It’s a Choice between the Virus or the Vaccine: Choose the Vaccine

The development of the COVID-19 vaccine represents one of the most astounding achievements in modern medical history.  Never has a vaccine been developed so quickly.  And never did anyone imagine it could be THIS effective – 95%.

However, the politics around vaccines in general and coronavirus in particular have created hesitancy to receive it. People question whether corners were cut in its development. States are struggling to roll out the vaccine and get them from the freezers into arms. And as a result, this moonshot achievement flounders. 

But make no mistake.  This coronavirus will be around for the foreseeable future. We will all be exposed to it. Therefore, we are all making a very simple choice: “Would I rather have the uncertainty of a coronavirus infection, or the uncertainty of this vaccine?” The answer is clear.  Choose the vaccine.

Viruses are very simple structures. They contain genetic material, either DNA or RNA, which is contained in a capsule that has proteins to help the virus stick to a host cell. Viruses cannot replicate without a host.  But once virus sticks to a host cell and invades it, the virus hijacks the machinery of the host cells, and then produces the materials to make new virus. Those new viruses go on to hijack other cells, and so on and so on. The more virus around (viral load), the sicker people can get.  

Thankfully, an immune response is mounted to fight the hijackers. And typically, against most viruses (including the virus that causes COVID-19), the immune system wins.

Traditional vaccine development takes a weakened virus, or a part of the dead virus, and injects that into the body to train your immune defenses.  After vaccination, when you are exposed to the real thing, the vaccine has trained your defenses, and you are armed and ready to defeat it.  However, weakening a virus, testing it, weakening it some more, and testing it some more takes years.  Likewise, killing a virus and isolating the part that can generate immunity also takes years.

So how were the COVID-19 vaccines developed so quickly? Two things: 1) It was known from the SARS and MERS outbreaks in 2003 and 2012, respectively, that the spike protein on coronaviruses generates immunity. Knowing the target saved LOTS of time.  2) Instead of weakening this virus or isolating the protein from lots of dead virus – which takes years to develop – scientists used an existing technology: mRNA vaccines.  mRNA vaccines work by constructing just the genetic code of the structure you want to make – in this case the spike protein of the coronavirus – and delivering that code into the body.

Again, the SARS and MERS outbreaks gave us the knowledge of what that genetic code should look like. The mRNA vaccines inject that code for the spike protein into your muscles cells, and your cell machinery uses the code to make just that protein, not the whole virus. That protein circulates in your body, your immune system recognizes it, and develops antibodies against it. The protein itself is harmless. It just circulates, and does not invade cells. It eventually gets metabolized and peed or pooped out.  Likewise, the injected code dissolves in less than minutes. Once it’s gone, it’s gone.  But the antibody defense remains.

It took two days, instead of years, to develop of the prototype vaccine that Pfizer and Moderna are now administering.  Not a single corner was cut.  The mRNA vaccines have been used for years for HIV and cancer treatments, so the know-how has been there.  Most importantly, the safety record over decades of mRNA vaccinations in these cancer and HIV trials is excellent.

The side effects of this vaccine are a sore arm and some short lived flu-like symptoms for a day or two in some, but not all, recipients. That certainly beats even a mild case of COVID-19. There has been one reported death associated but not necessarily caused by the vaccine out of nearly 10 million doses that have been administered.  Compare that to 100,000 deaths that would be expected with 10 million coronavirus infections assuming 1% mortality from COVID-19.

So please, take the vaccine.  I received my second dose January 12 (my son’s birthday) and felt an overwhelming sense of gratitude, elation and relief. I was not alone.  Until that needle entered my arm, I did not realize the amount of stress that I have been carrying going to the grocery store, seeing and operating on patients, and exposing my family to potential illness. 

The vaccine provides outstanding protection from a serious COVID-19 illness. It’s exceedingly safe.  But equally as important, it’s a vaccine against fear and an inoculate of hope, both of which are so desperately needed.

Dr. Chehab is an orthopedic surgeon at Illinois Bone and Joint Institute.