Your Questions Answered About Kids, Teens, and Covid Vaccines
Kira Peikoff was the editor-in-chief of Leaps.org from 2017 to 2021. As a journalist, her work has appeared in The New York Times, Newsweek, Nautilus, Popular Mechanics, The New York Academy of Sciences, and other outlets. She is also the author of four suspense novels that explore controversial issues arising from scientific innovation: Living Proof, No Time to Die, Die Again Tomorrow, and Mother Knows Best. Peikoff holds a B.A. in Journalism from New York University and an M.S. in Bioethics from Columbia University. She lives in New Jersey with her husband and two young sons. Follow her on Twitter @KiraPeikoff.
On May 13th, scientific and medical experts will discuss and answer questions about the vaccine for those under 16.
This virtual event convened leading scientific and medical experts to address the public's questions and concerns about Covid-19 vaccines in kids and teens. Highlight video below.
DATE:
Thursday, May 13th, 2021
12:30 p.m. - 1:45 p.m. EDT
Dr. H. Dele Davies, M.D., MHCM
Senior Vice Chancellor for Academic Affairs and Dean for Graduate Studies at the University of Nebraska Medical (UNMC). He is an internationally recognized expert in pediatric infectious diseases and a leader in community health.
Dr. Emily Oster, Ph.D.
Professor of Economics at Brown University. She is a best-selling author and parenting guru who has pioneered a method of assessing school safety.
Dr. Tina Q. Tan, M.D.
Professor of Pediatrics at the Feinberg School of Medicine, Northwestern University. She has been involved in several vaccine survey studies that examine the awareness, acceptance, barriers and utilization of recommended preventative vaccines.
Dr. Inci Yildirim, M.D., Ph.D., M.Sc.
Associate Professor of Pediatrics (Infectious Disease); Medical Director, Transplant Infectious Diseases at Yale School of Medicine; Associate Professor of Global Health, Yale Institute for Global Health. She is an investigator for the multi-institutional COVID-19 Prevention Network's (CoVPN) Moderna mRNA-1273 clinical trial for children 6 months to 12 years of age.
About the Event Series
This event is the second of a four-part series co-hosted by Leaps.org, the Aspen Institute Science & Society Program, and the Sabin–Aspen Vaccine Science & Policy Group, with generous support from the Gordon and Betty Moore Foundation and the Howard Hughes Medical Institute.
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Kira Peikoff was the editor-in-chief of Leaps.org from 2017 to 2021. As a journalist, her work has appeared in The New York Times, Newsweek, Nautilus, Popular Mechanics, The New York Academy of Sciences, and other outlets. She is also the author of four suspense novels that explore controversial issues arising from scientific innovation: Living Proof, No Time to Die, Die Again Tomorrow, and Mother Knows Best. Peikoff holds a B.A. in Journalism from New York University and an M.S. in Bioethics from Columbia University. She lives in New Jersey with her husband and two young sons. Follow her on Twitter @KiraPeikoff.
A lamb receiving a shot from medical personnel.
More than 114,000 men, women, and children are awaiting organ transplants in the United States. Each day, 22 of them die waiting. To address this shortage, researchers are working hard to grow organs on-demand, using the patient's own cells, to eliminate the need to find a perfectly matched donor.
"The next step is to transplant these cells into a larger animal that will produce an organ that is the right size for a human."
But creating full-size replacement organs in a lab is still decades away. So some scientists are experimenting with the boundaries of nature and life itself: using other mammals to grow human cells. Earlier this year, this line of investigation took a big step forward when scientists announced they had grown sheep embryos that contained human cells.
Dr. Pablo Ross, an associate professor at the University of California, Davis, along with a team of colleagues, introduced human stem cells into the sheep embryos at a very early stage of their development and found that one in every 10,000 cells in the embryo were human. It was an improvement over their prior experiment, using a pig embryo, when they found that one in every 100,000 cells in the pig were human. The resulting chimera, as the embryo is called, is only allowed to develop for 28 days. Leapsmag contributor Caren Chesler recently spoke with Ross about his research. Their interview has been edited and condensed for clarity.
Your goal is to one day grow human organs in animals, for organ transplantation. What does your research entail?
We're transplanting stem cells from a person into an animal embryo, at about day three to five of embryo development.
This concept has already been shown to work between mice and rats. You can grow a mouse pancreas inside a rat, or you can grow a rat pancreas inside a mouse.
For this approach to work for humans, the next step is to transplant these cells into a larger animal that will produce an organ that is the right size for a human. That's why we chose to start some of this preliminary work using pigs and sheep. Adult pigs and adult sheep have organs that are of similar size to an adult human. Pigs and sheep also grow really fast, so they can grow from a single cell at the time of fertilization to human adult size -- about 200 pounds -- in only nine to 10 months. That's better than the average waiting time for an organ transplant.
"You don't want the cells to confer any human characteristics in the animal....Too many cells, that may be a problem, because we do not know what that threshold is."
So how do you get the animal to grow the human organ you want?
First, we need to generate the animal without its own organ. We can generate sheep or pigs that will not grow their own pancreases. Those animals can then be used as hosts for human pancreas generation.
For the approach to work, we need the human stem cells to be able to integrate into the embryo and to contribute to its tissues. What we've been doing with pigs, and more recently, in sheep, is testing different types of stem cells, and introducing them into an early embryo between three to five days of development. We then transfer that embryo to a surrogate female and then harvest the embryos back at day 28 of development, at which point most of the organs are pre-formed.
The human cells will contribute to every organ. But in trying to do that, they will compete with the host organism. Since this is happening inside a pig embryo, which is inside a pig foster mother, the pig cells will win that competition for every organ.
Because you're not putting in enough human cells?
No, because it's a pig environment. Everything is pig. The host, basically, is in control. That's what we see when we do rat mice, or mouse rat: the host always wins the battle.
But we need human cells in the early development -- a few, but not too few -- so that when an organ needs to form, like a pancreas (which develops at around day 25), the pig cells will not respond to that, but if there are human cells in that location, [those human cells] can respond to pancreas formation.
From the work in mice and rats, we know we need some kind of global contribution across multiple tissues -- even a 1% contribution will be sufficient. But if the cells are not there, then they're not going to contribute to that organ. The way we target the specific organ is by removing the competition for that organ.
So if you want it to grow a pancreas, you use an embryo that is not going to grow a pancreas of its own. But you can't control where the other cells go. For instance, you don't want them going to the animal's brain – or its gonads –right?
You don't want the cells to confer any human characteristics in the animal. But even if cells go to the brain, it's not going to confer on the animal human characteristics. A few human cells, even if they're in the brain, won't make it a human brain. Too many cells, that may be a problem, because we do not know what that threshold is.
The objective of our research right now is to look at just 28 days of embryonic development and evaluate what's going on: Are the human cells there? How many? Do they go to the brain? If so, how many? Is this a problem, or is it not a problem? If we find that too many human cells go to the brain, that will probably mean that we wouldn't continue with this approach. At this point, we're not controlling it; we're analyzing it.
"By keeping our research in a very early stage of development, we're not creating a human or a humanoid or anything in between."
What other ethical concerns have arisen?
Conferring human properties to the organism, that is a major concern. I wouldn't like to be involved in that, and so that's what we're trying to assess. By keeping our research in a very early stage of development, we're not creating a human or a humanoid or anything in between.
What specifically sets off the ethical alarms? An animal developing human traits?
Animals developing human characteristics goes beyond what would be considered acceptable. I share that concern. But so far, what we have observed, primarily in rats and mice, is that the host animal dictates development. When you put mouse cells into a rat -- and they're so closely related, sometimes the mouse cells contribute to about 30 percent of the cells in the animal -- the outcome is still a rat. It's the size of a rat. It's the shape of the rat. It has the organ sizes of a rat. Even when the pancreas is fully made out of mouse cells, the pancreas is rat-sized because it grew inside the rat.
This happens even with an organ that is not shared, like a gallbladder, which mice have but rats do not. If you put cells from a mouse into a rat, it never grows a gallbladder. And if you put rat cells into the mouse, the rat cells can end up in the gallbladder even though those rat cells would never have made a gallbladder in a rat.
That means the cell structure is following the directions of the embryo, in terms of how they're going to form and what they're going to make. Based on those observations, if you put human cells into a sheep, we are going to get a sheep with human cells. The organs, the pancreas, in our case, will be the size and shape of the sheep pancreas, but it will be loaded with human cells identical to those of the patient that provided the cells used to generate the stem cells.
But, yeah, if by doing this, the animal acquires the functional or anatomical characteristics associated with a human, it would not be acceptable for me.
So you think these concerns are justified?
Absolutely. They need to be considered. But sometimes by raising these concerns, we prevent technologies from being developed. We need to consider the concerns, but we must evaluate them fully, to determine if they are scientifically justified. Because while we must consider the ethics of doing this, we also need to consider the ethics of not doing it. Every day, 22 people in the US die because they don't receive the organ they need to survive. This shortage is not going to be solved by donations, alone. That's clear. And when people die of old age, their organs are not good anymore.
Since organ transplantation has been so successful, the number of people needing organs has just been growing. The number of organs available has also grown but at a much slower pace. We need to find an alternative, and I think growing the organs in animals is one of those alternatives.
Right now, there's a moratorium on National Institutes of Health funding?
Yes. It's only one agency, but it happens to be the largest biomedical funding source. We have public funding for this work from the California Institute for Regenerative Medicine, and one of my colleagues has funding from the Department of Defense.
"I can say, without NIH funding, it's not going to happen here. It may happen in other places, like China."
Can we put the moratorium in context? How much research in the U.S. is funded by the NIH?
Probably more than 75 percent.
So what kind of impact would lifting that ban have on speeding up possible treatments for those who need a new organ?
Oh, I think it would have a huge impact. The moratorium not only prevents people from seeking funding to advance this area of research, it influences other sources of funding, who think, well, if the NIH isn't doing it, why are we going to do it? It hinders progress.
So with the ban, how long until we can really have organs growing in animals? I've heard five or 10 years.
With or without the ban, I don't think I can give you an accurate estimate.
What we know so far is that human cells don't contribute a lot to the animal embryo. We don't know exactly why. We have a lot of good ideas about things we can test, but we can't move forward right now because we don't have funding -- or we're moving forward but very slowly. We're really just scratching the surface in terms of developing these technologies.
We still need that one major leap in our understanding of how different species interact, and how human cells participate in the development of other species. I cannot predict when we're going to reach that point. I can say, without NIH funding, it's not going to happen here. It may happen in other places, like China, but without NIH funding, it's not going to happen in the U.S.
I think it's important to mention that this is in a very early stage of development and it should not be presented to people who need an organ as something that is possible right now. It's not fair to give false hope to people who are desperate.
So the five to 10 year figure is not realistic.
I think it will take longer than that. If we had a drug right now that we knew could stop heart attacks, it could take five to 10 years just to get it to market. With this, you're talking about a much more complex system. I would say 20 to 25 years. Maybe.
A crime scene photograph.
This past April, an alleged serial rapist and murderer, who had remained unidentified for over 40 years, was located by comparing a crime scene DNA profile to a public genetic genealogy database designed to identify biological relatives and reconstruct family trees. The so-called "Golden State Killer" had not placed his own profile in the database.
Forensic use of genetic genealogy data is possible thanks to widening public participation in direct-to-consumer recreational genetic testing.
Instead, a number of his distant genetic cousins had, resulting in partial matches between themselves and the forensic profile. Investigators then traced the shared heritage of the relatives to great-great-great-grandparents and using these connections, as well as other public records, narrowed their search to just a handful of individuals, one of whom was found to be an exact genetic match to the crime scene sample.
Forensic use of genetic genealogy data is possible thanks to widening public participation in direct-to-consumer recreational genetic testing. The Federal Bureau of Investigation maintains a national forensic genetic database (which currently contains over 16 million unique profiles, over-representing individuals of non-European ancestry); each profile holds genetic information from only 13 to 20 variable gene regions, just enough to identify a suspect. However, since this database and related forensic databases were established, the nature of genetic profiling has significantly changed: direct-to-consumer genetic tests routinely use whole genome scans involving simultaneous analysis of hundreds of thousands of variants.
With such comprehensive genetic information, it becomes possible to discern more distant genetic relatives. Thus, even though public DNA collections are smaller than most law enforcement databases, the potential to connect a crime scene sample to biological relatives is enhanced. The successful use of one genealogy database (GEDMatch) in the GSK case demonstrates the power of the approach, so much so that the genetic profiles of over 100 similar cold cases are now being run through the same resource. Indeed, in the two months since the GSK case was first reported, 5 other cold cases have been solved using similar methods.
Autonomy in the Genomic Age
While few would disagree with the importance of finally bringing to justice those who commit serious violent offenses, this new forensic genetic application has sparked broad discussion of privacy-related and ethical concerns. Before, the main genetic databases accessible to the police were those containing the profiles of accused or convicted criminals, but now the DNA of many more "innocent bystanders," across multiple generations, are in play.
The genetic services that provide a venue for data sharing typically warn participants that their information can be used for purposes beyond those they intend, but there is no legal prohibition on the use of crowd-sourced public collections for forensic investigation. Some services, such as GEDMatch, now explicitly welcome possible law enforcement use.
The decisions of individuals to contribute their own genetic information inadvertently exposes many others across their family tree.
The implication is that consumers must choose for themselves whether they are willing to bring their genetic information into the public sphere. Many have no problem doing so, seeing value in law enforcement access to such data. But the decisions of individuals to contribute their own genetic information inadvertently exposes many others across their family tree who may not be aware of or interested in their genetic relationships going public.
As one well-known statistical geneticist who predicted forensic uses of public genetic data noted: "You are a beacon who illuminates 300 people around you." By the same token, 300 people, most of whom you do not know and have probably never met, can illuminate your genetic information; indeed a recent analysis has suggested that most in the U.S. are identifiable in this way. There is nothing that you can do about it, no way to opt out. Thus, police interaction with such databases must be addressed as a public policy issue, not left to the informed consent of individual consumers.
When Consent Will Not Suffice
For those concerned by the broader implications of such practices, the simplest solution might be to discourage open access sharing of detailed genetic information. But let's say that we are willing to continue to allow those with an interest in genealogy to make their data readily searchable. What safeguards should we implement to ensure that the family members who don't want to opt in, or who don't have the ability to make that choice, remain unharmed? Their autonomy counts, too.
We might consider regulation similar to the kind that limit law enforcement use of forensic genetic databases of convicted and arrested individuals. For example, in California, familial searches can only be performed using the database of convicted individuals in cases of serious crimes with public safety implications where all other investigatory methods have been exhausted, and where single-source high-quality DNA is available for analysis. Further, California policy separates the genealogical investigative team from local detectives, so as to minimize the impact of incidental findings (such as unexpected non-paternity).
Importantly, the individual apprehended was not the first, or even second, but the third person subjected to enhanced police scrutiny.
No such regulations currently govern law enforcement searches of public genealogical databases, and we know relatively little about the specifics of the GSK investigation. We do not know the methods used to infer genetic relationships, or their likelihood of mistakenly suggesting a relationship where none exists. Nor do we know the level of genetic identity considered relevant for subsequent follow-up. It is also unclear how law enforcement investigators combined the genetic information they received with other public records data. Together, this leaves room for an unknown degree of investigation into an unknown number of individuals.
Why This Matters
What has been revealed is that the GSK search resulted in the identification of 10 to 20 potential distant genetic relatives, which led to the investigation of 25 different family trees, 24 of which did not contain the alleged serial rapist and murderer. While some sources described a pool of 100 possible male suspects identified from this exercise, others imply that the total number of relatives encompassed by the investigation was far larger. One account, for example, suggests that there were roughly 1000 family members in just the one branch of the genealogy that included the alleged perpetrator. Importantly, the individual apprehended was not the first, or even second, but the third person subjected to enhanced police scrutiny: reports describe at least two false leads, including one where a warrant was issued to obtain a DNA sample.
These details, many of which only came to light after intense press coverage, raise a host of concerns about the methods employed and the degree to which they exposed otherwise innocent individuals to harms associated with unjustified privacy intrusions. Only with greater transparency and oversight will we be able to ensure that the interests of people curious about their family tree do not unfairly impinge on those of their mostly law-abiding near and distant genetic relatives.