Barts-MS rose-tinted-odometer: ★ (Black & White Friday)
As the delta variant of SARS-CoV-2 is surging it is putting residents of Whitechapel at serious risk of getting COVID-19.
This is important because the vaccination rate in Whitechapel is so low; less than 30% of adults have both dose of the COVID-19 vaccine.
Why is the uptake of vaccines so low in our local community?
Vaccine hesitancy is very high in Whitechapel and the reason are complex. If you can do anything to encourage people to get vaccinated please do. We in Barts Health NHS Trust and the Royal London Hospital are bracing ourselves for another surge of COVID-19 admissions, but the knock-on effects on other services, including our MS service, will take its toll on staff and people with MS.
The following are a some answers to questions that vaccine hesitators may ask. if you are a hesitator are there any questions I have missed out?
The following Questions and Answers have been adapted from the Quinn & Andrasik perspective in this week’s NEJM.
How did these trials move so quickly?
Researchers used existing clinical trial networks.
Manufacturing started while the clinical trials were still underway.
Adenoviral and mRNA vaccines are faster to produce than traditional vaccines.
Other sponsors use platforms that have proven successful in the development of vaccines.
The studies included more participants than a typical study and disease transmission rates were high, enabling researchers to determine efficacy in a short time.
The MHRA prioritized review, authorization, and recommendation of Covid-19 vaccines.
Were vaccines tested on people like me?
Vaccine trials included all adults >18 yr of age.
It was mandated that a large number (~20-25%) of participants in most trials had to be >65 yr of age.
Study participants included ~25% of people with common health problems such as high blood pressure, diabetes, HIV, and cancer.
There were no exclusions for diseases or medications, except immunosuppression.
Vaccine studies did not include pregnant people.
Do these vaccines work for all races/ethnic groups?
Yes. There is strong evidence that the vaccines work well for all people, regardless of their genetic background.
What types of reactions have been reported after vaccination?
Common reactions: Sore arm, headache, aches, fever may appear within 48 hours. These are similar to reactions seen after shingles and influenza vaccines.
Rare reaction: anaphylaxis, blood clots
Current recommendation: 15 minutes of observation after injection
If you have a history of severe allergies or an anaphylactic reaction to a vaccine, it’s recommended that you discuss vaccination with your provider and undergo 30 minutes of observation after receiving the vaccine.
Most people with a history of allergies or anaphylaxis have received a vaccine with no issues.
Should I get a vaccine now or “wait and see”?
You should be vaccinated as soon as possible.
You are not the first: Over 1 billion people have received COVID-19 vaccines
Immunity takes time to develop and you are only maximally covered against the new variants of the virus about 2 weeks after your second or booster dose of the vaccine.
Please note the new Covid-19 strains are more contagious and cause more severe disease than the old variants.
Does mRNA and adenovirus DNA change your DNA?
No; mRNA and adenoviral DNA is a signal to your cell. It stays in the outer part of the cell and does not enter the nucleus where your nuclear DNA is located.
The mRNA and adenoviral DNA in the vaccine is present in the body for only 1–3 days; then it degrades and the immune system is primed and ready.
I’ve heard that the vaccines ….?
No, it will not give you Covid-19.
No, it does not affect women’s fertility.
No, it does not contain fetal tissue, microchips, or any other devices.
Which vaccine is the best?
All the vaccines are very good at preventing severe disease, so they will greatly reduce rates of severe disease progression, hospitalization, and death. When you are offered a vaccine, you should take it. Because the adenoviral vaccines are associated with rare blood clots, which is mainly in younger people (<30), it is recommended that young people have the mRNA vaccines (Pfizer or Moderna).
Why do I have to wear a mask after getting immunized against Covid-19?
The vaccines prevent Covid-19 disease, severe disease, and death.
We know much less about whether vaccines prevent asymptomatic infection, as this question was not studied. Until we know that, we must assume that vaccinated people might get Covid-19 and not know it.
Masks, social distancing and handwashing are still required until we have more information.
Is one dose of vaccine as effective as two doses?
The data are very clear that the best protection from Covid-19 disease happens after the second (booster) dose.
The first dose starts the immune response, and the second dose boosts it to make high antibody levels.
How long does vaccine immunity to Covid-19 last?
We don’t know. Covid-19 is a brand-new human disease, and we will need more time to determine how long vaccine responses last.
How will viral mutations affect Covid-19 vaccines?
Current vaccines work well against the variant originally identified in the UK.
There seems to be some reduced efficacy for the variants originally identified in South Africa, Brazil and India.
The vaccines are still highly effective in preventing severe disease (reducing risk of being hospitalised, requiring supplemental oxygen, needing a ventilator) and death.
The vaccines may not prevent you from getting mild symptoms, but they will prevent severe disease.
Please get out there and become a pro-vaccine warrior. The sooner we flatten the tail of this pandemic with vaccine immunity and not herd immunity form wild-type infection the lower the risk of immune escape variants and the fewer deaths.
Quinn & Andrasik. Addressing Vaccine Hesitancy in BIPOC Communities — Toward Trustworthiness, Partnership, and Reciprocity. N Engl J Med 2021; 385:97-100.
General Disclaimer: Please note that the opinions expressed here are those of Professor Giovannoni and do not necessarily reflect the positions of the Barts and The London School of Medicine and Dentistry nor Barts Health NHS Trust and are not meant to be interpreted as personal clinical advice.