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COVID Vaccine in Older Adults

COVID Vaccine in Older Adults

Development of safe and effective vaccines for Covid-19 have been a global priority for thousands of scientists.  Most of the participants in the varied trials are young and middle-aged adults.  This has led to a concern that the good results in younger adults might not apply to older adults.  Older age is a major risk factor for individuals having more severe disease and fatal outcome.  It is also known that in general older adults do not have as robust an immune response to vaccination as do younger adults. 

Emory University just completed a study of the m-RNA-1273 vaccine in older adults with their results being published in the New England Journal of Medicine.  They looked at two age groups:  56-70 years, and greater than 71 years.  Both groups received the recommended initial dose followed by the booster dose 28 days later.

The laboratory markers that were analyzed were assessment of T-cell response, and assessment of neutralizing antibody production.  Both T-cells and antibodies are critical in providing protection against Covid-19.  As it turns out, both age groups had excellent responses in their T-cells and antibodies. 

The other parameter that was studied was adverse events, including: arthralgia, fatigue, fever, chills, headache, muscle ache, nausea, local reaction at injection site, and pain at injection site.  First of all, there were no serious adverse events.  Secondly, the side effects were similar in both groups with two exceptions: the 71 and older group were more likely to experience fatigue and fever than the 56-70 age group. 

These results should be a source of reassurance and comfort to all those baby-boomers out there.

Dear Dr. K; Are you personally going to take the coronavirus vaccine?

Dear Dr. K; Are you personally going to take the coronavirus vaccine?

Yes. And let me tell you why.  In 1720 the average life expectancy in this country was 25.  A hundred years later in 1820 it was 41.  Then in 1920 it hit 54.  Currently it is in the mid-70’s.  Despite all the marvels of modern medicine from antibiotics, to trans-vascular heart surgery, to organ transplantation, the major reasons for this improvement in life expectancy boil down to the big three S’s:  sanitation, shoes, and shots.

It is hard to believe but the “why didn’t I think of that” realization that the sources of drinking water should be kept separate from human and animal waste is very recent.  It came with the scientific discovery of microbes (viruses and bacteria) and how they are transmitted.

Then the universal use of footwear came into play.  Prior to that innovation a majority of humans went bare-footed for at least part of the year depending on climate.  As a result, most humans picked up worm infestations through their bare feet that found their way to the intestinal tract: hookworms primarily, but also other species.  Once the worms set up housekeeping in the GI tract, they were there to stay (until the person died).  Their presence affected health in two ways: reducing available calories and vitamins from food intake, and by causing chronic anemia. 

The final “S” is shots, as in vaccines.  In 1798 Edward Jenner developed smallpox vaccination.  About 90 years later Louis Pasteur, often called the father of immunotherapy, developed anthrax and rabies vaccines.  It wasn’t until 1924 that Emil Von Behring developed the tetanus vaccine.  The polio pandemic was stopped in 1955 when Jonas Salk developed the polio vaccine.  Prior to vaccines, those five diseases killed countless millions of children and adults. 

It all comes down to the old adage of “an ounce of prevention is worth a pound of cure”.  Sanitation, shoes, and shots all work by preventing illness.  So, yes, I will get the coronavirus vaccine. 

Covid-19 and Allergy

Covid-19 and Allergy

Harvard researchers recently published their findings regarding allergic disorders and susceptibility to Covid-19.  The study was conducted on 220,000 people between January and May of this year. 

Previous to this study it has been known that people at greater risk for and from this virus include those: over 65, with pre-existing lung disease, with chronic kidney disease, with diabetes, with hypertension, with heart disease, obesity, with cancer, smokers, with immune compromising illnesses, with organ transplants and with HIV.  Now it appears that underlying allergy also confers greater risk. 

It has been known for many years that underlying allergic respiratory problems predispose to other types of respiratory infections from colds, to ear and sinus infections to bronchitis and pneumonia.  It has also been known for years that treating the underlying allergy reduces this risk.  Now, it seems that allergy predisposes to both catching Covid-19 and having a more serious outcome.  People with either allergic rhinitis or asthma have this increased risk.  The scientists feel the increased risk from allergy is probably multifactorial, but one aspect recently discovered is an increase in one of the cellular attachment proteins: TMPRSS2.

In order to enter the human body Covid-19 has to use certain available “doors” called cell receptors.  The more “doors” available, the more readily the virus can enter.  Allergic inflammation increases the number of TMPRSS2 doors.

The researchers went on to speculate that having good control of the allergic condition (and thereby reducing the inflammation) should help reduce this increased risk. 

Q – Tips: COVID-19

Q – Tips: COVID-19

The two main tests being used during this pandemic are nasal swabs to detect active infection, and antibody tests to detect prior infection.    

The nasal swab uses a polymerase chain reaction (PCR) which is a chemical tool that amplifies tiny amounts of nucleic acid to allow detection of viral RNA.

Antibody tests fall into two main categories:  detection and protective value. The two main detection assays are for either spike glycoprotein (allows the virus to enter human cells) or nucleocapsid phosphoprotein (the most abundant protein).  Both can confirm a prior corona virus infection.  

Neutralizing antibody assay is used to determine if the presence of antibodies can “kill” (neutralize) the corona virus in a test tube.  This type of testing will be used to determine how effective corona virus vaccines will be.