Summary paper on the vaccines with Fauci as senior author

January 20, 2021 • 10:45 am

Reader Simon sent me a link to this free paper about coronavirus vaccines written by several researchers, including Anthony Fauci (“senior author” means “last author”, and the convention that this spot is occupied by the Boss or lab head). It’s a useful summary of where we are, which other vaccines are coming, and what we don’t know, and is understandable by the layperson. (Here’s a link to one term you might not know: “mucosal immunity“, while “parenterally” refers to medicines taken outside the digestive tract, usually through injection.)

Click on the screenshot to read:

There’s a useful table of vaccines already used compared to those in development. Of the five remaining vaccines, three involve viruses: mostly inactivated viruses that can’t replicate but can produce the spike protein that activates your antibodies, while two others involve injecting spike proteins themselves, made in insect cells. Click to enlarge:


Here’s a figure I’ve posted before showing the protection you get from the two vaccines in use in America now: the Pfizer/BioNTech and Moderna formulations.

Note that you’ve already gotten substantial protection before you get to the second jab. For both vaccines the efficacy (the reduction in the chance you’ll catch the virus if exposed) is about 95%.

The paper raises several concerns about the vaccines and people’s willingness to take them.

A.)  What are the side effects? Monitoring of those injected has only taken place for several months, and there may be long-term effects we don’t know about. The authors note, though, that some of the vaccinated would have had stuff like cancer and heart attacks anyway—effects having nothing to do with the injection. The frequencies of such incidents and diseases need to be compared to those in unvaccinated groups or base rates already known.

B.) We don’t know the efficacy in some important groups, including “children, pregnant women, individuals with underlying illnesses, and those taking medications that might influence the immune response to a disease.”

C.) The duration of protection provided by the vaccines. We know that the efficacy of flu vaccines wanes substantially between six months and a year after injection. Will we have to get yearly injections of coronavirus vaccines as we do with flu shots?  Of course they will continue developing vaccines, so they will get better over time.

D.) How well do the vaccines protect against (asymptomatic) infection and transmission of the virus? We should have the answer to this question in a while, and the authors consider this the most important unknown in trying to stem the pandemic. If after injection you can get infected and not show symptoms, as well as transmit the virus, this will dramatically curtail efforts to stop the pandemic cold, and mandate different strategies, like testing those already injected.

And a paragraph from the paper, which is disturbing given that roughly half of Americans plan to get vaccinated. That is INSANE! Tell your worried friends to get their jabs, as it’s better than getting coronavirus.

The point made is that the vaccines currently in use don’t provide immunity in the mucosal membranes (as in the nose), while polio vaccine did bestow that immunity, but only if made with live weakened virus. (Current flu vaccines don’t provide it either.) Active immunity in the mucosa kills the virus in the respiratory system before it has a chance to get into the blood. The coronavirus vaccines now available don’t seem to provide mucosal immunity and, as the authors say, we need vaccines that will do that. A summary:

Given that recent polling suggests that only 40% to 60% of people in the United States are currently planning to get vaccinated, it is conceivable that without some impact on transmission, the virus will continue to circulate, infect, and cause serious disease in certain segments of the unvaccinated population. Administration of parenterally administered vaccines alone typically does not result in potent mucosal immunity that might interrupt infection or transmission. In the case of poliovirus, induction of mucosal immunity through vaccination with the live attenuated oral polio vaccine, in contrast to the parenterally administered inactivated vaccine, was thought to have played a critical role in interruption of transmission and control of poliovirus epidemics. For these reasons, additional data regarding protection from infection should be generated as soon as possible. If these vaccines do not provide durable, high levels of protection from infection, and do not drive the prevalence of virus in the community to near zero, a thorough analysis of shedding and transmission will need to be done through additional study. Armed with such data, public health officials can make decisions regarding prioritization of populations to receive the vaccine, and researchers could potentially improve upon the first wave of vaccines.

18 thoughts on “Summary paper on the vaccines with Fauci as senior author

  1. The UK emphasis on vaccinating as many as possible with dose A & a delay in dose B is supposedly a public health stress to vaccination, whereas the US reluctance to do that is supposedly because even though one dose gives good protection, US people are so litigious that they dare not try that approach.

    Apparently each approach risks giving the virus opportunities to change but there you go.

    Does vaccination work on those already ill?

    Argh sorry Jerry mistyped email 😩

  2. I’m intrigued to see how vaccination changes case numbers. The first clues might come in Israel. The country is leading the world in getting people vaccinated – around 5% fully vaccinated and 25% with at least one dose. Plus 6% or so who have had diagnosed disease. As the numbers of vaccinated people rise, and we need to account for the initial lag in immunity post vaccination, we should at some point start to see as sustained drop in cases. Numbers that go down and don’t come back up. With luck that should give the rest of the world some idea of what level of vaccine penetrance they need to reach.

    I’m intrigued by the UK approach (especially as my mother and in-laws are in the delayed second dose mix). As Dom notes, there are too many lawyers (50% of the world supply, should anyone want one) to try that experiment in the US

    1. The Palestinians will be the control group. If the Israeli government is serious about protecting everyone, they need to tackle that, as we need to regarding the vulnerable in other countries. If we want to reduce spread.

      It seems wrong to me that I will get the vaccine before a vulnerable person in say An African or South American country.

      The US obsession with law is bizarre – hardly as if it is a haven of peace & justice! 🤣🤪

  3. The dilemma for policy makers is how to maintain effective lockdowns when people have been vaccinated.
    Arguably, not disclosing whether vaccinated people can or cannot pass on the virus would lead to better lockdown compliance.
    In the uk we have also extended the time frame between injections. This too is, arguably, a means to ensure that people are not complacent because they have had their two jabs – the aim is to get as many to have their first jab and the protection it offers before giving people the idea that they are totally (or as near as) protected after two jabs.

    1. Are you sure that’s why they extended the time? I thought it was because they didn’t have enough vaccine to get everyone their two jabs within the requisite three weeks, so they drew out the time. The protection from one shot has not been shown to provide near the protection of two shots, nor have they tested whether drawing out the interval, as they are doing in the UK, won’t affect the efficacy of the vaccine. The argument you adduce seems to be making a virtue of necessity.

      1. The efficacy after one shot IS supposedly pretty good, but improved by the second. Also, arguments over the 3 weeks – apparently that was based on the time constraints of the test period – longer waits before a second shot, supposedly improve the ability of the body to build resistance. I cannot point to one source for these statements, merely various radio discussions with epidemiologists. The emphasis here is on reducing severity because even with one shot it is thought those who do still get it have a less severe form & are less likely to be hospitalised. The NHS is on the ropes & all those with other conditions are losing out.

        I have a number of friends who had the good old classic C19, one who is a nurse & a little overweight was within minutes of going to hospital as her breathing was so laboured, but she pulled through. I know at least 8 who had it, 3 recently, possibly the newer variant, losing sense of smell – the 6 yo was unaffected though he took it home from school. A 2yo I know has had it twice, definitely (he has regular medical care for other reasons so was tested) but was not ill. His mother is however struggling with the isolation – really concerned about her…

        Avoid getting it! Not hard for those of us who are solitary 😥
        STOP PRESS-

        Well there you go – ignore what I said! That’s what you get for listening to Tony Blair ( famous epidemiologist advocate of 1 shot strategy & war inIraq)…

    2. So being vaccinated doesn’t take care of the problem of virus spread because it can still infect cells of the nose and throat. Vaccination only keeps you from getting sick – you’re infected but feel fine. That’s a hell of a note. I’d wanted to think that it would be party time after the second vaccination.

      1. Maybe I should read beyond the first paragraph of the mucosal immunity paper, but … does an infection that can’t get into the bloodstream produce as many virus particles that can then be sneezed or spoken into the atmosphere? I would guess that at a minimum, the infection would not last as long in vaccinated people.

  4. And out of the 40-60% of Americans who don’t want the vaccine, I wonder how many are anti-vaxers, and how many are just Covid-19 anti-vaxxers. I’ve also read that many people have bought into the conspiracy that the vaccine is a ruse for injecting a microchip; I wonder how many of those 40-60% buy into that one. I’m sure many employers are going to mandate it, and that might bring the percentage down regardless.

    I’d be interested to know how the 40%-60% correlates with other countries. And will there be countries (China?) who force their entire population to get the vaccine?

  5. We’ve seen 100+ cases of problems in the elders that we vaccinate – including same day death – but nothing tied to the vaccine except 1 or 2 PEG allergic (which shouldn’t have gotten the mRNA vaccine). So, as promised from the tier 3 test program, side effects seem to be rare enough.

    Speaking of which, I was surprised that PEG allergy was a known problem. I had hoped that the fast, non-ova-cultured mRNA vaccines would lead to a general flu shot in the future.

    in other news, I read in passing that mRNA vaccine developers are testing higher temperatures and even freeze drying [!]. That would help providing vaccines in home care/remote areas/warm climates.

  6. First thing of interest that i noticed is that both Pfizer and Moderna can be stored for at least a wk @ 2-8 C. I had thought that Pfizer was going to require -80 until taken out for injecting, and that would have required a substantial outlay for vaccinating pharmacies. My vaccine pharmacy of choice is Rite-Aid, where they told me a couple mos ago that they didn’t have -80 capacity but would by the time the vaccine was rolling out.

    Also noted, the ordinates in the two graphs for some reason are denominated differently, as index number and %, but seem to be saying the identical thing.

    Otherwise noted: none are inactivated virus vaccines, like the Chinese one, so I won’t include a comment/question about their chemical inactivation strategy.

    1. What does “pharmacy of choice” mean? I’m unfamiliar. Does that mean you have more than a duopoly of drug stores? Otherwise how would they be able to treat customers like garbage?
      Here in Manhattan we have Aeroflot 1 and Aeroflot 2 brand pharmacies – there IS no real competition. Like having 4 major airlines now when 20 years ago we had nearly a dozen. It is the same in many industries. Like “choice” in internet browser or search.

      Somebody (both parties but one particularly… guess…) have been asleep at the switch when it comes to anti-trust to the detriment of all Americans.


      1. David – Here (Western PA, just E of Pittsburgh) I could go to a Rite-Aid, CVS or Walgreens. Rite-Aid is closest and I’ve been getting my flu shots there for the last 6yrs or so, since my MD’s office quit giving them for reasons unknown, and they do a good job. I think I can get them at the big grocery chain, Giant Eagle, which has a pharmacy where I get all of my prescription stuff and is even a tad closer, but haven’t investigated that.

        1. Giant Eagle! Remind me where you live again, Hemp? My parents retired between New Florence and Ligonier after a lifetime of living all over the world.

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