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In our last episode of 2020, we are joined by Antoinette Lee Toscano to discuss Whitewater TV and her ‘clapback’ of a previous episode of The Hammer Factor. From there we bring on Chris Hipgrave to get the scoop on whitewater boat designs past and future. Next Grace gets roasted for being nervous about the Coronavirus Vaccine and of course we shut down with rants and raves. Thank you for listening and enjoy.
Toscano Clapback on Whitewater TV: https://xotv.me/channels/359-whitewatertv/vod_videos/5891-bonus-episode-hammer-factor-plus-meme-boof-clapback
Email From Allen Roberts:
‘Hey Hammer Factor,
I’m an infectious disease epidemiologist and long time paddler. I heard some misconceptions about the Covid mRNA vaccines during your last episode. I want to help clear some of these up. This isn’t “hate mail” and I’m not calling anyone stupid or ignorant. Skepticism is healthy when it comes to any medical interventions that haven’t been rigorously tested. And our current administration’s attacks on health experts at the FDA, CDC, and NIH have only increased public mistrust. It’s completely understandable to be concerned.
However, the evidence thus far for both efficacy and safety is looking really good for the Pfizer and Moderna vaccines, which are the two mRNA vaccines that have results from rigorous testing. Here are a few common questions and misconceptions, many of which I heard on the podcast. I hope some of this information will be useful if you decide to keep talking about the Covid vaccine on the podcast or just in conversations with friends and family.
Also, the CDC has a nice summary about mRNA vaccines here:
Thanks for making the Hammer Factor happen – it’s great company when I’m driving to the river solo in these quarantine days.
Allen RobertsSeattle, WA
PS: I don’t work for any pharma company in case you think Pfizer executives are paying me to write into Hammer Factor (although that sounds like the start of a good conspiracy theory!). My only interest is to avert deaths and get through this pandemic as quickly as possible. Those of us who work in a hospital setting see how bad this disease can be, both for those who are sick and for the families who aren’t allowed to visit them as they die alone in the hospital. And even though most paddlers may be at low risk for severe illness from Covid, vaccination is the fastest way for us to get back to huge crowds at the Green Race and cramped van shuttles without worrying about spreading the infection.
Are the Pfizer and Moderna mRNA vaccines “self-replicating”?Is this “gene therapy in a needle”? Not at all. This vaccine is NOT modifying your genes, which would require changing your cells’ DNA. mRNA is the transcript that all of your cells use to make proteins. In this case, your cells are being provided a transcript to make a specific protein on the SARS-CoV-2 virus called the spike protein. This is the protein that your immune system mounts a response to. The mRNA in the Pfizer and Moderna vaccines is not “self-replicating”. Your cells take up the mRNA transcript, make the spike protein, and the mRNA gets degraded. The coronavirus itself is self-replicating – so if you are worried about self-replicating genetic material infecting your cells, you’re describing a virus, not a vaccine, and you should be worrying about getting Covid, not about getting vaccinated.
There are self-amplifying mRNA vaccines (called sa-mRNA) that are in development, which is maybe where you heard this. This type of vaccine also includes mRNA to produce the viral polymerase, which can replicate the mRNA transcript for the spike protein.There is good reason to try this, since you could give much lower initial doses of the mRNA, but even this isn’t “gene therapy”. But these vaccines will have to go through rigorous testing before they could be approved.
Have mRNA vaccines been tried before? Yes – mRNA vaccines have been developed for influenza, Zika, HIV, and others, and they have been tested in early stage clinical trials in humans. So far, none of these have been approved because they haven’t worked,but the technology has improved over decades of research. The notion that mRNA vaccines have never been tested in humans is not true.
Why have we been able to develop and test the vaccines so quickly? Some people are understandably nervous about how quickly the vaccines have been developed. There are a few reasons that we’ve been able to test vaccines so quickly. First, a pandemic is bad for population health but good for statistics. It’s far easier to compare risk of infection in placebo vs. vaccinated groups when lots of people in the placebo group are getting infected. In fact, the surge in cases this fall meant that we got readouts on vaccine efficacy from these trials far faster than initially expected. Second, the amount of funding and potential market size for Covid vaccines has sped everything up. In normal times, vaccine development is much slower because vaccines, while great for public health, just aren’t as lucrative for pharma companies (an ounce of prevention is worth a pound of cure, but selling a pound of cure makes more money!) Finally, for mRNA vaccines specifically, they are far easier to produce than other types of vaccines like inactivated viruses.
Do the Pfizer and Moderna mRNA vaccines work? Yes – in fact, they work really well. Placebo-controlled randomized trials are the most rigorous method for evaluating whether vaccines work. It’s incredibly affirming that two large (30,000 and 43,000 participants) and independent randomized trials of different mRNA vaccines both worked really well (about 95% reduced risk of symptomatic infection). Usually we don’t get to see the results of multiple independent trials at the same time, since trials are really expensive to conduct. The consistency between the two trials shows that the results aren’t a fluke. There are still some questions about how long the protection lasts, etc, that we’ll get answers to with longer follow-up, but these results are about as convincing as we can hope for.
Are the mRNA vaccines safe? Yes, based on what we’ve seen from the tens of thousands of people vaccinated so far. The primary safety concerns with mRNA vaccines are that the body’s immune system would overreact to the vaccine. The goal of any vaccine is to elicit an immune response, but if the immune response is too strong, then it can do more harm than good. One of the goals of early clinical testing is to find the dose that strikes the right balance. This overreaction occurs shortly after the injection is given (within hours to a few days), and this is the reason that some people can get a low grade fever after getting vaccinated. Since the side effects tend to occur quickly, we already have solid evidence from the trials that vaccine reactions for the mRNA vaccines are mild, similar to other vaccines that are in use today. For example, the Moderna vaccine had about 10% of participants feeling under the weather for a day or so. For me, that’s an easy tradeoff to make. I will take a chance of short-term flu-like symptoms over the risk of getting Covid any day. And as a young and healthy person, the scariest thing about Covid is that I could pass it along to others who may be at higher risk of dying.
As with any medical intervention, it is important to continue monitoring for rare events that may not have been detected initially with smaller sample sizes. But those events, if they occur, are rare – if they were common, we would have seen them earlier. Unlike live virus vaccines, there is no chance that the mRNA vaccine can cause an infection. Furthermore, since the mRNA vaccine is NOT gene therapy, it’s not like the vaccine is sticking around to cause some sort of unexpected harm way down the line.
Finally, while this is my reading of the evidence based on my epidemiology training, I encourage you to trust the decisions of the FDA. They have a rigorous process for approving vaccines that takes into account input from advisory panels of independent experts who aren’t paid by pharmaceutical companies or appointed by the president.’