The preliminary results on the AstraZeneca vaccine were based on a total of 131 Covid-19 cases in a study involving 11,363 participants. The findings were perplexing. Two full doses of the vaccine appeared to be only 62% effective at preventing disease, while a half dose, followed by a full dose, was about 90% effective. That latter analysis was conducted on a small subset of the study participants, only 2,741.
Hopefully more study will be done on that dosage question. From the AP:
“The report that an initial half-dose is better than a full dose seems counterintuitive for those of us thinking of vaccines as normal drugs: With drugs, we expect that higher doses have bigger effects, and more side-effects,” he said. “But the immune system does not work like that.”
The seemingly lower efficacy comes with some perhaps significant benefits: this vaccine is cheaper to produce and doesn’t require any special refrigeration.
The vaccine can be transported under “normal refrigerated conditions” of 2 to 8 degrees Celsius (36 to 46 degrees Fahrenheit), AstraZeneca said. By comparison, Pfizer plans to distribute its vaccine using specially designed “thermal shippers” that use dry ice to maintain temperatures of minus-70 degrees Celsius (minus-94 degrees Fahrenheit).
The Pfizer and Moderna vaccines were pretty similar in many respects and this one seems quite different. These results were just released a few hours ago, so it will be interesting to follow the debate and expert commentary on this. Stay tuned…
Update: This is amazing: the seemingly more effective 1/2 dose + full dose regimen was a mistake.
Around the time when Astra was initiating its partnership with Oxford at the end of April, university researchers were administering doses to trial participants in Britain.
They soon noticed expected side effects such as fatigue, headaches or arm aches were milder than expected, he said.
“So we went back and checked … and we found out that they had underpredicted the dose of the vaccine by half,” said Pangalos.
A far smaller number of participants was given the initial half-dose, so more research will need to be done to determine if this mistake will be added to the long list of scientific discoveries made because of errors. There’s a good piece in Nature that talks about what we know and don’t know about the vaccine results so far along with some informed speculation.
But, if the differences are bona fide, researchers are eager to understand why. “I don’t think it’s an anomaly,” says Katie Ewer, an immunologist at Oxford’s Jenner Institute who is working on the vaccine. “I’m keen to get into the lab and start thinking about how we address that question.” She has two leading theories for why a lower first dose might have led to better protection against COVID. It’s possible that lower doses of vaccine do a better job at stimulating the subset of immune cells called T cells that support the production of antibodies, she says.
Another potential explanation is the immune system’s response against the chimpanzee virus. The vaccine triggers an immune response not only to the SARS-CoV-2 spike protein, but also to components of the viral vector. It’s possible that the full first dose blunted this reaction, says Ewer. She plans to look at antibody responses against the chimpanzee virus to help address this question.
Update:A short thread by Dr. Natalie Dean, which leads with “AstraZeneca/Oxford get a poor grade for transparency and rigor when it comes to the vaccine trial results they have reported”.
The drugmaker Moderna announced on Monday that its coronavirus vaccine was 94.5 percent effective, based on an early look at the results from its large, continuing study.
Researchers said the results were better than they had dared to imagine. But the vaccine will not be widely available for months, probably not until spring.
Despite the delivery timeline, this is such good news.
The companies’ products open the door to an entirely new way of creating vaccines — and creating them fast. Both use a synthetic version of coronavirus genetic material, called messenger RNA or mRNA, to program a person’s cells to churn out many copies of a fragment of the virus. That fragment sets off alarms in the immune system and stimulates it to attack, should the real virus try to invade. Although a number of vaccines using this technology are in development for other infections and cancers, none have yet been approved or marketed.
“The fact that two different vaccines made by two different companies with two different kinds of structures, in a new messenger RNA concept, both worked so effectively confirms the concept once and for all that this is a viable strategy not only for Covid but for future infectious disease threats,” said Dr. Barry R. Bloom, a professor of public health at Harvard.
Natalie E. Dean, a biostatistician at the University of Florida, said an important finding was that the vaccine appeared to prevent severe disease. Pfizer did not release information about disease severity when reporting its results.
Researchers say the positive results from Pfizer and Moderna bode well for other vaccines, because all of the candidates being tested aim at the same target - the so-called spike protein on the coronavirus that it uses to invade human cells.
It’s only a few more months — please please do what you can to stay safe and keep others safe (especially medical workers) until these vaccines can be rolled out.
In a press release (and not a paper in a peer-reviewed journal) based on a preliminary outside review of data from its phase 3 trial, Pfizer says its Covid-19 vaccine was more than 90% effective in preventing the disease.
The company said that the analysis found that the vaccine was more than 90 percent effective in preventing the disease among trial volunteers who had no evidence of prior coronavirus infection. If the results hold up, that level of protection would put it on par with highly effective childhood vaccines for diseases such as measles. No serious safety concerns have been observed, the company said.
I really hope this analysis holds up when more data from the study is released:
The data released by Pfizer Monday was delivered in a news release, not a peer-reviewed medical journal. It is not conclusive evidence that the vaccine is safe and effective, and the initial finding of more than 90 percent efficacy could change as the trial goes on.
The world, and the United States, could really really use some good news like this about the pandemic.
Pfizer’s first analysis was planned for 32 events, which they pushed back after discussions with FDA. But by the time they analyzed the data, 94 had accrued. This shows how quickly trials can generate results when placed in hotspots (and how much transmission is ongoing!).
These vaccines are tested until a certain number of infections happen. So you have this interesting paradoxical situation where if a potential vaccine is more successful at curbing infection, the longer it takes for the study to conclude. You get a better vaccine but wait longer for it. Countering that are the rising transmission counts in the US — more community transmission will get you to the target number of infections more quickly.
Update: From virologist Dr. Florian Krammer, a thread about what Pfizer and other companies will be looking for in terms of the efficacy of vaccines in a number of different situations. Overall, he is optimistic about these preliminary results. And here’s a FAQ about the vaccine from the NY Times.
Another open question is whether children will get protection from the vaccine. The trial run by Pfizer and BioNTech initially was open to people 18 or older, but in September they began including teenagers as young as 16. Last month, they launched a new trial on children as young as 12 and plan to work their way to younger ages.
We’re all so goddamned tired of this fucking pandemic and so people are looking at the development and distribution of a vaccine as the thing that’s going to get us out of this (and quick). But realistically, that’s not what’s going to happen. Carl Zimmer wrote about some of the challenges with Covid-19 vaccines.
The first vaccines may provide only moderate protection, low enough to make it prudent to keep wearing a mask. By next spring or summer, there may be several of these so-so vaccines, without a clear sense of how to choose from among them. Because of this array of options, makers of a superior vaccine in early stages of development may struggle to finish clinical testing. And some vaccines may be abruptly withdrawn from the market because they turn out not to be safe.
“It has not yet dawned on hardly anybody the amount of complexity and chaos and confusion that will happen in a few short months,” said Dr. Gregory Poland, the director of the Vaccine Research Group at the Mayo Clinic.
See also Dr. Fauci’s belief that our best case scenario for returning to something close to normal life in the US is late 2021.
On Twitter, Zimmer also commented on something that I hadn’t really thought about: that all of these vaccines in development in the US are only for adults:
I wrote last month that no trials for kids had started. Update: still no US trials for kids. The goal of having shots ready for them by fall 2021 may be slipping further away.
Only if researchers discovered no serious side effects would they start testing them in children, often beginning with teenagers, then working their way down to younger ages. Vaccine developers are keenly aware that children are not simply miniature adults. Their biology is different in ways that may affect the way vaccines work. Because their airways are smaller, for example, they can be vulnerable to low levels of inflammation that might be harmless to an adult.
These trials allow vaccine developers to adjust the dose to achieve the best immune protection with the lowest risk of side effects. The doses that adults and children need are sometimes different — children get smaller doses of hepatitis B vaccines, for example, but bigger doses for pertussis.
You probably hate reading these kinds of articles; I know I do. But facing up to the reality of our situation, particularly here in the US where our political leadership has utterly failed in protecting us from this virus, is much better than burying our heads in the sand — that’s just not mentally healthy.
With a very effective vaccine ready in Nov/Dec, distributed widely, and if lots of people take it (i.e. the best case scenario), the earliest we could return to “normal life” in the world is the end of 2021.
At the New Yorker Festival earlier in the week, Michael Specter asked him about a return to normalcy and Fauci elaborated a bit more on this timeline (starts ~10:22 in the video).
When are we gonna get back to something that closely resembles, or is in fact, normal as we knew it?
We’re already making doses, tens and hundreds of millions of doses to be ready, first at least, in graded numbers at the end of the year in November/December. By the time we get to April, we likely will have doses to be able to vaccinate anybody who needs to be vaccinated. But logistically by the time you get everybody vaccinated, it likely will not be until the third or even the beginning of the fourth quarter of 2021.
So let’s say we get a 70% effective vaccine, which I hope we will get, but only 60% of the people get vaccinated. There are going to be a lot of vulnerable people out there, which means that the vaccine will greatly help us to pull back a bit on the restrictions that we have now to maintain good public health, but it’s not going to eliminate things like mask wearing and avoiding crowds and things like that.
So I think we can approach normality, but I don’t think we’re going to be back to normal until the end of 2021. We may do better than that; I hope so but I don’t think so.
Leaving aside what “normal” might mean and who it actually applies to,1 there’s some good news and bad news in there. The good news is, they’re already producing doses of the vaccine to be ready if and when the phase 3 trials are successful. Ramping up production before the trials conclude isn’t usually done because it’s a waste of money if the trials fail, but these vaccines are so critical to saving lives that they’re spending that money to save time. That’s great news.
The bad news is that we’re not even halfway through the pandemic in the best case scenario. We’re going to be wearing masks in public for at least another year (and probably longer than that). Large gatherings of people (especially indoors) will continue to be problematic — you know: movie theaters, concerts, clubs, bars, restaurants, schools, and churches — and folks staying within small pods of trusted folks will likely be the safest course of action.
A change in national leadership in both the executive branch and Senate could change the outlook for the better. We could get some normalcy back even without a vaccine through measures like a national mask mandate/distribution, a real national testing & tracing effort, taking aerosol transmission seriously, and easing the economic pressure to “open back up” prematurely. We’re never going to do as well as Vietnam or Taiwan, but I’d settle for Greece or Norway.
Topol: When do you think we’ll see pre-COVID life restored?
Rivers: I wish I knew. I’m thinking toward the end of 2021. It’s really hard to say with any certainty. We should all be mentally prepared to have quite a bit ahead of us.
It’s America. If we know anything by now about this country, it’s that access to healthcare and economic opportunity is going to apply unevenly to the people who live here. For instance, it’s likely that Black & brown communities, which have been disproportionately affected by the pandemic, may face difficulty in getting access to vaccines compared to wealthier, predominantly white communities.↩
Biologically, a vaccine against the COVID-19 virus is unlikely to offer complete protection. Logistically, manufacturers will have to make hundreds of millions of doses while relying, perhaps, on technology never before used in vaccines and competing for basic supplies such as glass vials. Then the federal government will have to allocate doses, perhaps through a patchwork of state and local health departments with no existing infrastructure for vaccinating adults at scale. The Centers for Disease Control and Prevention, which has led vaccine distribution efforts in the past, has been strikingly absent in discussions so far — a worrying sign that the leadership failures that have characterized the American pandemic could also hamper this process. To complicate it all, 20 percent of Americans already say they will refuse to get a COVID-19 vaccine, and with another 31 percent unsure, reaching herd immunity could be that much more difficult.
I am the least anti-vaxxer person in the world, but I have to say that getting a vaccine for Covid-19 that was rushed through trials in time for the election (October surprise!) and signed off by a Trump administration that has completely politicized science does not sound like something I want to go near. Which, for me personally, is a really really depressing thing to even think.
Update: I got a lot of flack for suggesting that I’d be skeptical of a Trump-approved vaccine rushed to market in time for the election (a very specific set of circumstances). But his buddy Putin is attempting something similar in Russia (skipping phase 3 trials), so if you don’t think Trump can try to bully the FDA and CDC into signing off on a vaccine that hasn’t been fully tested — perhaps made by a company whose CEO has donated millions to a Trump SuperPAC? — in order to salvage his reelection chances, I suggest that you haven’t paying proper attention over the past 4 years.
Update:A poll suggests that many Americans across the political spectrum are worried about a politicized FDA being forced to approve a Covid-19 vaccine before it’s adequately tested.
Seventy-eight percent of Americans worry the Covid-19 vaccine approval process is being driven more by politics than science, according to a new survey from STAT and the Harris Poll, a reflection of concern that the Trump administration may give the green light to a vaccine prematurely.
The response was largely bipartisan, with 72% of Republicans and 82% of Democrats expressing such worries, according to the poll, which was conducted last week and surveyed 2,067 American adults.
The sentiment underscores rising speculation that President Trump may pressure the Food and Drug Administration to approve or authorize emergency use of at least one Covid-19 vaccine prior to the Nov. 3 election, but before testing has been fully completed.
The most striking feature of the H1N1 flu vaccine manufacturing process is the 1,200,000,000 chicken eggs required to make the 3 billion doses of vaccine that may be required worldwide. There are entire chicken farms in the US and around the world dedicated to producing eggs for the purpose of incubating influenza viruses for use in vaccines. No wonder it takes six months from start to finish.
The post holds up pretty well because, according to the CDC, this is still the way most flu vaccines in America are manufactured. Here’s a look at pharmaceutical company GSK’s egg-based process:
Two other techniques for making flu vaccines were approved for use in the US in 2012 and 2013 respectively, cell-based flu vaccines:
‘Cell-based’ refers to how the flu vaccine is made. Most inactivated influenza vaccines are produced by growing influenza viruses in eggs. The influenza viruses used in the cell-based vaccine are grown in cultured cells of mammalian origin instead of in hens’ eggs.
A cell-based flu vaccine was developed as an alternative to the egg-based manufacturing process. Cell culture technology is potentially more flexible than the traditional technology, which relies upon adequate supply of eggs. In addition, the cell-based flu vaccine that uses cell-based candidate vaccine viruses (CVVs) has the potential to offer better protection than traditional, egg-based flu vaccines as a result of being more similar to flu viruses in circulation.
NIAID and its industry partners have made progress in moving from both the egg-based and cell-based flu vaccine production methods toward recombinant DNA manufacturing for flu vaccines. This method does not require an egg-grown vaccine virus and does not use chicken eggs at all in the production process. Instead, manufacturers isolate a certain protein from a naturally occurring (“wild type”) recommended flu vaccine virus. These proteins are then combined with portions of another virus that grows well in insect cells. The resulting “recombinant” vaccine virus is then mixed with insect cells and allowed to replicate. The flu surface protein called hemagglutinin is then harvested from these cells and purified.
Both of these new techniques make production quicker, thereby resulting in more effective vaccines because they are more likely to match the strains of whatever’s “going around”.
As a reminder, you should get a flu shot every year in the fall. The CDC recommends that “everyone 6 months of age and older should get a flu vaccine every season with rare exception”, especially those “who are at high risk of serious complications from influenza”. Flu vaccines are covered by your health insurance without copay (thanks, Obama!) and are often available at drug stores without an appointment or a long wait. So go get one!
For the New Yorker, Nick Paumgarten writes about this year’s measles outbreak in the US, the largest such outbreak in decades. The outbreak is solely due to a growing number of people who decline to vaccinate their children, so the fight has become one not against a disease, as it was decades ago, but against dangerous ideas.
But, if we have to pick a Patient Zero, Andrew Wakefield will do. Wakefield is the British gastroenterologist who produced the notorious article, published in The Lancet in 1998, linking the M.M.R. vaccine to autism. The study, which featured just twelve subjects, was debunked, the article was pulled, and Wakefield lost his license to practice medicine — as well as his reputation, in scientific circles anyway. But, owing to his persistence in the years since, his discredited allegations have spread like mold. In the anti-vaxxer pantheon, he is martyr and saint. There are also the movement’s celebrities, such as Jenny McCarthy and Robert F. Kennedy, Jr., stubborn in the face of ridicule, and the lesser-known but perhaps no less pernicious YouTube evangelists, such as Toni Bark, a purveyor of homeopathic products, and the Long Island pediatrician Lawrence Palevsky. If your general practitioner is Dr. Google, you can find a universe of phony expertise. The movement seems to sniff out susceptibility. Not surprisingly, there is money there, though the financial incentives behind this strand of advocacy are less clear than, say, what has led the Koch brothers to champion fossil fuels. This spring, the Washington Post reported that the New York hedge-fund manager Bernard Selz and his wife, Lisa, have given more than three million dollars to anti-vaccination causes and helped finance “Vaxxed,” Wakefield’s 2016 documentary, which purports to reveal a C.D.C. conspiracy to cover up the connection between vaccines and autism. Needless to say, the anti-vaccination ethos is by no means exclusive to the New York tristate-area Orthodox community. It thrives in certain pockets — affluent boho-yoga moms, evangelical Christians, Area 51 insurgents. The vaccination rates are about the same in Monsey and in Malibu. Before New Square, the three most recent big outbreaks of measles occurred among Somali immigrants, in Minnesota; Amish farmers, in Ohio; and a hodgepodge of visitors to Disneyland.
“It’s shocking how strong the anti-vax movement is,” Zucker said. “What surprises me is the really educated people who are passionately against vaccinations. I see this as part of a larger war against science-based reality. We need to study vaccine hesitancy as a disease.” He gave a TEDX talk recently about the crippling disconnect between the speed at which information, good or bad, spreads now and the slow, grinding pace of public-health work. He managed, by way of the general theory of relativity, to establish the equivalence of H1N1, Chewbacca Mask Lady, and Pizzagate: “How do we immunize and protect ourselves from the damaging effects of virality?”
The internet is such an efficient way to spread ideas (regardless of their validity) that you begin to wonder if instant global individual-to-individual and individual-to-everyone communication is an insurmountable Great Filter for societies.
The development of vaccines against infectious diseases is among the greatest of human accomplishments and has saved ten of millions of people from dying. And yet some are still hung up on their side effects (and also the widely disproved and debunked fraudulent claim that vaccines cause autism). In this video, Kurzgesagt looks at how vaccines work and compares the impact of their side effects (minuscule) to the potential effect of the diseases they protect against (children dying).
The extensive list of sources they used for the video can be found here.
The title of this video is “The Side Effects of Vaccines - How High is the Risk?”, which seems like it’s maximized for clicks and to spread amongst anti-vaxxers on social media. I wish it had a more accurate title — something like “The Absurdly Low Risk of Vaccine Side Effects” or maybe “Vaccines. And Now My Kids Don’t Die.” — but perhaps positioning it this way is a good strategy to get folks who may not be quite so radicalized to watch it.
Tetanus, popularly called “lockjaw,” is a serious illness, fatal in 10 percent of cases in North America and a larger percentage elsewhere. But despite the popular perception of its association with cutting oneself on a rusty nail, the disease has nothing to do with iron oxide, or rust:
Rather, tetanus is a product of the bacteria Clostridium tetani, which is in dirt, dust, and feces—in other words, everywhere. It can enter your body through puncture wounds, yes, but also through superficial cuts, bug bites, surgical procedures, and any other rupture to your skin. It can come from stepping on a rusty nail, or tending the soil in your garden. That’s why it’s so essential to track your booster shots: You need one every decade, not just when you rip your palm open on a rusty chain link fence. Waiting for a classic tetanus injury won’t work when anything could, in theory, be a tetanus injury.
If the bacteria enter your body and you aren’t up-to-date on your vaccinations, the tiny invaders begin to multiply rapidly. This incubation period, which lasts between three and 21 days, according to the CDC, is symptom free. But as the bacteria begin to die inside you, they form a neurotoxin that attacks the nervous system. Specifically, it inhibits the chemical GABA, which regulates muscle contractions. The result is a body-wide state of tension, from lockjaw in your face to uncontrollable arching spasms in your back to permanently-curled toes.
Luckily, here as elsewhere, tetanus vaccines (a series of three shots and a booster every ten years) work. Get those shots up to date and mind those cuts, no matter where they came from.
Roald Dahl’s oldest daughter Olivia died from the measles when she was seven years old. She died because there wasn’t a reliable measles vaccine then, and in this heartfelt letter he wrote years later, Dahl wants everyone to know that there is such a vaccine now.
Olivia, my eldest daughter, caught measles when she was seven years old. As the illness took its usual course I can remember reading to her often in bed and not feeling particularly alarmed about it. Then one morning, when she was well on the road to recovery, I was sitting on her bed showing her how to fashion little animals out of coloured pipe-cleaners, and when it came to her turn to make one herself, I noticed that her fingers and her mind were not working together and she couldn’t do anything.
‘Are you feeling all right?’ I asked her.
‘I feel all sleepy,’ she said.
In an hour, she was unconscious. In twelve hours she was dead.
The measles had turned into a terrible thing called measles encephalitis and there was nothing the doctors could do to save her. That was twenty-four years ago in 1962, but even now, if a child with measles happens to develop the same deadly reaction from measles as Olivia did, there would still be nothing the doctors could do to help her.
On the other hand, there is today something that parents can do to make sure that this sort of tragedy does not happen to a child of theirs. They can insist that their child is immunised against measles. I was unable to do that for Olivia in 1962 because in those days a reliable measles vaccine had not been discovered. Today a good and safe vaccine is available to every family and all you have to do is to ask your doctor to administer it.
I feel so tired when I think about parents not vaccinating their children against easily preventable fatal diseases. It’s child abuse and the kids know better! Here’s a tweet from Erin Faulk sharing some screenshots of teens asking how they can get vaccinated over their parents’ objections.
In only 90 seconds with the use of a few props (and some profanity), entertainers Penn & Teller offer a succinct and compelling argument of the benefits of vaccinating our children.
So even if vaccination did cause autism, WHICH IT FUCKING DOESN’T, anti-vaccination would still be bullshit.
Bill: If we could show you only one number that proves how life has changed for the poorest, it would be 122 million — the number of children’s lives saved since 1990.
Melinda: Every September, the UN announces the number of children under five who died the previous year. Every year, this number breaks my heart and gives me hope. It’s tragic that so many children are dying, but every year more children live.
Bill: More children survived in 2015 than in 2014. More survived in 2014 than in 2013, and so on. If you add it all up, 122 million children under age five have been saved over the past 25 years. These are children who would have died if mortality rates had stayed where they were in 1990.
Bill calls saving children’s lives “the best deal in philanthropy”. Melinda continues:
Melinda: And if you want to know the best deal within the deal — it’s vaccines. Coverage for the basic package of childhood vaccines is now the highest it’s ever been, at 86 percent. And the gap between the richest and the poorest countries is the lowest it’s ever been. Vaccines are the biggest reason for the drop in childhood deaths.
Melinda: They’re an incredible investment. The pentavalent vaccine, which protects against five deadly infections in a single shot, now costs under a dollar.
Bill: And for every dollar spent on childhood immunizations, you get $44 in economic benefits. That includes saving the money that families lose when a child is sick and a parent can’t work.
Horseshoe crab. We all owe a debt of gratitude to the helmet-shaped horseshoe crab, whose ancestors date back 450 million years. From vaccines to needles to pacemakers, any IV drug or medical equipment that will come in contact with the human body must first be safety-checked using a test that comes from a clotting compound in the crab’s blood. This compound can detect even the smallest amount of deadly bacteria and is sensitive enough to isolate a threat equivalent to the size of a grain of sand in a swimming pool.
Vaccines. Immunization is one of the most important public health achievements in human history. Vaccines helped eradicate smallpox globally and eliminate polio in the United States. The introduction of effective vaccines has also drastically reduced deaths from measles, diphtheria, rubella, pertussis (“whooping cough”) and other diseases that sickened hundreds of thousands of Americans in the early 20th century.
American Cheese. Food processing was actually developed to make food safer. Milk is pasteurized to kill harmful organisms, and canning and freezing foods such as meats, fruits and vegetables helps them last longer. But the food industry has taken processing well beyond these early origins. Often, to extend a food’s shelf life, manufacturers increase fats, sugars, and salt and add in chemical flavorings, emulsifiers, and other additives — taking foods that could have been healthy and making them much less so.
Pap smear. Since its introduction in 1955, the Pap smear has reduced death from cervical cancer by more than 60 percent. Invented by Dr. Georgios Papanikolaou, the Pap smear is a diagnostic procedure in which a health-care professional swabs a cell sample from the cervix and sends it to a lab to see if any of the cells are malignant. Before the invention of the Pap smear, cervical cancer was one of the leading causes of death for women of childbearing age in the United States. Today, it comes in at number 14 on the list of cancers found in women.
Spittoons. Spittoons were developed centuries ago as receptacles for spitting — think ashtrays for saliva. These brass or even porcelain repositories were everywhere: In homes, train stations, saloons and even the U.S. Congress. They were meant for men to dispose their chewing tobacco and the abundant phlegm that accompanied the habit. Convenience turned to concern in the late 19th century when a global tuberculosis epidemic took hold and scientists realized that spittoons might actually spread diseases. Some argued that when people spat in the general direction of a spittoon and missed the target, they caused a greater health threat than if the spittoon hadn’t been there at all.
Neoantigen vaccines use the DNA from a cancer patient’s own tumor to, hopefully, eradicate the cancer.
For some 50 years, cancer biologists have tried to incite the immune system to attack cancer by targeting molecules that commonly stud the surfaces of malignant cells. These “antigens” act as homing beacons that immune cells find and lock onto (much as antigens on viruses attract the immune system, the basis for preventive vaccines such as that for measles).
Trouble is, normal cells sometimes sport the same antigens as tumors, and the immune system is programmed not to attack antigens found on healthy cells. As a result, revving up the immune system to target common tumor antigens hasn’t worked, leading to a number of failed experimental cancer vaccines.
That led biologists to a different approach: siccing the immune system on antigens found only on cancer cells — and only on the cancer cells of a single patient. “It’s highly unlikely that any two patients have the same neoantigens,” said Dr. Catherine Wu of Boston’s Dana-Farber Cancer Institute. “That’s why we have an opportunity to make cancer vaccines truly personalized, loaded with patient-specific neoantigens.”
Host Hank Green of the SciShow looks at the anti-vaccination movement from a scientific perspective: why are US parents growing less likely to vaccinate their children?
In psychology, the search for these explanations is called “Explanatory Attribution” and different people have different “explanatory styles”. Some people are more prone to blame themselves, while others search for an external event to blame. But one thing is clear: we are very bad at not blaming anything. It’s not surprising that parents of children with autism, especially parents who notice a sudden loss of previous development, will search for a possible cause. And when the most significant recent event in the health of the child was a vaccination, as can be said for many moments in the life of a young American, we might identify that as a potential cause and deem that link worthy of further examination.
Now this, is completely logical. The problem is that over a dozen peer-reviewed papers have found no correlation between autism and the MMR vaccine, or any other vaccine for that matter. And yet, when you Google vaccines and autism, a fair number of the results claim that there is a link between the two, and that that link is being covered up either by the government or by big corporations. A parent, already experiencing frustration with the medical community’s inability to tell them why this thing has happened to their child, will, on the internet, find a vibrant community of similarly frustrated people who share their values and experiences. These communities are full of anecdotes that draw connections between vaccines and autism. And so, unsurprisingly, some people become convinced that they have found the reason for their child’s disability.
Once their mind has been made up, confirmation bias sets in. Confirmation bias is simply our tendency to more readily, and with less scrutiny, accept information, anecdotes, and world views that confirm our existing beliefs. And, again, it is a completely normal thing that every person does. Indeed, trying to convince someone that a previously held belief is incorrect has been proven to actually increase their affinity for that idea. And so a community is born, and the safety of vaccines is called into question. And once the procedure for getting a vaccine goes from the doctor telling you that it is now time for a vaccine — and 99% of parents agreeing because that person went through medical school — to it being a question to ponder, vaccination rates will go down.
Administrators at Palm Desert High School in California have banned 66 students who never got measles vaccinations.
“I think some parents see it as a personal choice, like homeschooling. But when you choose not to vaccinate, you’re putting other children at risk.” From WaPo: Why this baby’s mom is so angry at the anti-vaxxers.
“I respect people’s choices about what to do with their kids, but if someone’s kid gets sick and gets my kid sick, too, that’s a problem.” A Marin County father has demanded that his district keep unvaccinated kids out of school.
Today’s Google Doodle honors Jonas Salk on what would have been his 100th birthday. Salk developed the first successful polio vaccine in 1955 and was hailed as a hero for it.
On April 12, 1955, Dr. Thomas Francis, Jr., of the University of Michigan, the monitor of the test results, “declared the vaccine to be safe and effective.” The announcement was made at the University of Michigan, exactly 10 years to the day after the death of President Roosevelt. Five hundred people, including 150 press, radio, and television reporters, filled the room; 16 television and newsreel cameras stood on a long platform at the back; and 54,000 physicians, sitting in movie theaters across the country, watched the broadcast on closed-circuit television. Eli Lilly and Company paid $250,000 to broadcast the event. Americans turned on their radios to hear the details, department stores set up loudspeakers, and judges suspended trials so that everyone in the courtroom could hear. Europeans listened on the Voice of America. Paul Offit writes about the event:
“The presentation was numbing, but the results were clear: the vaccine worked. Inside the auditorium Americans tearfully and joyfully embraced the results. By the time Thomas Francis stepped down from the podium, church bells were ringing across the country, factories were observing moments of silence, synagogues and churches were holding prayer meetings, and parents and teachers were weeping. One shopkeeper painted a sign on his window: Thank you, Dr. Salk. ‘It was as if a war had ended’, one observer recalled.”
Because of Salk’s vaccine and subsequent vaccines, the US has been polio-free since 1979.
In a clinical trial at the Mayo Clinic, a woman with a type of blood cancer called myeloma was given an injection of measles virus large enough to innoculate 10 million people and has been “completely cleared” of her cancer.
So, as part of a two-patient clinical trial, doctors at the Mayo Clinic injected Erholtz with 100 billion units of the measles virus — enough to inoculate 10 million people.
Her doctor said they were entering the unknown.
Five minutes into the hour-long process, Erholtz got a terrible headache. Two hours later, she started shaking and vomiting. Her temperature hit 105 degrees, Stephen Russell, the lead researcher on the case, told The Washington Post early Thursday morning.
“Thirty-six hours after the virus infusion was finished, she told me, ‘Evan has started shrinking,’” Russell said. Over the next several weeks, the tumor on her forehead disappeared completely and, over time, the other tumors in her body did, too.
The cancer of the other person in the trial was unaffected and larger randomized trials still have to be performed, but this is encouraging news. Between this and the remission of cancer using HIV, it looks like viral therapy has a real shot at being a powerful weapon in fighting cancer.
America experienced the height of polio in the 1940s and ’50s, when about 35,000 people became disabled every year. Fear and panic spread and parents were known to warn their children to not drink from public water fountains, avoid swimming pools and stay away from crowded public places like movie theaters. Perhaps the most famous case of polio in America was Franklin Delano Roosevelt, the first president with a significant physical disability.
The development of the Salk and Sabine vaccines helped lead to eradication of polio in the United States in 1979. In India, too, vaccination was critical.
“There were three keys to our success,” Kapur says. “Immunize, immunize and immunize.”
As healthy as my lifestyle seemed, I contracted measles, mumps, rubella, a type of viral meningitis, scarlatina, whooping cough, yearly tonsillitis, and chickenpox. In my 20s I got precancerous HPV and spent six months of my life wondering how I was going to tell my two children under the age of 7 that Mummy might have cancer before it was safely removed.
This is the part that really gets to me: Parker wasn’t vaccinated but was given so many antibiotics for her childhood illnesses that she became immune to them! [Hair-tearing-out noise]
My two vaccinated children, on the other hand, have rarely been ill, have had antibiotics maybe twice in their lives, if that. Not like their mum. I got so many illnesses requiring treatment with antibiotics that I developed a resistance to them, which led me to be hospitalized with penicillin-resistant quinsy at age 21 — you know, that old-fashioned disease that supposedly killed Queen Elizabeth I and that was almost wiped out through use of antibiotics.
Update: Slate has corrected the passage above, taking out the part about Parker’s resistance to antibiotics. It now reads:
My two vaccinated children, on the other hand, have rarely been ill, have had antibiotics maybe twice in their lives, if that. Not like their mum. I got many illnesses requiring treatment with antibiotics. I developed penicillin-resistant quinsy at age 21 — you know, that old-fashioned disease that supposedly killed Queen Elizabeth I and that was almost wiped out through use of antibiotics.
People do not develop antibiotic resistance, microorganisms do. I regret the idiotic error and tearing out my hair. (thx @chrismize)
What if there were a new class of wonder drugs for children that prevented some of the worst diseases in history with very limited side effects…would you take them? Some people don’t “trust” that wacky “science” though.
What’s so confounding is that many of the parents requesting exemptions for their children cite specious, disproven fears — such as that the vaccine could cause autism — many of which were based on a fraudulent, retracted study or fringe research published in non-peer-reviewed journals. And the rest of the country hasn’t been as successful as Massachusetts in containing measles infections. Earlier this year, an intentionally unvaccinated 17-year-old from Brooklyn, New York, was infected with measles while on a trip to the United Kingdom. Because he lived in a community with a large number of other deliberately unvaccinated children, the virus quickly spread. By the time the outbreak was contained, 58 people had been infected — making it the largest outbreak in the country in more than 15 years. Nationwide, the Centers for Disease Control and Prevention reported 159 total cases between January and August, which puts 2013 on track to record the most domestic measles infections since the disease was declared eliminated from the United States in 2000.
From The New Yorker: Jenny McCarthy’s Dangerous Views. She’s been hired as a new host on The View. Some worry that we’ll be hearing a lot more about her anti-vaccine postions. Of course, if you are making life-decisions based on the views of people on The View, you might want to consider the host who thought the world might be flat.
An article from a mother who was anti-vaccine until her daughter (and then the rest of the family) got the whooping cough. And still she feels “funny” about vaccination.
And yet I still wondered about that list of things that I would now, I suppose, have to surrender to and immunise my child against. Polio, for one — a couple of my parents’ pensioner friends still carry the limp left by their childhood polio, but none of my friends do, because it isn’t around any more. And diphtheria — what was that, even? I knew it had killed one of Queen Victoria’s daughters, but that wasn’t our reality.
The reason it wasn’t our reality was, of course, due to a continuous programme of immunisation. Duh. Diphtheria is a disease that still kills one in five infants it meets, even if they get treatment, their necks swelling up until they can no longer breathe. I have now seen a picture of a child whose neck was ravaged by diphtheria, bloated like a foie gras goose about to burst. I wish I could unsee it.
Duh, indeed. This anti-vaccination nonsense is an instance in which the public’s lack of knowledge about how science works (and not just their lack of recall of scientific facts) is truly harmful. (via @CharlesCMann)
In June 2007 Jenny McCarthy began promoting anti-vaccination rhetoric. Because of her celebrity status she has appeared on several television shows and has published multiple books advising parents not to vaccinate their children. This has led to an increase in the number of vaccine preventable illnesses as well as an increase in the number of vaccine preventable deaths.
Indigo children is a term used to describe children who are believed to possess special, unusual and sometimes supernatural traits or abilities. The term is pseudoscientific. The idea is based on New Age concepts developed in the 1970s by Nancy Ann Tappe and further developed by Jan Tober and Lee Carroll. The concept of indigo children gained popular interest with the publication of a series of books in the late 1990s and the release of several films in the following decade. A variety of books, conferences and related materials have been created surrounding belief in the idea of indigo children and their nature and abilities. The interpretations of these beliefs range from their being the next stage in human evolution, in some cases possessing paranormal abilities such as telepathy, to the belief that they are more empathic and creative than their peers.
Some pediatricians are asking families who refuse to vaccinate their children to leave their practices.
For Allan LaReau of Kalamazoo, Mich., and his 11 colleagues at Bronson Rambling Road Pediatrics, who chose in 2010 to stop working with vaccine-refusing families, a major factor was the concern that unimmunized children could pose a danger in the waiting room to infants or sick children who haven’t yet been fully vaccinated.
In one case, an unvaccinated child came in with a high fever and Dr. LaReau feared the patient might have meningitis, a contagious, potentially deadly infection of the brain and spinal cord for which a vaccine commonly is given. “I lost a lot more sleep than I usually do” worrying about the situation, he said.
“You feel badly about losing a nice family from the practice,” added Dr. LaReau, but families who refused to vaccinate their kids were told that “this is going to be a difficult relationship without this core part of pediatrics.” Some families chose to go elsewhere while others agreed to have their kids inoculated.
Jenny McCarthy just won’t call it quits on the whole vaccines cause autism thing. Cause she’s a mom! And moms love their children! And are strong! QED. And of course this was published by Huffington Post, the blog equivalent of Jenny McCarthy.
As if there was actually more evidence needed that vaccines don’t cause autism, the 1998 British study that linked autism to childhood vaccines was recently discovered to be an elaborate fraud. Not just incorrect, a fraud.
An investigation published by the British medical journal BMJ concludes the study’s author, Dr. Andrew Wakefield, misrepresented or altered the medical histories of all 12 of the patients whose cases formed the basis of the 1998 study — and that there was “no doubt” Wakefield was responsible.
“It’s one thing to have a bad study, a study full of error, and for the authors then to admit that they made errors,” Fiona Godlee, BMJ’s editor-in-chief, told CNN. “But in this case, we have a very different picture of what seems to be a deliberate attempt to create an impression that there was a link by falsifying the data.”
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