Becoming a Vaccinator: A First-Hand, Behind the Scenes Look (plus a bonus – what to expect after your vaccination)

My husband was recently selected to be a vaccinator for Covid-19. Watch this space! I am excited to document the launch of a historic vaccine in his local medical practice.

It began with an application to the Texas Department of State Health Services. First the basics – are you a licensed physician in Texas? Where is your practice? What is the size of your practice?

Then more details: what kind of refrigeration and freezer equipment is on the premises? How many vials of vaccine can you accommodate? (He’s requested an initial 300 doses)

Both the Moderna and the Pfizer vaccines must be transported and stored at very low temperatures. My husband was required to purchase a special device for his refrigerator, a device designed to constantly record the temperature at specific intervals. The data can then be uploaded and analyzed to insure the “cold chain” has not been broken.

He doesn’t know at this point which vaccine (Moderna or Pfizer) will be shipped to him. 

The final step in approval was an agreement to honor the directives:

• Do you agree not to charge patients for the vaccine?

• Do you agree to abide by priority guidelines and to honor the criteria regarding who should be vaccinated first?

Approval was granted Friday, December 4. Stay tuned! 

In just a just matter of weeks, the first publicly offered vaccines will arrive across the U.S. at “warp speed”. 

Understand: a vaccine roll-out is not an instant, get-out-of-jail-free, burn your masks and breathe on your neighbor free-for-all.

But it’s a start.

A wonderful, excellent, science-y start.

What to expect after your vaccination:

Essentially 100% of those vaccinated will have side effects following the jab. For the vast majority of us, that means pain at the injection site, a little swelling, and some redness. 

A few people will have more intense side-effects, including fever, muscle pain, joint pain, headache, and fatigue. Side effects are temporary, usually lasting only a day or two. 

Still, a sore arm and feeling a bit crummy for a day is a small price to pay to rein in an infection that can damage hearts and lungs and is lethal in 2% of diagnosed cases (compare to the seasonal flu at 0.1%). 

Drew Weissman, an immunologist whose research contributed to both the Moderna and Pfizer vaccines wants people to be informed: “This is what you need to expect. Take Tylenol and suck it up for a day.”

Side effects are temporary and normal and are an indication that your immune system has shifted into high gear as it prepares to fight a future Covid-19 infection.

Redness, heat, pain, and swelling are signs of inflammation – your body’s natural response to invasion or injury. Think about itchy allergy eyes, a sprained ankle, or even a splinter in your finger. 

Both the Moderna and Pfizer vaccines use RNA molecules with the “recipe” for one of the protein spikes on a COVID-19 virus. The RNA enters your muscle cells, and your cells use the “recipe” to churn out spike proteins – perfectly harmless proteins that cannot make you sick. 

Fun fact – the spike proteins are constructed with raw materials found in your own, actual cells. The vaccine delivers the instructions, but the spike proteins are home-grown. 

After the RNA recipe has been used a few times to cook up some spike proteins, the cell breaks down the RNA molecule and destroys it, Mission Impossible-style. 

Your immune system learns to identify and remember the spike proteins and, in the future, will attack anything presenting the proteins (like an actual COVID-19 virus).

Inflammation is the result of this identification and learning process, thus the “side-effects” of a vaccine. 

Both the Pfizer and the Moderna vaccines require a booster, given either three or four weeks after the first vaccine. Full effectiveness occurs about two weeks after the booster. What is unknown at this point is how long this immunity lasts. 

On the horizon: using similar RNA therapy to trigger the body’s immune response to fight cancer.

What the vaccine does not do:

  • RNA vaccines cannot give you Covid-19. You cannot “shed” viruses to others following vaccination with an RNA vaccine. The vaccines do not contain actual viruses, killed or weakened or in any form.
  • RNA vaccines do not interfere or even encounter your own DNA. 

DNA is in the nucleus of the cell. Protein construction occurs outside the nucleus, in the watery cytoplasm filling the cell. The RNA molecules delivered by the vaccine stay out in the cytoplasm because that’s where the raw materials needed to build the spike protein are found. 

  • What about 20 years from now? What if the vaccine causes some future side effect? Again, an RNA molecule is very short-lived. Your cells destroy the RNA molecules shortly after they are used.

Would you like to find your place in line? Here’s a link for a handy-dandy tool that lets you estimate your place in the vaccine line. 

I, for instance, am in line behind 23.0 million people across the United States.

I’m behind 1.9 million in Texas.

In Denton County, I’m behind 31,800.

If the line in Texas was represented by about 100 people, I’d be standing 24th in line.

I’ll see you in line!

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

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)

A 20th Century Medical Miracle and the Hunt for a COVID19 Vaccine

The hospital ward had beds for as many as fifty children.

Dr. Banting and his associate quietly stepped inside. Bed after bed was occupied by a child, comatose and dying from diabetic ketoacidosis. Grieving parents sat bedside, awaiting the inevitable. 

The year was 1922. Medical researchers Fredrick Banting and his assistant Charles Best had been studying type 1 diabetes for the past two years. Using dogs, Banting and Best isolated insulin and treated (induced) diabetes in the animals. 

We’ve known about type 1 diabetes for centuries. The condition is well documented in ancient Egyptian, Hindu, and Chinese medical records. Aretaeus of Cappadocia, a second-century Greek physician, described diabetes as “the melting down of flesh and limbs into urine”. 

When the pancreas no longer produces insulin, people with type 1 diabetes cannot metabolize carbohydrates. Without insulin, patients waste away and suffer greatly, no matter how much they eat. The death rate for type 1 diabetes, prior to insulin therapy, was 100%. 

By the nineteenth century, we realized the role of carbohydrate metabolism in diabetes. Doctors attempted to control the disease with diet – prescribing only meat or fat for suffering children. On severely calorie-restricted diets, children lost weight and were critically malnourished.

Still, instead of death in a few weeks, children might survive a year. 

Encouraged by their success with dogs in the lab, Banting and Best injected an emaciated 14-year-old boy with insulin obtained from a cow in January 1922. Daily injections over the next twelve days dropped his blood sugar until it was no longer detectable in his urine. 

Soon after, Banting and Best walked into the solemn and quiet ward in a Toronto hospital, filled with comatose children. Banting and Best went bed to bed and injected each child with insulin. 

As they injected the last child, the first child woke up. 

One by one, all the children awoke from coma. 

A room filled with impending death became a place of hope. 

The 1923 Nobel Prize in Medicine was awarded to Fredrick Banting and John Macleod, in whose laboratory Banting and Best worked. Banting shared his prize with Best. 

The Eli Lilly Company improved the process for obtaining insulin from animals and sold the patent to the University of Toronto for $1.00. 

For the next six decades, insulin for human use was obtained from the pancreases of pigs and cows, a difficult and expensive process.

Everything changed in 1982. Using new genetic technology, the gene for making insulin was snipped out of human DNA and inserted into the DNA of a bacteria. The new transgenic bacteria were cloned. Entrepreneur Bob Swanson and his partner biologist Herbert Boyer grew vats and vats of the bacterial cells, all of which churned out huge quantities of insulin. 

HUMAN insulin.

For the first time, human insulin was produced in enormous quantities and made available to people with diabetes. 

Human insulin was the first genetically engineered drug approved by the FDA. Today, hundreds of medical conditions are treated with recombinant DNA drugs.

Objections to genetically modified organisms (GMOs) play on fears of the unknown. All too often, biotechnology is rejected without fully understanding the underlying science.

Fear of GMO technology results in absurd nonsense like the marketing of “NON-GMO” labeled salt. Salt contains no DNA to modify.

The top five contenders in the race for a COVID-19 vaccine use genetic information to teach our immune system to fight a viral infection. Already the anti-GMO movement is joining forces with anti-vaccine groups. Already vaccines developed using biotechnology are suspect.

Drugs developed using biotechnology have saved countless lives. A new generation of bioengineered vaccines are ready to join to the fight. 

November is National Diabetes Awareness month.

Thank you, Drs. Banting and Best. 

And thanks to the pioneers in recombinant drug therapies.

Best and Banting
National Museum of American History – Smithsonian

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)

Covid-19 Shortcut 4.0: The Great Barrington Declaration

Located halfway between London’s posh Barbican theater district and the famed Smithfield Market is a plot of land with a gruesome past. Excavation in the 1980s revealed bodies – loads and loads of bodies. So far, 600 bodies have been catalogued, but there are probably at least 2,400 total.

The year was 1348, and after devastating the continent, the Black Death had arrived in England. By 1350, one-third of Britain was dead of plague.

At the height of the plague in London, 200 people per day were buried in the mass grave known as “East Smithfield”. London’s churchyards could not accommodate such a colossal demand, so the city created the five-acre burial pit. Hastily, the dead were buried en masse, some neatly lined up, others tossed in haphazardly.

The plague struck hard and fast in Britain and across Europe, and in a short time decimated the population.

Prevention measures (as best as possible in the pre-scientific, pre-modern epidemiology days of the fourteenth century) were practiced. In order to avoid the “bad air” thought to spread plague, doors and windows were shuttered, suspending easy access to family, friends, and neighbors. Households with plague were quarantined.

But for the survivors, the story took a bit of an uptick.

For generations after the plague years, survivors were generally healthier and lived longer than did the general population pre-plague.

Interestingly, modern genetic studies suggest that some survivors had innate genetic resistance to the plague or to its fatality.

However, there was probably an additional environmental factor.

As much as half the population died in some areas. With the weak winnowed out, survivors had access to more food, more meat, more and better bread. After four years of lockdowns and quarantines, survivors were ready to return to life as usual.

Blinking in the plague-free sunlight, survivors emerged, ready to get on with life, with socialization, with commerce.

Centuries later, we, too, are weary of lockdowns. Our modern plague is world-wide, and the death and damage rates are frightening. Thankfully due to modern therapeutics, we are not looking at a death rate of one-third of our population.

Still, we are tired of it all. In the decade (it seems) of 2020, we have endured multiple claims of those who offer shortcuts to our misery: the “Plandemic” video, America’s Frontline Doctors’ white-coated press conference on the steps of the Supreme Court, and the Yale doctor with his hydroxychloroquine conspiracy.

After their fifteen minutes of fame, each faded, answered by evidence and the scientific method.

Enter the ostentatiously titled “Great Barrington Declaration”, signed on October 4 and currently muscling its way into the headlines.

The document argues that Covid-19 should be allowed to spread uncontrolled among the healthy, while presumably protecting the vulnerable. The result of such a strategy (according to the document) would be “herd immunity” without the use of a vaccine.

In the last few days, heavy hitters in the field of epidemiology and infectious disease have weighed in, including Anthony Fauci (“total nonsense”) and the prestigious Lancet medical journal (“a dangerous fallacy unsupported by scientific evidence.”) The director of the World Health Organization called the plan “scientifically and ethically problematic.”

Sponsored by a Libertarian think tank, The Great Barrington Declaration is penned by three scientists associated with big-name universities. The Declaration’s website claims tens of thousands of online signatures from medical practitioners and public health scientists, but the signees were recently made anonymous after too many Fakey McFakenames were found on the rolls.

In cases of viral diseases for which we have a vaccine (like measles), it’s true: we rely on herd immunity to protect the very young, the immunocompromised, and the few who (unknowingly) do not mount an immune response following a vaccine. But in the case of measles, herd immunity is not achieved by deadly disease sweeping through an entire population, killing and maiming many but leaving a few survivors with resistance. With measles, herd immunity is achieved without the devasting effects of the actual disease.

The Great Barrington Declaration is problematic scientifically:

  • A pandemic control strategy that relies on herd immunity is seriously flawed and is not supported in scientific literature.
  • Uncontrolled spread of Covid-19, even in a young population, increases the risk of death and long-term damage.
  • At this point, we do not know how long natural immunity to Covid-19 lasts. Relying on natural herd immunity could result in repeated epidemics, as we saw before the advent of vaccination.

The Great Barrington Declaration is problematic ethically:

  • Uncontrolled spread of Covid-19 increases the risk to frontline health workers, already at a heightened risk.
  • The Great Barrington Declaration advocates protecting vulnerable populations, but how do we define “vulnerable”? So, we isolate all the sick and elderly in nursing homes. What about people with unhealthy BMIs? What about people living in crowded homes with multiple generations of family? What about people with limited access to healthcare? That’s a lot of people to isolate while we let a virus run free.
  • Marginalized communities are at a higher risk, and many are young, the demographic in which The Great Barrington Declaration would allow the virus to run rampant. Are we willing to winnow the marginalized in pursuit of a shortcut to social normalcy?

No one wants endless lockdowns and the destruction of the economy. Social safety, common sense, increased and affordable testing, contact tracing, and mask-wearing are not draconian.

It’s not all or nothing.

I visited East Smithfield in London in 2016. Our “London Plague” tour guide lead us through the city with a rat on a stick.

Seen this weekend in my local Kroger: A Covid-19 mask, plague-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)

Photograph 51

It might be the most egregious slight in modern science.

By the early 1950s, we knew that whatever it was that parents passed along to their offspring was locked inside a mysterious chemical called DNA. The race was on to discover the structure of the DNA molecule. 

At Cambridge University, James Watson and Francis Crick were leading the pack. Trying (and failing) to build a model of a DNA molecule, Watson and Crick were close, but not yet successful. 

Nearby at Kings College London was the laboratory of Maurice Wilkins and Rosalind Franklin. Wilkins and Franklin were using x-ray photography to look at images of DNA molecules. Rosalind Franklin produced a particularly stunning photo of DNA, known as “Photograph 51”.

Photograph 51, called the “most important photo ever taken”, provided groundbreaking insights into DNA and modern genetics. 

Without her knowledge or consent, Maurice Wilkins showed Rosalind Franklin’s “Photograph 51” to James Watson. Watson later recalled that when he saw the photo, “my mouth fell open and my pulse began to race.”

Franklin’s physical image of DNA was the final piece of the puzzle. The now famous double-stranded twisted ladder shape of DNA was deciphered, thanks to Franklin’s photo and Watson and Crick’s mathematics. 

The discovery of the structure of DNA opened the door to modern genetics. Medicine, agriculture, and biotechnology leapt forward, and the 21st century is set to be the century of genetics. 

In 1962, the Nobel Prize for Medicine/Physiology was awarded to James Watson, Francis Crick, and Maurice Wilkins. 

In a slight still debated to this day, Rosalind Franklin was not included. 

The Nobel committee only awards the prize to living recipients, and Rosalind Franklin died four years earlier of ovarian cancer, at the age of 37.

Between 1901 and 2020, the Nobel Prize in Chemistry has been awarded to only seven women, and never to more than one at a time. 

For the first time in history, the 2020 Nobel Prize in Chemistry was shared by two women, Jennifer Doudna (U.C. Berkeley) and Emmanuelle Charpentier (Max Planck Unit for the Science of Pathogens, Berlin).

Jennifer Doudna and Emmanuelle Charpentier

Doudna and Charpentier were intrigued by an ancient immune response in bacteria. When a virus infects certain bacteria, the bacteria react by chopping up the DNA of the invading virus. The bacteria keep pieces of the chopped up viral DNA and incorporate it into their own DNA, kind of like a genetic “mugshot” of the invader. If the virus attacks again, the bacteria send chemical “scissors” to cut up the viral DNA at the precise location of the “mugshot” DNA. 

This bacterial immune response is named for the viral mugshots: CRISPR (pronounced like the drawer in the fridge where you store your vegetables).

Doudna and Charpentier retooled CRISPR and used it to edit DNA in living cells with incredible precision and accuracy.

Already their discovery has impacted plant breeding and agriculture. Probably most exciting, however, are the possibilities for treating genetic diseases. 

Meet Victoria Gray. 

Victoria, a wife and mom of three, was born with sickle cell disease, a devastating genetic disorder. One single mutation in the DNA of people with sickle cell disease turns their red blood cells into deformed, sickle-shaped cells. The misshapen cells get stuck in blood vessels, resulting in damaged organs, debilitating pain, and often premature death.

The gene that causes sickle cell disease produces a defective form of hemoglobin, the protein in red blood cells responsible for carrying oxygen. There is another kind of hemoglobin made by babies before birth called “fetal hemoglobin”. After a baby is born, a gene called BCL11A turns on. BCL11A tells blood cells to stop making fetal hemoglobin and start making adult hemoglobin. In people like Victoria with sickle cell disease, adult hemoglobin is defective. 

One year ago, doctors removed cells from Victoria’s bone marrow. Using CRISPR technology, the BCL11A gene was cut out, restoring production of fetal hemoglobin. 

As of June 2020, 46% of the hemoglobin in Victoria’s system is fetal hemoglobin, enough to significantly reduce her pain and hospitalizations. 

The doctor in charge of Victoria’s treatment had this to say: “She is functioning as somebody who does not have sickle cell disease. I believe this is absolutely, totally transformative therapy.” 

CRISPR therapy holds promise for other genetic diseases, including beta thalassemia, cystic fibrosis, and some cancers. 

“It’s a blessing,” Victoria said. “It gave me hope when I was losing it. So I feel joy, you know, knowing that there is hope.”

Congratulations to Drs. Doudna and Charpentier for the 2020 Nobel Prize in Chemistry. 

I think Rosalind would be proud.

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“)

Here I am with an actual model built by Watson and Crick (The Science Museum, London)

Two Sides of the Same Coin

It was a typical birthday party for a ten-year-old boy – balloons, cake, rambunctious kids. Oh, and party favors, too! 

But this was not your usual grab bag of gum and cheap toys. 

The loot bags also contained a British five-pound note, worth about $10.00 at the time. There was one small catch…

In order to get the party-prize, each little guest had to let the birthday boy’s dad draw a blood sample. 

Later, Dad laughingly recounted the hilariousness of the situation: “I lined them up and they stuck out their arms. Kids were fainting. One kid threw up all over his mother. It was just your standard 10-year-old’s birthday.”

And you thought bounce houses got out of control.

Dr. Andrew Wakefield used the blood samples he collected at his son’s birthday party in one of the most notorious medical studies in modern times. Wakefield’s study, published in the prestigious British medical journal Lancet, triggered a decades-long collapse of public confidence in one of the most significant medical advances in human history: vaccination. 

In his 1998 article, Wakefield claimed that in eight children, the onset of autism followed immunization with the MMR vaccine. Researchers all over the world tried to replicate his results, but no one could.

Still, vaccination rates plummeted in the UK and in the United States. 

The thing is . . . Wakefield made it all up.

The birthday party was just the beginning. In addition to an uncontrolled study with sketchy “volunteer” recruitment, he fabricated data. Before the Lancet article was published, Wakefield filed a patent for his own version of the MMR. Wakefield was also being paid for his “expert” testimony in a lawsuit against vaccine manufacturers.

Twelve years after publication, the Lancet retracted the article and Wakefield lost his medical license. Decades of world-wide research and tens of thousands of cases demonstrate no link between autism and vaccination.

Unrepentant, Wakefield continues to travel and speak to anti-vaccine groups. Despite the loss of a “measles-free” status in the UK and multiple measles outbreaks in the United States, groups continue to pay Wakefield thousands of dollars for his “expertise”. To celebrities and everyday moms and dads who do not want to “poison” their children, Wakefield is a martyr. 

Unfortunately, the science behind vaccine safety is lost on those with an anti-vaccination mindset. Research shows that exposure to science evidence reenforces anti-vaccination perceptions of parents. Emotions trump evidence.

Welcome to 2020, and welcome to the flip side of the anti-vaccination coin. 

As the world awaits the release of one of several Covid-19 vaccines now in phase-3 trials, opposition to the vaccine is rising, and from a very surprising precinct. Anti-Covid-19 vaccine voices are getting louder, and one in particular caught the attention of NIH director Francis Collins. 

Michael Zimmerman is a biologist and the founder of the Clergy Letter Project, an effort demonstrating that religion and science are not in conflict. Zimmerman begins his essay by citing his Ph.D. in biology, his opposition to the pseudo-science of vaccine denial, and his generalized rejection of conspiracy theories.

Yet, Zimmerman declares his opposition to a Covid-19 vaccine – at least for the next three months.

Zimmerman and other newly-minted antivaxxers do not trust the current administration. Zimmerman fears the anti-science dogma touted by the Trump administration. Zimmerman and others fear political pressure on the CDC and the FDA will result in the release of a risky vaccine. 

Collins, in his public response to Zimmerman, is direct and uncharacteristically blunt. 

Shouldn’t you reserve judgement until you see the data? Collins asks. 

The vaccine approval process is transparent and is overseen by respected life-long scientists like Collins and Anthony Fauci. And unlike “America’s Frontline Doctors’” claims in their fifteen minutes of summer fame, legitimate science studies are transparent and published for critical review.

In response to Collins’ hope for a Covid-19 vaccine by the end of 2020, Zimmerman writes this: 

“I hope your prediction is off by a month and that approval doesn’t occur until after 20 January 2021 with a new administration in place.”

To which Collins replied:

“Be careful that you don’t end up hoping and praying for the vaccine to arrive after January 20 — when an earlier scientifically rigorous result would have potentially saved many lives.”

To those who are usually on Team Science but find themselves rooting against a Covid-19 vaccine: trust the process. If you don’t trust Trump, fine. Trust Francis Collins and Anthony Fauci, two scientists with decades of stellar public health service and a history of withstanding political pressure from both parties. 

Recently, Fauci publicly took the CDC to task for an announcement made while he was under general anesthesia. Fauci lost no time in setting the record straight with his disapproval. And last week, Fauci scolded Senator Rand Paul in a congressional hearing for his repeated misrepresentations of Covid-19 evidence. 

Traditional anti-vaxxers and Covid-19 anti-vaxxers are two sides of the same coin. At their core, both groups mistrust science. Both groups are influenced by deeply held, emotional beliefs. 

Both traditional anti-vaxxers and Covid-19 anti-vaxxers threaten public health and the goal of herd immunity.

On September 25, 2020, Francis Collins was awarded the Templeton Prize for a lifetime of demonstrating harmony between modern science and faith. In his acceptance speech, Collins encourages us to return to our calling to love one another – both friends and enemies.

Loving our neighbor as ourselves means loving all our neighbors: our immunocompromised neighbors, our elderly neighbors, our newborn neighbors, our medically fragile neighbors, our neighbors undergoing chemotherapy. 

If you are medically able to be vaccinated, you are practicing love in a very real, very practical way. 

(Read the correspondence between Francis Collins and Michael Zimmerman here

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“)

string theory

Proud Mary

Mary Mallon was proud of her craft. 

At the turn of the 20th century, Mary was in demand by wealthy Manhattan families for her skills as a cook. One day, a city official, George Soper, knocked on the door of the fancy brownstone where Mary was employed. 

He had a few simple requests to make of Mary. Could he please have a sample of her blood, her urine, and her feces? Oh, and, this little question: Did she regularly wash her hands after going to the bathroom?

That was one question too many for Mary. She grabbed a carving fork, swore, and lunged for the man, who wisely exited the home.

And you thought the Target and Walmart anti-maskers overreacted.

Four months prior to his abrupt ouster from Mary’s place of employment, Sober, a New York City sanitary engineer, was asked to investigate an epidemic that would eventually sicken thousands of New Yorkers. Soper began by interviewing a particularly hard-hit family in their Long Island summer home. 

Just weeks into their vacation, the family’s nine-year-old daughter fell seriously ill. All told, six out of eleven members of the household, both family and staff, fell sick. 

Soper interviewed the family and discovered that the cook – Mary Mallon – had returned to New York City soon after, apparently healthy as a horse. 

New York was in the midst of a typhoid fever epidemic. Typhoid fever is caused by Salmonella bacteria and in 1907, was fatal in ten percent of infections. Immunization against typhoid fever was four years away and an effective antibiotic was almost forty years away. Carried in feces and usually found in areas with poor sanitation, typhoid fever’s appearance in wealthy areas was a mystery.

But Soper was onto to something. He questioned the family about the menus prepared by Mary, and discovered that shortly before illness broke out, Mary had served her Sunday specialty: homemade ice cream and fresh peaches. Compared to her hot cooked meals, Soper concluded that “no better way could be found for a cook to cleanse her hands of microbes and infect a family.”

Soper searched New York for four months, looking for Mary Mallon. In his search, he identified eight families for whom Mary had cooked, going back several years. Seven families had outbreaks, with twenty-two sick and several deaths. 

In a few years, newspapers would dub Mary Mallon “Typhoid Mary”.

It took police officers, an ambulance, a female doctor, and a foot-chase over the backyard fence to finally bring Mary in for testing. Mary tried her best to resist, holding her stool sample as long as possible. Ultimately, nature called, and Mary tested positive for high levels of Salmonella. Completely and absolutely healthy, Mary denied ever being sick with Typhoid.

She was quarantined on a hospital island for two years, producing typhoid-positive samples the entire time. 

She sued the health department, lost, but was finally freed from the hospital in 1910. Mary agreed to check in regularly with the health department, and importantly, Mary agreed never to work as a cook again. 

After a while, Mary stopped checking in and, feeling fit as a fiddle, returned to cooking: for a hotel, a Broadway restaurant, a spa, and a boarding house.

In 1915, typhoid fever broke out in a New York maternity hospital. At least twenty-five nurses, doctors, and staff were infected, and two died. The cook was a woman named “Mary Brown” who, surprise, surprise, turned out to be Mary Mallon. 

Mary was again transferred to the quarantine island, where she lived until her death in 1932, adamant that she had never been sick with typhoid. 

Mary was the first known case of a healthy carrier in the United States. She was traced to the infection of at least 122 people, including five deaths. In 1907 alone, 3,000 New Yorkers were infected with typhoid, most likely due to Mary. 

Mary’s legacy as an asymptomatic carrier of a deadly disease has informed every widespread disease outbreak since. 

Forty percent of Covid-19 infections have no symptoms. A Boston homeless shelter had 147 infected residents, but 88 percent of them had no symptoms. A Tyson poultry plant in Arkansas had 481 infections, and ninety-five percent were asymptomatic. Prisons across multiple states found 96 percent of infected people were asymptomatic. 

A large number of infected but asymptomatic people is a good thing, of course, but that’s not the whole story. Apparently, seemingly healthy people are just as capable of carrying large viral loads and infecting others as are people with symptoms. 

Compounding the situation are the “super-spreaders”. Super-spreader events, where a single person infects a large number of people, are widely documented. 

The World Health Organization initially did not recommend population-level face masking, but changed their recommendation in June 2020 when the extent of transmission by asymptomatic individuals was confirmed. 

It wasn’t a flip-flop. With new data, science changes its mind. 

A poor immigrant with little education, Mary can possibly be excused for not understanding the nuances of being an asymptomatic carrier. 

But we should know better. When you wear a mask in public spaces, you are probably protecting yourself a bit. But mostly, you’re protecting everyone else in case you are one of the asymptomatic carriers. 

Love your neighbor as yourself.

A popular illustration of the day, depicting Mary cracking skulls like eggs into a frying pan.

******

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

 

Meet Denny: A Front-Row Seat in the Story of Human Evolution

I love a good “best of” list at the end of each out-going year. A study by scientists who ate Legos and studied their “passing” made one such list for 2018 (Everything is Awesome: Don’t Forget the Lego). To the Google for more info on that one. My favorite top science story for the year was the story of Denny, a child from a very surprising blended family.

A very tangled family tree

Have you seen this poster?

The_March_of_Progress

The March of Progress, or The Road to Homo Sapiens was originally published by Time-Life in 1965.

It has been reprinted and repeated, held up as science fact and disparaged as the march to Godless evolution.

Both interpretations are wrong.

In reality, the Road to Homo Sapiens is no more scientifically correct than this version:

Homersapien

The evolution of modern humans was not an all-in-line march to the finish as the famous  March to Progress illustration implies.

Modern humans sit on one tip of a branch of an ancient human family tree – a tangled tree with many branches.

All of the other branches in this tangled tree have died out. We alone survive.

But in the not-so-far past (relatively speaking), this was not the case. In the past, modern humans shared our planet with some of the now extinct branches of our tangled family tree.

Last to leave, last to arrive

Modern humans have lived longer in Africa than any other place on earth – about 200,000 years.

Many modern humans stayed in Africa. Other groups of modern humans left Africa about 70,000 years ago and spread across Europe, Asia, the Pacific, and the Americas (see map).

But modern humans were late to the out-of-Africa party.

An ancestor of modern humans had already ventured out of Africa 500,000 – 600,000 years before. Once out of Africa, this ancestor group further split into at least two important groups: the Neanderthals and the Denisovans. The members of the ancestral group that remained in Africa gave rise to modern humans.

The Neanderthals spread out across Europe and western Asia and the Denisovans ranged from eastern Europe to eastern Asia. When modern humans finally moved out of Africa and trekked across the globe, they met some very ancient cousins. But by 30,000 years ago, modern humans stood alone – the last remaining branch on the tangled human family tree.

All three human groups (Neanderthals, Denisovans, modern humans) are distinct – some scientists consider them different species. However, modern humans were closely related enough to mate and have children with the other two groups.

How do we know this?  People with European and Asian ancestry have trace amounts (one to two percent) Neanderthal DNA in their genomes. Denisovan DNA is highest in the modern populations of southeast Asia and Oceania (4 – 6%). Trace amounts of Denisovan DNA are also found in east Asian populations. Interestingly, people in sub-Saharan Africa have zero-to-almost zero Neanderthal or Denisovan DNA.

Denny

An extraordinary new discovery tells us that early human groups also mated with each other.

For the last twelve years, a single cave in Siberia has produced important discoveries of Denisovan remains. The Denisova cave (for which this group was named) yielded an astonishing new find, first announced in August 2018.

A bone from a thirteen-year-old girl was found with equal amounts of Denisovan and Neanderthal DNA.

Humans have 23 unique chromosomes. But – we have two copies of each chromosome, one from biological mom and one from biological dad.

The chromosomes of the 13 -year old girl found in the Denisovan cave (nicknamed “Denny”) stunned scientists. In each chromosome pair, one chromosome came from a parent that was exclusively Neanderthal and one came from a parent that was exclusively Denisovan.

Additionally, humans have a tiny bit of DNA in the mitochondria of their cells. All mitochondrial DNA comes from mom (I wrote about mitochondrial DNA in this post). Denny’s mitochondrial DNA was Neanderthal.

It was as if we had a front-row seat. Denny was a first-generation offspring of a Neanderthal mom and a Denisovan dad.

The first reaction of the researcher studying Denny’s DNA was “what did I do wrong?”. The tests were repeated six times, and each time the results were the same.

Denny is an exciting, but not surprising find. We have indirect evidence of interbreeding: trace amounts of DNA from “cousin” human groups have been found in Neanderthals, Denisovans, and modern humans. With the discovery of Denny, we have direct evidence of interbreeding between human groups. How often did that happen? That’s a question to be answered, but Denny provides a hint. We’ve only known about Denisovans since 2008, and already we have a first-generation hybrid with another human group. We have yet to find a first-generation offspring of modern humans and Neanderthals or Denisovans, but they surely existed.

Screen Shot 2018-12-28 at 4.32.01 PM

Do you have more questions about the tangled human family tree? Here’s a link to an excellent six-minute animated graphic Last Hominin Standing: Charting Our Rise and the Fall of Our Closest Relatives.

*****

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“)

*****

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