Victoria writes:

Hello TWIVers!

Non-scientist question here, and I hope this is an easy one…but my quick Googling doesn’t give me a clear answer:

Can we expect that the at-home rapid tests (BinaxNow and the like) will still work (with similar levels of sensitivity) for infections with the omicron variant? 

Thank you!

Victoria

Tyler writes:

Hey TWiV!

First, I want to thank you for taking my last question. I did not think about final rights and whatnot. It makes sense that there would be no difference in whether they are asked to be part of a study.

I have two questions. First, I wonder about the type of antibody vaccines encourage the body to begin making. If I remember correctly, as the infection progresses, helper T cells encourage B cells to switch antibody types to match the type of infection. Does giving the injection intramuscularly change the type of antibody produced by B cells?

Second (though more of a statement), I think another correlate of protection to disease could be the affinity of antibodies to their respective epitope. During somatic hypermutation, the binding affinity SHOULD increase.  This isn’t a very realistic test for each person, but how informative could the binding affinity data be? Maybe this could be a test vaccine makers would need to pass to get authorization.

Thanks as always,

Tyler

Jerry writes:

Vincent et. al.,

Thanks again to the entire team for making the exploration of virology and science in general so engaging.

For Anthony

Newton’s laws of motion are great models but they are not complete. Einstein updated them to take into account the Lorentz contraction approaching the speed of light. Einstein said that nothing travels faster than the speed of light, but entangled partner particles change instantaneously when one is perturbed independent of the distance in between. And it goes on and on, which is the greatest thing about science. No need to ever feel like there is nothing left to explore and learn.

For Tyler

It is very standard in modern medicine to start discussing the possible death of a family member with those close as that time seems like it is coming close. It’s not asking the family to think about the person as dead but to soften the blow when it happens. Things like wishes and options for organ donation are on the list. I assumed that is what was involved with the prior approval. My brain may be pedestrian but it should make it into Harvard after I am no longer using it. [shameless plug for the Harvard Brain Tissue Resource Center]

jerry

Jeff writes:

I think that Dickson is confusing Gilda Radner with Lily Tomlin. The “big chair” was Lily Tomlin. (And, IMHO, LT was a far better comedian than GR, although, De Mortuis, they’re (were) both great!)

Holly writes:

Good Evening,

First of all, thank you for your amazing Podcast.  I find this the most reliable source for all things Covid but as a healthcare practitioner, I also really enjoy the older episodes pre-Covid era.  My question is two fold:

I had the Moderna vaccines in January and February 2021.  I had the lymph node response with enlarged, painful axillary and clavicular nodes that lasted a few days.  Fast forward to August and September when I was bitten/stung (never saw the offending insect) while outdoors.  Both resulted in significant reactions with severe swelling, itching, redness, lymph enlargement, and an overall cellulitic appearance.  Both required steroids to treat and I was given an epi pen just in case.  This has never happened to me before and I’ve talked to two other people who have had similar reactions to bites since vaccination. Perhaps it’s coincidence, perhaps it was a murder hornet (ha! ).  In the research you have reviewed and personal clinical experience, is this a potential vaccine reaction?  Yes, I reported to VAERS. 

Second, given the above, do you think myself or others like me should have any reservation to getting a booster?  I would like one as I do see Covid patients as part of my job and I’m a believer of the science, but feeling anxious given what I went through.  I haven’t gotten much feedback/advice from colleagues as they were unsure and my personal physician unfortunately was not pro-vaccine and well, now I’m in between docs.  

Thanks for your time and consideration! Keep producing great content! 

-Holly

John writes:

Low single digits C in Greater Braddock and so too cold to lay bricks, but in a couple days it should be [warm enough?].

Your A History of Poliomyelitis sounds like moral predecessor of A Shot to Save the World, which I just finished and for which I thank you for tipping me to.  When you said that JR Paul’s book was rare, I immediately went to my favorite used-bookseller aggregator, Alibris, where I found that none were listed.  It surely is rare!  I wonder if it was privately printed in a very limited number of copies?

Otherwise, after watching 835 and since I’m mostly indoors today, I went to an evolution + general stuff blog that I follow, where I learned that it was Busby Berkeley’s birthday.  I knew who Busby was, but I didn’t recall ever seeing a pic of him and so went to his Wikipedia page, where I soon found myself in a minor rabbit hole that delivered me to the Department of Elliptical Intersections (and my pick).  It seems that BB came out of retirement in 1969 to make this commercial for a popular over-the-counter cold remedy, that I had never seen:

https://www.oddballfilms.com/clip/13160_13270_contac

All roads lead to coronaviruses!

And so while we’re here, also a question I’ve had:  Do all of the common cold coronaviruses also use ACE-2 as their docking protein?  (I hate to call it a receptor since that makes it sound like that’s its function.)

Best regards,

John

Daniel writes:

Hi,

Ive been an on and off listener all of 2021 – sorry I couldn’t keep up because, well, my wife and I have a 11.75 month old baby/infant.

Both my wife and I are Moderna vaccinated since Apr/may of 2021, recently boostered as well.

A recent study (https://jamanetwork.com/journals/jamapediatrics/fullarticle/2786219) indicates strongly that IgG (vaccinated breastfeeding mothers) is present in breast milk, demonstrated to neutralize SARS-COV-2, along with a mild-to-moderate decline in IgG over 3 months. 

My question comes in parts and is related to “immunization” through breast milk. 

1) In general is there an equilibrium in the production-transfer of antibodies from mother to baby? Meaning does it ramp, plateau, then decline OR is it constant then decline?

2) Any data showing if the freeze/thaw/heat cycle of breast milk impacting the IgG concentration (or in general to antibodies, what is expected)? Very key question given we have plenty of frozen breast milk that correlates with the 3 month window of IgG measured in the study. In a perfect world this reserve would continue to provide IgG to the baby.

3) Is the transfer of IgG expected to have an impact for an 11 month old and beyond immune system? Does it take and learn to produce the spike protein?

4) Is it safe to say this is a play to immunize baby as best as possible given there are no COVID-19 vaccines for <5yrs old?

Thanks and keep up the amazing TWIV. 

Josh writes:

Dear TWiV,

It’s 2°C here and sunny in metro Atlanta. I’m just a graduate student in the MS Integrative Biology program at Kennesaw State University, but I have a question about future potential targets for the mRNA vaccines. 

In the beginning, Vincent et al expressed concern that just the spike protein transcript may not be enough for an effective vaccine. Obviously however, time proved that the mRNA jabs are fantastic vaccines with excellent effectiveness.  

Flash forward 20 months and three-fourths of the way through the greek alphabet to omicron with thirty-something different amino acid changes on spike. We are a far way off from having the mRNA vaccines lose effectiveness, but it has me wondering if Vincent was right. What if just one, albeit large, target is not enough? Of course Moderna and Pfizer can simply change the transcript sequence to whatever current or future variant may arise, but this sounds like Whack-a-mole. My question is, what are y’all’s thoughts on adding another transcript in with spike, such as the N-protein or another? 

I’m not sure if this is a great idea because I study predatory bacteria (Shout out to Myxococcus xanthus!) and not viruses or human immune systems (eww, eukaryotes!) However it seems to me that it would apply two selective pressures upon SARS-2 instead of just one, and allow us to slow down immune escape. Thoughts? 

Thank you for everything you do, y’all are awesome!

Josh

Ryan writes:

I have pick of the week for TWIV the Omicron rants by Rep Ronny Jackson

https://news.yahoo.com/rep-ronny-jackson-says-covid-204500936.html

https://web.archive.org/web/20211130052927/https://www.cnn.com/2021/11/29/politics/omicron-ronny-jackson/index.html 

There is a new conspiracy theory about the Omicron Variant? Apparently there are politicians not taking this variant seriously and making this about governors and congressional elections in 2022. Note this politician was a doctor at one point. Rep Ronny Jackson. He is doing this as a ploy to scare voters away from supporting vaccine mandates.