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Table of Contents
LETTER TO THE EDITOR
Year : 2021  |  Volume : 12  |  Issue : 2  |  Page : 103-105

Fighting COVID-19 with vaccines – The perspectives of a medical student


Department of Biomedical Sciences, School of Medicine, University of Missouri, Kansas City, MO, USA

Date of Submission13-Feb-2021
Date of Acceptance16-Feb-2021
Date of Web Publication30-Mar-2021

Correspondence Address:
Ms. Anuhya Dayal
School of Medicine, University of Missouri, Kansas City, MO
USA
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/injms.injms_22_21

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How to cite this article:
Dayal A. Fighting COVID-19 with vaccines – The perspectives of a medical student. Indian J Med Spec 2021;12:103-5

How to cite this URL:
Dayal A. Fighting COVID-19 with vaccines – The perspectives of a medical student. Indian J Med Spec [serial online] 2021 [cited 2021 Nov 29];12:103-5. Available from: http://www.ijms.in/text.asp?2021/12/2/103/312623



Dear Editor,

2020, the year of many hopes, many milestones, and many memories took a drastic turn for the unexpected early on. January 21, 2020, the first COVID-19 case was detected in Washington, USA,[1] a seemingly isolated occurrence, something to ignore as a passing headline. And yet, here we are today, eyesight degrading on Zoom, social ability degrading in solidarity, and the hope for a world without this virus degrading with each passing second. I am a high school graduate of the class of 2020 – a fun number we once bragged about but ultimately become historic in a completely opposite way.

I'm now a freshman in a 6-year BA/MD program at the University of Missouri Kansas City. COVID-19 has resulted in an otherwise exciting and engaging experience to be riddled with safety concerns and an unusual excessively optimistic approach to the formerly basic in-person interactions. While Zoom lectures do allow us all to study from the comforts of home, learning human anatomy on a completely online platform, never once touching models let alone working with real tissues leaves us wanting to learn more, and raises doubts about our comprehensive skills as medical professionals. As a student of science, I understand the need to stay home and stay safe but simultaneously long to study in the laboratory for the very reason of studying science further. These internal conflicts regarding the scientific thing to do, and the intrinsically desirable thing to do, is what has caused people around the world to make difficult decisions, decisions we don't know the right answer to.

However, science tells us the clear answer to this pandemic is a vaccine – the same way we've combatted viruses for centuries. The practice of variolation began in Asian medicine to help prevent the deadly effects of smallpox, dating back to the 16th century. The first official smallpox vaccine was developed by Dr. Edward Jenner in 1796, when he purposefully infected patients with cowpox, a milder relative of the smallpox virus, and noticed that these patients developed immunity against the smallpox virus.[2] Since then, various untreatable and deadly diseases, including but not limited to polio, measles, mumps, rubella, diphtheria, pertussis, influenza, human papillomavirus, and many more have been successfully combatted with vaccination. Sars-Cov2 is much the same, a virus – so the tried-and-tested solution is evident: creating a vaccination.

And create a vaccination they did – one of the fastest and truly admirable accomplishments of modern medicine. Today, in the United States, the Pfizer and Moderna vaccines are currently in distribution throughout the country; the Oxford vaccine is currently being distributed across the UK and various other countries. Typically, vaccines entail the introduction of weakened virus or inactive protein into the body so that our immune system can create the necessary antibodies to combat the virus if ever encountered again in future. The Oxford vaccine was created in this manner, taking an inactivated “spike” protein, or COVID-19 identifier protein. However, Pfizer and Moderna decided to take a newer route – an mRNA vaccine. This process involves introducing the body to a piece of viral genetic material (mRNA) that will then infect our body's cells and produce the COVID-19 spike protein. Then, our body will be able to react and create the necessary antibodies to combat it. Essentially, it involves introducing our bodies to a very limited and controlled amount of virus so that we can develop the natural protections needed to be safe if infected with higher and unpredictable viral load in future. While the mRNA vaccine has been widely studied and explored, this is the first time it has been commercially implemented as a vaccine, making it both a cause for concern but immense commendation.

In the United States, a country with the highest number of COVID-19 cases in the world (around 27.2 million cases),[3] a cure would be a godsend; a vaccine is the next best thing. While I will do my best to not focus on political viewpoints, an issue of public health that should be impartial has been largely politicized and influenced by leadership on both sides of the spectrum. Mask-wearing and social distancing policies are debated and inconsistently followed, individual states have their own unique and sometimes conflicting policies, and the general public is left either uninformed, misinformed, or unsatisfied. Poor handling of this pandemic early on led to the spread we see today, and it is at the point where a vaccine is possibly the only practical tool the country can depend on to minimize further spread. As people are fed up with the past year of isolation, implementing stricter quarantine policies and impeding the reopening of business will not achieve much; rather an efficient and effective distribution of the vaccine, along with a detailed, consistent, and reliable source of impartial information is required to unite the people in combatting this pandemic.

Personally, I think distributing the vaccine is only half the battle – it is vital that the CDC establishes a more effective and reachable communication platform to inform and educate the public of the nature of this virus, and how a vaccine works against it. Helping people understand how the virus works will help quell anti-vaccination sentiment and encourage people to take precautions (namely mask wearing) more seriously.

Vaccination, across the world, can serve as a short-term security blanket against COVID, hopefully buying the population time and herd immunity to survive another few months before the virus mutates into a new threat. After rounds of this process, it is possible that COVID-19 will be eliminated and go down into the history books next to smallpox and the Spanish flu. However, more likely is that the COVID-19 virus won't leave our population anytime soon. We will have to take a yearly or biyearly vaccine (just like influenza) and focus on methods to build internal immunity (eating vitamins, improving overall health). Mask wearing in tight areas of public transport will likely carry on for many years, becoming a new generational habit in light of the new awareness of pathogenic threats (I know I will be wearing a mask whenever on an airplane far into future).

However, despite these obvious benefits, abundant anti-COVID-19 vaccination sentiment remains. Disregarding the anti-vax movement that has been growing in the United States over the past years (concerning MMR), these hesitancies around specifically the COVID-19 vaccination hold validity, and here's why. This virus has required speed, efficiency, and efficacy, and in effort to meet all these necessary goals, most of the companies have created a novel mRNA-based vaccine, something that has been studied in the laboratory but has no prior research or longitudinal studies completed. In addition, the average vaccination development process once took about 10 years. A combination of technological advancement and imminent need contributes to accelerated vaccine development; the closest recent parallel I could think of was Ebola. The first serious outbreak of Ebola occurred in 2014, and then again in 2016,[4] and while vaccine development had started right away, it wasn't until November 2019 the Ebola vaccine was approved for use by the European Commission.[5] While Ebola wasn't a pandemic and had been adequately contained to the areas of origin, it was still a deadly threat that plagued news headlines. Looking at the SARS CoV-1 epidemic of 2003, the epidemic ended pretty quickly due to effective quarantine and quickly developing symptoms, but the vaccine was still in clinical trials in 2007, 4 years later.[6] The COVID-19 vaccine has been developed at rapid speeds, and it is simply too soon to tell if this is scientific greatness or a great scientific mistake.

By speeding through the trials, getting accelerated grants for production, and utilizing a strategy studied only in laboratories, but never implemented in society is risky, and there could be complications and side effects that science can't foresee. What if there is a long-term impact on the immune system? How will this hold up against new mutant strand? Will the long-term side effects of the virus be present in the vaccine? The logic is perfect on paper, but there are simply too many unknowns in reality.

Personally, I've been an advocate for vaccines my entire life. I understand their immense medical value and the way they work to build immunity, and for those reasons, I am still an advocate of vaccination. Despite my being a pupil of the medical field, I would be lying if I said I wasn't hesitant or concerned about the novelty and rushed nature of this particular vaccine's development. Furthermore, I am concerned about the length of efficacy – if immunization lasts only 3 months, should not the focus be toward producing a vaccine with longer lasting benefits? But, these concerns do not overpower the one underlying truth about the pandemic: the vaccine is our only hope. While it is not the best option, and I'm not 100% confident, right now the vaccine is the only option we have to stopping this pandemic quickly. While I like to trust the facts, look at the logic, and make calculated decisions, sometimes, even in science, we have to take a leap of faith.

And so, I conclude these conflicting, confused, and concerned thoughts with one glimmer of optimism: we are resilient. Whether the vaccine is a huge success or not, humanity will persist, learn from this experience, and grow stronger for it. Let 2020 be not only a sign of our greatest weaknesses and challenges but also a sign of our greatest initiatives, achievements, and strengths.

Financial support and sponsorship

None.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
AJMC Staff, A Timeline of COVID-19 Developments in 2020. Available from: https://www.ajmc.com/view/a-timeline-of-covid19- developments-in-2020. [Last accessed on 2020 Feb 16].  Back to cited text no. 1
    
2.
Riedel S. Edward Jenner and the history of smallpox and vaccination. Proc (Bayl Univ Med Cent) 2005;18:21-5.  Back to cited text no. 2
    
3.
John Hopkins University and Medicine, Cumulative Cases; 2021. Available from: https://coronavirus.jhu.edu/data/cumulative-cases. [Last accessed on 2020 Feb 16].  Back to cited text no. 3
    
4.
Kamorudeen RT, Adedokun KA, Olarinmoye AO. Ebola outbreak in West Africa, 2014-2016: Epidemic timeline, differential diagnoses, determining factors, and lessons for future response. J Infect Public Health 2020;13:956-62.  Back to cited text no. 4
    
5.
European Medicine Agencies, New Vaccine for Prevention of Ebola Virus Disease Recommended for Approval in the European Union. Science Medicines Health. Available from: https://www.ema.europa.eu/en/news/new-vaccine-prevention-ebola-virus-disease-recommended-approval-european-union. [Last accessed on 2020 Feb 16].  Back to cited text no. 5
    
6.
National Institute of Allergy and Infectious Diseases (NIAID), SARS Coronavirus Vaccine (SARS-CoV); 2007. Available from: https://clinicaltrials.gov/ct2/show/NCT00533741. [Last accessed on 2020 Feb 16].  Back to cited text no. 6
    




 

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