Search Results for "vaccines"

Dec 14 2020

mRNA Vaccines

This week should see the first people in the US to actually receive an approved (at least EUA) vaccine to prevent SARS-CoV-2. There are three vaccines currently ready to go in the West, the Pfizer vaccine which received it’s EUA in the US on Friday and was already approved in the UK, Moderna which should get approval this week, and the Astra Zeneca vaccine which should not be too far behind. The (arguably) biggest challenge has been met – a massive scientific effort to develop vaccines in record time. This has been a collaboration between government and industry, and shows what we can accomplish with sufficient motivation (which translates into both money and easing red tape).

Now we have three further challenges in front of us. The companies need to mass produce their vaccines. This is happening with about 100 million doses ready to ship. We should have another 2 billion Pfizer doses by the end of 2021, and 1.5 billion Moderna doses. We also need to distribute the doses. This is happening through collaboration among FedEx, UPS, and the military who will get the doses to hospitals and physicians, who can then administer and track the doses. So far, so good.

The final hurdle, however, may prove the stickiest – we need people to accept the vaccine. In a December 9th survey by the AP-NORC, only 47% of Americans said they would get the vaccine, with 26% saying they would not, and 27% saying they are not sure. These and similar results have caused some to comment that the disinformation virus may prove deadlier than the COVID virus. We have a vaccine that can protect people from a deadly pandemic – this is a no-brainer. Resistance is partly due to a dedicated anti-vaccine movement that appears immune only to logic and evidence. We can only marginalize them. But these numbers go beyond the hard-core anti-vaxxers. People also fear what they don’t know, and these are the first mRNA vaccines to hit the market. So let’s review what these are, and the safety data.

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Nov 24 2020

We Have Several Vaccines for COVID – Now What?

Two weeks ago Pfizer and German company BioNTech announced preliminary analysis of their phase 3 trial of an mRNA-based vaccine for SARS-CoV-2 showing it is 90% effective (later updated to 95%). One week ago Moderna announced that they too had promising results from their phase 3 trial, also an mRNA vaccine showing 95% efficacy. This week AstraZeneca announced they have developed a COVID vaccine as well (in partnership with Oxford University).

I have not discussed the AstraZeneca vaccine before, so here are the basic facts: “It uses a replication-deficient chimpanzee viral vector based on a weakened version of a common cold virus (adenovirus) that causes infections in chimpanzees and contains the genetic material of the SARS-CoV-2 virus spike protein.” In the study, overall there was a 70% efficacy in reducing symptomatic cases of COVID-19. However, in a subgroup analysis, those receiving a half dose followed by a full dose (instead of two full doses) had 90% efficacy, which is closer to the two mRNA vaccines. It is too early to say if this difference is real, and it does not make biological sense, so the company plans to expand the number of subjects getting this dosing regimen to see if the higher efficacy holds up. One advantage to this vaccine is that it can be stored in a regular refrigerator for up to 6 months, while the mRNA vaccines have to be frozen for transport (the Pfizer vaccine at -70 degrees C, the Moderna vaccine at -20).

All three vaccines have a good safety profile so far, but it always takes time to monitor for side effects so this is an ongoing assessment. Pfizer and Moderna say they can  produce over a billion doses by the end of 2021, and AstraZeneca says they can produce 3 billion doses. That is enough for about a third of the world’s population. Of course, there are many other vaccines being developed around the world so these won’t be the only three.

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May 04 2020

COVID-19 Immunity and Vaccines

We appear to be at the beginning of the end of the first wave of COVID-19 (at least in the US – other countries are at different places). We are at the point where states are starting to relax the physical distancing requirements, and there is discussion about how to transition to the next phase. That next phase might include disease tracking, targeted isolation, and “immunity passports.” But planning this next phase is complicated by the fact that we still do not fully understand this virus. We don’t know if there will be a second wave (or more), if it is seasonal, and if you can catch it twice. How we handle this next phase will likely determine if there is a second wave.

But what comes after that? When can we transition to the final phase – return to normal, even if it is a new normal? These next transitions will depend largely on the natural immunity that results from infection, and how long it will take to create a vaccine and how effective that vaccine is. Here is what we know and don’t know so far.

The big question for the next phase is – how much immunity results from natural infection? This is a more complicated question than it may first seem. But the short answer is, we don’t know.

The adaptive part of the immune system will remember infections, B-cells that create specific antibodies targeting the infecting organism will develop throughout an infection, and some of those B-cells are memory B-cells – they will hang around for a long time, ready to produce specific antibodies the next time the same organism is encountered. But there are important variables to how effective this adaptive immune strategy is. the virus or infecting organism itself is the main variable. What parts of itself does it expose to the immune system? Perhaps the critical functional proteins are hidden deep within folds that antibodies cannot get to. Another variable is how quickly does it mutate? If the parts that antibodies can target change quickly, then immunity does not last. Some organisms also evolve specific strategies to evade or compromise the immune system.

Another variable is the severity of the infection itself. The more severe and long lasting the infection, the greater the stimulation to the immune system and the greater the adaptive response.

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Aug 03 2018

Placebo Controlled Trials of Vaccines

There is a strong scientific consensus that vaccines generally are an effective approach to preventing infectious illness. The vaccine schedule is arguably the most effective and cost effective health promotion intervention ever devised. Vaccines are a public health home-run.

How, then, to explain the anti-vaccine movement? The anti-vaccine movement is based mainly on science-denial and conspiracy theories. This means they spread a lot of misinformation – the bits of misinformation become articles of faith, and any evidence to the contrary is denied or dismissed.

I recently received the following question, which is framed as a sincere question, but I have my suspicions that it may not be:

Have just read your article.

I fully agree that herbal medicines/substances should have full clinical trials but can never find anyone able to refer me to
any clinical trials placebo versus substance to be tested on vaccines.
So wondered if you could help me as you are obviously a man of science.
Would be very grateful as there must have been clinical trials sometime.
Even my Dr draws a blank.
Many thanks

Pam may simply be the victim of anti-vaccine propaganda, and may simply lack all Google skills, but the phrasing strongly suggests an anti-vaxxer goading a skeptic with a “gotcha” question. Since this is a common anti-vaccine trope, let me dispel it once again.

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Sep 25 2017

Lying About Vaccines

Robert F. Kennedy Jr. talks with reporters in the lobby of Trump Tower in New York, Tuesday, Jan. 10, 2017, after meeting with President-elect Donald Trump. (AP Photo/Evan Vucci) Robert F. Kennedy Jr. talks with reporters in the lobby of Trump Tower in New York, Tuesday, Jan. 10, 2017, after meeting with President-elect Donald Trump. (AP Photo/Evan Vucci)[/caption]

Robert F. Kennedy Jr. considers himself an environmentalist. While advocating for the environment, he has become particularly concerned about the effects of mercury on human health. This in itself is reasonable, and there is broad scientific agreement that we should make efforts to minimize human exposure to mercury.

But Kennedy goes beyond reasonable recommendations based upon scientific consensus. He has become part of what we call, “The Mercury Militia” who have become unmoored from reality in their zeal to combat the perceived evils of mercury. The mercury militia further became tied to the anti-vaccine movement when it was claimed that the mercury in some vaccines was causing harm (it doesn’t). He has become a visible example of how someone can cocoon themselves in their own reality.

In a recent interview for Stat News Kennedy tells a number of falsehoods about vaccines. In essence he is lying, although it is possible he believes the lies he tells. Kennedy has apparently dedicated a large portion of his life to this issue, publicly advocates for his position, and certainly has resources at his disposal. And yet he gets basic facts about vaccines hopelessly wrong. How does that happen?

Paul Offit has written an excellent take down of Kennedy’s interview, explaining many of his falsehoods. For example, in the interview Kennedy claims: Continue Reading »

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Sep 07 2017

Eliminating Personal Belief Exemptions for Vaccines

ExImmunMap15-TuesdayIn the US routine childhood vaccination is required for entry into public school, and in some states even private school. This is a reasonable public health policy. Vaccination not only protects the individual against common infectious diseases, but when enough people get vaccinated this creates community immunity (often referred to as herd immunity) which protects everyone.

Any parent knows first hand that children are seething vectors for germs. Their concept of hygiene, generally speaking, is often not the same as the average adult. Put a large group of children together in a close environment like a school, and you have basically created a disease factory.

Further, some children cannot be vaccinated for medical reasons. They may have a chronic illness that makes their immune systems too weak to handle the vaccine, or they have an intolerance to vaccines. For these children, if they want to attend school, their only protection is the community immunity that results from all the more healthy children being vaccinated.  Continue Reading »

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Sep 17 2015

Trump on Vaccines

I generally don’t cover purely political issues on this blog, but the second Republican primary debate from last night ventured into the area of vaccines and autism. Donald Trump has said in the past that he thinks the current “epidemic” of autism is caused by vaccines. He was challenged on this position during the debate, and face palms ensued.

Orac, perhaps presciently, gave a good recap of Trump’s anti-vaccine nonsense just yesterday. In 2007 Trump said:

“When I was growing up, autism wasn’t really a factor,” Trump said. “And now all of a sudden, it’s an epidemic. Everybody has their theory. My theory, and I study it because I have young children, my theory is the shots. We’ve giving these massive injections at one time, and I really think it does something to the children.”

That is pretty much exactly what Trump said during the second debate, almost word-for-word. This demonstrates several things about Trump, in my opinion. First, he feels comfortable forming his own opinions, based on nothing but casual observation and anecdote, even on complex scientific issues, without adequate information. The fact that the scientific community has come to an opposite opinion does not even seem to give him pause. Finally, he has learned exactly nothing on this issue over the last 8 years – nothing. He has added no depth or nuance to his position, let alone correcting his factual errors.

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Apr 04 2013

Vaccines are Gay

It’s always amusing to see two pseudosciences combined into one greater pseudoscience – it’s like chocolate and peanut butter. It’s not uncommon because those who would embrace one pseudoscience are likely to follow the same flawed logic and process to accept others. My colleague David Gorski has termed this effect “crank magnetism.”

Take, for example, Gian Paolo Vanoli. He has been making international headlines recently because of his claim that vaccines cause homosexuality, which he insists is a disease. The story appears to have been first picked up in English by the Huffington Post – all other reports of this story I have found cite this article as their source.

Because of the date of this article (4/1) I wanted to make sure I had another source, but the only other sources are in Italian. The story does seem to check out – here is one article: Gian Paolo Vanoli: Cricket on the urine that has been around the world. 

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Nov 01 2010

Joseph Mercola – Misinformation and Fear Mongering About Vaccines

Joseph Mercola, along with Rosemary Fischer, are promoting vaccine awareness week this week, Nov 1-7. David Gorski, who edits Science-Based Medicine with me, thought it would be a good idea to go along with this and participate fully in vaccine awareness week. So all week we will be focusing on vaccine issues, and doing our best to counter any misinformation.

Mercola, who runs a highly commercialized website, chock full of  health misinformation and anti-SBM propaganda, has started off the week with a broadside against the flu vaccine in an article titled: “New Proof that This Common Medical Treatment is Unnecessary and Ineffective”. He gives a Gish Gallop of error and misdirection – far more bits of falsehood than I have time to counter here. That’s the point of the Gish Gallop, it is far easier to create a misconception than it is to correct it. So if you throw enough mud at a topic you can overwhelm any attempt to defend accurate information, and leave your audience with the uneasy feeling that something must be wrong. In the case of Duane Gish his target was the science of evolution. With Mercola it is accurate health information.

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May 25 2010

Vaccines – Too Few, Too Late

The anti-vaccine movement is nothing if not savvy about marketing their nonsense – at least in the last decade. One of their successful slogans has been “too many, too soon” – implying that children are receiving too many vaccines while they are still too young to deal with them. The result, anti-vaccinationists argue, is potential neurological toxicity or “overwhelming” the immune system.

The slogan also serves double duty, allowing anti-vaccinationists to argue that they are not “anti-vaccine” just “pro-safe vaccine.” This is just more marketing savvy, however – a deliberate deception, as many of the people who make this claim also state that they would never vaccinate. (Orac has pointed this out many times in great insolent detail.)

But there are some parents who have bought into this notion and have reduced and/or delayed the number of vaccines their children receive in the hopes that they can strike a better balance of risk vs benefit than the experts have struck. And there are fringe doctors, like Dr. Jay Gordon, who promotes his own evidence-free alternate vaccine schedule, playing into the “too many, too soon” meme.

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