Health
The COVID-19 Vaccine Is Here! Should You Take It?
The Facts – simplified
What is Coronavirus?
Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) emerged in December 2019 and was then re-named to Coronavirus-19 (COVID-19).
Who has made a vaccine for COVID-19?
Moderna, Pfizer, BioNTech, and AstraZeneca.
How does the vaccine work?
“A vaccine stimulates your immune system to produce antibodies, exactly like it would if you were exposed to the disease. After getting vaccinated, you develop immunity to that disease, without having to get the disease first” (CDC, Vaccine Basics).
How was the vaccine made?
Traditionally, many vaccines are grown in cells of chicken egg yolk (Flu vaccine).
The virus is then weakened or killed and made into a vaccine (CDC, Vaccine Making).
This process can take years.
For perspective, the mumps vaccine was made in 4 years, and this held the fastest record until now.
As for the COVID-19 Vaccine:
In the same way that our body is made of genetic material – DNA, the COVID-19 vaccines were created using Messenger RNA (mRNA) genetic material from the Coronavirus.
Once injected into the body, the mRNA combines with our human cells and tells them to make a protein that looks like the Coronavirus.
Next, the immune system recognizes that this protein is not normal and activates our immune system – T-cells, to attack the virus.
Lastly, after our immune system kills the virus, the immune B-cells remember the virus for life (potentially).
How did they make the vaccine so fast?
The vaccines were developed quickly because:
- mRNA vaccine development is not a new concept. It was already being used to make other vaccines, including Influenza A (Jackson et al., 2020).
- They had a head start because of the prior Coronaviruses like the Middle Eastern Respiratory Syndrome Coronavirus (MERS-CoV) outbreak of 2012 that affected the United States in 2014 (CDC, 2019).
- Scientists were already making vaccines, but many lost the funding needed to continue because MERS did not develop into a pandemic. MERS was isolated to the Middle East primarily.
- mRNA virus development in a lipid capsule requires less time for vaccine development than egg yolks.
Who was in the vaccine trial?
Vaccine trials have 3 phases. The phases last for varying lengths of time and increases in sample size (the number of people in the trial).
Moderna – 45 Adults aged 18-55 were accepted in Phase I.
These individuals will be followed for up to 2 years after the second vaccine to determine immune responses (Jackson et al., 2020).
No children, pregnant women, or immunocompromised (HIV, cancer) have been evaluated at this time.
In Phase 3, over 30,000 patients will be enrolled in the vaccine trials.
How effective is the vaccine?
Moderna trialed 3 vaccine doses 25 mcg, 100 mcg, or 250 mcg. Antibodies to the virus were shown within 2 weeks of the first vaccination (Jackson et al., 2020).
After 2 weeks, antibody activity was not as high, suggesting that a second dose is needed.
Moderna has shown 95% effectiveness, Pfizer and BioNTech report 90% effectiveness, and AstraZeneca reports 70% effectiveness and up to 90% by tweaking the dose (Gallagher, 2020).
Pfizer and BioNTech have filed for FDA emergency use.
What does emergency use mean?
The FDA emergency use authorization (EUA) gets the vaccine to people quickly because it requires less vaccine data than needed for full FDA approval.
Does the vaccine prevent COVID-19?
The efficacy reported means that the vaccine is 70%-90% (depending on the vaccine) effective against the virus.
It is not 100%; therefore, you can still get the virus after being vaccinated. But, instead of getting very sick and possibly dying, the vaccine may prevent you from having severe symptoms or any symptoms at all.
How long does the vaccine remain effective?
For example, we know that the tetanus vaccine (Td) leaves antibodies in our system for up to 10 years. After that, you will need a booster vaccine.
As far as the COVID-19 vaccines, it is unclear.
After contracting a virus, the immune systems’ B-cells can remember the virus from what we know about the immune system.
So, even if the antibodies from the vaccines don’t last long in your system, your body may still remember the Coronavirus if you become infected after being vaccinated.
How safe is the vaccine?
So far, the safety data is based on a two month follow up after the second vaccine. The safety is currently similar to that of the flu vaccine.
In the Moderna Trial, one person did not receive the second vaccine because they experienced itching (possible allergic reaction) after the first vaccine.
How many vaccines will I need?
Two vaccines 3-4 weeks apart.
What are the side effects?
So far, Pfizer has reported injection site pain, fatigue, fever, and chills.
Moderna has reported side effects to include injection site pain, muscle aches, and headaches.
Side effects were more common after the second vaccine dose and with the higher vaccine dose of 250 mcg (Jackson et al., 2020).
21% of people in the high dose group graded the side effects as severe. Meaning, the participants graded the side effect as significant or prevented their daily activities.
Do I still need the vaccine if I have already had COVID-19?
Typically, getting the infection by exposure to the virus offers better protection than a vaccine.
However, little is known about how long antibodies last after being infected with COVID-19.
If you think you may have had COVID-19 your provider can order the antibody blood test.
When can I get the COVID-19 vaccine?
The dates are to be announced, but the vaccine will be distributed in 4 phases (NASEM, 2020).
Phase I – high-risk healthcare workers, older adults, adults with comorbid conditions
Phase II – Teachers, child-care workers, essential industry workers, homeless shelters, jail/prisons
Phase III – young adults and children
Phase IV – all others
Which vaccine is “better”?
As Moderna progressed through each trial phase, they enrolled more high-risk people (Age over 65, Black, Hispanic), which will result in better efficacy data for these groups.
“Moderna has announced that the vaccine can be kept in a conventional freezer for up to six months and that once thawed can be kept for up to 30 days in a standard refrigerator. This makes the vaccine much easier to deliver” (Openshaw, 2020).
Pfizer and BioNTech will have challenges with distribution, as their vaccine’s stability requires a special freezer to store the vaccine at a temperature below 70 degrees Celsius.
What if I can’t get vaccinated?
For people who cannot get vaccinated for whatever reasons, overall, 70%-94% of the population will need to be vaccinated before we can achieve herd immunity (Mayo Clinic).
Can my employer mandate me to get the vaccine?
No, not under the FDA EUA. But, even if the vaccines are given full FDA approval, vaccine mandates are unlikely anytime soon.
Should you take the vaccine?
Based on the current evidence, yes.
The global pandemic is of immediate concern. If we have any chance of returning to “normal,” vaccination is the best way to ensure a path forward.
Unanswered questions and my opinion…
How long does the vaccine remain effective?
Only time can tell.
Studies have shown that SARS-CoV and MERS-CoV may not generate long-lasting antibody responses. A long-term assessment is needed for SARS-CoV-2 (COVID-19) (Jackson et al., 2020).
How does the vaccine work against virus mutations?
All viruses mutate.
A mutation is a change in the virus’ genetic code.
Given that the vaccine was made based on one particular gene strain, it will be interesting to see if the current vaccines based on the December 2019 strain are still effective one year later in 2020 and beyond.
Mutations would make the vaccine less effective over time (Lash & Schlossberg, 2020).
Wash your hands and Wear a Mask
If you develop a cough, remember, this is also flu season, and there are other reasons you may be coughing.
Disclaimer: This blog is meant for educational purposes. It is meant to provide a snippet of the extensive research available for the COVID-19 vaccine race.
Jheneale R. Grandison, B.S, RN
