The best protection against anti-Vaxers…is knowledge.

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Want to learn about the new vaccine in the news. Watch the video from Dr Professor Roger Seheult from Webcram below. The information starts at 2min and is 20minutes long. The first is the Pfizer (/BioNtech) vaccine. They are doing 3 more and I will post them as they arrive.

#MSCOVID19

The Medcram team have done an amazing job of educating me during the COVID-19 pandemic and were acknowledged in our recent COVID19 paper

No sooner had the TV news of a successful vaccine finished when we got our first Anti- VAXers warning about the dangers of COVID-19 related vaccination. spouting “Learn from your history.”……The last time I used those words was when I wrote a song in 2011. However, my song about terrible events that year and went “Learn from your history or tomorrow more innocents will die”….

This may be an apt starting place to respond. Indeed I am sure we know about the loss of life with the black death in 1346-1353, the great plague in London in 1665-1666 and the Spanish Flu in 1918, which killed my great gran (in her youth) and left my nan orphaned after great grandad was killed (20:09:2014 one of the unlucky 71) in France 1914.

Now in the time of COVID-19 it is the nan’s and grandad who are getting it again, this time in their old age.

Age is the major risk factor for a bad prognosis with COVID19 and disability is the major risk factor for people with MS.

Age (1,7 times increase) and disability (I.7 times increase) increases risk of hospitalisation
Age (3 times increase) and disability (6 times increase) increases risk of death

The best way to protect such people is for them not to get the SARS-CoV-2 virus. Failing that you want an immune response that can deal with it.

This is the basis of vaccination in that you use a non-infective piece of the offending virus and give it to people so they make an immune response against it..so much so that if you get infected you eliminate the virus before you have a chance to infect someone else….it may not be your nan, but it could be someone elses nan.

In March there was no vaccine and we have now accumulated over 1 million deaths as a consequence of COVID-19 and financial ruin for many more. Vaccines have the potential to stop you from getting symptomatic infection and may help save you from a fatal infection. Some people think they are invinsible and will not risk a vaccine. This may help keep the virus circulating with more consquences for the economy and peoples future.

What are you going to decide?

Will you have the COVID vaccine or not?

For MS there is another level of complexity about when you will be offered a vaccine and what type of vaccine will you be offered.

What is clear is the suggestion, from an anti-VAXers, that the Government will enforce vaccination is unlikely…after all there are 60-70,000,000 people in the UK and they are only going to get 10,000,000 doses this year and another 30,000,000 next and as it is two doses of vaccine 3 weeks apart that is only 5,000,000 people. If health care professionals get it first then that leaves 3,000,000 so let’s face it that is not enough to go round.

You may say that you want to wait until more people have had it. Normally about 800-1000 people will be in pivotal MS trials. In a vaccine trial maybe 3,000 people are recruited and then you see rare side effects when the drug is approved. To date there have been over 44,000 people involved in the Pfizer vaccine study (www.raps.org). Therefore the wait for more people is a non argument. The vaccine often refered to as the Oxford Vaccine has over 40,000 participants (www.raps.org) and the Johnson and Johnson vaccine has a planned 60,000 participants (www.raps.org). So the side-effect profile is going to be known for each of the agents.

These are generally injection site reactions and fatigue, which is probably a response to cytokine (immune response) production as a result of your immune system being activated. It is a standard sickness behaviour. Also these could be worse because remember 50-80% are asymptomatic and have no clear evidence of infection but they will probably be immune and cause injection site reactions. For those used to beta interferon, I suspect you will say”So what, No Big deal”. It takes about 3-4 days to make a T cell response and 6 days to make a B cell response so a week after injection you will get rid of the stuff in the vaccine…Result sore arm.

Vaccines in Phase IIII testing (www.raps.org)

There are curently three main types of vaccine

(a) RNA vaccines. This is a new approach. RNA makes protein and this protein generates an immune response. There is no biological reason why it should be an issue for people with MS. RNA is easily destroyed and so it has to be stored really cold. This creates logistical issues and so there will be some countries that will be low on the availability list I suspect. Once the RNA has made the protein it is gone forever. We have heard the preliminary results form one variant. I understand a second variant is close to completion too.

When you hear anti VAXers spout forth challenge to name their source, it should be a valid on and because it says it on an anti vaxer website is not a reliable source

(b) Adenoviral vaccine. This is a new approach. It involves a live adenovirus that has a cornonavirus protein. You will destroy this adenovirus and make an immune response to coronavirus in the process. This is replication defective so it cannot make an infection. Also they do not go into the DNA so once the immune response trashes it, its gone. I suspect that this may not be used in people taking immunomodulatory drugs until the MS-drug manufacturers show that it is safe. In immunosuppressed people this may not get removed as quick. Is this a good thing. On saturday I contacted ProfG to say that he should get onto the manufactures to suggest that the UK is the best place to do these studies. We can measure the antibody response. Hope he wasn’t thinking about this when he had his accident. This is UK vaccine.

(C) Protein and adjuvant. This is just like standard vaccines that we know and love. These are starting their final tests now. The manufacturing processes for these types of agent are worked out. One manufacturer makes some MS drugs so they can easily test effect on their drugs. This may be ready by spring 2021.

I saw a corporate presentation the other week and the claims were this may make higher antibody levels. I’ll look into this There should be not reason why it should not be used in MS.

The main concern will be whether MS drugs inhibit the formation of the protective immune response. This is going to be a T and a B cell response. Will certain MS drugs influence this. I am sure some will and this is why the manufacturers need to check this and check it quickly

How much antibody do you need to get rid of the virus? This can be answered in studies with protective monoclonal antibodies. One was approved in the US this week, another is surely very close to approval too.

I am going to post some videos of the major vaccines. Just as you come here to hear an MS expert…no not me, ProfG. So if you want to hear about COVID-19 I go to a respiratory doctor.

So I post an educational video about the new pfizer/BioNT vaccine. Watch this video about the vaccine, it explains how it works, and its side effects

Watch and learn about the new Pfizer vaccine. Search Medcram 116 for the YouTube video

About the author

MouseDoctor

15 comments

  • Thank you Mousedoctor. I agree that Knowledge is our best defense from fear and inaction. Interesting fact, both Moderna and Pfizer are doing phase 3 trials in my area, in Texas US. https://www.houstonchronicle.com/business/houston-how-to/article/Want-to-volunteer-for-a-COVID-19-vaccine-trial-15464988.php. There were ads on T.v. Seeking individuals that are Covid negative without symptoms but have a household member that is positive. I assume this is in order to “challenge” the vaccine’s protectiveness ethically. Sadly, infected household members might not be necessary: community spread in high here. Texas just hit 1 million cases. Not sure what you all on the other side of the pond make of the lack of a national centralized response in the states, but it has led to disparate conditions between “red” or “blue” states. For ex. My child here plays her instrument in a marching band at football games, where many choose not to wear masks but my friend’s son in A “blue” state is not allowed to play his instrument at a football game, which she says has been reduced to a contactless game with no spectators. But all of us here need relief, and my hope is good data from these trials will show its safety and effectiveness, and most will jump on the band wagon to get out of this mess, regardless of being “blue” or “red”. P.S. I’m of northern wales decent, and am not the least grumpy.

    • :-). I guess it.is bye bye for the trumpster. On the other side of the pond I am sure we are sad that we will be losing such a good spitting image puppet.

      An interesting approach in Texas but likely to be a messed up study.

      I suppose there may be a chance to avert serious problems as they appear slowly. However if you have symptoms you have probably had the virus for a week you get symptoms call up they send people to see known infected people and you vaccinate you are talking a week probably 2-3 before you make antibodies.Is it too late. Vaccines work best if you get them before infection. So you will end up with a dog’s breakfast and you may get some nice injection site reactions. I suppose if it works then I will have egg on my face. There was a suggestion of challenge trials give vaccine and then infect

  • Extremely informative as always MD. Keep sharing your insights. This blog is the only place to find COVID related information specifically tailored to the MS community. (Well this blog and it’s sister….. the COVID micro site 🙂)

  • If you were on anti CD20 and a healthcare worker therefore likely to be offered the vaccine in the first rollout – would you accept the RNA vaccine?
    My thoughts are yes yes yes.

    I hope I’m not going to have to wait for MS bods to give a consensus about the RNA vaccine before I have it.

    Put me at the front of the queue thanks!

    • I am not a doctor.

      What do the MS bods know about RNA vaccines….as much or as little as Joe Smow….it will be uninformed opinion. The MS bods need to think about the adenovirus and get this tested asap.

      What have you got to lose, the vaccine may not give a good antibody response so ensure you have your bloods collected before and after, if you cant get this done locally write to Doctor Ruth Dobson we have got ethics to send blood spot cards to people with MS, just not the funds. I would think vaccination towards the end of the cycle has the best chance. You should ask your HCP to see if there is a national registry so that your actions informm that for others.

      If it doesnt work you may need another cycel of vaccinations

      The vaccine may boost your T cell response and this may give you protection.

  • If a healthy, covid vaccinated person is exposed to covid how long would it take for their immune system to kill it off, and would they be contagious during that time?

    • If the vaccination has worked well it will be gone within a day. In animals we know this from re-infection studies. If you are shedding virus you will be contageous but if the immune system is working well you may not even know you hav been re-infected. Obviously dat will emerge on this from the trials

  • Thanks for this. As a HCW with MS, the published hierarchy has set my head spinning a bit. Early access is great, but not sure whether they will exclude those with secondary conditions and if I even want it early doors! Hoping my neurologist will be able to tell me the best thing to do if/when I have to ring them to ask!

    • This is one reason why the MS community needs to be pro active and anyone getting the vaccine should inform. If the vaccine does not work it is pointless vaccinating thousands of people

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