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.
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.
This Mom Donated Her Lost Baby’s Tissue to Research
The twin boys growing within her womb filled Sarah Gray with both awe and dread. The sonogram showed that one, Callum, seemed to be the healthy child she and husband Ross had long sought; the other, Thomas, had anencephaly, a fatal developmental disorder of the skull and brain that likely would limit his life to hours. The options were to carry the boys to term or terminate both.
The decision to donate Thomas' tissue to research comforted Sarah. It brought a sense of purpose and meaning to her son's anticipated few breaths.
Sarah learned that researchers prize tissue as essential to better understanding and eventually treating the rare disorder that afflicted her son. And that other tissue from the developing infant might prove useful for transplant or basic research.
Animal models have been useful in figuring out some of the basics of genetics and how the body responds to disease. But a mouse is not a man. The new tools of precision medicine that measure gene expression, proteins and metabolites – the various chemical products and signals that fluctuate in health and illness – are most relevant when studying human tissue directly rather than in animals.
The decision to donate Thomas' tissue to research comforted Sarah. It brought a sense of purpose and meaning to her son's anticipated few breaths.
Thomas Gray
(Photo credit: Mark Walpole)
Later Sarah would track down where some of the donated tissues had been sent and how they were being used. It was a rare initiative that just may spark a new kind of relationship between donor families and researchers who use human tissue.
Organ donation for transplant gets all the attention. That process is simple, direct, life saving, the stories are easy to understand and play out regularly in the media. Reimbursement fully covers costs.
Tissue donation for research is murkier. Seldom is there a direct one-to-one correlation between individual donation and discovery; often hundreds, sometimes thousands of samples are needed to tease out the basic mechanisms of a disease, even more to develop a treatment or cure. The research process can be agonizingly slow. And somebody has to pay for collecting, processing, and getting donations into the hands of appropriate researchers. That story rarely is told, so most people are not even aware it is possible, let alone vital to research.
Gray set out on a quest to follow where Thomas' tissue had gone and how it was being used to advance research and care.
The dichotomy between transplant and research became real for Sarah several months after the birth of her twins, and Thomas' brief life, at a meeting for families of transplant donors. Many of the participants had found closure to their grieving through contact with grateful recipients of a heart, liver, or kidney who had gained a new lease on life. But there was no similar process for those who donated for research. Sarah felt a bit, well, jealous. She wanted that type of connection too.
Gray set out on a quest to follow where Thomas' tissue had gone and how it was being used to advance research and care. Those encounters were as novel for the researchers as they were for Sarah. The experience turned her into an advocate for public education and financial and operational changes to put tissue donation for research on par with donations for transplant.
Thomas' retina had been collected and processed by the National Disease Research Interchange (NDRI), a nonprofit that performs such services for researchers on a cost recovery basis with support from the National Institutes of Health. The tissue was passed on to Arupa Ganguly, who is studying retinoblastoma, a cancer of the eye, at the University of Pennsylvania.
Ganguly was surprised and apprehensive months later when NDRI emailed her saying the mother of donated tissue wanted to learn more about how the retina was being used. That was unusual because research donations generally are anonymous.
The geneticist waited a day or two, then wrote an explanation of her work and forwarded it back through NDRI. Soon the researcher and mother were talking by phone and Sarah would visit the lab. Even then, Ganguly felt very uncomfortable. "Something very bad happened to your son Thomas but it was a benefit for me, so I'm feeling very bad," she told Sarah.
"And Sarah said, Arupa, you were the only ones who wanted his retinas. If you didn't request them, they would be buried in the ground. It gives me a sense of fulfillment to know that they were of some use," Ganguly recalls. And her apprehension melted away. The two became friends and have visited several times.
Sarah Gray visits Dr. Arupa Ganguly at the University of Pennsylvania's Genetic Diagnostic Laboratory.
(Photo credit: Daniel Burke)
Reading Sarah Gray's story led Gregory Grossman to reach out to the young mother and to create Hope and Healing, a program that brings donors and researchers together. Grossman is director of research programs at Eversight, a large network of eye banks that stretches from the Midwest to the East Coast. It supplies tissue for transplant and ocular research.
"Research seems a cold and distant thing," Grossman says, "we need to educate the general public on the importance and need for tissue donations for research, which can help us better understand disease and find treatments."
"Our own internal culture needs to be shifted too," he adds. "Researchers and surgeons can forget that these are precious gifts, they're not a commodity, they're not manufactured. Without people's generosity this doesn't exist."
The initial Hope and Healing meetings between researchers and donor families have gone well and Grossman hopes to increase them to three a year with support from the Lions Club. He sees it as a crucial element in trying to reverse the decline in ocular donations even while research needs continue to grow.
What people hear about is "Tuskegee, Henrietta Lacks, they hear about the scandals, they don't hear about the good news. I would like to change that."
Since writing about her experience in the 2016 book "A Life Everlasting," Gray has come to believe that potential donor families, and even people who administer donation programs, often are unaware of the possibility of donating for research.
And roadblocks are common for those who seek to do so. Just like her, many families have had to be persistent in their quest to donate, and even educate their medical providers. But Sarah believes the internet is facilitating creation of a grassroots movement of empowered donors who are pushing procurement systems to be more responsive to their desires to donate for research. A lot of it comes through anecdote, stories, and people asking, if they have done it in Virginia, or Ohio, why can't we do it here?
Callum Gray and Dr. Arupa Ganguly hug during his family's visit to the lab.
(Photo credit: Daniel Burke)
Gray has spoken at medical and research facilities and at conferences. Some researchers are curious to have contact with the families of donors, but she believes the research system fosters the belief that "you don't want to open that can of worms." And lurking in the background may be a fear of liability issues somehow arising.
"I believe that 99 percent of what happens in research is very positive, and those stories would come out if the connections could be made," says Sarah Gray. But what they hear about is "Tuskegee, Henrietta Lacks, they hear about the scandals, they don't hear about the good news. I would like to change that."
Sloppy Science Happens More Than You Think
The media loves to tout scientific breakthroughs, and few are as toutable – and in turn, have been as touted – as CRISPR. This method of targeted DNA excision was discovered in bacteria, which use it as an adaptive immune system to combat reinfection with a previously encountered virus.
Shouldn't the editors at a Nature journal know better than to have published an incorrect paper in the first place?
It is cool on so many levels: not only is the basic function fascinating, reminding us that we still have more to discover about even simple organisms that we thought we knew so well, but the ability it grants us to remove and replace any DNA of interest has almost limitless applications in both the lab and the clinic. As if that didn't make it sexy enough, add in a bicoastal, male-female, very public and relatively ugly patent battle, and the CRISPR story is irresistible.
And then last summer, a bombshell dropped. The prestigious journal Nature Methods published a paper in which the authors claimed that CRISPR could cause many unintended mutations, rendering it unfit for clinical use. Havoc duly ensued; stocks in CRISPR-based companies plummeted. Thankfully, the authors of the offending paper were responsible, good scientists; they reassessed, then recanted. Their attention- and headline- grabbing results were wrong, and they admitted as much, leading Nature Methods to formally retract the paper this spring.
How did this happen? Shouldn't the editors at a Nature journal know better than to have published this in the first place?
Alas, high-profile scientific journals publish misleading and downright false results fairly regularly. Some errors are unavoidable – that's how the scientific method works. Hypotheses and conclusions will invariably be overturned as new data becomes available and new technologies are developed that allow for deeper and deeper studies. That's supposed to happen. But that's not what we're talking about here. Nor are we talking about obvious offenses like outright plagiarism. We're talking about mistakes that are avoidable, and that still have serious ramifications.
The cultures of both industry and academia promote research that is poorly designed and even more poorly analyzed.
Two parties are responsible for a scientific publication, and thus two parties bear the blame when things go awry: the scientists who perform and submit the work, and the journals who publish it. Unfortunately, both are incentivized for speedy and flashy publications, and not necessarily for correct publications. It is hardly a surprise, then, that we end up with papers that are speedy and flashy – and not necessarily correct.
"Scientists don't lie and submit falsified data," said Andy Koff, a professor of Molecular Biology at Sloan Kettering Institute, the basic research arm of Memorial Sloan Kettering Cancer Center. Richard Harris, who wrote the book on scientific misconduct running the gamut from unconscious bias and ignorance to more malicious fraudulence, largely concurs (full disclosure: I reviewed the book here). "Scientists want to do good science and want to be recognized as such," he said. But even so, the cultures of both industry and academia promote research that is poorly designed and even more poorly analyzed. In Rigor Mortis: How Sloppy Science Creates Worthless Cures, Crushes Hope, and Wastes Millions, Harris describes how scientists must constantly publish in order to maintain their reputations and positions, to get grants and tenure and students. "They are disincentivized from doing that last extra experiment to prove their results," he said; it could prove too risky if it could cost them a publication.
Ivan Oransky and Adam Marcus founded Retraction Watch, a blog that tracks the retraction of scientific papers, in 2010. Oransky pointed out that blinded peer review – the pride and joy of the scientific publishing enterprise – is a large part of the problem. "Pre-publication peer review is still important, but we can't treat it like the only check on the system. Papers are being reviewed by non-experts, and reviewers are asked to review papers only tangentially related to their field. Moreover, most peer reviewers don't look at the underlying or raw data, even when it is available. How then can they tell if the analysis is flawed or the data is accurate?" he wondered.
Mistaken publications also erode the public's opinion of legitimate science, which is problematic since that opinion isn't especially high to begin with.
Koff agreed that anonymous peer review is valuable, but severely flawed. "Blinded review forces a collective view of importance," he said. "If an article disagrees with the reviewer's worldview, the article gets rejected or forced to adhere to that worldview – even if that means pushing the data someplace it shouldn't necessarily go." We have lost the scientific principle behind review, he thinks, which was to critically analyze a paper. But instead of challenging fundamental assumptions within a paper, reviewers now tend to just ask for more and more supplementary data. And don't get him started on editors. "Editors are supposed to arbitrate between reviewers and writers and they have completely abdicated this responsibility, at every journal. They do not judge, and that's a real failing."
Harris laments the wasted time, effort, and resources that result when erroneous ideas take hold in a field, not to mention lives lost when drug discovery is predicated on basic science findings that end up being wrong. "When no one takes the time, care, and money to reproduce things, science isn't stopping – but it is slowing down," he noted. Mistaken publications also erode the public's opinion of legitimate science, which is problematic since that opinion isn't especially high to begin with.
Scientists and publishers don't only cause the problem, though – they may also provide the solution. Both camps are increasingly recognizing and dealing with the crisis. The self-proclaimed "data thugs" Nick Brown and James Heathers use pretty basic arithmetic to reveal statistical errors in papers. The microbiologist Elisabeth Bik scans the scientific literature for problematic images "in her free time." The psychologist Brian Nosek founded the Center for Open Science, a non-profit organization dedicated to promoting openness, integrity, and reproducibility in scientific research. The Nature family of journals – yes, the one responsible for the latest CRISPR fiasco – has its authors complete a checklist to combat irreproducibility, à la Atul Gawande. And Nature Communications, among other journals, uses transparent peer review, in which authors can opt to have the reviews of their manuscript published anonymously alongside the completed paper. This practice "shows people how the paper evolved," said Koff "and keeps the reviewer and editor accountable. Did the reviewer identify the major problems with the paper? Because there are always major problems with a paper."