In the news                  October 15, 2020

            Two coronavirus vaccine programs have been paused because recipients have developed serious medical conditions that might have been caused by the vaccine. What does that mean? How concerned should we be?

            The development of a vaccine is not as simple or straightforward as producing a new version of an iPhone or Samsung Galaxy. Though complex, a smartphone always conforms to physics; biological systems do too but the variations they share are complex beyond imagination.

            There is no one on the planet who is exactly the same as you, not even if you are an identical twin. We carry about 25,000 genes, each of which not only has several versions but whose functions may be turned on or off by environmental factors. You might think that fingerprints or retinal scans are unique but that is nothing compared to the enormous complexity of our immune system. No two people on the planet have had the identical exposure to viruses, bacteria, fungi and parasites so each of us has a unique immune system. When confronted by a new agent in the form of a vaccine, no two people will react in the exact same way. Therein lies the challenge for vaccine developers.

            One coronavirus vaccine recipient has developed a condition called transverse myelitis, a condition in which inflammation damages an area of the spinal cord. This can have multiple causes, usually a virus but sometimes a vaccine. The current case is being investigated but it’s not yet been determined if it was caused by the vaccine. If another case pops up among the next few thousand vaccine recipients the game will change dramatically.

            There have been more than a dozen cases of transverse myelitis due to naturally acquired SARS-CoV-2. If the vaccine mimics the natural infection, it’s possible that it will cause similar complications, although hopefully at a much lower frequency.

            The pause in the trial of this vaccine should be encouraging, not the opposite. It is the way that vaccine trials are designed and such interruptions are the norm in vaccine development. That’s why they usually take so long, sometimes years.

            Among the more than 150 vaccines now in development there are some whose design is unique, innovative and therefore unpredictable. Somewhere among them we might discover a silver lining.

Lifestyle

            See what happens when you change a dietary habit.

            Americans eat about six times as much sodium as hunter-gatherers and we pay a high price for that. Among African hunter-gatherers who take in about 600 milligrams of sodium daily the incidence of high blood pressure (hypertension) is zero. Their genetically identical cousins in the U.S. average about 3500 milligrams a day and hypertension is a leading cause of death in that group.

            Our taste for salt is acquired but if you go on a very low sodium diet for about six weeks by avoiding most fast and processed food and putting away the salt shaker you’ll find that when you eat a pretzel or a potato chip at the end of that time you won’t enjoy it! You might also discover that your blood pressure has come down a few points.

            The average sugar intake in the U.S. is more than 150 pounds per year; in colonial America it was about six! Try the same test with sugar. Stop eating candy, dessert and soft drinks for a month; don’t add sugar to your coffee. I’ll bet that you won’t be able to finish a Krispy Kreme donut by then.

            Heart disease is the number one cause of death and type 2 diabetes has moved up to number three! Two thirds of Americans over the age of sixty have at least one marker of coronary artery disease and a similar number at that age have either type 2 diabetes or prediabetes.

            You can’t change the world by cutting way back on salt and sugar but maybe you can change your world! Is it worth a try?

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