• Only a handful of blood-clotting cases have been reported among recipients of the Johnson and Johnson vaccine, but it’s predominantly women who have developed these rare symptoms. To answer questions about the “one dose fits all” mode of medical research that can occasionally lead to these kinds of outcomes, we spoke to Rosemary Morgan, a research scientist at Johns Hopkins Bloomberg School of Public Health. She’s currently studying the gendered effects of COVID-19 on several international communities.
• Plus, for headlines, we’re joined by comedian and actress Sasheer Zamata: a class action settlement for Fyre Fest attendees, a Canadian lawmaker accidentally goes nude on Zoom, and scientists grow human embryos in monkeys.

Transcript

Akilah Hughes: It’s Friday, April 16th. I’m Akilah Hughes

Gideon Resnick: And I’m Gideon Resnick, and this is What A Day, the podcast that we are giving away free to anyone who’s gotten the vaccine.

Akilah Hughes: Yeah, also free if you haven’t gotten the vaccine yet. But yeah, what Gideon said, it’s true.

Gideon Resnick: We don’t know if a podcast can technically be sold.

Akilah Hughes: Today we’re monitoring the fatal shooting of 13-year old Adam Toledo by police in Chicago more than two weeks ago, who is holding his hands up. Body cam footage of the killing was released yesterday after intense public pressure. I won’t be watching the video, but we’ll link to that ongoing story in our show notes.

Gideon Resnick: But first, the latest for today, where we wanted to recap one of the week’s biggest news stories: the nationwide temporary pause on administering the Johnson & Johnson COVID vaccine. Even before this development, Bloomberg News reported that certain U.S. states and cities had a growing surplus of doses by all manufacturers. It signaled that there are some pockets of people hesitant to get the shot. And so this recent news isn’t the best for making sure everyone gets in line so we can achieve herd immunity soon.

Akilah Hughes: But we’re focusing on the most sensational headlines: that the first reported cases of the rare blood clotting disorder occurred in six women. Johnson & Johnson later reported that there were two more cases of people who also developed blood clots, including one 25-year old man who participated in the trials.

Gideon Resnick: Right. But the fact that it’s predominantly women who developed these rare symptoms got us thinking about a long-standing problem in the medical research field: accounting for the ways that men, women, children, people of various races and more, all react differently to vaccines or drugs. There are pitfalls in thinking that there’s always a “one dose fits all.” So we wanted to dive deep into this issue with an expert in the field.

Akilah Hughes: Rosemary Morgan is a research scientist at Johns Hopkins Bloomberg School of Public Health. She’s also the Associate Chair in Inclusion, Diversity, Anti-Racism and Equity for the International Health Department, where she’s currently studying the gendered effects of COVID-19 on several international communities. Rosemary Morgan, thank you so much for being on our show.

Rosemary Morgan: Thank you for having me.

Gideon Resnick: So we wanted to start with, you know, the main news of the last few days. So when you first heard the news about the Johnson & Johnson shot being paused because of these rare blood clot conditions that had come up, but only in women on first reporting, what were the initial questions that you had?

Rosemary Morgan: Well, firstly, why is it only woman reporting these specific side effects: blood clots? Is there a biological explanation for this? And if so, what is it? Also more broadly, how much harm is the pause going to do in terms of vaccine hesitancy, specifically among women? And to be more frank, a bigger question I had was if they are so concerned about the risk of blood clots, particularly in relation to the Johnson & Johnson vaccine, why hasn’t there been a similar concern for the birth control pill? You know, I recognize that the mechanisms are different, like different types of blood clots, but for for the risk of the Johnson & Johnson, it’s one in a million. Right? But for birth control, for every 10,000 women taking the pill in a given year, between three and nine will develop a blood clot. And which is concerning. It may not be as a serious a blood clot, but it’s still a blood clot. And why now? Why do we care now?

Gideon Resnick: Right.

Akilah Hughes: Yeah, absolutely. And I mean, you know, we also know that there were a number of cases where women face side effects with the AstraZeneca vaccine as well. We still don’t know if that’s, you know, the definite connection there. And also that could be because, you know, more women just are receiving the vaccine in general. But do either of these cases give you concerns about how any of the COVID-19 vaccine research has been done so far? You know, like in regards to that?

Rosemary Morgan: Well, yes and no. So my main concern with the COVID-19 vaccine research is the same with all medical research to be honest, is whether or not the data that was being recorded, was the data being recorded by sex and then analyzed. So were they even looking for differences, you know, in both, in terms of outcome data, but also adverse reactions or side effect data? So you have men and women in your study—you know, hopefully it’s around 50% men, 50% women. One, you need to, you know, collect questions about what adverse reactions did you, what side effects did you experience: chills, fever. Right? So once you’ve got that data, what you now need to do is like, OK, how many people reported that they had the chills and a fever after? All right, how many of those people were men and how many of those were women? Because right now, if you look on the websites for the adverse reactions during in the clinical trials, it doesn’t do that. You know, there are definitely some common side effects, you know: sore arm, rash, fever and chills, with the COVID-19 vaccine. But there might also be some sex-specific side effects. So right now, I don’t know if you’ve seen recently in the news, while it’s anecdotal, some women are reporting disruptions in their menstrual cycles—

Akilah Hughes: Yep. Can attest, can attest.

Rosemary Morgan: See. And it’s anecdotal. I know some research, some researchers are looking at that now.

Gideon Resnick: And more broadly speaking, can you talk about why women and men can have different reactions to vaccines in a general sense?

Rosemary Morgan: Sure. So we do know that women report more side effects from vaccines in general. So not just COVID-19. I do research related to the influenza vaccine and it’s the same. And, you know, there’s a lot of data to support that. So when it comes to vaccines, women experience a greater immune response, that can make vaccines work, actually work better in women than men. And this is due to how hormones like estrogens and our genetic makeup affect the functioning of our immune system. And when it comes to drugs particularly, women absorb and metabolize drugs at a different rate than men.

Gideon Resnick: Right.

Gideon Resnick: And that that’s a great lead-in to the next question. You know, we know that modern medicine is mostly based on how white men react to medical studies. You know, even in the Johnson & Johnson vaccine trials, 44% of participants were women— though there are more women on Earth than men, that is just a fact. So what is the history of white men being the so-called default, and what problems has this caused over time?

Rosemary Morgan: Sure. And this is like an issue I feel particularly strongly about. I get up on my soapbox and it—

Akilah Hughes: I’m up here with you. I’m mad. [laughs]

Rosemary Morgan: It makes me angry. It does this issue makes me really angry. So the fact that clinical research has historically neglected sex and gender differences. So, you know, in the United States particularly, so prior to 1993—it was the U.S. Revitalization Act of 1993—women were excluded from clinical trials. And, so they were excluded primarily due to fear of potential harms to pregnant women and their fetuses, and also, how might women’s hormones affect. So the decision was made to use the male body. And as you rightly pointed to, it wasn’t just any male body, it was a male body of a certain height, weight, age, also white, as the standard by which everything else was measured. So many drugs in the market today, especially those that were developed pre-1990s, are therefore based on research which excluded, you know, women and other groups, minority men likely as well. Things have changed. Women are included in clinical trials now, but are the outcomes being compared differently? And you mentioned what the implications of this are. So, there was one study, for example, that showed—and this was in relation to the influenza vaccine—that woman’s response to a half dose was similar to men’s response to a full dose, in terms of effectiveness. So the question is, if men and women are being given the same dosage and this is often based on research on what worked for men’s bodies—women tend to be smaller. A really good example to highlight this is related to Ambien, which is that common sleep aid.

Akilah Hughes: Is it that one that made Rosanne racist. [laughs] She was like: oh, I’m sorry, my Ambien, it was tweeting.

Rosemary Morgan: Exactly. Just to say Ambien, does not cause, it does not cause racism. However, research has shown that Ambien has been linked to higher rates of car accidents among women in the morning. And this is because men and women are being given the same dosage, 10 milligrams, and when men woke up, it was completely out of their system. But when women woke up, it was still, some of it was still in the system because it metabolized differently. So really, women should be getting five milligrams, not ten. This is about sex, some drugs, and the question is also with some vaccines, should we be having sex-specific dosages?

Akilah Hughes: Absolutely. And I mean, this does in ways go beyond gender too. You know, you’ve done quite a bit of research about these disparities in vaccine trial representation, particularly among women and people of color. Now, I did my own deep dive on the J&J trial data, and I found that 44% of those people, of the participants were Americans, but almost 3/4ths of those people were white. And, you know, I get that the company, maybe American, so maybe that’s why Americans are such a big chunk of the study, but the entire world is hoping to rely on that research, and the majority of the world is not white. So does it even make sense to have a trial that is not diverse like the world’s population is?

Rosemary Morgan: Diversity in medical research is so important, whether it’s gender or racial diversity. You know, data needs to be collected and analyzed in a disaggregated manner. Sometimes some differences may present as behavioral or biological, but are actually the result of larger social structural inequalities, such as structural racism. So this is where, you know, racism does cause health inequities. Right? Which affects, you know, these inequities affect minority access to health care, healthy food, education, you know.

Akilah Hughes: The actual environment that they’re growing up in. The air is bad.

Rosemary Morgan: Exactly.

Akilah Hughes: I mean, sort of to that point, you know, I just anecdotally, I have asthma and my entire life, I’ve been prescribed albuterol. And it wasn’t for, you know, most of my life that they had ever researched the differences between how races react to it and for a lot of Black people in Puerto Rican people, Albuterol is ineffective. I found that out this year, for the first time talking to a specialist. And so, you know, I just think that it’s a really important point that you’re making, which is that like, you know, we’re not saying that if you’re a different race, you are in any way lesser than or whatever, it’s just that the medicine should work for you.

Rosemary Morgan: That you answered your question before by why is it problematic if we’re only measuring things against white male body. And racial groups, you know, Black Americans versus white Americans, experience things differently. It goes without, should to me, it goes without saying that Black woman might, things may affect them or will affect them differently than Black men. But we are not seeing these types of intersectional analyzes, which I think are so important.

Gideon Resnick: Yeah. And to kind of bring it all back to what may or may not happen here in the next week or so, after more research is done, is there a possibility that the Johnson & Johnson vaccine gets recommended for certain groups in the United States and not others? And then also, how do you balance out the risks of any vaccine that gets rolled out so fast like these have been, against the need to find some solution to COVID-19 immediately? Because I could definitely hear a pharmaceutical CEO try to defend themselves, you know, answering any of these questions, saying: well, the virus has the potential to be so much more lethal than any of the things that we may or may not have missed throughout our clinical trial data.

Rosemary Morgan: It’s really important that we understand or, you know, think about what the risk-benefit ratio is, so what’s the risk to me versus the benefits that I might get. And this has to go with vaccines or medicines. I mean, how many commercials have you seen on TV for drugs, you know—especially in the U.S., it’s a US thing, I’m actually Canadian, this is a U.S. thing—where the list you know, the list of potential side effects are like the length of your arm, and they’re so fast you don’t even know what they’re saying. You know, but people still take them. Right? Why? Because the potential benefits for them outweigh the risks. And I think it’s the same with vaccines. You know, and the one thing with the COVID-19 vaccine, I think is important to recognize is that, you know, the rollout was fast or it seemed very fast, but you have to understand that the infrastructure to develop the vaccines was already there. So the science was there and so much work had already been put into this, that they were able to produce it so quickly. So, you know, it is possible that after more research, a certain vaccine might be recommended from one group or another, which may actually be due to biological reasons, and I don’t necessarily see that as problematic. We need sex-specific dosing. You know, as long as people are making informed decisions based on their own risk-benefit analysis.

Gideon Resnick: Right.

Akilah Hughes: Totally. Yeah. You know, we can’t let perfect be the enemy of the good. [laughs].

Rosemary Morgan: Exactly. Exactly.

Rosemary Morgan: You know, all of the issues that we’re talking about here today, unfortunately, can sometimes undermine people’s trust in science, because we can point to enough examples of times that science overlooked some pretty crucial information. What can scientists do here in this case, you know, as a step to rebuilding trust during such an important time? Like how do you think they can sort of mend what is already broken?

Rosemary Morgan: As scientists it’s really important that we have clear messaging, for example, you know, and that we answer people’s questions as they come up. And it’s also important that the messaging we put out, is not alarmist. I think that’s important, especially with these vaccines. So, yes, more women are reporting side effects, for example, but these side effects are more often than not mild. And it actually means women’s immune systems are working. You know, they’re more robust, they’re ramping up, they’re working. So it’s, how can we fix what’s already broken? I think we also need to talk to each other and make sure we’re doing appropriate and correct science. That is, that has diverse representation, that we’re asking the right questions. And that to me, these equity questions are so important.

Akilah Hughes: Absolutely.

Gideon Resnick: And knowing more about how trials and tests work and how it may filter down to us when we go to the pharmacy or a doctor, what’s your advice to people for when they get that next vaccine, whatever it may be, or that next prescription? What questions, if any, should or could they be asking from health care professionals about dosages, for instance?

Rosemary Morgan: The questions that I would have, I don’t think local pharmacies or pharmacists would be able to answer, because they wouldn’t know. So, you know, my, so my questions are actually for those conducting the research in the first place: are your samples diverse? Are you disaggregating and analyzing your data by sex and other stratifiers? Are you asking the right questions in the first place to understand how men and women might be affected differently? So when a woman or man, when a person goes up and talks to their pharmacist, talks to their doctor, and asks: what side effects might I experience? They can tell them the right answer. They can say, look, your menstrual cycle—if we do see it’s linked—might be disrupted. It’s not just about fevers and chills, it’s not just about a sore arm and a rash. And, you know, I think the pharmacists and doctors need, we need the science and the data for them to be able to also give, relay the right information to women and men.

Gideon Resnick: Rosemary, this has been so wonderful. Thank you so much for speaking to us.

Rosemary Morgan: Oh, great. Thank you for having me.

Akilah Hughes: That was Rosemary Morgan, a research scientist at Johns Hopkins Bloomberg School of Public Health. And that’s the latest for now. We’ll be back after some ads, with a special headlines guest.

[ad break]

Akilah Hughes: Let’s wrap up with some headlines.

[sung] Headlines.

Akilah Hughes: And today, we have a very special guest, comedian, actress and star of Home Economics on ABC, and co-host of Best Friends with Nicole Byer—that comes out every Wednesday. It’s a podcast. Listen to her where you get them. Sasheer Zamata, hello.

Sasheer Zamata: Hello. [Ber ber ber!]

Akilah Hughes: [laughs] Welcome. Welcome.

Sasheer Zamata: Thank you. I like that I had to bring my own sound effects.

Gideon Resnick: Yeah.

Gideon Resnick: I can’t believe you didn’t have them set up for me.

Gideon Resnick: We apologize, from the bottom of our hears.

Akilah Hughes: Yeah, you know, no budget. [laughs]

Gideon Resnick: DIY is the set-up.

Sasheer Zamata: It’s hard. It’s hard in these COVID times.

Akilah Hughes: Let’s do it.

Sasheer Zamata: Let’s do it.

Akilah Hughes: All right. Well, there is a great new way to make money, and it’s called getting scurvy four years ago at Fyre Fest: a class action settlement was reached this week and now the 277 people who attended the event in 2017 will get about $7,000 each. As a reminder, Fyre Fest was pitched as a luxury music festival on a tropical island and when people got there, they found: no music, limited water, FEMA emergency tents, and meals that could only be described as “apocalypse Lunchables.” You hate to see it. Well, I actually love to see it. [laughs] Founder Billy McFarland and co-founder Ja Rule face dozens of lawsuits since the disaster, including one that ordered McFarland to pay five million dollars to two attendees who bought $13,000 VIP packages.

Gideon Resnick: Woah.

Akilah Hughes: So, yeah, that’s that’s the new Dogecoin, I guess. There are no true winners in this case, only people who lost less than others. McFarland is still in prison serving a six-year sentence.

Sasheer Zamata: I wonder how much money is that guy who, he sucked dick for water?

Akilah Hughes: [laughs] Yeah, yeah. I hope he sued as well. He deserves at least a million.

Sasheer Zamata: How much is getting in compensation for that? [laughs]

Akilah Hughes: Yeah.

Sasheer Zamata: He deserves more than anybody.

Akilah Hughes: Right? And he said it on TV.

Sasheer Zamata: I mean, damages for the rest of his life.

Gideon Resnick: That’s undisclosed money. Right.

Sasheer Zamata: Yes.

Akilah Hughes: Yeah, he shows up, you know, he uh, that’s, everybody’s asking where the waters at?

Sasheer Zamata: Or they’re like: I got some water for you. How badly do you want it.

Akilah Hughes: [laughter] Exactly. Aw, poor baby.

Sasheer Zamata: Well, in Canada, there was a tragic example of Zoom fatigue overlapping with clothes fatigue: liberal lawmaker—which I love that they keep saying liberal lawmaker, because it’s like conservative, we’d be like: this makes sense.

Akilah Hughes: [laughs] Exactly. Par for the course.

Sasheer Zamata: A liberal lawmaker accidentally, he accidentally exposed himself during a virtual meeting of parliament this week because he didn’t realize he was on camera. William Amos of Quebec was apparently changing into workout clothes—which, you know, the message here is never work out.

Akilah Hughes: Don’t do it. [laughs] It’s a trap.

Sasheer Zamata: Save, save your job, never work out. His mistake was called out by a fellow lawmaker who also used the opportunity to shoot her shot:

[voice clip] We have seen that the member was in very good shape, but I think that this member should be reminded of what is appropriate, and to control his camera. Thank you.

Gideon Resnick: Woah.

Sasheer Zamata: Surprised she didn’t go farther and she’s like: this member is very long—[laughter]

Sasheer Zamata: And this member is very thick.

Akilah Hughes: Just in case you don’t know who we’re talking about, we talking about the one with the really big balls. [laughter]

Sasheer Zamata: The incident led to plenty of jokes, but also criticisms of the people who leaked the pictures and helped spread them online. You guys like nudes so much, I’m sure there are at least one or two others on the Internet. But that’s like illegal, right? Shouldn’t everybody—only government officials were on the zoom. So, you know someone—

Gideon Resnick: You know who leaked it.

Sasheer Zamata: Yeah!

Akilah Hughes: It’s pretty straightforward. It was that person who was like: Got em!

Sasheer Zamata: Now he’s a famous Amos. [laughter]

Gideon Resnick: Exactly. The second one.

Akilah Hughes: Yeah.

Gideon Resnick: Oh, man. That’s not what he wants. President Bush is finally standing up for the nation’s computers, hitting Russia with sanctions yesterday for its role in a massive hacking scheme last December. And this is the first time the federal government has openly blamed Russia for executing these so-called SolarWinds hack, which compromised computer systems of multiple government agencies, and around 100 private companies in the U.S.—do not worry, my laptop was untouched, even though it contains dozens of hilarious reaction gif that the Russians, quite frankly, would have loved. You are missing out, Vlad. The SolarWinds hack was first detected back in December, but the Trump administration was a little hesitant to acknowledge it, let alone blame Russia—that is just not how you treat your ride-or-dies in these times. The sanctions will affect Russian financial institutions, tech companies, and individuals the Biden administration deemed responsible for the hack.

Sasheer Zamata: I didn’t hear about this when this actually happened last year, and so I was like: did someone hack the wind? Like, I thought that all the—[laughs]

Akilah Hughes: Yeah the sun.

Gideon Resnick: The solar winds—

Sasheer Zamata: The solar winds—so the, so I guess wind during daylight, that’s being hacked now.

Gideon Resnick: Yeah.

Sasheer Zamata: Redirecting it to other places?

Akilah Hughes:  Yeah, don’t breathe it in.

Gideon Resnick: It all belongs to Russia.

Akilah Hughes: That’s Russian [air].

Sasheer Zamata: My gosh, we don’t want that, we don’t want that at all.

Gideon Resnick: We need some wind. It’d be nice.

Sasheer Zamata: A group of scientists have decided to reboot evolution by successfully growing human embryos inside monkeys. Everyone has their little quarantine project, and there was laughing in the face of God. [laughs] The facts of the experiment were published yesterday in “Cell”—not incell, “Cell.” [laughs] To clarify. And they’re a little less freaky than the one-line summary. The embryos only grew for 19 days, so no one had to address the question of who the monkey baby would call mom. If you’re wondering why someone would do this, like I am. Besides just to freak everyone out, scientists hope that by learning to grow human cells in animal models, they’ll eventually be able to grow organs which could be used for transplants. Just be aware that if you do get a hybrid monkey heart, you will become addicted to bananas.

Akilah Hughes: You know, I’ve heard about this, and the monkey ear, you know, how they like sometimes don’t hear evil? That could be a real hindrance. Is all I’m saying.

Sasheer Zamata: Ooooh. Or even see evil!

Akilah Hughes: Yeah, no evil, I mean.

Sasheer Zamata: Or speak it!

Akilah Hughes: Speak it. Right.

Gideon Resnick: All three at once.

Akilah Hughes: Let’s just decide what animal we want to—

Sasheer Zamata: More crime, more crime will happen. I tell you that. [laughs].

Akilah Hughes: Exactly. This is the crime that we all need to be looking out for, quite frankly. [laughs] My goodness. Well, Sasheer, you are absolutely a ray of sunshine. Is there anything else that you would like to plug, anywhere else people can find you?

Sasheer Zamata: My socials are @thesheertruth. And yeah, my podcast, Home Economics is airing right now. We’re going to film Woke season two soon, so catch up and watch Woke season one on Hulu. And, you know, just be kind to each other.

Akilah Hughes: Oh, wow. What a wholesome, good way to end the headlines.

Gideon Resnick: What a wonderful message.

Akilah Hughes: Well, those are the headlines.

Gideon Resnick: That is all for today. If you like the show, make sure you subscribe, leave a review, collect $7,000 from Billy McFarland, and tell your friends to listen

Akilah Hughes: And if you’re into reading, and not just terrifying species combination news like me, What A Day is also a nightly newsletter. Check it out and subscribe at Crooked.com/subscribe. I’m Akilah Hughes.

Akilah Hughes: I’m Gideon. Resnick.

[together] And turn off your Zoom cam!

Akilah Hughes: You don’t even have to have it on when you join. There’s no excuse

Gideon Resnick: Yeah. Pants off. Zoom cam:

[together] Also off.

Akilah Hughes: Please.

Gideon Resnick: Yeah that’s how goes.

Akilah Hughes: What A Day is a production of Crooked Media.

Gideon Resnick: It’s recorded and mixed by Charlotte Landes.

Akilah Hughes: Sonia Htoon is our assistant producer.

Gideon Resnick: Our head writer is Jon Millstein, and our executive producers are Leo Duran, Akilah Hughes and me.

Akilah Hughes: Our theme music is by Colin Gilliard and Kashaka.