COVID-19: Public Policy Can Be Like a Good Vaccine

Part 8: To be successful, education needs to begin in kindergarten.

Posted Nov 30, 2020

But where are the more than trillion-dollar WARP SPEED COV-19 vaccines going?  A single measle vaccination (MMR vaccine) provides 93% and if paired with a follow up shot 97% protection, respectively, in children’s robust immune system (1).  However, the response in the general population with many impaired high-risk people (e.g. elderly, obesity, hypertension, etc.) may be more like the reactivation of the chicken pox virus in older people (they had it as a child) call the shingles (very painful) occurring as our aged immune system fails.  The initial vaccines only had a 50% rate of protection (2) which Dr. Fauci has suggested would be a good response for a COV-19 vaccine.  However, a more recent vaccine (approved in 2017) by adding HZ/su (3) an adjuvant (a substance which enhances the body’s immune response to the virus or the antigen), increased the protection to the shingles up to 90% with 2 doses (2,3), which Dr. Fauci has suggested would be a “great” response for a COV-19 vaccine.  Yet, as of 2019 only 34.5% of adults over 60 years of age have taken the improved shingles vaccine (4) possibly because of cost.

We might learn from influenza a corona virus.  During the past flu year (10/1/19 – 11/4/20) the CDC estimates that influenza has resulted in between 410,000 - 740,000 flu hospitalizations and between 24,000 – 60,000 deaths (5), even though influenza testing was higher than normal because of the COV-19 pandemic.  Nevertheless, only 43% to 46% of the population has taken the flu vaccine annually and many have already announced they will refuse to take the COV-19 vaccine. Pfizer with Germany’s Bio N. Tech SE (P Bio) and Moderna reported vaccine trials with at least 95% effectiveness in preventing COV-19 infection after the second of two doses approximately one month apart.  Both of these vaccines need to be frozen (-70 Celsius or -94 degrees Fahrenheit (°F) for P Bio and -40 degrees Celsius or -40 °F for Moderna) (6).  A third vaccine from Astra Zeneca developed by Oxford University was around 90% effective when first administered at a half dose followed by at least one month later with the second full dose.  Two full dose results combined with the latter provided only a 70% average efficacy, but it also prevented infection and can be stored in a refrigerator rather than in a specialized freezer (7).  There are however, many unanswered questions, and possible problems.

What will be the rate of serious side effects, and the actual effectiveness in real world populations of minorities, obese, elderly, etc?  Will these vaccines actually prevent infection and not just illness and for how long?  The possibility of mutation is real.  Nevertheless, the results of a poll taken between 10/1 and 10/4/20 are of concern (8).  Even if the COV-19 vaccine was inexpensive and easily available only 51% of respondents said they would try to get vaccinated, while 45% responded they would not try, and 4% had no opinion.  The highest percentage of people who would try were 65 years or older at 60%.  Herd immunity is where a “large portion of a community becomes immune”, making person to person spread unlikely.  With measles, because it is so infectious, there has to be 95% immunity. With COV-19 it is thought to be 70% suggesting that 70% of the population needs to be immune or vaccinated (9) or COV-19 could keep circulating, but perhaps not so intensely.     Though there is a belief in the supremacy of technology, the human body is more miraculous.  Americans especially, generally want magical answers that are done for them.  However, a COV-19 vaccine does not guarantee immunity for many of us. 

There is a “Secret” that reduces the number of people who would be prone to die from COV-19 whether they received a vaccination or not. For the most part, a tuned-up body is good at resisting infection and responding to vaccinations (e.g. generally our young), while an untuned body is a doctor’s paradise (e.g. especially those with predisposing illness for COV-19).  The Secret will be compared to metformin which has been used successfully to treat type 2 diabetics, who are generally older and obese, for the past 30 years. 

In 1999 the Diabetes Prevention Program Research Group (DPPRG) published the design and method for preventing type 2 diabetes, results of which were e-published in 2002 (10).  They randomly assigned 3234 non-diabetics with impaired glucose tolerance (IGT) median ages 51 to a placebo (no active treatment), metformin (850 mg by mouth twice daily) or a lifestyle modification with the goals of at least a 7 percent weight loss through a healthy low-calorie, low-fat diet and to engage in physical activity of moderate intensity, such as brisk walking for at least 150 minutes per week with an average follow up of 2.89 years.  A 16-lesson curriculum covering diet, exercise, and behavior modification which was flexible and culturally sensitive helped participants achieve their goals.  Intensive lifestyle reduced the incidence of type 2 diabetes by 58%, and with metformin by 31%.  It is impressive that simply tuning up obese (mean body mass index or BMI was 34) prediabetic bodies, with moderate exercise and diet, could make such a difference (Figure 1) (10)

393-403.
Changes in Body Weight, Leisure Physical Activity and Adherence to Medication Regimen According to Study Group.
Source: The Diabetes Prevention research group (Haffner, S., Temprosa., M., Crandal, J., et al.: Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J. Med 2002, 246:393-403.

Figure 1: Changes in Body Weight (Panel A) and Leisure Physical Activity (Panel B) and Adherence to Medication Regimen (Panel C) According to Study Group.

In a subsequent study, the inflammatory marker CRP, and fibrinogen, a coagulation factor, both of which are observed to be elevated in IGT or prediabetic patients, were studied (11).  The main findings were the median changes in CRP in men after 1 year of -33% in the lifestyle group, -7% in the metformin group, and in women -29% in the lifestyle group and -14% in the metformin group.  Remember many immune markers besides CRP were beneficially affected by metformin (post 7).  Nevertheless, lifestyle utilizes the body’s innate healing Secrets thru exercise, diet, and some weight loss to make it more resilient.

Sesame Street taught children about COOPERATE, but today PREVENTION may be just as important and should be taught in kindergarten along with Smokey The Bear.  We need people like Mr. Rodgers to help our children understand.  Afterall, “Everything I needed to know I learned in Kindergarten”.  There are vast numbers who change their oil every 4,000 miles or get regular tune ups to maximize and to protect their motors, but not their diet, exercise, smoking, etc, to protect their body.  One of my patients asked, there’s not a lot of money (to be made) in prevention?  Well just imagine if we had 10 (safe and effective) adjuvants to tune up our bodies for the top 10 infectious illnesses?

Viral infections are here to stay, just like influenza which Hippocrates described almost 2500 years ago.  We need to find ways to strengthen and protect the body’s immune system, mitochondria, and their organs including blood vessels so as to be more resistant and resilient to infections and their sequalae.  The best possible protective combination dose of omega and aspirin to prevent clotting (40% aspirin alone, to 62% with the combination), is unknown (12).  Moreover, we need to know what are the best specific age related types and amounts of exercise, MM, fiber, plant-based, or other diet supplements, etc., to maximize our immune system’s preventative and protective functions?  All of which, should be provided by government sponsored funding and leadership. This is partially beginning under the rubric of “precision nutrition(13).  My esteemed former National Institutes of Health (NIH) colleagues may be missing a central message of the DPPRG findings (10, 11) in that nutrition is only one part of lifestyle. For example, our relationships, and spiritual issues, affect the assimilation of what we eat (i.e. our nutrition) (14).

 Governments have mandated science-based food additives, such as iodine to salt to prevent thyroid disease.  Dietary fiber has been shown to decrease type 2 diabetes mellitus (T2D), cardiovascular disease, and colon cancer and evidence is rapidly accumulating for infection prevention and improvement of mood (15 - 18).  More than 15 years ago the American Heart Association recommended that the ratio of carbohydrates to fiber should be no more than 10 to 1, respectively, and ideally less, because higher ratios were linked to T2D.  Presently, many foods such as potato chips, crackers, white rice, many breads and breakfast cereals, pizza dough, pasta, etc., not made from whole grains would be excluded.  However, this is easily remedied by adding fermentable fiber (not cellulose), which has been found not to change palatability or taste (14).  The Secret is that we have innate healing powers which we do not optimally utilize.  A favorable possibility may lie in “tuning up” our bodies and minds in ways which may reduce and prevent risk factors and infection per se.  Secret ways to “reverse aging” and make our immune and muscles cells and their mitochondria younger and more resilient have been documented here and in previous posts with exercise, fiber, metformin, MM, etc. all of which are related.  It is not difficult, for example, if you exercise regularly or even just before getting  vaccinated, exercise acts as an adjuvant to augment the immune response to the vaccination (19).  The next two trillion dollars must be spent more wisely and cost effectively on precision lifestyle training, research, and programs beginning in kindergarten.  You are the choir and we need a call for action.  If you forward this to three friends, we may be able to start a grassroots conversation and engage people like Dr. Anthony Fauci about other reasonable paths forward to protect ourselves from this and future pandemics.  Thank you.

                This article is not meant to be or interpreted as medical advice.  All medical and health care decisions should be only be made between the reader and his or her health care provider. 

References

1. http://www.cdc.gov/vaccines/vpd

2. Maltz, F.: Shingrix: A New Herpes Zoster Vaccine. P T. 2019 Jul; 44(7): 406-409, 433. https://www.ncbi.nlm.nih.gov>Pmc

3. www.pharmacist.com/shingles-vac

4. http://www.cdc.gov.briefing

5. Preliminary In-season 2019-2020 Burden Estimates, October 1, 2019 through April 4, 2020 U.S. Infulenza Surveillance System CDC.gov

6. www.weforum.org/agenda/2020/11/vaccines-on-the-horizon-how-business-leaders-can-plan-ahead/

7.  www.weforum.org/agenda/2020/11/astrazeneca-covid19-vaccine-effective-results

8. www.cnn.com/2020/10/05/health/covid-19-vaccine-willingness-cnn-poll-wellness/index.html

9. Herd immunity and Covid-19 – what you -need-to-know/ Mayo Clinic.org June 30,2020

10. The Diabetes Prevention research group (Haffner, S., Temprosa., M., Crandal, J., et al.: Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J. Med 2002, 246:393-403.

11. The Diabetes Prevention research group (Haffner, S., Temprosa., M., Crandal, J., et al.: Intensive lifestyle intervention or metformin on inflammation and coagulation in participants with impaired glucose tolerance. Diabetes. 2005 May;54(5):1566-72. doi: 10.2337/diabetes.54.5.1566.

12. Irish, A., Dogra, G., Mori, T., et al: Preventing AVF Thrombosis: The Rationale and Design of the Omega-3 Fatty Acids (Fish Oils) and Aspirin in Vascular Access Outcomes in Renal Disease (FAVOURED) Study. BMC Nephrol. 2009 Jan 21;10:1. doi: 10.1186/1471-2369-10-1.

13. Rodgers, G. P., Collins, F. S.: Precision Nutrition-the Answer to "What to Eat to Stay Healthy". AMA. 2020 Aug 7. doi: 10.1001/jama.2020.13601.

14. Ryback, R.: Why French women don’t get fat? Unpublished manuscript.

15. Trompette, A., Gollwitzer, ES., Pattaroni, C., et al: Dietary Fiber Confers Protection against Flu by Shaping Ly6c- Patrolling Monocyte Hematopoiesis and CD8+ T Cell Metabolism. Immunity. 2018 May 15;48(5):992-1005.e8. doi:10.1016/j.immuni.2018.04.022.

16. Zhao, L., Zhang, F., Ding, X., et al: Gut Bacteria Selectively Promoted by Dietary Fibers Alleviate Type 2 Diabetes. Science 2018,359, 1151-1156.

17. Kaczmarczyk, M. M., Miller, M. J., Freund, G. G.: The Health Benefits of Dietary Fiber: Beyond the Usual Suspects of Type 2 Diabetes Mellitus, Cardiovascular Disease and Colon Cancer. Metabolism. 2012 Aug;61(8):1058-66. doi: 10.1016/j.metabol.2012.01.017.

18. Miki, T., Eguchi, M., Kurotani, K., et al: Dietary Fiber Intake and Depressive Symptoms in Japanese Employees: The Furukawa Nutrition and Health Study. Nutrition. 2016 May;32(5):584-9. doi: 10.1016/j.nut.2015.11.014.

19. Pascoe, A. R., Fiatarone Singh, M. A., Edwards, K. M.: The effects of exercise on vaccination responses: a review of chronic and acute exercise interventions in humans. Brain Behav Immun. 2014 Jul;39:33-41. doi: 10.1016/j.bbi.2013.10.003.