Tag Archives: #PfizerBioNTech

Can COVID Burst America’s Bubble While The World Battles The Virus?

On May 13, after combating three waves of the coronavirus, the CDC released guidelines stating that  Americans who are fully vaccinated against Covid-19 can resume activities without wearing masks or physically distancing in most settings, indicating that the pandemic may be near an end.

“If you are fully vaccinated you can start doing the things you had stopped doing because of the pandemic,” announced CDC Director Dr. Rochelle Walensky.

But experts at a May 14 Ethnic Media Services briefing questioned whether it was too soon to go back to normal.

“Bubbles are beautiful, but bubbles do not last long in this world,” remarked Dr. Ben Neuman, Chief Virologist at the Global Health Research Complex at Texas A&M University.  “Any vaccine bubble that may exist is going to be fragile, unfortunately.”

As Covid-19 outbreaks occur in Michigan, Florida and Puerto Rico, the AMA reports  there is potential for a fourth pandemic surge.

And yes, the Indian B.1.617 variant is here, says the CDC. It’s monitoring the Indian mutation that the World Health Organization classified as “a variant of concern at a global level” because it may spread easily. According to the CDC, new mutations of the virus are more transmissible and are resistant to treatments or vaccines. These include five notable variants – B.1.1.7: (UK),  B.1.351 (S. Africa), P.1 (Japan/Brazil), B.1.427 and B.1.429 (identified in CA).

Going back to normal could expose adults and children to deadly new strains of the virus and its variants, rippling across the US and elsewhere in the world.

 

Can America survive in its Covid-19 bubble?

Variants can burst our bubble said experts, voicing concerns about our vulnerability to virus mutations and the prospect of ever reaching herd immunity.

Dr. Neuman has been sequencing the virus strains in Texas, and has identified different variants thriving even locally. At the peak of Covid-19 in January, he found that 30% variants of concern were from the B.1.1.7. UK variant. By late April and early May however, he added, “every single virus …has been a variant of concern.”

The virus is changing in unexpected ways, explained Dr. Neuman, driving certain lineages of the virus out of existence.  It’s a Darwinian process that  showcases “an increase in viral fitness.”

But, without any checks or balances on the virus which operates on a short-term risk-reward cycle – a 6-to-8-hour timetable – scientists find it difficult to predict long-term movement.

You can trust a snake, a chicken, or a cat to act in its own best interests to the best of its ability said Dr. Neuman, but “a virus has no such impulse.” Instead, it has an evolutionary incentive that drives it not in the direction we would hope or expect, but in the direction of more severe, sustained disease.

Over time the virus will continue to mutate, and vary unpredictably, warned Dr. Neuman, and solutions will have to be updated continually.

“In this particular place and time, there is approximately a 100% chance that you will run into something that grows faster, and has the potential to spread farther, and perhaps hit harder than one would be expecting otherwise.”

The world has underestimated the virus over and over by relaxing restrictions and causing a virus resurgence, reiterated Dr. Neuman.

 

The question is, “Can we do the wrong things and still expect the right results?”

One outcome that scientists predict could keep the virus at bay or banished altogether is Herd Immunity, a popular concept that is mired in misconception and misunderstanding. Dr. Marc Lipsitch, Professor of Epidemiology and Director of the Center for Communicable Disease Dynamics at the Harvard School of Public Health, described herd immunity as a state in which completely immune completely or partially immune people in a population slow down transmission by making it impossible for the virus to pass through them from one person to another in a sustained way, “till the virus essentially goes away.”

Will vaccinations and infections create herd immunity in the current phase of the pandemic? Dr. Lipsitch believes that’s an unlikely scenario – even with the vaccines we have.

At the start of the pandemic, before lockdowns and social distancing, a person infected up to 21/2 or 3 people each. But compared to early versions of the virus, contagious new variants have increased transmissibility by up 4 to 5 persons each. To reduce transmissibility by a factor of 5, explained Dr. Lipsitch, means immunizing 80% of the population,  a challenge that may be impossible given a number of factors.

At the moment, every variant in the world is present in the US.  Immunizing the nation won’t be easy because vulnerable populations – especially racial/ethnic minority groups and economically and socially disadvantaged communities – lack equitable vaccine access, children under the age of 12 are ineligible, and vaccine hesitancy is prevalent.

In the US vaccine hesitancy is based on a lack of trust in its efficacy. At issue also, is that all vaccines currently available in the US do not offer 100% protection. But added Dr. Neuman, “I trust the virus less!”

While Yale Medicine rated Pfizer-BioNTech at 95% for preventing symptomatic disease, its stability depends on strict storage requirements; Moderna has a similar high efficacy of 90% upon full immunization, while the single shot Johnson & Johnson vaccine has a 72% overall efficacy.

There is also concern about waning immunity and about revaccination. Limited studies that exist clarify that antibodies decrease over time, but there is uncertainty about at which point a person is no longer protected.

Annual boosters may be necessary at a minimum, confirmed Dr. Neuman, but although each of the vaccines is reasonably effective against each of the variants, there is definitely a lower effectiveness against some, like those coming out of Brazil and South Africa.

It’s more the virus changing than waning immunity that will drive the vaccination cycle.

 

Defanging Not Defeating the Virus

In the wake of the CDC’s new mask guidelines, Dr. Neuman noted that people calculating what precautions to take – to mask, social distance, or get vaccinated – are making decisions predicated on the original versions of the virus.

As ‘stay-at-home’ lockdown measures gradually ease, NIH reports also say that much of the population may return to spending increasing amounts of time in inadequately ventilated workplaces, offices, schools and other public buildings, where they may be exposed to a risk of acquiring viral infections by inhalation.

So, in the midst of an ongoing epidemic, as social barriers to transmission are lowered without reaching herd immunity, and high-risk populations in the other parts of the world face vaccine shortages, we are “in some sense “ said Dr. Lipsitch, “not ‘totally defeating, but simply defanging the virus,” – just making it less dangerous to have transmission.

He predicts “a quiet summer” followed by “some virus resurgence in the fall” as people move indoors and continue to lower their guard.

 

Fighting the Virus at Warp Speed

All the experts argued that the only way out of the pandemic is to ensure that more vulnerable populations across the world get vaccinated.

Peter Maybarduk, Director of Public Citizen’s Access to Medicines Group, called for a global response at warp speed for the world – a catalyst for more funding, sharing resources and technical assistance, more manufacturing, and a definite plan to vaccinate everyone, everywhere, with at least 8 billion doses of MRNA vaccine within a year to make up the global shortfall.

Apart from the moral argument, added Dr. Lipsitch, “we like having interactions with the rest of the world, and for all the reasons we value the rest of the world, we should value their health as well.”

Dr. Neuman called for a single global solution to vaccinate everyone within a window of six months to a year.

Maybarduk, an expert on the Covax initiative which partners with the World Health Organization to get vaccines to low-income countries by sharing vaccines equitably, pointed out that wealthy countries have purchased much of the global supply of doses in bulk, so less than 5 % of the world’s population – only 340 million (one quarter of the doses already administered in the US alone) – have been vaccinated worldwide.

In Brazil only 17% of Brazilians have been vaccinated, said Dr. Rosane Guerra from the Department of Pathology, Biological and Health Sciences Center at the Federal University of Maranhao (UFMA). Brazil does not have an adequate supply of medication to prevent or control the virus.

Covax aims to vaccinate 20 percent of the world with a 2 billion dose target for 2021 but has only been able to ship 64 million doses, stated Maybarduk.  Worldwide access to vaccines is hobbled by the lack of manufacturing capacity, inefficient distribution channels, and low production volumes, access to raw materials, export controls, meeting regulatory requirements for safety and efficacy, obtaining qualifications from WHO for manufacturing facilities, and by politicians prioritizing their own citizens for vaccination first.

Sharing vaccines and vaccine knowledge (like the Trips waiver) is imperative to overcome the vaccine shortfall Maybarduk suggested, and getting vaccines to those who desperately need it in other countries..

“We should not cross our fingers and assume all is going to work out.”

Fighting the virus is like mobilizing for a world war which requires collective, integrated human effort towards achieving one goal. “I don’t think halfway solutions are going to get us there,” said Dr. Neuman. Getting to the next stage requires an integrated effort that scientists know is doable but is ultimately a political decision that world leaders must make.

“It’s impossible to have any kind of bubble in a world when people can move between countries in the middle of an epidemic. We have to close every border to control the disease,” Dr.Guerra concluded.

The bubble could burst as restrictions are relaxed before the pandemic is under control, said Dr. Neuman. “I don’t think that is the path that leads to the fastest extinction of the virus.”

“Get the vaccine, wear a mask, and when the numbers go down, then you know it’s safe to relax!”


Meera Kymal is the Contributing Editor at India Currents

Photo by Marc Sendra Martorell on Unsplash

Photo by Fusion Medical Animation on Unsplash


 

Did It Feel Like A Truck Hit You After Your Covid Vaccination?

If you think vaccination is an ordeal now, consider the 18th-century version. After having pus from a smallpox boil scratched into your arm, you would be subject to three weeks of fever, sweats, chills, bleeding and purging with dangerous medicines, accompanied by hymns, prayers and hell-fire sermons by dour preachers.

That was smallpox vaccination, back then. The process generally worked and was preferred to enduring “natural” smallpox, which killed around a third of those who got it. Patients were often grateful for trial-by-immunization — once it was over, anyway.

“Thus through the Mercy of God, I have been preserved through the Distemper of the Small Pox,” wrote one Peter Thatcher in 1764, after undergoing the process in a Boston inoculation hospital. “Many and heinous have been my sins, but I hope they will be washed away.”

Today, Americans are once again surprisingly willing, even eager, to suffer a little for the reward of immunity from a virus that has turned the world upside down.

Roughly half of those vaccinated with the Moderna or Pfizer-BioNTech vaccines, and in particular women, experience unpleasantness, from hot, sore arms to chills, headache, fever and exhaustion. Sometimes they boast about the symptoms. They often welcome them.

Suspicion about what was in the shots grew in the mind of Patricia Mandatori, an Argentine immigrant in Los Angeles, when she hardly felt the needle going in after her first dose of the Moderna vaccine at a March appointment.

A day later, though, with satisfaction, she “felt like a truck hit me,” Mandatori said. “When I started to feel rotten I said, ‘Yay, I got the vaccination.’ I was happy. I felt relieved.”

While the symptoms show your immune system is responding to the vaccine in a way that will protect against disease, evidence from clinical trials showed that people with few or no symptoms were also protected. Don’t feel bad if you don’t feel bad, the experts say.

“This is the first vaccine in history where anyone has ever complained about not having symptoms,” said immunologist Dr. Paul Offit, director of the Vaccine Education Center at Children’s Hospital of Philadelphia.

To be sure, there is some evidence of stronger immune response in younger people — and in those who get sick when vaccinated. A small study at the University of Pennsylvania showed that people who reported systemic side effects such as fever, chills and headache may have had somewhat higher levels of antibodies. The large trial for Pfizer’s vaccine showed the same trend in younger patients.

But that doesn’t mean people who don’t react to the vaccine severely are less protected, said Dr. Joanna Schaenman, an expert on infectious diseases and the immunology of aging at the David Geffen School of Medicine at UCLA. While the symptoms of illness are undoubtedly part of the immune response, the immune response that counts is protection, she said. “That is preserved across age groups and likely to be independent of whether you had local or systemic side effects or not.”

The immune system responses that produce post-vaccination symptoms are thought to be triggered by proteins called toll-like receptors, which reside on certain immune cells. These receptors are less functional in older people, who are also likely to have chronic, low-grade activation of their immune systems that paradoxically mutes the more rapid response to a vaccine.

But other parts of their immune systems are responding more gradually to the vaccine by creating the specific types of cells needed to protect against the coronavirus. These are the so-called memory B cells, which make antibodies to attack the virus, and “killer T cells” that track and destroy virus-infected cells.

Many other vaccines, including those that prevent hepatitis B and bacterial pneumonia, are highly effective while having relatively mild side effect profiles, Schaenman noted.

Whether you have a strong reaction to the vaccine “is an interesting but, in a sense, not vital question,” said Dr. William Schaffner, a professor of infectious disease at Vanderbilt University Medical Center. The bottom line, he said: “Don’t worry about it.”

There was a time when doctors prescribed cod-liver oil and people thought medicine had to taste bad to be effective. People who get sick after covid vaccination “feel like we’ve had a tiny bit of suffering, we’ve girded our loins against the real thing,” said Schaenman (who had a slight fever). “When people don’t have the side effects, they feel they’ve been robbed” of the experience.

Still, side effects can be a hopeful sign, especially when they end, says McCarty Memorial Christian Church leader Eddie Anderson, who has led efforts to vaccinate Black churchgoers in Los Angeles. He helps them through the rocky period by reminding them of the joyful reunions with children and grandchildren that will be possible post-vaccination.

“I’m a Christian pastor,’’ he said. “I tell them, ‘If you make it through the pain and discomfort, healing is on the other side. You can be fully human again.”


This story was produced by Kaiser Health News, an editorially independent program of the Kaiser Family Foundation.

image credit: getty images at KHN