Johnson and Johnson Vaccine Update
Critical COVID-19 Mortality Prevention Research and Covid Variant Updates
from Dr. Dale Migliaccio, D.C.
This Newsletter is focused on the Johnson and Johnson Vaccine Updates. Additionally, because February was Heart Health month, we have some key pieces on that subject, including our first newsletter focus on Nitric Oxide. If you haven't gotten your vaccine yet, please read the article below on Vaccines as this is an important decision for everyone.

Our key topics this week are
Johnson and Johnson Vaccine Review Update
Update on Santa Barbara COVID-19 Numbers
New Research Heightens Key COVID-19 Focuses
Covid Variants, and Get Out of Jail Free Card!

Good News, good news and more good news, with caution! As of Monday, March 8th, SB County average daily new cases are down from a high of 413 to 62, our weekly death rate peaked on Feb 13th at nearly 6 deaths per day, which is down to 1 per day now. Of course the low death rate is the most important stat. Active cases have decreased more than 10 fold, from a high of 3,256 to 272 as of March 8th! That is MASSIVE improvement.

These positive changes are the result of the drop from the holiday peaks created by too much social gathering in closed spaces, and people being much more careful since the peaks. We are likely beginning to see the benefits of the vaccine roll out as well.

You are well aware the first 2 vaccines have been rolling out and as of last Friday, March 5th, our 3rd Vaccine, the Johnson and Johnson vaccine has arrived in SB! Additionally, some of the rules and regulations on businesses have been relaxed and we are slowly, but excitedly moving in the direction of even less restrictions.

One negative is the increased presence of some new Covid strains. This picture is not yet 100% clear, but it does appear that what is being called the California Strain spreads faster and possibly more dangerous. There is a detailed report below regarding the new strains. The other concern is that locally and nationally there has been a very recent flattening out of the curve of new cases. In SB we are actually up 17% from our low of last week on the 2 week rolling average. It is suggested by the "experts" that this is possibly due to people suddenly becoming less cautious again and also possibly the new strains. Time will likely tell.

Please see my notes on the Johnson and Johnson Vaccine below and the new CDC decision, which I call the "get out of jail free card"!

Let's continue to use our smarts, be cautious, and strongly protect those higher risk patients who have not been vaccinated and do everything you can to be as healthy as can be! That is your best bet.

Also, please forward this newsletter to your friends and family.  By doing this you can help others reduce their risk and, at the same time, reduce their fear, and hopefully get Santa Barbara back to "open for business".
Dr. Dale Out of Office
Laurie, the kids and I will be on a ski trip to Tahoe, so I will be out of the office on Wednesday, March 10th, through Tuesday, March 16th. I will have additional hours Monday, March 8th, from 8:00-12:30 and 2:30-5:30, Tuesday, March 9th, from 9:00-12:00 and 2:00-6:00 and Wednesday, March 17, from 8:00-12:30 and 2:30-5:30. If you need care while I am gone, please see Dr. Niko or Dr. Mark. They are here to help you.
Importance of Nitric Oxide
Nitric Oxide (NO) is a gas naturally produced by the body that is important for many aspects of health. The most important function is vasodilation, meaning it relaxes the inner muscles of the blood vessels, causing them to widen and increase circulation. For this reason, it is one of the most researched molecules regarding the role it plays in supporting cardiovascular health. Nitric oxide production is essential for overall health because it allows blood, nutrients and oxygen to travel to every part of the body effectively and efficiently. NO has also been shown to act as a cell signaling molecule, affecting numerous activities of the nervous, immune, gastrointestinal and endocrine systems.

As we age, our bodies become less efficient at producing NO. In fact, by 40 years old, the enzyme function responsible for generating the active form of NO is reduced to about 50%. By 60 years old, enzyme function falls to only 15%. Certain medications are also known to decrease NO synthesis, including NSAID’s, oral contraceptives, antibiotics, SSRI’s, and acid blockers. Factors causing oxidative stress, like alcohol, nicotine, environmental toxins, pollutants and others also limit NO production. Additionally, sedentary lifestyles, certain genetic predispositions and chronic stress all adversely affect available levels of NO in the body.

Signs and Symptoms of low NO production
Low brain endurance
Less stamina/endurance
Fungal growth on toenails
High Blood Pressure
Decreased heart function
Swollen ankles, lower legs
Poor memory
Poor nail health
Cold hands/feet
Aches/pain in veins
Muscle Cramps
Asthma, poor lung function
Poor focus & concentration
Fatigue or low energy levels
Irritability & Depression Anxiety Disorders
Insomnia, difficulty sleeping
Next time you are in for an appointment ask Dr. Dale to do an NO test on you. There is no charge for the test and the test results are immediate.

Cardiovascular Health
Increased vasodilation decreases blood pressure, and supplementation with dietary nitrates has been shown to decrease blood pressure by up to 12.5/4.7 mmHg. A decrease of just 5 mmHg in a hypertensive patient can decrease stroke risk by up to 34%.
Updated Key COVID Focuses
Introduction to the Coronavirus Variants

A new virus variant has one or more mutations that differentiate it from the wild-type or predominant virus variants already circulating among the general population. As expected, multiple variants of SARS-CoV-2 have been documented in the United States and globally throughout this pandemic.

B.1.427/B.1.429, aka The California Variant
  • Two studies pending publication have shared details about this variant, first identified in California, which has since shown up in 45 states to date, and in several other countries, including Australia, Denmark, Mexico and Taiwan. But it has so far taken off only in California. It wasn't seen in any samples from September, but by the end of January it was found in half of them. The scientists say the variant has a different pattern of mutations than the ones first seen in the United Kingdom and South Africa. One of its mutations affects the spike protein of the virus. They have observed "increased severity of disease" associated with the new variant, including "increased risk of high oxygen requirement."
At this time, it is unclear if the vaccines in use will be any less effective against this variant.

B.1.1.7, aka The UK Variant
First documented in the United Kingdom, this variant carries a large number of mutations and has since been detected around the world, including in the United States (US). This variant was first detected in the US at the end of December 2020. In January 2021, scientists from the UK reported early evidence that suggests the B.1.1.7 variant may be associated with an increased risk of death compared with other variants. More studies are needed to confirm this finding.

B.1.351, aka The South Africa Variant
Another variant of SARS-CoV-2 known as B.1.351 emerged independently of B.1.1.7. According to a non-peer-reviewed preprint article, this variant shares some mutations with B.1.1.7. Cases attributed to B.1.351 have been detected outside of South Africa, and this variant was first detected in the US at the end of January 2021. Preliminary evidence from non-peer-reviewed publications suggests that the Moderna mRNA-1273 vaccine currently used in the US may be less effective against this variant, but additional studies are needed.

P.1, aka The Brazil Variant
In Brazil, a variant of SARS-CoV-2 known as P.1 emerged; it was first identified in January 2021 in travelers from Brazil who arrived in Japan. This variant was detected in the US at the end of January 2021. There is evidence to suggest that some of the mutations in the P.1 variant may affect the ability of antibodies (from natural infection or vaccination) to recognize and neutralize the virus, but additional studies are needed.

Overall the Variants may be one of the reasons for our most recent increase in new cases, and one of the reasons we still have to be cautious.
Key Nutrition for Creating a Very Strong Host
to Combat Immune Attacks.

This is from one of my first newsletters on Covid back in March 2020, and this is still the most critical information when it comes to being healthy in unhealthy situations.

Keys to Being a Strong Host

As you already know, Prevention is critical toward warding off infections. And Being a Strong, Healthy Host is the smartest thing you can do. 

With all of these "visitors", we can still be very healthy. The key here is how strong we, the host are at keeping the visitors from adversely affecting us. That job is left to our immune system, which is comprised of the healthy bacteria in our gut, the lining of the GI tract, the lymphatic system, lymph nodes, the thymus (which produces T-cells), bone marrow (which produces white blood cells and B-cells/antibodies) and the spleen and liver (which filter the blood). 

Doing everything we can to create a healthy immune system is critical as well as taking care of our overall health and of course living a healthy lifestyle.

The Lifestyle keys to creating a strong, healthy host are: 
  • Getting plenty of good quality sleep. 
  • Eating a high vegetable, moderate protein, blood sugar stabilizing diet that is low in sugars, carbs and milk products. Avoid spikes in blood sugar, which have an immune suppressive affect. 
  • Getting your regular exercise. Exercise is very immune stimulating and supportive. 
  • Taking a thorough supplement regime including some additional immune products.
Do everything you can to create a very relaxed state on a daily basis.

Current Host Strengthening Program
  • Humacel: 2-3 caps upon arising.
  • Herbal Biotic: 3 caps with breakfast 
  • IG-26: 3 caps at breakfast
  • Vit. D3 5000 or K2D3 5000, 1 per day.
  • Over age 40, One 3mg Melatonin capsule at dinner or before bed.
  • Stellar C, 1 with lunch.
  • Omega MonoPure EC, 1-2 at breakfast or Omegagenics EPA/DHA 2400, 1 tsp.

If you are someone who gets sick often or more severely, use our powder version of IG-26 and take 2 scoops per day. This is very effective at decreasing all infection frequencies and severity. 

Active Viral Infection Protocol
The key here is to be prepared! If you are taking the Host Strengthening Program then you have these on hand and can easily ramp up as soon as you feel something coming on. It is easy to build resistance if you are quick to respond with the below.

  • Humacel: 3 caps, 3x’s per day away from food. (Upon arising, mid-morning and late in the day) 
  • Herbal Biotic: 4 caps, 3x’s per day with food for 4 days, then 3 caps, 3x’s per day. 
  • IG-26: 3 caps, 3x’s per day with or without food.
  • Vit. D3: increase your intake to 3 caps, 3x's per day for 3 days then return to one per day.

If COVID-19 is even suspected, Add:
  • Quercisorb-SR: 2 caps with your morning and afternoon Humacel.

If compromised breathing, oxygen levels or severe cough, Add:
  • MuSolve: 2 caps upon arising and 2 late afternoon.  This is a very effective product for Lung congestion or restriction.  At times we go as high as 3 caps, 3x/day. 

If loss of taste or smell, Add:
  • B-Active: 1 breakfast, 1 dinner

Additional support for strong microbes, or older and/or compromised individuals either:
  • MonoLaurin or CompliVir 1 cap per meal, or
  • Silvercillin: 2 teaspoons, 3x's per day. Swish, gargle deeply and swallow. (Preferred if loss of taste or smell).

Important Note: If you are not noticing improvement within the first 3 days, call the office and let them know what your primary symptoms are. We have many other immune products that may be necessary for you. Also, if necessary, we can set up a phone consult. You can also email me.

Viral Protection Product Handout, (a more detailed write up of each of our immune products)

Johnson and Johnson Vaccine Update
and new CDC guidelines
Since my last newsletter, more information on the vaccines has emerged and the most important news is the availability of the Johnson and Johnson Vaccine. This is the vaccine I am recommending to my patients who have not yet gotten a vaccine and want one. With the cautions that are covered toward the bottom of this article.

  • The J&J vaccine requires just one shot, thus achieving full benefits within 4 weeks. The Moderna and Pfizer vaccines require 2 shots, reaching their maximum potential 6 weeks after the initial dose.

  • Clinical-trial data peg the rate for J&J's effectiveness at 72 percent in the United States, compared with 94 and 95 percent for the Moderna and Pfizer vaccines, but many experts say we shouldn’t fixate on those numbers.

  • J&J’s numbers can’t be used as a direct comparison to the other two vaccines because it’s a single dose and the company’s trial was conducted when there were more infections as well as new, more contagious variants.

  • Once considered fully vaccinated, there have been zero cases of hospitalizations or deaths in clinical trials for all of these vaccines. Both are considered 100% effective at preventing COVID-19 deaths and Johnson andJohnson had NO hospitalizations!

  • Pfizer and Moderna vaccines showed a decrease in effectiveness at preventing symptomatic COVID-19 cases in the over 60 population, whereas the J&J vaccine yielded an increase in effectiveness in the higher age groups.

Let me start by clarifying some essential information in understanding what we know these vaccines do for us at this point. In order to get approval, the vaccine companies had to prove only two key benefits: First that they reduced the severity of COVID-19 infections, and second that they reduced the number of COVID-19 positive PCR tests.  Of course, they had to prove a very specific degree of safety also. 

A key factor is that these vaccines were not tested on very compromised individuals and this is the area, along with highly allergic individuals and pregnant women, that caution is most important.

In Jan. over 30 elder, frail patients died within 3-4 days of receiving their first shot of the Pfizer mRNA Vaccine in Norway.  This is especially significant given that only 545 Norwegians had died from COVID-19 at that point. This was a specific group, whom if the public health “experts” in Norway had followed some common sense would have respected the “wait and see” approach and avoided these deaths.  Now they are withdrawing treating this group.  

The more compromised someone is, the more likely they are to succumb to the side-effects of the vaccine.  Hopefully, some of the vaccines coming soon will be less likely to cause these types of reactions. 

Of course, this group is also the group that needs the most protection.  So, as we have said all along, be very vigilant in protecting yourself if you fall into this group and protecting any loved ones from getting exposed who are at the greatest risk. 

I personally will likely get the Johnson and Johnson vaccine at this point to take advantage of some of the loosening of rules and regulations and the "Get out of jail free card".
Important New Guidelines from the CDC!
People who have been fully vaccinated against Covid-19 do not need to quarantine if they are exposed to the coronavirus. In the updated guidance, the CDC said such quarantining is not necessary for fully vaccinated people within three months of having received their last doses as long as they do not develop any symptoms. "Fully vaccinated" means that at least two weeks have passed since a person has received the second dose of a two-dose vaccine or one dose of a single-dose vaccine

This also applies to those who had previously been infected. As long as they remain asymptomatic, they would not need to quarantine after re-exposure. This "free pass" is good for 3 months after the end of their initial symptoms.

The following are new guidelines released by the CDC on March 8th:

Fully vaccinated Americans can gather with other vaccinated people indoors without wearing a mask or social distancing, according to long-awaited guidance from federal health officials. In spite of this I would recommend some caution for higher risk individuals until we know more about the variants.

The recommendations also say that vaccinated people can come together in the same way with people considered at low-risk for severe disease, such as in the case of vaccinated grandparents visiting healthy children and grandchildren.
Critical Keys for You and Yours

It is very straight forward how to totally or dramatically reduce your risk of getting COVID-19 or for that matter other infections, and how to minimize the severity of infection if you are exposed.

1.  If you don’t want to get COVID-19, protect yourself from any interaction with someone who is out and about, especially if they do not practice careful protocols themselves.  If you fall into the "high risk" group, it is possible to completely protect yourself by staying away from others or practice the info in #2 below.

2.   Spending time with others that you are not sure are safe should be done outdoors while maintaining a distance of 6 feet or more.  There is a dramatic difference in the ability of being exposed in the open air vs. a closed space, where if someone is infected the aerosol particles can concentrate over time. Fresh air is your friend.  Spending time outdoors in nature is also a big plus when it comes to our immune and mental health.

3.   Taking a preventative protocol on a daily basis will decrease your likelihood of both getting sick, and if you happen to become COVID-19 positive, it will increase your resistance, which should reduce your degree of symptoms.  Please see our very important article regarding Omega 3's reducing mortality risk in COVID-19 positive patients. This is brand new, critical research.

4.   If you or a loved one becomes COVID-19 positive and have any symptoms at all, then contact me ASAP if they want to strengthen their Immune System to better fight any infection. I have not had one COVID-19 positive patient of the more than 30 that I have supported who ended up in the hospital, and all but one were dramatically improved within 3 – 5 days. Some of those patients were quite sick when we started, including very low Oxygen levels.  Being able to stay out of the hospital is a huge plus.

5.   Don’t watch the mainstream media coverage of Coronavirus and get confused by misinformation and stressed by the common approach of news agencies who love drama and spread fear.  Fear is VERY unhealthy, especially when it occurs over a long period of time.

6.   Have fun, eat healthy, get your exercise (outdoors if possible) and spend time with loved ones who are not sick and those that are not likely to be positive.  

7.   Go to Great Lengths to protect anyone you know who is at high risk: this is still Key. No matter how many people test positive, IF none of them are high risk, our situation is dramatically different. Then the hospitals are NOT busy and death rates are very, very low.

This virus is actually very easy to beat if you take the right steps, so follow numbers 1 – 7 above and please let me know if you have any COVID-19 questions!

Current Trends in COVID-19 Cases
Santa Barbara County

In Closing
Please know we are here to serve you and yours in every way we can, so please reach out to us if you have any health care needs we may be able to help you with.

And may 2021 be as exciting and enjoyable a year as 2020 was challenging.

Please send me any of your Coronavirus questions or comments at