Dr. Joel's presentation on video here if you missed the meeting or want to share it with family or friends.
Click on this link: https://youtu.be/GklSnHuc7H8
Welcome our new Member, Anjana Bose below:
Dan Snyder provided our inspiration to get us started.
Tina introduced 3 guests today:
- Terri Trotter
- Jeffrey Blum
- Ken Toren
Karen Anderson and Jay Quinby were also guests.
We celebrated January birthdays today, and Don Mcleve played happy birthday for us on the piano.
Anjana Bose was welcomed as a new member by Jamie.
Winefest & Auction - Almost sold out!
We are up to 91 out of 125 tickets sold. Sign up while they are still available!
Virtual Student Speech Contest
Tina announced that there will be a speech contest on February 9th, and we need judges and timers for this virtual event. Please keep an eye out for an email from Tina about this in case you are interested in volunteering.
Los Gatos Lodge
Los Gatos Lodge will not open for meals, so we are looking for alternatives so if you have one to offer please let us know.
Micro Loans Project
Tom Boyce gave an update on the micro loans project. These loans are a few hundred dollars, and are designed to help lift people out of poverty. They are partnering with Kiva on this, and we specifically have a focus on Kenya where we have loaned $81,080 over the last 9 years.
Guest Speaker
Hal Rosen introduced Dr. Joel Ernst to talk with us about the Covid-19 vaccine. Dr. Ernst is a professor and an expert in the development of effective vaccines. He gave background on the accelerated vaccine development and explained that the acceleration occurred by having activities happen in parallel rather than in series – no safety steps were skipped but were rather done simultaneously. He also talked about the side effects of the vaccine (most common: local pain, fatigue, headache, muscle pain). These effects are less common in people 55 and older. There have been 3 allergic reactions to date. When looking at the incidence curves, it is clear that after 2 weeks both vaccines are very effective at reducing the incidence of covid for the group who got the vaccine compared to the control. The vaccines appear to be equally effective regardless of age, sex, or ethnicity. In conclusion, both vaccines are highly efficacious in Phase 3 trials.
Dr. Ernst also spoke about the new virus variants. These variants don’t appear to be associated with increased severity, but they are associated with increased transmission (up to 70%). It is wide spread, and growing in frequency and there is substantial reason to believe it will worsen the surges we are currently enduring. There is evidence that the people who were getting the vaccine are still protected against the new variants.
QA Session with Dr. Ernst: https://youtu.be/GklSnHuc7H8
For the vaccines that require 2 doses, can you use different manufacturers?
No one has done that experiment, and no one would probably recommend that. If there is a supply shortage for when someone is due to have their second dose, it wouldn’t be unreasonable to get a different dose since the 2 vaccines are so similar.
Can one choose among the vaccines?
It depends on where you are. In most places no, and the supply is finite and changing. I don’t know of any place who has given anybody the choice. Although (anecdotally) in some cases since people knew ahead of time which vaccine was being administered where, they could choose where to line up.
Why are we hearing that so many nurses and physicians are hesitant to get the vaccine?
That is an unfortunate situation. There is anti vaccine sentiment and hesitance as well. Medical professionals are aware that there are side effects to everything they do, and may be wary of the side effects of the vaccine, but the side effects of the vaccine are far less than the side effects of covid. If someone is hesitant about getting the vaccine and want to see how it goes for a while I can understand that, but people who are at risk, or on the front lines seeing patients really ought to think twice about deferring vaccination. They should probably get vaccinated as soon as possible.
Has any testing of youth been done, and when will children be able to be vaccinated?
Children weren’t in the vaccine trials because there was early evidence that they were less susceptible to the disease. Children 5-12 are now included in these trials, and we should get safety results relatively quickly given that the infections rates are so high.
Regarding transmission of disease by vaccinated people, are there other diseases where people who are vaccinated still transmit the disease?
There are vaccines that prevent disease, and those that prevent infection. The difference is that a vaccine that prevents only disease doesn’t prevent infection like with Measles. So in that case someone can be prevented from symptomatic infection/disease, but can still get infected and shed virus
Can you speak about the AstraZeneca/Oxford vaccine from the UK?
That is a different category of vaccine. That is an adenoviral vectored vaccine. An adenovirus is a family of viruses that cause common colds and upper respiratory infections this version is crippled so it can’t replicate or can’t multiply in the body. It’s modified to stitch in the spike protein from the sars cov2 virus. It’s also injected in 2 doses. The initial clinical trial was unfortunately complicated by an unfortunate does issue that gave a surprise result where the people who got the lower dose seemed to be better protected than those who got the higher dose. People are trying to make sense out of that, but it’s a little confusing to decide how effective is that vaccine really then. It had lower effectiveness than either of the 2 RNA based approaches, and the lower dose seemed to be more effective so they are redesigning their phase 3 approach to see where this fits into the larger picture.
What is relationship of #infected and probability of variants?
The virus makes random errors when it replicates its RNA. Covid-19 makes fewer random errors than other RNA viruses. It’s a random process, and so these mutants spread and some are successful and some are not. So the more people who are infected, the more viral particles there are, the more chances for errors, and more chances for those mutant viruses to see what works. So the higher fraction of people who are infected and transmitting the higher likelihood to create these strains. Hopefully masks, physical distancing, and vaccines will help reduce the chance of these infections and reduce the chance of mutation and variation.
What is your opinion on one shot to get more people vaccinated vs everyone getting 2 shots of the vaccine?
Great question and I’m gladded you framed it with ‘what is my opinion’. Because there really is no data. Clinical trials were designed and executed based on 2 doses. Those are the data that we have. So deviation from that routine from the trial, we don’t’ know what the impact will be. We know a little about people who got infected prior to getting their second dose. But we are having trouble getting vaccines into people (that we have in stock), so until we solve that problem it is really impractical to talk about administering the vaccines to twice as many people.
Can you speak more to the evidence that the vaccine is still effective against this new variant?
The way those studies were done was to take an example of the variant virus, and serum samples from people who had received the Pfizer vaccine, and then to study the ability of the antibody in that vaccine recipient serum to block infection of cells in culture, and compare with their ability to block the earlier (ancestral) version of the virus compared to the variant. And there was a slight decrease in the ability to block the variant, and probably was a difference that wasn’t biologically important. So far it looks like the vaccines protect against this new variant.
Can you speak to what appears to be a poor or helter skelter distribution of the vaccines in California?
Not without getting too political! Frankly it has been patchy everywhere. I think we are not any worse here in California than elsewhere across the US. It’s partly that we’re trying to do it quickly and didn’t have a lot of time for planning, it’s partly because our public health infrastructure has been weakened over the years by budget cuts. We know it’s possible, and we know we’re going to have to get creative and vaccinate people in non-traditional places. I’ll just recall that in 1947 there was an outbreak of small pox in new york city, and 6 million people were vaccinated in a month. So that’s what’s possible, and it was possible because there was a very effective director of public health who had politicians support and knew how to speak to the public and get people vaccinated. So it’s all possible we need to get more creative and start giving vaccines in football stadiums and basketball stadiums and not expect people to go to clinics or pharmacies.
Have you received the vaccine?
I have! Right here. Last Thursday!
I have heard some have had mental issues. Can you speak to this?
The mental issues I have heard of are associated with infection, and not vaccination. There is a certain amount of memory loss, confusion, inability to concentrate, and they have been associated with infection but I have not heard of any examples of that occurring with vaccination. It’s not terribly uncommon for severe illness and sever infectious diseases to have this impact on people.
Is Pfizer riskier since it has to be frozen?
There’s no evidence for that. They both do need to be frozen. It’s just that Moderna happens to be a little bit stabler outside of the freezer for longer.
When someone tests positive, they are told to stay home for 10 days. If they have no symptoms to begin with, is a 10 day quarantine really long enough? How do we know?
That’s a really excellent question. It’s been the source of substantial frustration for people, and was more frustrating when it was harder to get tested. There are really 2 reasons for that quarantine period, and one is the incubation time - The time from exposure to symptoms can be as long as 2 weeks, and second, about 50% of the transmissions have come from people who are asymptomatic. This is the main hazard of this virus. It is transmitted by people who don’t consider themselves sick. As frustrating and as difficult as the quarantine is, it’s designed to keep things from getting out of hand due to that. The 10 days are meant to accommodate for that.
How long will vaccine immunity last?
We don’t know yet, but it’s looking pretty promising. With such a new vaccine we don’t have years of follow up to know, but what has been done is to measure the stability of the antibodies, and right now we have measured 4 months where there’s very little drop off. So if you extrapolate those curves out it looks like we should have several years of immunity.
What about long term effects ( 3-5 ) years ?
We can’t really know about this, because these vaccines were just put into humans. There are however reasons to feel comfortable about this. The RNA particles don’t persist. They break down very quickly, and so it would be very surprising if there were long term effects of these vaccines.
With hospital ICU space so low, will opening schools, even with low risk, add to the community risk?
This is little bit outside of my expertise. It’s really an epidemiology mathematical modeling question. I think what we know is that school age children don’t transmit very efficiently to other school age children. The risks are teachers transmitting to teachers. That’s why teachers are among the next priority group to get vaccines in the nation. So that will be done in parallel with clinical trials in school age children
What is the limit of time for someone to get second dose and it to be equally effective?
There’s not much deviation from the +- 3 day time period allowed in the clinical trials. I think in the absence of data, and the basic immunicological principles it’s probably fair to say you can wait a month or two without too much damage. But sometimes if you do a booster late, you have to start again with both doses.
If one already had Covid 19 and they have antibodies, does this safeguard them from getting the virus?
So far the data say that having covid and recovered does prevent infection. However most people who get covid and recover don’t’ get tested for their antibodies, so the recommendation is that if your infection was greater than 90 days ago, the evidence suggests you should get vaccinated. There’s no real evidence for harm in doing this by the way.