On Veterans’ Day this year, Jessica Dudley will think a lot about someone she’s never met. An Army Veteran she’d searched for her whole life.



“I’m very proud of him. I think he’s my hero,” she said. “Even though I never had the chance to know him. I feel very close to him. I feel his presence.”



<figure class="wp-block-image alignright"><img loading="lazy" decoding="async" width="225" height="300" src="http://35.88.189.111/wp-content/uploads/2021/11/image0-3-scaled-e1668737947434-225x300.jpeg" alt="" class="wp-image-29279" srcset="https://blogcms.23andme.com/wp-content/uploads/2021/11/image0-3-scaled-e1668737947434-225x300.jpeg 225w, https://blogcms.23andme.com/wp-content/uploads/2021/11/image0-3-scaled-e1668737947434-768x1024.jpeg 768w, https://blogcms.23andme.com/wp-content/uploads/2021/11/image0-3-scaled-e1668737947434-660x880.jpeg 660w, https://blogcms.23andme.com/wp-content/uploads/2021/11/image0-3-scaled-e1668737947434-885x1180.jpeg 885w" sizes="auto, (max-width: 225px) 100vw, 225px" /><figcaption class="wp-element-caption">Sgt. Lee Eugene Dudley</figcaption></figure>



<h2 class="wp-block-heading" id="h-a-man-she-never-knew">A Man She Never Knew</h2>



For almost 50 years, she searched for her father, a man she’d never known. She didn’t even have his name. Born in Cam Ranh Bay in 1972, Jessica had a Cambodian mother and a father who was a US soldier. Her mother only told her about him that he was white, had a brace on one of his knees, and his name was “Lee.” Her mom told Jessica that he’d wanted to take them to the United States, but Jessica’s mom didn’t want to go.



It wasn’t easy growing up in Vietnam as an Amerasian kid. Her mother sent her off to live with a distant relative in Trà Vinh, a city far to the south. On top of that, she went blind when she was very young, adding to all the things that set her apart from everyone else around her.



“I woke up one morning and could not see,” Jessica said. “It was after the war and being an Amerasian kid&#8230;no one really cared.”



<h2 class="wp-block-heading" id="h-coming-to-america">Coming to America</h2>



She made do. However, when Jessica turned 17, she immigrated to the United States alone and did not speak English. 



She ended up in New York City, where she was taken in for a short time by a foster care family while attending a school for the blind. What followed was a short-lived marriage and three kids. She worked, raised her children, and made a living as a massage therapist. But she never stopped searching for her father.



Then, a few years ago, her boyfriend gave her a gift, a 23andMe kit.



It took a while for Jessica to see how priceless his present had been.



“When my result came back, a woman named Lisa was predicted to be my first cousin,” Jessica said.



<h2 class="wp-block-heading" id="h-exploring-her-23andme-matches">Exploring her 23andMe Matches</h2>



Jessica sent her a message, and Lisa quickly sent her a message back.



“When I got Lisa’s message, it felt like someone had just given me a million dollars.”



<figure class="wp-block-image aligncenter"><img loading="lazy" decoding="async" width="640" height="480" src="http://35.88.189.111/wp-content/uploads/2021/11/Corrine-Lisas-twin-Jessica-Lisa-1-rotated-e1679007720908.jpeg" alt="" class="wp-image-29277" srcset="https://blogcms.23andme.com/wp-content/uploads/2021/11/Corrine-Lisas-twin-Jessica-Lisa-1-rotated-e1679007720908.jpeg 640w, https://blogcms.23andme.com/wp-content/uploads/2021/11/Corrine-Lisas-twin-Jessica-Lisa-1-rotated-e1679007720908-300x225.jpeg 300w" sizes="auto, (max-width: 640px) 100vw, 640px" /><figcaption class="wp-element-caption">Lisa, center, with her twin cousins Corine on the left and Lisa on the right.</figcaption></figure>



She messaged Lisa sharing her story with her, asking if she was related to a man named “Lee.” Lisa thought she meant the last name of “Lee” and she didn’t know anyone in her family with that last name. She wished Jessica the best and their messages stopped there.



However, about a year later, Lisa reread Jessica’s message. It was clear they were closely related, and so she talked to her mom, telling her she didn’t know how to help since there was no one in the family with the name “Lee.” Her mom said they didn’t have anyone with that as a last name, but one of her uncles’ first names was Lee.



<h2 class="wp-block-heading" id="h-uncle-gene">Uncle Gene</h2>



Lisa had known her favorite uncle as Uncle Gene. She didn’t know his first name was “Lee Eugene.” Quickly she was back in communication with Jessica and shared photos of her uncle, the man who was Jessica’s biological father, Sgt. Major Lee Eugene Dudley died in 2005. Jessica has a computer program that can describe a photo, and she’d listen to the description of each photo her cousin Lisa shared of her dad that detailed the uniform, the close-cropped light brown hair, blue eyes, the square jaw, and the medals. He’d been so proud of that uniform that after he’d retired, he’d asked his niece if she’d mind him wearing his uniform to her wedding.



In turn, Jessica shared photos of herself with her newfound biological family, and immediately, they saw the resemblance between the cousins. Jessica looked so much like her father’s mother, and she shared the same slim, long-limbed build as her cousins. Lisa and her twin sister Corine are also Amerasian but half-Japanese. Jessica looks like their sister.



<figure class="wp-block-image alignright"><img decoding="async" src="http://35.88.189.111/wp-content/uploads/2021/11/Jessica-at-Sand-Hill-Cemetery-1-300x225.jpeg" alt="" class="wp-image-29276"/></figure>



<h2 class="wp-block-heading" id="h-getting-to-know-more-about-her-father">Getting to Know More About Her Father</h2>



More importantly, Jessica learned about her father. He had no other children. He’d served four combat tours of duty in Vietnam, as well as in the Dominican Republic and Grenada. He’d risen to the highest enlisted ranks as a sergeant major in the infantry and served in the 82nd Airborne. He’d been awarded a silver and bronze star with ‘V’ and oak leaf, a recognition for the medals received in combat for valor and heroism. He received a Purple Heart for being wounded in combat. He also had a meritorious service medal for his time in combat. Jessica’s mother had met him after he’d been shot in the leg, hence the brace. Duty and service were essential to him, and he told his family that he’d never married because he didn’t want to burden a wife with that kind of life. Even when he retired after 30 years of service, he taught ROTC first at a college in Oklahoma and then at a high school in North Carolina.



She was sad that he’d died before she could meet him, but learning all this about her father gave her a sense of pride and belonging. She changed her last name to “Dudley.” And even though it was during the pandemic, she drove from her home in Connecticut to Fort Bragg, North Carolina, where her father is buried. She found his gravestone and ran her fingers over the inscription, name, rank, and birth and death dates. She placed flowers there and at the grave of one of her friends, a fellow soldier with whom he served. She opened a bottle of his favorite cognac and poured a bit on each grave.



“I’d waited so long to find him, so the least I could do was go to his grave,” Jessica said. “I’m very proud of my father even though I didn’t ever meet him.”



Jessica has met her cousins and plans to move to the West Coast to be closer to them.



“I feel so complete,” she said. “I feel I’m home. I feel like I belong.”

A photo of Jessica at Sand Hill Cemetery touching her birth father's gravestone.

23andMe Blog

23andMe Blog Team

A Veterans’ Day Story From 23andMe

Editor&#8217;s note: A previous version of this blog post had an error in the HLA table, which has been corrected in this version.
By Janie Shelton, Ph.D., and Daniella Coker, MPH*
As part of 23andMe’s ongoing study into COVID-19, our scientists have recently looked at how people <a href="https://blog.23andme.com/23andme-research/covid-19-vaccine-reactions/">react differently to different vaccines</a>, noting that those who previously had COVID-19, as well as women and younger people reacted the strongest to the vaccine.
Following up on that data, we also wanted to better understand whether genetics could help explain those differences and whether that could help us better understand the virus. We found that some variants in a complex of genes involved in immune response are associated with being more likely to have a strong reaction to the vaccine and some make it less likely.

<h6>Participating in COVID-19 Research</h6>
Before we go into details it’s important to note that this kind of study is possible because millions of individuals have already been vaccinated. Among them are a large number of 23andMe customers who have consented to participate in research. That has allowed our scientists to quickly explore how genetics plays a role in both the <a href="https://www.nature.com/articles/s41588-021-00854-7">susceptibility and severity of COVID-19</a>. We’ve also looked at other aspects of the pandemic like its impact on <a href="https://blog.23andme.com/23andme-research/covid-impact-on-sleep/">sleep</a>, <a href="https://blog.23andme.com/23andme-research/stepping-back-up-amid-covid-19/">physical activity</a>, and how it has <a href="https://blog.23andme.com/23andme-research/impact-disparities-of-covid-19/">hit some communities harder than others</a>. In this latest study, we looked at the factors associated with “reactogenicity”, or how noticeable a person’s response was to the vaccine. Some reported feeling nothing at all while others reported feeling very ill. This gave our scientists the data needed to study whether genetics could explain those differences.
To do that we conducted a genome-wide association study looking at these different responses to the vaccine between those who described feeling “Not at all sick” to those who felt “Extremely sick.”
<h6>Genetic Associations</h6>
We found a strong association between variations in the HLA genes — the human leukocyte antigen complex which is involved in regulating immune response. These genes encode for a number of proteins that make up the major-histocompatibility complex, which is on the frontline of your immune system&#8217;s infection recognition system. These results show that variations in the HLA complex are related to the degree to which one feels ill after vaccination.
First, it’s helpful to understand a bit about how vaccines work. These vaccines teach your immune system to recognize and respond to the virus that causes COVID-19. The mRNA vaccines (e.g. Pfizer/BioNTech &amp; Moderna) introduce genetic instructions to make a harmless protein that is unique to the virus. The other most common vaccine in circulation is the Johnson &amp; Johnson/Jansen vaccine, which uses a viral vector encoding the spike protein. In all three of these vaccines, your immune system develops a response to the spike protein of SARS-CoV-2, so your immune system can recognize the virus faster if you become exposed and eliminate it before you become severely ill.
<h6>Immune Response</h6>
Given how the vaccines work, why would we expect the HLA to be involved? The primary function of HLA molecules is to present foreign antigens on the cell surface in order to elicit an immune response. As such, the HLA plays a key role in presenting the proteins derived from the vaccine to the immune system.
But why do some people feel very sick from their COVID-19 vaccine, and others don’t feel sick at all?
Our findings suggest that prior history of COVID-19, younger age, female sex, and the type of HLA alleles you carry are strong predictors. Note that in the below table effect sizes below 1.0 decrease the likelihood of a reaction to the vaccine and the ones above 1.0 increase the likelihood (all reported effect sizes are statistically significant after correction for multiple tests).

 <figure class="wp-block-image size-large is-style-default"><img loading="lazy" decoding="async" width="1008" height="368" src="https://blogcms.23andme.com/wp-content/uploads/2021/12/HLA-Alleles-React.jpg" alt="" class="wp-image-29352" srcset="https://blogcms.23andme.com/wp-content/uploads/2021/12/HLA-Alleles-React.jpg 1008w, https://blogcms.23andme.com/wp-content/uploads/2021/12/HLA-Alleles-React-300x110.jpg 300w, https://blogcms.23andme.com/wp-content/uploads/2021/12/HLA-Alleles-React-768x280.jpg 768w, https://blogcms.23andme.com/wp-content/uploads/2021/12/HLA-Alleles-React-880x321.jpg 880w" sizes="auto, (max-width: 1008px) 100vw, 1008px" /></figure>
 
<h6>Long-haulers</h6>
Other studies have also found variation among populations for other alleles within the HLA that are associated with the severity of COVID-19. So for example, <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/tan.14284">a recent study</a> by researchers at the Translational and Clinical Research Institute within Newcastle University found that an allele protective against severe COVID-19 symptoms in the HLA gene, at HLA-DRB1*04:01, was found at much higher frequency in people of Northwestern European ancestry. (Other studies have also found a genetic link to susceptibility to <a href="https://blog.23andme.com/articles/study-on-pneumonia">pneumonia</a>, also linked to genes associated with immune response.)
23andMe’s data on genetic associations related to different reactions to the vaccine offers other clues about the complexity of COVID-19. It is part of our on-going work to better understand the virus and the best approaches to fight it. Along with the workaround how genetic differences in immune response and blood type may play a role, our researchers are studying the long-term effects of the virus. We hope to look at so-called COVID-19 long-haulers to determine whether genetics can also explain why some individuals suffer health effects from the virus for weeks, months, and longer.
For more, you can go to our COVID-19 Information Center <a href="https://you.23andme.com/covid19-study/">here</a>.
<hr>
*The 23andMe COVID-19 research team includes: Adam Auton, Adrian Chubb, Alison Fitch, Alison Kung, Amanda Altman, Andy Kill, Anjali Shastri, Antony Symons, Catherine Weldon, Chelsea Ye, Jason Tan, Jeff Pollard, Jey McCreight, Jess Bielenberg, John Matthews, Johnny Lee, Lindsey Tran, Maya Lowe, Michelle Agee, Monica Royce, Nate Tang, Pooja Gandhi, Raffaello d’Amore, Ruth Tennen, Scott Dvorak, Scott Hadly, Stella Aslibekyan, Sungmin Park, Taylor Morrow, Teresa Filshtein Sonmez, Trung Le, and Yiwen Zheng.

A logo for 23andMe's COVID-19 Research Study

Janie Shelton

The Genetics of Reactions to COVID-19 Vaccines

Scientists with 23andMe and Google have collaborated to develop an imputation reference panel using 23andMe’s <a href="https://blog.23andme.com/23andme-research/african-american-sequencing-project/">African American Sequencing Project </a>to help expand diversity in genetic health research. This new reference panel enables researchers to more accurately identify associations between genetic variants and traits or health conditions within Black Americans and other non-European populations.
&#8220;This work will help address disparities in genetic research, as researchers outside of 23andMe will be able to use this data to inform their studies,&#8221; said Jared O&#8217;Connell, a 23andMe senior scientist and lead author for the paper. 
<h6>Expanding Analysis</h6>
All participating individuals were contacted and specifically consented to sharing their sequencing data via <a href="https://www.ncbi.nlm.nih.gov/projects/gap/cgi-bin/study.cgi?study_id=phs001798.v2.p2">dbGaP</a> with qualified researchers.
An imputation reference panel consists of genome-wide variation discovered through whole-genome sequencing in a set of individuals. Researchers often use such reference panels to perform genotype imputation. Unlike whole-genome sequencing, genotyping microarrays look at hundreds of thousands of sites that are known to vary between individuals, not the entire genome. Hence, there are hundreds of millions of such sites that are not assayed by microarrays. 
Genotype imputation is the process of inferring genotypes at many of these missing sites. Much like a code breaker filling in missing letters in a message, scientists — using algorithms and data from a whole-genome sequenced reference panel — can predict, or impute, the missing letters of genetic data. This allows large-scale genetic studies to expand the number of genetic variants that can be analyzed. But currently, most publicly available reference panels only include people of European ancestry, which limits their applicability to other populations.
<h6>A Reference Panel for Research</h6>
In this effort, described in <a href="https://www.nature.com/articles/s42003-021-02777-9">“A population-specific reference panel for improved genotype imputation in African Americans”</a> published this month, the teams built an imputation reference panel with high levels of African ancestry. It is the first peer-reviewed publication derived from 23andMe’s <a href="https://blog.23andme.com/23andme-research/african-american-sequencing-project/">African American Sequencing Project. </a> The panel includes genetic sequence data from more than 2,000 volunteers residing in the US, who identified as Black. With their consent, 23andMe created a reference dataset for research that consists of a de-identified reference panel and associated raw sequencing data. By including more individuals with non-European ancestry within the panel, imputation in non-Europeans is improved. For comparison, the commonly-used <a href="http://www.haplotype-reference-consortium.org/">Haplotype Reference Consortium</a> panel consists of 27,166 individuals which are predominantly of European descent. There is a subset of 2,001 individuals in that panel included from <a href="https://www.internationalgenome.org/">the 1000 Genomes Project</a>, and just 661 of these have substantial African ancestry.
&#8220;This biased reference panel composition generally leads to substantially poorer imputation quality for non-Europeans than for Europeans,&#8221; according to <a href="https://www.nature.com/articles/s42003-021-02777-9">the paper</a>. 
<h6>DeepVariant</h6>
Additionally, the team leveraged Google&#8217;s state-of-the-art variant caller, <a href="https://github.com/google/deepvariant">DeepVariant.</a> This allowed the researchers to further improve both the accuracy and richness of genetic variation in the reference panel. DeepVariant was compared with two versions of the popular GATK caller. It was shown to have a more accurate single sample calling performance as well as generate better performing imputation panels. Extensive comparisons of genotype refinement and phasing software were also conducted to establish a useful pipeline for creating imputation panels with DeepVariant. 
&#8220;The best practices for creating imputation panels we outline here are broadly applicable for improving imputation quality in non-European populations,&#8221; said senior author and Google staff software engineer Cory McLean.
This reference dataset was uploaded to the National Institute of Health&#8217;s dbGaP. It has already helped researchers studying conditions such as lymphoma, neurodegenerative disease, and cardiovascular disease. The reference dataset is also available to other qualified and vetted genetic scientists. It is meant to help expand research in Black Americans and other populations.
The team also published a blog post about the research <a href="https://healthcommunity.nature.com/posts/a-new-resource-for-african-american-genetics">here</a>.

Helping Expand Diversity in Genetic Health Research

By Anne Greb, MS, CGC, 23andMe Lead, Medical Education
For Genetic Counselor Awareness Day this year, we want to celebrate the important role genetic counselors play in healthcare, but we also want to educate people about how genetic counselors can help them sort through their test results and family health history in making important medical decisions.
<div id="attachment_26688" style="width: 310px" class="wp-caption alignright"><img loading="lazy" decoding="async" aria-describedby="caption-attachment-26688" src="https://blog-api.23andme.com/wp-content/uploads/2018/11/Anne-Greb-300x259.jpg" alt="" class="wp-image-26688 size-medium" width="300" height="259" srcset="https://blogcms.23andme.com/wp-content/uploads/2018/11/Anne-Greb-300x259.jpg 300w, https://blogcms.23andme.com/wp-content/uploads/2018/11/Anne-Greb.jpg 629w" sizes="auto, (max-width: 300px) 100vw, 300px" />Anne Greb, MS, CGC, 23andMe Lead, Medical Education</div>
A future in which genetic and genomic health information is part of clinical care is around the corner, offering hope for more personalized medicine and disease prevention. It will be genetic counselors who help us get there. 
<h6>What We Do</h6>
The simplest description of what we do (I’m a genetic counselor) is to help people assess risk in making critical decisions about their health. These could be decisions about such things as cancer treatment, or pregnancy, or rare disease interventions. While genetics is part of the equation, it’s by no means the only thing a genetic counselor considers. We are often involved before a genetic test is done. Even helping a person decide whether testing is right for them. Often a genetic counselor is needed right at a critical decision point in a person’s life. A genetic counselor has the training and understanding to meet the gravity of those moments. 
Unfortunately, there are too few genetic counselors to meet this growing demand. Over the next decade that demand is only going to get bigger. A recent estimate projects the field is going to grow by <a href="https://www.bls.gov/ooh/healthcare/genetic-counselors.htm">more than 25 percent,</a> according to the Bureau of Labor Statistics. 
<h6>What&#8217;s to Come</h6>
In many ways, this big increase in demand is what we anticipated long ago with the mapping of the human genome. Now more than ever genetic discoveries and new technologies are being used to diagnose rare diseases, or help tailor pharmaceutical approaches to treatment, or identify disease risk. On top of that, the widespread use of direct-to-consumer genetic testing has encouraged more and more people to learn about their own genetic predispositions, prompting discussions with their healthcare providers. 
While we await current efforts to build the ranks of genetic counselors, it’s these healthcare providers who are left to discuss genetic issues with patients. Right now, a lack of knowledge and training for those providers is often an obstacle, so providing genetic education and resources specifically for medical professionals is vital to help ensure that genetics becomes a part of clinical care.
<h6>Medical Education</h6>
That’s part of my role as a genetic counselor and lead of medical education at 23andMe both within the company, but also externally. I’m often engaging with other healthcare professionals to figure out the best way to incorporate genetics into clinical care. 
I’m not alone. Indeed, in a recent National Society of Genetic Counselors Professional Status <a href="https://www.nsgc.org/Portals/0/Docs/Policy/PSS%20Executive%20Summary%202020%20FINAL%2005-03-20.pdf">Survey</a>, 45 percent of genetic counselors reported that education and training played a significant role in their job-related activities. While education is by no means the only thing we do as genetic counselors, it’s an important part of the work. And as a genetic counselor at 23andMe, I can see how this surge in direct-to-consumer genetic testing presents a teachable moment. We know from studies that about 30 percent of direct-to-consumer genetic testing customers ask their healthcare providers about their results.<a id="f1" href="#a1">[1]</a>,<a id="f2" href="#a2">[2]</a> This offers those providers an opportunity to engage with their patients in important discussions, and use these moments to update and discuss family health information. Primary care providers who often have long-standing relationships with patients may be best positioned to offer support when patients discover unexpected findings as a result of one of these tests, and they can refer them to genetic counselors to help navigate the next steps.
So in recognition of Genetic Counselor Awareness Day this year, let&#8217;s consider the work that genetic counselors do to support not just consumers of direct-to-consumer genetic testing, but healthcare providers as well. 
<h6 class="footnotes">References:</h6>
<footer class="footnotes"><code style="display: none;"> </code><code style="display: none;"> </code> <a id="f1" href="#a1">[1]</a> van der Wouden CH, et al. <a href="https://www.genomes2people.org/wp-content/uploads/2016/02/Van-Der-Wouden-et-al-2016.pdf">&#8220;Consumer Perceptions of Interactions With Primary Care Providers&#8221; </a> Ann Intern Med (2016)
<footer class="footnotes"></footer>
<footer class="footnotes"></footer>
</footer>
<footer class="footnotes"><code style="display: none;"></code> <a id="f2" href="#a2">[2] </a> Vassey JL, et al. <a href="https://www.science.org/doi/abs/10.1126/scitranslmed.aaa2401">&#8220;How to know when physicians are ready for genomic medicine&#8221;</a> Science Translational Medicine (2015) </footer>

Genetic Counselor Awareness Day, A Perspective

23andMe has been included in another “Best” list, this one for its leadership. 
In Inc. magazine’s first annual Best-Led Companies list, 23andMe was included after being evaluated on a 12-point measure of management excellence. The company was one of 250 on <a href="https://www.inc.com/best-led-companies/2021">the list</a> that honors both public and private U.S. companies with revenues that range from $50 million to $2 billion. In total the companies employ more than 35 million people or about one in four workers in the US. 
“This inaugural list of companies represents the remarkable mid-sized companies, both public and private, often founder-led, that are at the vanguard of reinventing American business,” says Scott Omelianuk, editor-in-chief of Inc. magazine. “With their leadership, all business will benefit from an exciting, competitive future full of possibilities.”
<img loading="lazy" decoding="async" src="https://blog-api.23andme.com/wp-content/uploads/2021/11/IncBestLedCompanies_SocialImage1-1024x576.jpg" alt="" class="aligncenter wp-image-29267 size-large" width="1024" height="576" srcset="https://blogcms.23andme.com/wp-content/uploads/2021/11/IncBestLedCompanies_SocialImage1-1024x576.jpg 1024w, https://blogcms.23andme.com/wp-content/uploads/2021/11/IncBestLedCompanies_SocialImage1-300x169.jpg 300w, https://blogcms.23andme.com/wp-content/uploads/2021/11/IncBestLedCompanies_SocialImage1-768x432.jpg 768w, https://blogcms.23andme.com/wp-content/uploads/2021/11/IncBestLedCompanies_SocialImage1-880x495.jpg 880w, https://blogcms.23andme.com/wp-content/uploads/2021/11/IncBestLedCompanies_SocialImage1-1180x664.jpg 1180w, https://blogcms.23andme.com/wp-content/uploads/2021/11/IncBestLedCompanies_SocialImage1.jpg 1200w" sizes="auto, (max-width: 1024px) 100vw, 1024px" />
To be considered for the list, each company had to fill out an application answering questions about its performance, executive team, and leadership. Applicants were then analyzed via an algorithm that identified the very best companies according to their leadership teams’ superlative accomplishments in four key areas: performance and value creation; market penetration and customer engagement; talent; and leadership team.
To see the complete list, go <a href="https://www.inc.com/best-led-companies/2021">here</a>.
The honorees will be featured in the November issue of Inc. magazine, which is available online at<a href="https://www.inc.com/magazine"> https://www.inc.com/magazine</a> and will be on newsstands beginning November 9, 2021.
 
&nbsp;

23andMe Named in Inc.’s First-Annual Best-Led Companies

This week 23andMe made Fast Company’s first annual list of “Brands that Matter,” an award honoring companies and nonprofits with a mission or ideals that have had a cultural impact and are relevant and authentic.
This new award singles out <a href="https://www.fastcompany.com/brands-that-matter/2021">95 organizations </a>that, like 23andMe, have inspired people and given them compelling reasons to care about innovation, or social issues, cultural issues, the environment, or their fellow humans. Among those on the list are not just massive multinational conglomerates, but also small companies and nonprofits. All of them have forged an emotional or meaningful connection with people. All were judged on their relevancy, cultural impact, ingenuity, and business innovation. 
“Fast Company is excited to highlight companies and organizations that have built brands with deep meaning and connections to the customers they serve,” said Stephanie Mehta, editor-in-chief of Fast Company. “At a time when consumers are holding companies to very high standards, businesses have much to learn from these brands that have garnered respect and trust.”<img loading="lazy" decoding="async" src="https://blog-api.23andme.com/wp-content/uploads/2021/10/BTM_Facebook_Shared-Image_Free-1024x538.jpg" alt="" class="aligncenter wp-image-29242 size-large" width="1024" height="538" srcset="https://blogcms.23andme.com/wp-content/uploads/2021/10/BTM_Facebook_Shared-Image_Free-1024x538.jpg 1024w, https://blogcms.23andme.com/wp-content/uploads/2021/10/BTM_Facebook_Shared-Image_Free-300x158.jpg 300w, https://blogcms.23andme.com/wp-content/uploads/2021/10/BTM_Facebook_Shared-Image_Free-768x403.jpg 768w, https://blogcms.23andme.com/wp-content/uploads/2021/10/BTM_Facebook_Shared-Image_Free-880x462.jpg 880w, https://blogcms.23andme.com/wp-content/uploads/2021/10/BTM_Facebook_Shared-Image_Free-1180x620.jpg 1180w, https://blogcms.23andme.com/wp-content/uploads/2021/10/BTM_Facebook_Shared-Image_Free.jpg 1200w" sizes="auto, (max-width: 1024px) 100vw, 1024px" />
<h6>Lead with Science</h6>
It’s that trust that is probably most important to 23andMe’s brand, said Tracy Keim, Vice President of Consumer Marketing and Brand at 23andMe. 
“It started with Anne Wojcicki, (23andMe’s CEO and Co-Founder),” Tracy said. “She co-founded 23andMe to help people — to be a brand that made a difference in people’s lives — we were a brand born out of purpose, not profit.” 
23andMe is also a brand driven by science. And Fast Company pointed to two of our more recent very large scientific initiatives in singling out 23andMe for this award. 
The first was a study using genetics to look at the human impact of the <a href="https://www.cell.com/ajhg/fulltext/S0002-9297(20)30200-7">transatlantic slave trade</a>, as part of the largest study to date of people with African ancestry in the Americas. The second is an ongoing study on the genetics associated with differences among people in <a href="https://you.23andme.com/covid19-study/">susceptibility to and severity from COVID-19</a> that involved more than a million research participants. Several findings from that study have already been published or shared, and our researchers are currently investigating the genetics of COVID-19 “long-haulers.”
“It’s exciting to see this list of brands making a difference,” said Tracy. “We’re all interested in solutions through action, not just advertising. One of 23andMe’s core values is to ‘lead with science.’ DNA data can tell us so much about problems we confront today and in the future — whether it’s studying COVID-19 or our fraught racial history, or important health issues — our team of researchers have big hearts and open minds and go where the science leads them.”
<h6>Mission Driven</h6>
It’s been almost two decades since the mapping of the human genome, the most significant scientific breakthrough of our generation. 23andMe works to bring the power of genetic science to everyone. As a brand, 23andMe has always been mission-driven, focused on helping people access, understand, and benefit from the human genome. We created an industry offering people direct access to their genetic information, as well as an opportunity to participate in research if they choose. We share our research findings and ensure that those who participate in research know we’ve done it through solid science and innovation, but also with whimsy and a human touch. 
You can find a complete list of winners<a href="http://www.fastcompany.com/brands-that-matter/2021"> here</a>.
23andMe will be featured along with the other honorees in the November issue of Fast Company magazine, which is available online<a href="http://www.fastcompany.com/brands-that-matter/2021"> now</a> and will be on newsstands beginning November 2, 2021.
&nbsp;

23andMe Honored in Fast Company’s First Annual List of “Brands That Matter”

Dear 23andMe Community,
Today is an exciting day in the development of our mission to help people access, understand and benefit from the human genome. We are thrilled to announce that we are taking another step in making personalized healthcare a reality by agreeing to acquire <a href="https://www.lemonaidhealth.com/">Lemonaid Health</a>.
<img loading="lazy" decoding="async" src="https://blog-api.23andme.com/wp-content/uploads/2021/10/1200x628-LH-23-Banner-1-1024x536.png" alt="" class="aligncenter wp-image-29234 size-large" width="1024" height="536" srcset="https://blogcms.23andme.com/wp-content/uploads/2021/10/1200x628-LH-23-Banner-1-1024x536.png 1024w, https://blogcms.23andme.com/wp-content/uploads/2021/10/1200x628-LH-23-Banner-1-300x157.png 300w, https://blogcms.23andme.com/wp-content/uploads/2021/10/1200x628-LH-23-Banner-1-768x402.png 768w, https://blogcms.23andme.com/wp-content/uploads/2021/10/1200x628-LH-23-Banner-1-880x461.png 880w, https://blogcms.23andme.com/wp-content/uploads/2021/10/1200x628-LH-23-Banner-1-1180x618.png 1180w, https://blogcms.23andme.com/wp-content/uploads/2021/10/1200x628-LH-23-Banner-1.png 1200w" sizes="auto, (max-width: 1024px) 100vw, 1024px" />Over the years we have asked you, our customers, what more do you want from 23andMe. We heard from many of you that the genetic information you got from 23andMe can change your life — but when you take it to a physician you may meet skepticism or uncertainty about what to do with the information. We want to change that.   
We are acquiring Lemonaid Health so that we can bring true personalized healthcare to 23andMe customers. Personalized healthcare means healthcare that is based on the combination of your genes, your environment, and your lifestyle — with recommendations and plans that are specific to you.
Lemonaid Health is a pioneer in telemedicine and digital pharmacy. In Lemonaid Health we found a team of passionate, patient-obsessed people who want to bring better healthcare to everyone in an affordable, accessible way. Lemonaid Health’s focus on the patient and its philosophy of delivering individualized care fits perfectly with our mission of empowering people to take control of their health.
Twenty years ago Francis Collins, then the Director of National Institutes of Health, said, “Genome science will &#8230;revolutionize the diagnosis, prevention, and treatment of most, if not all, human diseases.” With healthcare still being one size fits all, we believe 23andMe will be the leader in using the incredible potential of genetics to enhance every individual’s primary care experience. We want to make that a reality for you — in an affordable, accessible, and meaningful way.
Here’s to being healthy at 100!
<img loading="lazy" decoding="async" src="https://blog-api.23andme.com/wp-content/uploads/2015/10/sig_small_transparent.jpg" alt="" class="aligncenter wp-image-23161 size-full" width="318" height="133" srcset="https://blogcms.23andme.com/wp-content/uploads/2015/10/sig_small_transparent.jpg 318w, https://blogcms.23andme.com/wp-content/uploads/2015/10/sig_small_transparent-300x125.jpg 300w" sizes="auto, (max-width: 318px) 100vw, 318px" />

A Letter from Anne: Making Personalized Healthcare a Reality

Most of us have felt the embarrassment of having an unsightly pimple at the worst possible time, but the impact can be more than just temporary mortification for those with severe acne and instead leave both literal and psychological scars.
About 85 percent of Americans have had acne, and it is estimated that less than 20 percent have experienced moderate to severe acne. While new treatments can help manage the condition and prevent scarring, there remains a lot of misinformation about the causes and best ways to deal with this common skin condition.
A new 23andMe+ Premium report Powered by 23andMe Research looks at a person&#8217;s likelihood of developing severe acne and provides information about some of the causes, and some of the ways to reduce the frequency and severity of breakouts. The new report uses machine learning techniques to estimate a person&#8217;s likelihood of having severe acne. To make that estimate, we use a statistical model that looks at more than 8,500 genetic variants as well as a person&#8217;s ethnicity and sex. 
Although it is most common during puberty, acne affects people of all ages. It occurs when hair follicles in the skin become clogged with oil, bacteria, and dead skin cells, which in turn can lead to many deep and painful types of pimples along with many whiteheads and blackheads. To help reduce the frequency and severity of breakouts, experts recommend using gentle skin cleansers, avoiding aggressive scrubbing, and avoiding touching and picking areas prone to acne. Severe acne can be persistent and lead to scarring, especially without proper treatment, which usually includes prescription medication.

 <figure class="wp-block-image size-large is-style-default"><img loading="lazy" decoding="async" width="808" height="318" src="https://blogcms.23andme.com/wp-content/uploads/2021/10/image-18.png" alt="" class="wp-image-29207" srcset="https://blogcms.23andme.com/wp-content/uploads/2021/10/image-18.png 808w, https://blogcms.23andme.com/wp-content/uploads/2021/10/image-18-300x118.png 300w, https://blogcms.23andme.com/wp-content/uploads/2021/10/image-18-768x302.png 768w" sizes="auto, (max-width: 808px) 100vw, 808px" /></figure>
 
<h6>Severe Acne</h6>
Severe acne often extends deeper into the skin than a mere breakout and can last a lot longer. In these cases, the acne may consist of cysts or nodules that are painful. In addition, after severe acne heals, scars can form. Enlarged and raised scars, called keloids, are more common in people with darker skin. In addition, severe acne may change the color of the skin.  It is often associated with changes in hormone levels caused by menstruation, or high levels of androgen hormones, for instance.
While genetics plays a role, other factors such as age and family history can increase the chances of developing acne. Some conditions that are also associated with changes in hormone levels, like polycystic ovary syndrome or congenital adrenal hyperplasia, can also increase the chances of developing severe acne. Certain medications also can play a role.

 <figure class="wp-block-image size-large is-style-default"><img loading="lazy" decoding="async" width="774" height="340" src="https://blogcms.23andme.com/wp-content/uploads/2021/10/image-17.png" alt="" class="wp-image-29206" srcset="https://blogcms.23andme.com/wp-content/uploads/2021/10/image-17.png 774w, https://blogcms.23andme.com/wp-content/uploads/2021/10/image-17-300x132.png 300w, https://blogcms.23andme.com/wp-content/uploads/2021/10/image-17-768x337.png 768w" sizes="auto, (max-width: 774px) 100vw, 774px" /></figure>
 
<h6>Taking Action</h6>
Understanding more about the genetic and non-genetic factors that may influence your likelihood of having severe acne can help in understanding how to help reduce the frequency and severity of breakouts. Remember to talk with your healthcare provider before making any significant lifestyle changes.
23andMe&#8217;s new Severe Acne report (Powered by 23andMe Research) is available to all 23andMe+ Premium members. To learn more about your report, go <a href="https://you.23andme.com/reports/prs.severe_acne/">here</a>.
Not yet a 23andMe+ Premium member? Find out more <a href="https://www.23andme.com/membership">here</a>.
<hr />
*The 23andMe Severe Acne report is based on 23andMe research and incorporates more than 8,500 genetic variants to provide information on the likelihood of having severe acne. The report does not account for lifestyle or family history and has not been reviewed by the US Food and Drug Administration.

New 23andMe+ Premium Report on Severe Acne

Editor&#8217;s note:  It&#8217;s National Liver Awareness Month we&#8217;re reposting this post with Wayne Eskridge to raise awareness about nonalcoholic fatty liver disease. 
Wayne Eskridge says he’s “just a typical American guy,” but that doesn’t begin to describe him really.
It’s true that, like a lot of Americans, Wayne loves red meat and potatoes. And like a lot of people, as he aged, he put on a pound or two each year until he was overweight. And like a lot of Americans, not just men, Wayne was told over and over during doctors’ visits that he should exercise more and watch what he ate. Over the years, he did diet and lose weight. But he gained it back. In that way, he was just like a “typical American guy.”
But something changed for him a few years ago that sets Wayne apart. 
“We’ve all heard these things endlessly, ‘lose weight and exercise’, and yet we don’t change our ways,” he said. “But if you can capture a person’s attention and emotional commitment to an idea at the right time, and with the right message, you can precipitate lasting change.”
&nbsp;

 <figure class="wp-block-image size-large is-style-default"><img loading="lazy" decoding="async" width="559" height="802" src="https://blogcms.23andme.com/wp-content/uploads/2021/09/NASH_portraits-3970-2.jpg" alt="" class="wp-image-29117" srcset="https://blogcms.23andme.com/wp-content/uploads/2021/09/NASH_portraits-3970-2.jpg 559w, https://blogcms.23andme.com/wp-content/uploads/2021/09/NASH_portraits-3970-2-209x300.jpg 209w" sizes="auto, (max-width: 559px) 100vw, 559px" /></figure>
 
<h6></h6>
<h6>An Unknown Risk</h6>
That’s what happened for Wayne, and he’s spent the last several years trying to help others to do the same.
He recently sat down with us at 23andMe to talk about his journey from an average American guy to a man who started a foundation to save others like him and help them on a path to better health.
The CEO and founder of the <a href="https://www.fattyliverfoundation.org/">Fatty Liver Foundation</a>, Wayne wants to raise awareness about a life-threatening condition that few people know anything about: nonalcoholic fatty liver disease. But he also wants to help people more broadly make health changes, and he’s willing to use his own story to help.
Tens of millions of people are walking around with fatty liver disease and don’t even know it. It’s one of the many potential consequences of being overweight. According to the <a href="https://www.niddk.nih.gov/health-information/liver-disease/nafld-nash/definition-facts">NIH&#8217;s National Institute of Diabetes and Digestive and Kidney Diseases</a>, it’s estimated that about 24 percent of American adults have the condition. Wayne was once like millions of others, walking around with a condition he didn’t know anything about. He wants to change that by raising awareness not only about fatty liver disease but also about the benefits of adopting healthy habits.
<h6>Healthy Changes</h6>
Lifestyle really is key. While genetics do play a role in the likelihood of developing fatty liver disease, lifestyle is very important. As part of our 23andMe+ membership, we have a report powered by our own research on nonalcoholic fatty liver disease. It looks at more than 1,400 genetic variants to estimate a person’s likelihood of developing the condition. But beyond genetics, lifestyle and diet play a big role in one’s likelihood in developing the disease. Wayne wants to raise awareness about all the factors that could lead to risks for the condition and push for more research.
Similar to other chronic conditions like type 2 diabetes, high blood pressure, and other various cardiovascular diseases, the number of people with nonalcoholic fatty liver disease has grown as the rates of obesity have risen. So many people are overweight that it’s been normalized, Wayne said.
“It’s as if it’s a non-event and there’s been this generational drift to accept less wellness,” he said.
In his own experience, he thinks back to long before his diagnosis, when his blood pressure was creeping up and his weight edged up, and he asked his doctor about it.
“And he said, ‘all my patients are dealing with this. It’s just how we are,’” Wayne recalls.
<h6>Taking Charge</h6>
For Wayne, it was a missed opportunity for the doctor to impress on him the importance of taking charge of his health.
“I may not have listened but he let that opportunity slide,” Wayne said.
Here are some sobering statistics. In the last two decades, the percentage of the American population who are obese went from about <a href="https://www.cdc.gov/obesity/data/adult.html">30 percent to more than 40 percent</a>, according to the Centers for Disease Control (CDC) and Prevention. Even among children, there’s been an uptick in obesity. In 1980 only about five percent of kids were considered obese, but by 2018 <a href="https://www.cdc.gov/nchs/fastats/obesity-overweight.htm">more than 19 percent were</a>, according to the CDC. And there is a cascade of chronic health issues that stem directly from that increase in obesity. Wayne’s focus has been on one of those conditions. And he started the <a href="https://www.fattyliverfoundation.org/">Fatty Liver Foundation</a> to raise awareness about this condition that affects so many people but remains largely unknown.
“If you have two friends, one of you likely has fatty liver disease, and don’t even know it,” said Wayne. “It’s that bad, there’s this whole suite of metabolic diseases — heart disease, diabetes, high blood pressure — that are all related to what’s happening in our society with the obesity epidemic.”
<h6>An Ah-Ha Moment</h6>
Wayne’s knowledge about fatty liver disease and other chronic metabolic conditions comes from the experience of years of trying to figure out what was going on with his own health. Ten years ago, Wayne didn’t know anything about fatty liver disease.
“I’d had my gallbladder removed and, after the procedure, the doctors showed me a photo of my liver,” he said.
The surgeon told him it appeared that he had stage four liver cirrhosis. If true that would be a bleak diagnosis with little that can be done. It turned out that Wayne didn’t have liver cirrhosis, but that encounter began a difficult five-year-long medical journey before being diagnosed with fatty liver disease, or more accurately cirrhotic nonalcoholic steatohepatitis (NASH) due to the build-up of fat in his liver, causing inflammation and liver damage.
That was Wayne’s ah-ha moment. That’s when he changed.
In going through all the challenges leading up to his diagnosis, Wayne and his wife had become much more aware of the true impact of diet and lifestyle on health. It’s as if it took that long, arduous journey for them to be receptive to the message he got when he was diagnosed. There really was no other way.
“I was determined to do everything I could to defeat the liver beast,” Wayne said. 
<h6>Helping Others</h6>
He and his wife went home and cleared out the pantry. They looked at the changes not as a diet but as a whole shift in how they lived, creating a healthy food strategy, passing on sugary desserts, processed foods, and juicy steaks. The shift paid off and he lost 45 pounds. He said the biggest accomplishment was going in for a liver biopsy and learning that his condition wasn’t progressing.
“My wife and I celebrated by eating a salad,” he said. 
Since then, Wayne has worked very hard to help others either dealing with a later-stage liver disease diagnosis, but also trying to prevent others from getting to a point of no return. The mission of the foundation is pretty stark. 
“We want to help you avoid this kind of death by helping you understand how you may be killing yourself slowly &#8212; and, what you can do about it. If you are already ill, we will do our best to help you with that process.”
According to the Fatty Liver Foundation:
<ul>
<li> 100 million Americans have a fatty liver, and the vast majority of them have no idea.</li>
<li> 20 million of them will develop nonalcoholic fatty liver disease.</li>
<li> 5 million will develop liver cirrhosis or NASH, which can end in liver failure. </li>
</ul>
<h6>Teachable Moments</h6>
In his work trying to make a dent in those stats, Wayne has used his own experience of seeing an image of his swollen liver. That’s what helped him internalize the message about how important his day-to-day lifestyle and diet had been to his health. The vision of his ailing liver was that of a “deadly beast” that was trying to kill him. Seeing it made him determined to do what he could to stop that from happening. 
He used that experience to inspire a recent study done by the foundation in Houston. There they did liver scans of patients, and showed them the condition of their own liver, and found that it did indeed register with patients who began making healthy changes to their diet.
That’s a message that goes beyond people at risk for fatty liver disease, and Wayne knows it. Fatty liver disease and being overweight can raise the risk of developing type 2 diabetes and heart disease. It can also progress to even more severe conditions. He wants to help people prevent that.
“It really comes down to how to motivate people to make a change,” Wayne said. “We’re looking for those teachable moments because we’ve all heard these messages endlessly about diet and exercise.”
<h6>Lasting Change</h6>
Food is about more than just nutrition and sustenance for so many of us. There are emotional and psychological components to what we eat and when we eat it. In a book about his own struggles to lose weight, the writer Tommy Tomlinson said that telling someone who is overweight to “eat less and exercise is like telling a boxer don’t get hit. You act as if there’s not an opponent.”
Food carries with it memories, for some, it becomes a reward or a reminder. Wayne knows that from personal experience. It’s why he and his wife had a tradition of celebrating big occasions with a chocolate volcano cake. They don’t do that anymore.
“It is so hard to change, but if you can capture a person’s attention and emotional commitment to an idea you can help them with lasting change,” he said.
For more information about the Fatty Liver Foundation visit their website <a href="https://www.fattyliverfoundation.org/">here</a>. You can find your 23andMe+ Nonalcoholic Liver Disease report (Powered by 23andMe Research) <a href="https://you.23andme.com/reports/prs.nafld/">here</a>.* Not yet at 23andMe+ member? Find out more <a href="https://www.23andme.com/membership">here</a>.

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