Jeff Wise

Thanks to vaccines, the number of COVID-19 cases has plummeted in the U.S. and restrictions are being lifted across the country. But as we return to our normal activities, we face a more familiar summertime scourge. We’re in the thick of Lyme disease season – the two-month run from early June to the end of July when 85 percent of infections take place. Surprisingly, vaccines may have allowed us to avoid this epidemic, too. As I learned during my own recent bout with Lyme disease, a vaccine has existed for decades, but it’s no longer available.

It’s yet another frustrating aspect of this mysterious disease. One bite from a tiny, hard-to-detect tick can lead to a host of odd symptoms, including arthritis, serious cardiac issues, and neurological damage in the most severe cases. The disease is easy to treat once you get a diagnosis, but that can be elusive. And while work is underway to develop a new and better vaccine, it may take years to come to market. Here’s what we know about how the disease works, and what you can do to stay safe. Continue reading New York: There’s a Vaccine for Lyme Disease. So Why Can’t We Get It?

While everyone’s excited for “hot vaxx summer,” a reminder: Americans are still dying of COVID. Not in the same numbers as during last winter’s horrific peak, but still at an agonizing clip, with more than 700 fatalities a day on average. In other words, tens of thousands of otherwise healthy people walking around today will die of it in the months ahead.

Sure, there are plenty of reasons to feel optimistic. We now have highly effective vaccines, and close to half the adult U.S. population has gotten at least one dose, conferring a high degree of protection from the virus. Given that a third or more of the country may have built up immunity through already getting infected, that means we’re in striking distance of herd immunity, which will gradually drive new infections to sufficient rarity that the pandemic will effectively be over nationally. “We have reason to believe we’ll be in a good place by July,” says Justin Lessler, an infectious-disease epidemiologist at Johns Hopkins.

But it’s not at all clear how we’ll get there. After an unexpectedly successful rollout of the Pfizer and Moderna vaccines, uptake is now slowing, with many locations now having more doses than people taking them. Meanwhile, new variants of concern are emerging and spreading. One of them, B.1.1.7, first appeared around the New Year and now constitutes the majority of new infections in the United States.

“We’re in a footrace between the vaccine and the variants,” says Columbia University disease modeler Jeffrey Shaman. How that race plays out will make the difference between a gradually weakening pandemic that yields relatively few additional fatalities and one that drives the death toll to another spike. The experience of Michigan, where cases spiked eightfold between February and April even as overall caseloads in the U.S. were broadly declining, could be played out again and again in pockets of vulnerability. Continue reading New York: The Pandemic’s Lethal Twilight

When the actress Sarah Wynter got her first dose of the Pfizer COVID-19 vaccine, she didn’t experience any side effects apart from a little soreness in her arm. Dose two was a different story. About 12 hours after she received it, as she was about to go to bed, “it hit me like a freight train,” she says. “I just started feeling very achy, very tired and heavy.”

She woke up the next morning experiencing what felt like the worst hangover of her life. After some Tylenol and coffee, she felt almost better by late morning and was well enough to host a small birthday party for her 10-year-old twins. Then, at bedtime, it was round two, this time including violent chills. A night’s rest helped, but the following day she still felt under the weather.

Wynter’s experiences may not have been exactly typical, but they weren’t unusual, either: The second dose of Moderna and Pfizer vaccines really do pack a wallop. A study by the Centers for Disease Control and Prevention found that while 30 percent of recipients experienced fatigue and a quarter suffered headaches after the first dose, those figures climbed to 54 percent and 46 percent, respectively, after the second dose. The number experiencing chills or fever climbed from 9 percent to 30 percent.

These unpleasant effects are a result of the way the immune system works. Continue reading New York: Why the Second COVID Shot Makes You Miserable

If you’ve recently received a COVID-19 vaccination, congratulations — but you’re not out of the woods. Right after your first dose, you’re as vulnerable to infection as you were before, since it takes time for your immune system to learn how to find and kill the coronavirus. When that happens, recipients of the Pfizer, Moderna, and Johnson & Johnson vaccines will all enjoy nearly 100 percent protection against hospitalization and death. So when can you start to feel safe? Sooner than you might think.

Pfizer and Moderna, the only vaccines to have published their Phase 3 trial results in a peer-reviewed journal, are both based on mRNA technology, and as might be expected showed similar trajectories. During the first two weeks after the first dose, recipients were almost as likely as control subjects given a placebo to develop COVID-19. But after that, the vaccinated infection rate dropped quickly. Pfizer’s data is more detailed, and it’s striking. Before day 11, vaccination offers very little protection. After day 11, the protection is substantial. Given the overall similarity in efficacy, presumably Moderna is the same way. (Johnson & Johnson’s vaccine uses a different technology, and detailed results of their Phase 3 study haven’t been published yet, so it’s harder to say what’s going on there.)

Rachel Roper, a professor of microbiology at East Carolina University, says this timing isn’t surprising. The body makes millions of white blood cells that are randomly shaped to match all possible unknown things. “Most just lie dormant and die, but if one binds a virus or other pathogen, it will become activated, and then proliferate, and then differentiate to be an effector cell, making antibodies or becoming a killer cell.  This is why it takes a week or two to get over an illness.  It takes time for these very few specific cells to activate and proliferate to large enough numbers to control infection.”

Looking at the Pfizer graph, the protection level is nearly binary: none, and then all. Day 11 after the first shot seems to be the magic point beyond which you can consider yourself vaccinated. Continue reading New York: So You’ve Been Vaccinated. When Are You Safe?

UPDATE: On April 13, the FDA and CDC recommended that use of Johnson & Johnson’s COVID-19 vaccine be suspended after six women developed serious blood clots after receiving a dose, one of whom died. The CDC will “review these cases and assess their potential significance,” the agencies said in a joint statement. While the cases amounted to less than one per million vaccinations, they resembled similar blood-clot events suffered by recipients of the vaccine made by AstraZeneca, which uses a similar adenovirus vector.

As an object, it’s not much: an inch and a half of glass with a stopper and some liquid inside. But a thimbleful of the stuff has amazing power — the ability to liberate us from our yearlong collective trauma. The fact that it’s available, scarcely a year after the start of a pandemic, is both an industrial miracle and a freakish stroke of luck; a decade ago, technology did not exist that could bring vaccines so quickly to the public’s arms.

Pfizer and Moderna crossed the finish line first, neck and neck, in December. The third and most recently approved vaccine was from Johnson & Johnson. The J&J vaccine holds some crucial advantages: Only one dose is required rather than two, and while the other approved vaccines expire 30 days after thawing, Johnson & Johnson’s lasts three months, making it easier to distribute in countries that lack an advanced cold chain. The story of the vaccine’s path from development to mass distribution is a lesson in the power of the global capitalist system — the network of corporations and supply chains that, though it can suffocate and disempower us as individuals, can also summon forth immense material and intellectual resources and deploy them for the greater good.

From the start, J&J struggled to catch a break. The pharmaceutical giant played it safe during development and lost crucial time, failed to get FDA approval for parts of its U.S. production chain, missed several delivery targets, and wound up with a vaccine that underperformed its rivals in clinical trials. Then, another obstacle: Last week, the New York Timesrevealed that the new batch J&J had pledged would be delayed even further, after a mix-up at a subcontractor’s production facility ruined 15 million doses. The Biden administration has since directed J&J to take over every aspect of vaccine production at the plant.

The setback was significant, but not fatal. The facility where the mix-up occurred was part of a production process that relies on a precise orchestration of timing, engineering, and logistical expertise across multiple continents, which makes it vulnerable to bad luck and human error. But the system is also resilient: When the batch of J&J doses was compromised, alternative supply lines were available to compensate for the failure. Here is how that entire tempestuous journey unfolded — the breakthroughs, the setbacks, and the way the pieces came together to bring vaccines to millions of arms. Continue reading New York: The Story of One Dose