COVID Vaccine (2)

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I just did a quick literature search for chemical composition of RNA lipid nanoparticles. FYI, the lipid nanoparticles used to stabilize RNA typically include an ionizing lipid (e.g. a piperazinyl lipid), a phosphatidyl choline, cholesterol, and a polyethylene glycol lipid. Pretty tame stuff--mostly detergent-like lipids. In addition, the quantities used in a typical vaccine dose are miniscule, essentially enough to encapsulate around 30 micrograms of RNA. I won't spend any time worrying about adverse effects from these materials.
 
PlasticCigar said:
Dr. Steingar, I respect your knowledge and experience but please consider the effect of your comments before posting them in a public forum. Your words affect people’s choices, and possibly their lives.
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That's the idea, chuckles. By all means get vaccinated against COVID when the time comes. But skip the Astra Zeneca vaccine, use another. If I'm wrong, you'll still be vaccinated and immune to the 'rona. If I'm right you'll have dodged a bullet.
 
Which vaccine are you recommending, in your infinite wisdom, that does not use mRNA?

If you’re wrong, you’ll have missed out on months of immunity to COVID-19 and possible be dead or on disability. Hopefully your decision making when it comes to flying is more refined than your decision making when it comes to medical issues.

steingar said:
That's the idea, chuckles. By all means get vaccinated against COVID when the time comes. But skip the Astra Zeneca vaccine, use another. If I'm wrong, you'll still be vaccinated and immune to the 'rona. If I'm right you'll have dodged a bullet.
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PlasticCigar said:
Which vaccine are you recommending, in your infinite wisdom, that does not use mRNA?

If you’re wrong, you’ll have missed out on months of immunity to COVID-19 and possible be dead or on disability. Hopefully your decision making when it comes to flying is more refined than your decision making when it comes to medical issues.
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I'm guessing he means the Pfizer or the Moderna ones.
See his post here, where he explains his reasoning in a different fashion:
https://www.pilotsofamerica.com/community/threads/covid-vaccine.129252/page-3#post-3004845
 
steingar said:
That's the idea, chuckles. By all means get vaccinated against COVID when the time comes. But skip the Astra Zeneca vaccine, use another. If I'm wrong, you'll still be vaccinated and immune to the 'rona. If I'm right you'll have dodged a bullet.
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I sincerely hope you have shared your concerns with the NIH/CDC or others. While I appreciate your comments, I feel that it would be more valuable to discuss them with those directly involved with the programs.

Cheers
 
flyingron said:
I used to have two mud-fuds working for me. Doesn't guarantee anything.
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With the hundreds of folks who have worked for me over the years, I will stipulate academic credentials doesn’t guarantee anything except discussions over whose sports teams are superior (if their respective institutions had such things).

Cheers
 
FYI, there are four basic technologies currently being used to produce COVID-19 vaccines. They are:
  • encapsulated mRNA - these vaccines (e.g. Moderna, Pfizer/BioNTech) contain a modified mRNA molecule that codes for a portion or all of the viral spike protein. The mRNA is protected by encapsulation in lipid nanoparticles, becuase it is chemically unstable. The way it works is the mRNA is translated into viral spike protein in your own cells, complete with the proper glycosylation as natural virus particles, in order to raise an immune response. This is a new technology, but one that appears to have worked better than expected based on early results. The main advantage of mRNA vaccines is that mRNA is relatively easy to automate and manufacture in pure form at large scale, although the current pandemic demand may strain supply chains for specialized reagents for RNA synthesis. mRNA is not likely to persist in your body for any length of time.
  • viral vector - these vaccines (e.g. Astra Zeneca, CanSino) use a modified adenovirus to deliver into cells RNA coding for all or part of the viral spike protein, which your cells make, with the proper glycosylation, to generate an immune response. This is a relatively new technology that was originally developed for Ebola and SARS vaccine research. One complication is that, depending on which viral vector is used, one may already have partial immunity to the viral vector, reducing the amount of immunogen that can get into cells to generate the immune response. The result is lower antibody titers than ideal. CanSino is using a human Ad5 adenovirus, which has relatively low (but not zero) exposure in the human population. AstraZeneca is using a modified Ad26 chimpanzee virus for which humans should not have immunity. A potential downside of the viral vector design is that after receiving a viral vector vaccine, future vaccines using the same vector could be less effective due to immunity developed to the viral vector. Manufacturing is technologically complex and challenging at large scale.
  • recombinant protein - these vaccines (e.g. Sanofi) rely on the production of the viral spike protein using recombinant DNA technology using mammalian cell culture. The target protein is purified and stabilized (e.g., using lipid nanoparticles) for administration. Sometimes adjuvants are added to the recombinant protein to enhance immune response to the protein. This is proven technology which is used in current commercial vaccines, like the Shingrix shingles vaccine. The manufacturing of purified proteins is fairly technologically complex, and challenging at large scale. Proteins will not be persistent in the body. They will be broken down and recycled relatively quickly.
  • inactivated whole virus - this is very old-school, highly proven technology (e.g. SinoVac). Live virus is grown in an appropriate cellular medium, then purified and chemically inactivated. The real, whole virus is used to raise an immune response. This is basically how the flu virus is made today, using chicken eggs as the growth medium. This is also a challenging manufacturing method, especially at large scale.
Any of these technologies is likely to produce effective vaccines, and all of them together may be necessary to develop enough doses to staunch the pandemic. Of these, I would have some concern about some of the viral vector vaccines not achieving a high level of protection for all individuals. If you happen to have antibodies against the viral vector, your immunization experience may not be ideal. The AstraZeneca vaccine may be a better bet than any of the Ad5-based viral vector vaccines. Personally, I would be hoping to get one with a high level of proven efficacy through phase 3 trials. And it would be desirable to receive one that prevents infection as well as disease, to be kind to your fellow human beings. But any protection is better than none.

Be careful. Stay safe, and let's work toward a future to pursue our love of aviation in good health. Vaccines can be a step in that direction.
 
In case the powers want an aviation connection with this subject I have flown zero hours due to covid-19 and won't do any significant flying before a vaccination as no where safe to fly to now.
 
Snowmass said:
In case the powers want an aviation connection with this subject I have flown zero hours due to covid-19 and won't do any significant flying before a vaccination as no where safe to fly to now.
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I've been flying a lot during covid, I go somewhere, stop for a few minutes, then go somewhere else. On some of my flights I have no contact with other humans except for texts and radios. I think it's safer than going to the super market.
 
PaulS said:
I've been flying a lot during covid, I go somewhere, stop for a few minutes, then go somewhere else. On some of my flights I have no contact with other humans except for texts and radios. I think it's safer than going to the super market.
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I also have been doing that lately. Nice to social distance at 3000+ feet. Some times I just make a loop of 3 or 4 local fields with a T&G at each. This week has had nasty winds, sometimes 20 gust 40 direct crosswinds so I’m stuck on the ground.

Cheers
 
X3 Skier said:
I also have been doing that lately. Nice to social distance at 3000+ feet. Some times I just make a loop of 3 or 4 local fields with a T&G at each. This week has had nasty winds, sometimes 20 gust 40 direct cross winds so stuck on the ground.

Cheers
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I went up yesterday, over to Barnes then up to Keene. Good thing I had the seat belt cinched tight, because the turbulence tried to smack me into the headliner several times. Winds were 11 G16 about 20 degrees off the runway on all three landings. Fun day.
 
steingar said:
First, I'm not a vaccine maker. Set of skills I don't have. I do stuff vaccine makers don't, though what I do isn't as useful in the middle of a pandemic. The Pfizer and Moderna vaccines are very, very new technology. Folks have been working on mRNA vaccines for many years (actually, mRNA therapeutics. The ability to temporarily deliver gene products is going to be BIG). It sounds like they finally came of age at just the right time. Only mRNA vaccines could be made in the time frame we're looking at. By the way, the mRNAs get cells to temporarily produce a viral protein. The immune system reacts to protein, you have immunity.

Gene therapy has been around for three decades. I heard seminars about it as a young graduate student. I recall one seminar where the speaker talked about using retroviruses to deliver therapeutic genes. Retroviruses were thought to be better for gene therapy because they integrate into the genome, thus becoming a permanent part of the cell. I asked what would happen when the retrovirus jumped into an essential gene. While I was silenced then, I came to the opinion that retroviral gene therapy was dangerous and was going to kill people. I was at the NIH when it did.

After that debacle the gene therapy folks switched to a new virus, the Adeno-associated virus. This virus doesn't integrate into the genome, but the viral DNA can stay in cells a very long time. Thus you have a way to safely and stably deliver genes into human cells, a very good thing, normally. However, I (and only I, so far) think that this isn't a good thing for a vaccine. I suspect that Adeno-associated viral vector is going to remain in cells for a long time after you have immunity to COVID. As such you're going to have cells making a viral protein that the immune system is actively reacting to. If the cells make the protein the immune system can react to them. That's autoimmunity, a Pandora's box I'd rather not open.

I hope to Odin I'm wrong, I really do. The Russian vaccine was made the same way, though I can't be certain of the viral vector employed. If I'm right a lot of people are going to get very sick. If I'm right confidence in vaccines is going take a BIG hit. I've never been so hopeful to be wrong in my whole life.
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This is one reason I'm not rushing to get any vaccine, altho I'm in a high-risk category. I'll happily wait until the summer or even much later to see what happens with a very large population sample. I'm very happy to have a job, to work from home, go fly by myself when the weather is good, and hit the grocery store late at night.
 
steingar said:
Baloney. Adjutants aren't used if they aren't proven safe. The mRNA vaccine consists of a strengthened mRNA and some sort of coating to get it into cells. That coating is a wild card, no one really knows if it's safe. And based on this test we aren't going to find out. Sorry, when you do science well you test all the variables, not just the ones you like better.
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Welcome to software design - the right way. Test everything including the edge conditions.
 
steingar said:
You need the lipid (i.e. the "fat") to get the vaccine through the lips bilayer that surrounds all cells and forms the cell membrane.
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Context, all things are context. I hear "fat for packaging" and I immediately think "huh? Storing vials of the vaccine in tubs of Crisco or butter?"
 
Agree that flying is safer than grocery shopping Covid wise. Also helps keep sanity through this odd time - so there’s that.
 
murphey said:
Context, all things are context. I hear "fat for packaging" and .....?
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Now - I know I’ve gained a few pounds during 2020 what with working at home and all.... so does means I’m prepared for the vaccine ?
 
chemgeek said:
I just did a quick literature search for chemical composition of RNA lipid nanoparticles. FYI, the lipid nanoparticles used to stabilize RNA typically include an ionizing lipid (e.g. a piperazinyl lipid), a phosphatidyl choline, cholesterol, and a polyethylene glycol lipid. Pretty tame stuff--mostly detergent-like lipids. In addition, the quantities used in a typical vaccine dose are miniscule, essentially enough to encapsulate around 30 micrograms of RNA. I won't spend any time worrying about adverse effects from these materials.
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'polyethylene glycol' - isn't that anti-freeze?
 
Ethylene glycol is auto antifreeze, and very toxic. Propylene glycol is used for non toxic antifreeze for things like for winterizing RV water systems... as well as medical use.
 
Fun fact. Antifreeze isn’t toxic by itself. It is when the liver breaks it down it creates toxins. If your pet gets antifreeze they treat it with alcohol - yes, think vodka. Keeps the liver so occupied processing the alcohol it minimizes the antifreeze toxin creation.
 
murphey said:
'polyethylene glycol' - isn't that anti-freeze?
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No, it's a polymeric material, and it's really a class of compounds with different chain lengths H-[C2H4O]n-H, where n is the number of repeating chain units. Some are short chains, some are long, and one type is used as a laxative, as well as other things, as mentioned above. Sometimes, the PEG (PolyEthylene Glycol) chain is covalently bound to a molecule. I've seen it covalently bound to peptides and various nucleic acid compounds. I've no idea if the vaccine is PEGylated covalently or simply mixed with the RNA. My guess is covalently bound, otherwise I suspect it would only be effective locally. The PEG would otherwise get "washed off" before it could get very far into the body. Dr. @steingar probably could shed more light on this and correct me as needed.
 
Cap'n Jack said:
No, it's a polymeric material, and it's really a class of compounds with different chain lengths H-[C2H4O]n-H, where n is the number of repeating chain units. Some are short chains, some are long, and one type is used as a laxative, as well as other things, as mentioned above. Sometimes, the PEG (PolyEthylene Glycol) chain is covalently bound to a molecule. I've seen it covalently bound to peptides and various nucleic acid compounds. I've no idea if the vaccine is PEGylated covalently or simply mixed with the RNA. My guess is covalently bound, otherwise I suspect it would only be effective locally. The PEG would otherwise get "washed off" before it could get very far into the body. Dr. @steingar probably could shed more light on this and correct me as needed.
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I honestly can't shed as much light as I would like. I have no access to the formulation of these vaccines as I don't work for the relevant companies. All I can really say is these things have been tested extensively in lab animals and now in people. I never had any doubt they were safe, and the data revealed by the companies makes it appear they're quite effective. As I've said, this is very new technology. To see it working this well is gratifying. None of this would have been possible without the legions of scientists doing blue sky science in Biology. I think the monies spent by the US in biomedical research have just paid for themselves many times over.

I think @chemgeek explained it quite succinctly. They're making things that look like lipid micelles, to get the nucleic acids into cells. This technology is actually a bit old, I was using micelles to transform mammalian cells in grad school. I think the tricky part here was making the RNA molecules sufficiently stable that they'd persist long enough to get a sufficient quantity of the needed protein made to trigger a strong immune response.
 
murphey said:
This is one reason I'm not rushing to get any vaccine, altho I'm in a high-risk category. I'll happily wait until the summer or even much later to see what happens with a very large population sample. I'm very happy to have a job, to work from home, go fly by myself when the weather is good, and hit the grocery store late at night.
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I'd be really shocked if the mRNA vaccines have any untoward effects. I think I've made my thoughts clear about some fo the other vaccine candidates.
 
PlasticCigar said:
Here’s some non-partisan medical news that expresses a perspective which may be new for some:

https://www.medpagetoday.com/infect...utm_term=NL_Gen_Int_Medpage_Exclusives_Active
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LOL. If my wife had a buck for every patient who argued their diagnosis in the last 30 years, we’d have an island nation to ourselves.

These “pity party” articles by interviewing other (almost always younger) nurses claiming they’re being harmed by that, make her roll her eyes very loudly.

Most patients don’t even know what meds they’re on or they’ll say crap like “I don’t have high blood pressure, Doc gave me pills for that years ago.”

Yesterday a patient refused three different ways to get pressure off her feet so they could heal. “Nope nope nope I want something that’ll make it so I never have to come back here. I’m sick of it.”

Doc looked her straight in the eye and said, “If you’d have let us do this the first time you visited us, you wouldn’t be here today.”

Karen said she was doing everything she could not to crack up laughing.

Vast majority of healthcare workers aren’t bothered in the slightest by a patient not believing them. The few who are, like to whine to reporters or write blogs. Especially during Covid.

The rest are like, “You’re kidding me, right? How long you been doing this?”

And someone told me their computer was plugged in three times recently when it wasn’t. Took her husband to figure it out. LOL.

The article is pretty much laughable around here. Oh no! Some patient is an idiot! When’s lunch?
 
WDD said:
Fun fact. Antifreeze isn’t toxic by itself. It is when the liver breaks it down it creates toxins. If your pet gets antifreeze they treat it with alcohol - yes, think vodka. Keeps the liver so occupied processing the alcohol it minimizes the antifreeze toxin creation.
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Just to be safe I pre-treated myself for accidental anti-freeze ingestion for years....:lol:
 
I think they picked these people to interview because the ones who committed suicide weren’t available to comment.

You really have no clue what treating COVID patients during this pandemic is like.

People risking their lives to help you not die because of the bad choices you made and you call it a “pity party?” Please, get a clue.

Next time you’re sick or injured, please make it a point to tell your healthcare provider how little you care for them as a human being. Or about human beings in general.

You and your wife both sound like wonderful people and I wish you both long, happy and healthy lives. May our paths never cross again (I just figured out how to use the “ignore” function so I’m hopeful about the future for us both).

Take care, my friend.

denverpilot said:
LOL. If my wife had a buck for every patient who argued their diagnosis in the last 30 years, we’d have an island nation to ourselves.

These “pity party” articles by interviewing other (almost always younger) nurses claiming they’re being harmed by that, make her roll her eyes very loudly.

Most patients don’t even know what meds they’re on or they’ll say crap like “I don’t have high blood pressure, Doc gave me pills for that years ago.”

Yesterday a patient refused three different ways to get pressure off her feet so they could heal. “Nope nope nope I want something that’ll make it so I never have to come back here. I’m sick of it.”

Doc looked her straight in the eye and said, “If you’d have let us do this the first time you visited us, you wouldn’t be here today.”

Karen said she was doing everything she could not to crack up laughing.

Vast majority of healthcare workers aren’t bothered in the slightest by a patient not believing them. The few who are, like to whine to reporters or write blogs. Especially during Covid.

The rest are like, “You’re kidding me, right? How long you been doing this?”

And someone told me their computer was plugged in three times recently when it wasn’t. Took her husband to figure it out. LOL.

The article is pretty much laughable around here. Oh no! Some patient is an idiot! When’s lunch?
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Denying one’s own diagnosis is one thing (and one’s right to be wrong), but when widespread denial leads to illness and death in others, that’s a step too far.
 
PlasticCigar said:
I think they picked these people to interview because the ones who committed suicide weren’t available to comment.

You really have no clue what treating COVID patients during this pandemic is like.

People risking their lives to help you not die because of the bad choices you made and you call it a “pity party?” Please, get a clue.

Next time you’re sick or injured, please make it a point to tell your healthcare provider how little you care for them as a human being. Or about human beings in general.

You and your wife both sound like wonderful people and I wish you both long, happy and healthy lives. May our paths never cross again (I just figured out how to use the “ignore” function so I’m hopeful about the future for us both).

Take care, my friend.
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Like I said, my wife does, the neighbor I’ve know for 20 years, his wife does, etc.

Yes. There are overly sensitive medical workers posting blogs and giving reporters fodder right now who’ll probably rethink their career choices soon.

The vaaaaaast majority haven’t let a patient making things up bother them for decades. They also aren’t being interviewed about Covid out of reporter boredom or page clicks and ad revenue.

“I didn’t OD. It was just a little coke.” LOL. Yeah. This is the sixth time we’ve hit you with Narcan, dummy.

People doing their jobs without drama aren’t “newsworthy”. Neither are well run hospital networks with plenty of staff and handling things just fine.

Just how it always goes.

But pleeeeze. Tell me how my wife doesn’t know patients and patient care again. It’s truly cute. She does know a freaking out nurse when she sees one though.

Probably why she’s supervised them for years...

Is there burnout in some isolated places? Bad management? Low pay? High case load? Sure. If that’s the only story one can find online though, one should be highly skeptical. It’s not the majority or the norm.

Ask @bbchien how much sleep he has lost over patients lying to him over his career. LOL. Not much, I bet. He even “fires” those patients these days. Different type of practice, same humans. Doing the usual human stuff.

You should hear how many patients lie through their teeth to the nurse until the “wonderful” Doctor walks in, too. Hahaha.

Never said Covid was nice to treat. Said the article focuses on an age-old problem in patient care that indicates a few folks just aren’t cut out to deal with patients who lie.

Or who don’t have enough experience yet to know it’ll be happening their whole lives... long after the reporters aren’t hunting Covid sob stories.
 
wrbix said:
Denying one’s own diagnosis is one thing (and one’s right to be wrong), but when widespread denial leads to illness and death in others, that’s a step too far.
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By all accounts not common either, anywhere but the internet full of worried and bored people.

Symptomatic people aren’t out in any “widespread” numbers anywhere. Nowhere.

Just the internet doing what it does. Amplifying the minority stories.

People who are sick are home or in a hospital depending on severity. Vast vast vast majority of them.

People who aren’t sick, can’t be held accountable for anything other than the boring mask debate.

And that’s not what the article is about. The article is about normal human foibles in any patient care being touted as “harming” the caregivers. It doesn’t for the vast majority of them.

They know patients lie. To themselves, to them, doesn’t matter. They tell multiple patients a day not to lie to themselves. Not news. Not even close to being out of the norm.
 
My ex had a classic patient. He was transported to the ER with a rapid heartbeat, sweating, just a mess. They got him stabilized and he was waiting for a room.

She gets called back in by the nurse and his symptoms were as bad when the paramedics brought him in.

She asked what had changed. No meds had been given.

The guy says, "I went outside for a bump". He actually walked outside and smoked meth while he was in the hospital!
 
denverpilot said:
By all accounts not common either, anywhere but the internet full of worried and bored people.

Symptomatic people aren’t out in any “widespread” numbers anywhere. Nowhere.

Just the internet doing what it does. Amplifying the minority stories.

People who are sick are home or in a hospital depending on severity. Vast vast vast majority of them.

People who aren’t sick, can’t be held accountable for anything other than the boring mask debate.

And that’s not what the article is about. The article is about normal human foibles in any patient care being touted as “harming” the caregivers. It doesn’t for the vast majority of them.

They know patients lie. To themselves, to them, doesn’t matter. They tell multiple patients a day not to lie to themselves. Not news. Not even close to being out of the norm.
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You assert that one can’t be a contagion spreader unless one is “sick”? Come on, really?
The same denial of reality expressed to the health care worker presents as asymptomatic spread in the community. It’s not about “harming the caregiver” so much as it is harming the populace in general.
Yes, patients, like all humans, can be stupid but stupidity wears on caregivers when many others are resultant victims.
 
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PaulS said:
I've been flying a lot during covid, I go somewhere, stop for a few minutes, then go somewhere else. On some of my flights I have no contact with other humans except for texts and radios. I think it's safer than going to the super market.
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Of course it is but after I land then what? After 8000 hours flying in circles has lost it's excitement. I started flying for transportation and still use it for this purpose.

But flying just to be flying makes you happy never land.
 
Snowmass said:
Of course it is but after I land then what? After 8000 hours flying in circles has lost it's excitement. I started flying for transportation and still use it for this purpose.

But flying just to be flying makes you happy never land.
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That's too bad.
 
denverpilot said:
People who aren’t sick, can’t be held accountable for anything other than the boring mask debate.
.
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Certainly what you seemed to imply....perhaps you’d care to further explain.
 
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