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Effective vaccines to fight COVID-19 have arrived, and they’re our best hope for bringing the current pandemic to an end.
In recent news, vaccine manufacturers Pfizer and Moderna released data showing that their vaccines are up to 95 percent effective against the novel coronavirus. In other words, in 95 percent of people who received the shots, their immune systems prevented the development of COVID-19 disease. This is a much better average than we hoped for. The influenza vaccine, for example, tends to be about 60 percent effective.
The FDA has issued emergency authorization to approve the Pfizer and Moderna vaccines here in the United States. The United Kingdom recently became the first nation to approve the Pfizer vaccine and began to administer it immediately.
After 10 months of lockdowns, quarantines and social distancing, these vaccines—and others now in development—have real potential to help us begin defeating COVID-19.
The Hope of Vaccines
History has shown that vaccination works. From smallpox and polio to whooping cough and influenza, vaccines have saved millions of lives and routinely protect society from potentially harmful pathogens.
Those of us working in infectious diseases are very optimistic about the COVID-19 vaccines. This pandemic has presented one unknown after another—yet most have been resolved. I believe that trend will continue as vaccines are administered to people around the world.
Vaccination is the key to herd immunity, the tipping point when enough people (approximately 80 percent) have enough immune defense against a disease to protect the entire population. Providing immunization to so many will take time, as the nations of the world must meet the challenges of manufacturing, distributing and administering the shots.
I recently heard an excellent analogy: Imagine fire trucks arriving at the scene of a raging wildfire. The vaccine is like the firefighters unrolling water hoses—it’s just the start of an intensive, challenging race to bring that fire under control.
First Priority: Safety
Although the new vaccines were fast-tracked, they underwent rigorous development just the same. We have Phase 3 trial data from 30,000–40,000 human test subjects—virtually the same standards used for vaccine development that typically occurs over a much longer period of time.
Most people who received a trial vaccine have reported no serious issues. Occasional side effects were similar to that of other vaccines—pain at the injection site, muscle aches and low-grade fever for a day or two. These reactions aren’t just normal—they’re appreciated, as an indicator that the immune system is responding and building protection. Severe reactions were very uncommon in the trial groups.
Safety remains a key tenet of FDA approval. Patients who volunteered for trial vaccines will be followed long-term, and our data stream will grow as the vaccine is more widely adopted. Individuals with an interest in volunteering for a trial have opportunities to do so. To participate in a trial, visit the clinicaltrials.gov website, the comprehensive national database of studies in search of trial candidates.
COVID-19 vaccines are our best hope for bringing the current COVID-19 pandemic to an end. Learn more from Dr. Glenn Wortmann. @MedStarWHC via https://bit.ly/3gKHlp1.
How the New Vaccines Work
The human immune system is miraculous—it neutralizes a variety of pathogens that could make you sick, day in and day out, from the moment you’re born. Troubles can begin when a new pathogen emerges that the body doesn’t recognize. Like sophisticated hackers breaching a computer network, some bugs can successfully infect a person whose immune system is not ready for them.
To combat such a threat, the vaccine acts as a trigger, introducing to the body an agent that trains the immune system to recognize the target pathogen.
The initial COVID-19 vaccines from Pfizer and Moderna employ messenger RNA (mRNA). The mRNA code is like sheet music telling a musician what to play. It instructs the cells to produce a tiny protein molecule, the same protein that COVID-19 uses to gain entry to the cells. It’s just the protein, not the whole virus, so it can’t give you the infection.
In this way, mRNA vaccines differ from traditional ones. Rather than introducing a harmless piece of the target pathogen, they prompt the patient’s cells to make it instead.
The immune system is programmed to isolate and destroy invaders, regardless of where they come from. As the proteins move through the bloodstream, the immune system learns to view them as bad actors and destroy them. When it has that knowledge, it can fight off the coronavirus, which is covered with the same protein molecules.
The COVID-19 vaccine cannot trigger a false coronavirus test, the kind that shows you have an active infection. It may trigger a positive blood antibodies test, but that would be a welcome indicator that it did its job. And it is chemically impossible for the mRNA to enter your DNA and change your genetics.
Also in Development
In addition to the current vaccines from Pfizer and Moderna, at least 13 more large-scale studies are underway, each investigating a different vaccine. This is great news. This array of options can help get vaccines into the arms of more people.
Some of the vaccines currently in trial follow traditional methods: The virus is grown in quantity, with tiny particles isolated and neutralized for the vaccine. The end result is the same—by managing a harmless piece of the virus, the patient’s immune system learns to recognize the real thing. But the production process for these vaccines takes longer; mRNA technology is faster, which is one reason why the initial vaccines we’re seeing are in that category.
Like the shingles vaccine, these initial COVID-19 vaccines call for two injections, three to four weeks apart (depending on the manufacturer). In the trial subjects, maximum immunity was achieved after the second shot, so it’s very important to receive both doses of the vaccine. Also, it’s important to remember that while the vaccines had 95% protection, some people still developed COVID-19 (approximately 5%), so masking and social distancing remain extremely important. Hopefully, once a large percentage of the population has been vaccinated, transmission of the virus will drop and we’ll eventually be able to stop masking and go back to normal.
How long will immunity last? We don’t know yet. But we’re hopeful it will be long enough to see the pandemic brought under control. We have little evidence to suggest the virus is mutating significantly, so we are confident that these initial formulations will remain effective.
Vaccination injections are delivered into the muscle of the patient’s upper arm. So far, we have no indication that an oral or nasal alternative is on the horizon.
The vaccination is not recommended for people actively ill with COVID-19 or another infection. In those cases, the immune system is already on overdrive, and a vaccine introduced at that point may not prove as effective. However, the vaccination is a good idea for those who have recovered from the coronavirus. Some patients in the Pfizer trial had antibodies, indicating they’d been infected before. The vaccine boosted any immunity built from fighting the virus itself.
The initial vaccines are not yet approved for anyone under age 16, but ongoing studies are developing COVID-19 vaccines for children. We have not yet seen recommendations regarding pregnant women or patients with compromised immune systems.
I recommend not receiving other vaccines—such as flu, shingles or immunizations needed for travel—at the same time as the COVID-19 vaccine. The COVID-19 vaccines are new and have not yet been studied when given at the same time as other vaccines.
Because supply of the vaccine is just becoming available, its distribution must be prioritized. First to receive inoculation will be frontline healthcare workers who come in daily contact with COVID-19 patients, as well as nursing home patients and their caregivers.
The second priority will likely be police officers, firefighters and other emergency responders and possibly schoolteachers in areas where school buildings remain open. As production increases and other vaccines gain approval, inoculations will become more widely available to the general population.
Our Best Hope
I have absolutely no qualms about the COVID-19 vaccine. I will take it when it becomes available to me—and I encourage you to do the same.
Remember, we have no way to predict the severity of the virus; some people experience no symptoms, some suffer a mild case and some die. With that level of uncertainty in a disease that has already killed over 300,000 Americans, I would choose the vaccine. It remains our best hope against the pandemic, since research has not yet yielded a new drug to treat it and since prevention calls for consistent safety measures by all.
With strong participation, we will see things improve. We don’t know if we will be able to completely eliminate COVID-19 from the world, but vaccination is the first step in protecting ourselves and getting back to normal.
Front-line associates reflect on receiving the first dose of the COVID-19 vaccine.