The Coronavirus Vaccines
There is great excitement currently about a series of new vaccines against COVID19 or more accurately the SARS-CoV2 virus. It is incredible to think that vaccines were being trialled in April of this year, only weeks after the pandemic was recognised. How is this possible?
The answer is that a number of groups have been working on vaccine technology that can be adjusted to incorporate any new virus.
The Oxford vaccine was designed to fight Ebola but, in the process, they established a virus vector, an unrelated virus that has been developed to deliver the genetic information contained in any entirely new pandemic virus.
Other groups instead worked on RNA, establishing a mechanism for delivering the genetic code for an important part of the pandemic virus to the vaccinated human. In the case of SARS-CoV2 they chose the genetic information coding for the vital spike protein on the virus surface. This is crucial for the virus to gain access into our cells.
By producing an immune response to the spike protein, we effectively disable the virus before it can establish itself.
The press has been equally excited about two cases of anaphylaxis with the Pfizer/BioNTec vaccine currently being distributed. Both were in highly allergic people carrying epipens. The reactions were recognised quickly, and the patients are now well. New guidance suggest that such patients should not now be offered the Pfizer vaccine.
The biggest difficulty with this vaccine is the need to store it at -70C as most freezers work to -20C. Nevertheless, the Pfizer vaccine is now being distributed in about 100 hospitals and as of next week we hope to receive it in the community. It may later be possible to vaccinate in other GP surgeries if the Oxford/Astra vaccine, which can be refrigerated, gains approval.
The new vaccines seem highly effective and have generally mild side effects, those you might expect with any vaccine. Pain and redness at the swelling site, fever, and aches.
Anaphylaxis in spite of today’s headlines was actually very infrequent in the trials. Protection levels of 90-95% are extremely good, the Oxford vaccine may be less effective but there were no serious hospitalised cases at all in the vaccine group in the Oxford trials.
There was concern about the rapidity of authorisation of the Pfizer vaccine by the MRHA but in fact the organisation recognised the need for a vaccine early and started its due diligence long before the trial evidence was finally produced.
There is no need to contact your surgery to book a vaccination, the system is managed centrally. Our only role is to provide accurate lists of patient ages, those in care homes and those who have conditions putting them at higher risk of COVID19, in order that the most appropriate people are vaccinated first. We cannot otherwise influence when you have the vaccine. Please do not call us about the vaccine as it will clog up the system and we cannot book you a slot or promote your case ahead of others in your risk group. Unfortunately we are unable to offer the vaccine privately.
I have discussed vaccine safety with several people who know far more about the technology than do I. I do not have any concerns about vaccine safety given the trials undertaken and cannot wait until I can be vaccinated and return to some normality.
I am already booking events for 2021 as I see the pandemic steadily reducing in impact as it is estimated that over 90% of deaths will be prevented by the very first wave of vaccinations. With every subsequent wave of vaccination, care home patients, then over 80s, over 70s and so on, the impact will continue to lessen. Younger people will continue to become infected mildly and will build on herd immunity provided by the vaccine and past infection with covid. There is an end to this pandemic, and it is approaching rapidly. Have. Very Happy New year.
Dr Allan Fox
Recent Comments