Vaccine

As a physician, I get a lot of questions about various health care topics both within and outside my clinical setting.

They usually range from issues relating to colds, rashes, surgical options, the latest diet and so forth. With the advent of the Covid19 pandemic- all the questions are pretty much in the same vein.

In the past, when asked medical questions outside the workplace I am always careful to remind the individual that they should really speak to their personal physician and that I cannot comment on any healthcare practice that has occurred since I am not their treating physician. I also am careful to say that I cannot offer an expert opinion unless we schedule an official appointment (as anything I say can and may be used against me should an adverse event occur based on said opinion).

Lately though, I have been receiving hypothetical questions. Especially as relates to the new vaccines that have been rolled out under Emergency Use Authorization.

Why was the vaccine made so fast?

Because we had the entire world concentrating all resources on the same project, advanced technology was available, the number of volunteers for the study was in the thousands and we had a large number of sick individuals with whom to compare.

Will it change our DNA?

This is with regards to the mRNA vaccines (there are other types that will be released shortly as of this post). It does not alter your DNA. It sends a message to your cell to create a portion of the spike protein of the virus. Not the whole virus itself. Your body them creates antibodies to attack this foreign spike protein and creates memory cells so it knows what to attack should the virus present itself in the future.

Can someone be infected by the COVID-19 virus after the vaccine?

Yes. If you were exposed to the vaccine close to the first dose of the 2-dose vaccine, your body will not have built up its full immune response (which happens around 2 weeks after the second dose). So until that point you can still be infected by the virus. The expression as symptoms depends on the individual. You can complete your second dose after you are symptom-free.

Do we still need to wash our hands, wear a mask and social distance after we receive the vaccine?

Yes for now. Your having the vaccine means that your body is ready to fight the virus should you be exposed to it, which will help to keep you from getting sick. However we do not know enough about someone who is carrying the virus in their upper respiratory tract and the potential to spread it to others even though they themselves are protected by the vaccine. Remember, the regular mask helps you to keep your germs to yourself and not spread to others. Once we get to herd immunity (more than 70% of the population vaccinated) we should be able to ramp down those other protective measures.

Why not have a natural herd immunity?

Because natural herd immunity would require millions of people to be infected of which hundreds of thousands would be very sick and may die. It’s better to build up your immune system from a piece of the spike protein of the outer layer of the virus (current mRNA vaccine) than by being exposed to the live virus.

What about the new variants?

The new variants of the virus which are currently in the United Kingdom, Brazil and South Africa have spread globally – even here in the US. They appear to spread faster than the original virus but also seem to be affected by the current vaccines. The vaccines may not give the same 90% plus protection but any protection is better than none.

What about people with chronic conditions or other illnesses?

This is basically deciding if being exposed to the virus will put one at risk for a serious complication, hospitalization and/or death versus having your immune system built by the vaccine. That is a conversation to be held with your health care provider. The current teaching (as of this past week- depending on your source) is that every non-pregnant adult is eligible unless they have an allergy to the vaccine or it’s ingredients or has had Guillain Barre Syndrome).

What about kids and pregnant women?

Some vaccines are approved for 16yrs and up, others for 18yrs and up. Studies are underway for 12yrs and up and eventually for those younger. For pregnant women, current recommendations are that those on the front line should get the vaccine since being infected by the live virus could cause complications leading to hospitalization and other adverse outcomes. For others, they should seek the advice of their health care providers.

Is the vaccine mandated?

No it is not (as of this post).

What people need to do is have a conversation with their health care provider and with their family. Discuss any concerns. Do appropriate research. Ask questions and make a decision.

For health care providers- the key is to listen to everyone’s concerns. Address them based on information that we have at hand today. Allow people to process the information and discuss with their family. And do not bully or shame anyone while providing the education.

The bottom line is we all want to get to a place of normalcy where we can travel freely, congregate, visit loved ones, hug and smile without wearing a mask.

We can get there by getting this virus under control using all of the tools in our toolkit – washing hands, wearing a mask, social distancing and taking the vaccine if eligible.

When everything is under control, we can put our toolkit away. (Except maybe the vaccine which may become routine as is the flu vaccine).

Until then, please use the tools we have available.

Wishing everyone a safe and healthy week.

(Disclaimer – this post is a commentary and not meant as medical advice; please contact your health care provider for more information)