-19-durability/index.html

Personally I will keep taking vaccines if and when the medics prescribe them. My first 4 vaccines were Pfizer and the fifth was Moderna. I've not had any reaction to them, other than a mildly aching arm for a couple of days after the Moderna. In March my wife had covid, testing positive for 10 days with me in the house as cook, waiter and general dogsbody, then in May my son tested positive the morning after he had visited me. I tested regularly with LFTs and didn't contract it on either occasion so hopefully the vaccines were having the desired effect. My wife has a friend who is immunosuppressed and tested positive last month. She contacted the local health authority number for antivirals and she got them that evening and is now fine so that appears to work.

As @frogmorton says I still wear a mask when going into any commercial premises and don't use public transport. I test at least twice a week and my family test before visiting me.

The general public appear to think covid is over despite the latest ONS figures showing the weekly death rate for the first week in June was twice the number it was for the same week last year (211 vs 108).

MoiraA

Just heard covid infection rates in Scotland have risen to 1:30 this week driven by subvariant BA4 and BA5. I believe rates across UK have risen too.

Does anyone know if current booster vaccine includes these new subvarinats as it was BA1 and BA2 that were dominant when spring boosters started?

Think it’s time to reintroduce some restrictions to not only protect immune compromised people but wider society too if uptick in infections continue.

Arthuritis

@frogmorton Still hanging in there, yes, covid rising, however as the variant mainly deadly to immune compromised & elderly, the powers that be are pretending its not there. Indeed, the health sec said unkindly “adding more cash to the NGS would be unfair to the young”, echoing the policy of not admitting anyone over 60 at the height of covid when ICU beds were tight. Fully understand from a financial perspective, the elderly & chronically sick are a drain on the young & healthy taxpayers, and given a choice to treat a drain or a future source of taxes… What they forget is these people have already paid their tax dues over a life time, even if squandered by successive govts, and looking after the frail is what makes the difference between the civilised & not.

@stickywicket I think the article could have been better written, but in short the main points are:

1. All the approved vaccines today prepare your immune response against the part that changes its “mask” (spike head) most frequently, like the flu. As the spike mutates the vaccine stimulated antibodies bind only weakly to it, which means you need increasingly higher concentrations of antibody to make the virus struggle to wade through. This is why you need repeated vaccinations of the same vax-antigen to maintain high concentrations. The pharmas can’t adapt to the changing spike mask as quickly as it can mutate & swap them.
2. The longer you host a virus, esp an RNA virus the higher the chance of developing a mutation by random chance that will bypass a healthy vaccinated carer’s defences and go on to replicate, either as a mild illness or something more serious, however the milder one is more likely to spread as humans treat mild covid as “a cold”, and something that knocks them out as “maybe its flu or covid”. The length of time needed to evolve an effective mutation is quite long, is months, usually in a hospital. The evolution is through random chance, so most mutations will fail.

The antivirals are not that good, Molnupiravir barely works and passed FDA approval because there was little else, and works by accelerating mutations to cause more failed progeny. Remdesivir works a little better by halting viral RNA synthesis, however these drugs, like all drugs, are not free of side effects and we don’t know how well they will be tolerated as they are new, but hey, when its life or death best to take whats available.

@MoiraA I am not aware of any approved vaccine customised to the current variants. The Walter Reed Army hosp & research centre (US Army) are working on developing a vaccine against the essential parts of the virus that it cannot mutate eg you can swap your disguise mask but you can’t swap your blood type kind of logic. However the virus is smart, and hides this vulnerable part well. This type of research is very expensive and there’s no prospect of selling govts multiple doses, so not commercially attractive and best run by a govt or non profit.

@jamieA Good CNN article, I might have covered similar points here in my post.

The vaccines are generally well tolerated by older people, ie over 45, in fact the older you are the more likely it will be a non event, and you need the help, as older immune systems are fairly weak with age already and won’t go nuts on a marauding rampage like a young person’s, shooting at everything in sight and over reacting.

So for it to be a non event for you, I’d guess you are over 45, with a worldly wiser immune system but my apologies if I offended! 😉

Personally I’d rather not have an endless series of vax stimulation for the same virus if my cellular response after 2 jabs is adequate, even if my antibodies have dropped off after my mRNA vax. I have worked in some grotty parts of the world so have a very lengthy vaccination record card, but accutely aware that until I am a bit older my immune sys is more likely to go nuts with each stimulant!

jamieA

https://community.versusarthritis.org/discussion/comment/696213#Comment_696213

Hi @Arthuritis

No offence taken - I'm 66. Everyone is different and I can appreciate your point regarding endless vaccines. I wish there were developments in a longer lasting solution but it doesn't seem that any time soon it will appear.

Since covid appeared in the UK in March 2020 I've had at least 10 chest infections - possibly as a result of contracting covid just when the UK had stopped testing in March 2020. Three of these required hospitalisation for pneumonia, the first of which occurred 3 weeks after my PsA diagnosis and my PsA went on the rampage at the same time. So my CRP level peaked at 340 and they didn't know whether it was the pneumonia or the PsA or both - one of the nurses told me later that if it were down to the pneumonia then that's above sepsis levels. I spent the best part of a week on a full face oxygen mask, getting pumped full of steroids - not something I'd wish to repeat if I can avoid it. I've ended up with a patch on my right lung so any protection is gratefully received.

Baloo

Thats interesting. So am I right or wrong in thinking that immunosuppressants are reversible, you stop taking them if you want to, and your immune system returns to the strength it was before? In the case of steroids I had to taper off, and still this time I suspect I got a flare up, but its maybe settling down afterwards, and maybe I would be better off toughing out the remaining aches without any steroids?

jamieA

https://community.versusarthritis.org/discussion/comment/696231#Comment_696231

Hi @Baloo

I think so. It was described to me that the cytokine proteins that tell my immune system how and when to function are out of control causing the immune system to attack my joints. As far as I understand it the immunosuppressants don't eradicate the cytokines that cause the problem they inhibit or block them.

Arthuritis

@Baloo Its as @jamieA describes, the immune suppressants (accurate) temporarily disables a part of the complex machine that is your immune system. The more modern versions and steroids interfere with the signalling process. So you could have like huge hive of white cells with the potential to attack, but they can’t receive the attack signal, so nothing happens. Older ones like MTX deplete the warrior cell supply by preventing new ones from being produced at a rapid rate, so RA is greatly slowed down. (MTX competes with folate, essential for new cell production, which is why children and pregnant women cannot take this). When you stop taking these “DMARDS” as they are euphemistically called (they suppress your immune sys and the useful side effect is relief from RA, however they do not directly modify the disease-causing faulty dendritic cells exclusively, but pharma likes to call them “Disease Modifying AntiRheumatic Drugs”, as it sells better than “nuke your immune system for RA pain relief”).

Unfortunately the moment you stop taking them, your immune system will go on the rampage destroying anything it thinks is out of place, including your joints, and any other disease present, which will just stimulate it more like an angry hornet’s nest.