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COVID Vaccine Update: The Importance of Patience and NOT Jumping to Conclusions.


A vaccine for COVID has been a hot topic forever. So I wanted to give an update and my thoughts on where we stand at this point.


First things first: personally, I do not focus on the technology used for the vaccine, even if it would be a "first of its kind" vaccine.


Science moves forward because it, uhhhh, moves forward.


So IF the vaccine passes all safety trials, I am not concerned if the vaccine results from a tried-and-true method (attenuated virus) or a new technology (mRNA). So I would not fret.


Next, here is a comment Richard Horton, editor-in-chief of the medical journal The Lancet - one of the most prestigious medical journals in the world - recently made regarding Trump’s statement that a COVID-19 vaccine could be delivered by the end of October:


“If we make a mistake and license a vaccine too early – just think – we have already got a growing anti-vaccine movement, which is extremely disturbing. We can't cut corners. There will not be a vaccine available for public use by the end of October. President Trump is simply wrong about that,” Horton said, adding: “I have no understanding why he is saying it. Because his advisers will surely be telling him that that's just impossible.”


This is the only sane answer that can be given, no matter if American Pfizer and German BioNTech both claim they will likely have a "safe" vaccine ready by October 🤦🏽‍♂️. Even if they did (which I highly doubt, THAT'S NEXT MONTH!!!), this does NOT mean the vaccine will be available for widespread public use at that time.


And in addition to safety trials, efficacy trials are equally as important.


Vaccinations can have variable responses in different populations, including the elderly, the obese, and those of different races.


So even if a vaccine shows promising results, if the volunteers enrolled are not representative of the population we are looking to treat - and this has been an issue - then many questions will be left unanswered:



In short: the vaccine CANNOT be rushed. And the vaccine CANNOT be used as a political tool. It is too DANGEROUS to do so.


Nine manufacturers have made a pledge to adhere to strict safety guidelines and not rush the production of a vaccine, including the two mentioned above. I hope that pledge is honored, though the rhetoric gives me pause.


Finally, there was a great amount of hullabaloo yesterday regarding AstraZeneca-Oxford pausing their vaccine study due to concern for a severe illness in one of their participants. The illness was suspected to be a case of transverse myelitis (TM).


Let's talk about this.


First of all, pauses in research during vaccine development happen ALL THE TIME. This is a GOOD thing.


It means they are taking the time to identify the possible cause of the illness and evaluate if this may be a significant cause of concern moving forward. The reason this may seem concerning to the general population is because usually NO ONE IS PAYING ATTENTION when a vaccine is being developed.


Obviously, not the case with COVID.


If I did NOT hear about any obstacles in the development of the vaccine, I would be MORE concerned. So do not stress.


Regarding TM, a quick break down of the words gives us:


Transverse - an imaginary, horizontal plane that cuts the body entirely in half, and separates the top and bottom half of the body.


Myelitis - inflammation of the fatty covering (myelin) around the nerves of the spinal cord, which results in damage of the myelin and the underlying nerves.


Therefore, TM is inflammation of the spinal cord that causes neurologic injury, on both sides of the body, below the level of where the inflammation originates.


I could delve more into the disease, but it will not serve a purpose besides scaring people. It is a serious disease with some treatment options available, but where a not-insignificant percentage of people may never recover full nerve function. No one is arguing the seriousness of it.


But this is the MOST important point: TM is VERY rare, with only 1400 cases reported nationally every YEAR. Remember: we have had multiple days already where COVID KILLED more people than that in a given day.


The causes of TM are numerous, with post-infectious inflammatory responses or multiple sclerosis being the most common. It is caused by an abnormal and excessive immune response - sorta like a localized "cytokine storm of the spinal cord" - where the exact cause is unknown:



Fortunately, the woman in the study seems to have suffered only a mild case and is to be discharged soon.


Again, it is scary. But again - VERY rare. And there are case reports of patients developing TM with COVID infection itself:



NOTHING in life is 100% safe. And as such, everything is a risk-benefit analysis. And we must keep things in perspective.


We do not yet know if these serious side effects will manifest more as the trials continue. But do you know what we do know?


COVID has led to the death of 190k people in the US thus far. So it is important we not make ANY conclusions about ANY vaccine at this point. Patience is of the essence.


And in short supply.


A big issue is perception. Most medical professionals are aware TM is a very rare complication due to infection, and there are very rare case reports of TM with the flu vaccine as well.


But because of the ominous feeling felt by many that the vaccine is being "rushed", even an isolated case of TM feels dangerous. But that is just not the case.


Assuming these sorts of side effects remain rare.


So mere doston, aaraam karo - "my friends, relax" in Hindi - and let's take everything one day at a time.


Because, well, it is either that or continue to make yourself crazy on a day-to-day basis. I personally prefer the former, but you do you.


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1 Comment


MJ Kim
MJ Kim
Sep 16, 2020

:)

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