What A Day - One Vax Fits Most

Episode Date: April 16, 2021

Only a handful of blood-clotting cases have been reported among recipients of the Johnson and Johnson vaccine, but it's predominantly women who have developed these rare symptoms. To answer questions about the “one dose fits all” mode of medical research that can occasionally lead to these kinds of outcomes, we spoke to Rosemary Morgan, a research scientist at Johns Hopkins Bloomberg School of Public Health. She’s currently studying the gendered effects of COVID-19 on several international communities.Plus, for headlines, we’re joined by comedian and actress Sasheer Zamata: a class action settlement for Fyre Fest attendees, a Canadian lawmaker accidentally goes nude on Zoom, and scientists grow human embryos in monkeys.Show Notes:Chicago Tribune: "In several fateful seconds, video appears to show 13-year-old Adam Toledo toss gun, turn with empty hands before police shooting (warning: graphic content)" – https://bit.ly/3gaYvOhFollow What A Day on Instagram at instagram.com/whatadayFor a transcript of this episode, please visit crooked.com/whataday.

It's Friday, April 16th. I'm Akilah Hughes. And I'm Gideon Resnick, and this is What The Day, the podcast that we are giving away free to anyone who's gotten the vaccine. Yeah, also free if you haven't gotten the vaccine yet, but yeah, what Gideon said, it's true. We don't know if podcasts can technically be sold. Today, we're monitoring the fatal shooting of 13-year-old Adam Toledo by police in Chicago more than two weeks ago, who was holding his hands up. Body cam footage of the killing was released yesterday after intense public pressure. I won't be watching the video, but we'll link to that ongoing story in our show notes. But first, the latest for today, where we wanted to recap one of the week's biggest news stories, the nationwide temporary pause on administering the Johnson & Johnson COVID vaccine. Even before this development,

Bloomberg News reported that certain U.S. states and cities had a growing surplus of doses by all manufacturers. It signaled that there are some pockets of people hesitant to get the shot. And so this recent news isn't the best for making sure everyone gets in line so we can achieve herd immunity soon. But we're focusing on the most sensational headlines, that the first reported cases of the rare blood clotting disorder occurred in six women. Johnson & Johnson later reported that there were two more cases of the rare blood clotting disorder occurred in six women. Johnson & Johnson later reported that there were two more cases of people who also developed blood clots, including one 25-year-old man who participated in the trials. Right, but the fact

that it's predominantly women who develop these rare symptoms got us thinking about a long-standing problem in the medical research field, accounting for the ways that men, women, children, people of various races, and more all react differently to vaccines or drugs. There are pitfalls in thinking that there's always a one-dose-fits-all. So we wanted to dive deep into this issue with an expert in the field. Rosemary Morgan is a research scientist at Johns Hopkins Bloomberg School of Public Health. She's also the Associate Chair in Inclusion, Diversity, Anti-Racism, and Equity for the International Health Department, where she's currently studying the gendered effects of COVID-19 on several international communities. Rosemary Morgan, thank you so much for being on our show.

Thank you for having me. So we wanted to start with the main news about the Johnson & Johnson shot being paused because of these rare blood clot conditions that had come up, but only in women on first reporting. What were the initial questions that you had? Well, firstly, why is it only women reporting these specific side effects, blood clots? Is there a biological explanation for this? And if so, what is it? Also, more broadly, how much harm is the pause going to do in terms of vaccine hesitancy, specifically among women? And to be more, and to be more frank, a bigger question I had was, if they are so concerned about the risk of

blood clots, you know, particularly in relation to the Johnson and Johnson vaccine. Why hasn't there been a similar concern for the birth control pill? You know, I recognize that the mechanisms are different, like different types of blood clots, but for the risk of the Johnson and Johnson, it's one in a million, right? But for birth control, for every 10,000 women taking the pill in a given year, between three and nine will develop a blood clot. And which is concerning. It may not be as a serious a blood clot, but it's still a blood clot. And why now? Why do we care now? Right. Yeah, absolutely. And I mean, you know, we also know that there were a number of cases where women face side effects with the

AstraZeneca vaccine as well. We still don't know if that's, you know, the definite connection there. And also that could be because, you know, more women just are receiving the vaccine in general. But do either of these cases give you concerns about how any of the COVID-19 vaccine research has been done so far, you know, like in regards to that? Well, my, yes and no. So my main concern with, I guess, the COVID-19 vaccine research is the same with all medical research, to be honest, is whether or not the data that was being recorded, was the data being recorded by sex and then analyzed? So were they even looking for differences, you know, in terms of outcome data, but also adverse reactions or side effect data so you have men and women in your study you know hopefully it's around 50 men 50 women um one you need to you know collect questions of like what what adverse reactions did you what side effects did you experience chills fever right so once you've got that data, what you now need to do is like, okay, how many people

reported that they had a chills and a fever after? All right, how many of those people were men and how many of those were women? Because right now, if you look on the websites for the adverse reactions during the clinical trials, it doesn't do that. There are definitely some common side effects, sore arm, rash, fever, and chills with the COVID-19 vaccine, but there might also be some sex specific side effects. So right now, I don't know if you've seen recently in the news, while it's anecdotal, some women are reporting disruptions in their menstrual cycles. And yeah, can attest. And it's anecdotal. I know some research, some researchers are looking at that now. And more broadly speaking, can you talk about why women and men can have different reactions to vaccines in a general sense?

Sure. So we do know that women report more side effects from vaccines in general. So not just COVID-19. I do research related to the influenza vaccine and it's the same. And there's a lot of data to support that. So when it comes to vaccines, women experience a greater immune response that can make vaccines actually work better in women than men. And this is due to how hormones like estrogens and our genetic makeup affect the functioning of our immune system. And when it comes to drugs, particularly women

absorb and metabolize drugs at a different rate than men. Right. Absolutely. And that's a great lead into the next question. You know, we know that modern medicine is mostly based on how white men react to medical studies. You know, even in the Johnson & Johnson vaccine trials, 44% of participants were women. that modern medicine is mostly based on how white men react to medical studies. Even in the Johnson & Johnson vaccine trials, 44% of participants were women, though there are more women on earth than men. That is just a fact. So what is the history of white men being the so-called default? And what problems has this caused over time? Sure. And this is like an issue I feel particularly and strongly about. I get up on my soapbox and it makes me angry. It does. This issue makes me

really angry. So the fact that clinical research has historically neglected sex and gender differences. So, you know, in the United States, particularly, so prior to 1993, it was the U.S. Revitalization Act of 1993, women were excluded from clinical trials. And so they were excluded primarily due to, you know, fear of potential harms to pregnant women and their fetuses, and also how might women's hormones affect. So the decision was made to use the male body. And as you rightly pointed to, it wasn't just any male body. It was a male body of a certain height, weight, age, also white, as the standard by which everything else was measured.

So many drugs in the market today, especially those that were developed pre-1990s, are therefore based on research which excluded, you know, women and other groups, minority men likely as well. Things have changed. Women are included in clinical trials now. But are the outcomes being compared differently? And you mentioned what the implications of this are. So there was one study, for example, that showed, and this was in relation to the influenza vaccine, that women's response to a half dose was similar to men's response to a full dose in terms of effectiveness. So the question is, if men and women are being given the same dosage, and this is often based on research on what worked for men's bodies. Women tend to be smaller. A really good example to highlight this is related to Ambien, which is that common sleep aid. Yeah, isn't it that one that made Roseanne racist?

She was like, oh, I'm sorry, my Ambien. That's who was tweeting. Exactly. Just to say Ambien does not cause racism. However, research has shown that Ambien has been linked to higher rates of car accidents among women in the morning. And this is because men and women were being given the same dosage, 10 milligrams. And when men woke up, it was completely out of their system. But when women woke up, some of it was still in the system because they metabolized it differently. So really, women should be getting five milligrams, not 10.

This is like about sex. Some drugs, and the question is also with some vaccines, should we be having sex-specific dosages? Absolutely. And I mean, this does in ways go beyond gender, too. You know, you've done quite a bit of research about these disparities in vaccine trial representation, particularly among women and people of color. Now, I did my own deep dive on the J&J trial data, and I found that 44% of those people, of the participants were Americans, but almost three-fourths of those people were white. And, you know, I get that the company may be American, so maybe that's why Americans, you know, are such a big chunk of the study. But the entire world is hoping to rely on that

research. And the majority of the world is not white. So does it even make sense to have a trial that is not diverse like the world's population is? Diversity and medical research is so important, whether it's gender or racial diversity, you know, data needs to be collected and analyzed in a desegregated manner. Sometimes some differences may present as behavioral or biological, but are actually the result of larger social structural inequalities, such as structural racism. So this is where, you know, racism does cause health inequities, right? Which affects, you know, these inequities affect minority access to healthcare, healthy food, education, you know. The actual environment that they're growing up in, if the air is bad. Exactly.

I mean, sort of to that point, you know, I just anecdotally, I have asthma. In my entire life, I've been prescribed albuterol. And it wasn't for, you know, most of my life that they had ever researched the differences between, you know, how races react to it. And for a lot of black people and Puerto Rican people, albuterol is ineffective. I found that out this year for the first time talking to a specialist. And so, you know, I just think that it's a really important point that you're making, which is that like, you know, we're not saying that if you're a different race, you are in any way lesser than or whatever. It's just that the medicine should work for you. Exactly. You answered your question before by why is it problematic if we're only measuring things against white male body and racial groups, you know, black Americans versus white Americans

experiencing this differently. It goes without, to me, black Americans versus white Americans experiencing this differently, it goes without, to me, it goes without saying that black woman might, things might affect them, or she will affect them differently than black men. But we are not seeing these types of intersectional analyses, which I think are so important. Yeah. And to kind of bring it all back to what may or may not happen here in the next week or so after more research is done, is there a possibility that the Johnson and Johnson vaccine gets recommended for certain groups in the United States and not others? And then also, how do you balance out the risks of any vaccine that gets rolled out so fast like these have been

against the need to find some solution to COVID-19 immediately? Because I could definitely hear a pharmaceutical CEO, you know, try to defend themselves, you know, answering any of these questions saying, well, the virus has the potential to be so much more lethal than any of the things that we may or may not have missed throughout our clinical trial data. It's really important that we understand or, you know, think about what the risk benefit ratio is. So what's the risk to me versus the benefits that I might get? And this has to go with vaccines or medicines. I mean, how many commercials have you seen on TV for drugs, you know, especially in the U.S.? It's the U.S. thing. I'm actually Canadian. It's the U.S. thing where the list, you know, especially in the U.S., the U.S. thing. I'm actually Canadian. This is a U.S.

thing where the list, you know, the list of potential side effects are like the length of your arm. And they're so fast, you don't even know what they're saying. But people still take them, right? Why? Because the potential benefits for them outweigh the risks. And I think it's the same with vaccines. You know, and one thing with the COVID-19 vaccine, I think it's important to recognize is that, you know, the rollout was fast or it seemed very fast, but you have to understand that the infrastructure to develop the vaccines was already there. So the science was there and so much work had already been put into this that they were able to produce it so quickly. So, you know, it is possible that after more research, a certain vaccine might be recommended from one group or

another, which may actually be due to biological reasons. And I don't necessarily see that as problematic. Like we need sex specific dosing, you know, as long as people are making informed decisions based on their own risk benefit analysis. Right. Yeah. You know, we can't let perfect be the enemy of the good. You know, all of the issues that we're talking about here today, unfortunately, can, you know, sometimes undermine people's trust in science because we can point to enough examples of times that science overlooked some pretty crucial information. What can scientists do here in this case, you know, as a step to rebuilding trust during such an important time? Like, how do you think they can sort of mend what is already broken? As scientists, it's really important that we have clear messaging, for example, you know, and that we answer people's questions as they come up. And it's also important that the messaging we

put out is not alarmist. I think that's important, especially with these vaccines. So yes, more women are reporting side effects, for example, but these side effects are more often than not mild. And it actually means women's immune systems are working. They're more robust, they're ramping up, they're working. So how can we fix what's already broken? I think we also need to talk to each other and make sure we're doing appropriate and correct science that has diverse representation, that we're asking the right questions. And that to me, these equity questions are so important. Absolutely. And knowing more about how trials and tests work and how it may filter down to us when we go to the pharmacy or a doctor, what's your advice to people for when they

get that next vaccine, whatever it may be, or that next prescription? What questions, if any, should or could they be asking from healthcare professionals about dosages, for instance? The questions that I would have, I don't think local pharmacies or pharmacists would be able to answer because they wouldn't know. So, you know, my, so my questions are actually for those conducting the research in the first place. Are your samples diverse? Are you disaggregating and analyzing your data by sex and other stratifiers? Are you asking the right questions in the first place to understand how men and women might be affected differently? So when a woman or man, when a person goes up and talks to their pharmacist,

talks to their doctor and asks, what side effects might I experience? They can tell them the right answer. They can say, look, your menstrual cycle, if we do see it's linked, might be disrupted. It's not just about fevers and chills. It's not just about a sore arm and a rash. And, you know, I think the pharmacists and doctors need, we need the science and the data for them to be able to also give, relay the right information to women and men. Rosemary, this has been so wonderful. Thank you so much for speaking to us. Oh, great. Thank you for having me. That was Rosemary Morgan, a research scientist at Johns Hopkins Bloomberg School of Public Health. And that's the latest for now. We'll be back after some ads with a special headlines guest. That was Rosemary Morgan, a research scientist at Johns Hopkins Bloomberg School of Public Health.

And that's the latest for now. We'll be back after some ads with a special Headlines guest. Let's wrap up with some Headlines. Headlines. And today we have a very special guest, comedian, actress, and star of Home Economics on ABC and co-host of Best Friends with Nicole Byer that comes out every Wednesday. It's a podcast. Listen to her. You get them.

So cheers, Zameda. Hello. Hello. Be-be-be. Welcome. Welcome. How you doing? Thank you.

I like that I had to bring my own sound effects um yeah i can't believe you didn't have them set up for me we apologize uh for the bottom of our hearts no budget it's hard it's hard in these covet times let's do it let's do it yeah all right well there is a great new way to make money and it's called getting scurvy four years ago at Firefest. A class action settlement was reached this week and now the 277 people who attended the event in 2017 will get about $7,000 each. As a reminder, Firefest was pitched as a luxury music festival on a tropical island and when people got there, they found no music, limited water, FEMA emergency tents, and meals that could only be described as apocalypse lunchables.

You hate to see it. Well, I actually love to see it. Founder Billy McFarland and co-founder Ja Rule faced dozens of lawsuits since the disaster, including one that ordered McFarland to pay $5 million to two attendees who bought $13,000 VIP packages. So, yeah, that's the new Dogecoin, I guess. There are no true winners in this case only people who lost less than others mcfarland is still in prison serving a six-year sentence i wonder how much money is that guy who um didn't he suck dick for water yeah right yeah i hope he sued as well. He deserves at least a million. How much is he getting in compensation for that?

He deserves more than anybody. Right? And he said it on TV. I mean, damages for the rest of his life. Right. Yes. Yeah. He shows up, you know, everybody's asking where the water's at.

They're like, I got some water for you. How about it? Exactly. Aw, poor baby. Well, in Canada, there was a tragic example of Zoom fatigue overlapping with clothes fatigue. A liberal lawmaker, which I love that they keep saying liberal lawmaker, because if it said conservative, we'd be like, this makes sense. A liberal lawmaker.

Exactly. He accidentally exposed himself during a virtual meeting of Parliament this week because he didn't realize he was on camera. William Amos of Quebec was apparently changing into workout clothes, which, you know, the message here is never work out.

Don't do it. It's a trap. Save your job. never work out. Don't do it. It's a trap. Save your job. Never work out. His mistake was called out by a fellow lawmaker who also used the opportunity to shoot her shot. We have seen that the member was in very good shape, but I think that

this member should be reminded of what is appropriate and to control his camera. Thank you. Whoa. Surprise. She didn't go farther. And she was like, uh,

this member is very long. And this member is very thick. Just in case you don't know who we're talking about. Talk about the one with the really big balls. Um, the incident led to plenty of jokes, but also criticism of the people who leaked the pictures And helped spread them online

If you guys like nudes so much I'm sure there are at least one or two others on the internet But that's like Illegal right? Shouldn't everybody realize That only government officials were on the Zoom So you know someone Yeah

Seems pretty straightforward It was that person who was like got him now he's a famous amos exactly the second one oh man that's not what he wants uh president biden is finally standing up for the nation's computers hitting russia with sanctions yesterday for its role in a massive hacking scheme last December. And this is the first time the federal government has openly blamed Russia for executing the so-called SolarWinds hack, which compromised computer systems of multiple government agencies and around 100 private companies in the U.S. Do not worry.

My laptop was untouched, even though it contains dozens of hilarious reaction gifs that the Russians, quite frankly, would have loved. You are missing out, Vlad. The SolarWinds hack was first detected back in December, but the Trump administration was a little hesitant to acknowledge it, let alone blame Russia. That is just not how you treat your ride or dies in these times. The sanctions will affect Russian financial institutions, tech companies, and individuals the Biden administration deemed responsible for the hack. I didn't hear about this when this actually happened last year. And so I was like, did someone hack the wind?

Like I thought that all the... I thought that all the like... The solar wind. The solar wind. So I guess wind during daylight, that's being hacked now and redirecting to other places? It all belongs to Russia. That's Russian ass.

We don't want that. We don't want that at all. We need some wind. It'd be nice. A group of scientists have decided to reboot evolution by successfully growing human embryos inside monkeys.

Everyone has their little quarantine project and theirs was laughing in the face of God. The facts of the experiment were published yesterday in Cell. Not in Cell. Cell. By a bunch of to clarify.

And they're a little less freaky than the one line summary. The embryos only grew for 19 days so no one had to address the question And they're a little less freaky than the one-line summary. The embryos only grew for 19 days, so no one had to address the question of who the monkey baby would call mom. If you're wondering why someone would do this, like I am, besides just to freak everyone out, scientists hope that by learning to grow human cells and animal models, they'll eventually be able to grow organs, which could be used for transplants. Just be aware that if you do get a hybrid monkey heart, you will become addicted to bananas.

You know, I've heard about this. And the monkey ear, you know, you know how they're like, sometimes don't hear evil. That could be a real hindrance. Or even see evil. Yeah. Or speak it. Speak it, right? Let's just decide what animal we want more

crime more crime will happen i tell you that exactly this is the crime that we all need to be looking out for quite frankly my goodness well so sheer you are absolutely a ray of sunshine is there anything else that you would like to plug anywhere else people can find you uh all my socials are at the sheer truth t-h-e sheer truth and yeah my podcast home economics is airy right now um we're gonna film woke season two soon so catch up and watch woke season one on hulu and you know just be kind to each other oh wow what a whole good way to end the headlines. Well, those are the headlines. That is all for today.

If you like the show, make sure you subscribe, leave a review, collect $7,000 from Billy McFarland, and tell your friends to listen. And if you're into reading and not just terrifying species combination news like me, what a day is also a nightly newsletter. Check it out and subscribe at crooked.com slash subscribe. I'm Akilah Hughes. I'm Gideon Resnick. And turn off your Zoom cam.

You don't even have to have it on when you join. There's no excuse. Yeah. Pants off, Zoom cam. Also off, please. Yeah, that's how it goes. writer is John Milstein and our executive producers are Leo Duran, Akilah Hughes, and me. Our theme music is by Colin Gilliard and Kashaka.