Fasten your seatbelts

It's going to be a bumpy ride entry. And a long one.

Last evening, my buddy Milwaukee Dan #1 sent me the link to the Facebook page of one of our state government representatives, Jackie Walorski, asking me to check out her most recent update and the comments she's received.

I have to ask...do you folks enjoy getting me riled up? Do you like it when I Hulk out? Dan seemed to get a kick out of my initial reaction to what he sent, saying that he knew it would get me riled up. I could be wrong, but I think there might have been a tone of sadistic glee in there somewhere! Hmph. (Seriously, thank you for sending that to me, Dan. You knew very well that I would run with it!)

I have written about Jackie Walorski in the past, and just so you know, I am going to tag the hell out of her in this post, because I would love it if people found this entry when searching for her. Word on the street (ha) is that she'll be running—excuse, me, attempting to run—against my Congressman, Joe Donnelly. Yeah, good luck with that! Even my Mom and Dad, staunch Republicans, voted for Congressman Donnelly (a Democrat), so you're going down in flames, Walorski. I wrote about Walorski's efforts to close Indiana's Planned Parenthood clinics. I wrote about my letter to Walorski concerning those efforts, and her subsequent non-response. I also wrote about my letter to my representative concerning Walorski's misguided and evil efforts, and finding out that Walorski had lied about forwarding my email to my representative. You don't have to follow all the links, but to get a sense of what she was trying to do, how I felt about it, and how I felt about her lying ways, you might want to.

The most recent status update on her Facebook page said this:

Jackie Walorski: Is it not interesting that the "government" is "running out" of H1N1 vaccine..there is already a "shortage" and yet the President has declared a National Emergency and there's not enough vaccine....THAT is government health care..good luck holding them accountable.

Well, those of you who know me can probably imagine how I reacted to that. Those of you who are friends on Facebook know, and I can assure you that I was holding back.

First of all, her fatuous use of "is it not interesting" makes me want to hurl. I can almost see her arching an eyebrow under that god-awful female mullet she sports as she purses her lips like Dana Carvey as the Church Lady yelling, "Could it be...SATAN?!"

Secondly, I love how she puts the word government in quotes. Is she implying that this is not a true government? Is she trying to say that this is bogus leadership? Hey. News for you, Walorski. This is MY government you're talking about, and although you might not like it, it is also your government. This is the government that was elected by the people, and if you don't like it, if you somehow think it is a sham or a farce, and if you think it's amusing to put quotations around it, I say that you are disrespecting the people of your district and your state and your country. The people have spoken, Walorski, and I find your condescension incredibly offensive. If you are trying to get others to feel the same way, it is nothing less than seditious.

Thirdly, she overuses quotation marks...period. (Haha) I can picture Chris Farley in my mind placing finger quotes around "running out" and "shortage." These also seem to be sarcastic jibes against the Obama administration. There is nothing funny about it, Walorski. There is a shortage at the moment, and the initial doses have run out, and people are getting very ill. What you seem to be utterly incapable of comprehending is why and how this has happened...or perhaps you're capable of understanding it but just don't give enough of a fuck to try to do a little research before you irresponsibly accuse our government of not responding properly to this outbreak.

If you had bothered to do a little research, you would have found out the difficulties and tedious processes involved in producing influenza vaccines. These vaccines are produced in chicken eggs, and it is not a quick or easy process. Fertilized eggs arrive at the vaccine plant, and the virus is injected into them and incubated for several days. Then the eggshells are cracked, the fluid containing the virus is extracted, the virus is inactivated and the material is purified. In the best case scenario, this takes six months, but when there is an epidemic, this crude egg technology is incapable of churning out mass quantities of vaccine in a short time. There are companies that are developing vaccines that can be produced by recombinant technology, which will significantly shorten the time of production, but they are not up and running yet. For now, this tedious egg technology is what we've got.

As with any manufacturing venture, there are often delays. One of the delays in this case has been the H1N1 virus itself. The strain has been found to be a slow grower in the chicken eggs, slower than the seasonal flu strain. We used to joke in the lab about people calling up and wanting culture results STAT! Microorganisms will only grow so fast, and there is no magic bullet that will make them grow faster.

Additional problems have been bottlenecks at the plants where the virus is loaded into syringes or vials, as well as development of the tests and reagents used for quality control on the vaccines before they are released for use. Then, of course, there is the problem of plants also manufacturing vaccine for the seasonal flu, essentially doubling their workload.

Here's a brief timeline of how an influenza vaccine is produced.

1. Identification of the new strain. World surveillance data is collected, analyzed, and submitted to the WHO. If a new strain is found, this is considered to be a possible cause of pandemic.
2. Preparation of the vaccine strain. The virus is adapted for use in manufacturing vaccine by combining it with a standard lab strain, allowing the two to grow together. This hybrid contains the "innards" of the lab strain and the exterior parts of the pandemic virus, which will trigger the immune response desired. This makes the virus less dangerous to work with and easier to grow in eggs.
3. Verification of the vaccine strain. The hybrid virus is then tested to see if it makes the correct outer proteins, is safe, and will grow in eggs. It then moves on to vaccine manufacturers.
4. Preparation of reagents to test the vaccine. WHO produces standardized reagents that are given to all vaccine manufacturers. In tests using these reagents, they will be able to measure how much virus they are producing, and that they are packaging the correct dose of vaccine.
5. Optimization of virus growth conditions. The vaccine manufacturer tests different growth conditions in eggs using the hybrid virus from the WHO laboratories in order to find the conditions that will produce the best yield.
6. Vaccine bulk manufacture. This is the step that I mentioned above, the actual growing of the virus in millions of eggs, its harvest, processing, and purification. The resulting antigen is the active ingredient in the vaccine. Limiting factors here are the facilities themselves (you can only start and process so many batches at once), how many eggs can be obtained, and the number of virus particles per egg.
7. Quality control. Each batch of antigen is tested using the reagents supplied by the WHO.
8. Vaccine filling and release. The batch of vaccine is diluted to the desired concentration of antigen, packaged into vials or syringes, and labeled. Some of these are then tested for sterility, the appropriate protein concentration, and safety in animals.
9. Clinical studies. In certain countries, each new influenza vaccine has to be tested in a few people to show that it works the way it is supposed to.
10. Regulatory approval. Each country's regulatory agency has its own rules for testing before the vaccine is released for use. If the agency requires clinical trials, this can add to the time of regulatory approval.

As you can see, it is neither a simple nor a short process. You don't just throw a bunch of shit together in an Erlenmeyer flask and make vaccine. It is a lengthy process with many oversights and checks along the way, and it is subject to delays based on everything from how many eggs the vaccine manufacturer can get from Farmer John to whether or not the virus is cooperative and grows well in chicken eggs. Even just identifying the new strain can be a process, recognizing that it could be a new pandemic virus. The seasonal vaccine is always formed from three strains, usually two Influenza A's and one Influenza B. Deciding which strains are going to be more prevalent or more lethal is usually a very educated guess; they can do their best to check epidemiological patterns and the way the virus behaves in patients, but sometimes a strain isn't included and ends up being tougher than originally thought. In that case, you can't go back and remake the vaccine, because of the long process I just described. By the time you did so, it would probably have mutated, anyway. Viruses mutate rapidly, which is the very reason why a new shot is needed each year. The viruses change so rapidly from year to year that the body's immune system does not recognize the new invader as the same virus, and an immune response isn't generated.

Now, having said all that, yes, I have a background in this area, but I didn't rattle all this off the top of my head. I did a few minutes of research using the WHO site and the CDC site, and then put this together for you all. I would love to ask Walorski why she couldn't do a little research and educate herself about how vaccines are produced, and why it takes so long, before she spewed some idiotic conspiracy theory about how the "government" is "running out" of vaccine, as if it were a planned thing. This is fear-mongering based on ignorance, and for her to try to blame the vaccine delay on the Obama administration is simply complete and utter idiocy and irresponsibility.

It is exactly this sort of willful ignorance and intellectual incuriosity that makes me want to blow my stack when I see comments like Walorski's on her Facebook page. She, Palin (She Who Hates Fruit Flies, and no, Dan, I will never let that go), and Bachmann are cut from the same cloth. It's not just that they don't know this stuff before they speak on it...they don't know and they don't want to learn. For me, such types are the truly dangerous ones out there. Decisions are made and policies are formulated using their limited intellectual capacity for understanding and their personal feelings about a subject rather than any sort of rational, well-thought-out or well-researched process. This attitude of "I'm a dumbass and I like it that way!" continues to boggle my mind. Well, I suppose that as long as there are enough people out there who believe the nonsense these types spout, they'll keep hanging around, so I'd better get used to it. That doesn't mean I have to like it.

Like I keep saying: Smart is the new sexy.

One final thing, from the Timing Is Everything File. Just as I was finishing this up, the phone rang. It was an unknown name and number, but I went ahead and answered it. They asked for Ken, and when I said he wasn't here and asked if I could take a message, they asked if I was Ms. R., and I said yes. She went on to say that she was calling from the...guess who? The Republican National Committee. I think I actually laughed out loud. I said, "Sorry, but we don't support the Republican Party anymore." After a brief pause, she asked, "Can I ask why?" I laughed again. "There are too many reasons to go into. Please take us off of your list. Thank you." [click]

The moral of this story? Don't mess with Beth when she's in the middle of a rant. You might have to deal with Feisty Beth.