I’ve received a bunch of questions about the new Covid-19 vaccine that was approved today and so I wanted to write a little post to try to help alleviate any fears people may have right now.
First - it’s okay to be nervous about it. This is the fastest vaccine production for a novel virus in history. That, rightfully so, will cause some questions about whether or not it was tested properly. Second, it’s a type of vaccine most people aren’t familiar with - mRNA vaccines as opposed to a live attenuated or killed virus. And though the science of that makes people like me excited, it can be a bit overwhelming for folks who know nothing about it.
Before I get into the nitty gritty science of vaccines and why this is SO COOL, I want to straight upfront say that though this vaccine may be new, our knowledge of vaccine production isn’t. And though vaccines have been a big thing in the news before this, what it really comes down to is a balance of probabilities risk assessment. Meaning - what’s your risk of an adverse event with the vaccine versus what’s your risk of an adverse event with the virus, versus what’s the risk to the people around you plus the risk to the general population at large if the virus is able to spread unchecked?
Everything in life carries some risk. Literally everything. Staying in bed all day comes with the risk of developing fatal blood clots in your legs. Getting out of bed comes with the risk of stubbing your toe, tripping over something left on the floor, having to ugh interact with people. We live our lives balancing the risks with the benefits of those actions. Getting out of bed and going to work gets us money that allows us to have a bed and a safe place to keep it. The benefit of that outweighs the risk of, you know, all that that entails.
Taking a vaccine is no different. The risk from the virus itself to you, the people around you, and society at large is greater than the risk of adverse events from the vaccine. The general anti-vaxxer argument has been that, because most people take vaccines, the individual risk of adverse events from the vaccine doesn’t outweigh the benefit they feel they get from the vaccine. This argument comes with caveats. You’ve likely heard of herd immunity by now. Herd immunity is basically the number of people in a given population that need to be immune to a particular disease causing agent that it limits the ability of that disease causing agent to spread within the population. Each virus has a different threshold for this. That means that, for those who are unable to take the vaccine due to health reasons, like being allergic to components that make up the vaccine, they are protected by the fact that everyone else around them is immune.
Why this is important - herd immunity also protects the immunized. Most vaccines, by themselves, are only so effective. So, if you get immunized but no one else does, you may still get sick. This is because the viral load you are exposed to from the people around you may be so great that it overwhelms your immune system’s ability to fight it, even with the vaccine. So the reason people get up in arms about anti-vaxxers is because if too many people don’t get immunized, then that herd immunity falls apart and not only are the people who can’t be vaccinated due to health reasons now susceptible to the germ, but so are the immunized people as well.
That’s why you’ll see a lot of stuff about still having to wear a mask and take precautions for a while even after you’re vaccinated for Covid-19 until enough people are vaccinated that herd immunity comes into effect.
This is why we can’t discount adding the societal benefit and the benefits to the people around us to the risk-benefit calculations we make when deciding to take a vaccine. No one lives in a vacuum and what we do as individuals impacts everyone around us.
The next thing I want to talk about before getting into the science of this particular kind of vaccine is the idea of it not being well tested. The way the roll out is designed, the people who will be getting the shot before ‘healthy immune system you’ will be the elderly, the vulnerable and the groups most likely to have adverse events. Healthy people won’t be able to get immunized until likely around early summer. By that point, if there was anything at all to be worried about, it will be made abundantly clear from those groups.
The way vaccine development is designed, it has already been tested on healthy volunteers to assess for safety and adverse events. Then it’s assessed on even more volunteers to see if it actually protects against the illness. By the time it gets approved, it’s already been tested on thousands of people. In the case of the Pfizer vaccine, the US study had 43,661 participants. It has to be shown to be safe in this random sampling of regular folks first before they feel comfortable risking the vulnerable populations that they begin the vaccination programs on. If they were at all worried about its safety, they would not begin vaccinating the groups most likely to have adverse events because that’s just going to decrease trust in the vaccine. So they are already very sure it’s safe before they start to roll that sucker out. So by the time it gets to you being able to take it, that thing has been through so much testing that you have more risk taking Tylenol for a headache than you do getting the shot. Or eating at McDonalds. Or driving your car to work.
As a side note, if you are worried about adverse reactions, you can talk to your doctor and see if you can set up getting the shot at the hospital so if anything bad happens, you’re already right there. Problem solved!
Okay, now that that’s all out of the way - let’s get to what you’re all actually here for. The Science!
So, why are geeks like me so excited about this vaccine?
Most vaccines until now have used either weakened live virus or killed virus as the basis for the shot. Since vaccines have been around for so long, this approach makes sense to most people. You inject a germ that your body can easily fight and kill, which programs your immune system to recognize it in the future, hence giving you immunity to that germ.
That’s not what this new vaccine is using, however. This new vaccine, instead, is using what is essentially a blueprint for a segment of a viral protein instead of the actual virus itself. It’s like downloading a video from the internet that tells you how to build a bookshelf, but you need to use your own tools and materials to do it.
So, our cells take that instructional video, build a bookshelf, or, in this case, a viral fragment that it can then recognize as a viral fragment, and then the usual immune response happens from there. This is why it’s brilliant. Because your body doesn’t know that it’s making the viral protein until it does and recognizes it for what it is. And then it flips out, fights it, and then produces your immunity, just like with the weakened live or killed virus vaccines. It’s just a little bit of do-it-yourself hobby-making built in at the outset.
How cool is that?!?!
Why this is revolutionary is that it is so much easier to create these do-it-yourself instructional videos than it is to have to make and ship bookshelves. It’s going to advance vaccine production for all kinds of things we’ve struggled to create workable vaccines for.
So, why is this scary for people? Because it’s a newer way of doing vaccines. People have come up with all kinds of misinformation and worried half-science thought experiments about it - like what if the mRNA becomes incorporated into our DNA, or our cells just keep churning out spike proteins and yadda yadda, without understanding how introducing mRNA into the body actually works. mRNA is a transient molecule. It is quickly broken down by the body.
Okay, let’s talk about cell biology! You’re going to love this!
No, really.
So, our cells have a bunch of organelles that do stuff - like so:
So, DNA is the stuff inside the nucleus of the cell. It contains the blueprints for all cell functioning. Because the DNA stays inside the nucleus of the cell, it needs a way to tell the stuff outside it what to do. How it accomplishes this is by a process called Transcription, which is basically when the information contained on a particular section of a strand of DNA is copied, producing messenger RNA (ribonucleic acid is what that stands for), or mRNA. This photocopy of the instructions (the mRNA) gets sent out into the cell where the machinery of the cell reads it and produces a protein from it (basically the bookshelf). That protein then does whatever job that protein is supposed to do, like hold books.
The key here is that mRNA 1) does not travel back into the nucleus and become incorporated into DNA. That’s ridiculous. 2) The mRNA, once used, gets quickly degraded by the cell, much like you throw away (or recycle, preferably) a photocopy once you’re done using it.
So, the injection of mRNA from the vaccine is essentially a photocopy of instructions to the cell to build a bookshelf from its own materials, so that it can identify it and learn to fight it. This mRNA breaks down once the bookshelves are built, so we don’t have to worry about that. And because we’re only given so much of it, we can control how many bookshelves get made by the cells. And once the cell proudly displays its work, our immune system comes along, identifies the bookshelf as not being something good, and destroys it, so that the bookshelves themselves don’t hang around in our system either. The rest of the process is exactly what happens with traditional vaccines. The immune system basically updates its viral software to include scanning for that viral protein so that it becomes a routine part of its job, thus giving us immunity to the disease by being able to quickly recognize, identify, and destroy any cells with that protein in the future.
Sound scary?
Hopefully it doesn’t, but if it does please feel free to message me and we can chat further.
So, why are people worried about adverse events?
As with any foreign anything that you introduce into your body - food included - you run the risk of the body deciding it does not like that thing and flipping out. We actually experience this all the time but we’re used to a certain amount of discomfort for things we routinely encounter - anyone have a favourite food they know will keep them in the bathroom all night but eat it anyway? How about drinkers? We got any drinkers reading this post? Ever drink too much? Alcohol is literally you enjoying the effects of a mild poison. When you drink too much of that mild poison, it becomes a moderate poison, which your body definitely makes you aware of.
Because vaccines aren’t things we really understand or encounter often, and since there are a lot of very vocal, well intentioned and misinformed people out there, vaccines can seem mysterious and scary. But so is absinthe and I know a whole bunch of you who would gladly take that risk, amiright?
Should we continue to advance vaccine science so that we search for the safest components we possibly can to make them with? Absolutely. Does that mean the components used to currently make them are unsafe? No. You run a greater risk of having an adverse event to dairy than you do to vaccines. And yes, it’s not the best example because people are also trying to villainize that right now too… My point is, not everything works for everyone. We all have different DNA. Trying to find something that no one will ever have even the slightest reaction to is hard. Plus, you should have a reaction to a vaccine. Aches and pains, mild fever, headaches, all of these are signs that your immune system is mounting a defence against the germ, or in this case germ fragment. You actually want those things to happen. But some people mistake those totally natural and harmless signs of your immune system doing exactly what it’s supposed to as bad.
Point is, this will be the most scrutinized vaccine in the history of vaccines. If it’s not safe, you’ll know soon enough. But the fact that it has made it this far tells me it probably is. And honestly, the risk to you from the vaccine versus the risk from Covid… I’ll be the first in line to get the shot when it’s finally available to me, is all I’m sayin’. The science here is sound. But again, if you are worried about it, that is totally okay and perfectly natural. There are all kinds of things you can do to reduce your risk while also keeping yourself protected. And as always, if you have questions, you know where to find me. I love questions!
Until next time, Folks!