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This Is Your D*ck on COVID-19: Reaching Stubbornly Unvaxxed Men

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[NB: Note the byline, thanks. /~Rayne]

New Yorker’s contributor Jelani Cobb tweeted this weekend about improving vaccination rates:

Color me highly skeptical.

Anti-vaxx/COVID-hoax/Anti-Mask men have studiously ignored science throughout the pandemic, including 15 months of published research about the risk COVID poses to their ‘nads.

I wrote last September about the risks to men’s reproductive organs:

Autopsies of COVID-19 victims showed damage to testicles:

Yang M, et al. Pathological Findings in the Testes of COVID-19 Patients: Clinical Implications. Eur
Urol Focus (2020), https://doi.org/10.1016/j.euf.2020.05.009
https://www.sciencedirect.com/science/article/pii/S2405456920301449

Based on findings, not only should kidney function and hormone levels be monitored but younger men should receive fertility counseling for family planning:

Wang, S., Zhou, X., Zhang, T. et al. The need for urogenital tract monitoring in COVID-19. Nat Rev Urol 17, 314–315 (2020). Published 20 April 2020 Issue Date June 2020
https://doi.org/10.1038/s41585-020-0319-7
https://www.nature.com/articles/s41585-020-0319-7

There have been many anecdotes of patients with sequelae lasting months after their initial illness. A large enough number exist for them to form groups in social media to compare notes about their experience. As the underlying SARS-CoV-2 virus is novel, we don’t have years of experience to look back upon for trends. We can’t yet predict whether there will be lifelong disability though many patients have reported development of diabetes, kidney dysfunction, heart disease, neurological impairment which have lasted months after they were technically deemed recovered. Studies on COVID-19’s long term effects have only recently begun and may last months to years.

Last fall we didn’t have anywhere near the amount of data we have now on COVID-19. The evidence accrued since the first published study from last April only confirmed many men infected by SARS-CoV-2 have suffered vascular damage to penile and testicular tissue. Though at least one study indicates semen may be an unlikely vector of infection carrying little active viral material, biopsies of living and deceased patients show damage to testicles which may result in lower sperm counts.

In other words, not only may men who’ve had COVID not be able to get it up, they may have difficulty impregnating their partner.

And we don’t yet know with certainty what percentage of men will have permanent damage versus long- or short-term damage.

If COVID damages blood vessels in men’s reproductive organs the same way it does in other organs and limbs, erectile dysfunction medications like Viagara and Cialis may not work as well (or at all) because functioning blood vessels are needed to distribute the medication throughout tissues, so to say.

Are women also experiencing damage to their reproductive organs? At least one study from last summer suggested SARS-C0V-2 could affect the endometrial cells in women’s uteruses posing a risk to pregnancies.

But here’s a key difference in the amount of COVID damage risk between women and men: men have more ACE2 receptors because of their testosterone. The study on women’s uteruses suggests ACE2 levels will vary with progesterone levels during a woman’s cycle and phase of pregnancy — they won’t have the same level of risk all the time.

There have been more studies examining the risk to men’s reproductive organs since last September:

Achua, Justin K et al. “Histopathology and Ultrastructural Findings of Fatal COVID-19 Infections on Testis.” The world journal of men’s health vol. 39,1 (2021): 65-74. doi:10.5534/wjmh.200170
[Published online 2020 Nov 3]
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7752514/

Abdel-Moneim, Adel. “COVID-19 Pandemic and Male Fertility: Clinical Manifestations and Pathogenic Mechanisms.” Biochemistry. Biokhimiia vol. 86,4 (2021): 389-396. doi:10.1134/S0006297921040015
[Published 2021 Mar 19]
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7978437/

Kresch, Eliyahu et al. “COVID-19 Endothelial Dysfunction Can Cause Erectile Dysfunction: Histopathological, Immunohistochemical, and Ultrastructural Study of the Human Penis.” The world journal of men’s health vol. 39,3 (2021): 466-469. doi:10.5534/wjmh.210055
[Published online 2021 May 7]
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8255400/

Moghimi, Negin et al. “COVID-19 disrupts spermatogenesis through the oxidative stress pathway following induction of apoptosis.” Apoptosis : an international journal on programmed cell death, 1–16. 2 Jun. 2021, doi:10.1007/s10495-021-01680-2
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8170653/

There are more studies out there, and there have been articles in media outlets about these studies along with a corresponding uptick in social media after each article.

But men don’t seem to be paying attention to these studies or reports, let alone personal anecdotes which surely must be emerging in their social circles.

Nor have men paid close attention to COVID’S gender disparity:

COVID-19 doesn’t strike the sexes equally. Globally, for every 10 COVID-19 intensive care unit admissions among women, there are 18 for men; for every 10 women who die of COVID-19, 15 men die. …

What the heck is it going to take to get men vaccinated if they don’t care about their reproductive health and sexual wellbeing, or even their greater risk of death and disability from COVID?

Perhaps if COVID looked more like a gun, men would be more willing to go out and arm themselves against it.

3 Things: Myths of Overnight Success, Herd Immunity, and COVID-19 Vaccine

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[NB: I’ve spent several days drafting this post only to have today’s FDA’s pause on J&J vaccine throw a wrench in the works. I will try to pull something together about that issue in a separate post. / ~Rayne]

Friends and family tell me they are frustrated by people they know who are dragging their feet getting a COVID-19 vaccine. Some are actively resisting vaccination, refusing to get one.

Nearly all of this has been driven by misinformation, often been spread by well-meaning but skeptical folks. Anti-vaxx disinformation has been spread by those who have a vested interest in seeing Americans getting sick and dying, accepted by the same audience.

One friend told me a skeptical acquaintance explained, “I’m not an anti-vaxxer, I just don’t trust how fast this has been put together.”

Others have waved off the vaccine, saying they “don’t need a vaccine because we’ll reach herd immunity,” or “I already had COVID so I’m fine.”

We are never going to reach herd immunity so long as people refuse to be vaccinated.

And people wonder why CDC Director Dr. Rochelle Walensky was so emotional a couple weeks ago about the need to continue infection prevention and the rate of vaccination.

The problem in my home state is evident in this profile piece (now paywalled) featuring Michigan residents in the 10th congressional district. You’ll recall Rep. Paul Mitchell who won in 2018 declined to run for reelection because of the political atmosphere. It wasn’t just the toxicity in Washington DC from Trump and his backup singers in the GOP-majority Senate, but back at home where constituents have become increasingly unmoored from reality.

Their part of the state is the worst for new cases and deaths; given how thinly populated the rural district is and how small these communities are, they have to know people who are severely ill and dying and yet they just don’t give a flying fuck.

There will be no reaching some of these folks, ever, but we have to reach folks who are on the fence if we are ever going to stop the spread of COVID including new variants.

~ 3 ~

Misinfo/Disinfo 1: The vaccine was developed too fast.

Truth: The mRNA vaccines like Pfizer-BioNTech’s and Moderna’s were at least 31 years in the making. Work on adenovirus-vector vaccines like Johnson & Johnson’s began in the 1950s looking at defenses against adenoviruses. These are the only two types of vaccines currently distributed in the U.S. under Emergency Use Authorizations.

Research for the COVID-19 vaccine began in 2002 with the emergence of severe acute respiratory syndrome (SARS), caused by the coronavirus now known as SARSr-CoV. The epidemic which ran its course from 1 November 2002 – 31 July 2003, resulted in approximately 8,000 cases and nearly 800 deaths.

Research into Middle East respiratory syndrome (MERS), another coronavirus which is very similar to SARSr-CoV and SARS-CoV-2, also contributed to the body of knowledge. MERS epidemic resulted in 2,500 cases and nearly 900 deaths.

In total there were at least 12 years of research into similar coronaviruses before funding dried up because neither then-known coronaviruses were spreading.

In tandem with the research on coronaviruses, technology used for genetic sequencing and analysis improved exponentially in sensitivity, capability, and speed. Once SARS-CoV-2 was isolated and the unique spike protein identified, the vaccine research had most of what it needed to develop a trial-worthy vaccine candidate. The genetic sequencing in January 2020 couldn’t have done so quickly and in such detail in 2002.

The mRNA approach used by Pfizer and Moderna was first proposed in the late 1980s after more than a decade of conjecture; research into HIV and Ebola are among the diseases which contributed to the body of knowledge for these COVID vaccines. That’s more than 30 years of research leading up to the current vaccines.

If funding for research hadn’t stopped in the mid-2010s, COVID vaccines might have been delivered weeks or even months earlier than late October/early November last year.

~ 2 ~

Misinfo/Disinfo 2: Don’t need vaccination because of herd immunity.

Truth: We are nowhere near herd immunity. The safe approach to herd immunity also relies on vaccines.

While there are a number of ways this concept is being distorted, I ran into a situation last week in which someone I know who is a health care provider had begun to doubt the use of vaccines for COVID.

They’d been exposed to a European doctor’s claim that wearing masks and the vaccines themselves prevented our bodies from eliciting a natural immune response.

Ignoring, of course, the fact that nearly 600,000 Americans alone have died from the effects of their natural immune response to infection with SARS-CoV-19. That’s the disease, COVID – the response to the infection.

I went and did some digging to check this Euro doc’s credentials and lo, there it is: he’s a fucking DVM. A veterinarian who did some work on viruses in animals, with a handful of papers published a couple decades ago about viruses in donkeys. I won’t even name this bozo because I don’t want to give his nonsense any more oxygen.

In retrospect this guy is akin to the French researcher whose early, extremely small, and utterly lousy study was used to rationalize the use of hydroxychloroquine as COVID therapy. Poor credentials and bad track record combined with inadequate evidence, launched from overseas into American consumers’ social media – and they lapped up his misinfo and disinfo without any skepticism let alone the wherewithal to check credentials.

Just stop them. Cut them off as soon as they start talking about herd immunity.

That includes cutting off morons like Texas Gov. Gregg Abbott:

Nobody should listen to this stupid asshat when it comes to COVID-19 because he’s propagating false information when he should be turning this over to professionals with appropriate credentials.

I’ll let biologist Carl Bergstrom discuss the concept of herd immunity with regard to a pandemic in this Twitter thread:

Bergstrom distills the challenge:

“The key thing to note is that the herd immunity threshold is the point at enough people are immune (by vaccination or previous infection) to prevent a new epidemic from starting from scratch.

It is *not* the point at which an ongoing epidemic disappears.”

COVID will still be with us after a majority of the adult public has been vaccinated because children and unvaccinated adults will constitute 20-30% of the population while the herd immunity threshold for COVID as an airborne disease will be closer to that of other other airborne diseases like pertussis and measles. This means at least 90% percent of the public must be immune before the disease will stop spreading.

And with only 35.9% of the U.S. having had a dose of vaccine, there’s no way in hell any part of the U.S. is close to herd immunity – including Texas where as of today only 19.9% of residents have been fully vaccinated.

All of this assumes there isn’t a new strain mutating in an unvaccinated person which may bypass the existing vaccines. It’s urgent that we vaccinate as many people as possible as quickly as possible to stem the spread of the disease before this can happen, setting off a new epidemic.

Anybody who is waiting for herd immunity while refusing to wear a mask and rejecting the vaccine is a nihilist wishing sickness and death on others if not themselves.

But don’t take my word for it; find virologists, epidemiologists, public health experts, and/or others with solid credentials who’ll explain why we need to be vaccinated to reach herd immunity.

~ 1 ~

And then the excuse used by the oppositional defiant/libertarian/owning the libs crowd –

Misinfo/Disinfo 3: Getting vaccinated means submitting to the federal government which is taking away freedom by issuing “vaccine passports.”

Truth: NO. Fuck, no. The only thing being issued at vaccination sites is a record of vaccination. Vaccination records are shared with one’s doctor under HIPAA privacy regulations.

I am so disappointed with former representative Justin Amash on this point. It’s as if he’s forgotten universities and public schools have long required proof of vaccination for entrance, because education provided in a shared public space requires students who are not at risk of death from other students’ diseases.

It’s as if Amash has forgotten the Constitution is not a suicide pact, and that the nation’s founders lived in a world when travel was often restricted by epidemics like smallpox, measles, and yellow fever requiring mandatory quarantines.

Or that state and federal governments regularly require proof of baseline safety measures like passing vision and driver’s tests for a driver’s license.

Businesses and government functions should not be held hostage by a pandemic. They should be able to ask their employees and customers to act prudently to protect themselves and others, which may include providing proof of vaccination.

(Florida’s Gov. Ron DeSantis can pound sand with his ridiculous executive order banning “vaccine passports,” intended to prevent cruise ships requiring booking passengers to have proof of COVID vaccination. It’s as if he’s completely forgotten what happened to cruise passengers last year.)

Here’s a more personal example as a business case for required vaccination. My youngest contracted mild food poisoning from a chain restaurant’s takeout, but the first question posed by his employer and co-workers who all work in a facility which tests foods and pharmaceuticals, is whether he really contracted COVID since some symptoms like nausea may be present after infection with SARS-CoV-2. Imagine the repercussions to the supply chain if someone asymptomatic simply went to work in that environment.

My kid is taking the day off and getting tested for COVID to assure their workplace is safe, but imagine this happens again next week to a different employee, and the week after that to yet another. The cost to business and to workers could be staggering when simply requiring vaccination with proof could resolve the challenge.

And your own foods and drugs might also be safer for it.

Fortunately my youngest will be vaccinated soon; my oldest already is as of last week when Michigan opened vaccinations to all ages.

~ 0 ~

As of this morning we have lost 562,007 Americans to COVID – 476 died yesterday, the lowest number of daily deaths since last autumn.

Most of these deaths were not caused by UK variant B.1.1.7 which is now dominant in the US, nor by Brazilian variant P1, nor by South African varian B.1.351, all three of which appear to be more transmissible, and in the case of P1, more deadly, sickening younger people more often, and re-infecting those who already had an earlier strain.

Had we not mitigated the first strains of COVID with a combination of social distancing, mask wearing, increased hygiene, and lockdowns as well as vaccines, we would be on our way to several million dead.

But we are still on our way to that number if people do not continue mitigation measures and get vaccinated. Brazil’s 1,480 deaths yesterday alone, most caused by P1, offers proof.