Thursday, April 15, 2021

Team Placebo


To put it politely, Europe is struggling to get its population vaccinated. So, when the opportunity to participate in a vaccine study came along at the end of January, I thought it might be worth pursuing. If you had asked me six months before that to participate in such a study, I would had said “no way, Jose!” But with the success of the Pfizer-BioNTech and Moderna vaccines, I figured that this could be one way to get vaccinated before I might otherwise, and well, “for the science,” and all that.

I signed up for the trial and initially didn’t hear anything. It turns out that many people were willing to participate, and they had more than 1,500 volunteers for 1,000 spots here. In the end, everyone was invited to participate because enough people were disqualified or chose to not to enroll after all. The study will last for two years and requires five in-person appointments, plus three telephonic follow-up calls within the first year, and four more the following year. Participants who receive the placebo will be entitled to receive the vaccine if it is approved. I knew going in that the proposed vaccine is an mRNA project (like Pfizer and Moderna) by a German company called Curevac.

I was excited, and then I was a bit intimidated. First, because I had never done anything remotely similar, and second because I would be doing this all in Spanish. I admit I was nervous, but I was lucky that my friend Carol had her first appointment the day before mine, so her description of what would happen and where to be was super helpful. I carefully reviewed the 15-page informed consent and description of the study, which took a long time to review in Spanish!

At the first appointment (February 24), I checked in and was promptly asked to take a pregnancy test because pregnant women are excluded from the trial. While I explained that I knew with absolute certainty that I was not and could not be pregnant, I still had to take the test. It was negative. I then met with a doctor who reviewed the consent form with me, which we then signed. The next step was a blood draw. After that, a nurse took my vital signs, and I received an injection. As this is a “gold standard,” stage three, double-blind study, no one knew what I received. I then had to wait 30 minutes to see if I had any adverse reaction, after which I met with the nurse and had my vital signs taken again. While I was waiting, I was given instructions on how to use the study’s “app” and provided an oral thermometer as we need to monitor our temperature and report it, along with any symptoms, twice a week. After all that, which took about two hours, I was free to go.

I had no symptoms or adverse effects from my first shot, not even a sore arm. This was disappointing, but not unexpected since everyone had a 50% chance of receiving the placebo or vaccine. But since many people have no effects after a first vaccine shot, I could not be sure what I had received. I dutifully recorded my lack of symptoms and my temperature using the app twice a week. I have now taken my temperature more times in the past several weeks than I have in my lifetime. It is somewhat interesting how it varies from day to day.

The second appointment (March 25) was practically identical to the first, only there was no blood draw. The physician meeting focused on my lack of any reaction to the injection and lack of any COVID symptoms. I received my second injection, dutifully waited, and went home hoping I would soon feel like I got hit by a truck – a sure sign that I got the vaccine. Only I felt fine – perfectly fine. Again, not even a sore arm. Thus, I’m nearly certain that I am on “Team Placebo.” How disappointing. But that was obviously possible and is part of the process.

My third appointment (April 8) was a quick and easy follow up in which a nurse took my vitals, I again explained to a doctor that I had no adverse effects after the second shot and no COVID symptoms, and had my blood drawn. The next follow-ups will be in June and September. In the interim, I’ll keep monitoring for symptoms and taking my temperature twice a week.

Since my first appointment I’ve done a bit of research on Curevac and am keeping track of its progress in the approval process as much as possible. The good news is that so far things are looking promising and that the company has been submitting data on a rolling basis to the European approval authorities to speed things up. It is unclear when the approval process will finish, but this week they confirmed that they hope to be approved by May or June. If you’re curious about the company, which happens to be the one that Trump supposedly wanted to buy, here’s a link to the best article I’ve read so far:  https://www.irishtimes.com/business/health-pharma/how-vaccine-laggard-curevac-hopes-to-come-out-on-top-1.4493799

While it is possible that we could be “eligible” to be vaccinated before the vaccine is approved, perhaps at the earliest late May (although there seem to be new delays on a daily basis), my plan is to stick with the study. Because we are not part of the Spanish national health system, getting vaccinated is going to be one of those “fun” challenges as the regional health services are responsible for administering the entire vaccination program and we are not on their radar. I’ve checked with our private insurance carrier, which is a Spanish company, who confirmed that are not involved and have no control over the vaccination process. We’ll be figuring it out for Jeff when the time comes. I’m sure it will make for an interesting future blog post.

Hasta luego,

Shana


Saturday, April 3, 2021

La Copa Del Rey

European soccer (futbol) is weird. Each country has multiple leagues with the top teams in lower leagues moving up (promotion) and bottom teams moving down (relegation) each year. In addition, there are European-wide leagues (Europa League and Champions League) that teams in the top national leagues qualify for each year. For example, each year Spain's top league, La Liga, sends its best four finishers to the Champions League, while its fifth and sixth place finishers go to the Europa League. In essence its wall-to-wall futbol.

In Spain (and perhaps in other countries as well), there is also a national tournament, El Campeonato de Espana-Copa de Su Majestad El Rey or La Copa del Rey. This tournament allows all of the professional teams in Spain (all 126 of them) to compete regardless of the level of their league. Of course, the teams from La Liga dominate the tournament, but there can be interesting upsets by teams from lower-ranked leagues.

So, why are we writing about this now? Well, tonight is the final of La Copa 2020, which was delayed a year due to Covid, and not only is the team from San Sebastian, La Real Sociedad, in the final, but they will be playing their arch rivals Athletico Bilbao in the first-ever final meeting for these teams in almost 120 years of La Copa.

To say this is a big deal in the Basque Region would be an understatement. News coverage has been extensive for several weeks, but the last few days have been crazy. In yesterday's paper (no paper today because of Semana Santa (holy week)), the first 40 pages were dedicated to the game, with additional articles in each major section of the paper -- politics, economics, culture. And, this was the day after they published a 62-page (!) special insert. It is like the Super Bowl on steroids.

Frankly, we really did not understand why this was such a big deal. And, since we are not huge soccer fans we had not been following the build-up closely, although we were aware that Real was in the final. But then, yesterday, The Guardian newspaper out of England published an article that explained why this is such a big deal, so we decided to write about it.

It turns out that the Basque Derby (which is what the Real-Athletico rivalry is called), is more than just a rivalry. Up until 1989, both teams maintained an unwritten policy of not signing non-Basque players. Athletico continues that policy to today. Of the 25 players to appear in La Liga for Athletico this year, 21 are Basque and four are from Navarre, which was historically a Basque territory although not part of the modern Basque Region of Spain. The numbers for Real are 17 Basque players and two from Navarre of 28 who have appeared. In essence, this final is like a civil war. However, it turns out, it is a very friendly civil war with fans of the two teams mixing both in the stadium (normally) and among the population. In the end, the people put their Basque identity above the rivalry.

At the 1976 final, which took place less than one year after the death of the dictator Francisco Franco, and during a time when the Basque flag was still illegal, the captains of Real and Athletico (which won the game against a team from Sevilla) carried the flag into the stadium:


As you can imagine, this relationship goes well beyond futbol.

Given the nature of this rivalry, both teams agree that having their fans present for the game is of utmost importance. So, when the final was first delayed because of Covid, the teams agreed that they wanted to wait to play the game until they could do so in front of their fans (the game is played at a pre-determined site, this one in Sevilla). Unfortunately, the final for the 2021 Copa is scheduled for two weeks from today (Athletico is in that one as well against Barcelona, the most successful Copa team of all time with 30 titles), and the people who organize the tournament said they would not allow the 2021 final to happen before the 2020 final. So, the game will have to go on without fans in the stadium. But, you can bet that almost every TV in the Basque Region, including ours, will be tuned in to the game at 9:30 pm tonight.

We can't wait to see what the post-game news coverage looks like. Especially if Real Sociedad wins!

Hasta pronto,

Jeff and Shana