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Warning: This blog is sciencey


As the US races past 0.1% of the population dying of COVID-19, help is on the horizon in the form of shots in arms. With two vaccines being widely distributed in the US and more on the way, one can be hopeful we will conquer this virus soon and get back to our normal lives. This article will focus on vaccines available or soon-to-be available in the US. Additional and/or different vaccines are available in other countries.


SARS-CoV-2, the virus causing COVID-19, is an RNA virus. Such viruses are known to mutate frequently. Vaccines against SARS-CoV-2 are aimed at raising an immune response against the virus’s spike protein, with some eliciting a response against other parts of the virus, too. The spike protein, made of 1273 amino acids, is distributed around the viral surface and attaches the virus to receptors on human cells, allowing the virus to enter. The general thinking is that since binding of the spike protein to specific human cell receptors is crucial to the virus’s infectivity, it is unlikely to remain infective if the spike protein mutates significantly, especially in the region that actually attaches to the human receptor.


If you’ve been trying to keep up with vaccine development in the news, you have probably heard about the different kinds of vaccines. Many are in the pipeline in various countries. Below is an overview of the main types of vaccine platforms, or types:


Nucleic acid vaccines (These are very new and had not been distributed to humans prior to the current RNA vaccines in use.)


Messenger RNA vaccines: Both the Pfizer BioNTech and Moderna vaccines use messenger RNA (mRNA) manufactured in the laboratory, then suspended in a lipid coating. The latter protects the mRNA from degradation as it makes its way into the vaccine recipient’s cells. Once inside the cell, the mRNA directs the cellular machinery to make the protein the mRNA instructs it to make—the viral spike protein. Well, almost the spike protein. Due to instability of the viral spike protein in suspension, the vaccine mRNA codes for a protein almost identical to the SARS-CoV-2 spike protein, but substitutes two amino acids to enhance stability. The vaccines produced by the two companies appear to use the same mRNA, although the lipid coatings are different. As the body produces many copies of the modified spike protein from the vaccine mRNA, an immune response is mounted.


DNA vaccines: These are limited as they need special modes of delivery so the DNA can reach the cell’s nucleus where it can direct the production of protein molecules. DNA vaccines tend to be less potent. A vaccine against COVID-19 using this technology is being studied by Inovio Pharmaceuticals together with the International Vaccine Institute in South Korea.


Viral Vector vaccines (These are fairly new.)

These vaccines use harmless viruses (vectors) in which a component of a pathogenic virus has been added to raise an immune response against the pathogenic virus. COVID-19 vaccines of this sort use harmless viruses carrying the COVID-19 spike protein. The Oxford-AstraZeneca vaccine, which may be approved for use in the US soon (and is currently being administered in the UK, India, Mexico, and several other countries), and the Johnson and Johnson vaccine (in trials now) are viral vector vaccines. Chinese and Russian vaccines also use this type of platform.


Acellular vaccines (These are fairly new)

This type of vaccine is made from a component of the pathogenic virus. The Novavax vaccine uses the spike protein of the SARS-CoV-2 virus having the same changes introduced in the mRNA vaccines, but with additional alterations to render it more stable.


Traditional:

Inactivated virus: These vaccines are made of chemically inactivated, non-replicating pathogenic viruses. (These are being developed in India, China, and Kazakhstan).


Live attenuated virus: Genetically weakened forms of a pathogenic virus are used. These vaccines can be given intranasally to induce a mucosal immune response. Several for COVID-19 are in preclinical development.


Virus-like particles: Viral protein(s) such as the spike protein, are incorporated into virus-like particles.

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Now a word about clinical trials. These are highly regulated procedures whereby the safety and efficacy of vaccines and medications are tested. Clinical trials progress through phase I, phase II, and phase III. This happens after preclinical evaluation, which includes animal testing. Completing each phase typically takes several years, but the timeline was significantly shortened for the development of the COVID-19 vaccines. Below are brief descriptions of what the different phases are in terms of vaccines.


Phase l: A small number of healthy volunteers (usually <100) is given a low dose. If that dose is found to be safe, other subjects are tested with increasing doses as safety allows. Minimal data regarding efficacy is collected. This would likely include information on the production of neutralizing antibodies and T-lymphocyte response, thought to be important in protecting against COVID-19.


Phase ll: This usually involves several hundred people. More safety information, and data regarding the immune response are collected.


Phase lll: This involves a large number of people who receive the vaccine or a placebo. Safety information is collected, and the vaccine efficacy is calculated. In case you’re wondering how vaccine efficacy is calculated:


Efficacy =

[(attack rate in unvaccinated - attack rate in vaccinated)/(attack rate in unvaccinated)]x 100


Example:

100 people in the unvaccinated (control) group and 100 people in the vaccinated group are followed.

25 unvaccinated people get the disease, while 2 vaccinated people get the disease.

Efficacy = [(25-2)/25] x100= 92%

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The data on the new vaccines is all preliminary due to the limited number of people studied, and lack of long-term follow-up. Conclusions will be adjusted over time as warranted.


Vaccines are recommended for people who have recovered from COVID-19. Due to lack of data, COVID-19 vaccination within two weeks of another vaccine is not recommended.


What we know (by the time you read this, some information may be out of date):

The Pfizer/BioNTech vaccine:

Two doses, given 21 days apart.

Age 16 and older are eligible.

95% effective 7 days after 2nd dose.

Patients older than 65 have a slightly lower antibody response.

Side effects are less in people over 55 years of age.

2 weeks after the first dose, the rate of infection in vaccinated people starts to decrease relative to those who received a placebo (52% efficacy).

For those who do contract the disease, there appears to be reduced risk for a severe outcome.

The Moderna vaccine:

Two doses, given 28 days apart.

Age 18 and older are eligible.

94% effective 14 days after 2nd dose

For adults 65 and older, the vaccine is 86% effective.

Side effects are less in people older than 65 and in those with previous COVID-19 infections.

Vaccine efficacy from a single dose is 80%, with a mean follow-up of only 4 weeks. Data suggests there is a reduction in asymptomatic infections between dose 1 and 2.

For those who do contract the disease, there appears to be reduced risk for a severe outcome.

Oxford/AstraZeneca vaccine:

70% efficacy 14 days after 2nd dose

Strangely, a subgroup receiving a lower 1st dose had 90% efficacy, but this may not be statistically significant.

There was one possible significant side effect.

Janssen (Johnson and Johnson):

This will probably be given as a single dose, although the effect of a 2nd dose is being studied.

Age 18 and older are being studied.

Recently released data indicates the vaccine is 85% effective in preventing severe disease 28 days after a single vaccination, and 100% after 49 days.

Side effects are lower in people older than 65.

Novavax:

Clinical trial in UK: almost 90% efficacy.

Clinical trial in South Africa: just under 50% efficacy.

Almost all the positive cases were caused by the new South African variant.

Many trial participants infected with the new South African variant had previously tested positive for COVID-19.


What we don’t know:

These vaccines haven’t been tested on children. However, clinical trials are underway on older children and, if found to be safe, will be performed on younger children.


These vaccines haven’t been tested on pregnant women. Studies are being planned, starting with women in the second and third trimesters.


Can you get COVID-19 twice? Probably, but only rarely (this may not hold for the South African variant).


How long are you immune after infection or immunization?


Is a booster needed? If so, what would be the best timing for that?


We don’t have hard numbers on the chances of serious illness or death following one or two vaccinations.


How many vaccinated people are asymptomatic carriers (contagious) after one or two doses? This will affect the impact of vaccination on community transmission. Until we know, it appears prudent to enforce mask-wearing, even among those who have been vaccinated.


What is the long-term efficacy of only 1 dose of vaccines now requiring two doses? (Most people in studies received a 2nd dose.)


Will vaccines be effective against new variants? The South African variant is currently the most worrisome. It has multiple mutations, some of which change the shape of the virus surface and thereby weaken the effectiveness of vaccines. A recent study by Pfizer indicates the South African variants has only a small impact on the effectiveness of the antibodies produced by their vaccine. I don’t know the details of the study, or what the “small impact” was. Experts believe that if the efficacy of an mRNA vaccine is significantly reduced by a viral mutation, they will be able to quickly manufacture a slightly tweaked booster to increase potency.

The Novavax vaccine efficacy is significantly decreased in the South African variant. Preliminary studies regarding the Johnson and Johnson vaccine indicate it is very effective in preventing severe disease from the South African variant. This may not hold up as more data is collected.

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The pandemic has given us a peek at the complexity of vaccine production and distribution.


Many in the public were amazed that vaccines against COVID-19 were produced so rapidly. This is not completely without precedent. After all, a vaccine against the Zika virus was produced in approximately 7 months by Inovio Pharmaceuticals. There was much less hoopla about that, as by the time the vaccine was made, the Zika virus no longer posed a major threat. The usual exhaustive clinical trials required before marketing a vaccine weren’t done with the Zika vaccine, and still haven’t been completed. There is so little disease caused by the Zika virus now, phase III clinical trials aren’t possible unless volunteers are purposefully infected.


Let’s not forget that the rapid development of the current vaccines is due to the hard work of dedicated scientists. Only after years of basic science research laying foundations for more patient-oriented research, were the pieces in place to rapidly produce much-needed vaccines. This includes the ability to sequence the nucleic acids that form the core of viruses, and the ability to produce specific proteins and nucleic acid segments at will (check out some of this technology in my recently published novel, Unnatural).


It is important to note that Chinese scientists had completely sequenced COVID-19 RNA early in 2000, and shared the information with the world. That gave vaccine manufacturers a leg up in producing vaccines using the various platforms available. Vaccines targeting the spike proteins of related viruses (SARS-CoV-1 and MERS) had already been developed, further facilitating development of vaccines for COVID-19. (Human trials for these earlier vaccines were halted when the diseases they protected against decreased significantly.)


COVID-19 vaccine production was expedited by increased collaboration between governments, regulatory authorities, and the scientific community around world. Governments (including the US, the UK, Canada, Belgium, Switzerland, Norway, Germany, and the Netherlands), charities, and Big Parma invested billions of dollars into research and simultaneous (rather than sequential) industrial “scaling up” to mass produce vaccines before they were developed.


The two COVID-19 vaccines currently being distributed in the US were approved for emergency use, eliminating the long wait the FDA usually requires before allowing a vaccine to be widely delivered. Not only was the follow-up time shortened significantly, but the time it took to get a sufficient number of positive cases in the control group after the vaccine was given was much less than expected due to the soaring infection rate.


I hope you can get your vaccine soon if you haven’t already. You probably won’t have a choice, but whichever vaccine you are offered in the US, I’m confident it will be safe. I’m not so sure about the Russian or Chinese vaccines.


You’ve probably seen a movie where an actress or playwright is waiting for the newspaper to come out after the opening night of their play. They look on as their manager or better half opens the paper, looks for the review and starts to read. This is followed by either elation or crushing despair.


I hate to be overdramatic, but that describes how it was for me, waiting for the first reviews of my debut novel, Unnatural. I had several reviews pending, and had no idea what they would say. After all, I hadn’t had a completely unbiased, honest assessment of the book by a complete stranger. Sure, my publisher accepted it, but maybe he made a mistake. Happens. My friends weren’t about to tell me it sucked, even if it did. So, I was left to wonder, preparing myself for the worst (although you can never be fully prepared, can you?).


A few days ago, with my novel due to be released in a month, I finally got my first review. Unlike the movies I’d seen, there was no newspaper – only an email notification. It was from Midwest Book Review, a well-known, respected source of reviews. My first thought was “Uh-oh.” Should I click on it right away? Should I think about it first, try to prepare myself for the final reckoning?


I’d probably be sitting there still, with my finger on the upper left button of my mouse, hovering over the email had I not momentarily summoned the courage to make that fateful click. I instantly averted my eyes as the email loaded, then slowly moved my gaze to the first line of the email.


It proved to be anticlimactic – the beginning of the email explained all the ways I could use the review: post online, put on my book cover, use all or excerpts, etc. So far, so good. Then I slowly worked my way down to the dreaded review itself. I had to read it twice to be sure I hadn’t missed anything. By the time I finished, I was feeling pretty stoked. The reviewer liked it! It felt good, having a complete outsider give positive feedback about my novel. You can read the entire review on the “novels” page of this website.


Surprisingly, less than a day later, another review arrived in my inbox. That one was from Indies Today. Having one good review under my belt made me less concerned about the second one. Even if the second review was terrible, I still had Midwest. Nobody could take that away. I clicked on the Indies Today link, which directed me to their website where the review was there for all to see. Again, a good review. They use a star rating system and I got five out of five stars.


My journey ends there, for now. As of this writing, I haven’t received any more reviews. But I’m ready. With two good reviews, I can withstand some bad ones (I think).


Since I gave final approvals for the cover and the text, I’ve been able to relax somewhat, but my work isn’t finished. My publisher took care of things like providing sales information to Amazon and Barnes and Noble, I had to choose excerpts from my book reviews and find out how to get them displayed on the Amazon site. Did you know that information has to be uploaded separately for the eBook and the paperback? Neither did I. Now I have to find out why the information was uploaded correctly for the paperback book, but not for the eBook.

Each day seems to present a new small task, often frustrating.


If you haven’t already, consider pre-ordering my book. If you read an earlier draft, I guarantee the published edition is different – although the general story is unchanged.


Best wishes for the holidays and the new year!

If you haven’t seen it yet, and you subscribe to Netflix, I suggest you watch The Social Dilemma. It’s about ninety minutes and attempts to explain how social media sucks up our time and manipulates susceptible people into accepting misinformation as true. Part interviews with knowledgeable people from the worlds of Facebook, Twitter, Mozilla, Firefox, Apple, Instagram, Uber, Pinterest, YouTube, and Google, and part docudrama, I found the show to be very informative.


It all boils down to the monetization of social networking platforms. There’s no free lunch. What you think is free is costing you your time and, if you don’t take responsibility for verifying information, your ability to know what is true. There are some pretty scary forces out there trying to hack our brains and, in many cases, succeeding.


Part of what I discuss below is in the Netflix movie, some isn’t. Likewise, not everything mentioned in the film is discussed below, so I recommend watching The Social Dilemma to learn about everything it covers.


Social networking started off as mainly a force for good. It kept people connected—united family members, helped bring attention to good causes, and kept people informed about local events. Monetization wasn’t important back in the good ol’ days. The turning point for that was 2012, when Facebook went public. It had many users hooked, and now was poised to make a lot of money.


In the 2010s, the biggest moneymakers in Silicon Valley have not been the hardware and software companies that garnered the area’s reputation for tech innovation and profit. The biggest profit centers in recent years have been the social networking platforms, the companies basically selling YOU, their users. More specifically, they are selling YOUR ATTENTION. To be clear, the people who use these platforms to connect with friends and search for the best deal on a laptop are the USERS, not the customers. The real customers are the advertisers.


As I see it, there are two main problems here: 1) the insinuation of these platforms into our lives, causing addictive behavior and wasting our time, and 2) the changes these platforms can produce in our view of the world.


In the movie, Jaron Lanier explained it best: “It’s the gradual, slight, imperceptible change in your own behavior and perception that is the product” using manipulation and persuasion techniques. Sounds like a slow form of brainwashing to me. What’s really scary is that as the companies gather more and more information on us by following our likes, the videos we watch, and how long we stay on a page, they constantly improve their algorithms, allowing them to “sell certainty” that a particular ad will get the attention of the users they target and therefore enhance their already substantial bottom line.


How do they draw us in, keep us engaged and coming back, inviting friends? A technique called positive intermittent reinforcement. In the case of social media, rewards are doled out unpredictably, on a variable-ratio schedule. By offering rewards (a notification, a like, an email, a news item you like) in an unpredictable fashion, it keeps you checking your phone and scrolling. A slot machine operates in the same manner – you never know when you’re going to come up with three cherries. Maybe with the next quarter . . . Having studied behavior modification in the past, I’m familiar with the power of intermittent reinforcement, especially if given in a variable-ratio schedule. It can be much stronger than a predictable reward, such as picking a certain number of apples for a predictable paycheck.


With so many users, companies are able to optimize manipulation using small changes in subsets of users which they can test, tweaking and continually improving their behavior modification techniques. Even people who work in these companies say they fall prey to the manipulation.


In the movie, some attention is given to the harmful effects social media has on children. I won’t go into that here, but will repeat that members of Gen Z, those born after 1996, are the first generation to use social media in middle school, and it’s probably not good for them.


Wasting your time and conning you to spend lots of time scrolling through junk is bad enough. The really scary aspect, however, is how social media has been hijacked by people and groups with a nefarious purpose. This has been easy because YouTube and Facebook are set up to present information to you based on your profile (gleaned by spying on you), the goal being to keep you engaged (in contrast to Wikipedia, where everyone sees the same content, and they don’t strive to keep you on their site).


For example, a search for climate change will give you different results depending on your interests. You may be directed to sites indicating it is a great hoax, or sites showing it to be a great threat. Whichever type of site you are led to, you can get a false sense that everyone agrees with you. Then you can easily fall prey to manipulation. When people are presented with different information they deem to be credible, they will come to different conclusions.


Interestingly, an MIT study concluded that fake news on Twitter spreads six times faster than accurate stories. The more outrageous the story, the more interesting it is, and the more it spreads. The Social Dilemma used Pizzagate as an example.


I remember first hearing about Pizzagate on the news, where it was described as a belief some people had that Hilary Clinton and other high-ranking Democrats were involved in a child sex ring working out of restaurants, including a Washington, D.C. pizzeria. I dismissed the story as being so ridiculous, nobody would believe it, but the facts show that I was wrong. According to Wikipedia, one poll showed that 9% of registered voters thought Hillary Clinton was involved in this child sex ring, and 19% weren’t sure.


The conspiracy theory, which was subsequently connected to Michael Flynn and his son, was spread by a number of right-wing news organizations. One man became so upset by the story, he drove to the pizzeria from his home in North Carolina and shot into the restaurant three times with his rifle.


You may wonder how so many people believed the story. Apparently, once the conspiracy groups popped up, Facebook started suggesting these groups to other users deemed susceptible to conspiracy theories, such as anti-vaxxers and believers in chemtrails. These malleable individuals were directed to social media platforms discussing Pizzagate, even though they had never searched for it. The ultimate goal of Facebook was to keep the users engaged, so they could be shown ads from paying customers. However, often those customers, paying for directed messaging, have perverse intentions.


Charging for directed ads has become sophisticated and lucrative. I first heard about this from my son who attended a conference where this was discussed. Platforms can have instant pricing where advertisers agree to spend a certain amount of money to reach a particular sort of user.


By targeting users who meet specific demographics, social media has been weaponized. People with a lot of money, or governments (Russia for example), can send out manipulative messages quickly and cheaply. In this way, a government can be destabilized. Right now, most countries targeted in this way run democratic elections. Russians don’t need to hack into our system – they just exploit our existing platforms to sow chaos and division.


How is this done? Facebook can find thousands of people who believe the earth is flat, for example. A nefarious actor can promote conspiracy theories and misinformation to these people, influencing their beliefs, and, ultimately, their vote.


If you have someone in your household who you know has very different opinions than you do, I suggest you do an experiment and see what shows up on your searches when you enter certain words, such as: Trump, Biden, the second amendment, Palestinians, fracking, the affordable care act, etc. You get my drift. I would be interested in finding out what happens.


At the core of the problem is the business model. There is little in terms of rules, regulation, and competition. All businesses need to be reined in. I think of them as like bacteria – they will seek the most profits they can get mindlessly, without regard to the ultimate outcome. Just as bacteria mutate to evade antibiotics, businesses hire lawyers to get around regulations. Governments must constantly adapt to keep companies in line, just as we do what we can to overcome bacterial infections. Our lawmakers have a new challenge – they need to come up with ways to prevent the manipulative techniques at play.


Facebook has promised to set up and oversight board to protect us from false information. That still hasn’t happened. Recently, a group of concerned citizens has organized the “Real Oversight Board” in an attempt to hold big tech accountable. Until a better way is found, we need to judge for ourselves what to believe and what not to believe.


Here’s my approach: look at reliable news sources from both the right and the left. Importantly, check things out. If something doesn’t seem reasonable, search for reliable information. Rely on trusted sources as well as your own common sense. The latter is very important. I present two falsehoods I’ve come across, one political, one not.


Political: In an ad funded by America First Action (a Trump super PAC), a video of Joe Biden is presented as “Defund the police?” is splashed on the screen. Joe Biden says, “Yes, absolutely.” If you are not paying attention, you might think Joe Biden said he wants to defund the police, while he actually might have been answering “Yes, absolutely,” to the question, “Would you like your bagel toasted?” In truth, Biden has never supported defunding the police. I remember listening very carefully to him after defunding the police became a popular topic of conversation. He immediately dismissed the idea and has consistently held that he is not in favor of it. If you don’t believe me, check out his website and try to find something about defunding the police.


Nonpolitical: My hairdresser informed me that she’d heard doctors have the cure for cancer, but don’t want to give it to people because they make more money treating cancer patients than they would by curing them. It’s surprising that anyone could believe this, especially since doctors die of cancer, just like non-doctors. The same is true of pharmaceutical executives who some people think are withholding cures to make more money on medications for patients who aren’t cured. There are so many reasons why this makes no sense – a doctor or pharmaceutical company with a cancer cure could charge a whole lot of money (some medications which don’t cure cancer cost over $100,000/year currently). Why would a doctor or pharmaceutical company waste their time finding a cure if they had no intention of using it? Wouldn’t you expect at least one egotistical or humanitarian doctor or person in the pharma industry to break with the others and divulge this information? Using a little common sense, anyone should be able to figure out that this idea is nonsense.


If we as a society continue as we are going, we run the risk of destroying civilization through willful ignorance. We need to take control of the situation before we reach the singularity – the point where we can’t outsmart the computers, and can no longer control our technology. Let’s not go there.


Start with watching The Social Dilemma if you haven’t seen it yet.


And now (I really hate doing this), I’m going to ask you to please visit my Facebook page at https://facebook.com/devengreeneauthor. I’m giving in to pressure to advertise my first novel on Facebook (remember, I said social media can be used for good). On my Facebook page you’ll find useful links to area 51, the alien autopsy, the Sandy Hook Elementary School hoax, and verified sightings the Loch Ness monster (if you think I might be lying, check out the site). If you like the site even a little, please give it a like.

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