HomeMy WebLinkAbout081922 KPTZ Listener Questions for Monday_ August 22_ 2022 BOCC Update________________________________
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County Commissioners, Dr Allison Berry, and Willie Bence,
Please see the KPTZ listener questions listed below for Monday, August 22, 2022 BOCC Update.
Thank you,
Lynn Sorensen
KPTZ Virus Watch Team
Questions for Dr Allison Berry:
1. I am excited that the Omicron-specific booster will be available this fall.
In the past, receiving a booster has resulted in a few short weeks of great protection against infection followed by several months
of much higher risk of a breakthrough infection.
While the vaccine provided me with great protection against non-milder illness and death, it didn't offer me much freedom since I spend a lot of time
with elderly folks and I didn't want to endanger them if I got a breakthrough COVID infection.
Will the Omicron-specific booster provide longer protection against infection (specifically) than the original booster has? Or can we expect the same pattern of only a few weeks of safety
from infection before vaccinated people once again become a danger to the seniors in our lives?
2. Does small pox vaccine received as a child protect an adult from MPV? (new name for monkey pox?)
If so, what would have been the last year and month that small pox vaccine was routinely given to children in this country?
3. The CDC has long claimed the following regarding the COVID-19 biological products:
The mRNA and the spike protein do not last long in the body.
* Our cells break down mRNA from these vaccines and get rid of it within a few days after vaccination.
* Scientists estimate that the spike protein, like other proteins our bodies create, may stay in the body up to a few weeks.
Last month, however, the CDC removed this language from its webpage "Understanding mRNA COVID-19 Vaccines." The most recent version of this web page and archived versions of it can be
found on the Wayback Machine here <https://web.archive.org/web/20220723161304/https://www.cdc.gov/coronavirus/2019-ncov/vaccines/different-vaccines/mrna.html> .
Is this a tacit admission that the mRNA does not, in fact, disappear within a few days after vaccination, and that the spike protein stays in the body for longer than a few weeks following
vaccination, both of which are conclusions that have been reached in a number of scientific publications?
Why did the CDC get this wrong, keep the wrong information up for so long, and then in lieu of stating that a mistake was made, simply try to remove the information from the page without
telling anybody (note that the Updated date is July 15, 2022, even though this information was updated more than a week later)?
4. This article states:
The issue is that it’s essentially impossible to retain a high level of neutralizing antibodies without regular, repeated exposures—and it gets even harder
I have been wondering whether it might be helpful for a healthy person over 65 (I'm in my mid-seventies) to have repeated low-level exposure to Covid-19. Might this occur when I go
out in public outdoors not wearing a mask? Might low-level exposure be helpful as compared to isolation?
Why older people are at higher risk for severe COVID-19 <https://substack.com/redirect/2/eyJlIjoiaHR0cHM6Ly95b3VybG9jYWxlcGlkZW1pb2xvZ2lzdC5zdWJzdGFjay5jb20vcC93aHktb2xkZXItcGVvcGxlLWFyZS1hdC1oaWdoZX
Itcmlzaz90b2tlbj1leUoxYzJWeVgybGtJam8yTURRMk9USTBMQ0p3YjNOMFgybGtJam8yT0RrM01ESTRNQ3dpYVdGMElqb3hOall3T1RFME5UUXhMQ0pwYzNNaU9pSndkV0l0TWpneE1qRTVJaXdpYzNWaUlqb2ljRzl6ZEMxeVpXRmpkR2x2YmlKOS5NS01xSS1YU
DdULUdxR1R6UlV3RWVmSXo1b0xSTDdMVzBYUjI5MlhyU1NzIiwicCI6Njg5NzAyODAsInMiOjI4MTIxOSwiZiI6dHJ1ZSwidSI6NjA0NjkyNCwiaWF0IjoxNjYwOTE0NTQxLCJpc3MiOiJwdWItMCIsInN1YiI6ImxpbmstcmVkaXJlY3QifQ.2YRT_366YkgPNvfOp
fm6XciNSZ7ZoLIdwqR0f0O7AII?>
Katelyn Jetelina <https://substack.com/redirect/a6d50178-36c8-4215-8103-1ba15711be5d?r=3llu4>
Aug 19
Age is the strongest predictor of COVID-19 severe disease and death. Even though those aged 65+ are the leaders in vaccination rates, they continue to lead hospitalizations in the U.S.
and across the globe.
But… why?
Hospital admissions by age group (CDC)
An onslaught of scientific information can tell us why this may be the case. I worked with Edward Nirenberg <https://substack.com/redirect/c62d9705-e347-4f6c-973c-b3ea498cc14e?r=3llu4>
to translate the science to show why boosters among this population, especially, should be of utmost priority.
First wall of defense: Degrading
We have a complex immune system, but for simplicity, we can reduce it to a few major walls of defense.
The first wall is neutralizing antibodies. These antibodies are powerful because they act fast—you inhale the virus and neutralizing antibodies stop the virus before there’s a chance
for it to get into your cells (and start replicating). This prevents infection from happening in the first place. The issue is that it’s essentially impossible to retain a high level
of neutralizing antibodies without regular, repeated exposures—and it gets even harder as you get older.
A recent preprint <https://substack.com/redirect/84d9d526-1d80-4a64-a91d-7dea5f75bcd9?r=3llu4> study found that the number of neutralizing antibodies you make in response to infection
differs by age: the older you are, the fewer neutralizing antibodies you have (see figure below). In fact, when faced with Omicron, 43% of people had no detectable neutralizing activity
and, among those, the mean age was 63.5 years.
Bates et al., preprint; Source here <https://substack.com/redirect/84d9d526-1d80-4a64-a91d-7dea5f75bcd9?r=3llu4>
Another important aspect of antibodies is not just the sheer number we have, but also the ability for the same antibody to recognize different variants of the same part of spike. Scientists
found that antibodies among people 65+ years old were less likely to recognize multiple variants’ spikes compared to antibodies among those less than 65 years old.
Second wall of defense: Solid
Another line of defense are memory B cells. When we come in contact with a virus after having been vaccinated or previously infected, B cells remember what they need to create and start
pumping out antibodies to help fight the virus. B cells can be quickly called in the event that more antibodies are needed.
An article <https://substack.com/redirect/30f090ca-9528-4b30-8664-aeb0833cf141?r=3llu4> published this week showed that B cell levels largely did not differ by age, which is great news.
This wall of defense is solid. The challenge, however, is that for B cells to live up to their potential, they need the help of another wall: T cells.
Third wall of defense: Degraded
The third wall of defense is T cells. T cells are a key factor <https://substack.com/redirect/8d13e042-a930-4c95-8859-40fae0e4058e?r=3llu4> in determining the outcome of infections
(severe or mild disease). There are two major groups of T cells.
* Killer T cells recognize and kill infected cells
* Helper T cells help B cells make antibodies and instruct B cells to make better antibodies
This means that while T cells can’t stop infections from happening altogether, they can rapidly control them once they start, potentially even to the point that people don’t have symptoms.
But there’s a challenge with T cells. Once we reach puberty, the thymus (the organ that gives rise to T cells) gradually degrades into a useless blob of fat and we stop making new T
cells. There’s an especially big decline <https://substack.com/redirect/f09ca59c-af75-476b-be75-70dbf59378d0?r=3llu4> once we hit about age 40. This is usually okay because we typically
accumulate all of the T cells we need throughout our lifespan. Unless a totally new microbe comes along that we have no exposure to (and fortunately, though SARS-CoV-2 is new, it’s
still a coronavirus, so there is T cell memory from old coronavirus infections to work with). But as we get older, just like the rest of the body, our T cells age too.
Unfortunately, we see T cell dysfunction in COVID-19. An article <https://substack.com/redirect/30f090ca-9528-4b30-8664-aeb0833cf141?r=3llu4> published this week showed that the diversity
of T cells for those aged 50+ years is much more limited than those under 50 at infection. Once symptoms resolved, there was restoration but people over 50 can’t really make full use
of this unless they are infected again.
Implications
Two of the three defense walls among people over 50 years old have more holes than those of younger people. Comorbidities also increase with age, which means the immune response in general
is a lot more taxed. This means the rate of breakthrough cases, and specifically severe breakthrough cases, is substantially higher for older people.
The good news is that the immune system is still working for a majority of people. We clearly see that the risk of severe disease even in the very elderly dramatically declines <https://substack.com/
redirect/94861a88-0e4b-478b-b798-223cc4cd76ed?r=3llu4> with even just the primary vaccine series.
(CDC)
However, it may take more doses to coax immune systems into doing the things we want. This may mean more frequent boosting in older age groups. We already see benefits with older people
vaccinated with one booster dose having 4 times the risk of dying compared to people with two booster doses. (Unvaccinated people had 42 times the risk of dying from COVID-19 compared
to those with 2 boosters.)
How much each incremental booster helps (or does not help) is something that we really don’t have a good grip on prospectively. For example, we didn’t really know a second booster was
needed among 50+ year olds. We kind of guessed and relied on data from Israel (and the recent articles suggests why 50 might be a key age). Retrospectively, we can see that this was
certainly the right policy call. But, the FDA needs to require pharmaceutical companies to test B cell and T cell functions—not just neutralizing antibodies—to assess the added benefit,
instead of retrospectively determining good or bad policy.
Bottom line
Only 39.8% <https://substack.com/redirect/4e41f6eb-ee10-4ce8-bf3a-bab5434b45da?r=3llu4> of 65+ year olds are up-to-date on COVID-19 vaccines. The best thing that this group can do is
to fill the holes in their immunity walls by staying up-to-date. This also highlights that we cannot rely on immune systems alone, especially people aged 50+. Everyone else also needs
to do their part <https://substack.com/redirect/8f318fd0-9660-4130-8df9-b4c2ac9ec5cf?r=3llu4> (still) to keep the more vulnerable safe.
Love, YLE and Edward Nirenberg
“Your Local Epidemiologist (YLE)” is written by Dr. Katelyn Jetelina, MPH PhD—an epidemiologist, biostatistician, wife, and mom of two little girls. During the day she works at a nonpartisan
health policy think tank, and at night she writes this newsletter. Her main goal is to “translate” the ever-evolving public health science so that people will be well equipped to make
evidence-based decisions. This newsletter is free thanks to the generous support of fellow YLE community members.
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