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Should I Get the Shot?

Do I really want to make a run to the grocery store today? Do I really need to go to the clinic? Do I risk it and go visit my 68-year-old hypertensive and diabetic mother? Is my workplace safe? Am I sending my child back to school now that they are re-opening? These are all decisions that for most people were once easily made, but now pose real dilemmas and may turn into personal, family or professional crises. Now add to all of these the question that will perhaps mark 2021: “Should I get the shot?” As easy as one would want the answer to this question to be, we must realize that in an age of highly accessible information (both good and bad, true and false), making such a decision entails sifting through scientific facts, statistics, misconceptions, opinions, superstitions, and personal and religious beliefs. In order to answer that big question, let us look at a few smaller questions in an effort to spur some thought and compel readers to make an informed decision on whether or not they should take the COVID-19 vaccine.

What is a vaccine?
The immune system is your body’s main defense mechanism. Think of it as a dictionary. Once exposed to a virus or bacteria (pathogen), your immune system catalogs a definition so that when it encounters the pathogen again, it can be easily identified. Not only does your immune system identify the virus or bacteria, but it learns how to create cells and antibodies (cell and protein soldiers) to attack. This can take a while, however, and in the process the pathogen can multiply exponentially and has an opportunity to cause an illness.

Instead of waiting for your body to be exposed to a live pathogen, a vaccine exposes you to a weakened or dead portion of the virus or bacteria or allows your body to make a portion of it. This way, your immune system is given a definition to enter, which special cells remember. These cells are also prepared to create the necessary antibodies to attack. This is called an immune response. As a result, your body is ready so that once you are exposed to the live virus or bacteria in the future, it is quickly identified and attacked, not giving the pathogen time to multiply and cause illness.

Why is this vaccine different?
Older vaccines use a technology that introduces dead or weakened portions of a virus or bacteria into your body. These are unable to cause a disease, but they do prompt your body to create an immune response. These types of vaccines remain highly effective and have led to the worldwide eradication of smallpox and the near-eradication of other diseases such as polio, diphtheria, mumps, measles and rubella. The COVID-19 vaccines are of a new generation. This new technology works essentially in one of two ways: 1) your body is given the genetic information that prompts certain cells in the body to create harmless portions of the virus; or 2) your body is given a harmless portion of the virus. Once this happens, those portions of the virus are identified, a definition is catalogued and your body is prepared to attack when it is exposed to the whole, live virus in the future.

What do I need to know about the AstraZeneca vaccine?
Readers may know by now that at least in a first instance, Belize has been supplied with the AstraZeneca vaccine. This vaccine is called a viral vector vaccine. The genetic information for a harmless portion of the SARS-CoV-2 virus (yes, that’s the one that causes COVID-19) is introduced into a different, harmless virus. In this case a type of virus known as the Adenovirus is used, which has been modified to make it unable to cause a disease in humans. This virus is then introduced into your body in the injection and proceeds to prompt an immune response. Its efficacy is around 76%, with two doses required 8-12 weeks apart in order to obtain the best efficacy.

76% doesn’t sound too good … or does it?
It is important to explain that the 76% efficacy of the AstraZeneca vaccine should not be taken at face value. Indeed, others such as the Pfizer and Moderna vaccines have an efficacy of around 95%. But let’s look into what efficacy means in order to get a better understanding of this number. A 76% efficacy for a COVID-19 vaccine means that there is a 76% chance that even if you are infected with the virus, you will not develop any symptoms. That leaves a 24% chance that you may develop mild to moderate symptoms of COVID-19. What is most important about the vaccines, however, is how well they protect persons from becoming severely ill, being hospitalized and possibly dying of COVID-19. Fortunately, in this regard, all of the currently approved vaccines perform at or near 100%. This means that the studies have shown that once vaccinated, near 100% of people do not end up seriously ill, hospitalized or dead of COVID-19. Literally, we can live with that 76%.

So how were these vaccines made so quickly?
The technology for these vaccines has been in development for over three decades now. After years of modifications, the unfortunate opportunity finally arose for the technology to be put into effect. These vaccines have gone through all the stages of clinical trials before being approved for widespread use and being made available to the public. Although some aspects of approval were fast-tracked, the most critical points, such as monitoring for side-effects and allergic reactions, and grading efficacy were done within normal timeframes to allow for proper data collection and analysis. This is how vaccines have become available within about one year after the initial outbreak in Wuhan, China in December, 2019.

What about the new variants?
The more a virus spreads, the more it multiplies. The more it multiplies, the greater the chances are that there will be mutations. Therein lies a key reason for the importance of getting the vaccine. The more people are vaccinated, the less the possibilities are of spreading, multiplication and mutation.

The efficacy data on how well the vaccine works to protect against the UK, South American and South African variants tends to vary, depending on the source of information. What does appear to hold true, however, is that the vaccine does work very well to protect against severe disease, hospitalizations and deaths caused by these variant strains of the virus. Furthermore, it must be mentioned that the technology behind these vaccines allows for them to be updated so that the protection can be expanded to include the different COVID-19 variants.

Can I catch COVID-19 from the vaccine?
The vaccine only contains either the genetic material for your body to create a part of the virus (the spikes on the surface of the virus) or portions of the virus. These components cannot cause you to become ill of COVID-19, simply because they are not the whole, live virus.

What are the side effects of the vaccine?
Side effects to the vaccine commonly occur. These are, however, slight to mild in intensity and last on average between one and two days. You may experience pain and swelling at the vaccination site, fever, fatigue, chills, headache, muscle ache, or joint pains or may feel unwell. These side effects should be resolved by taking paracetamol (Tylenol), drinking abundant fluids and getting some rest (this does not mean that you automatically get a sick leave after you get the shot!). That you do not experience side effects does not mean that the vaccine is not working. It just means that in your case, there were no side effects.
I have high blood pressure or HIV or diabetes. Is the vaccine safe for me?

Persons over 60 years old, those with high blood pressure, diabetes, HIV, cancer, kidney failure, etc. are more likely to develop more severe forms of COVID-19, compared to the rest of the population. This group therefore stands to gain the most from getting the vaccine, as one of the strong points of the vaccine is that it helps to prevent severe illness, hospitalization and death. If we do a risk-benefit assessment here, we realize that the “risk” with the vaccine is that a person has to go through the “trouble” of going to a vaccination site, getting the stick in the arm, and possibly experiencing some of the side effects of the vaccine. The benefit is that the chances of one developing a severe form of COVID-19, ending up hospitalized and dying of COVID-19 are drastically reduced. It would seem clear that the benefit here by far outweighs the risks.

I’ll still have to use a mask after I take this vaccine, so what’s the point?
It is still uncertain how much the vaccines protect against transmission of the virus. For this reason it is still important that after someone is vaccinated he/she continues to practice preventive measures so that the virus is not transmitted to other susceptible individuals.

Most estimates indicate that once around 60-70% of a country’s population is resistant to COVID-19, the possibility of the virus being transmitted through the population is significantly reduced and the population is less likely to suffer from the severe effects of the disease. At that point, that population would be considered to have attained herd immunity.

We have all had to learn how to wash our hands really, really well; how to properly use a mask (well, some of us still haven’t); how to social distance; how to stay in touch with our family without actually touching them. We have learned the signs and symptoms of this disease and now know when to go in and get checked up and possibly tested. All of this has been done with the ultimate goal of staying safe and healthy and with a yearning to someday return to a normal way or life. This will only be achieved if we bring the transmission of COVID-19 under control. Vaccination is not the only way to do this, but it is a vital weapon that we now have in our arsenal to fight against this dreaded virus. I sum up this article with a football analogy used by Dr. Jonathan Van-Tam, the Deputy Chief Medical Officer for England, in which he explained where we are in this pandemic and what we need to do. He says, “It’s clear in the first half, the away team gave us an absolute battering, and what we’ve done now is, it’s the 70th minute, they got a goal, and in the 70th minute we’ve now got an equalizer. Okay, we’ve got to hold our nerve now, see if we can get another goal and nick it.” We have suffered from the effects of COVID-19, we have managed to contain it to some extent, and now we need to get vaccinated. Take the shot!

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