Tag Archive for: vaccine

Why We Need Hope

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I hope you all had a good Thanksgiving and were as safe as possible. The COVID-19 seven-day average continues to stay over 150,000 cases per day. We’ll find out in a couple weeks how we did during the Thanksgiving holiday related to masking and social distancing. It’s difficult to be without family and friends, especially over the holidays, but the one thing we can take solace in is that this is temporary; the better we all follow the rules, the sooner we can all be together again.

It reminds me of an interview a well-known business advisor had with a prisoner of war in Viet Nam years after the war ended. He asked who did better in captivity—people who were optimistic about rescue or those who decided they would simply endure? The answer surprised him: the optimists did far worse than other POWs. The optimists would say, “We’ll be out by Christmas for sure!” Then Christmas would come and go, so they would pick the next significant event and say the same thing. The events would pass, one after another, and soon, the optimists lost all hope.

Don’t do that. One thing we have is hope. The current treatments for those who get COVID are better than six months ago, and they will be better tomorrow as we learn more about the disease. Vaccinations will start soon and while the distribution will take time, there’s hope for those who are most at risk. If we do all we can with the things we can control, there will be an end to this. We don’t know exactly when that will be, but it will happen. Until then we grind it out, we endure. We’re tougher than we think we are. Let’s prove it.

What are you prepared to do today?

        Dr. Chet

Not Fear, Respect!

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I’ve read many comments on social media platforms about COVID-19, and the tone remains the same. An ever-growing group of people are talking about theories and conspiracies of all type. “The numbers are rigged to show more deaths from COVID-19 than there really are,” or “Doctors have discovered treatments that work and are being suppressed.” Lately we have this “Plandemic” movie making the rounds. Then there are the people who claim that our liberties are being taken away by being forced to stay home, wear masks, and not work or go to restaurants; they claim we are being forced to be afraid to go into public.

Our perspective on life is governed by the prism we look through. People who fear vaccinations are already saying they will never get a COVID-19 vaccination if there ever is one. People who fear the government are alarmed by the slightest perception of the infringement of their constitutional rights. Almost everyone who understands the disease is afraid of the COVID-19 virus. I want to change your perspective. In doing so, I’ll explain why staying home is a good idea.

In case you’re wondering why my opinion carries any weight, there’s this: in my heart of hearts, I’m a scientist and a teacher. You can check my website bio to learn more, but the important point is that I probably understand science and scientific research better than you do (you undoubtedly know more about your area of expertise than I do). I don’t look at the science news with a political bias, just with a solid education and years of experience that helps me understand what the science really means and what the studies really prove. My mission in life is to share that information with you to help you be healthier, and I can’t think of a time that offer to share has been more important than now.

The Virus: We Just Don’t Know Enough

The virus is the enemy. In order to defeat it, we need to know enough about it to beat it, but we just don’t know enough yet. Here are the most significant questions.

Why do some people catch the virus and don’t have symptoms, yet they can spread it to others very easily? This is the primary question we need answered. Is it that the virus mutates more easily in some people than in others? Is it the total amount of exposure? Is it a genetic factor? The easy ones such as ethnicity, hair color, and eye color haven’t been explored as deeply as they should. Is the microbiome a factor? I could go on and on, but until we know why some people have no symptoms while the virus kills others, we should be prudent in exposing ourselves to it.

Why do some treatments work well in some people and not in others? Case in point is intravenous vitamin C; it helped some people live longer when treated with hydroxychloroquine and the Z-pack while it had no impact on others. We have a partial answer: it worked only in those who were deficient in vitamin C. That also tells us that even people who had enough vitamin C were still susceptible to the virus and died. Not everyone can take the malaria drug hydroxychloroquine because it causes fatal arrhythmias in some people. Until we get a treatment in place that can work for just about everyone if they get the severe form of COVID-19, we should be prudent in being exposed to the virus.

Do we have to wait for a vaccine? No, because there may never be one. While it’s a completely different virus, there’s still no vaccine for HIV some 40 years after its discovery, and it’s possible there may never be a vaccine for this one either. However, scientists seem to be making progress so it looks hopeful, but probably not for 18–36 months.

Testing

Testing is going to have to be part of the solution. Who wants to go to a place of business for an extended visit such as a gym or a haircut or a meal if you don’t know if the people working there have the infection or not? The number of tests required to open the economy and keep it open should create an economy of scale that lowers the cost, and in time the testing should be dependable, precise, and cost effective. The industrial health-manufacturing complex should take on the task of providing these products at the lowest price possible to make it worthwhile for businesses to provide it for employees and customers.

Antibody testing to see if a person had the virus should also be a priority. Antibodies may not create immunity, but they may have some benefit against the virus should a person be exposed again. That’s important to know.

If I had a business where people must show up in person, I’d begin to create the signage “All employees tested daily!” and “We test our customers for free!” That will happen at some point and the sooner the better.

The Bottom Line: Respect

The word “respect” should replace “fear” when talking about COVID-19. People can rant and rave in social media if they want; that’s their right. But if they’re exposed to enough of the virus, they will get it. What happens to them? We can’t predict. We also can’t predict what will happen to their family, their friends, and every person they come in contact with. I can’t imagine anyone who would be willing to put people they care about at risk.

One of the saddest aspects of our time is the stark partisanship and the way it colors everything we see—red versus blue, urban versus rural, white collar versus blue collar. When it shapes the way we see science, it frankly scares me. It’s not a situation where, oops, you might gain a few pounds or vomit for a couple days. This virus could take your life or your parent’s life or your friend’s life; even if you or they survive, you or they may face a lifetime of health challenges such as severely diminished lung function; as an example, a runner may never have the lungpower to run again. And at this point, we know the virus can produce devastating symptoms in a small percentage of children who get it, but we don’t know why and we have no idea what the life-long aftereffects may be; most parents (and grandparents) won’t want to take that gamble.

I don’t want you to be afraid, I just want you to respect the power of the virus and the scientific knowledge we’re slowly gaining.

I’m staying home with the exception of grocery shopping and doctor’s appointments that can’t be done by phone, and I wear a mask when I go out—not to protect myself, but as a courtesy to others. Same for Paula.

We’re not prisoners. The warm weather is finally here, and there’s work to do in the yard. We’re blessed because Paula and I have been working at home for years. We don’t fear catching the virus. We just respect it and understand where we stand at this moment in time.

If you change the prism you look through, respect makes a lot more sense than fear or disbelief. Act accordingly.

What are you prepared to do today?

        Dr. Chet

Build Herd Immunity: Vaccinate

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Let’s take a look at both types of herd immunity with the goal of deciding which is better in 2017 when it comes to the flu vaccination.

Natural Herd Immunity

The benefit of natural herd immunity is the innate ability of the immune system to protect against other forms of the same virus. No question that’s a benefit that’s not available via vaccination to any degree. In response to the initial Memo on the flu vaccinations, someone posted a link on Facebook to an interesting study (1).

In that study, researchers examined the immune response of children to the flu vaccine several years ago. The results indicated that vaccinations did not promote the ability of the immune system to manufacture specific types of immune cells that would protect against variations of the viruses in that flu vaccine. It was a small study, but it demonstrates why we need flu vaccinations every year: one shot does not fit all viruses.

The downside to natural herd immunity is obvious: in order to get immunity, lots of people have to get sick. The flu can knock a healthy person out for a few days—inconvenient but not usually life threatening. But for the very young, the elderly, those who are pregnant, and those with an auto-immune disease, it can be life threatening.

The strains this year are not especially virulent, but that begs the question: what if there’s a strain that’s similar to the Spanish flu of 1918-1919? A half million people died in that pandemic. How many people would we be willing to risk to achieve natural herd immunity?

Vaccination Herd Immunity

When it comes to the flu vaccine, there are a couple of concerns besides the potential lack of protection against future viruses. The first is allergies to eggs because the vaccine is typically grown in eggs. Good news: there are some vaccines available that are made from recombinant DNA and thus do not need to be grown in eggs.

The second are the preservatives that are used to keep the vaccine safe when used in multiple doses per vaccine vial. The primary concern is thimerosal, a mercury-based preservative that has been used since the 1930s. There are thimerosal-free vaccines available if you want to avoid it altogether; the single-dose vaccination, for example. However the amount and type of mercury found in a vaccination will be eliminated by your liver’s detoxification system within 24 to 48 hours, so I wouldn’t be concerned about it.

The real benefit to vaccination herd immunity is also obvious: lots of people don’t have to get sick in order to gain the immunity to the flu viruses in this year’s flu vaccine. True, we may have to get a yearly flu vaccine, because there are always new viral flu strains. However it seems worth it.

The only issue is getting enough people to get each year’s flu vaccination. The numbers have to get to more than 80% to develop herd immunity.

The Bottom Line

I’ve always recommended that people assess their immune systems before getting a flu shot. As I said last week, I typically don’t get one because I rarely get sick. However, with a two-year-old grandson, I’m more concerned about keeping him safe. He’s very healthy, but viruses don’t discriminate. This is not about me being able to handle the flu if I get it; it’s about trying to prevent those most at risk from getting it. For me, vaccination herd immunity is the correct way to go.

What are you prepared to do today?

Dr. Chet

 

Reference: J Virology. 2011;85(22):11995–12000.

 

What’s Herd Immunity?

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Herd immunity is a way to protect a population against the transmission of an infectious disease from one person to another by increasing the number of people who are immune to the disease. This results in lower transmission of the disease and thus protects more people or “the herd”; herd immunity is the only way to protect people who can’t get the flu shot, such as the very young, the elderly, pregant women, and people with compromised immune systems.

There’s a lot written on the net about herd immunity, and most of it’s confusing or plain misleading, especially when it comes to vaccinations. I’m going to break it down to natural herd immunity and vaccination herd immunity. Today, I’ll define both terms.

Natural herd immunity develops as many people become infected, get sick, and generate antibodies to the virus or other pathogen. When a large number of people get infected and generate an immunity to the virus, those people can no longer catch that virus; thus they won’t be transmitting it, and that protects the rest of the herd. A side benefit is that it will also provide some immunity to similar viruses.

Vaccination herd immunity uses vaccines to help people become immune to a disease without getting sick. When enough people become vaccinated, the herd immunity goes into effect: those people can no longer catch that virus; thus they won’t be transmitting it, and that protects the rest of the herd.

In both cases, the issue is getting enough people to be immune to the disease. Estimates vary but the target is somewhere between 80% and 94%. The question is simple: do we want 80–94% of the population getting sick or do we want vaccinations? More on this question on Saturday.

What are you prepared to do today?

Dr. Chet

 

Further Reading:
1. http://www.pbs.org/wgbh/nova/body/herd-immunity.html
2. https://vector.childrenshospital.org/2017/03/social-media-mumps-herd-immunity/

 

What’s Viral Shedding?

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Based on the response to my email about the flu vaccination, people raised a few questions and I had one of my own. The first question is about viral shedding. Your first thought is probably “What’s that?”

Viral shedding is the period of time when you’re infected and can transmit the flu virus to someone else—it’s when you’re contagious. The question from the reader wondered whether someone who has been vaccinated will still be contagious to others if they’re infected with the flu. The answer is yes; being vaccinated against this year’s flu will not inhibit your ability to infect others if you get the flu. Remember, some people who are vaccinated will still get the flu.

The problem with the flu is that you can be shedding the virus while you still feel fine. You can be infectious up to a day before the onset of symptoms and up to 24 hours past the end of the fever. The difference may be related to the form of flu, whether influenza A or B. However, the data are not completely clear.

The point is that you should still be cautious if you begin to feel symptoms, whether vaccinated or not. While you can’t catch the flu from the vaccination because the virus used is dead, you might still get the flu. The goal is to protect others. Speaking of others, we’ll talk about herd immunity on Thursday.

What are you prepared to do today?

Dr. Chet

 

Reference: https://www.cdc.gov/vaccines/hcp/vis/vis-statements/flu.html