Katelyn Jetelina MPH PhD
Here we go again. Pandemic fatigue coupled with the most contagious Omicron subvariants yet, BQ.1.1 and XBB, are driving yet another viral surge across the globe. Pair this with waning immunity and suboptimal booster uptake among the vulnerable, and the U.S. may see what’s happening in Germany right now.
Why is booster uptake suboptimal? Throughout the pandemic we have leveraged “bench science”—a field that deals with things that can be observed and measured explicitly in a lab, such as immunology and virology. This was crucial as it got us innovative, novel COVID-19 vaccines in record time. However, vaccines in vials are not useful; vaccines have to get into arms. This is where we have desperately missed the mark in our pandemic response as we have not leveraged “social science”— a field that studies people and behaviors, which can be more difficult to predict.
I partnered with two social scientists, Benjamin Rosenberg, Ph.D., and Jason Siegel, Ph.D. who study psychology and how it impacts healthy choices. Their efforts were recently showcased in the New York Times on how Marin County—a wealthy Bay Area county—had the lowest rates of child vaccination more than a decade ago but now has one of the nation’s highest COVID-19 vaccination rates.
Several years ago, Dr. Siegel was doing research on how to persuade people to become organ donors. This work resulted in something called the IIFF Model—a framework that maximizes the likelihood that people will act on their favorable attitudes—bridging the gap between feeling good about something and actually doing it.
Their work describes an orientation called passive positive. Drs. Rosenberg and Siegel thought that, given similarities, this model could be applied to better understand the low booster shot uptake.
In COVID-19, passive positives are people who are not motivated to find out if they are eligible for another booster, are actively trying not to think about COVID-19 or the booster, are not willing to exert energy to find out where they can get another booster shot, and are likely ambivalent about receiving the shot (e.g., may have positive attitudes about the protection it gives and negative attitudes about the immediate side effects).
All of this paints a relatively counterintuitive picture, as folks who have received two, three, or four COVID-19 shots are likely to hold relatively positive attitudes toward the vaccine—they were, after all, willing to get the primary series—but have yet to get the fall booster. The IIFF Model could offer some guidance that should bump up booster uptake:
Immediate and complete booster opportunity: If people lack motivation to get a booster, they will be less likely to exert effort to receive one. Moreover, even if someone becomes motivated to get a booster, that motivation is likely to be short-lived. As such, it is critical to have a booster shot immediately available the instant a person becomes motivated to get the shot. Doctors’ offices and pharmacies seem like easy and logical places to do this.
Information about eligibility for a booster: An oft-cited barrier to receiving a booster shot seems to be a relic from many months ago when it was unclear who, exactly, could get boosted. Now, though, nearly everyone who has received two shots is eligible for a fall booster—whether they know it or not. Even though this information is available on numerous websites, passive positives are not inclined to search for additional information due to a lack of motivation. As such, this information must be proactively presented to passive positives (e.g., via doctors, nurses, or pharmacists, as well as public health messaging).
Focused engagement at the time of the booster opportunity: People are exhausted from more than two years of COVID-19; they likely now turn away rather than toward information about it. As such, we need to take steps to make sure people actively process information about the benefits of booster shots. Behavioral supports must be implemented (e.g., doctors and pharmacists telling those who have received two shots that they can receive another one—ideally right then) to ensure that passive positives will engage with the information provided about the booster and that they are aware of the immediate opportunity to get one.
Favorable activation of booster attitudes at the time of booster opportunity: Although people who have received two COVID-19 shots but not a third likely feel positively about the vaccination, it is unlikely that their attitudes are entirely positive. That is, this group probably also harbors some negative feelings about the vaccines—perhaps rather than thinking about the lives that vaccines have saved, they think about the people who have had breakthrough cases of COVID despite being boosted. At the time a booster is offered, then, the practitioner should purposely encourage patients to focus on the positives of being boosted (e.g., increased short- and long-term protection).
Putting it all together, imagine a scene in a CVS pharmacy: Any time a medication is given to a customer, the pharmacist can ask about vaccination status (or check the patient’s records). If the patient is not boosted, the pharmacist can let them know they are eligible to receive a booster, that they can receive one right now, and describe the benefits. Ideally, the pharmacy could have posters advocating the benefits of booster shots so the topic is salient even before the pharmacist breaches the topic. This approach can work because all four elements of the model are simultaneously present. However, if even one aspect of the model is missing, the likelihood of success drops dramatically. Pharmacies are currently understaffed, overwhelmed, and burnt out. Getting vaccines into arms has to be an investment and public-private partnership, just like we did to get vaccines into vials.
Another great, real world example of this model is a success story in increasing COVID-19 vaccination rates among children in Boston.
There is no one foolproof strategy to increasing booster uptake. At this point in the pandemic, a promising approach is aiming to persuade passive positives—people with favorable booster attitudes but little motivation to get one. This is less about “bench science” and more about “social science” —meeting people where they are. It will move mountains.
Love, YLE, Dr. Siegel and Dr. Rosenberg
Dr. Siegel is a professor of social psychology at Claremont Graduate University and director of the Depression and Persuasion Research Lab. Dr. Rosenberg is an assistant professor of psychology at Dominican University of California and director of the Health and Motivation Lab.
“Your Local Epidemiologist (YLE)” is written by Dr. Katelyn Jetelina, MPH PhD —an epidemiologist, data scientist, wife, and mom of two little girls. During the day she works at a nonpartisan health policy think tank, and at night she writes this newsletter. Her main goal is to “translate” the ever-evolving public health science so that people will be well equipped to make evidence-based decisions. This newsletter is free thanks to the generous support of fellow YLE community members.
I’ll err on the side of science every time. I recently got my 5th Covid vaccine, this time it included an Omicron deterrent. I’m still wearing a mask in stores and not socializing with the unvaccinated.
I've had 2 boosters already. I don't have a problem getting a 3rd, 4th, 5th, 6th, 7th, 8th, 9th, 10th, 11th. 12th,...
So, you must be able to read and comprehend all of the data that proves that the vaccine trials were a sham and that the vaccines never offered any protection from a pathogen that in reality posed no threat to more than 99% of the population.
VAERS COVID Vaccine
Adverse Event Reports
Reports from the Vaccine Adverse Events Reporting System. Our default data reflects all VAERS data including the "nondomestic" reports.
@BDair Transparency is a key characteristic of science. Scientists are keen to share their work with the world. The standard for dissemination of information regarding the safety and efficacy of vaccines is publication of peer-reviewed articles in reputable scientific journals. Journalists who cover the science beat read the journals and interview the scientists who write the articles. And just as scientists are constantly double-checking each other's work, so too are journalists. Interested individuals routinely get information from multiple publications. You never rely on just one source. Over time you get to know your sources. You have been seeing their work confirmed for years. Suddenly some unknown source comes out of nowhere with information that is completely at odds with everything you are seeing elsewhere. You look for credentials and associations, but it's thin or nonexistent. You may find that the new source has a criminal history; he/she did time for fraud or practicing medicine without a licence. It's not too hard to determine who is actually doing journalism a who is just blowing disinformation out their ass.
Since you are a man of science, can you please point me to a peer reviewed scientific paper that explains the mechanism of action of injecting a synthetic mRNA computer derived spike
protein intramuscularly to prevent a respiratory virus that takes hold in the mucosa? We are all here to learn from others that have expertise we do not have.
@BDair Here are some major journals that might interest you. However, what you seek is something you would find in good biology, immunology, and/or molecular biology textbooks.
American Journal of Epidemiology
Journal of Epidemiology and Community Health
European Journal of Epidemiology
International Journal of Epidemiology
The Lancet Journal
The New England Journal of Medicine
Journal of the American Medical Association
The British Medical Journal
The Journal of Pathology
Journal of Immunological Sciences
The Journal of Immunology
The Journal of Allergy and Clinical Immunology
Frontiers in Immunology
Nature Reviews Immunology
Genetic Vaccines and Therapy
Human Vaccines and Immunotherapeutics
Journal of Immune Based Therapies and Vaccines
Journal of Vaccines and Vaccination
To answer your question:
The mRNA in a vaccine is built according to a viral DNA code called a gene. Whether the mRNA is made in a lab or in a cell makes no difference; mRNA is mRNA.
The skeletal muscles are composed of cells. Intramuscular injection introduces the mRNA vaccine 8nto cells. Once the mRNA is in a cell it finds an organelle called a ribosome. There are many ribosomes in the cell's watery cytoplasm. There are also lots of amino acids floating around in the cytoplasm. Amino acids are the building blocks of proteins.
When the mRNA links up with the ribosome, the ribosome begins to act like an enzyme, catalyzing a series of chemical reactions. Each reaction adds a new amino acid to a growing chain of amino acids, called a polypeptide.
There are twenty different types of amino acids. Which specific acid goes where in the sequence is determined by the mRNA code.
As the ribosome "reads" the mRNA the polypeptide gets longer. When complete, the polypeptide separates from ribosome. It then folds up into the final shape, called a tertiary protein structure. In this case, that structure is the spike protein.
It's not really a spike: it's a more complicated shape, more analogous to a key. But even that analogy is not good, because the protein is not long and thin; it's short and squat. This protein fits into a receptor on the surface of a body cell, like a key in a lock.
If there were an actual virus, it would thus gain access to the cell. But in the vaccine there is no virus.
The presence of these spike proteins is detected by specialized cells of the immune system called T-cells. T-cells are like a general on a battlefield. They rally troops to fight off an invader. T-cells "tell" B-cells to produce antibodies against the spike protein.
Antibodies are proteins too. They are custom made by the B-cell to neutralize a specific foreign body (in this case, the spike protein). The general term for any substance that precipitates an immune response (as in the production of antibodies) is called an antigen. The spike protein is an antigen.
Millions of antibodies are manufactured by the B-cells, in much the same way that the spike protein was made: by ribosomes.
The antibodies circulate in the blood, interstitial fluid, and lymph, attaching themselves to any spike proteins they happen to bump into. The spike proteins get mobbed by antibodies. The blood plasma/interstitial fluid/lymph circulation brings the mobbed spike proteins into the lymph nodes, where they are devoured and destroyed by immune cells.
When the T-cells are giving the B-cells their marching orders, they are also passing the intelligence to memory cells. It is the job of memory cells to remember that spike protein, and raise the alarm if they ever see it again.
If, down the road, a memory cell sees an antigen on its hit list, it tells the T-cells, who in turn rally the troops...again. this secondary immune response is bigger and more swift than the first. Which is why many people notice little or no reaction from their first shot, but might temporarily feel tired are get a fever from the second or third shot.
The thing that a lot of people fail to appreciate is that our immune systems are constantly bombarded with antigens, and are constantly fending off attacks from a huge number of potential pathogens: viruses, bacteria, toxic chemicals, parasitic protists.
Our immune systems are truly badass ninja warrior mother fuckers, successfully deflecting a constant barrage of pathogens. They're so good that we often don't notice that anything is going on. The little COVID-19 spike protein is nothing special. Its like a fly to an elephant. With a flick of his tail, or twitch of the ear, that fly is dead.
SARS CoV-2 is a virus that attacks the cells of the lungs (but it also apparently affects other cells as well). All the cells of the body are bathed in the same fluid. When an infected cell sheds viruses into the bloodstream, they travel throughout the body. Many viruses have evolved to specifically attack cells of the respiratory system because the coughing and sneezing they cause aids in their spread to other hosts.
Whether the antigen enters through a needle in the deltoid muscle or through the alveoli of the lung, it will end up facing the same immune system.
I hope I have answered your question.
@BDair RE vaers: the most important line in the page(s) in the link is the very last one. It reads, "Reports are not proof of causality."
The thing is, people are dying all the time, from a variety of causes. Some old guy gets up one morning, pulls on his socks, and later that morning kicks the bucket. We don't ascribe his death to pulling on his socks, even though the sequence of events does imply a causal link. That would be a fallacy known as post hoc ergo propter hoc (it happened after, therefore because of). It's the same thing with the vaccines. Somebody gets their shot, and then they die from one of the other million things that can kill you. But some family member says "Wow! He got the shot and now he's dead!" The assumption of a causal relationship is fallacious.
As of October 19, 9 deaths in the US have be caused by the vaccines. That's after administration of almost 700 million doses. You have a better chance of winning the lottery than of dying from a COVID-19 vaccine.
SARS-CoV-2 vaccine and increased myocarditis mortality risk: A population based comparative study in Japan -
Conclusion - SARS-CoV-2 vaccination was associated with higher risk of myocarditis death, not only in young adults but also in all age groups including the elderly. Considering healthy vaccinee effect, the risk may be 4 times or higher than the apparent risk of myocarditis death. Underreporting should also be considered. Based on this study, risk of myocarditis following SARS-CoV-2 vaccination may be more serious than that reported previously.
ALREADY KNOWN ON THIS TOPIC There are many epidemiological studies showing increased myocarditis incidence after SARS-CoV-2 vaccination. There are also some case reports of fulminant myocarditis after receiving SARS-CoV-2 vaccine. However, no epidemiological studies focusing the association between vaccination and myocarditis death.
FDA urged to publish follow-up studies on covid-19 vaccine safety signals -
Other research groups, including Fraiman’s, have produced results that are compatible with the FDA’s surveillance data. An observational study from three Nordic countries—Denmark, Finland, and Norway—found statistically significant increases in thromboembolic and thrombocytopenic outcomes following both Pfizer and Moderna mRNA vaccines.
@BDair Again, the last line is telling: "However, no epidemiological studies focusing [on] the association between vaccination and myocarditis death."
Look man, you asked me to school you, and I did that. If don't trust your education, or the CDC, or the National Institutes of health, that's on you.
My question to you is this: why do you keep posting this anti-vax nonsense? Can't you just make your choice and let others make theirs? Who exactly are you trying to impress?
The standard for dissemination of information regarding the safety and efficacy of vaccines is publication of peer-reviewed articles in reputable scientific journals.
I gave you a list of relevant scientific journals. I defy you to find one epidemiological study showing that thousands of people have been killed by the vaccines.
Put up or shut up.
(mic drop )
This is all falling apart.. the only reason so many fell for this in the beginning wàs because of distractions of politics and the novelty of it ..
Most All that's over with ,now we see a handful of people in masks..
The vast majority has shifted
No one's going to put up with these people anymore,but for those still wearing masks and they are outnumbered
No Fucking way another lockdown will happen even if it gets deadlier
Live free or die
No one is going to take anymore injections other than those still in masks ..
Which has become a very small percentage.. it was only so high because people were being forced or felt socially forced..
Now most people are done with it all..
Still though there's billions of dollars to be given to those who are doing their best to manipulate the public to still be in fear and to be controlled by people who have no rights to be in control ..
And there's people who repost the nonsense of these people who get paid billions to fuck with us ...
I don't wear a mask unless it's absolutely required. The reason I feel so confident is that I am VACCINATED and BOOSTED.
Should include the handicapped.
Covid is coming back coz winter is approaching. At my workplace we have one person out with Covid right now. Younger ones at my work wanted to get into discussions about masks yesterday. I simply said that could do what they want to. I don't want others to spit, sneeze, or slobber on me.
IDGAF who gets a shot, anymore, or whether they live. My next shot is due in March and I might not get it. Depends on how this election goes.
@Flyingsaucesir Not if we lose this election. I won't want to be here, anymore. Certainly not in this pathetic nation of zealots. I'll probably die from police bullets before COVID can infect me, though. What you kids do with the situation will be your problem.
@Flyingsaucesir They are whom I'm talking to. At least they'll have to read what they've accomplished.
The upside is...the dumb ones will die out. Thin out the herd.
Booster uptake is suboptimal because the shots do not work and nobody wants them.
People with two shots and 3 boosters are still testing positive. There are millions of doses of the vaccines that are expiring and headed for disposal, and billions of our tax dollars are going to waste.
I am 84 yrs. I had the first J&J shot, 2 Moderna boosters and will get the third booster this week. I have not had Covid and am not dead. You do you, I do me and lets strive to love one another and do or cause no harm.
Dude, the shots do work. They may not prevent infection, but they vastly reduce the odds of becoming mortally sick.
You people will always complain about something wasting our tax dollars. For a nation of people who buy cig's @ $50/carton you are awfully worried about tax dollars. You know, people who take aspirin can still get a headache. Infections happen but illness and death don't with the vaccine. This has been demonstrated but you go on whining about tax dollars because those will be important after you're dead.
More than wasting tax dollars , 10% inflation rise , crime increases by 30%,, third world war and on and on , life has not ever been fucked this much since world war 2.
@Castlepaloma "life has not ever been fucked this much since world war 2."
How old are you? Being eligible to get drafted into a pointless war, or just volunteering for one or two, seems pretty fucked. Every 'publican since Reagan (inclusive) has had at least one recession. Reagan had two (came into office as one launched and had another in 86). This is certainly a fucked up time but it's because Capitalism produces lots of recessions. Crime is largely caused by poverty and has been this bad in previous recessions, also. Poor neighborhoods, largely populated by POC because America is a racist place, have worse crime but it's largely against their own neighbors. That's because of the hate for those who brought them into this mess. Police forces are Authoritarian minded so causing worse demonstration violence and death. This has caused a distrust of police which makes crime even worse. Then add the multitude of guns and you have more death/fear.
How much of this have Democrats caused? I have stated that B.C. was a total disaster, almost as bad as Jr/43, but Obama largely failed because 'publicans-becoming-Q'ers shut him down. That was 8 years of very poor funding for societal programs and needs which degenerated them further. Some of Obama's failures were caused by inexperience (which kept him from fighting them as FDR or LBJ would have). That was our fault for nominating someone with little experience but the alternatives were not good, either.
@Castlepaloma You're soooo wrong about that! In the 70s we had double-digit inflation, mortgage rates were through the roof, high gas prices, long lines to get gas, and sometimes there just wasn't any. We had huge riots, worse than anything we have seen lately. What's worse today is mass shootings. Back in the day only soldiers on active duty in Vietnam had AR-15s. And 55,000 American soldiers were killed there; way more than in Gulf wars 1 & 2 and Afghanistan combined.
I know you want to blame Biden for inflation, but it only shows you you know nothing about economics. What devalues your money is spending on things that give no value in return, i.e. misguided and unnecessary wars in Iraq and Afghanistan, and huge tax holidays for Corporations and filthy rich mother fuckers. At least what Biden is spending money on are investments in people and infrastructure, worthwhile things. Get a fucking clue man!
@Flyingsaucesir umm ,the war in Ukraine is okay though That's not doing anything I guess..
Collect the whole set and get FREE Myocarditis.