Jlang, You need to read and understand evolutio

Jlang,

You need to read and understand evolutionary biology.

You clearly don’t.

Viruses mutate, with mutations both accumulating and deleting every time the virus reproduces, through random genetics.

Large infected populations and hosts that don’t clear the virus allow more mutations by simple mathematics. More reproduction yields more opportunity for mutations.

The mutations become variants of interest and concern when the traits of the virus, change the traits of the virus. These include immune evasion, increased pathogenicity or increased reproductive capacity.

As an example, let’s compare Lambda and Delta, both variants of concern. Lambda is reportedly more pathogenic than Delta, but Delta has higher fitness due to increase nasopharyngeal viral load early in the course of infection, with a resultant significantly increase transmission, reportedly approaching that of varicella. Pathogenicity is concerning to us, but does not increase the fitness (ability to survive and outcompete other strains) of Lambda.

Vaccines and previous infection, through antibodies and killer T cells, provide a selective pressure favoring survival of variants that can avoid being neutralized by these adaptive response.

Immunosuppressed patients from AIDS or treatment (steroids and drugs like CD20 inhibitors for RA, cancer, COPD), have pretty poor immune response, often generating insufficient antibodies with vaccination. Again, these patients are a reservoir for continued viral reproduction, but so are the unvaccinated and to a continued degree, the fully vaccinated. Singling out HIV feels to me like prejudicial scapegoating.

Perhaps you can explain how HIV patients matter so much more than the other 200M+ Covid infected but HIV- patients.