Today Ark Valley Voice, introduces a a weekly Q&A Column written by Dr. Lydia Segal in conjunction with Chaffee County Public Health. This column is focused on questions readers have about COVID-19 news and the sciences. As Segal points out, “Everything I write today is valid for today. COVID-19 news and science are rapidly evolving; assume updates will be made.
Question: I am vaccine hesitant. What can you tell me to help me make a decision about getting the vaccine?
Lydia Segal, MD, MPH
Background: Vaccine science has evolved over more than the last two hundred years, when smallpox was developed. Vaccines against viruses such as polio began in the 1950s. Since the early 1990s research has advanced so that vaccines could be developed that target just small pieces of a virus. This decades-long development process has allowed for more rapid development of vaccines we now have available for the coronavirus.
All medical decisions are in part balancing risks. Simply put, do I want to risk getting COVID-19 that might be severe enough to hospitalize me or die from, or do I want to take the vaccine which eliminates the risk of death and reduces by 95 percent chance of having severe or moderate COVID that would result in hospitalization?
Answer: the details
Three types of vaccines: NONE of the vaccines change our genetics
- mRNA: These vaccines code for the spike protein that is on the ‘outside’ of the virus. When the immune system sees the spike protein, it recognizes it as a foreign and makes antibodies against it. The vaccine does NOT enter a cell’s nucleus, so they can NOT change our genetics. In clinical trials mRNA vaccines have been tested on over 40,000 people. This type has been shown to be 95% efficacious thereby reducing the possibility of getting COVID or getting a milder form. The two companies that produce these essentially identical vaccines are Pfizer and Moderna. Depending on availability, both are available in the county at public health vaccine clinics and the hospital vaccine clinics.
- Adeno: The genetic coding for the spike protein is added to an adenovirus to create the basis of this vaccine. This method of vaccine production has been around for decades. Adenoviruses are examples of some of the common cold viruses. The first company likely to get emergency approval is Johnson & Johnson, often referred to as J & J. The vaccine is shown to be about 87% effective and is the only vaccine to be a one shot instead of two regime. AstraZeneca is also producing an adeno-based vaccine, likely to complete its trial in the spring.
- Protein: This vaccine produced by Novavax uses the spike protein inserted into a microscopic particle to trigger an immune response. It is likely to be completing its trial also in the spring.
How safe are these vaccines?
There are two levels of safety, one is the mild symptoms we all get after a vaccine such as arm pain, fatigue, fevers. These are actually good signs that our immune system is working. Often overemphasized in the press, though extremely rare, is the risk of a severe life threatening allergic reaction called anaphylaxis. The staff at public health and the hospital are prepared with medications on site should this occur. This is the main reason folks are asked to wait, as if one is going to develop anaphylaxis, it happens in under 15 minutes.
Lastly, is there a long term major complication from these vaccines?
So far, there hasn’t been a case of any major problem. There is a study out of Israel, that looked at greater than 700,000 people, and there has not yet been any major complications from the vaccines. The question about late, long-term major complication is unknown at this point. There have been no reported deaths from the combined 70,000 people who have been in clinical trials.
How well do they protect me?
All of the vaccines produce immune responses that markedly reduce the chance of getting severe or moderate COVID-19. This means you either don’t get it at all or only get a mild case of something like a cold. Depending on the vaccine you will see numbers like 88% to 95% efficacious. This means, between 5 and 12 % of people get moderate to severe COVID. The majority do not get sick at all or get only a very mild case. Hospitalizations are markedly decreased with all vaccines. There have been no reported cases of folks immunized in the clinical trials that died from COVID.
How do I get a vaccine in the valley?
Currently vaccines are offered via public health and the hospital: Web links to follow:
http://chaffeecounty.org/Public-Health-Coronavirus
https://www.hrrmc.com/covid-19-updates/covid-19-vaccine/
Next week: vaccines and variants will likely be the subject of next week’s column.
If you as a reader have a question related to COVID-19, please send it to arkvalleyvoice@gmail.com
By Lydia S. Segal, MD, MPH
Dr. Segal is a board-certified family physician who is attempting to retire. She also has a Masters in Public Health. She co-teaches with members of the Pelvic Physical Therapy staff at HRRMC classes on men’s and women’s pelvic health. In her former life she was a general assignment reporter. In her spare time she hikes, skis and cooks.
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