Over a month and a half before the World Health Organization officially declared a pandemic, BioNTech CEO Uğur Şahin met with his wife, BioNTech’s co-founder and chief medical officer Özlem Türeci, and together they agreed to redirect most of the company’s resources to developing a vaccine. Up until that point, BioNTech was little-known internationally and primarily focused on developing novel cancer treatments. The founders were confident in the potential of their mRNA technology, which they knew could trigger a powerful immune response. That confidence wasn’t necessarily shared by the broader medical community. No mRNA vaccine or treatment had ever been approved before. But the couple’s timely breakthrough was actually decades in the making. CNBC spoke with Şahin and Türeci about how they, along with Pfizer, created a Covid-19 vaccine using mRNA.
This commentary concerns a video showing aspects of the development of MRNA vaccines. It is all about Pfizer’s German partner, BioNtech, which manufactures the vaccine. They have produced the bulk of the worlds mRNA vaccines, due to Pfizer‘s great financial strength and experience in marketing.
Moderna, a wholly American company and by comparison a small fry, has also been doing decades of work with mRNA platform technology, mainly on cancer treatment.
With $800 million from the U.S. government, Moderna was able to scale up their manufacturing process and deliver a vaccine, approved by the FDA, shortly after Pfizer did so.
These vaccines were made possible by two technical advances.
The first advance was in substituting pseudouridine for uridine in the mRNA, so that the target cells natural defenses would not destroy it. The second involves coating the mRNA with a nano size particle to get it into the target cell.
Each of these advances will probably receive a Nobel prize, and is an elegant example of the sophistication of modern biotechnology.
Molnupiravir (MK-4482, EIDD-2801) is an investigational oral antiviral medicine that significantly reduced the risk of hospitalization or death at a planned interim analysis of the Phase 3 MOVe-OUT trial in at risk, non-hospitalized adult patients with mild-to-moderate COVID-19. At the interim analysis, molnupiravir reduced the risk of hospitalization or death by approximately 50%; 7.3% of patients who received molnupiravir were either hospitalized or died through Day 29 following randomization (28/385), compared with 14.1% of placebo-treated patients (53/377); p=0.0012. Through Day 29, no deaths were reported in patients who received molnupiravir, as compared to 8 deaths in patients who received placebo.
Doctors are increasingly turning to monoclonal-antibody drugs to treat high-risk patients who get sick with Covid-19. WSJ takes a look at how the therapies work and why they’re important for saving lives. Illustration: Jacob Reynolds/WSJ
As mRNA-based COVID-19 vaccines are deployed to protect hundreds of millions of people across the world from the deadly global pandemic, the University of Pennsylvania scientists whose research breakthroughs laid the foundation for swift vaccine development have been awarded the 2021 Lasker-DeBakey Clinical Medical Research Award. Here, mRNA vaccine pioneers Drew Weissman, MD, PhD, and Katalin Karikó, PhD, share the story behind their development of this groundbreaking technology, and what it means for the future of medicine.
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In a very good article, the Journal ‘Science’ has collated a lot of basic science regarding aerosol transmissions in viral infection generally, and Covid-19 in particular.
Early in the epidemic, I thought that large droplet transmission, which fell to the floor, and was transmitted by fomites and hand autoinoculation into the respiratory membranes, was more important. The main thesis of the article is that it is not large droplets, but aerosol particles that mainly transmit.
The secondary assertion is that aerosols can be up to 100 µm microns in diameter and still be transmitted by inhalation. they also stated that particle size of equal or less than 5 µm contain more virus particles than all the larger particles put together in spite of the greater mass of the larger particles . Normal speaking creates about 1000 aerosol particles per minute, And normal breathing about 7200 aerosol particles per liter of exhaled air. Coughing is more sporadic and tends to produce the larger droplets which don’t stay airborne as long, but I wouldn’t count on it.
There is a tremendous difference between individuals as to the number of particles they generate. It’s estimated that 10 to 20% of individuals account for 80 to 90% of the virus.
Slide number two deals with viral load and infectivity which is a function of the pH value, electrical charge, and other characteristics of the virus. An important point is that even though there is lots of viral RNA, that doesn’t mean that the virus is infective. Once again there’s a tremendous difference between the infective viable virus content of the aerosols from infected patient to patient. He stated that in one room with two Covid patients, they were 6 to 74 TCID/50 per liter, which means you’re almost certain to be infected if you don’t have a mask that filters out the virus, or some kind of purification in the room.
Slide Three was very interesting to me. The persistence in hours graphed against the aerosol particles size. 100 µm particles stay in the air only about five seconds, 5 µm particles stay in the air for 30 minutes, and one micrometer particles will stay in the air for 12 hours or more.
The fourth slide talks about factors affecting the distribution of indoor aerosols. There may be certain parts of the room where the particles congregate , depending on the ventilation type, whether natural, mechanical or filtered, flow patterns within the room, and indoor filtration and killing devices such as ultraviolet light.
Mention is made of the CO2 level in the room as a measure of air circulation. There is a higher CO2 in the air with lots of people and poor ventilation. The recommendation is that 7-8 ppm is about the highest acceptable level, and the possibility of using a portable HEPA filter would not be a bad idea for people frequenting indoor restaurants. Of course, outdoor air with its breezes, dispersion, less humidity, higher ultraviolet and usually Greater dispersion of people is preferable to indoor contact.
Some other interesting points are that children produce less aerosol particles because they have a smaller number of bronchi. I thought the bacteria were less likely to be aerosol transmitted than viruses, but they state that the R0 of tuberculosis can be as high as 4.3, vs. 7-8 for covid. The typical tuberculosis bacillus is relatively large, and yet is only 2 µm in length, well within the size of an aerosol particle.
In the video above, Alexander Stockton, a producer on the Opinion Video team, explores two of the main reasons the number of Covid cases is soaring once again in the United States: vaccine hesitancy and refusal.
“It’s hard to watch the pandemic drag on as Americans refuse the vaccine in the name of freedom,” he says. Seeking understanding, Mr. Stockton travels to Mountain Home, Ark., in the Ozarks, a region with galloping contagion and — not unrelated — abysmal vaccination rates. He finds that a range of feelings and beliefs underpins the low rates — including fear, skepticism and a libertarian strain of defiance.
This doubt even extends to the staff at a regional hospital, where about half of the medical personnel are not vaccinated — even while the intensive care unit is crowded with unvaccinated Covid patients fighting for their lives. Mountain Home — like the United States as a whole — is caught in a tug of war between private liberty and public health. But Mr. Stockton suggests that unless government upholds its duty to protect Americans, keeping the common good in mind, this may be a battle with no end.
I am a Doctor Who has studied the miracle of MRNA Covid vaccine, and who knows that it cannot get into the nucleus of any of my cells or long remain in my body.
I have studied the transmission and pathogenesis of Covid, and know how it works. The knowledge that it could affect my thinking, memory, my very essence, and the fact that it could last indefinitely after the initial illness has certainly made me a believer.
There is an element of truth in the concerns of anti-vaxers and anti-maskers. Unfortunately the problem is not black and white. No vaccine is 100% safe, although the mRNA vaccines come close. There is some worry about clotting problems with a few people, particularly the young. This risk is measured in terms of problems per million people getting the vaccine, and is vanishingly small compared to the alternative of exposing yourself to the ravages of Covid.
An intelligent friend of mine who is a nurse has auto immune disease, and vaccines tend to hit her hard. Unfortunately the fact that she is a nurse and is exposed a lot to the public make her more likely to get Covid, and her auto immunity would render her much more likely to have complications, should she get it. She has received her first injection of Covid vaccine, and had a lot of fatigue, headaches and symptoms that were relatively self-limited.
Masks are mainly useful in protecting other people from the mask-wearer and only slightly helpful in protecting the mask wearer from other people. Also, I have read a long article about some subtle disadvantages of forcing children to wear masks although I think it’s still a good idea, particularly when Covid is common in the community.
The main problem is that Americans have freedom of choice without the knowledge to weigh the benefits and hazards of receiving the vaccine, versus the hazards of getting the disease.
There are times when we should unload the making of such statistical decisions on people who know more about the vagaries of disease.
In my opinion, the states which allow hospitals to require their healthcare workers to receive vaccination, and allow schools to require their students and teachers to receive vaccination are in the right. Currently, there are less problems in those states.
Covid is certainly a nasty disease, and even doubly vaccinated people can be spreaders. As an elderly vaccinated person, I still treat everybody as if they are infected, and require masks when visitors come. When inside, I sit by an open door, with a fan behind me blowing air in the other direction.
At the age of 89, I cannot afford to get Covid-19.
The Biden administration announced that Americans who have been fully vaccinated with a two-dose regimen against Covid-19 should receive a booster, citing the threat from the highly contagious Delta variant. WSJ breaks down what you need to know. Photo: Kamil Krzaczynski/Reuters