Let’s Discuss the Vaccine

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“As of this writing, there are currently two vaccines approved in the US – Moderna and Pfizer, with a third (Johnson & Johnson) pending approval.”

Since I have received so many questions on the COVID 19 vaccine, I thought I would use this month’s article to discuss the vaccine!  In the absence of historical data on the COVID 19  vaccines, I will provide a background on vaccines in general and then discuss some of the COVID-19 vaccination options.  In general, vaccines are developed when a virus creates so much illness or death in a population that prevention by vaccine becomes crucial.  Vaccines are used to prevent viruses because they live in healthy tissue and can be nearly impossible to treat once someone is sick – in general, we can only treat the symptoms.  A vaccine is designed to look so similar to the real virus that the immune system recognizes it as an invader and develops antibodies (protective proteins) to the virus , protecting the person from infection from that particular illness.  Without a vaccine, you would have to experience illness from a virus so that your body could naturally develop antibodies and prevent you from re-infection.  Again, since most of these illnesses are very severe, prevention by vaccine means fewer people become so ill that they die or suffer lifelong consequences.

Vaccines are not all the same – some are synthetic (manmade), some are killed or weakened pathogens (attenuated) and some include a single protein or sugar from the pathogen that can be recognized. The proteins that allow our system to recognize them are called antigens and they cover the surface of virus.  While it may take thousands of antigens to create illness, most vaccines only use a handful of them to create the immune response … our bodies are so smart! Regardless of how they are made, vaccines must trigger the immune system to create antibodies and they must also create an attraction for the virus to bind to the antibodies.  If both of those criteria are met with minimal side effects, a vaccine becomes reality and is approved for use.

It is important to recognize that any immunization puts a tremendous load on the immune system, so getting vaccinated while you are “under the weather” is almost certain to push you into being sick – your immune system can only do so much at the same time.  It is also important to understand that the development of antibodies and subsequent immunity takes time, in fact, in the 2 weeks following most vaccines you are not fully protected.  Finally, remember that we get vaccines not just to protect ourselves, but also those in our communities who cannot be vaccinated – those who are too young, too old or too compromised.  By having healthy people vaccinated, there is no one to give illness to those who cannot be vaccinated – if there is no one to give it, no one gets it!

The first vaccinations date back to 1796, when the first trial vaccine for smallpox was given.  As was common in that time, it was a simple curiosity of how milkmaids avoided illness with smallpox that started the process. Through observation, a family doctor noticed that milkmaids who contracted cowpox, as was common in their profession, had some immunity to smallpox.  With the trust of his community, and many trials he discovered that the viruses were so similar that having had one, often provided immunity to the other.   In the many years since, multiple layers of protection in the development, delivery and surveillance of vaccines have been put in place.  These measures have resulted in discontinuing vaccinations (smallpox) when the disease was considered eradicated and changing the composition of vaccines (Thimerosal) when there were concerns over safety.  Many of these steps have been made much more streamlined with advances in technology and this year we witnessed a vaccine go from idea to reality in record time.  While that speed made many people unnerved, it does not mean safety corners were cut, but more likely that many of the steps that involved “red tape” were shortened or combined.  

As of this writing, there are currently two vaccines approved in the US – Moderna and Pfizer, with a third (Johnson & Johnson) pending approval.  These vaccines are what we call mRNA, which are a relatively new type of vaccine that teaches our immune system how to make a protein that looks enough like the ones on the COVID-19 virus that it will trigger the immune response (antibody creation) in our body!  While there are side effects from the vaccine for some portion of the population… the side effects are far less harmful than the actual disease itself.  I am asked all of the time if I would take the vaccine and the answer is an emphatic “YES”!  While I am not eligible yet, some of the people I love the most have had the vaccine and I have fully supported it having seen so much illness and loss associated with COVID-19.  That said, there are two groups that should not get the vaccine unless they have discussed it with their healthcare provider.  The vaccine is not approved for children under 16 years old – trials are just starting in children so unless your child has an exceptional situation, they would not get the vaccine.  The other group is women who are trying to become pregnant or are currently pregnant.  With very little information about the effects in pregnancy, it is advisable to discuss your concerns with your healthcare provider and decide after that conversation.  

I am hopeful this is helpful in making decisions about becoming vaccinated.  Next month, I am back to answering your questions so keep them coming!

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