Opinie: Gommers’ populistische oproep mRNA-vaccins vrij te geven, zit ernaast

Want niet de productiecapaciteit, maar het zwabberend vaccinatiebeleid is het probleem, betoogt Willem Mulder.

Willem Mulder                                       8 april 2021, 13:16

Pfizer/BionTech vaccines bij Movianto in Oss.Beeld EPA

Diederik Gommers deed ­afgelopen weekend, via ­LinkedIn, een oproep aan BioNTech/Pfizer en ­Moderna hun mRNA-vaccins vrij te geven, zodat ze op grotere schaal goedkoop kunnen worden geproduceerd en gedistribueerd. Hij voegde eraan toe ‘Of sla ik de plank helemaal mis als arts, maar dan hoor ik het graag.’

Hij slaat de plank inderdaad vol­ledig mis. De oproep klinkt oppervlakkig misschien goed, maar wat Gommers voorstelt, zal geen overheid of private partij voor elkaar krijgen.

Laten we beginnen met de prijs van het BioNTech/Pfizer-vaccin. Volgens de website van de NOS kost dat 12 euro per dosis. Wat krijg je daarvoor? Een vaccin dat bestaat uit synthetisch en door nanotechnologie gestabiliseerd mRNA met een effectiviteit van meer dan 90 procent.

Het toepassen van mRNA voor therapeutische doeleinden is een dertig jaar oud idee van Katalin ­Karikó. Zij kon dat nog niet vertalen in therapeutische toepassingen bij gebrek aan technologie om mRNA te stabiliseren en van een nanoverpakking te voorzien.

Die technologie is er nu wel en dwingt ertoe de vaccins op heel lage temperatuur te vervoeren en te bewaren. Alleen al deze complexe logistiek maakt de lage prijs van 12 euro heel bijzonder.

De tweede vraag is of de productiecapaciteit snel kan worden verhoogd met het opheffen van patentbescherming. Het antwoord is ‘nee’: de beschikbare productiecapaciteit is al sinds maart/april vorig jaar gemaximaliseerd. Het product, mRNA verpakt in lipide nanodeeltjes, het productieproces en de logistiek zijn ontzettend complex. Zo complex, dat het überhaupt een wonder mag heten dat deze vaccins zo snel en op zo’n grote schaal gedistribueerd konden worden. De biotech-industrie is het enige goed functionerende onderdeel van de huidige crisis.

De laatste vraag is of andere partijen met het recept in handen in staat zijn dit huzarenstukje te kopiëren. The proof of the pudding is in the eating: Daar waar de biotechwereld haar zaakjes meer dan op orde heeft en in een recordtijd van minder dan negen maanden innovatieve en zeer effectieve vaccins op grote schaal wist te distribueren, is het Nederland niet eens gelukt in vijftien maanden de vaccinatielogistiek op orde te krijgen. Dat we met 10 procent vaccinatiegraad onder aan de ranglijst bungelen is een gevolg van het zwalkend beleid van de overheid, en heeft niets te maken met productiecapaciteit.

We zitten inmiddels al meer dan een jaar in een crisis waarvan het einde nog lang niet in zicht is en we de naweeën nog jaren, mogelijk decennia zullen ondervinden. Er is nog veel werk aan de winkel voor de ­Nederlandse experts. De beperkte ­ic-capaciteit en de genant lage vaccinatiegraad houden Nederland in een wurggreep. Daar ligt de oplossing, niet in populistische schrijfsels op sociale media. Om met een citaat van de natuurkundige Richard Feynman te eindigen: ‘Science is the belief in the ignorance of experts.’

^{Willem Mulder is hoogleraar precisiegeneeskunde, Radboud Universitair Medisch Centrum & Technische Universiteit Eindhoven.}

^{https://www.volkskrant.nl/columns-opinie/opinie-gommers-populistische-oproep-mrna-vaccins-vrij-te-geven-zit-ernaast~bb74c08d/}

 

Rates of Parkinson’s disease are exploding. A common chemical may be to blame

Adrienne Matei

Researchers believe a factor is a chemical used in drycleaning and household products such as shoe polishes and carpet cleaners

‘The EPA estimates that 250 million pounds of TCE are used annually in the US.’ Photograph: Justin Kase/Alamy Stock Photo

Wed 7 Apr 2021 14.04 BST

Asked about the future of Parkinson’s disease in the US, Dr Ray Dorsey says, “We’re on the tip of a very, very large iceberg.”

Dorsey, a neurologist at the University of Rochester Medical Center and author of Ending Parkinson’s Disease, believes a Parkinson’s epidemic is on the horizon. Parkinson’s is already the fastest-growing neurological disorder in the world; in the US, the number of people with Parkinson’s has increased 35% the last 10 years, says Dorsey, and “We think over the next 25 years it will double again.”

Most cases of Parkinson’s disease are considered idiopathic – they lack a clear cause. Yet researchers increasingly believe that one factor is environmental exposure to trichloroethylene (TCE), a chemical compound used in industrial degreasing, dry-cleaning and household products such as some shoe polishes and carpet cleaners.

To date, the clearest evidence around the risk of TCE to human health is derived from workers who are exposed to the chemical in the work-place. A 2008 peer-reviewed study in the Annals of Neurology, for example, found that TCE is “a risk factor for parkinsonism.” And a 2011 study echoed those results, finding “a six-fold increase in the risk of developing Parkinson’s in individuals exposed in the workplace to trichloroethylene (TCE).”

Dr Samuel Goldman of The Parkinson’s Institute in Sunnyvale, California, who co-led the study, which appeared in the Annals of Neurology journal, wrote: “Our study confirms that common environmental contaminants may increase the risk of developing Parkinson’s, which has considerable public health implications.” It was off the back of studies like these that the US Department of Labor issued a guidance on TCE, saying: “The Board recommends [...] exposures to carbon disulfide (CS2) and trichloroethylene (TCE) be presumed to cause, contribute, or aggravate Parkinsonism.”

TCE is a carcinogen linked to renal cell carcinoma, cancers of the cervix, liver, biliary passages, lymphatic system and male breast tissue, and fetal cardiac defects, among other effects. Its known relationship to Parkinson’s may often be overlooked due to the fact that exposure to TCE can predate the disease’s onset by decades. While some people exposed may sicken quickly, others may unknowingly work or live on contaminated sites for most of their lives before developing symptoms of Parkinson’s.

Those near National Priorities List Superfund sites (sites known to be contaminated with hazardous substances such as TCE) are at especially high risk of exposure. Santa Clara county, California, for example, is home not only to Silicon Valley, but 23 superfund sites – the highest concentration in the country. Google Quad Campus sits atop one such site; for several months in 2012 and 2013, the Environmental Protection Agency (EPA) found employees of the company were inhaling unsafe levels of TCE in the form of toxic vapor rising up from the ground beneath their offices.

While some countries heavily regulate TCE (its use is banned in the EU without special authorization) the EPA estimates that 250m lb of the chemical are still used annually in the US, and that in 2017, more than 2m lb of it was released into the environment from industrial sites, contaminating air, soil and water. TCE is currently estimated to be present in about 30% of US groundwater (the non-profit Environmental Working Group created its own map of TCE-contaminated water sites nationwide), though researcher Briana de Miranda, a toxicologist who studies TCE at the University of Alabama at Birmingham School of Medicine, says: “We are under-sampling how many people are exposed to TCE. It’s probably a lot more than we guess.”

Under EPA regulations, it’s considered “safe” for TCE to be present in drinking water at a maximum concentration of five parts per billion. In severe cases of contamination, such as that which occurred at Camp Lejeune, a North Carolina marine corps, between the 1950s and late 1980s, people are believed to have been exposed to up to 3,400 times the level of contaminants permitted by safety standards. A memorial site known as “Babyland” honors the children of military personnel who died after they or their pregnant mothers were exposed to TCE-tainted water while living on the base.

While De Miranda says researchers do not believe low concentrations of TCE in drinking water specifically are enough to cause illness, Dorsey doesn’t think it’s an overstatement to say US groundwater could be giving people Parkinson’s disease. “Numerous studies have linked well water to Parkinson’s disease, and it’s not just TCE in those cases, it can be pesticides like paraquat, too,” he says, referencing a lethal weedkiller the US still uses despite it being phased out in the EU, Brazil and China.

Using activated carbon filtration devices (like Brita filters) can help reduce TCE in drinking water, yet bathing in contaminated water, as well as inhaling vapours from toxic groundwater and soil, can be far more difficult to avoid.

De Miranda says policy and effective government intervention are crucial when it comes to testing, monitoring and remediating TCE contaminated sites, and that it’s important to raise awareness of TCE’s role in surging rates of Parkinson’s. Failure to address the issue will not only continue to negatively affect people’s health, but will exacerbate the adult home care crisis that has already left 50 million Americans responsible for providing care to sick loved ones, as Parkinson’s is characterized by slow, progressive degeneration and has no cure.

In May 2020, Minnesota became the first state to ban TCE; New York followed suit last December, as should more states, especially as federal action on the issue has lagged. Given the negative health effects of TCE have been documented in the Journal of the American Medical Association since 1932, it’s well past time for the US to stop using it, and to better protect its civilians from hazardous chemicals that put lives at risk.

• Adrienne Matei is a freelance journalist

• https://www.theguardian.com/commentisfree/2021/apr/07/rates-of-parkinsons-disease-are-exploding-a-common-chemical-may-be-to-blame