Genetics, statistics and religion...

1.?????Do genetics modulate Covid lung symptoms? Yes. For many years, we have known that certain infections stimulate autoantibodies in some people, and that autoantibody process is genetically influenced. Autoantibodies are antibodies directed against our own cells and tissues as opposed to doing what they should be doing which is fighting infections. We also know that some people are more genetically prone to make autoantibodies. An article in Nature from earlier this year reviews this topic -- ?https://doi.org/10.1038/d41586-021-00149-1 More recently, some new data suggests that persons with more severe lung infection with Covid are genetically prone to creating antibodies directly against the lung tissue. On the other hand, a paper published in the?Journal of Clinical Investigations?describes how the presence of certain antibodies and antibody-secreting cells within the lungs can quickly induce an immune response to minimize the effects of these respiratory infections. In other words, genetically influenced immune responses can either hinder or help the immune response against Covid.

?2.?????How big a problem is the J&J vaccine induced Guillain-Barre syndrome (GBS)? Most of us have trouble understanding the meaning of big numbers. In this case, Johnson & Johnson reported that their vaccine was associated with a slightly increased rate of a serious neurological syndrome called Guillain-Barre syndrome above the background baseline rate in the population. This is a syndrome in which the body attacks its own neurological system. Most of the cases occurred in men over the age of 50 around 2 weeks after being vaccinated. Guillain-Barré syndrome is a very rare side effect known to occur after other infections, like influenza, gastrointestinal infections, and other respiratory infections. It can also occur after vaccinations, such as the flu shot and pneumococcal vaccine. Johnson and Johnson described the rate as 100 cases out of 13 million vaccinations. I find that easier to understand as 1 out of 130,000 shots. Or if you prefer, that translates into a rate of 0.00077. If you consider the chance of getting sick from Covid is far higher than this rate, it seems like taking the vaccine is a pretty good gamble. But, what I like to call the “tyranny of the anecdote” is often operative whereby one story of a citizen getting sick with Guillain-Barre syndrome can overwhelm the facts and statistics of the situation. To put this in another perspective, in my 30+ years of practicing medicine, I have seen exactly one case of Guillain-Barre syndrome. And that patient fully recovered, as they usually do. There is no known link between the mRNA vaccines – Pfizer and Moderna – with the Guillain-Barre syndrome.

?3.?????Connecticut and Maine get rid of the religious exemption for the Covid vaccine. All 50 states have laws requiring vaccines for students.?Although exemptions vary from state to state, all school immunization laws grant exemptions to children for medical reasons. Only 6 states do not grant religious exemptions for people who have religious objections to?immunizations. Currently, 15?states allow philosophical exemptions for children whose parents object to immunizations because of personal, moral or other beliefs. What is new is that more parents are requesting religious exemptions for their children. For example, in Connecticut, according to the state Department of Public Health, the number of children claiming a religious exemption increased from 7,042 in the 2017-18 school year to 8,328 in 2019-20. This past April, Connecticut Governor Ned Lamont signed a bill dismissing the possibility of a religious exemption. You can see the bill here. This made Connecticut the 6th state in the country to cancel the religious exemption for school vaccinations. 3000 people gathered outside the Connecticut Senate to protest and a coalition of parents objecting to this law have vowed to pursue a legal fight to overturn it as unconstitutional. The legislation, which includes public and private schools, higher education, day care and childcare centers, will take effect with the 2022-23 school year.?In some strange political bedfellows, Connecticut joins Maine, California, New York, West Virginia and Mississippi as the six states that now do not allow school religious exemptions.