Corona Vaccine Straight-talk

http://gty.im/1220603190 Are you going to get the vaccine when it is available?

I know there are people firmly in both camps (“No way, I don’t vaccinate” and “I’ll be the first one in line”), but most of us are in the middle, wanting to protect ourselves and return to our lives as soon as possible, but nervous about taking a new vaccine. So let’s cut through all the noise and discuss simply what is going on with the corona vaccine. To do that, we need first a simple explanation of how vaccines work.

Vaccines are built in different ways, but the idea is like this: Viruses have a body like all creatures, which contains an outside (a sort of shell), and an inside (the machinery). Generally, to arm your body against the disease, scientists capture the virus, kill it and introduce it the dead bits to your immune system. Your body meets it, produces antibodies, and then if you ever catch the live virus, the body recognizes it and is ready to fight it off before it can do damage.

You may have heard that this corona vaccine is a bit different in that it is an mRNA vaccine. What this means is that instead of injecting the actual virus, the vaccine sends in blueprints to our cells – like a message in the bottle. The blueprints are directions to build a replica of those spikes which the coronavirus has on its surface. This enables our body to recognize the coronavirus if it ever enters. The message does not need to interact with our DNA. Since it already has the building directions, it goes to straight to our cell’s factory where we print out the decoy spikes and then shows them to other cells which make antibodies to them. Thus we are armed against the coronavirus. Using mRNA instead of actual virus is a new approach but it seems to be working well in clinical trials.

So far, two companies have created vaccines ready for the public; Pfizer which has tested on 44,000 trial participants, and Moderna tested on 30,000 participants. Both of these are in the realm of usual number of tests before vaccine release. They were completed much more quickly than usual vaccine trials because they were fast-tracked, and people were eager to be involved. Also, usually in order to know if the vaccine works the trial participants need to naturally encounter the virus, which takes time. In this case, it happened quickly because corona is so widespread, enabling sufficient data to be collected in a shorter than usual period of time.

Some people feel hesitant about how quickly the vaccine was developed. In fact, the number of patients and period of time it has been studied is comparable to other vaccines we use. It was the business end (applying for grants and funding, regulation and red tape) that was fast-tracked, not the science. The only side-effects that have been found are similar to other vaccines – redness or soreness at the site of injection, mild fever, fatigue, headaches, muscle and joint aches in the first few days after receiving it. These side-effects represent our body’s response to the decoy spike – we may feel like we are getting sick as we mount an immune response, but that will never materialize, as there is no COVID in the vaccine.

There is some nervousness that the mRNA approach is new. While this is true, mRNA vaccines have been tested for years in animals, preparing for the possibility of a pandemic which necessitated rapid vaccine deployment. It was used to create an ebola vaccine, effective in human trials, but never widely needed. Some people may question whether there are serious side-effects which have not been found in the months of monitoring. Scientists feel comfortable releasing the vaccine after these past few months of testing because other vaccines’ serious side-effects become apparent in a matter of days or weeks – never beyond six weeks – and we have more data on these than that. Still others may be concerned with the use of mRNA and how long our body will produce these spike proteins. In animals, the production lasts around 10 days. In humans, while we do not know exactly, but mRNA is known to be a very short-lived thing; the body crumples up the blueprints once made.

In a world where movies and literature are filled with the disaster-of-scientific-hubris plots, it is only natural to hesitate. But the pandemic is a reality, and we may have discovered a shield. We should be asking questions as everything is moving quickly and certainly there are things we do not know. It gives me confidence that there are third-party regulatory bodies in every country which are vetting the original data around the vaccine knowing that their decision will affect mankind. For most of us, there is time to watch and see how the vaccine rollout goes. Highest-risk groups of front-line healthcare workers and maybe nursing home residents will likely be offered it first. Combined with continued mask-wearing, avoidance of indoor groups and crowds, and hand-washing, the vaccine can be an important part of beating this pandemic.

About the Author
Dr Roth is a US-trained family physician with specialties in research and global health. She made aliyah five years ago to Ra'anana, and is mother to four young children. Dr Roth currently practices both in Israel and to the US via telemedicine, and directs the Clinical Reasoning Course at Sackler Medical School (Tel Aviv University).
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