Local doctor eminent veteran of viral wars
Immunology expert Dennis Metzger, Albany Med department leader, hopes vaccines are accepted
O... It was an emergency. And it was a big change from the past, when companies were unwilling to spend a lot of money on something that wasn’t a sure bet. Here they were willing to . ... ” Dennis W. Metzger
ur Capital Region Q&A feature talks to local people about their lives and jobs. Today’s subject is Dennis W. Metzger, who has been chairman of and professor in the department of immunology and microbial disease at Albany Medical Center since 1999. After earning his PH.D. in the field at the University of Illinois Medical Center in 1978, Metzger worked at hospitals and universities in California, Tennessee and Ohio before moving to the Capital Region almost 22 years ago. Metzger, 69, lives in Niskayuna with his wife, Colleen; they have five children, ages 19 to 29, and two dogs. Answers have been minimally edited for space and clarity.
Q: More than 850,000 New Yorkers, including 55,000 people in the Capital Region, have received at least their first dose of the COVID -19 vaccine. Is there any doubt in your mind that most of us should get it when we become eligible, depending on where we fall in the priority list?
A: At Albany Med, we’ve vaccinated between 70 and 80 percent of our employees. As soon as I became eligible, I was right in line with my sleeves rolled up. I have no hesitation in recommending that anyone that can get the vaccine should get it. I can’t wait for my family to be able to get it.
Q: The chairman of immunology at Albany Med wasn’t able to have his family jump the line?
A: (Laughs.) No. It doesn’t work that way.
Q: You’ve been researching immunology for more than four decades.
Put bluntly, how bad is COVID -19, officially known as SARS-COV-2, on the scale of what you’ve seen over those many years?
A: It’s bad. We certainly remember the influenza pandemic of 100 years ago that killed more than half a million people in the U.S. We thought we’d never see that again, but here we are, approaching those numbers. It’s very surprising how transmissible SARS-COV-2 is and how deadly. We’ve been studying influenza for 100 years and have been worried about another flu pandemic; my colleagues who study it say it’s not a question of are we going to see it, it’s a question of when the next influenza pandemic will come. Now we have a type of virus that typically just causes the common cold, but this one is extremely virulent and has changed the way all of us live.
Q: A cancer doctor I know said one of the reasons he continued to study cancer was because it was a formidable foe. Are viruses like that for you — impressive in how good they are at their jobs?
A: You said it better than I could: Viruses are very good at what they do. We largely understand the basic biology of most viruses, but the surprise is how they behave inside the human host and can change rapidly. We don’t have a lot of weapons against them. They’re inside our cells, where it’s hard to reach them like we can with antibiotics, which are effective against bacteria because they’re growing outside of cells.
Q: The national vaccination campaign seems likely to accelerate after the start of Biden administration, as the new president has said he wants to have 100 million people vaccinated in his first 100 days. Were that to happen, at what point will we be able to say that, as a nation, COVID -19 is safely behind us?
A: There are still many questions we don’t have answers for. We have very good evidence that the vaccines from Pfizer and Moderna prevent development of the disease; we don’t know yet if they prevent actual infection. People could get infected after being vaccinated and not develop the disease but still transmit it. That’s a concern, and it’s part of why we don’t know when we’ll be able to say when we can put this pandemic behind us.
Q: The first line of your bio says your research “concentrates on examining new approaches for induction of protective mucosal immune responses.” Does that mean you’ve spent 40 years looking up people’s noses?
A: (Laughs.) No. We’ve been using animal models for ways to treat respiratory infections.
Q: Does that mean you look up animals’ noses?
A: No, but we’re certainly looking at their lung tissue.
Pop quiz: Speaking of noses, what year was the Kleenex brand trademarked?
A: Wow. Gosh. I have no idea.
Q: It was 1924.
A: Wow.
Pop quiz part 2: How many disposable facial tissues do Americans use annually?
A: A lot!
Q: About 255 billion.
A: Wow.
Q: A book on the history of smallpox says that a Chinese emperor was an early proponent of vaccines and had his children inoculated against the disease using methods including grinding up smallpox scabs and blowing it into nostrils, or scratching tissue
from a smallpox sore into the skin of a healthy person. That was no later than the mid-1600s, probably earlier, and the emperor’s campaign was credited with saving millions. Given that we’ve known this works for 500 years, why is there still resistance to the idea of vaccines?
A: That method was also used during the Revolutionary War, when smallpox was a major problem in the Continental Army. They’d take pustules from infected people and sniff those pustules. There was a level of danger to it; some of those people developed smallpox, but most of them did not and were protected. I think there will always be a suspicion of
vaccines in a select group of individuals who do not trust the government, and there’s probably no convincing them. For everyone else I’d say that the two vaccines being offered were tested on over 70,000 people in clinical trials. That’s a huge number for human clinical trials. What’s important is the safety record of the vaccine and the efficacy. About 50 percent is considered good for some vaccines, and in better years the influenza vaccine protects perhaps 70 percent. For COVID -19, to see the kind of numbers we’re seeing for the efficacy of both vaccines — over 90 percent for both — is really stunning. Although it was
done very fast, these vaccines were developed in a scientifically rigorous manner, the clinical trials were very, very large, and the results are fantastic. These are the facts. That’s all you can do: Present the facts and get people to look at them, hopefully unemotionally.
Q: Will the current vaccines work against the new COVID -19 variants that are now spreading?
A: The belief is that they will. Pfizer tested the immunity that was induced against a panel of variants, and it was equally effective against them. We don’t know yet whether the vaccines will work against this new variant that’s now present, but I think there’s reason to believe the vaccines will be effective. We need more data.
Q: Spoken like a scientist. How many times in your career have you said, “We need more data?”
A: Just about every day.
Q: What significant failures have there been in the history of vaccines?
A: I don’t know if there have been “failures,” but certainly there have been major challenges. Trying to develop a vaccine for the AIDS virus has been very challenging, because the virus changes very rapidly — much more rapidly than SARS-COV-2. It’s like the AIDS virus almost decides, “I’ll just change so the immune system doesn’t recognize me anymore.” That’s the same problem with influenza. And it’s historically taken a very long time to develop vaccines. It took 50 years after the polio virus was identified, until the 1950s, for a vaccine to be developed.
Q: How was it possible for what seems to be highly effective COVID -19 vaccines to be developed in less than a year?
A: There are a number of factors, starting with the technology having changed. They’re using RNA that can be synthesized in a matter of weeks. In the past they had to grow the virus in eggs. That takes a long time, you can have only so many eggs in one facility, and if you guess wrong about
the virus, you have to start all over again, but RNA can be synthesized very quickly. That really is a gamechanger, and the exciting thing is this technology can be applied to other vaccines such as influenza.
Q: To sum up, the speed in getting the COVID -19 vaccines done so quickly was a combination of the nature of the virus, new technology, political will and available money?
A: Yes. All of that. It was an emergency. And it was a big change from
the past, when companies were unwilling to spend a lot of money on something that wasn’t a sure bet. Here they were willing to. I think Pfizer alone spent $1 billion.
Q: And they didn’t take any public money.
A: That’s right.
Q: Of course, Pfizer had the cash available because they’ve sold more than $30 billion of Viagra alone since 1998.
A: That’s right.
Final question: Because I have magical powers, I can arrange for you to trade jobs for up to one month with anyone in the Capital Region, and I can give you the skills needed to do that job. With whom would you trade?
A: I’d trade with someone who’s able to get the vaccine to people in the Capital Region. We have the vaccine available. Now we need to be able to deliver it to the population. I’m anxious to see that happen and would like to be able to help get it done.