The Darya Rose Show
July 5, 2021

The Ultimate COVID vaccine Q&A with Dr. Jennifer Grier

The Ultimate COVID vaccine Q&A with Dr. Jennifer Grier

Professor of Immunology, Dr. Jennifer Grier, answers questions about the development, safety and long-term effects of the COVID-19 vaccines.


Dr. Jennifer Grier is an Assistant Professor of Immunology at the University of South Carolina School of Medicine Greenville. Dr. Grier earned her Ph.D. from the University of Pennsylvania where she studied the innate immune response to viral infections. At the school of medicine, Dr. Grier teaches virology and immunology to the first- and second-year medical students while her research lab studies immune responses in the lung during viral and bacterial respiratory infections. She lives in Greenville, South Carolina with her husband, their three cats, and a rotating cast of foster animals.

Emergency Use Authorization for vaccines explained

Understanding mRNA COVID-19 vaccines

Different COVID-19 Vaccines

Guillan-Barre Syndrome

Jennifer Grier, Ph.D at University of South Carolina

Jennifer Grier on Twitter @DrGrier

 

Transcript

Dr. Darya Rose:  [00:00:00] I'm Dr. Darya Rose and you're listening to, The Darya Rose Show where we bring a fact-based perspective to answer all of those confounding questions that come up in our day to day lives from achieving optimal health, to making conscious choices about your purchases and raising kids that thrive. We are here to help you navigate your life with confidence.

Hello friends and welcome back to the Darya Rose Show. Today we have the ultimate COVID vaccine Q&A discussion with Dr. Jennifer Grier. We'll talk about how vaccines work, how the new COVID vaccines were developed and tested for safety. What it means that they were approved for emergency use, potential long-term risks, and what's different between the mRNA vaccines and the adenovirus vaccines.

We'll talk about how risks are assessed for children and pregnant women, as well as how long immunity lasts and what we can expect in the future. And we'll try really hard to make the science as [00:01:00] simple and understandable as possible. So you can feel confident that you understand what's important when making decisions for yourself and your family.

Dr. Jennifer Grier is an Assistant Professor of Immunology at the University of South Carolina School of Medicine Greenville. Dr. Grier earned her PhD from the University of Pennsylvania, where she studied the innate immune response to viral infections. At the School of Medicine, Dr. Grier teaches virology and immunology to the first and second year medical students while her research lab studies immune responses in the lung during viral and bacterial respiratory infections, super, super relevant to what we're talking about today.

She lives in Greenville, South Carolina, with her husband, their three cats and a rotating cast of foster animals. It is a great discussion and I really hope you enjoy it and learn a lot. Jennifer, welcome to the show.

Dr. Jennifer Gr...:  Thank you. I'm excited to be here.

Dr. Darya Rose:  I am so excited to talk to you. I have been thinking so much about vaccinations, uh, for many years now because I'm a fairly new mom. [00:02:00] I have a three-year-old and a two-year-old and obviously it's something that comes up a lot. And so I was, I was sort of excited about doing a vaccine episode or I'm gonna probably do a few, but then COVID.

Dr. Jennifer Gr...:  Oh, yeah.

Dr. Darya Rose:  So when I, when I started trying to figure out what to do and I started asking my audience what they wanted to know about vaccines, I just got flooded with COVID questions. So I thought that we would just start there and, [laughs] and see where this-

Dr. Jennifer Gr...:  That sounds good.

Dr. Darya Rose:  So let, let's start with just the basics. So I think that in order to, for everybody to follow the conversation, we just have to have sort of a baseline about what we're talking about. So can you just sort of the background of how vaccines work to induce immunity? And I know everybody's, a lot of people are concerned about the COVID vaccine specifically, is kind of new technology. Can you kind of talk about how vaccines work and how we got to this particular vaccine and, and just, just sort of the fundamentals?

Dr. Jennifer Gr...:  [00:03:00] Yeah, of course. So the general idea behind the vaccine is to effectively introduce your immune system and your body to a pathogen but in a way that's not actually gonna cause you any disease. So usually it's a weak form of whatever the agent might be. And when I say pathogen, I really mean anything that can cause a disease. So it might be a virus, it might be a bacteria, there's even hopes that we might have vaccines against cancer at some point in the future. So it could really be anything that could cause disease but we obviously don't wanna give you the full thing and get, get you sick.

Dr. Darya Rose:  Right.

Dr. Jennifer Gr...:  So the idea with a vaccine is, is to just give a piece of it or a really weak version. And so it might be, uh, some... Some of the original vaccines that were started when research started on vaccines was just to kill the, the original pathogen. So you could just heat it up until it died and then you could give it to somebody and that person would see parts of the virus or parts of the [00:04:00] bacteria, know that it was something attacking, fight it off and then be ready if it were to see that disease again in the future.

Dr. Darya Rose:  So when you heat up a pathogen, it, it breaks to parts?

Dr. Jennifer Gr...:  So it sort of dies. You can almost think of it like cooking a piece of meat.

Dr. Darya Rose:  Okay.

Dr. Jennifer Gr...:  So it's, it's still there. It's still present. It's still kind of looks like the disease but it's no longer living. It's not gonna do any damage to the person that receives it.

Dr. Darya Rose:  Got it. And, and then you inject it usually?

Dr. Jennifer Gr...:  So the most common way is we've done this as sort of, sort of injections into the muscle and yeah, that's the sort of the common way. Most of the vaccines that we have are done that way through sort of a shot. There are studies going on to find other ways to give vaccines. And I think for a while there we had a flu vaccine that you could sort of inhale through your nose which was called, it was called FluMist. And I think we only had it for a couple of years just because we found that the, the other forms worked just better. So the shot form was great.

Dr. Darya Rose:  Got it. I [00:05:00] think my, one of my kids or both my kids got oral rotavirus. Is that the one that they give orally? Yeah.

Dr. Jennifer Gr...:  Yes, yes, yeah. There are some oral forms as well.

Dr. Darya Rose:  Mm-hmm [affirmative]. Very interesting. And I, I can understand a little bit why, why that would be a little bit scary. [laughs] That just be like, “Here's some polio, it's fine.”

Dr. Jennifer Gr...:  Yeah.

Dr. Darya Rose:  "Just take it." So how, how are they tested for safety? Like how do they know that it's dead?

Dr. Jennifer Gr...:  Yeah. So with a full virus. So if I was gonna take a full virus, a full bacteria and kill it, before I could give it to anybody, I would have to confirm that it was really, really dead and not able to cause disease and kind of backing up a little bit. I forgot to mention that not every vaccine has the full pathogen in it. So there's actually a whole class of vaccines that include just pieces. So rather than seeing a full virus you might just see one protein or a couple of different molecules that are important too, for the [00:06:00] pathogen to survive. And so if we can target those and block those, then now we don't have the infections. But if we are worried about safety and which we always are when we introduce any sort of new treatment or drugs, there's a whole process that any new approved drug has to go through for approval. So usually that starts with studies in animals just to get an idea of, is it safe?

Dr. Darya Rose:  I'm curious, how many... Do you know... So I used to work in a molecular biology lab and-

Dr. Jennifer Gr...:  Mm-hmm [affirmative].

Dr. Darya Rose:  ... we, there's lots of different animals. So for a vaccine trial specifically, is it mice? Is it rats? Is it ma- like higher mammals? What, what do they, what, what are the typical sort of stages that they have to go through for that safety protocol?

Dr. Jennifer Gr...:  Yeah. So initially it usually starts with mice simply because they're, they're well-studied and they're somewhat, I don't want, for lack of a better word, cheap. Um, there, you can get a lot of them. You can study a lot of them. They're, they're small, they're easy to handle, but before it would go into humans, you would go into probably [00:07:00] rats, we use occasionally. There may be some other mammals in there but most of the time the last step in animals before it goes into humans is, is monkeys of some sorts. So chimpanzees, bonobos, so something as close to we genetically as we can get to the human immune system and body without quite going into humans yet.

Dr. Darya Rose:  And in those animal studies, are they generally looking for acute issues or how long do they study them? Because a lot of people are asking about long-term effects. We'll get more into that later, but I'm curious at the animals study level, like how, how far do they take those safety trials?

Dr. Jennifer Gr...:  Yeah. So that's a good question. And I, I can't say that I know for certain because part of the reason is these safety trials are gonna differ based on which animal you're looking at. The, the lifespan of a mouse is much shorter than a human. So trying to do a two or three-year long study-

Dr. Darya Rose:  Or a monkey. [laughs]

Dr. Jennifer Gr...:  Yeah. Um, trying to do two or three year study in mice is just not gonna work. But in monkeys, uh, you may do a couple of months. I think months are usually the range that we're looking at. There's also [00:08:00] the, the benefit of doing this in animals is that you can sort of control the exposure. And so we don't necessarily, when we do this to, to humans, you give the vaccine and then you have to wait for a natural exposure to whatever we're trying to protect against. But if you're doing this in animals in the lab, you can give the vaccine, wait until they've developed the protection, which is usually, uh, two to three weeks after the second dose or whenever the last dose is. And then you are able to just give the agent and see if they're protected or not. So you can get answers actually quite quickly in animal trials that might take longer in humans.

Dr. Darya Rose:  Got it. So it sounds like the number one thing they're testing for is efficacy. And obviously if there was some super acute issue, they would see that as well?

Dr. Jennifer Gr...:  Yeah. Well, and they would see safety as well. So they're, they're not necessarily gonna end the trial as soon as they do the exposure. They would follow the, these animals out for probably, like I said, about two [00:09:00] months, I think is the general range. And so you will get that kind of idea of, oh, a week or two later, how are they doing? And maybe a month later, how are they still doing and kind of, so we, we'll see the hyper acute for sure if there's going to be anything that goes wrong. But then you'll also see some of that, like things that might happen shortly after the vaccine, if there was gonna be any safety concerns.

Dr. Darya Rose:  And, and what kind of things are those? Like, what are they looking for specifically?

Dr. Jennifer Gr...:  Yeah. So the biggest thing that we're always looking for is allergic reactions, because those can be really severe if somebody has an allergic response to the vaccine. Beyond that they can be highly variable and often it's dependent on the disease that you're, that you're researching. So for example, I think one of the, the things that we sometimes will see is if the disease causes a particular complication, we wanna make sure that the vaccine doesn't cause that as well, whether it's some type of hyperinflammation or some sort of [00:10:00] damage to a particular tissue. You just wanna make sure that whatever piece of the, the virus or the pathogen or the milder version that you're giving, isn't able to cause similar symptoms.

Dr. Darya Rose:  I see. So kind of like what we're seeing with the COVID vaccine. I know that COVID has been associated with blood clots in certain people and we're seeing at least some families of the, of the vaccine, the vaccines that have been developed are, do seem to be resulting in some blood clots.

Dr. Jennifer Gr...:  Mm-hmm [affirmative].

Dr. Darya Rose:  And so that's the type of thing you would be looking for. And it is a sort of thing that would come up fairly soon.

Dr. Jennifer Gr...:  Yeah. You would expect to see that. I think historically if we've seen complications from vaccines, they really have happened in that, the two month window after vaccination. So that's all the more reason why we're studying people at least two months out after vaccines, before we're even considering approval.

Dr. Darya Rose:  Got it. So that was my next question is, how long are the humans followed after in the, in the early trials, how long are they followed after we get, given a vaccine?

Dr. Jennifer Gr...:  Yeah. So after obviously we do the animal trials and it's, it looks safe, [00:11:00] uh, and effective in the animal trials, then it'll go into humans. And really the first trial is just a safety trial. They're not even trying for, uh, whether it's gonna work or not to prevent this, but just, is it safe to give to people? And so they're really gonna wait, these, the researchers doing these experiments are gonna wait sometimes two to three months to see what the initial response is, but then that doesn't necessarily mean they're gonna stop studying. So the people that got the vaccine in the very first phase one clinical trials, which I think we're now coming up on almost a year ago, they are still being studied.

Dr. Darya Rose:  Got it.

Dr. Jennifer Gr...:  So we're still collecting data from them. So if we were going to see something longterm, we're not gonna miss it. We're still collecting that data.

Dr. Darya Rose:  And does that continue like indefinitely? So for example, vaccines that were developed 30 years ago are the first kids that were in those trials still, like if they get cancer or something horrible like that, you know, and they're, they start, there starts to be some, some thing, is that, would that be seen at this point?

Dr. Jennifer Gr...:  So we're not following quite that far out. [00:12:00] Uh, the COVID trials, I believe, uh, their first initial kind of study termination will be after two years. So two years from the receiving, from getting the vaccine, I think from the first dose for the ones that have two doses. So they should have quite a lot information. And within that two years, I think we'll have the, the understanding of, do we need to continue following these people further out or have we kind of passed the window of, we don't expect more complications to potentially appear.

Dr. Darya Rose:  Okay.

Dr. Jennifer Gr...:  And yeah, and again, historically, we really haven't seen any vaccine complications showing up past two months. So going out to two years is already well past what we would need based on the data that we have so far.

Dr. Darya Rose:  Really? So there's never been any complications that's gone up past two months?

Dr. Jennifer Gr...:  So I think some of the, the complications you've seen might be six weeks, but, but really it seems to be quite soon after the vaccine and not something that we see so far in the distance.

Dr. Darya Rose:  [00:13:00] For all vaccines?

Dr. Jennifer Gr...:  Yes.

Dr. Darya Rose:  Okay.

Dr. Jennifer Gr...:  Yeah. Across the board.

Dr. Darya Rose:  How, then is this all this process changed? Because I know with the COVID vaccine, we have done the Emergency Use Authorization. So we're-

Dr. Jennifer Gr...:  Mm-hmm [affirmative].

Dr. Darya Rose:  ... which parts were skipped?

Dr. Jennifer Gr...:  Mm-hmm [affirmative]. None of them actually.

Dr. Darya Rose:  Oh, cool.

Dr. Jennifer Gr...:  Yeah. So just to highlight kind of what happened. I think we were talking about the vaccines and there's a couple of things that have happened since we first started with vaccines to get us to where we are now. What I think has been really, really important is that all this time we've been studying the vaccines that we've created to find better ways to make them to make them faster and more efficient. And we're studying the pathogens too, so that we understand which proteins or which pieces of the pathogen we can use in the vaccine that's gonna be the safest and the most effective potentially. And so these vaccines were done using information that we, we already had from SARS coronavirus one.

[00:14:00] So back in the, the early 2000s, we had that outbreak of SARS one that was obviously a really concerning disease. And so there was a lot of study on that and people found which proteins were most important for the virus to infect. And they were able to sort of start understanding the, the biology of the virus so that when SARS-CoV-2 appeared, and this is the virus that causes COVID, we already had a ton of information from SARS-CoV-1. So we, it wasn't starting at a blank slate. We could have take what we already knew about COVID one and just apply it and update it for their new information. So it saved us a lot of time. So we were able to get to an authorized vaccine, much quicker.

Dr. Darya Rose:  My God, we are so lucky. [laughs]

Dr. Jennifer Gr...:  Yes. Absolutely.

Dr. Darya Rose:  We are so lucky because I mean, first of all, SARS one was so much worse. I mean, it was so more deadly-

Dr. Jennifer Gr...:  Yes.

Dr. Darya Rose:  ... and we're so lucky that we were not only able to contain that before it really did as much of an [00:15:00] infection as, as, as COVID. But also that we were able to learn so much to kind of get ahold, I mean, obviously this one is still a disaster, but at least we now have vaccines. And I went on vacation last week and I haven't been like locked in my house still [laughs] you know, like that, that part's kind of ending. So that's, that's amazing. The dosage. So how, like during the trials, how do they, do they give different doses and, and figure out the most effective one? Do they start that process in animals and then sort of guess about humans based on body weight? Or how does that go?

Dr. Jennifer Gr...:  Yeah. So both. They do in animals, they will try different doses and then they'll scale those up to humans based on body weight. So we can figure what dose per, you know, kilogram or gram based on the animal and then you can scale it up to a human. But then they will try a couple of different doses because as, as good as the animal models are, they're obviously not the same as a full human being. So they do try a couple of different doses. So if I remember correctly, [00:16:00] Moderna tried two or three different doses and found at their highest dose, they had some, that they had good immune responses but the side effects were much stronger. And then on the lower end you got a reasonably good immune response, slightly less side effects. And so I think they actually ended up kind of in the middle with their middle dose, where they have some side effects, but they're manageable, but you do get a really strong immune response that then hopefully at the time they were hoping would translate into protection.

Dr. Darya Rose:  So back to the emerge- Emergency Use Authorization then. So if they didn't skip any steps, why, why doesn't it just get the full approval right away?

Dr. Jennifer Gr...:  So it's partially because we don't have or at the time that they were applying, we didn't have real world data. So we didn't know how this would, how the vaccine would work in people living their day-to-day lives. So what instead they started out with was the data from their phase three trials, which was really thousands of people, 20, 30,000 people across [00:17:00] these trials that got the vaccines. Uh, and they followed them for, I think at least two months. And some of these patients, they had data for, for further out, and then they are able to apply. And what, the decision is coming from the fact that this is a disease that's causing death. So there's definitely advantage to getting this out sooner rather than later.

So the thought with the FDA Emergency Use Authorization is if we get this vac out, vaccine out, we can start saving people's lives now while we finish collecting this data, get more information, get more sort of examples of how it works in the real world. Because you can imagine that people that are part of this vaccine are probably people that are behaving very carefully. So they're probably, you know-

Dr. Darya Rose:  You mean people in the trial?

Dr. Jennifer Gr...:  Yeah, in the trial. Sorry. In those initial trials, they, they knew the seriousness of, uh, the infections. And so they were probably the people that were masking and distancing and staying home as much as possible. Whereas, [00:18:00] you know, once you get it into a larger population, there's so many more variables and behaviors and activities. And so you don't always know if that initial trial is going to look the same-

Dr. Darya Rose:  Right.

Dr. Jennifer Gr...:  ... as it is in the full population.

Dr. Darya Rose:  Yeah. It's also a numbers game, right? 'Cause it sounds like-

Dr. Jennifer Gr...:  Absolutely.

Dr. Darya Rose:  ... the blood clots are really like really few. And you might, that's the sort of thing that you might not catch in a trial of 30,000 people because it only happens in like one in 10 million people or whatever, whatever the numbers are there.

Dr. Jennifer Gr...:  Yes, exactly.

Dr. Darya Rose:  Crazy. Okay. So, so the FDA decided to get it out, but, uh, presumably are they, they're gonna go through this process, right? Is it, is it just that the FDA process is slow and because of like bureaucracy, is that... So the science wasn't, wasn't compromised, but-

Dr. Jennifer Gr...:  Correct.

Dr. Darya Rose:  ... The bureaucracy part is what takes forever and that they decided to skip?

Dr. Jennifer Gr...:  Yes and no. So there is definitely, so the safety requirements for authorization are exactly the same between emergency use and [00:19:00] full use. So there's no shortcuts on the safety side. It's just a matter of how much data you have to collect. So it's sort of saying like, how confident are we in this data? And so at the point of the Emergency Use Authorization, they did have, like I said, a couple, it was like 30,000 patients and that's enough for a reasonable confidence, but it's not full confidence. And so the difference is just how much data did you have.

Dr. Darya Rose:  I see. So for example, if there weren't a pandemic and this was just a disease that happened if you traveled to the tropics, then it would go through the normal process. And then how many people would they have had to do the trial on like 50,000, a hundred thousand?

Dr. Jennifer Gr...:  So they probably would have done, yeah. They probably would have done more people and that would have just been over a longer time period as well. For better or worse since COVID was spreading so quickly at the time that they were doing the trials, they actually had a fair number of people get infected quickly in the placebo [00:20:00] group. So you could-

Dr. Darya Rose:  I see, yeah, yeah.

Dr. Jennifer Gr...:  ... you had that comparison. Um, so they got-

Dr. Darya Rose:  So the issue... Right. The issue could be that if, if people are being super careful and, and they're now vaccinated, then you might not see any cases for a long time?

Dr. Jennifer Gr...:  Right.

Dr. Darya Rose:  And then it would take you a long time to get a proper number to say, this is 80% effective or whatever. But because there was a lot of COVID-

Dr. Jennifer Gr...:  Unfortunately, yeah.

Dr. Darya Rose:  ... then a lot of people did actually get breakthrough infections or whatever, and it was enough to give them numbers that they could use then to say, this is our, this is our effective? Right.

Dr. Jennifer Gr...:  Yeah, yeah. Exactly.

Dr. Darya Rose:  Okay. Got it. Sorry. It took me a second. Okay, cool. So it's sounds like on that front, it's going pretty well. Can you talk a little bit about mRNA vaccines because I know there was some concern about those being on the newer side. And, and I think, I think people get a little scared by new science words. When I [00:21:00] think of mRNA, I have decades of history in my brain that makes me be like, “Oh, that's gonna be clearly better, [laughs] clearly.”

Dr. Jennifer Gr...:  Yeah.

Dr. Darya Rose:  Like to me, that, that sounds clearly better, but I'd love for you to explain kind of the different types of vaccines and what, what we can, how we can feel about an mRNA new vaccine?

Dr. Jennifer Gr...:  Yeah. So I'm actually really excited to talk about this 'cause some of the work, the, the research that I've done in my past was looking at immune responses to RNA. So this is actually, I was, I was so excited when I heard that there was mRNA vaccines in the process. So really the idea behind the mRNA vaccine is that rather than giving a piece of the virus or a protein or a dead virus, we're really kind of giving instructions to the body on how to make that piece of the virus. And so it's turning the cells of the person that gets the vaccine into a factory to make these proteins just for a short amount of time.

Dr. Darya Rose:  And that's what the virus does too, right?

Dr. Jennifer Gr...:  Right. A virus infection is going to make just as much [00:22:00] if not significantly more.

Dr. Darya Rose:  Right. [crosstalk 00:22:02]. So if a virus infects a cell, it's gonna inject its own genetic code and you're cell, your own cell machinery is gonna start copying using, it's gonna use your cell machinery to make copies of itself and like spread out. So it's gonna be every single protein that is needed to repackage the virus, right? And so in this case they're putting in a part of the code but just a tiny part of it, right?

Dr. Jennifer Gr...:  Yeah. So most of the vaccines for COVID are based on just one protein and that's the spike protein and it's a protein that's sort of on the surface. So it's not even something that could have a function inside your cells that might do some damage. It's just, it shows up on the surface of the cells. So yeah. So we can give this piece of mRNA. It goes into the cell, the cell's own machinery starts to kind of copy it and make, um, new versions of it and really turn it into proteins. So it's really making copies of the protein, not making [00:23:00] copies of the mRNA and it puts those on the surface and that is going to be sort of the symbol or the, the signal to the immune system that, “Hey, something's here, that isn't supposed to be here.” And that's gonna trigger the immune response to start and respond.

And the nice thing about mRNA, doing this with mRNA is one, it's really easy to make. So one of the questions you asked earlier is, if you're giving a dead version of a virus, how do you know it's dead? If I'm giving a piece of mRNA, it was never alive in the first place. So I don't have to worry about making sure that it's dead and can't in fact or can't do no more damage. It's literally just a piece of molecules. And so that means that they're usually kind of, there's less safety precautions, not safety precautions, but there is less concerns about the safety with this.

Dr. Darya Rose:  Right. Because it's, because it's, because it's not, the entire virus it's gonna have less of the parts that are dangerous?

Dr. Jennifer Gr...:  Yeah, exactly. And it doesn't even have any of those parts. In fact, all it has is I think of it almost [00:24:00] like, like I said, it's almost like instructions for how to make it. So the instructions for something that could do damage, the instructions themselves are not particularly damaging.

Dr. Darya Rose:  Although it does seem like there might be some... The spike protein seems really sticky, right?

Dr. Jennifer Gr...:  Yeah. It does. We're, we're definitely learning more about the spike protein as we follow, as we learn more about this virus in general.

Dr. Darya Rose:  Yeah. So yeah. So that's, but the, the real risk is gonna be, if the spike protein itself does something wonky and it seems like it may be in a few people that makes them-

Dr. Jennifer Gr...:  Maybe.

Dr. Darya Rose:  Maybe. [laughs]

Dr. Jennifer Gr...:  Yeah.

Dr. Darya Rose:  Maybe it makes them-

Dr. Jennifer Gr...:  Right.

Dr. Darya Rose:  ... clotting things happen, but for the most part it's yeah, you're just giving instructions and then... So, so you, so the injection is in your shoulder muscle.

Dr. Jennifer Gr...:  Mm-hmm [affirmative].

Dr. Darya Rose:  And so the cells that then take up the mRNA are gonna be muscle cells that are presenting the-

Dr. Jennifer Gr...:  Yes.

Dr. Darya Rose:  ... the spike protein.

Dr. Jennifer Gr...:  Yes.

Dr. Darya Rose:  And that's why your arm gets sore.

Dr. Jennifer Gr...:  Sore. [laughs]

Dr. Darya Rose:  Got it. Does it move [00:25:00] around? Like once it's in your arm, does it move around your body?

Dr. Jennifer Gr...:  So, um, it can a little bit. So those nanoparticles or the nano lipids that are used to kind of help get the mRNA into the cells. It is possible that those could kind of travel a little bit, right? They're kind of in the space between cells when you first inject it but then they're, as they come in contact with cells, they are sort of gonna almost think of like, if you ever put oil in water, you might have some oil bubbles that float around on the surface, but when they contact each other, sometimes they'll merge.

Dr. Darya Rose:  Mm-hmm [affirmative].

Dr. Jennifer Gr...:  And so what's really happening is those lipids are kind of floating around and as they come in contact with the cells, they'll kind of merge and just release that mRNA that's inside into the cytoplasm of the cell. So a single nano lipid might float around for a little bit longer and not merge right away. It might make it a little bit further, but eventually it's gonna come in contact with that membrane and, and it, that's, there it's gonna stop.

Dr. Darya Rose:  And so then all the immunity [00:26:00] comes from those muscle cells presenting the spike protein?

Dr. Jennifer Gr...:  So that is definitely a big part of it. There's, there's definitely a lot more in kind of like how the immune system talks to itself and responds. And some cells will take pieces of it and travel to your, your lymph nodes, but really it starts with the expression of the mRNA in those muscle cells.

Dr. Darya Rose:  It's kind of amazing that that works. [laughs]

Dr. Jennifer Gr...:  Yeah. It's really amazing. And the add, I mean the added benefit of mRNA is it, the mRNA of the vaccine stays in the cytoplasm. So there's no change to the cellular DNA. So you don't have to worry about longterm changes to somebody's muscle cells. And then mRNA itself is somewhat unstable, which has turned into some concerns with having to keep all the vaccines super cold. So for transport, but it also means that once you put it in, it's gonna start to degrade relatively quickly. So it's not like you were gonna have this mRNA sticking around for years so that you're always making spike protein. And in fact, [00:27:00] after a couple of days, it seems like you're, you stop making it. And that's still enough for an immune response.

Dr. Darya Rose:  Yeah. So, so mRNA doesn't get at all incorporated into DNA, right? Because that is-

Dr. Jennifer Gr...:  Correct.

Dr. Darya Rose:  ... not, they're not compatible and there are generally mRNA. So mRNA are like these little, little bits of, of genetics that sort of code for a specific protein.

Dr. Jennifer Gr...:  Mm-hmm [affirmative].

Dr. Darya Rose:  And, so there's, your cells are making proteins all the time. So there's like tons of RNA like floating around in your cells.

Dr. Jennifer Gr...:  Yes.

Dr. Darya Rose:  So it has a disposal process for those?

Dr. Jennifer Gr...:  Oh, yeah. Yeah. We have tons of the mRNA and they can get degraded by enzymes or they're just, sometimes they're kind of unstable and they fall apart on there-

Dr. Darya Rose:  Just fall apart.

Dr. Jennifer Gr...:  Yeah.

Dr. Darya Rose:  This is still pretty new technology though, right?

Dr. Jennifer Gr...:  Yes.

Dr. Darya Rose:  Like in terms of using it as a human vaccine?

Dr. Jennifer Gr...:  So relatively new, although the studies have been kind of ongoing for these mRNA vaccines for a couple of years. And so I think, Moderna actually was, has some studies to do mRNA vaccines with Zika virus. So if you [00:28:00] remember Zika virus from a couple of years, years ago.

Dr. Darya Rose:  I was pregnant. I was terrified. [laughs]

Dr. Jennifer Gr...:  Oh my goodness. Yeah. So this is something that they've been studying for a while. And that's another reason why we were able to get a vaccine to market so quickly is, they had already kind of worked out all the kinks in the process of making an mRNA vaccine. And then all they had to do was change from whatever protein in Zika they were studying to now the spike protein and COVID. And, and yeah, and that's a pretty fast change. You can just do that in, as soon as you have the sequence, you're pretty much ready to start making that mRNA.

Dr. Darya Rose:  So I can imagine that like we're about to be flooded by mRNA vaccines.

Dr. Jennifer Gr...:  Yes.

Dr. Darya Rose:  Because this has gone really well. [laughs]

Dr. Jennifer Gr...:  Yeah. I believe Moderna is already working on two or three more other vaccines against other viruses that are based on mRNA.

Dr. Darya Rose:  So you mentioned the, the nano lipids and yeah, I liked your analogy of sort of oil on water. So, right. So cell membranes are made out of fats. Lipid is another word for fats.

Dr. Jennifer Gr...:  Mm-hmm [affirmative].

Dr. Darya Rose:  And [00:29:00] basically in order to get to fat bubbles to merge. So, or if you want anything to go into the fat bubble, that's your cell, you need it to be another fat bubble. So you put the mRNA inside of the little fat bubble and it merges with the other one and then it's inside your cell, which is where we want it. So I'm curious, like, I, that sounds all great, but I'm sure there's other like stabilizers and other things that need to be in there. Do we know actually what's inside the, do we know all the ingredients in the COVID vaccine?

Dr. Jennifer Gr...:  For most of them, yes. So you can go online and if you just Google COVID vaccine ingredients, uh, and find a reputable source. So I believe the CDC has some information out there and that you can find the full list, about what the, what's in there. The only thing you may not find the exact molecule name for is the lipids themselves because the companies have kind of made their own version of the lipid and that's where their-

Dr. Darya Rose:  They're proprietary. [laughs]

Dr. Jennifer Gr...:  It's proprietary. That's where they're gonna make their money, but everything [00:30:00] else that's in there, you can find. And so a lot of the things that are in there are, are pretty much salts and sugars that are just stabilizing the, the nano lipids and, and salts and sugars that's in our diet, that's in the bloodstream already. So they are-

Dr. Darya Rose:  And that's why it stabilizes it, right?

Dr. Jennifer Gr...:  Yeah.

Dr. Darya Rose:  Cause that's what a cell sits in.

Dr. Jennifer Gr...:  Exactly. So those, I wouldn't expect those to be causing you much of, uh, of an issue because those are things that are already present in significant quantities in our bodies already.

Dr. Darya Rose:  So there's no mercury or arsenic or anything fun like that in there?

Dr. Jennifer Gr...:  No, not at all.

Dr. Darya Rose:  When, when I was asking people about this, I, the biggest question I got over and over again was concerns that it was developed too fast and that we don't know what's gonna happen in 10 years. And so, I mean, based on everything you just said, which is, uh, squares with everything I've already heard about-

Dr. Jennifer Gr...:  Mm-hmm [affirmative].

Dr. Darya Rose:  ... from immunology in my training, which was not nearly as extensive as yours, I'm wondering where these, where these fears are coming from? I mean, I, the, [00:31:00] the quickness totally makes sense. I mean-

Dr. Jennifer Gr...:  Yes.

Dr. Darya Rose:  ... most people don't know, uh, what you just described about how we had SARS one, and that-

Dr. Jennifer Gr...:  Mm-hmm [affirmative].

Dr. Darya Rose:  ... that was such a scary disease. And a lot of scientists just like went to town, trying to figure that out in case it ever got out again. And also it makes total sense that the mRNA vaccine had been in the works and-

Dr. Jennifer Gr...:  Mm-hmm [affirmative].

Dr. Darya Rose:  ... that we just sort of poured it, this idea into that package, which turned out to be fantastic. [laughs]

Dr. Jennifer Gr...:  Yeah.

Dr. Darya Rose:  Um, but you know, I don't... Yeah. So that part to, to me makes sense. The part that I, is harder to grok is the, the long-term effects that don't, that we don't have any data for.

Dr. Jennifer Gr...:  Right. So this is hard because there's, there's always the possibility as, so as a scientist I hate to say there's no chance, right? Because there's, there's always new information that we might get that might say that, “Oh, there is [00:32:00] this one potential.” But historically we, I mean, we have a lot of vaccines that are already available and we just don't see long-term effects in, with vaccines. We don't see long-term side effects. Obviously we have long-term effects because they're effective for years, but we, we are seeing 10 years after the measles vaccine, we're having some change. We're not seeing it with any of the, like the tetanus or pertussis or any of these other vaccines.

So we just, there doesn't seem to be a historical ground for these concerns, but it doesn't mean they aren't valid concerns, Absolutely. But, but if anything going from say a killed virus or a protein piece in a vaccine back to mRNA, the mRNA itself is, is almost safer and even more inert-

Dr. Darya Rose:  Right.

Dr. Jennifer Gr...:  ... than those killed versions or some of those modified weakened versions. And so we've, we've kind of taken a step to the safer side. And so I'm [00:33:00] pretty confident saying that we are unlikely to see long-term effects and alternately, I mean, there, there might be something about COVID, right? There may be something. We mentioned the spike protein is sticky and weird and it seems to be doing something. And to me, I think about if we didn't have this vaccine, then chances are we'd all probably get COVID at some point and we're all gonna get exposed to that spike protein, but we're gonna see it in the context of the virus, which has all of the other nasty pieces of the virus happening, plus that risk for like the severe COVID, where people are in the hospitals and on ventilators.

So I, I can't say that there will never be any long-term risk from this vaccine, but I think for me, the risk of the infection is so much worse and, and highly, if I wasn't vaccinated, that's my future. So the vaccine it's sort of, that risk may be unavoidable if it even exists. But I do think it's unlikely with the vaccines.

Dr. Darya Rose:  [00:34:00] But the, but the other thing with COVID too, is that a lot of people are like, but I'm young and healthy and you just said maybe something in the future maybe, but a lot of people that are young and healthy get COVID and they're fine. And, or at least, you know, their symptoms are fairly mild and they recover and they feel that, that is a known risk, I think. And so that was another question, like, I, that I got a lot was, I'm young and healthy. Why bother, why, why not wait two years and see if, if something does come up with this vaccine that, that might be worse for me than a brief bout with COVID at the age of 30?

Dr. Jennifer Gr...:  Yeah. So I guess one thing that I, that's always in the back of my mind is we don't really know what the long-term effects of infection are either, right? So we don't know if 10 years down the line we're gonna find some sort of long-term issue in people that did have COVID even if they had a mild infection.

Dr. Darya Rose:  And in fact, we've [00:35:00] seen-

Dr. Jennifer Gr...:  Right.

Dr. Darya Rose:  ... some of that.

Dr. Jennifer Gr...:  And we are.

Dr. Darya Rose:  That's just scary to me. That's what I've, I'm like,

Dr. Jennifer Gr...:  Yeah.

Dr. Darya Rose:  ... I'm very likely to be an asymptomatic person. I'm like so healthy and I never get sick, but I'm like, “I don't know if I'm gonna get problems down the road from this disease, which seems to like have like effects in the brain, effects in the heart effects, in the lungs.” Like, ugh, yeah. [laughs]

Dr. Jennifer Gr...:  Right. So to me, I think risking COVID, even if you feel like it's probably not gonna be a bad infection for you is kind of a gamble because we, we don't know what that long-term effect is gonna be. And then you do, you hear these stories of someone in their twenties and thirties that was healthy and active-

Dr. Darya Rose:  That died.

Dr. Jennifer Gr...:  ... and they do get a serious, severe infection-

Dr. Darya Rose:  Or died.

Dr. Jennifer Gr...:  ... and it gets away. Yeah.

Dr. Darya Rose:  There are kids who have died from COVID. People act like-

Dr. Jennifer Gr...:  Yeah.

Dr. Darya Rose:  ... kids are immune to it, which is absolutely false. [laughs]

Dr. Jennifer Gr...:  Right. Right.

Dr. Darya Rose:  It's like kids have died five-year-olds have died and it's tragic.

Dr. Jennifer Gr...:  Yeah. So the risks are, are still there. And so we're not seeing the vaccine [00:36:00] causing anything near the level of fatalities or side effects or these complications that the infection is.

Dr. Darya Rose:  Right.

Dr. Jennifer Gr...:  So, and, and like I said, if, if the vaccine is causing a long-term effect, it's probably gonna be something very similar to what we see with the full infection. And so you're, you're choosing if that long-term effect is gonna exist, do I want to take that risk with a vaccine or do I want to take it with the full or risk with the full infection and I think the full infection scares me-

Dr. Darya Rose:  Right.

Dr. Jennifer Gr...:  ... A little bit.

Dr. Darya Rose:  Yeah. Me too.

Dr. Jennifer Gr...:  Right.

Dr. Darya Rose:  It really scares me a lot. And that's why I'm still super cautious around my kids. I don't let-

Dr. Jennifer Gr...:  Mm-hmm [affirmative].

Dr. Darya Rose:  ... them go anywhere still [laughs] without a full hazmat suit. [laughs] But that's a joke, but yeah, I'm very, very protective around my children because I'm nervous about all that. So one thing also that comes up sometimes when, 'cause I, I spent a couple of weeks before prepping for this interview kind of in-

Dr. Jennifer Gr...:  Mm-hmm [affirmative].

Dr. Darya Rose:  ... in anti-vax.

Dr. Jennifer Gr...:  Yeah.

Dr. Darya Rose:  And one of the things that [00:37:00] people seem to be concerned about and I, and I've... Gosh, I've listened to a really long podcast about it, that didn't quite make sense to me, but there was people, people... Some people didn't seem to think that vaccines in particular and maybe not even specifically COVID, but vaccines in general can create like long-term autoimmune issues. And did you know the basis of this? Because I, I, I've, like I said, I listened to the podcast, I have scientific training and I was like, "So the B cells and blah, blah blah and they reduce your natural immunity versus your adaptive immunity." Have you, have you heard this stuff?

Dr. Jennifer Gr...:  I haven't heard the details, but I did when you asked sort of me to do this podcast, I kind of did a similar thing-

Dr. Darya Rose:  Mm-hmm [affirmative].

Dr. Jennifer Gr...:  ... where I kind of looked to see what, what are the myths and the information that's out there. And so I, I know that there's at least been one or two sort of like viral videos that, that made those claims. And there has been, uh, historically there is some potential side effects, the biggest one called, called [00:38:00] YAN Bah-RAY syndrome, which we saw with, I think it was a previous iteration of a flu vaccine, but that's for the record, YAN Bah-RAY happened, can happen with vaccines, but it can also happen with virus infections and it can happen with some common types of drugs. So that wasn't something that's specific for vaccines and it's really rare. And it's like-

Dr. Darya Rose:  Do you mean like, like recreational drugs or prescription drugs?

Dr. Jennifer Gr...:  Prescription drugs. Yeah. So it's, it's something that the, in the hospitals they keep an eye out for, but it is, it is pretty rare. And so that might've been kind of the... The original source is back when this first flu vaccine and I think, I'm looking at my notes as it was in the '70s. So this isn't anything recent. No recent vaccines, but, you know, so it is sort of like, uh, the body is reacting inappropriately to some sort of immune challenge, whether it's a vaccine or virus or drug. So I, I think it's, it's worth considering and looking [00:39:00] into, because I think we'd be remiss if we just said, "Oh no, we don't need to worry." Right?

Dr. Darya Rose:  Right.

Dr. Jennifer Gr...:  That's not really going to instill, uh, confidence in anyone.

Dr. Darya Rose:  Right. Right.

Dr. Jennifer Gr...:  But, but in looking at specifically, especially the mRNA vaccines, autoimmunity really means immune response against yourself. And so the mRNA vaccines that we're giving, it looks very similar to itself. So there isn't anything in there that says, "Hey, we need to, to destroy this." We make, each cell makes millions of copies of mRNA every day and that's survivable and it doesn't induce autoimmunity. And so I think it's unlikely with this. And the fact is now that we've been following patients that received the first clinical trial doses over, over a year ago and now millions of people since, and we're really not seeing these autoimmune flares ups or dysfunctions or anything like that.

Dr. Darya Rose:  Yeah. And it's hard to imagine why that would come very much late [00:40:00] later.

Dr. Jennifer Gr...:  Right. Usually if you're gonna get autoimmune response to something it's happening within the first week or two.

Dr. Darya Rose:  Right. You're not looking at something 10 years out-

Dr. Jennifer Gr...:  Yeah.

Dr. Darya Rose:  ... or 20 years out. Can we, let's talk a little bit about the adenovirus vaccines too because it's Pfizer and Moderna that are the mRNA vaccines-

Dr. Jennifer Gr...:  Mm-hmm [affirmative].

Dr. Darya Rose:  ... but the AstraZeneca and Johnson&Johnson are-

Dr. Jennifer Gr...:  Mm-hmm [affirmative].

Dr. Darya Rose:  ... based on a different technology, is that right?

Dr. Jennifer Gr...:  Correct. Yeah. So they're based on adenovirus. And what that is, is an adenovirus is really, for most of us, a common cold. We've probably been infected with multiple adenoviruses in our lives. And so what AstraZeneca and Johnson&Johnson did, and I think the Sinopharm, there's a couple of other vaccines built around the same idea, but they took that piece of the spike protein from the SARS coronavirus two and put it into an otherwise, mostly harmless virus, but then to be extra safe, they also [00:41:00] killed it too, or they made it a replication in competence. So it, it can get in, but it's never gonna make more copies. And so it's kind of just, again, in this case, the adenovirus is a delivery vehicle. It's just kind of like an envelope for a message with the message being the spike protein.

Dr. Darya Rose:  Is there... So those ones have been not as effective in a couple of ways. One, they, they don't seem to have quite the robust immune response that we're seeing from the mRNA, especially against some of the variants. So that was-

Dr. Jennifer Gr...:  Mm-hmm [affirmative].

Dr. Darya Rose:  ... something that was kind of a bummer, I thought-

Dr. Jennifer Gr...:  Yeah.

Dr. Darya Rose:  ... 'cause I would've loved for the Johnson&Johnson and AstraZeneca vaccines to be crushing the Brazilian variants-

Dr. Jennifer Gr...:  Right.

Dr. Darya Rose:  ... and the south African variant but it seems that if you live in those areas, you, you really wanna get one of the mRNA vaccines. But then the other issue was that those were the two that were starting to be linked to very, very, very, very rare blood clots and I don't think we quite understand why, you know.

Dr. Jennifer Gr...:  Yeah, no. [00:42:00] I, I actually looked into that 'cause I thought, “Well, this is something we, we definitely wanna talk about.” And it's not really clear why. So the first thought was maybe it's the spike protein, right? 'Cause we see clotting in the virus, we see clotting in, uh, just a few, very few people after these vaccines, but we're not really seeing this after the, the vaccines. So that makes me think that it's probably more about the adenovirus vector that we might wanna, to study that a little bit more.

And, and actually as I looked into the processes, we really, we're still not quite certain what causes the clotting after COVID. I think there's a lot of research happening and so we may know quite soon. But it seems like after the vaccines, it's, it's kind of related to potentially some of the, and now I've, I can't remember the word, just sort of like platelets and, and the there's one particular factor which I can't remember the name of now. So they, they have found, uh, sort of the involved piece [00:43:00] for the vaccine related clotting. And it seems to be actually kind of different than what we're seeing in the COVID related clotting.

Dr. Darya Rose:  Oh, interesting.

Dr. Jennifer Gr...:  Yeah. So it could be that there's an overlap and we just haven't found it, but the thought is, I'm not really certain why it's happening in the adenovirus vaccines. But for COVID there, it seems to be that it might be something to do with the repair pathways in the inflammation that's happening, especially 'cause the infections with COVID are just widespread. It's throughout the body. Lots of damage is happening and it's kind of a repair thing. And so-

Dr. Darya Rose:  Got it.

Dr. Jennifer Gr...:  ... they, yeah. So they think COVID it's about repair, but we're not really with the, the adenovirus, there's a particular factor that's involved that seemed to be connected. So maybe they're both part of the same pathway. I'm definitely not like a blood biologist. [laughs] I'm not, I'm not all up on like clotting factors, but it seems like there may be actually kind of different ways that it's happening. And so that makes me feel a little bit better that we could get [00:44:00] COVID specific vaccines that aren't gonna have this clotting side effects. And again, kind of thinking about, we're not seeing this in the mRNA vaccine. So it seems like we could, uh, find a way to get around this.

Dr. Darya Rose:  Okay.

Dr. Jennifer Gr...:  And just kind of a fun fact, I looked up based on like how rare the, the side effects are, that clotting. And then I looked at risks of like some other things that might happen is, someone is three times more likely to be killed by lightning than to have a blood clot after that adenovirus vaccine, so.

Dr. Darya Rose:  That's good.

Dr. Jennifer Gr...:  Just to put that in context.

Dr. Darya Rose:  Yeah. That's, that's, I like that, that helps. Actually I'm suddenly curious. I know that were was some, I saw some early reports that, speaking of blood, that blood type actually matters for COVID risk and I was also wondering, is there, do we have any idea of who is getting these clots? Is it something kind of like if, if I'm a pregnant woman on birth control, is, is that, does that make me more likely? 'Cause I know that, that makes me more susceptible to clots, [00:45:00] but does that necessarily mean that I should be more afraid of getting a COVID vaccine and then also how does that interact with my blood type? That's all very interesting.

Dr. Jennifer Gr...:  Yeah. I actually have no answers for that. So I also saw the stories that said that there's a tie to blood type and I don't remember the blood type that makes you more susceptible, but I do know I'm type O and that was one of the less susceptible-

Dr. Darya Rose:  Yeah. I think it was A.

Dr. Jennifer Gr...:  Yeah. I think so. But I just remember reading it and like kind of wiping my brown and be like, "Okay, type O, I'm all right." So, but yeah, it sounds like there was some connection to blood type, but I, I really don't know how all of that ties in. And I don't know that we have enough data on people with blood clots after the vaccines to even kind of figure out the risks. Does that make sense? Like there so few, it's been so few cases-

Dr. Darya Rose:  Right.

Dr. Jennifer Gr...:  ... that we don't know what makes them-

Dr. Darya Rose:  You don't have the statistics, just statistical power to figure out anything? [laughs]

Dr. Jennifer Gr...:  Yeah, exactly right. “Oh, did they all go out to dinner the night before? Okay. Maybe.” [00:46:00] Maybe that's important, maybe it's not. It's something we just don't have enough information to know.

Dr. Darya Rose:  They definitely did not go out to dinner. [laughs]

Dr. Jennifer Gr...:  Yeah. Probably not.

Dr. Darya Rose:  I have not been to anywhere. All right. Let's see. Well, and that's an example. Like the blood clots, I think, I feel like are a great example of the type of side effect you can catch within two months.

Dr. Jennifer Gr...:  Yeah.

Dr. Darya Rose:  Yeah.

Dr. Jennifer Gr...:  Well, and you know, a great thing for better or worse is that we, as soon as we, it was recognized by the scientific community, it was taken really seriously.

Dr. Darya Rose:  Mm-hmm [affirmative].

Dr. Jennifer Gr...:  Right? There, there was a pause on the Johnson&Johnson. People were studying this really extensively. And so it, it kind of also speaks to that question of like, did we cut any corners? Did we, do we have to worry about vaccine safety here? And the answer is I don't, I don't, there was no corners cut because they are really, really being careful about what's being given to the, to the public. And so the fact is we could have seen these really rare complications and said, “Oh, they're rare, we're not gonna worry about it.” But they stopped those trials. They stopped [00:47:00] those, giving the vaccines and studied it. Made sure that it was extremely rare or figuring out that it's not gonna be happening wide scale and then said, “Okay, now that we have more information, it's safe enough to continue.” And so I think it just says to how serious it's or how serious researchers are taking the potential for complications.

Dr. Darya Rose:  Absolutely. And I'm curious, do you happen to know what, what they did when they paused?

Dr. Jennifer Gr...:  I don't know for sure. My guess is that they honed in on those specific patients and then, well like you mentioned, just tried to find things in common to see if there was a particular risk. So if they, if they did study it and every patient had some particular disease or if, you know, you mentioned, all of them were on birth control or something, then they might change the recommendations and change the-

Dr. Darya Rose:  Right.

Dr. Jennifer Gr...:  ... who can get which vaccines but they-

Dr. Darya Rose:  They found a pattern.

Dr. Jennifer Gr...:  Right. They didn't find any particular pattern that they were concerned about or that they could predict. So they, they did continue on. Although I have read that [00:48:00] there, I think they are now encouraging pregnant women to get the mRNA vaccine if they are able, just to, to avoid because-

Dr. Darya Rose:  The clots.

Dr. Jennifer Gr...:  ... pregnant women are-

Dr. Darya Rose:  Yeah.

Dr. Jennifer Gr...:  Right. At higher risk for blood clots and then you add in this potential risk, although small with the vaccines. And so the idea is, you know what, just don't-

Dr. Darya Rose:  Yeah. I don't see risking two lives, not one. Yeah.

Dr. Jennifer Gr...:  Yeah, Right. So don't add that extra risk from the vaccine. If you can just get the mRNA and you, you don't have to worry.

Dr. Darya Rose:  So as a mom I'm, and I know that I am not alone on this. People want their kids to be back in school and they want their kids not to get COVID and they want their kids definitely to not die of COVID. And ideally they would get to have birthday cakes at school again, and stop wearing masks and all that.

Dr. Jennifer Gr...:  Yeah.

Dr. Darya Rose:  So as they're, as they're doing these trials and they're considering vaccines for the children, I'm curious like how that's different? So that, that was another question I got a lot. Like kids are low-risk. Why would I risk my kids? [00:49:00] But you know, when I think about vaccines, I mainly think about kids and-

Dr. Jennifer Gr...:  Mm-hmm [affirmative].

Dr. Darya Rose:  ... and they tend to tolerate vaccines quite well. And, but I'm curious sort of what the, the process is for, for the, the development and, and what should parents be concerned about?

Dr. Jennifer Gr...:  Yeah. So if we're talking about a vaccine that's going to be used in children, often it goes through the whole process of safety in adults first. And part of that is just because we, you know, adults are kind of done developing and we know a fair bit about what's going on, but the other piece of that is children are considered a vulnerable population. A lot of children may not have the knowledge or the sort of the expertise or the even sort of the emotional capacity to make an informed decision. So when deciding on what could be an eligible vaccine for children, there's a lot of considerations into reducing the risks as much as possible so that whatever we're [00:50:00] giving to them is safe. They don't have to be so concerned about what is gonna be the side effects to me or the potential for long-term risks. So the safety process is really, really rigorous for children.

So as I said, getting that FDA authorization usually requires going through the whole process of approval for an adult vaccine and then restarting the whole process with even more rigorous safety standards, to be able, give it to children. And the biggest one that we mentioned earlier is dosing. You can imagine a dose for an adult human might look very different than an adult or a dose for a small child. So we start with the dosing and we start with what we know is a safe dose already. And then they'll kind of figure out, “Okay, we're changing the weight by what percent, so we might need to scale this down.” And so they did that with all of these COVID vaccines. They tried again, they kind of jumped all the way back to the phase one trials and then phase two and then now they're kind of getting into phase three. So it's [00:51:00] almost like you have to go through the whole safety process twice before you can get even-

Dr. Darya Rose:  Even more of that, right? 'Cause they're doing, they're like doing age batches, I feel like.

Dr. Jennifer Gr...:  Yeah. I mean it is really, really rigorous. And that's part of the reason why it just takes longer to get into to children because you do have all of these additional considerations.

Dr. Darya Rose:  And I'm curious, you mentioned earlier that children or that one, the most, one of the most common, actual negative effects of vaccines is allergies.

Dr. Jennifer Gr...:  Mm-hmm [affirmative].

Dr. Darya Rose:  And do you, do you know what it is typically that people are allergic to in vaccines?

Dr. Jennifer Gr...:  So a big one is eggs. It is, for a fair number of vaccines, the, the, if we're using a killed virus or a modified virus, they're often grown in eggs 'cause eggs are sort of just like a soup of proteins-

Dr. Darya Rose:  Right.

Dr. Jennifer Gr...:  ... uh, without having to worry about lots of different cells. And so if someone does have an egg allergy that's would be a concern, uh, for potential allergy to getting vaccines. That is not the case for the, at least the mRNA vaccines. I'm not [00:52:00] as clear on the adenovirus or how those are prepared if they have, if they do passage them through eggs or not.

Dr. Darya Rose:  That's it interesting. My daughter is allergic to eggs and has had no trouble with vaccines at all.

Dr. Jennifer Gr...:  That's great.

Dr. Darya Rose:  Yeah.

Dr. Jennifer Gr...:  Yeah. Right. Different people have different levels of severity of their allergies. So it, it may not even be a concern for everyone that has an egg allergy.

Dr. Darya Rose:  Yeah. She, they, they, they're hoping she's gonna grow out of it. I'm hoping she's gonna grow out of it because we want pancakes. [laughs]

Dr. Jennifer Gr...:  Yeah.

Dr. Darya Rose:  And, and I presumably, have they, you, did you say they, they are testing it on pregnant women or they... I think that they've just allowed pregnant women to do it if they wanted, correct? Or-

Dr. Jennifer Gr...:  Yes.

Dr. Darya Rose:  ... are they just doing specific trials on pregnant women?

Dr. Jennifer Gr...:  I believe both, actually.

Dr. Darya Rose:  Okay.

Dr. Jennifer Gr...:  Yeah. So I think they are definitely, there's definitely studies happening on pregnant women because for sure we wanted to study that population. But in the meantime, there are groups that are collecting data on women that have already been vaccinated who were either pregnant [00:53:00] when they got vaccinated or got, got pregnant sort of during that vaccine course. So if you had the two shot, if you got pregnant in between the two shots. And I know it was even reported in some of these early, like the giant phase three clinical trials, that there were patients that got pregnant during the trial. So we have data from those patients as well.

Dr. Darya Rose:  I recall when I was pregnant, you, you do get vaccines, right? I think I had to get-

Dr. Jennifer Gr...:  Mm-hmm [affirmative].

Dr. Darya Rose:  ... tetanus or what is it? [crosstalk 00:53:27] or that, that one.

Dr. Jennifer Gr...:  Yeah. [laughs] Yeah. The Tdap.

Dr. Darya Rose:  The Tdap. Oh gosh. That one hurts.

Dr. Jennifer Gr...:  Oh, yes.

Dr. Darya Rose:  And if I remember correctly, you do that so that your child has that immunity.

Dr. Jennifer Gr...:  Correct.

Dr. Darya Rose:  Right?

Dr. Jennifer Gr...:  Mm-hmm [affirmative].

Dr. Darya Rose:  So in theory, if a pregnant woman got a COVID vaccine, her baby may be protected.

Dr. Jennifer Gr...:  Yes. Yeah, absolutely. I, and I have seen some studies now where people are kind of studying the transfer of those COVID vaccine antibodies from mother to child, and they're, they're starting to see that. So it does look really, really promising for [00:54:00] protecting newborn infants.

Dr. Darya Rose:  Yeah. That's interesting. And I also remember when I was, you know, pregnant and reading about, seeing and all that-

Dr. Jennifer Gr...:  Mm-hmm [affirmative].

Dr. Darya Rose:  ... that one of the benefits of nursing is that, you impart some of your immunity to the baby through breast milk as well. And I'm curious-

Dr. Jennifer Gr...:  Yes.

Dr. Darya Rose:  ... if a nursing mother gets a vaccine. I don't know if, um, I don't know. I haven't seen any data yet, but I'm curious if you would think that it would be beneficial as well?

Dr. Jennifer Gr...:  Yeah. Uh, I think actually that data is out.

Dr. Darya Rose:  Oh.

Dr. Jennifer Gr...:  So we definitely do see the antibodies in breast milk. Yeah. That was, we actually saw that before we saw sort of the antibody is transferred after birth, simply because it's a lot easier to get samples of breast milk than it is-

Dr. Darya Rose:  Yeah.

Dr. Jennifer Gr...:  ... to attract out of one, one of the few women that got vaccinated while pregnant and then followed them out to after birth, but yeah. And in both cases, whether it's from mother to child while they're pregnant or while breastfeeding, we, we are seeing transfer of antibodies.

Dr. Darya Rose:  This is so fascinating. I wonder if we could all just make some breast [00:55:00] milk, like cheese or ice cream-

Dr. Jennifer Gr...:  Yeah.

Dr. Darya Rose:  ... and maybe people wouldn't have to get vaccines. They could just [laughs] just have an ice cream cone. [laughs]

Dr. Jennifer Gr...:  Oh, my gosh. Yeah. The unfortunate thing is that, if you're ingesting it, it doesn't stick around for very long. So we would have to constantly be having ice cream.

Dr. Darya Rose:  Eat ice cream.

Dr. Jennifer Gr...:  Yeah.

Dr. Darya Rose:  I think we just solved our, our problem here. Oh, and then do we know yet how... So I know this has been an evolving story.

Dr. Jennifer Gr...:  Mm-hmm [affirmative].

Dr. Darya Rose:  And, so we, we know for sure that the vaccine, the COVID vaccine, like help like, does a pretty effective against getting COVID, uh, getting severe COVID. But do we know if, yet if it protects against transmission or infection in general?

Dr. Jennifer Gr...:  Yeah. So these studies are pretty much coming out right now.

Dr. Darya Rose:  Yeah.

Dr. Jennifer Gr...:  Um, so we're seeing the, the mRNA vaccines seem to be really effective. So the original studies that came out said that they were over 90% effective at blocking the disease form, so like symptoms and stuff. But we're now [00:56:00] seeing that, they've looked at people that got these vaccines and they're testing them regularly. And it seems that the vaccines are blocking over 90% of the infections as well. So like 80% of infections, 90% of disease. So and-

Dr. Darya Rose:  And that's astoundingly high.

Dr. Jennifer Gr...:  That's huge. And some of these studies included areas that had the variants already circulating.

Dr. Darya Rose:  Oh, wow.

Dr. Jennifer Gr...:  So we're seeing protection against the variants from the mRNA vaccines as well. The adenoviruses are still pretty good. They're not quite as good as the mRNA vaccine. So they're, uh, more in the range of like 50% to 70% protection against infection and then it drops a little bit depending on which variant might be in the area, but in, in all cases we're seeing pretty good decreases in the risk of infection. And then going along with that, if we're having fewer infections, that means fewer chances for transmission. So less likely to spread it to people that someone might come in contact with.

Dr. Darya Rose:  So, like, I mean, I just can't imagine a better case scenario.

Dr. Jennifer Gr...:  [00:57:00] Yeah.

Dr. Darya Rose:  I mean for, I mean, I mean, it's just astounding.

Dr. Jennifer Gr...:  It's, yeah. I completely caught me, as a virologist and as a immunologist, I was completely caught off guard by how successful these were and kind of on the first try.

Dr. Darya Rose:  So first.

Dr. Jennifer Gr...:  Right?

Dr. Darya Rose:  Yeah.

Dr. Jennifer Gr...:  One and done. Yeah, it was great.

Dr. Darya Rose:  It's incredible. So and in speaking of one and done, do we have data yet on how long these vaccines they're gonna last, do we need booster shots?

Dr. Jennifer Gr...:  So we have some data and it's kind of an ongoing data. So right now I think the most-

Dr. Darya Rose:  Okay. We've only had COVID for like a year and half.

Dr. Jennifer Gr...:  Right. Yeah. And so, yeah. So we have data that says that our vaccine protection will last at least eight months 'cause that's what we have eight months of data. So that doesn't mean it's eight months and over-

Dr. Darya Rose:  Right.

Dr. Jennifer Gr...:  ... but we followed it for eight months. It's still here and they're gonna continue following it. And so I think I mentioned earlier that the, at least the phase three trials, they're following people for two years. So we'll have a good idea for at least two years and then they may be able to predict what's gonna keep happening after that. So it [00:58:00] looks like definitely we're, we've got eight months for certain and very likely much longer.

Potential for a booster, we'll have to see. It may depend on how long that protection lasts. So if it looks like we're gonna have protection for five years, it might be something like tetanus or protests where you just have to get a booster. Maybe you go and you get your tetanus shot and your COVID booster all at the same time. The other thing though is we don't really know what's gonna happen with the variance. And so I think if we're gonna need a booster, the first boosters we're gonna see are probably gonna be against some of these kind of nasty variants that are starting to form. So right now we don't know. And I do know Moderna is testing some boosters against the different variants that are circulating.

Dr. Darya Rose:  Smart. They... Oh, I thought I saw a study like a week ago, maybe, maybe two that said that, something to the effect of, if you've had COVID and you get a vaccine, there's a [00:59:00] decent chance you barring a crazy variant where you, it's like so different that you would need something new, but you're unlikely to need a booster in that scenario. But if you have just been vaccinated without ever being infected with COVID, you might be more likely to need a booster, kind of, I guess, something like that.

Dr. Jennifer Gr...:  Interesting. Yeah. I haven't seen that specific study, but I have, I did look at some of the data that shows kind of the immune response after getting COVID and getting vaccinated or getting just vaccinated alone. And for the people that had COVID and then also got vaccinated, their antibody levels are like sky high.

Dr. Darya Rose:  Mm-hmm [affirmative].

Dr. Jennifer Gr...:  They have like six times the amount of antibody as somebody that's been vaccinated. So if you think-

Dr. Darya Rose:  Don't you know what those numbers are?

Dr. Jennifer Gr...:  Not off the top of my head. I do know it was a six fold increase.

Dr. Darya Rose:  Okay.

Dr. Jennifer Gr...:  It was, it was high. But, so that makes me think that if I'm thinking about how long is, is my immune response gonna last, it's really, you know, I could kind of follow how many antibodies are left circulating in my blood. And so if [01:00:00] you start at a really high level of antibodies and they slowly are kind of degrading and you have fewer and fewer, it's gonna take a lot longer to get down to none than it is if you start kind of, I don't wanna say in the middle, 'cause the vaccine is still a really great antibody response, but if you have-

Dr. Darya Rose:  Does it just decay like that? I mean, is there no, like memory?

Dr. Jennifer Gr...:  Kind of. I mean, there is, there are definitely memory cells and we, most of what we're looking at the easy way to test is for antibodies, but there are T-cells out there. T-cells are really important in immune response and protection and they can be like super long, lived. Like 20, 30 years. So right now a lot of our predictions on how long this is gonna last, it's just based on antibodies 'cause they're easy to test. But more research is definitely happening where they're looking at T-cell responses and how long those will last too. So we, honestly, we could all be good-

Dr. Darya Rose:  Yeah. It will be amazing.

Dr. Jennifer Gr...:  ... for a while, which would be fantastic.

Dr. Darya Rose:  I actually, I'm participating in this study and it, I had to get [01:01:00] antibody tested sort of a few months ago and between then and when I got tested again recently, I, I had gotten a vaccine-

Dr. Jennifer Gr...:  Mm-hmm [affirmative].

Dr. Darya Rose:  ... and it was interesting because they could actually tell if I had, I had COVID or if I'd just had the vaccine-

Dr. Jennifer Gr...:  Yeah.

Dr. Darya Rose:  ... with, with the antibody test, but I was surprised. So I had, I got my second shot in February and in May, yeah, my antibodies were still like really high, so that made me happy. [laughs]

Dr. Jennifer Gr...:  That's awesome.

Dr. Darya Rose:  And you can just go to Labcorp and get an antibody test.

Dr. Jennifer Gr...:  Yeah.

Dr. Darya Rose:  If you're just curious, you can just go do that.

Dr. Jennifer Gr...:  Yup.

Dr. Darya Rose:  Oh, and I wanted to ask one more thing about the numbers about efficacy. So when you hear the vaccine is 90% effective, 80% effective, what does that actually mean? And in terms of breakthrough infections and, I'm just curious, 'cause I, I've heard a lot of different things and it's, it's sort of hard to wrap your head around.

Dr. Jennifer Gr...:  Yeah. So I think of it as, not so much as a number like, oh, there's gonna [01:02:00] be, if a 95% reduction means there's still gonna be five cases, that's, that's not quite what it is. It's really a reduction in risk. So if I came into contact with somebody that had COVID for a really long time and that I left there with a 90% chance that I was gonna get COVID. Just not, unvaccinated, totally normal. And then if you compare that to somebody that was vaccinated, fully vaccinated, same exact scenario, their risk of getting the vaccine, oh, sorry, getting, uh, the virus after the vaccine drops by 95%. So now they might have a 2% chance of getting infected in that same situation.

So the, the efficacy is really decreasing a risk, but there's still all of those other random factors that are at play. So it's hard to turn those into exact numbers, right? It's not gonna be four people now get it and the other don't, but that for each contact you come in or any, each time you [01:03:00] come in contact with the virus, you now have greatly decreased the chance that, that contact will turn into an infection.

Dr. Darya Rose:  Got it. So that's why it's important to still wear masks and-

Dr. Jennifer Gr...:  Right.

Dr. Darya Rose:  ... not cough on anybody? [laughs]

Dr. Jennifer Gr...:  Yeah, exactly. Well, so actually you can think about it if you had a hundred, if you came in contact with a hundred different people that had COVID and you had the vaccine, so that's a 95% risk, maybe only five of those instances might change, might lead to an infection.

Dr. Darya Rose:  Yeah. And it sounds different that way. Doesn't it? [laughs]

Dr. Jennifer Gr...:  Right. I still think of that. Like when I go to the grocery store, I was like, "There's more than a hundred people here. I should be careful."

Dr. Darya Rose:  You just still need to be careful in the grocery store. Absolutely.

Dr. Jennifer Gr...:  Yeah.

Dr. Darya Rose:  Well, well, well, I think we just covered COVID pretty darn well. I learned a lot, so thank you. [laughs]

Dr. Jennifer Gr...:  Yeah.

Dr. Darya Rose:  Do you have any parting thoughts for anybody who's still sort of on the fence or struggling with, with certain aspects of this?

Dr. Jennifer Gr...:  Yeah. So I think one thing, we kind of touched [01:04:00] on it and didn't go too much into it is, you know, if somebody had COVID or you, or they're young and healthy, do they, should they really get the vaccine? Right? What's the purpose of it if they're gonna be probably okay anyways, and even with kids. And one thing I just kind of really caution people is to think about, again, those long-term effects. We don't know what the long-term effect of infection is. It could be 10 years from now, we'll learn something we didn't know.

But the other thing is, I'm really concerned about the, the variants. The, the, every time somebody gets infected, there's a chance for the virus to mutate. So the more of infections means the more risk of variance. So even if we can get a greater percentage of the population vaccinated, that kind of decreases our chance for future variants, which then decreases the chance that we could all need a booster or that we might have a new variant-

Dr. Darya Rose:  Very early deadly version. [laughs]

Dr. Jennifer Gr...:  Exactly. Something that suddenly becomes really bad for everybody or really bad for children. And so I, I think probably a fair number of people [01:05:00] and we've seen this in the clinics, that if you're young and healthy, you'll probably do okay and you don't have any symptoms, but there's still that risk that this may be the source of a new variant or unfortunately there's, uh, a fair number of people that aren't able to get vaccinated because of their medical history or if they're immunocompromised, even if they get vaccinated, they may not have that same level of protection. And so I think if we can limit the overall infections, we can help out the, protect the people that aren't otherwise able to, to benefit from the vaccines directly.

Dr. Darya Rose:  Yeah. I just wanna summarize those three points because I feel like, like one more time 'cause I think-

Dr. Jennifer Gr...:  Yes.

Dr. Darya Rose:  ... they're so important. So first we don't know the long-term effects of getting COVID even mild COVID-

Dr. Jennifer Gr...:  Right?

Dr. Darya Rose:  ... and we ha- we know of viruses that cause cancer, like this is-

Dr. Jennifer Gr...:  Yeah.

Dr. Darya Rose:  ... like, there's lots of weird things. And this virus is one that is particularly enigmatic-

Dr. Jennifer Gr...:  Mm-hmm [affirmative].

Dr. Darya Rose:  ... and it's going, it's touching so many different body organ systems and [01:06:00] so many, there's just been so many different pathologies associated. I, personally, to me, that's why it was so terrifying. And why like the second I heard about it last January, we started like, I had tons of toilet paper because I started locking this stuff down early. I had all the N95 Mask. [laughs] Sorry guys for that. But I was like, I was immediately concerned about that. So there's that. The second is, there are people who are, it's not just for yourself, there's-

Dr. Jennifer Gr...:  Mm-hmm [affirmative].

Dr. Darya Rose:  ... the people around you. Like, you might be fine but you might kill somebody else. You might kill somebody else's child.

Dr. Jennifer Gr...:  Right.

Dr. Darya Rose:  Like not, it's not just grandma's. Like people are, are seriously at risk and, and then these variants, right? Like the, the possibility that SARS-CoV-1 could come back at this infection rate. I mean-

Dr. Jennifer Gr...:  Yeah.

Dr. Darya Rose:  ... that, that thing was so deadly.

Dr. Jennifer Gr...:  Mm-hmm [affirmative].

Dr. Darya Rose:  And if we mutated closer to something like that, we could be in a situation where we're in lockdown for like years.

Dr. Jennifer Gr...:  Yeah.

Dr. Darya Rose:  And, and if people [01:07:00] are still unwilling to get vaccines, we, even people that would normally be healthy, won't be able to go outside. And I just feel like, I, like to me, the risk benefit of a vaccine that has been shown to be incredibly effective and largely safe-

Dr. Jennifer Gr...:  Mm-hmm [affirmative].

Dr. Darya Rose:  ... compared to all those other like horrific outcomes, it just, to me, it seems not a hard choice. And I, I do hope that people can take those thoughts and, and sit with them and, and consider the big picture.

Dr. Jennifer Gr...:  Right. And you bring up a good point that it is, it's about risk. So there are some people that are probably not at risk if they're able to work from home and they're getting their groceries delivered. Maybe they've got some time to think about this and weigh some options, but there are a lot of people that are working face-to-face jobs. They're con- constantly coming in contact with people.

Dr. Darya Rose:  Right.

Dr. Jennifer Gr...:  And so it's really important if you are, or if someone is experiencing risks or put in, in a situation where they're at risk, the, the [01:08:00] vaccine can really put a stop to that risk and-

Dr. Darya Rose:  Right.

Dr. Jennifer Gr...:  ... and decrease it significantly.

Dr. Darya Rose:  Right. And we didn't even touch on like what happens to the economy and to livelihoods and to loneliness-

Dr. Jennifer Gr...:  Oh, gosh.

Dr. Darya Rose:  ... and stuff when-

Dr. Jennifer Gr...:  Yeah.

Dr. Darya Rose:  ... when we do have to lockdown and, yeah. And then there, then there are so many people that just don't have that luxury to stay home.

Dr. Jennifer Gr...:  Mm-hmm [affirmative]. Yeah.

Dr. Darya Rose:  And it's... Yeah. I just feel like if you're able to get a vaccine and especially if you're low-risk for any, any complications, I mean, it's just-

Dr. Jennifer Gr...:  Yeah.

Dr. Darya Rose:  ... I think it's important.

Dr. Jennifer Gr...:  Yeah. And I guess, there, there was one point I wanted to make, I forgot to mention it when we were talking about pregnant women earlier is, we did talk about how the vaccines are generally safe, but I think it's important that pregnant women have a conversation with their doctor-

Dr. Darya Rose:  Mm-hmm [affirmative].

Dr. Jennifer Gr...:  ... before they get vaccinated. Because we're talking about sort of general population data, but every pregnancy is different, um, and there is a lot of considerations that can go into this. And so I think it's important for individuals to have those conversations because it may be a high-risk [01:09:00] pregnancy or there may be concerns of complications just without putting the vaccine in the picture. And so I think, I don't wanna say every pregnant woman should get vaccinated because I think there are gonna be risks and considerations there, which then makes it all the more important that the people that they come in contact with should also, should be vaccinated so that they have that protection if they need it.

Dr. Darya Rose:  Yeah. That's a great point. Everybody should talk to your doctor if you're having any, any questions or concerns. Yeah, that's the person who knows you. If you're-

Dr. Jennifer Gr...:  Mm-hmm [affirmative].

Dr. Darya Rose:  ... if you're concerned about a specific risk, you could do a genetics test if you really want to. [laughs]

Dr. Jennifer Gr...:  Yeah.

Dr. Darya Rose:  And like learn your risks for blood clots and there's, there's lots of things you can do. Actually, I do have one more thing I wanted to ask you. Is there any-

Dr. Jennifer Gr...:  Yeah.

Dr. Darya Rose:  ... any evidence for sort of prophylactic vaccine? What I'm trying to get at is, I took a lot of vitamin D [laughs]

Dr. Jennifer Gr...:  Mm-hmm [affirmative].

Dr. Darya Rose:  ... and vitamin C and zinc before going into my vaccines, because I know that vitamin D can bind to the ACE-2 receptor [01:10:00] which is what the spike protein binds to. So I'm like-

Dr. Jennifer Gr...:  Mm-hmm [affirmative].

Dr. Darya Rose:  ... I'm gonna bind up all those so it doesn't get any like, and I had zero side effects [laughs] from the vaccine. Like I didn't even have a sore arm. I'm just curious, but like that's totally anecdotal and in my head.

Dr. Jennifer Gr...:  Yeah. [laughs]

Dr. Darya Rose:  So I'm wondering if there's, uh, any evidence in, not necessarily COVID, but with any vaccines, anyway, to support our immune systems or support our, our interactions with the, with the vaccine to make it more effective or make it more, less, less risky or, or less side effects, things like that?

Dr. Jennifer Gr...:  Yeah. I, I can't say of any particular drugs but I've, I've read some of the stuff about vitamin D and I'm still like, I've read stuff that it's pro and stuff that says it doesn't really do anything. And so I think that there's, there's still more to be done with a lot these.

Dr. Darya Rose:  I should qualify that by saying I have like three mutations for low vitamin D.

Dr. Jennifer Gr...:  Oh, yeah. Absolutely.

Dr. Darya Rose:  So I, I take that amount of vitamin D anyway-

Dr. Jennifer Gr...:  Yeah.

Dr. Darya Rose:  ... just to be normal. [laughs] But that morning, I was like, “Yes.”

Dr. Jennifer Gr...:  Yeah, yes. [laughs]

Dr. Darya Rose:  Yeah. [laughs]

Dr. Jennifer Gr...:  I mean, that very much, that very much brings to point the idea that [01:11:00] like everybody is different and so what works for one may not work for another. But I think, if I'm thinking about ways to kind of boost your immune system and give it the best fighting chance, honestly, it's a lot of those like good, healthy things. Like drink water, getting a good night's sleep can actually be a huge, huge boost to your immune system. Moderate exercise is a really good boost, but also getting rest when you're having kind of that fight. Because if you're over-exercising, exercising, then all of your energy is going to the exercise and not your immune response. And so you, make sure you're kind of being active but then when you get the vaccine, give yourself some time to rest and recover so that you, you know, get a good fight going for your immune response. Yeah. But otherwise it's just mostly, honestly, for most of us, it's probably just sleeping. [laughs]

Dr. Darya Rose:  Right. Don't get hammered the night before. [laughs]

Dr. Jennifer Gr...:  Yes. Right.

Dr. Darya Rose:  Stuff like that. [laughs] Amazing. Well, thank you so much, Jennifer. I, I really learned a lot and I, I really appreciate you taking the time to explain this to the rest of us.

Dr. Jennifer Gr...:  Yeah. This was really fun. And, and it's nice [01:12:00] to just have a conversation about it, where we get to kind of throw ideas back and forth and discuss, because I think we get, these conversations can often get quite charged and emotional. And so it was nice to kind of just discuss different perspectives and, and how we might want to consider what's going on with the vaccines and with the virus. So I really enjoyed this. Thank you very much.

Dr. Darya Rose:  Thank you. Thank you so much for joining today. If you'd like to learn more about Dr. Grier, you can follow her on Twitter @DrGrier. That's D-R-G-R-I-E-R for news and information about infectious disease, immunology and medicine. As always, if you liked the show, I would really appreciate it if you would tell a friend about it.

This episode in particular is a fantastic resource for anybody who's curious about COVID vaccines and whether or not they feel comfortable getting one. So please share it far and wide. If you could also leave us a review on Apple or whatever podcasts device you use, that would mean a lot to me as well. It helps us get [01:13:00] more great guests like Jennifer and just keep this show going strong. So thank you guys and I'll see you next time.