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“It feels like I’ve lived a decade within one year,” Akiko Iwasaki says. “The pandemic has definitely changed the way we do science.”

In the midst of a global health crisis, the professor of immunology at Yale University has been a trusted voice of reason. Iwasaki has become known for breaking down complex science to deliver accessible messages to the public and the media, dispelling myths and publishing leading research on SARS-CoV-2.

The Iwasaki lab, which the Japanese-born scientist set up 20 years ago, shifted its research focus when COVID-19 struck and has been working around the clock ever since.

“The transition was abrupt, because the pandemic just hit us,” says Iwasaki, whose team was studying viruses including herpes, rhinovirus, influenza and Zika prior to the outbreak. “We threw ourselves in and just started doing research.”

The team members’ studies on how the immune system detects viruses and how innate and adaptive immune systems are connected meant they were well-positioned to tackle the questions COVID-19 raised.

In the months since, Iwasaki and her lab team have produced a succession of high-profile research papers. These cover immune profiling, differences in immune response by sex and how SARS-CoV-2 can infect the neurons, leading to neurological symptoms. Most recently the team published a paper on the impact of diverse autoantibodies in patients with COVID-19.

“It’s almost like a medley, every piece of research adds to the next and it’s really wonderful to see,” says Iwasaki, who is also an investigator with the Howard Hughes Medical Institute. “I’m very proud of what we’ve been able to do, and will continue to do.”

‘Long haulers’

Iwasaki is now turning her attention to people with lingering COVID-19 symptoms, known as “long COVID-19” or “long haulers.”

The World Health Organization reports that 1 in 10 people still experience health problems 12 weeks after having COVID-19. Symptoms can include severe fatigue, breathlessness, headaches, chest pains, brain fog and dizziness among many others. Surveys worldwide have found anywhere from 50 different symptoms associated with long COVID-19 to more than 100.

Akiko Iwasaki has endeavored to do away with hierarchy in her lab, which is now working on long-term symptoms of coronavirus infection. | COURTESY OF AKIKO IWASAKI
Akiko Iwasaki has endeavored to do away with hierarchy in her lab, which is now working on long-term symptoms of coronavirus infection. | COURTESY OF AKIKO IWASAKI

Along with faculty members at the Yale School of Medicine, Iwasaki is launching a new study to determine the effect of vaccines on long haulers. The idea came from a grassroots COVID-19 patient group called Survivor Corps, which polled its community on the effects of vaccines on long COVID-19, and found that 40% of people reported mild to full recovery from their symptoms after they were vaccinated.

“We’re recruiting patients who have long COVID and are not yet vaccinated, so we can collect their blood samples and saliva before and after vaccination,” Iwasaki says. “We can then study the changes in their immune response and whether any of those correlate with symptom improvement.”

Iwasaki says she’s heard anecdotally from numerous people that their symptoms have improved post-vaccination, but research around common improvements in long haulers is still very much in its infancy.

“I suspect that some people are suffering from autoimmune disease, while others might have persistent virus infection or remnants of the virus. Depending on what they have, the treatment will be very different,” Iwasaki says.

“It’s known that the long COVID symptoms do resolve over time in many people,” she adds, with caution. “So if you look at people who have symptoms for two months, versus six and then 12 months, the numbers do definitely decline. Some people are getting over long COVID, but others are maintaining it for over a year, and it’s going to be very difficult for them to recover from it.”

Iwasaki is encouraged by the vaccine rollout in the United States and continues to follow the situation in Japan, where her parents and one of her two sisters live. “One thing that is a little disappointing to me is the vaccine rollout in Japan,” she says.

Parts of the country remain under measures intended to limit spread of the virus, with just a small proportion of the population fully vaccinated. Controversy continues to simmer over whether the Tokyo Olympics, scheduled to run from July 23 to Aug. 8, should go ahead.

“It has really been slow and thank goodness it is starting now,” Iwasaki says, “but if a country wants to host an Olympic Games, the vast majority of the people should ideally be already vaccinated — just for the purpose of protecting citizens, as well as the athletes.”

‘Role models’

Born in Iga, Mie Prefecture, Iwasaki spent most of her childhood in nearby Hyogo Prefecture. Growing up, she was fascinated by ancient Japanese literature and loved the outdoors.

“My father would take us to natural sites and the lakes to go hiking and we’d explore nature,” Iwasaki says. “That exposed me to a kind of curiosity about the world.”

Her father, a physicist, was a significant inspiration for Iwasaki to pursue a career in science, while her mother worked at a radio station and fought for women’s rights in the workplace.

“My parents are definitely role models in very different ways,” she says. “My mother had three daughters during her tenure at the radio station and faced a lot of bullying and pressure to quit after having children. It was very difficult for her, and yet she stuck with it.

“She unionized with other women and promoted their rights in the workplace. I was really proud of her and influenced by that. I think it’s where my advocacy for women comes from.”

After a nine-month placement as an exchange student in Canada, Iwasaki moved to Toronto at 16.

“There was a lot of mismatch between my ambition and the country’s societal expectations,” she says. “I have a dream job right now and I love what I’m doing. I’m not sure I could have achieved that if I’d stayed in Japan.”

Iwasaki completed high school in Canada before applying to the University of Toronto, where she earned a bachelor’s degree in biochemistry and physics, then a PhD in immunology in 1998. She moved to the U.S. that year, accepting a postdoctoral position at the National Institutes of Health, where she studied dendritic cells (specialized immune cells) in the gut before joining the Department of Immunology at Yale in 2000.

Dismantling hierarchy

One thing that has remained a constant in the 20 years since forming her lab at the university has been Iwasaki’s dedication to building inclusive and diverse teams.

More than half of the nearly 100 people who have been lab members are women, hailing from all over the world and with very different backgrounds. Iwasaki has dismantled all hierarchy in her lab and fights against the “power dichotomy” in academia. She still faces daily battles with sexism, bullying, racism, misogyny and mansplaining (explanations of something by a man in a condescending manner toward a woman).

“It’s been a long-term problem in academia where there’s a lot of implicit and explicit bias against people who are not the dominant group, which is white males,” Iwasaki says.

Immunologist Akiko Iwasaki has been critical of the slow pace of Japan's COVID-19 vaccine rollout. | POOL / VIA AFP-JIJI
Immunologist Akiko Iwasaki has been critical of the slow pace of Japan’s COVID-19 vaccine rollout. | POOL / VIA AFP-JIJI

“There is a really toxic culture for women and underrepresented people in some pockets of academia. If, every step along the way, women are being discriminated against for a promotion, for retention, for publication, for committees, then there is a chipping away of the women’s workforce in academia, and added to that are caring responsibilities (child care or elder care), which women tend to take on.”

Iwasaki believes hierarchy is “an impediment to creativity and innovation” and says the low percentage of female professors in every academic discipline in Japan is worrying and needs urgent change. Japan ranks 120 out of 156 nations on gender equality according to the 2021 World Economic Forum’s Gender Gap Index (GGI), with women representing only about 16% of researchers in the country today.

“I’m just one voice, but I know for sure other women feel the same way in my position,” Iwasaki says. “We have to explain ourselves to male colleagues who question our opinions, authority, degrees or whatever it is they want to tackle. It is exhausting mentally.

“Structural issues at the institutional level need to change (worldwide), as well as promoting more role models for women and underrepresented minorities. If you don’t see a role model at the top, it’s really hard to, kind of, see yourself going that way.”

Iwasaki also believes in the importance of science communication and sees it as a duty of a scientist to communicate the truth about what science is understood. “We owe it to society to communicate,” she says.

She gets animated when talking about how “armchair immunologists” and scientists speaking outside of their fields of expertise helped fuel some of the “dangerous” misinformation around COVID-19.

“Scientists have to be mindful of what they are really experts in and state their opinion with that in mind,” Iwasaki says. “We just need to be more humble and more open to say we don’t know, but this other person might.”

Iwasaki’s public profile has risen dramatically over the past year, and alongside her media appearances, which continue apace, she has been a notable authority on Twitter. This is where she’s had a prolific impact in demystifying false claims about the disease, explaining basic concepts in immunology and building a following of more than 130,000 users.

“One of the worst myths is about the vaccine causing infertility in women,” Iwasaki says. “It’s hopefully been debunked as it was based on extremely weak science, but unfortunately I believe in Japan there is still information circulating around this.”

The immunologist has also created short video explainers on social media, translating them into different languages including Japanese and Portuguese, as well as making a concerted effort to engage with nonscientific communities.

“I wanted to reach out to people from completely different backgrounds who don’t come into contact with immunologists every day,” she concludes. “That’s where the real value is, because I think everyone in the world needs the truth.”

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