Friday Update for 2021-01-22: Hesitancy
Herewith three items of pandemic news you may have missed recently: More on virus variants; Novavax’s Phase III study is leaking volunteers; and vaccine hesitancy in the Black population. Plus news briefs and a frippery.
Black vaccine hesitancy
For all the larger society’s anti-government opinions, anti-vax sentiment, and conspiracy thinking that lead to vaccine hesitancy (currently 27% say they won’t take a vaccine), US Black and indigenous populations have even more reasons historically to mistrust the medical establishment. When they haven’t been ignored they have sometimes been actively harmed (see: Tuskegee) or had their rights trampled (see: Henrietta Lacks). About half of Black adults say they will not get vaccinated, even though Covid-19 hits their communities hardest.
One group aiming to change minds in these populations is the National Medical Association, a professional society of Black doctors founded 126 years ago. The group has in essence formed its own FDA with the intent of vetting the safety and effectiveness of Covid-19 vaccines and treatments. The NMA has its work cut out in talking to BIPoC communities — as the Stat article linked above notes, “Too often, the very words used to describe these dynamics — ‘health literacy,’ say, or ‘adherence’ — carry hints of blame or disdain or both.”
The NMA has been holding meetings with churches, fraternities and sororities, universities, etc., taking the questions raised there — without judgement or blame — to Pfizer, Moderna, and the FDA, and bringing answers back to the communities.
I was heartened to see that in the Biden administration’s pandemic response strategy document, resources and attention are devoted to “equitable pandemic response and recovery.”
Novavax’s Phase III leaking volunteers
As we discussed earlier this month, the existence of effective (and authorized) vaccines is having an impact on the late-stage trials of other drug makers. Novavax has seen a measurable diminution of its volunteer ranks as people who signed up — especially people over 65 — drop out of its Phase III to line up for their shots of Pfizer or Moderna vaccine. (New York just opened up vaccinations to people over 65.)
The Washington Post first reported Novavax’s difficulties, but a follow-up by Fierce Pharma featured statements from Novavax downplaying any adverse impact on its study. Overall about 1% of those signed up have requested to be unblinded (i.e., to find out if they got a placebo shot), and among the over-65 population it’s more like 2%. The study “is overpowered, and we expect to have far more enrollees than needed to demonstrate efficacy,” the company said.
About those variants
Read these pieces in Stat News and The Atlantic for background on the mutations, variants, lineages, and strains of SARS-CoV-2 that are showing up now around the world, and around the news.
Mutation in this coronavirus is not a new thing. One geneticist whose opinion I read said she disliked the term “variant” for an instance of SARS-CoV-2 with a particular genetic makeup — to use that term paints a picture of some sort of uniform genetic background with which the genome of interest is contrasted. In point of fact, the background is wildly various. Every single viral particle produced in humans in this pandemic, millions of trillions of them, has a chance of coming out different from any other.
When a virus is widespread, more mutations happen. And as initially naive populations develop some immunity, mutations begin to be guided by selection pressures to evolve greater transmissibility and/or greater infectivity (as we are seeing with some of the variants in the news.)
Naming the variants is a source of confusion — “a bloody mess” as the linked article describes it. There is not one standard naming scheme, there are a number of them in use. The same viral entity may be referred to as B.1.1.7, 20I/501Y.V1, or VOC 202012/01. (Identifying the variants by geographical names — “the UK variant” — is deprecated, but press outlets still do it.) A committee organized under the auspices of the World Health Organization met earlier this month to try to come up with a single naming scheme, and adjourned without arriving at that goal.
- B.1.1.7 variant may be deadlier: The numbers are small and the uncertainty large, but this variant, according to experts in the UK, may be 30% to 40% more deadly (BBC coverage; NERVTAG advisory group report).
- Lilly monoclonal antibody is preventative: Eli Lilly announced by press release (no real data available yet) that their authorized mAb, bamlanivimab, succeeded in preventing Covid-19 among staff and residents of a nursing home. This monoclonal is the drug that was given to then-president Trump, as a therapeutic — expect Lilly to apply for authorization to use it as a prophylactic soon.
- A deep dive into mRNA technology, and a deeper: Derek Lowe writes about what happens after an mRNA vaccine is injected into muscle, and exactly where in the body it happens. At the end of the piece Lowe links a long article by Jonas Neubert that provides enough detail on the ingredient lists, suppliers, and manufacturing steps for mRNA vaccines that you could practically build one yourself. (Do not try this at home.)
Your frippery today: animals interrupting wildlife photographers (as at top left), a Twitter thread by @JoaquimCampa. I can’t tell how many of these shots are in animal parks or the like, where the wolves, bears, and cheetahs are at least somewhat friendly and accustomed to humans. But they are hilarious — the ones that aren’t alarming, that is.
Your Frippery is priceless, Keith: I love those animal photos!! The information you send out is amazing — keep it up. What a wonderful record! I seem to have lost my drive, maybe to return one of these days… Thanks for all you are compiling and sending out!