By Dr Jenny Laithwaite, an opthamologist working in Randburg. She is a member of GGPC (Gauteng General Practitioners Collaboration) which has created a platform for doctors to share resources during Covid-19. Look for #voicesthatcare on the GGPC Facebook page.
This year we have all learned a lot of new words – from Corona to quarantine to spike proteins. As much as we try to make wise decisions, the information overload can be really overwhelming. Many people are concerned about whether the new vaccines that are becoming available are safe and beneficial – and the fake news media hasn’t helped. Should you take the COVID-19 vaccine?
Frequently asked questions about the COVID-19 Vaccine
1. HAS THE PROCESS BEEN TOO RUSHED?
In a disease that has been around for only a year, we still have so many questions. Obviously, there are many things we are still learning, and that definitely makes us wonder whether a vaccine produced so soon could be safe.
Some factors to consider:
The development of these vaccines started long before 2020. SARS-CoV-2 is a member of the coronavirus family of viruses. These viruses have been known to cause diseases in humans and animals for many years. Following the outbreaks of SARS in 2002, and MERS in 2017/2018 (both caused by coronaviruses), scientists had already started work on vaccines that could be effective against these pathogens. The vaccines being tested now are an extension of this research.
One of the greatest limitations on vaccine development is funding. For once the whole world has had an interest in developing a vaccine, leading to many groups of scientists being funded. Companies have seen it as worth their while to invest in having it on the market, philanthropists have been willing to contribute, and countries have pooled their resources to try to fast-track the development of these vaccines. This has made the process much faster than usual.
Usually a lot of scientific development is private and shared in journals that are not accessible to everybody. Something truly remarkable about this pandemic is the way so much research has been published “open source”, where anyone who desires can access it. The publishing of the genetic code for the SARS-CoV-2 virus spike protein on the 11th of January 2020 was a huge milestone and making it available to all researchers helped to get the process moving faster.
• Exponential spread of disease
Vaccines can only be tested by observing whether people who have had the vaccine develop the disease when they are exposed to it. Apart from exposing them in a lab (which is not being done for COVID-19, and has serious ethical questions around it), this means that the vaccines can only be tested in communities where the disease is actively spreading. The fact that COVID-19 has been spreading exponentially in many of the communities where the vaccine has been trialled has given us much more rapid evidence as to whether those injected with the vaccine have been protected.
- So have they cut corners?
Each of the vaccines that has been approved for use has followed the accepted processes of being tested in Phase 1 (safety/dosage), Phase 2 (human safety) and Phase 3 (human efficacy) trials. They have been shown to effectively prevent a large percentage of those who received them from contracting COVID-19 in their communities. The side effects that they caused have been very mild. As the vaccines are rolled out to the public, they move into the next phase of surveillance, where their effectiveness and any new, rarer side effects are observed, reported and monitored.
2. WHAT IS IN THE COVID-19 VACCINE?
Remember that there are many different vaccines being developed at the moment. Most of these are either mRNA vaccines (eg Pfizer and Moderna) or viral vector vaccines (eg AstraZeneca and Johnson&Johnson). To understand how each of these works, see the section on how the vaccine will affect your DNA below.
The active ingredient in each vaccine is a fragment designed to mimic the outer coating of SARS-CoV2. None of them contains the actual virus or any actual cells at all. No human tissue is present in the vaccine.
Apart from the active vaccine ingredient, the COVID-19 vaccine contain the following:
- For the mRNA vaccines, lipids which coat the vaccine material to allow it to enter your cells.
- Some “buffering” chemicals, which keep the solution stable.
- The adenoviral vaccines will probably contain a preservative. Which one has not been confirmed yet. People are particularly concerned about the use of thiomersal as a preservative in vaccines, although it has not been proven to cause any harm.
There is no evidence of any technology like chips or trackers being present in any of the vaccines.
3. CAN THE COVID-19 VACCINE CHANGE MY DNA?
NO. The way your DNA works is by giving your cells a code to make proteins which build and shape the structure of who you are. None of the vaccines being studied can change this integral part of the cells in your body.
The mRNA vaccines work by entering your cells and giving them a message to produce a protein. This is the same protein that is found on the outside of the coronavirus. As your body notices this foreign protein floating around, it is stimulated to produce antibodies and T cells which will then be ready to recognise this protein and fight it off if you are ever exposed to the real thing.
The viral vector vaccines use the shell of a virus that has been inactivated and had the COVID-19 outer protein added to it. As a result, it can’t enter your cells and replicate, but your body can learn to recognise the protein and again have antibodies and T cells ready to fight off any future infection.
4. WILL THERE BE ANY LONG TERM SIDE EFFECTS?
Ideally we would like each of these vaccines to be tested for a good few years before we decide whether to take them. Unfortunately 2020 has taught us all that this is not an ideal world. No population has ever been able to stop the spread of a disease by herd immunity without the use of vaccinations – and we are all desperate to be able to enjoy unrestricted life again.
Over 200 000 volunteers have participated in the trials for the various vaccines; and to date, as roll out of the first contender vaccines has begun, over 1.1 million people have received the vaccine.
The vaccines that have been registered for use, and those that have published stage 3 data indicate that so far, the side effects of the vaccines are very mild. These include:
- pain and redness at the injection site and
- fever and headache for a day or two after the injection.
- There has been one reported case of a patient who received a vaccine developing a nerve condition called transverse myelitis. They are not sure whether it was caused by the vaccine, and the patient has recovered.
- A few patients have had allergic reactions to the vaccines. As long as the vaccine is given in a health facility, and the patient is observed for 15 to 30 minutes afterwards, this can easily be treated.
The safety profile of vaccines in use across the world is extremely good, meaning that almost everyone has very mild side effects. Being vaccinated can make a large percentage of recipients immune to the disease. This can benefit the patient personally by preventing them from developing the sickness, and also the community as a whole by stopping the chain of transmission of the disease.
As much as we worry about the long-term effects of the COVID-19 vaccine, we need to remember that we still do not fully understand the long-term effects of COVID-19. There is more and more evidence that this disease does not just last for 2 weeks and then pass. Many people worldwide are experiencing long term debilitating symptoms of COVID-19 which we are still not able to treat fully.
5. OKAY, SO WHO SHOULD HAVE THE JAB?
People who should choose to get vaccinated sooner:
- Anyone working in healthcare who might be exposed to COVID-19, including cleaners,catering staff, nurses and doctors
- Anyone who is an essential worker, who can’t avoid contact with the public
- Anyone who is in contact with high-risk people such as elderly family members
- Anyone aware that they live in an area with high levels of transmission
- Anyone who has any conditions which make contracting COVID-19 more dangerous
People who could delay or shouldn’t be vaccinated:
- If you are pregnant or breastfeeding, please discuss with your doctor whether vaccination is advisable.
- The vaccines have been tested in those older than 16 to 18years. If you are younger than this, you might want to wait until studies in younger patients are out.
- If you are known to be allergic to any of the vaccine ingredients or have previously had a significant reaction to a vaccine, you will need to discuss your situation with your doctor.
- If you are at a lower risk, in terms of your age, disease profile, or exposure, you may not be among the first to be given the vaccine.
- If you live in an area with minimal transmission of COVID-19 and can easily avoid exposure for the foreseeable future, you could delay being vaccinated until it has been studied a little longer.
Finally, we note that it has been an extraordinary year, and the steepest learning curve, in the medical sphere in particular. While there is still a long way to go, not least to achieve effective vaccine roll out, it is encouraging, to say the least, that we are facing 2021 with this option.