In the movie, “Contagion,” scientists and government officials toil tirelessly to rescue the world — and Gwyneth Paltrow — with a vaccine. In another film, “I Am Legend,” a miraculous cure for cancer lets loose a virus that turns most humans into vampires — except Will Smith.
These were entertaining portrayals of our love-hate relationship with science and technology. There’s nothing we can’t do if we work together. Or, there’s no such thing as a free lunch. Where are you?
Today, Americans are facing this dichotomy and being forced to decide this question with a vaccine choice, even if they haven’t figured out which team they are on.
Americans were told a year ago that the way out of the COVID-19 pandemic would most likely come from a vaccine — social distancing not withstanding. We were also told that there were already vaccine scaffolds out there that would shorten the wait from the decades it took for a polio vaccine to maybe just a year.
In fact, the first vaccines rolled out in less than a year. When the one-year mark arrived for COVID-19, however, many of us had not been able to get one. And when the vaccines become widely available, many of us will not be willing.
As of March 6, the latest data from the state, 46.8% of people 65 and over in Charlotte County had received at least the first dose of a vaccine. Of the total population in the county, 22% had gotten at least the first dose. A higher percent of people 65 and over in Sarasota County had received the first dose — 55.8%. About 24.7% of Sarasota’s total population had received the first dose. In all of Florida, 58.6% of people 65 and over have gotten at least one dose and 16.5% of the entire population has gotten one dose, and 16.5% of the state’s total population has at least one dose. DeSoto County has 36.9% of its people 65 and over getting at least one dose, and 11.7% of the total population. Charlotte County was frustrated earlier that a smaller percent of its elder population had been vaccinated. Indeed, Miami-Dade County, as of March 6, had vaccinated almost 60% of people over 64 with at least one dose, but only 15% of the total population.
How long have vaccines been around
When the first vaccine was developed, people didn’t often live long enough to worry about the long-term effects. It was 1796. That’s when the widespread and successful small pox vaccine was developed. They used the Latin word “vacca” for cow, because they thought they had developed the vaccine from cow pox.
Small pox is now considered to be eradicated, but vaccination protocols remain as world leaders fear the use of small pox as a biological weapon.
The prospect of mass vaccination has led many to contemplate everything that could go wrong. While some are optimistic, others dwell on human foibles or the great unknown.
In the early 1800s, it was hard to transport the new vaccine for small pox without refrigeration. So they tried simply touching one person’s vaccination sore to another person’s opened sore. The unintended consequence was that some people were also infected with such blood-borne diseases as syphilis.
In the 1955, when mass vaccination for polio began, a scientist working for the U.S. government wrote an urgent report saying one of the vaccine manufacturers, Cutter Laboratories, had not properly inactivated the virus. Test monkeys were dying after being vaccinated. Her report never made it to federal regulators and that batch of vaccine was distributed. Five children died of polio and 51 were paralyzed before that manufacturer was cut off.
What has gone wrong so far with the COVID vaccines:
A doctor in Miami died in January from a rare autoimmune blood platelet response several weeks after a Pfizer vaccine. This is a rare but known side effect of certain vaccines including the measles vaccine. It is usually treatable. Not long after the doctor’s death, a woman in Queens, New York had the same uncontrollable response. In this case, doctors from around the country plus the Miami doctor’s wife recommended new strategies to physicians handling the case in Queens. Perhaps due to this collaboration, the woman in Queens survived as did a woman in Texas.
An Australian COVID vaccine was abandoned during testing even though it appeared to be effective. It caused some people to test positive for HIV, although they were technically not infected by that virus. The vaccine technology employed an inactivated AIDS virus. The Australian government decided no one would agree to be vaccinated so they halted that vaccine.
Arguments about vaccines, real and imagined
People worry about whether vaccines will affect their fertility, and COVID vaccines have not yet been tested on pregnant women. That testing is due to begin soon. Initial research on lab animals found no effect on fertility.
Bill Gates’ foundation actually did fund research before the pandemic at the Massachusetts Institute of Technology to insert vaccine microchips like tattoos, according to an MIT press release. This was for places in the world without medical records, to help them keep track of who had been vaccinated. Gates’ foundation is focused on vaccination in technologically underdeveloped nations.
Measures of current effectiveness and safety
Experts remind us that the big measure of a vaccine out of the starting gate is called efficacy and it refers to how many people in the clinical study got sick with COVID-19, and whether they got the vaccine. Clinical trials take time, because you have to wait until enough people get sick to have statistically significant numbers. The current pandemic was helpful in that way, providing lots of opportunity to be exposed and get sick.
Efficacy is not the same as “effectiveness,” in the vocabulary of epidemiology. Measures of effectiveness come later, with results in the broader population. Effectiveness of COVID-19 vaccines is still uncertain.
Scotland claimed victory in late February, however, with early measures of effectiveness for Pfizer and the United Kingdom drug by Oxford-Astrazeneca. With only one dose (the policy in the United Kingdom) the chances of being hospitalized with COVID-19 were reduced 94% for Astrazeneca and 85% with Pfizer.
While mRNA vaccines measured much higher in efficacy than Johnson & Johnson’s older technology in preventing all infection, the differences may only be in reducing mild disease. All three vaccines are considered equally effective at preventing severe disease and death, some experts say.
“Waiting for a more effective vaccine is actually the worst thing you can do to lower your risk of getting severely ill and dying of COVID-19,” wrote the members of the Biden-Harris Transition COVID-19 Advisory Board, in a USA Today opinion piece in mid-February. “The vaccines were all 100% effective in the vaccine trials in stopping hospitalizations and death.”
One of the fears of Pfizer and Moderna is that mRNA vaccines are new. But using messenger RNA to control infectious disease or cancer has been in the works for decades, according to U.S. Health and Human Services. A 2018 review of the technology in the journal Nature — before the pandemic — considered mRNA vaccines potentially safer than some DNA vaccines in terms of genetic after effects.
“There is no risk of long-term genetic changes with mRNA vaccines,” Medical News Today wrote in February.
That’s because the mRNA vaccine cannot enter the cell’s DNA, and is quickly cleared by the cell. All vaccines so far seek to force the body to create immune cells to fight an infectious agent. mRNA vaccines also don’t contain any infectious agent, while some conventional vaccines do.
The J&J vaccine uses another virus, the adenovirus, as its mode to stimulate an immune response.
The biggest safety concern in the 2018 article was that scientists should make sure to control the level of effectiveness of mRNA vaccines so that they don’t generate autoimmune reactions.
In general, the 2018 Nature writers considered the mRNA vaccine a likely improvement in some aspects of safety and effectiveness over conventional vaccines. So far, the high effectiveness of the mRNA COVID vaccines has surpassed the effectiveness of COVID vaccines using conventional methods. These mRNA vaccines, however, have generated some cases of anaphylactic shock, none of which have been fatal. An autoimmune response killed the vaccinated physician in Miami, but Pfizer did not claim responsibility.
Perhaps the most compelling aspect of mRNA vaccines is that they are far easier to develop and manufacture. You don’t have to grow them in a chicken egg or other complex problems in conventional vaccines. Aside from the potential for corporate profit, a vaccine that is quicker to develop and produce could save more lives in a deadly pandemic. Pfizer’s vaccine was ready to roll in December, while Johnson & Johnson has said it will not have substantial supplies until the end of March.
Currently approved vaccines elsewhere in the world
- Oxford-Astrazeneca, adenovirus vector, in UK, EU
- Sputnik V, adenovirus vector, Russia
- Convidecia, adenovirus vector, China
- Sinovac, inactivated coronavirus, China
- Sinopharm, inactivated coronavirus, China
- Covaxin, inactivated coronavirus, India
Effectiveness with new mutations of the coronavirus
According to a Feb. 2 article in STAT, Johnson & Johnson’s vaccine was actually tested under tougher conditions. J&J began testing when the number of cases was far higher, and genetic variants had taken hold in Great Britain, South Africa and Brazil. J&J tested the vaccine in all these locations, and it proved acceptably effective even in the toughest variants.
Pfizer and Moderna were not tested in such difficult circumstances. But Moderna is able to start adjusting the vaccine for the new variants, and the speedy development and manufacturing profile could come in handy.
While mRNA vaccines speed the process of development, it’s still a painful delay. Since 2014, the prospect of a universal coronavirus vaccine (including the common cold) has been an option that no one was pursuing, according to the British magazine New Scientist. The outbreaks of deadly coronaviruses like MERS and SARS fizzled out. Things have changed. At least two labs are working on a universal COVID vaccine now, and plan to start human testing by the end of the year. One of the labs is the government’s Los Alamos National Laboratory Labs in New Mexico. The other is a private lab in Massachusetts, VBI Vaccines.