By Peter Bridgman, MD
December 19, 2020
I am a retired physician and have lived in Yarmouth for over 30 years. Honestly, the pandemic scares me. When I open the New York Times pandemic tracking section, the entire country glows red with widespread community virus transmission, and over 2500 deaths per day. If we think of the pandemic as a war, this is a bad one, casualties so far exceeding 300,000. That is more than all the combat deaths in World War Two. In the back of my mind there is a nagging fear that before the pandemic burns itself out I will catch the virus and die before I can see my newborn granddaughter in Los Angeles. You could say that for me, winning the war against the virus has become personal.
So if this is a war against the virus, everyone has to do their part to keep transmission low until the vaccines become more widely available. That means not letting our guard down, wearing masks, staying physically distanced and washing our hands frequently. We will have to follow these guidelines until at least the early summer of 2021. That’s a long time but when the majority of the country’s population is immunized virus transmission will fade out. I am looking forward to eventually being able to fly out to Los Angeles and hold my granddaughter.
Now to consider the vaccines. The two available are made by Pfizer and Moderna, and received emergency use authorization from the FDA recently. The FDA did not cut corners when considering the applications for approval. FDA staff worked nights and weekends to review information provided by the manufacturers so that a safe and effective product would be available. We should all be thankful that these career scientists did their jobs so efficiently. As far as I can tell, there was no “political” influence asking anyone to cut corners.
The two vaccines have been developed using a new technology; both shots contain a tiny fragment of mRNA nucleic acid that codes for the Spike protein that latches onto human cells. Since there is no complete virus genome, you cannot catch COVID from the immunization. The mRNA eventually degrades and cannot be incorporated into your own DNA.
Once the mRNA enters your muscle cell at the site of the shot, Spike protein is produced and transported to the surface of the muscle cell. Your immune system immediately recognizes the protein as foreign and begins to make antibodies. This final step is exactly the same as when we get the usual flu shot every fall. The mRNA technology was necessary in order to get the vaccine quickly.
Large vaccine studies began last summer with tens of thousands of subjects. The subjects have been followed for over two months since the last person got an injection, to pick up serious delayed side effects. None were seen. Both vaccines are about 95% effective in preventing the COVID disease but we do not know whether the protection extends to preventing transmission of the virus.
Most people who received the vaccine had local side effects like a tender arm or swollen lymph nodes. About 1 in 6 developed a fever. There have also been occasional allergic reactions with hives, shortness of breath, scratchy throat etc. In all cases the people recovered after treatment with Benadryl and epinephrine. The FDA recommends that all sites administering the vaccine have these anti-allergy medications on hand for immediate administration. If you have a history of an allergic reaction to a previous vaccination it would be best to talk with your primary care physician to decide whether or not you should take the shot.
The vaccines are in limited supply so for now, only healthcare workers, and later, nursing home residents and staff will get the vaccine. Both manufacturers are working hard to ramp up production so that tens of millions of doses will be available by the Spring. Several more vaccines may also be available by that time- we need all the help we can get! When enough vaccine is available to administer to the general population, the State government will make available a list of sites where people can get the vaccine. Older people and those with chronic medical conditions like diabetes or cancer will get priority.
Finally, I urge everyone to follow the news about the pandemic and adhere to State guidelines. Here in Maine, the pandemic has not been as bad as other parts of the country, but case numbers have been rising relentlessly. You can learn a lot by listening to the State CDC director, Dr, Nirav Shah, who holds a press conference every Mon/Wed/Fri at 2pm. This is broadcast live on Maine Public Radio.
Once the vaccines are widely available I encourage everyone who can to get vaccinated to stop transmission of the virus through “herd immunity”. Getting vaccinated has benefits both for the person receiving the shot, and for the neighborhood, town, state and country. We will all have to step up, suffer the minor local soreness of getting the shot, in the knowledge that we are helping our country win the war against this invisible enemy. I believe that it is a patriotic duty for everyone to consider the risks and benefits of vaccination, and if the facts fall in favor of the vaccine to get the shot as soon as possible: “Your Country Needs You!”.
Consult your physician for further questions about the pandemic, or if you are unsure as to whether to take the vaccine. State information can be found at www.coronavirus.maine.gov.
Peter Bridgman MD
Dec. 19, 2020