The Weekly Dose
July 23, 2020
Welcome to The Weekly Dose! Each week, we will review one scientific article, summarizing the research and providing key takeaways. Our goal in this endeavor is to make science understandable and accessible to all.
Early evidence from a clinical trial of a SARS-CoV-2 vaccine was published this week in the journal, The Lancet. The study, which was conducted at 5 sites in the United Kingdom on a participant group of 1,077 healthy adults 1 between 18 and 55 years of age, evaluated the efficacy, safety, and side effects of an adenovirus-vectored vaccine called ChAdOx1 nCoV-19 up to 56 days after administration. ChAdOx1 nCoV-19, the “candidate” vaccine, was compared to a meningitis “control” vaccine, called MenACWY, which has a similar side-effect profile. 2 The design of the study called for participants to be randomly assigned to receive the candidate vaccine or control vaccine in equal numbers. All but 10 participants were given a single dose of vaccine At two of the five sites, investigators allowed participants to take acetaminophen to treat such side effects as injection-site tenderness, chills, and muscle aches. Participants were assessed for two types of responses: the presence and level of antibodies, which neutralize the virus and may protect against reinfection; and replication of T cells, which attack virus-infected cells and are thought to be involved in eliminating the virus among individuals who never develop symptoms. 

1 Investigators confirmed the absence of SARS-CoV-2 infection and COVID-19-like symptoms.
2 Saline, a common placebo in clinical studies which administer a treatment intramuscularly via syringe, was not used in this trial because it does not elicit any response (not even the frequent reaction of warmth/tender arm). This helped to preserve the “blinding” of the study, wherein participants did not know whether they received the candidate vaccine or the control.. 
3 10 participants were given a second, booster dose of the “candidate” vaccine only (no control) .
Key Takeaways:
  • Both antibody and T-cell responses were observed in participants who were given a single dose of the candidate vaccine, and the antibody response (but not the T-cell response) was enhanced by the booster dose. 
  • There were no serious adverse events, and side effects were limited and appeared to be managed by acetaminophen. 
  • An immune (i.e., antibody) response does not necessarily translate to protection against reinfection, although the authors point out that the average level of antibody observed 28 days after vaccination has been effective at preventing reinfection in non-human (primate) studies. 
  • Participants were young (average age 35) and healthy volunteers, a group that is quite different from the groups most vulnerable to SARS-CoV-2 (i.e., older persons, obese individuals, and those with comorbid conditions).
Who is VSC?

Vital Statistics Consulting (VSC) is a healthcare consultancy that specializes in the evaluation of policies and programs and provides independent, rigorous, innovative analysis to support data-driven recommendations that improve healthcare quality and organizational efficiency.
What's New at VSC?
Vital Statistics Consulting has begun the second phase of evaluating a Medicaid Comprehensive Primary Care (CPC) Program in a midwestern US state. CPC was designed to improve population health outcomes by aligning payment mechanisms with a team-based, patient-centered medical home (PCMH) model of care delivery, and was launched under a State Innovation Model (SIM) grant that requires evaluation of outcomes related to quality, cost, and patient experience.

Employee Spotlight
Each week The Weekly Dose will introduce readers to one of our team members.

This week VSC’s Managing Consultant, Dr. Miriam Ryvicker, is in the “spotlight.” We have asked her three questions, the answers to which reveal some of her professional and personal inspiration towards improving public health.    


Which people and/or events influenced your decision to work in this field?   

One summer during college, I worked for an organization that my mom had founded that sent friendly visitors to check on residents of nursing homes throughout the state of Rhode Island. I visited people in over a dozen facilities. I was struck by the variation among facilities and had many questions planted in my head. Why did some places seem more cheerful than others? Why did residents at some locations seem sleepier? Why did some facilities have a predominantly Black and Latino resident population, while others were predominantly White? During college, I majored in urban studies, and my interests were very interdisciplinary. I went straight from there to a PhD program in sociology, and when it came time to propose a dissertation topic, I circled back to these questions about nursing homes. I wanted to understand more about the factors that shaped the experience of aging and long-term care in the U.S., sociologically and in terms of health policy. I knew that I wanted to do research and evaluation for a living, motivated especially to help address the problems of health disparities over the life course. I wanted to take these interests in an applied direction, rather than follow an academic career path, though the latter was the more common path coming out of a PhD program. I didn’t really know at the time what to call the career path towards which I was embarking, nor did I have an example to follow, but I followed my curiosity, which led me to the work I do now.

What was the answer you gave people as a child when asked what you want to be when you grow up? 

I don’t remember having a consistent answer to this question or any clear picture of what I wanted to be when I grew up. I probably answered “doctor” a few times, only because I might have thought that was expected and an acceptable answer.

What advice would you give yourself 3 years ago? 3 years from now?  

Looking three years back, I would encourage myself to think broadly and outside the box, and to pursue my passion projects (though with strategic focus). I think three years from now, my advice might be the same.
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