As we enter 2021, there are many questions around how to protect ourselves from COVID-19 moving forward, and whether or not the vaccine we’ve been pining for is safe. I’m a writer and producer that has always been fascinated by medical science, growing up in a home with both parents as physicians. My interest in the intersection of art and science led me to Immunologist and Researcher, Dr. Azza Gadir. I came across Dr. Gadir’s work when doing a project for LA based company, SEED, where Dr. Gadir is the Director of Research and Development. This interview touches on the basics of immunology, Dr. Gadir’s work as a scientist in the POC community, the impact of our choices, and what it means to build trust, both in our communities and in the healthcare system.
“In order for this pandemic to end, we have to follow and trust the science and scientific experts paving the way. ”
Meetra: Can you tell us a little bit about your personal background and how you got interested in Immunology?
Dr. Gadir: Raised in London, I was brought up in a Sudanese household passionate about science. By the time I was born, there were already two generations of dentists in my family—naturally I planned on studying dentistry just like my mother and her father. But life never goes according to plan. I didn’t get the grades needed to pursue that path, and ended up studying Biochemistry and Immunology instead. It was through these studies that I was immersed in the world of the human body. I became fascinated by the immune system and how intricately the body works to protect us from disease—particularly autoimmune diseases: a set of conditions in which your immune system mistakenly attacks your own body. This led me to pursue a masters degree in the Immunology of Infectious Disease at the London School of Hygiene and Tropical Disease, and ultimately a PhD in the Immunology of Lupus at University College London.
After my PhD, I began my postdoctoral fellowship at the Boston Children’s Hospital studying the immunology of food allergies. Specifically, a group of cells called regulatory T cells, that are responsible for sending the signals that moderate your immune responses. In people with food allergies, regulatory T cells fail to stop the immune system from mounting attacks on foods, like peanuts or eggs. We discovered that these same cells are also important for controlling inflammation in the microbiome—the community of 38 trillion microbes, mainly bacteria, that live inside and on your body.
Towards the end of my postdoc, I decided to pivot away from lab work, and searched for positions at biotech companies that would allow me to explore how academic research can be used to create innovative products. In 2018, I joined Seed, a microbial sciences company focused on the application of bacteria to improve human and planetary health. Our focus is on the human microbiome, which impacts human health in numerous ways—it’s sometimes hard to even fathom the critical role they play. Microbes work to maintain your gut barrier integrity, sustain an acidic environment, interact with your immune cells, and act as checkpoints for what passes through to the body, amongst other important functions.
On a base level, can you break down how immunity works?
When your body encounters an antigen like Sars-Cov-2 (the virus that causes COVID-19) the immune system is responsible for recognizing it, and subsequently removing it from the body. ‘Immunity’ is the word used to describe the ability for any organism to prevent harm from foreign organisms—immunity is performed by the immune system.
The immune system consists of two parts: innate immunity and adaptive immunity. You can think of it like an American football game, the aim is for the defense to prevent the “ball” (pathogen) from “reaching the end zone” of causing mass inflammation in the body. While the course of events may be complicated, this is a highly coordinated process with many “players” (your immune system and cells) playing specific roles. It starts with your defensive line, which you can think of as your innate immunity—at this point you’re throwing all you have at the pathogen, but, if the “ball” gets past this line of defense, you target it with specialized “players” from your adaptive immune response.
Our innate immune response is the first line of defense; it starts fighting the infectious organism immediately with chemicals and cells that can quickly raise an alarm and prevent the spread of the infection to the rest of the body. Your adaptive immune responses, in contrast, may take more than 96 hours to activate, but last a long time, are highly specific to the infection, and (most importantly!) generate immune memory. Any future interactions with the same infection are met immediately with strong, targeted responses, for example, quick production of antibodies specific to the virus for future protection.
Other than wearing a mask and staying a safe distance, what are some things we can be doing to strengthen our immunity?
The best approach to support your immune system is to get enough sleep, exercise, eat a balanced diet (with lots of fiber!), and try to limit stress. In the future, one additional way you can prepare your immune system for encountering the Sars-Cov-2 virus is by vaccination, which exposes the body to weakened forms of the virus, so that when you face the real thing, your innate memory responses are ready. That said, there will of course be some people who are unable to be vaccinated for medical reasons – most commonly children who are too young or who are immuno-compromised.
Once the vaccine is out, what would you tell those people who want to avoid it?
To invest time researching vaccines and the vaccination process, pick reliable sources and speak to as many experts as possible to help you navigate the evidence, before making a decision.
Here are a few tips to gauge whether a source is reliable:
Who wrote the source? Was it a scientist or someone with relevant expertise to speak to the topic? This is crucial because somebody who has invested substantial time gathering expertise, will have an extensive knowledge of the past research and therefore will be able to provide context.
It’s important to read sources that provide in-text citations or references, highlighting the evidence provided to support their claims, which can be validated and tracked.
Try to be conscious of the author’s potential objectivity, or inherent biases.
Look for any disclaimers listed on the page to be aware of any conflicts of interest.
Based on your knowledge and experience, can you talk to us a little bit about herd immunity and what it means, and how it works...if it works?
If a big group (or “herd”) of people are immune to a contagious virus, then someone in the middle of that group is unlikely to be able to catch the virus as it will not be able to travel through the “herd” to infect the non-immune person. Herd immunity is when enough people in a community are protected from catching the virus and disease, that non-immune individuals are also protected—it reduces the risk that vulnerable people will come into contact with the virus. Herd immunity essentially slows down the spread of a virus and may eventually stop it altogether.
With any infectious disease, there are two ways for a population to acquire herd immunity:
Either a very large portion of the population becomes infected naturally (and is unable to be reinfected).
Or, more commonly and effectively, a large enough portion of the population is vaccinated.
While those that have recovered from natural infection with the Sars-Cov-2 virus will contribute to herd immunity, we’re still very far from achieving it. If we were to achieve herd immunity by simply allowing this virus to move through the population unchecked, many more people would die and we would likely have more individuals living with long-term symptoms (“long COVID”). Also, a number of people do not mount long term memory responses even after getting sick with the disease, so vaccines remain the safest and most effective way to achieve herd immunity.
As a Person of Color and Scientist, can you share some personal highs and lows you have experienced during this time?
It has been truly spectacular watching the scientific community rally together to address this crisis. So many of my former colleagues that remain in academia stopped their own work and pivoted to COVID-19 research. I’ve never felt so inspired by the magnitude of scientific efforts, and I’ve enjoyed closely watching the science grow. I’ve also felt very encouraged by the increase in scientific literacy among the general public—I absolutely love that my friends and family know what antibodies are!
Federal, state, and local data all show that people of color are disproportionately impacted by COVID-19 in both case numbers and deaths. These disparities persist at all age levels, and people of color may also experience increased barriers to testing. This reality, combined with the problems of misinformation and distrust of the healthcare system within these same communities of color, has inspired me to more explicitly engage in scientific communication and attempt to explain the virus, COVID-19, and the vaccines being developed and becoming available. The hope is that increased communication and transparency will increase community trust in science, especially among those most affected by COVID-19.
What, in your opinion, can we as a society from a scientific point of view, learn from this collective experience?
The pandemic has really magnified how connected we all are—humans do not operate in siloed, discrete bubbles, but instead function within interconnected ecosystems which make up the Earth—our collective home. To be cheesy for a minute, it’s quite similar to how our microbiome operates as an internal ecosystem within our bodies—no microbe is an island. Never has it been more clear that the actions of one impacts the greater community. It’s therefore so important for all of us to continue contributing to preventing the spread of this infectious virus. Our individual actions such as wearing face masks, practicing social distancing and other measures not only help protect us, but can also meaningfully play a role in mitigating the spread of the virus and therefore protect others.
Lastly, in order for this pandemic to end, we have to follow and trust the science and scientific experts paving the way. We’re not always right, but we strive to constantly deepen our understanding, and bring the most exact and up-to-date information to the public, based on the research being done within this ever-changing field. The development and approval of a COVID-19 vaccine within less than a year is testament to the herculean effort of the scientific community -- governments, academic scientists, and pharmaceutical companies-- in response to the pandemic. In the recent words of Ed Yong “No other disease has been scrutinized so intensely, by so much combined intellect, in so brief a time”.
