Vaccine Cheat Sheet and a Thanksgiving Prayer for the Scientists

Just in time for your Thanksgiving dinner (live or zoomed) or those fun holiday social media debates, I’ve made a little vaccine cheat sheet!

Three top vaccine contenders recently released phase three results: Pfizer/BioNTech, Moderna, and AstraZeneca/Oxford University. 

All three studies meet the gold standard of science research: huge study groups, randomly assigned and double-blinded trials. In a double-blind trial, neither the study groups nor the people running the trial know if a volunteer receives a placebo or the actual vaccine. 

All three of the first-out-of-the-gate vaccines are bioengineered. All three use genetic information to teach the immune system to attack the COVID-19 virus. 

The Pfizer and Moderna vaccines are very similar, so we’ll start with them.

How Do They Work?

Both vaccines use a molecule of RNA, coated in an oily micro-bubble. 

RNA is closely related to DNA, the molecule that carries the genetic code. When our cells need to make something (like a protein), a copy of the DNA gene for that protein is made on an RNA molecule.

Think of it this way: grandma’s cookbook contains all her recipes. You make a copy of one cookie recipe on a notecard and carry it back home, where you create the cookies. DNA is the cookbook; RNA is the notecard.

Both the Pfizer and the Moderna vaccines use RNA with the “recipe” for one of the protein spikes on the COVID-19 virus. 

When injected, the oily micro-bubble fuses with a muscle cell. The cell uses the RNA “recipe” to make spike proteins, which are released into the body.

A spike protein alone won’t make you sick, but it will teach your body to attack anything presenting the protein – like an actual COVID-19 virus.

Although RNA vaccines have been studied for years and are approved for animal use, if approved, these vaccines would be the first for human use. 

Do They Work?

Apparently, magnificently.

The Pfizer vaccine was reported to be 90% effective and the Moderna vaccine 94.5% effective. 

What does that mean in actual humans?

In the Moderna study, for example, 95 of the 30,000 volunteers got sick with COVID. Of the 95 sick people, ninety people received the placebo and only five received the vaccine, giving us an effectiveness rate of 94.5%. 

An especially promising bit of news is that the five who got the vaccine and also got sick experienced only minor symptoms. 

Severe symptoms were only found among the 90 people who got the placebo. This finding suggests that Moderna’s vaccine reduces the severity of disease in vaccinated people who still get sick. 

To put a 90-95% effectiveness rate in perspective: in order for the FDA to consider a vaccine for use, it must demonstrate a 50% efficacy rate. Seasonal flu vaccines are 40-60 % effective. The measles vaccine is 97% effective. 

Are They Safe?

Neither the Pfizer trial (44,000 participants) nor the Moderna trial (30,000 participants) uncovered any serious side effects. Both studies included volunteers of all ages and multiple ethnicities. But research doesn’t stop there. Safety studies continue as vaccines are rolled out to the general population.

Before launching their large phase three study, Pfizer tried out four versions of their vaccine in smaller groups. Pfizer selected the version that produced the fewest cases of mild and moderate side effects, such as fever and fatigue.

Once Approved, How Will the Vaccines be Distributed? 

Gus Perna is the army general in charge of “Operation Warp Speed”, the plan to distribute enough vaccine for 300 million Americans in the most timely and efficient way. General Perna is an army logistics expert. (Check out Perna’s “60 Minutes” interview on November 6 for the details). 

A problem to be solved with both the Pfizer and the Moderna vaccines is transportation and storage. 

Pfizer’s vaccine needs to be really cold, stored at -112 degrees Fahrenheit. Pfizer is making special ultra-cold shipping boxes and storage containers for use until the vaccines are given. (For reference, your home freezer is 0 degrees Fahrenheit). 

Moderna’s vaccine is a little less finicky, requiring “only” -4 degrees Fahrenheit. Additionally, Moderna’s can be stored in a regular refrigerator for 30 days after shipping. 

The latest vaccine announcement comes from AstraZeneca and Oxford University.

How Does it Work?

Although the AstraZeneca vaccine is also bioengineered, it differs in delivery from the other two. The AstraZeneca vaccine uses a “vector” – a biological delivery truck – to deliver the genetic information needed to teach the immune system how to fight the actual COVID-19 virus. 

The vector used is an adenovirus. This adenovirus causes colds in chimpanzees but is harmless to humans. 

The adenovirus’ DNA is modified to contain the code for a COVID-19 spike protein. The adenovirus given in the vaccine “infects” human cells, delivering the gene for the spike protein. The cells in turn churn out the spike protein.

And just as with the other two vaccines, the spike protein teaches your system to fight future infections by the actual virus. 

Adenovirus vaccines have been studied for decades, and European regulators recently approved a Johnson & Johnson adenovirus vaccine for Ebola. 

Does it Work?

The AstraZenaca vaccine is reported to be about 70% effective. During the phase three trial, two versions were used. One version was 62% effective, one was 90% effective, for an average of 70%.

Is this enough data for AstraZeneca to ask for FDA emergency authorization? We don’t know yet. 

Is it Safe?

AstraZeneca’s phase three trial was briefly halted due to possible reactions by two volunteers. However, the symptoms were found not to be directly related to the vaccine and the trials resumed.

That’s your cheat sheet for the first three vaccines. 

So, what’s next?

Mark your calendars for December 10, 2020. Pfizer’s vaccine is on the FDA’s docket for emergency authorization consideration. If approved, get in line – healthcare workers, you’re first. 

Regardless of your Thanksgiving dinner plans, consider this lovely little prayer, penned by Amanda Held Opelt, sister of Rachel Held Evans:

“These vaccines represent the tireless work by scientists & researchers who have already led lives of rigorous study and discipline.  Lord, for these women & men, many of whose names we may never know, we give thanks.”

Happy Thanksgiving, 2020 style.

And as You speak

A hundred billion creatures catch your breath

Evolving in pursuit of what You said

If it all reveals Your nature so will I

(Hillsong United So Will I)

Meme Busters: The Anonymous Nurse

They escaped from Alcatraz, exploded a toilet, drank mentos and Diet Coke at the same time, and lived to tell the tale. They even proved there was room for Jack as well as Rose on that plank of wood. 

Discovery Channel’s long-running MythBusters put questions, myths, and urban legends to the test. Sometimes there was truth, sometimes a bit of truth, and often the myth was busted (no, your stomach will not explode if you drink Coke and Mentos at the same time). 

INTRODUCING: Science Meme Busters! I can’t bust them all, but I’ll be on the lookout for the good ones!

Memes make the rounds on social media, especially science memes. Sometimes photos with clever captions, sometimes cut-and-paste stories that begin with “I copied this from someone else” or “copied and shared from a friend”.

Making the rounds lately are the thoughts of an anonymous “ER nurse” regarding “diverse opinions” about Covid-19. 

So much to bust in this meme, but for now, I’ll focus here:

Anyone out there who can tell me what our end game is with the covid19? . . . Is it a vaccine? . . .It took 25 years for a chicken pox vaccine to be developed.” “Do you really think people will flock to get a fast tracked, quickly tested vaccine, whose long term side effects and overall efficacy are anyone's best guess?

Vaccines train our immune system to recognize and fight invading pathogens. Before the 20th century, this could be an effective but often dangerous practice. 

For centuries, doctors rubbed scabs from smallpox victims into a scratch on the arm of a healthy person, a process called “variolation”. A single smallpox blister would form, heal, and the variolated person was immune to smallpox . . . hopefully.

Sometimes the variolated person developed smallpox. Two percent of variolated people died. Still, two percent is a far cry from the 30% death rate from natural smallpox infection. 

Weighing the risks, many opted for smallpox variolation when it was available. George Washington ordered the variolation of his troops at the height of the American Revolution. 

No one knew why variolation (sometimes) worked. But by the 20th century, we knew about viruses and we fixed our attention on them. 

We looked for a safer way to train the immune system using vaccines containing inactivated or weakened viruses. 

When vaccines for diseases like measles, mumps, and chickenpox were developed, researchers weakened viruses by systematically growing them in a variety of cultures. Viruses were forced to grow for hundreds of generations in a hodgepodge of human and animal cells. As the viruses adapted to ever-changing environments, they became less dangerous to humans. 

As you can image, it was time-consuming to grow strains of disabled viruses. Following the creation of a disabled strain, vaccines were developed, then tested – all time-consuming processes. 

We aren’t starting from scratch with Covid19. This is the 21st century and we aren’t just figuring out this whole vaccine thing.

In 2020, we have more technology in our arsenal. In our age of modern genetics, the five top candidates for a Covid19 vaccine use information to teach our immune system, not the actual Covid19 virus.

Two of the top contenders use a copy of a gene that makes one of the protein spikes on the corona virus. The vaccine delivers the genetic instructions, and the body responds by using the instructions to make the spike protein. 

The spike protein alone won’t make you sick. BUT – the presence of the protein teaches your immune system to recognize and destroy anything presenting the protein – including an entire Covid19 virus. 

wiki commons

The remaining top contenders use other versions of delivering genetic instructions for a single Covid19 protein. 

Instead of months (and more) of transferring viruses from culture to culture, the genetic code for a protein can be read almost immediately. 

We can make an experimental batch of vaccine in a week. 

The mysterious and anonymous “nurse” in this meme cites the years needed to develop the chickenpox vaccine and worries about the “fast-tracking” of a Covid19 vaccine. Should we fear a vaccine developed under a program termed “Operation Warp Speed”?

The unprecedented speed of a Covid19 vaccine is not due to fast-tracking and corner-cutting in safety and effectiveness testing. 

The “speed” refers to the manufacturing process. While all the long phases of safety trials are occurring, the most promising vaccines are being manufactured on an industrial scale. Usually, vaccines aren’t manufactured until after the trials.

In order to speed things up, doses of the promising vaccines are already being made. If all of the phase trials show a vaccine to be safe and effective, we won’t have to wait months to manufacture it.

On the other hand, we are possibly manufacturing doses that will never be used.

The risk in Operation Warp Speed is financial, not safety.

Conclusion: Meme Busted!

The 2nd place winner at Mark’s office Halloween party (she was robbed I say!). Her cute red “spikes” aren’t so scary.

And as You speak

A hundred billion creatures catch your breath

Evolving in pursuit of what You said

If it all reveals Your nature so will I

(Hillsong United So Will I)

What We Don’t Know (Or Don’t Remember) Can Hurt Us

The virus belongs to a class of pathogens called “teratogens” – literally: “monster makers”.

Yet, for decades, it flew under the radar. In children and adults, infection was mild: a bit of fever, an unimpressive rash. After a few days, the sick bounced back with no harm done.

Rubella was considered the mildest of childhood diseases. In a time of polio, rubella was ignored.

But an astute Australian ophthalmologist picked up on a disturbing pattern: nine months after a 1939 rubella epidemic, sixty-eight out of seventy-eight babies born blind were born to mothers infected with rubella in the first trimester of pregnancy. Over the next twenty years, research confirmed his findings.

Americans experienced the horrors of rubella in a massive outbreak between 1963 and 1964. Six thousand babies spontaneously aborted, two thousand babies died at birth.

Twenty thousand babies were born with damaged livers, pancreases, and brains. The babies suffered hepatitis, diabetes, mental retardation, blindness, deafness, epilepsy, and autism.

Eight or nine out of ten babies infected in the first trimester were damaged. That’s 85%.

An American vaccine scientist predicted another outbreak would occur sometime between 1970-1973. By 1965, he had developed a rubella vaccine, shown in testing to be safe and effective. By 1969, he had modified a version of the vaccine, and a hundred million doses were distributed throughout the United States.

Rubella epidemic averted.

Today, children are routinely vaccinated for rubella (it’s the “R” in the MMR vaccine). In 2005, the CDC declared rubella eliminated in the United States.

Everyone has heard of Albert Einstein, Jonas Salk, and Marie Curie, but Maurice Hilleman has saved more lives than any other scientist.

Maurice Hilleman is the father of modern vaccines. He is considered by many the greatest scientist of the 20th century, but few know his name.

Hilleman developed nine of the fifteen routine vaccines given to children today. Hilleman developed the first vaccine against human cancer, the hepatitis B vaccine. He developed and collaborated on many more vaccines, but never named any of them after himself, with one small exception…

The mumps vaccine in use today is manufactured using a strain of the virus Hilleman swabbed from the throat of his own little daughter when she awoke sick in the night. There’s a famous photo of Hilleman’s younger daughter, Kirsten, being vaccinated with the “Jeryl Lynn Mumps Vaccine”. Big sister Jeryl Lynn is close by, comforting her baby sister.

Jeryl Lynn and Kirsten photo

Jeryl Lynn Hilleman with her sister, Kirsten, in 1966

 

jeryl Lynn Mumps vaccine photo

The Jeryl Lynn Mumps Vaccine

 

Despite responsibility for saving countless lives, no vaccine carries the name Hilleman.

*****

We have collective short-term memories. When public health measures prevent or reduce the impact of a crisis, we forget what we were afraid of. When we dodge a bullet, we forget what won the battle.

No one knows Hilleman because few us know rubella. We aren’t afraid our teenagers will die of diphtheria. We don’t fear disability or death from polio, and we aren’t afraid our babies will die of measles or whooping cough. A generation does not fear mumps or chicken pox and the deadly complications that might follow.

At the end of his life, Hilleman’s groundbreaking MMR vaccine was the target for a rising anti-vaccination movement. A British doctor, Andrew Wakefield, claimed the MMR was responsible for an “epidemic” of autism. Hilleman died before Wakefield was discredited and lost his medical license for his fraudulent claims.

The general public has been harder to convince, however, and long-vanquished diseases are popping up in anti-vax hotspots.

We’ve forgotten what it was like.

When we flattened the Covid-curve, many declared “See! It’s all overblown! Back to business as usual! We aren’t afraid!”

Sometimes, what we don’t know (or don’t remember) can hurt us.

Maurice Hilleman would have been 101 this month.

time capsule contribution Hilleman 1999

Replica of the six vaccines put into the National Millennium Time Capsule by Dr. Hilleman. (Washington, D.C., 1999).

 

*****

And as You speak
A hundred billion creatures catch Your breath
Evolving in pursuit of what You said
If it all reveals Your nature so will I

(Hillsong United “So Will I“)

*****

 

 

science cat explores gravity