​They say Get Your Vaccines, and do it right now. The media and public health authorities these days are encouraging us to go in for both our flu vaccine and our bivalent covid booster at the same time. Last night's news reported that you CAN get both vaccines at the same time with little increase in minor side effects, and no increase in major adverse effects. This is true. You CAN.

What they did not address is SHOULD you. Public health authorities want you to get both vaccines at once because they fear that if you only get one, you won't be back for the second one. Their motivation is about convenience (for them and for you), and enhancing (numbers) coverage in the population. But for the individual there are more concerns.

You are not a number. You probably want to know how well YOU will be protected by a vaccine. You will not see news or magazines reporting about the relative efficacy of vaccines with different dosing schemes. Odds are there hasn't been a double blind placebo control study asking exactly that question.

There are things we do know. For example, we know that getting sick with two diseases at the same time makes you less able to fight either one. Getting vaccinated with two vaccines at the same time does the same thing. It’s a two-front war. We know that the standard advice about getting a vaccine is to delay it until you are not sick. When your immune system has to fight two adversaries at once it does not fight as well. You will muster a stronger and longer immune response if you only get one vaccine at a time.

Public health authorities think that the public is not able to understand and act on information this complex. I think otherwise. I think you are smart enough to do it. Here's the plan. (This applies unless you have a contraindication, which you should discuss with your doctor.)  Get one of the two vaccines ASAP. On the day you get that vaccine, put a reminder on your calendar to get the other one in one month’s time. What that reminder comes up, go get the other one ASAP. That is how you do it. Prove them wrong.

(Image text below is a screenshot from the CDC.)

The WHO chief says AVOID "endgame" talk about Covid
https://apnews.com/article/coronavirus-pandemic-health-pandemics-united-nations-world-health-organization-d500f7942d0c920912261b30ab8bfd66

New Phase Initiated by Omicron
nytimes.com/live/2022/01/24/world/omicron-covid-vaccine-tests


Recently I became acquainted with a virologist here in PDX who, working at OHSU, helped develop an antibody test for covid. The test he developed has not gained wide usage. 

The virus makes 20+ proteins for which our bodies make antibodies, but the vaccines contain only the spike protein. What this means is that we can tell if people have had the virus, or if they have just had the vaccine. IMO this would be useful information at the population level.

It is still possible for us to know how many people have had the virus. Many people have probably had it but didn't know because they were asymptomatic. Many others have probably had it but don't know because testing wasn't available--especially early in the pandemic. Of course there are pockets of population who still haven't been exposed--but Omicron is reaching many of them. We will not have a good sense of the immunity level of humans on earth until we know the proportion who've had the disease.

Tracking the proportion who've had the vaccine is easier. I have a vaccination card that shows that I've had 3 jabs so far. For me it was mandatory because I work in healthcare. It was also a no-brainer because I'm old and fat enough that covid posed a significant risk, whereas the vaccine poses a miniscule risk.  Sure, it's uncomfortable and unpleasant to deal with the symptoms after vaccination.  I have some tricks for minimizing that.  But basically I agree with the vaccine pushers that getting the vast majority of us stuck makes good sense.

Infection does confer a higher level of immunity than the vaccine. This is because the virus makes those 20+ proteins and our immune systems recognize all of them. The vaccine only contains one protein, the spike. When you've had the virus, your body knows 19 more ways to recognize the virus than if you've just had the vaccine.

Our bodies have T-cells that remember viral proteins that they have met, and go on attack whenever the virus is in us. T-cell immunity is different from antibodies. T-cells last 10-20 years after an infection. B-cells make antibodies and some of them stick around a long time too. "Memory" B-cells live for years and make antibodies for an infection for about 6 months, then they go on break. They are still there to make more antibodies if needed.

Years after vaccination you still have memory B-cells that can resume antibody production, and T-cells that can go on the attack. Unless. Unless you are immune compromised somehow. Unless you get measles, which actually KILLS memory B-cells. This is why I recommend that most people get the MMR vaccine too. It protects you from the damages done by measles, which are more than most people realize.

The nugget here is that the immune system is complicated and managing a pandemic is even more complicated. The public messaging is simplistic. Public health officials are trying to get everyone to take the jab. This is for the benefit of the population; we do it for each other. What I wish that public health as an institution would do for us is invest in antibody testing AND some ways of evaluating immune function so that we can move forward and leave this pandemic era behind.

The world will never be the same again. Those of us who've lived through this pandemic are changed. So many people are dead. Some near to me. Some far away. Wearing a mask is hard. Being isolated from people is hard. But in spite of this we are resilient and we who have survived so far have a good chance of continuing to survive. Let us unite in caring for each other, in being decent to each other.

Let us plan ahead for the possibility of another pandemic in our lifetimes. The increasing density of humans on the planet increases the odds of pandemics. The crowding of our food animals also increases the odds. Rather than pretending that the conditions for pandemic-making are the same as they were in the past, we need to collectively recognize the reality of our situation and do our best to be prepared. It is never over.

In this polarized time, people are falling into groups as if it were their only safety.  In politics if you aren't a Republican, you're a Democrat.  In medicine you're either pro-vaccine, or an anti-vaxxer.  In religion you're either devout, or an atheist.  I'm here to tell you that none of those are true.

I'm an Independent, politically.  I'm a vaccine moderate, meaning I think some vaccines are good and some not so good, and some people should get vaccines that other people should not.  I'm "spiritual but not religious" meaning that I don't go to any church but I have my own practice which brings me into contact with the sacred and sublime, and I believe that some such practice is essential for becoming a moral human.  In other words, I live in the grey.

If you are like me and don't fit into the pre-made groups, welcome.  Fellow seekers, people who do not accept anyone else's narrative and prefer to learn and discover and make our own story, we are this nation's hope for the future, this world's hope for the future.  Collective intelligence relies on both diversity and disagreement; we have to be able to talk about tough issues without shutting each other down.  Without disrespecting each other.

When you already know all the answers, in spite of not having done the study for yourself, you are taking a shortcut to a dead end.  People who are sure that one political party or the other is 100% on the right track are mistaken.  People who think that every single human should be given the Covid-19 vaccine are just as mistaken as those who think it's a government effort to inject micro-chips and track us all.  People who think that every single soul who does not agree with their religion is going to hell, they're already in a philosophical dead end.  It can be hard to turn around in a dead end.

It is important to understand the best arguments of your adversaries.  It is valuable to develop real arguments for your positions rather than simply saying that the other side is wrong, or so-and-so told you so.  Humans being social creatures are susceptible to accepting whatever version of reality is used by those around us--but we are also intelligent enough to question it.

It's time to develop our moderateness, our humility and kindness.  Nobody can know everything.  Admitting that we don't know is an opportunity to learn.  Admitting that we've been listening to an authority figure who doesn't actually know gives us an opportunity to investigate new sources, to check out different experts, and to develop a more nuanced and complete view of our world.  The truth pretty much always lies somewhere in the grey.

KIDS CAN TRANSMIT COVID AFTER ALL---AND PRETTY WELL
https://www.princeton.edu/news/2020/09/30/largest-covid-19-contact-tracing-study-date-finds-children-key-spread-evidence
Remember how they were saying that children don't transmit the virus, so it's OK to send your kids to school?  Well that appears to have been wrong.  Best protect your kids from exposures so that they don't bring it home to you.

VACCINE TRACKER
https://www.raps.org/news-and-articles/news-articles/2020/3/covid-19-vaccine-tracker
Been dorking out about all the vaccines under development?  Yeah lots of people are.  Not me, so much, I'm just working and waiting.  My take on vaccination: we're going to want it, but we also don't want it to hurt us, so it's worth waiting.  If you end up getting a vaccine that works really well, great.  If you get a vaccine that kinda halfway works, get another one the next time you have a chance.  Do what you can to improve your immune response to the vaccine.  A future email newsletter will be about this subject.

MOST CONTAGIOUS STRAINS COME TO DOMINATE
https://todayspractitioner.com/covid-19/coronavirus-genetic-mutation-may-mean-it-is-more-contagious/#.X701_6pKjNZ
Lots of mutations have appeared in COVID-19 the ​ones that make it more contagious are a big advantage for the virus, meaning that more and more of the cases are the most highly contagious strains.  Which means that mask wearing is even more important, and during our current spike staying completely away from others may be of ultimate importance.  The study was done in Houston, TX: https://mbio.asm.org/content/11/6/e02707-20.

THE CURRENT SURGE IS WORSE THAN ANYTHING BEFORE
https://www.npr.org/sections/health-shots/2020/11/13/934566781/the-pandemic-this-week-8-things-to-know-about-the-surge
This article is 11 days old already but it documents how fast the case rate accelerated in the first half of November.  An increased case rate is inevitably followed by increased hospitalizations and deaths.  During this time when so many people have the virus, there is nothing you can do except stay away from people.  Even your dearest friends and relatives can give you the virus, or you can give it to them.  So take some time to hibernate, meditate, read books, and otherwise entertain yourself at home.  Don't even go shopping if you don't have to.  This situation could last all winter if lots of people ignore this advice, but you don't have to be the one dying or killing your dearest people.  Being a homebody is not the end of the world.  It's easier to be free when you are alive.

NEW REVIEW OF MANY STUDIES ABOUT COVID ANTIBODIES
​https://www.nature.com/articles/s41467-020-18450-4

Released 2 days ago, this synthesis review shows that immunity to SARS-COV2 behaves in a normal way.  When a person has been quite sick and survived, they will likely have high antibody levels for that particular sickness--for a little while.  These are the people from whom you might wish to get convalescent plasma, because it's probably full of antibodies that could help.  But these antibodies ramp down pretty quickly once you clear the sickness.  A person who had the virus months ago will not have as many antibodies in their plasma as a person who just cleared it last week.  This is why there aren't studies to prove that convalescent plasma is a good treatment: it depends on the person's immune response and on the timing. 

IgM is the first kind of antibody your body makes, and appears about a week into an illness.  After that your body switches over to making IgG antibodies.  The fact that IgM antibodies decrease after the illness is NORMAL.  The IgG antibodies that are made next are the keepers.  They keep being made, but at lower and lower levels if you aren't still fighting the same virus.  This is also NORMAL.  Your body does the same thing for ever flu it ever encounters.  The fact that your body KEEPS making antibodies has to do with its MEMORY.  The immune system has cells called Memory B Cells--the ones that know how to make antibodies for a specific condition--they are your body's memory.  As long as your memory B cells survive, your body has a blueprint of how to make more B cells that can more antibodies to fight that remembered infection--in other words, it can respond faster.  

Memory B cells can live a long time but eventually they die.  The rate at which they die varies by age and lifestyle and also by what other infections you get.  One really good reason to get vaccinated against Measles is that getting measles infection can kill your memory B cells, making you MORE susceptible to things that you've had before.  And that stinks.  I hope that you are vaccinated for measles (the MMR is available if you aren't) and that you also get vaccinated for the flu this year, because it's good to protect your lungs. 

As for the COVID vaccine, we're likely to have a lot of options with varying efficacy that are available to most of us next year.  I don't know for sure what will come out, but I will say that for myself I will try to get one vaccine/year, hopefully different kinds each year, to help my body build up resistance by exposure to lots of different parts of the virus.  For those who are worried about adverse effects from vaccines, let me just say that they really are rare, a lot more rare than the diseases. Also you can also minimize your risk of adverse effects to vaccines by improving your ability to detoxify your body.  I can help with that for sure.  Spring and fall are good times for a deeper detox!

CDC GUIDANCE ABOUT COVID-19 FLIES IN THE FACE OF SCIENCE
https://www.nytimes.com/2020/09/17/health/coronavirus-testing-cdc.html
Several of our most important government agencies have fallen prey to anti-science populist politics and can no longer be trusted to sort through the information and tell us what to believe or trust.  We need good-faith gatekeepers of information in this age of excessive and some false "speech" clouding every question.  In this case the scientists (especially the ones that study infectious disease) are telling us that to contain this pandemic we need to test EVERYBODY and make sure that all the asymptomatic carriers are quarantined.  The CDC just issued a report saying that we shouldn't be tested unless we have symptoms.  This is what we have been doing, and it has resulted in nearly 200,000 dead in this country alone.  If we continue with this method, and with the likely efficacy of vaccines being in the neighborhood of 50%, and with the likely avoidance of the vaccine by somewhere around 50% of the population, we can expect A MILLION DEAD in this country alone.  So the CDC, in line with the authoritarian administration that has perverted it, is setting us up for an ongoing pandemic disaster.  Best get some great time outdoors with friends this fall while the weather is still good, because when wintertime comes smart people will keep their indoor social circles tiny.  TINY.

WE NEED TO KNOW WHAT HAPPENED WITH THE ADVERSE EFFECT
https://blogs.sciencemag.org/pipeline/archives/2020/09/14/vaccine-transparency
It is not OK for vaccine manufacturers to hide the specifics of adverse effects, any more than it is OK for governments to hide the specifics of nuclear incidents.  If the people is to trust the makers of vaccines or the governments of countries, we need to hear prompt, factual information from them.

Don't Be A Superspreader!  They start more cases than the rest of us.
https://arstechnica.com/science/2020/06/just-10-20-of-covid-19-cases-behind-80-of-transmission-studies-suggest/

Tear Gas: The Whole Story
https://www.propublica.org/article/tear-gas-is-way-more-dangerous-than-police-let-on-especially-during-the-coronavirus-pandemic

The Party Might be Virtual but Our Pride is Not
https://theweek.com/articles/917795/pride-celebrations-virtual-during-coronavirus-pandemic
​
You Probably Want a Flu Shot This Year
https://thehill.com/policy/healthcare/502166-the-next-covid-19-challenge-convincing-people-to-get-their-flu-shots

A 17 year old Tracks Disease and Protest better than the Government
https://www.technologyreview.com/2020/06/12/1002838/avi-schiffmann-17-year-old-guide-building-pandemic-protest-tracker/
​
​Diabetes is a Risk Factor for COVID, and COVID is a risk factor for Diabetes
https://www.nejm.org/doi/full/10.1056/NEJMc2018688

Cases in India Take Off
https://ourworldindata.org/grapher/daily-cases-covid-19?country=~IND

Cases Increase as States Open: Wear a Mask
https://apnews.com/feb4c26d9364497cf82ee7c0c1b1b3d5

T-Cells are Part of the Immunity You Need
​https://www.cell.com/action/showPdf?pii=S0092-8674%2820%2930610-3

Updated 4/24

1/5 of New Yorkers have had the Dread Virus
https://www.nytimes.com/2020/04/23/nyregion/coronavirus-antibodies-test-ny.html

Vitamin C Reduces ICU and Ventilator Duration, Might Help Before That
​https://todayspractitioner.com/respiratory-health/is-vitamin-c-the-unsung-covid-19-hero/#.XqMVz9NKgiN

Parisian Poop Patterns Parallel COVID-19 Cases
https://www.medrxiv.org/content/10.1101/2020.04.12.20062679v1

Arguments about ReOpening Especially Interesting Given the Politics
https://www.foxnews.com/us/americans-support-extending-coronavirus-stay-at-home-orders

Virus is Expanding in Navajo Nation
https://www.knau.org/post/northern-arizona-coronavirus-cases-grow-navajo-nation-infections-continue-surge

Hemostatic Derangement?  Washing Post Reports Clots Killing Pts
https://www.washingtonpost.com/health/2020/04/22/coronavirus-blood-clots/

Antibody Testing (Serology) Strategy
https://www.centerforhealthsecurity.org/our-work/pubs_archive/pubs-pdfs/2020/200422-national-strategy-serology.pdf

Accuracy of Current Serology Testing Variable
https://www.fiercebiotech.com/medtech/covid-19-antibody-testing-a-disaster-says-roche-ceo-as-its-diagnostics-sales-rise

Vaccination Rates in Freefall
​https://www.nytimes.com/2020/04/23/health/coronavirus-measles-vaccines.html?referringSource=articleShare

Covid Patients Should NOT Discontinue ACE Inhibitors or ARB's 
https://www.ahajournals.org/doi/abs/10.1161/CIRCRESAHA.120.317134

​

Are you an immunologist? Yeah, probably not. There aren't a lot of immunologists in the world. I'm not one, though I've studied immunology under one of the best (Dr. Heather Zwickey) and I try to keep up. It's a fast moving field. Every time I hear Dr Zwickey speak she tells us about some new receptor or cytokine that they've discovered, and a bunch of new correlations between the things we already have a little info about. 

If you don't speak the language of immunology, a lot of the talk these days won't make a lot of sense. How does the body fight off a virus? How is a vaccine made? These questions have long, complicated answers. In this post I want to teach you the basic outline of the answers, even if we don't go into all the terminology and details.

One word you're going to hear a lot about is ANTIBODIES. Antibodies are, for the most part, a good thing. Antibodies are what you have if you have gotten sick and managed to fight off the infection.

But how do you get them?