sonally , for a 2:1 randomization of the original Oxford-developed vaccine , the Astra Zeneca trial . The Clinical Research Unit is next to the Bone Marrow Unit ; everyone was very good at masking . I kept thinking , Lance Armstrong probably walked these same halls . I got randomized into the every two week visit group through 2020 and then far less often . Everyone was utterly thorough , professional and nice ( though the physical exam was , well , not an internist one ). I felt fine for a day , then mildly achy for a day , arm a little bit sore for two days . I was mildly encouraged , but accused myself of dramatizing the soreness .
Besides genetically-engineered M-RNA vaccines , multiple companies have developed other mechanisms for stimulating an immune response against COVID-19 . The Oxford / Astra Zeneca vaccine relies on a weakened chimpanzee adenovirus which has been engineered to insert into the human cell and cause it to make neutralizing antibodies against COVID-19 ’ s spike glycoprotein . It also induces T-cell responses in the hope the “ immune system will continue to remember .” ( Clinical researchers found that people with very high levels of IgG neutralizing antibodies were more likely to survive severe COVID-19 infection , thus the emphasis on developing vaccines that stimulate production .)
The Novavax candidate is unique : it contains a proprietary adjuvant “ deliverer ” of a recombinant nanoparticle vaccine constructed from full-length wild-type COVID-19 spike glycoprotein . The spike protein mediates attachment of the COVID-19 to an angiotensin converting enzyme receptor in the host cells . This vaccine stimulates CD4 + and CD8 + T-cell responses with a T-helper dominant type . Per the Sept . 2 , 2020 New England Journal of Medicine , it “ demonstrated a reassuring safety and reactogenicity profile and induced robust antibody responses numerically superior to that seen in human convalescent sera .” Novavax began larger scale Phase
3 human studies in late September overseas .
DOCTORS ' LOUNGE
Chinese-originated vaccines are being studied in various countries and a CanSino vaccine , from the company that helped to develop an Ebola vaccine , has been issued an emergency-use license for the Chinese military already .
Two Russian vaccines have been approved for use by Russia and they have exported these to other countries as well , even though Russia approved them without Phase 3 trials ( the Sputnik V and EpiVacCorona vaccines ). Western doctors are highly skeptical due to the lack of safety data .
The Johnson & Johnson viral vaccine was built by veterans of other viral vaccines , led by Dr . Dan Barouch ’ s lab at Beth Israel in Boston . It uses a well-tested Ad26 adenovirus vector which must be specially grown by Dutch collaborators in their giant designed vats . Carl Zimmer wrote all about them in a July 17 New York Times article : they ’ ve been sleepless , hungry and exhausted for months now , but Phase 3 trials are ongoing in Kentucky and other states . The Johnson & Johnson vaccine only has to be refrigerated , too - not deep-frozen , a definite advantage for so many parts of the world , including rural Kentucky and Indiana .
I always think , as a clinician , of the endless , ever-increasing debt I owe to people like Dr . Barouch and his team , to the legions of post-docs , techs and students , whose dedication , imagination and sheer refusal to quit have made our patients ’ lives safer and better for generations . I admire you so , and pray for your health . I quote indomitable internist Dr . Shannon Lynn : “ I tell every patient : doctors fear what they cannot treat . Prevention is our only option .”
Dr . Barry is an internist and Associate Professor of Medicine ( Gratis Faculty ) at the University of Louisville School of Medicine , currently taking a six-month sabbatical .
Your GLMS membership provides more benefits than you may know .
We will visit your practice to discuss benefits and services to determine how we can better serve you .
GLMS MAKES House Calls
WE KNOW YOU ARE BUSY SO LET US COME TO YOU !
Here are some of our most common requests : » Hassle Reporting / Issues with Insurance Companies » Practice Management Resources » Physician Education & Compliance » Healthcare Policy & Advocacy » GLMS Membership Benefits , Programs , Services and
Discounts » Provider Enrollment / Insurance Credentialing » MedCentral Hospital Credentialing » Market Your Practice » IT Services
Call 502-736-6350 or email physician . education @ glms . org to schedule a visit for your practice .
DECEMBER 2020 31