Time to Vaccinate

After many months of discouraging trends, news reports and heartache, the approval of two vaccines is like a ray of sunshine breaking through the clouds on a stormy day. Yesterday, I was excited to receive the first dose of the Pfizer vaccine. Many of my patients are anxiously waiting their turn. Many others are unsure and just anxious. To allay fears, I wanted to share what I have learned about these vaccines. 

How the vaccines work: 

Messenger RNA Both the Pfizer and the Moderna vaccines are "messenger RNA" vaccines (mRNA). Normally, mRNA is made in the nucleus of our cells from DNA and acts as a code of instructions to make proteins. Proteins are used as enzymes, structural building blocks, receptors, antibodies and many other purposes. This happens on the ribosome. Think of it as a 3D printer for proteins. The mRNA interacts with the ribosome which deciphers the code. The mRNA from the vaccine codes for the Corona Virus spike protein. This is the part of the virus that allows it entry into the cells and cause infection. The mRNA goes right to the ribosome where spike proteins are produced. They are then released into the body where our immune system recognizes them as foreign material and mounts an immune response by making antibodies that attach to the spikes. 

Activating the Immune Response 

Once a person becomes infected, his/her immune system recognizes the spike and can mount an immediate response. This differs from a person who has not been vaccinated. Their immune system also recognizes the spike protein but are not able to immediately make antibodies as that process can take several weeks. One of the reasons that patients give me for not being vaccinated as that they "have a good immune system" and don't want to put foreign material into their body. To me this is like saying that a runner wants to enter a marathon without doing any training runs. Exposure to the vaccine gives our immune system a head start. Primed and ready to go, it can be prepared on race day to act right away. 

Cell Delivery 

Many vaccines in the past used altered organisms that were not as deadly. This made an individual sick to some degree. Obviously, this is not an ideal situation. No one wants to get sick to prevent illness. The beauty of the mRNA vaccine is there are no infectious particles being injected. We have never had this technology before because mRNA is quickly degraded outside of cells and would be destroyed before reaching its target. Scientists have discovered how to pack the mRNA in lipid membrane vesicles (think of tiny little soap bubbles). This membrane is similar to our cell's membrane allowing for delivery of the vaccine right into the cell. The lipid membrane in the Pfizer vaccine is unstable at warmer temperatures which is why it must be stored in special low temperature freezers. 

Foreign Material 

One of the fears that I have heard from others is that the vaccine is injecting animal DNA into our cells. This is incorrect. Animals may be involved in making the mRNA strand but it does not enter the cell nucleus and does not interact with our DNA. In addition, there is no biochemical difference in the nucleosides (mRNA building blocks) from an animal source versus our own. In reality, unless we are strict vegans, we come in contact with animal particles every day. There is no concern for these vaccines. 

Side Effects 

The side effects stem from our immune response. The first shot will likely just give an individual a sore arm. The second shot may give more symptoms related to a larger immune activation on repeat exposure. This may consist of a headache, fever, and muscle aches. For individuals who are already prone to severe immune reactions that require them to carry injectable medicine (EpiPen) with them at all times, they are more likely to have a severe reaction to the vaccine. Such patients should consult with their physician.

Safety 

I am quite impressed that we were able to get data on clinical trials with over 50,000 patients in so short period of time. Frankly, if our country did not have such rampant spread of the virus, this would not have been possible. With so many being infected, it was easier to tell how effective these vaccines worked. We have safety data from these trial participants, but obviously it is short-term data. While, no one can say with absolute certainty that there will not be long-term issues, there is no indication so far to justify this concern. We will continue to learn and make recommendations, as more data is available.

Bottom Line 

My colleagues and I are not hesitant to receive or recommend these vaccines. We know with certainty what COVID can do. Not only is it currently killing more people each day than died at Pearl Harbor or the 911 attacks, it has also surpassed heart disease and cancer as the most common cause of death. The pandemic has wreaked havoc on our society, our economy, and our families. It is time to make this all end. Personally, I have received the vaccine and am grateful to put on this protective armor as I go to work each day. As a society, we need about 75% of our population to receive the vaccine so that the virus has nowhere to spread (herd immunity). This is the message that needs to go "viral." Pass the word, get your shot. Let's put an end to this virus now.