VACCINES – HOW DOES THEY WORK AND WHAT ARE THE RISKS?
There is a lot of confusion about this issue and it is imperative that when a vaccine becomes available, everyone is on board or our efforts may be futile. The initial vaccine may not be perfect and we will likely need to be re-vaccinated, but if there is any hope of getting past this pandemic, the only way through is with herd immunity.
First of all, there IS a simple way to eradicate this virus. If everyone on the planet hunkered down and really isolated for 2 weeks, the virus would die off in those infected, no new spread would occur and the virus would disappear. We saw that in New Zealand and a few other countries. The only new cases in those locations were seen when outside introduction of the virus occurred or, people took advantage of loosening rules and behaved irresponsibly. How likely are we ALL to follow the rules for 2 weeks solid? Well all you have to do is watch how violently some people reacted to being asked to wear a mask in Walmart or watch how our leaders behave in groups to see that this is essentially an impossibility. People are too selfish or ignorant.
Second, our best chance is to develop herd immunity, which means that enough people have the disease or have had an immunization that the virus can’t spread and dies off. I know there are some debates about how long immunity lasts, but it seems that even when antibody levels fade, there is still cellular memory so some protection still exists. For herd immunity to occur, 70-80% of the population must either have had the infection, actively enough to develop lasting immunity, or get immunized. That way, the virus can’t spread and find a host to replicate and it dies off.
So how do vaccines work? Basically, the microbe, or a part of the microbe, are used to generate an immune reaction in the body, mimicking infection from the actual bug. As a result, our body can inactivate the bug when actually exposed, by impairing its ability to bind or attaché to a host cell (a neutralizing antibody) or stimulate the immune system to kick-in faster to kill it through other mechanisms.
Early historic versions of vaccines were actually small doses of the active bug, like with smallpox, and some people contracted the disease but today that simply does not happen. Either inactivated microbes or parts of the microbe are used which can’t give you the disease but do generate antibodies to the bug. ALL vaccines can generate similar side effects like fever, muscle aches, headaches and sometimes GI issues but this is a generalized immune reaction and usually passes within a few days. You don’t get the flu from the flu vaccine.
There are many vaccine trials going on out there but the most promising ones are working on generating the nneutralizing antibodies. The coronavirus has proteins on their surface called “spike” proteins, hence the name “Corona” like a crown. The spike proteins bind to host cells, change shape and then let themselves into the cell where they Hijack the genetic making machinery, replicating themselves. The key to a good vaccine is to isolate the spike protein, BEFORE it changes shape, and then create an antibody in the lab to that protein. If you isolate the virus and the spike proteins after the spike protein has changed shape, the vaccine is not as effective at preventing the virus from binding. It will still provide some immune stimulation but not as effectively. It might lessen the degree or duration rather than prevent the infection. This has been the biggest challenge so far but things look pretty hopeful.
Looking at all of the trials, almost all of the people developed side effects but most were mild and they were dose dependent. The key is to find the sweet spot between an effective virus and the fewest or least impactful side effects.
The BIGGEST challenge we face is what happens when a good vaccine, or a few good vaccines, become available. Even with 70-80% efficacy (keep in mind that the flu vaccine is usually only 30-40% effective and still saves many lives and prevents significant illness), if 1/3rd of people don’t get vaccinated for whatever reason, we will never reach the estimated 70-80% population immunity level to achieve herd immunity and the virus will keep going from hotspot to hotspot indefinitely. The selfishness of the few will impact on the health of the rest of the population.
It is that simple.
Vaccination helps protect you, but more importantly, vaccines help protect society as a whole and we are not islands. If you want to live in the woods like Ted Kaczynski (the unabomber), or off-grid up in Alaska, then do whatever you want but if you live in society, amongst people, you must look out for everyone, not just yourself. I literally had a conversation with a patient this week who is a retired nurse for the county we live in and she described a case some years ago of a family who refused to vaccinate their kids, travelled to Europe and their kids came back with measles. That one case led to the cancellation of the entire school district’s sporting season for all students and numerous other infections resulted. The last few years, there were more cases of mumps than in the previous decades combined in the US.
Yes, on occasion, side effects occur from immunizations but that’s the case with ANY drug. The most deaths and drug-related complications worldwide occur with…. Aspirin, the “wonder drug”. The most commonly taken over-the-counter drug class taken by Americans, acid reducers, increase the risks of catching Covid by almost 3x. The point is that there is risk with everything and it is a matter of managing and leveraging that risk. As far as autism is concerned, that link has CLEARLY been disproven. You can debate that all you want but that is simply the case.
Vaccines have saved MANY more lives than they have hurt and our getting past Covid 19 may well be dependent on everyone doing their part. We clearly won’t do the basics like wearing masks or distancing so what option do we have?
Stay safe and be well.
AC 😎✌️🌱❤🐖🏃🏻🧘🏻♂️🌎😷