AT the start of the first national lockdown last year, family doctor Jane Wilcock was looking forward to the day there would be a scientific breakthrough against coronavirus.
Now that day is here with the successful development of vaccines.
GP Dr Wilcock, who lives in Harwood, explains everything you need to know about the injection— from the science to receiving a jab — in the latest in a series of occasional articles for The Bolton News to keep people informed during the coronavirus pandemic.
SHOULD I HAVE A COVID-19 VACCINE?
YES! SARS-CoV-2 is a very infectious respiratory virus.
We all remember the horror of hearing that we had reached 300 deaths at the end of March 2020, as we locked down and watched case numbers and deaths rise. I am writing this article on a day of 1,243 deaths in the UK.
For each ill person there is anxiety amongst friends and family, grief, and some people have continuing symptoms, unable to regain their previous health easily and at high prevalence society locks down.
Vaccinations trick the body into thinking it has been infected and our cells later recognise and destroy the live virus if we do get infected, preventing illness. Our children are vaccinated against polio, mumps, measles and rotaviruses to name a few.
(Michael and Ann Clubley, first to receive the jab in Bolton)
WHO IS BEING IMMUNISED?
At present the priority is to vaccinate the over 80 year olds, including those housebound or in residential care, and frontline health and social care workers. Then invites reduce every 5 years and start to include the extremely vulnerable people of younger ages.
COMING TO THE VACCINATION CENTRE.
There is a large vaccination centre at the Etihad campus and NHS England has written inviting some residents for vaccination.
However, if it is too far away, more and more local centres are opening up in Bolton and you will get a local invitation.
Ensure you continue with hygiene measures travelling to the vaccination centre and back.
Read more: Every vaccination centre in Bolton
Postpone the vaccination if you feel you have an infection.
Bring a list of medications and allergies.
Have an emergency contact name and phone number ready to prevents delay booking in.
If you have allergies or are on an anticoagulant tablet or injection, or have a known bleeding tendency let the vaccinator know.
You will be asked about these things before your injection.
Wear a loose sleeve which comes right up to your shoulder so you aren’t struggling to find your deltoid muscle!
If you cant have an upper arm injection tell the vaccinator (this is usually because of previous breast cancer lymphatic surgery).
After the vaccination, wait until told you can go — waiting times vary according to the vaccine given.
Side effects are like the flu jab, there may be soreness at the injection site, aching, headache, fatigue which are mild and a paracetamol can be taken if needed. There is a ‘covid yellow card’ scheme online to report side effects.
(Colleen Bowness receives the jab at Old Vicarage Care Home in Bolton)
WHEN IS THE SECOND DOSE?
There will be a delay of up to 12 weeks.
My second dose was cancelled hours before it was due. Pwfft!
However, it is the right decision. One vaccination gives 89 per cent efficacy (Pfizer) and 73 per cent efficacy (Astra-Zeneca) so by immunising two people and not one there is good antibody response and we can reduce infection rates, admissions, deaths, reduce transmission and also keep the NHS running for other illnesses.
CAN YOU GET COVID-19 FROM THE VACCINE?
No. Currently there are three vaccines available in the UK, they have been studied by the Joint Committee on Vaccination and Immunisation (JCVI) and the Medical and Healthcare products Regulatory Agency (MHRA) and have been given approval— Pfizer BioNTech, Oxford Astra-Zeneca and Moderna.
The first vaccine used in the UK is by PfizerBioNTech. If you have ever bought aciclovir for a cold sore, you may have bought a Pfizer product. Pfizer teamed up with a biotechnology company, BioNTech, in Germany. This was founded by a Turkish immigrant, Ugar Sahin and his wife. He is a cancer therapist and the company has been developing immune therapies against cancer – cancer vaccines in effect - using ribonucleic acid (RNA).
We have heard of DNA, but before COVID-19 might not have realised that DNA is translated to messenger RNA (mRNA) and this codes for specific proteins.
Within a few days of receiving SARS-CoV-2, biotechnology companies around the world found the RNA sequence to viral S protein, or Spike protein, as this is key in infecting our cells.
The company placed the mRNA code into small fatty orbs and trialled it on animals, then humans, all in line with world- wide and UK regulations.
I have had one dose, injected into my upper arm muscle and apart from a slightly sore arm to sleep on that night, there were no side effects. However, inside me the vaccine was taken up into some cells who decoded the mRNA to produce spike protein, which my immune cells then reacted against, realising it was not my protein and produced antibodies.
This happens over one to two weeks and the mRNA dies off.
My antibody producing immune cells don’t die though, they become memory cells so if I get infected I am now primed to recognise and attack the virus and have a much less risk of becoming ill.
Pfizer vaccine is stored at -70 degrees Celsisus before thawing and reconstitution, which makes transport to vaccination centres difficult. GP vaccine fridges run at 2-8 degrees Celsius.
The Moderna vaccine, produced by a biotechnology company in US is just authorised, but not yet shipped to UK and doesn’t need to be quite as cold, yet other companies are exploring creating mRNA vaccines without cold storage problems.
A more stable vaccine which we can store in GP fridges for months, is the Oxford Astra-Zeneca vaccine. Astra-Zeneca is a British-Swedish pharmaceutical company.
Some readers with asthma or COPD may have a Symbicort inhaler, they make a large number of medications.
In 2018 Oxford university was funded to produce a vaccine against MERS and reused this technology against SARS-Cov-2 teaming up with Astra-Zeneca. The vaccine is manufactured in the UK and has been passed for use in India too.
This vaccine uses DNA which codes for spike protein and is placed into a chimpanzee cold virus cell, modified so it cant reproduce. However, once vaccinated our bodies take the adenovirus into a cell to destroy it and the DNA then codes for production of mRNA and then spike protein, which our bodies recognise as not ours and we produce the immune cells to create antibodies against it.
There are lots of other vaccines on the horizon, some contain viral protein, some whole inactivated virus.
They are all injected into muscle, although one company is exploring a patch to deliver the vaccine.
Dr Wilcock (pictured) said: "In March 2020 I wrote an article looking forward to treatments and vaccines. Thank goodness that time has come."