Hello all! In my last newsletter, I talked about the science behind public health: epidemiology. Check it out here.
For this week’s newsletter, I am introducing a new series in which I apply the public health perspective, outlined in previous newsletters, to our current realm, coined Public Health Unfiltered. As is no surprise, I will be discussing new research about the coronavirus and the different vaccines coming out.
New Research by UofM School of Public Health: MI CReSS
This semester, I joined a joint research study with the University of Michigan School of Public Health and the Michigan Department of Health and Human Services, called the MI COVID-19 Recovery Surveillance Study (MI CReSS). MI CReSS aims to document and analyze Michiganders’ experience with the COVID-19 illness and pandemic. Our first report was released on October 21st, 2020, concluding that 1 in 4 Michigan residents had not fully recovered to their usual state of health. Recovery time varied greatly for those who recovered, from less than one week to 18 weeks, with an average recovery time of 4 four weeks. Other key findings include:
Of those who thought they knew the source of exposure, half believed they were exposed at work, while a quarter thought they were exposed by a family member.
Approximately 69% of participants who were employed at time of diagnosis had to report to work following Governor Whitmer’s “Stay Home, Stay Safe” executive order. 88% of those were considered an essential employee.
You can find the entire report here.
Vaccination Proclamation: Operation Warp Speed, mRNA, spike proteins, and more
What is Operation Warp Speed?
Announced on May 15th, Operation Warp Speed is a partnership between the Department of Health and Human Services, the Department of Defense, and the private sector whose goal is to oversee and accelerate the COVID-19 pandemic by advancing the development of therapeutics, vaccines, and other countermeasures. OWS is responsible for ensuring that the COVID-19 vaccines are properly and safely created and distributed by providing funding and direct oversight.
How Do Vaccines Work?
To start, vaccines revive the body’s own protective immune responses so that if a person is infected with a pathogen (a bacterium or virus), the immune system can quickly prevent the infection from spreading within the body and causing the disease. In a way, the vaccine imitates the natural infection but without actually causing the individual to become sick. Common vaccines contain a weakened or dead antigen that is injected into the body, prompting the immune system to develop a fighting mechanism if the body were to actually be penetrated by the disease.
The SARS-CoV-2 (Coronavirus) virus is studded with spike proteins that it uses to enter human cells. These proteins make it an easy target to create vaccines and treatment against the disease.
The Vaccine Candidates
There have been many candidates working on vaccine development for COVID-19, five of which have reached Phase 3 of the clinical trials in the United States.
AstraZeneca
Johnson & Johnson
Moderna
Novavax
Pfizer/BioNTech
For the sake of clarity, I will dive into two that will likely be distributed in the coming weeks.
Moderna
efficacy rate of 94.1%
Moderna utilizes messenger RNA (mRNA), genetic material that provides instructions to the body on which proteins to make. Instead of having the weakened virus injected into the body, a person receives mRNA that describes the spike protein on the surface of SARS-CoV-2. Once received, the body responds by producing the spike proteins, triggering the immune system to develop a fighting mechanism. This approach copies what coronavirus does in nature, but the vaccine only carries the code for the vital protein and no other part of the virus. That way, if an individual were to become infected with coronavirus, the immune system will already have a prepared response.
There are many difficulties with using mRNA due to its inherent instability; it is likely to break apart in above freezing temperatures, however Moderna claims its vaccine can be stored in household or medical freezers for up to six months.
This vaccine will require two doses, taken four weeks apart.
Pfizer/BioNTech
efficacy rate of 95%
Similar to Moderna, Pfizer uses mRNA technology to build the spike protein.
Like I mentioned, mRNA is extremely difficult to work with because of its instability and if solely injected, our body’s natural enzymes would dismantle it into pieces. Thus, Pfizer must wrap it in oily bubbles made of lipid nanoparticles and store it in special containers with dry ice.
Requires two doses, taken 21 days apart
These two candidates are the only ones using mRNA technology, while the others use a viral vector, inactivated, or weakened virus to deliver an antigen into the body. There have not been any DNA/RNA vaccines approved for human use yet, but they have been studied and worked on for years.
When will the vaccine be approved and distributed?
On December 10th, the Food and Drug Administration (FDA) medical advisory panel recommended an emergency use order for the coronavirus vaccine. On December 11th (30 minutes ago as I am typing this…), the FDA historically approved Pfizer’s vaccine for emergency use in the U.S. This is coming after the White House Chief of Staff, Mark Meadows, threatened the FDA commissioner, Dr. Stephen Hahn, that if he had not authorized the emergency approval for the vaccine by Friday evening, he would need to look for a new job. An Emergency Use Authorization (EUA) is not an FDA approval; it allows the use of a product during a public health emergency. Within just a few days, the first doses could be given to millions of health care workers and nursing home residents, as the CDC recommended these individuals receive them first; however, each state will lay out guidelines for distribution and priority. Pfizer has said that they likely can supply 25 million doses before the end of 2020 and can supply 100 million doses by March. The FDA’s intense analysis does assert that this vaccine is safe and effective.
Moderna is expected to receive an EUA from the FDA soon and is likely to start distributing doses on December 21st.
Lots of new information and data will be released in the coming days about vaccine trials, distribution, etc. While we are entering a dark winter as cases and deaths continue to increase, there is hope.
Thank you for reading; Be well, be kind, and stay healthy.
If you have any general questions, please email me at reemlfawaz@gmail.com.