The Importance of COVID-19 Vaccinations with Dr. Vincent Venditto

Dr. Vincent Venditto is an Assistant Professor of Pharmaceutical Sciences at the University of Kentucky College of Pharmacy. He received training in vaccine design and immunology and continues to investigate vaccine strategies to better understand how the immune system works in disease progression. On this episode, Dr. Venditto speaks on the importance of getting the vaccine and helps to clarify some of the questions surrounding the COVID crisis. We also discuss the impact of COVID on the population of people who have disabilities and issues related to the access barriers for getting vaccinated.

For more information:
Fact vs. fiction: https://pharmacy.uky.edu/news-events/archive/covid-19-vaccines-fact-vs-fiction
Top 10 questions: https://pharmacy.uky.edu/news-events/archive/10-quick-questions-about-covid-19-vaccines

SPEAKERS: Vince Venditto, Tony Delisle

Tony Delisle  00:00

It is in our nature, to want to grow, to expand, and to learn more information, to acquire knowledge, and wisdom. And to be more that comes from Abraham Maslow, and I believe is a very important quote that relates to making sure that we have the most accurate information possible when making choices. In order to learn and grow, got to have the right information. And today, it can be a very difficult time to get the right accurate information. And so in today’s podcast, as we interviewed Dr. Vincent Venditto, to get more information about something that’s really important to be informed on the vaccination for the COVID-19 virus, and for people with disabilities, to get the accurate information about that, to have that knowledge to have that wisdom to learn more is important in terms of this topic, so that we can be more so I look forward to you hearing this episode. Hey, welcome back to another episode of The Independent Life. I’m here with Dr. Vince, Venditto. He comes to us from the University of Kentucky College of Pharmacy, and He is an expert in infectious disease and vaccinations. And he is come here to have a conversation with us because I think what he has to share is very important for us to understand and making important decisions regarding the COVID vaccination, and people with disabilities. So there’s a lot to unpack here. And before we do, please tell us a little bit about who you are and what you’re an expert in in this area, and why you have the credentials and background to have the information that we should be listening to.

Vince Venditto  02:06

Great, thanks. It’s pleasure to be here. So my background, I got my PhD in Chemistry actually at Texas A&M University. And then for a postdoc, I went to do a to learn how to make vaccines to use my Chemistry experience, and learn how to make vaccines and learn about immunology. And so really, it was through this process that I that I really got the experience and expertise that that brings me here today. During my postdoc I was i was focused on making HIV vaccines and trying to develop this was out at University of California in San Francisco. And I was I was developing HIV vaccines trying to, you know, to address another public health need where we really do need a vaccine. And so since moving to the University of Kentucky, I’ve kind of retooled the the technology that I was using the vaccine technology to focus on studying immune responses in other diseases where we think vaccine technology could have an impact like in cardiovascular disease. So a lot of my work right now actually focuses on trying to modulate immune responses in the context of cardiovascular disease. But the other thing that I’ll say that AI is really important, and I think really what brought me to this point is certainly I have this experience in training in vaccine design and Immunology. But there’s so much misinformation out there, and scientists who have experience and understanding about the vaccines about the process that we’re going through. And you know, I mean, we’re all completely surrounded by COVID-19, inflammation and misinformation. And so, as a as a scientist, and as a person who’s interested in in scientific communication, and making sure that the public is properly educated, I cede my duty to inform as many people as possible on the appropriate information and trying to dispel some of the myths, misconceptions that are out there.

Tony Delisle  04:06

Well, you have your work cut out for you, because it just seems like the onslaught of misinformation out there in the platforms that is just been multiplied over the years. And it’s been interesting and somewhat disheartening, being someone myself from public health, to see how much misinformation around COVID-19 has been out there, how it’s been a real challenge for people like yourselves, to really combat that misinformation is very valuable and appreciate your efforts and being able to do that, because that is certainly one of the most important areas is to, you know, have the right information, the correct information to make the informed decisions that we need to make and thank you for making sure that we are bringing the right evidence base information to the forefront before I dive into the you know, why should we get vaccinated What’s this you know, science behind the reasons of why We should add to your understanding about, you know, COVID-19. And its impact perhaps on people with disabilities, when we look at, you know, the people that are most likely to, you know, be impacted by COVID? And who that might be and pertaining to disabilities. Do you see anything in terms of the raise prevalence or issues related to COVID? pertaining to disability to your knowledge?

Vince Venditto  05:25

Yeah, so I it’s it’s a good question. I mean, you know, I think what we see right now with people that are impacted by COVID-19, it’s it’s it’s affecting people who have health disparities in other areas. So people who have increased rates of heart disease, increased rates of diabetes, increased rates of lung conditions. And so, you know, this is, I would say, across the board, anybody that has increased rates of those conditions are certainly going to be impacted. And I know that you shared some data that these rates are are increased in people living with disabilities. And so, you know, really, I think of concern because getting infected with coronavirus, if you have one of these conditions, and you’re in one of these populations that maybe doesn’t have appropriate health care doesn’t have the appropriate access to care, then getting infected can really have a huge impact on your life and long term effects on living and long term health conditions. 

Tony Delisle  06:24

So thank you for bringing that up, that people with disabilities are more likely to have cardiovascular disease, respiratory disease, diabetes, though secondary outcomes that are related to COVID-19. But also people over 65, you know, over half of all people over 65 have a disability as well. And then I looked at a lot of the, you know, rates in institutionalized care, and you know, how many, the percentage of people in institutionalized care, the nursing home facilities, you know, do have disabilities, as well, and the impact that it’s had on our community, in that sense. And so I do believe that, you know, COVID-19, and its impact on people disabilities is, is an important area to understand more on what’s happening so we can do better to serve. And so I appreciate your pointing to some of that information in terms of that sense.

Vince Venditto  07:12

So I think the other point that you just brought up is people living in institutionalized care, and that really, is kind of optimal place for coronavirus to spread through a community. So you know, if coronavirus comes into a place where there is, you know, it where it’s difficult to physical distance from other people or, you know, nurses are potentially carriers of the virus and, and so even if you’re vaccinated, and we can get into this a little bit later, even if you’re vaccinated, you could still potentially spread, but it’s just going to keep you from getting sicker. And so that’s why the vaccine is so important for people living in different settings with close quarters, and where there’s a lot of high end interactions with other people. So yeah, I mean, the vaccine is just so important. And we can talk about that more in a bit, I guess.

Tony Delisle  08:02

Are gonna ready to jump in on that one. Yeah. Right now, but I feel like there’s something else to before we, you know, put a bow on the institutionalized care, because like there, yes, we’re Centers for Independent Living. So in a way, we have the space that’s somewhat juxtaposed to institutionalized care. So we try to make sure that people with disabilities to whatever extent possible can live in the community, or the least restrictive environment possible, and preventing any type of institutionalized care if possible. But do you see the role for institutionalized care? There’s certainly a need for institutionalized care. And does this mean that perhaps we should look at how institutionalized care is done differently? Is there ways of doing it non congregate ways of doing it to, you know, institutionalized care that would mitigate the amount of close quarters that are people in with maintaining connection and community perhaps, I don’t know it for me, it makes me think about the model in which it’s currently in and the model which currently could be to be the best one that, you know, would help mitigate the effects that we’re seeing from COVID-19.

Vince Venditto  09:09

Yeah, I mean, I think it’s a great point, and I wish I had an answer to it.

Tony Delisle  09:12

Yeah, I just throw that out there. Yeah.

Vince Venditto  09:16

I mean, I yeah, I it’s certainly something that I think that you know, coronavirus in the pandemic has really brought up a lot of things in how we care for people and how we think about our normal daily lives and how we can change how we’re living to improve the you know, the care for all people, whether they’re, you’re in an institutionalized setting, or you’re, you know, or you’re, you’re in your own home, and I think all of those things have changed because of the pandemic and I think will continue to change because of the health disparities that we’ve seen come up with, you know, different conditions, different living settings.

Tony Delisle  09:52

So please tell us why, you know, there’s there’s a lot of us out here again, have information misinformation, overload. And everything else like that. Why is it that we should get the vaccination for COVID-19?

Vince Venditto  10:06

Yeah. So I mean, the short answer is that it’s going to keep you out of the hospital or it’s going to keep most of the people out of hospital. This is the data that they collected with the clinical trial. And that is that in the 40,000 people or thereabout. 40,000 people that were included in a clinical trial, people who were vaccinated had had better outcomes, they didn’t have the progression to hospitalization, they didn’t have any of the sudden severe disease that we saw on people who were not vaccinated. And that that alone is is the importance of getting the vaccine, it’s really to keep people out of the hospitals, and keep people off of ventilators, the vaccine is designed to give your immune system just a little bit of a boost so that you can help fight the virus without succumbing to the pretty serious consequences if you are infected.

Tony Delisle  10:55

So is there any, like certain health conditions or types of disabilities or anything that you know, group of people that might have a certain type of condition should, you know be wary of having the vaccination at all that you want to say, Hey, baby, you know, check with a doctor before you get the vaccination if you have such and such condition?

Vince Venditto  11:18

Yeah, so I mean, my blanket response really is anybody that has some concerns should definitely talk to their their primary care provider, their physician, about their specific conditions, their specific concerns, because I certainly don’t have all the health information for everybody that has those questions. But I, you know, based on on what we’ve seen so far, really is that there have only been a few, really, I think, severe adverse responses. And this is, they’ve seen pretty strong allergic responses, really, it’s only been a handful of people. You know, they’ve they’ve immunized I don’t know how many million people so far, but they’ve only seen this really strong anaphylaxis response in maybe about 20 or 30 people. So it’s a relatively small number of people. But they have issued a warning, you know that if you have a strong anaphylactic response to other things to foods or to this isn’t seasonal allergies, this is something that that requires an epi pen or requires hospitalization at something that you’ve had in the past. And so they are indicating that if you have any anaplastic reactions in the past anything that you talk to your healthcare provider, make them aware and and if you are getting the vaccine, which is still recommended, it should be done in a clinical setting, rather than in a drive thru clinic, where professional care is there in case you have any strong responses. But again, they’re rare. So you know, it is recommended that most people get the vaccine.

Tony Delisle  12:54

Gotcha, gotcha. So yeah, that that definitely, you know, is one thing that goes through people’s minds about reasons kind of why not to and, you know, it’s thinking of other reasons that, you know, I’ve heard from people I know, friends, I know, and etc, why they shouldn’t get the vaccine, and I want to hear maybe, what do you think of him? So, you know, I have some people that say, hey, look, the trials, you know, for this vaccine, you know, maybe went off in April, May, or whatever it may be, it’s been such a short amount of time to develop a vaccine of this nature against a virus like this, like a true amazement of like science to be able to do something this fast, like quite incredible, mind blowing, and say that well, because of that, you know, nature, we haven’t had enough time longitudinally to kind of see the effects of what the, you know, vaccine might do to us in terms of any kind of, you know, reactions to it right away or down the road. So, I’m gonna wait and see, you know, what, how this pans out? And you know, so I’ve heard that before. So what would you tell someone like that, that, you know, has those kind of reasons why they might not get vaccinated?

Vince Venditto  14:05

Yeah, I mean, I’ve heard this quite a bit, too. And I think it’s understandable. But let me tell you why I’ve gotten vaccinated, even though those concerns do exist in the community. And so first, let me talk about the approval process. And then I’ll talk about some of the what we see in side effects with with other vaccines and the timeframe of those. So this approval process, you know, it was the fastest vaccine to be to get approval from the FDA and that it only took a year and that, you know, that is quicker than the next fastest, which is the measles vaccine, which took four years. And the reason that this process was so yeah. Yeah. And it’s a testament to the science really, that that this happened. Yeah. And to the public investment in the federal investment that to get us to this point.

Tony Delisle  14:56

Yeah, I think I’m so glad you’re saying that. I think that does need to be acknowledged. That’s really a great amazing feat that has been accomplished.

Vince Venditto  15:03

It is. So the the mRNA technology that’s the basis for both the Pfizer and Moderna vaccines that was really devised, I would say in the not in the 90s. And it was it was designed with the goal of doing a rapid development of a vaccine. And we can get into the the way that works in a little bit if you’re interested. But, but basically, because it was designed for rapid rollout, and and it was, you know, they they kind of invented the technology in the 90s. They then started to continue to optimize the technology, they were doing a lot of preclinical studies in different small animal and primate models. And then when MERS came around when SARS came around, these are other coronaviruses that happened. I guess SARS one happened 13 years ago, or something like that, I forget the actual date. So when that came around, they wanted to do a clinical trial with the same technology. The problem is it didn’t spread around the globe the way that it did for this pandemic. And so they weren’t able to actually immunize the 40,000 people that they did in the phase three trial, like they did for this pandemic. And so while it was being developed for these other, these other viruses, they never had enough people to do a proper controlled trial. And so did you have a question?

Tony Delisle  16:24

No, I was just like, like, really appreciating how they’re able to scale this up? Yeah, have been able to do this. I marvel, I marvel at the administrative and the scientific level. I mean, gather to coordinate, you know, it’s To me, it’s like the moonshot. Yeah, you know, in a way, it’s like a moonshot opportunity, you know, point in science that I think needs to be like seen like that. Right? Absolutely. So again, that goes back to that, you know, I guess person that saying, Well, again, you know, that comes in part and parcel with the notion that, you know, we haven’t seen enough time with it. But I also have other people that are weighing like, oh, that, you know, this cost benefit analysis that they have in their head where, you know, what, whatever reaction I might get out of the COVID-19, or your reaction that I have, it’s not gonna be any bad, but COVID, I’ll be COVID. It’ll be okay. Whatever I can do. COVID is not gonna be as bad as whatever I’m actually getting from this vaccine and kind of having that attitude. What do you would you say to that kind of reason for perhaps not getting the vaccine? Yeah. So

Vince Venditto  17:30

As this vaccine went through clinical trials, the FDA told them that they had to wait for at least eight weeks after the second dose in the phase three trial to determine if there were any side effects. And the question is why eight weeks. And that’s because generally, any adverse event that’s seen with the vaccine with any other vaccines, they generally occur either immediately after immunization, or 68 weeks later. And because we haven’t seen that the risk of the vaccine is actually quite low, obviously, we’re still monitoring, we’re going to be doing studies monitoring these patients for years to come. And so you know, all this stuff will will play out over that time, but but based on all of the evidence we have, from all of the vaccines, six to eight weeks is kind of that sweet spot. And if you don’t see anything by then, then they’re relatively safe. And if you compare the risk, the the very low risk of the vaccine, with the relatively high risk of actually getting infected, and potentially hospitalized and potentially even dying from the virus, the risk reward with the vaccine is certainly advantages, the the benefits of the vaccine as opposed to the virus getting infected.

Tony Delisle  18:45

So gotcha. Thank you. So when we talk about people also wanting to give the vaccine, some of the things that people you know, having leery about also are kind of related to sometimes things that have happened in science in the past that have been confusing to people and also led to a movement. And since what I mean by is, is that there’s been, you know, an anti vaccination movement. And one part of that, you know, story of the anti Vax movement is that it is linked to people that have autism. And so that, you know, is directly related to disability and vaccinations and perhaps, you know, you know, could have repercussions today, in terms of some people and whether or not they want to get this COVID-19 vaccination as well. So, is there anything that you would have to say to somebody that, you know, kind of is, you know, connecting those things together with getting the COVID vaccination? 

Vince Venditto  19:42

Yeah I mean, you know, first of all, none none of those things are actually true all the that data has been proven to be falsified and not accurate. But this anti vaccine movement has been going on since vaccines were developed by Edward Jenner. And there were a lot of political cartoons indicated. That people who were vaccinated were turning into cows. And this was around the smallpox vaccine, where they were taking cow pustules. And so there’s, so this is not a new thing. And they, you know, they went from saying that people are going to turn into cows, too then saying that when the paper was published, saying that the vaccines cause autism, none of these things are true, and none of them have been have been shown to be true. And that paper that linked autism to vaccines was proven to just not be correct. But there’s a lot of people in the media, there’s prominent celebrities and politicians that continue to promote this just false science. And, and that, that’s pretty detrimental. Because there’s a lot more people that know these celebrities than know me. And so I can only do so much, I only have such, so big of a platform. But they they reach so many more people so much more easily. So it, it’s easy for them to get their false science to people rather than me trying to dispel those myths. So really, there is no connection to any of these disabilities, I can set tell you that. There are some occasionally some side effects that are observed in vaccines, and we haven’t seen any of them with the Pfizer maternal vaccines. And those observations are typically made during clinical trials. And if there is a high abundance of the side effects, then they wouldn’t approve them. And so and we’re not seeing any of that with these vaccines. So these vaccines seems safer than most other vaccines that are on the market. And, and they’re all safe, too. So you know, it’s it’s, it’s really a testament to the science and the opportunity here to actually target other viruses as well. 

Tony Delisle  21:45

Really, that makes a lot of sense. And there is a consensus. Yeah, that I’m aware of in the research that says that it is not linked to autism, I believe the article you’re referring to was in the Lancer. It was retracted. I think it was one of the rare times like, you know, an article, at least in that kind of a publication is retracted. Right, you know, for good reason when you go back on it, so, so I’m glad you brought that up. So if you get the vaccine, I know, a couple common questions that people might have is that if I get the vaccine, does that mean, I? Am I still able to get someone else infected? Or am I protected from getting someone else infected? So if someone gets the vaccine, you know, can they get someone else? You know, COVID? Or are they immune to that?

Vince Venditto  22:35

Yeah, so it’s it’s a good question. It’s something that we’re still trying to figure out what the clinical trials did was they determined whether or not people who were vaccinated would have less severe disease. And the clinical trial showed that if you’re vaccinated, you have less severe disease, it did not prove that if you’re vaccinated, that you can that you won’t transmit to other people anymore. And so it’s important that if you are vaccinated, that you continue wearing a mask, you continue physical distancing, washing your hands, until we actually prove that the vaccine prevents transmission. And right now, we just don’t really have all the data to say that.

Tony Delisle  23:13

Okay, all right. Fair enough. And, you know, as we’re recording this, you know, January 27, seems like it’s a race against time, you know, the clock’s ticking, for sure. At the same time, we’re hearing, you know, different strains, you know, coming out of different countries at this point. And these are hybrids. And then, you know, questions get raised about, well, well, this vaccine that’s currently be distributed, be protective against these other strains. Is there any educated guess there? Or what’s the thoughts?

Vince Venditto  23:43

Yeah, that’s that’s a good question. So I think there’s, I’ll first say that mutations in viruses are very common. And I could tell you the data that we see in Kentucky right now is that there have that been about 23 mutations in the virus in the past year. And so that’s a relatively low rate of mutation, which are some and none of those mutations have really led to any dramatic differences. We’re not seeing increased infectivity, we’re not seeing any increased and this is in in Kentucky I’m referring to now there are some of these variants and mutations that are occurring. There’s this one that a lot of public health, individuals are looking at to make sure that to look at the transmissibility, and the infectivity, and every time a new mutation arises in a community, they then make that virus and they then test to see whether or not the vaccine can still neutralize or limit infectivity. And so far, the vaccines have proven to do their job. The nice thing about the vaccine technology though, is if we find that there’s a variant that’s coming around, that does not respond to the vaccine that’s currently approved. It’s a relatively easy process to get an new vaccine made, because you’re just changing the few, a little piece of the genetic code that’s in the, it’s in the vaccine. Wow, that’s good. And the approval process will actually be much faster because they’ll they’ll have to do a small clinical trial to show that there’s no additional adverse are no, there’s no adverse events that come up with this minor change in the genetic code. But everything else is effectively the same. And it’s not anticipated that changes to the genetic code of the vaccine is going to impact safety or efficacy. So I imagine that in a matter of months, we can have a new vaccine to get to people, if a specific strain starts circulating, that is different and more virulent.

Tony Delisle  25:45

That’s very encouraging to hear. That’s great to hear. Well, so alright, so to kind of round this out, the one end is developing it, the other would be then, you know, getting it out to people. We’re trying to be a part of where we can encourage people to say yes to it. But then once you say yes, you know how people can get LinkedIn and go about that? Are you on kind of inside about, you know, how best practices would run in terms of getting your vaccines to people, especially like with disabilities, who may be in the community, but have limited access to the vaccine, you know, how they can get it, you know, in a way that’s effectively communicated to them and offered in a way that’s accessible to them as well? Are you in on your that kind of end of the vaccination coordination?

Vince Venditto  26:32

I’ve not, and I don’t envy the the people in those positions. Who are, I think the one thing that I would say, though, is, I think politicians have a lot of pull in this area, and they’re the ones that are making the laws on how the vaccines are distributed. And so I would urge anybody who’s listening to this to, you know, write your senators, right, your Congress, people that that the state and federal level, and tell them that it’s important to get vaccines to the, to your community, and, you know, I would certainly encourage people to do that. And, and it’s so important to make sure that everybody has access to this, and certainly those with, as we talked about previously, people with increased risk for cardiovascular disease, lung disease, diabetes, things that that, you know, are elevated in, in the disability community. So, yeah.

Tony Delisle  27:22

Thank you for bringing up that point, that’s something that we really want to underscore here at the independent life is, people getting involved at the local and state level on advocating and this is certainly an important place to advocate for, I think, also, because people with disabilities aren’t necessarily included in the first round of priority. People that you know, should be getting the vaccine. And, you know, there’s good reasons of, you know, why the data, my point is why we should be, and so, you know, advocating for us to make sure that, you know, we do get the vaccine at the appropriate time because of the need, and it being there, I think is a very important thing, that’s a real time advocacy issue for our community right now, to end and to be able to do it in a way that you know, people have access to, and will be able to get it, you know, just as equally as anyone else will be able to so I can appreciate how you don’t envy, that part of the lift that’s going on. Like that, again, is a you know, a systematic moon left, there will also have to happen in coordination with the incredible feats of science that is occurred as well. Alright, well, let’s try and put a bow on this, if you are giving me your elevator speech, you know, to everybody about Okay, why we should get vaccinated. You know, why the people perhaps even living with somebody who has a disability get vaccinated, because they’re going to be around them all the time, and etc. You know, why should we get vaccinated? Why should we be doing this right now?

Vince Venditto  28:45

Yeah, I mean, it’s so important to get vaccinated to keep you out of the hospital. And after you’re vaccinated, it’s important to continue wearing a mask, physical distancing, washing your hands, to keep the people around you out of the hospital, you know, until everybody has access to the vaccine, we’re still living through a pandemic. And so we need to not only protect ourselves with the vaccine, but protecting our communities, and those around us is so critical. So I would encourage everybody to get the vaccine, speak with your health care providers. And, and, you know, hopefully, we’ll be through this soon so we can get back to, you know, life as as new normal, I guess, right?

Tony Delisle  29:24

Yeah, it’ll be very different on the other side, that’s another fascinating conversation to be had about, again, you know, how can we do things different moving into the future, you know, we just do one little nugget out there about institutionalized care, but there are many more to consider as well, you know, to mitigate it, you know, in the first place, and maybe perhaps one day we can continue a conversation though, going down. There’s other areas that would be very interesting to talk about and related to what you do and what you do is I just want to acknowledge you, and thank you for doing the hard work that it is there for you to do. This is an easy work that you’re a part of, it takes a huge amount of you know dedication you know, PR personally and professionally to do the work that you’re doing then to go beyond that it’s kind of above and beyond and to really feel that it’s their responsibility to get this out to the public and to you know, in a way that they can understand and real information and make a really good informed decision on and so I just want to acknowledge you for taking that you know, extra leap even beyond you know, the incredible work that you already do, you know, in this field to reach out to the public and communicate this information in a way we can absorb so that’s huge and for you to put yourself out there and to do this and you know, your time super valuable, says a lot about you and and yeah, can go a long way. And abating my opinion about the University of Kentucky being over here in the University of Florida, you know, sometimes there’s a bias in the community. And, you know, so you know, these are times where we can work and be more diverse and so I can be more accepting of, you know, expertise that come out of this institution. So I say all that and just because of, you know, our connections and love for one another’s universities, I’m sure all right, yes. But uh, but uh, hey, well, I again, you know, thank you so much for your time. And, you know, if ever to continue the conversation and really promote pro messaging, you know, for vaccinations, I’d love to call on you and continue getting good information out to the people that we can make a better informed choice here.

Vince Venditto  31:31

Thank you very much for having me. And I appreciate being here and I appreciate what you’re doing for the community. So I’d be happy to come back anytime.

Tony Delisle  31:40

All right, thank you, Dr. Venditto. All right, again, another episode for the independent life until the next time, onward and upward.

Amy Feutz  31:50

Thanks for listening to The Independent Life podcast brought to you by the Center for Independent Living of North Central Florida. If you like what you hear, please rate review and subscribe. And if you know anyone who might benefit from listening, share this podcast and invite them to subscribe to for questions or suggestions or if you have a story you’d like to share, please email us at cilncf.org@gmail.com for call us at 352-378-7474. Thanks for joining us. Until next time, support, advocate and empower each other to live the independent life.