As we approach the end of 2020, I think that we can all agree that this year has been a challenge on many levels.
The COVID-19 pandemic has infected millions and resulted in the deaths of hundreds of thousands in our country. Meanwhile, it has disrupted lives and livelihoods.
Yet there is now a glimmer of hope with the recent arrival of two safe and effective vaccines, one from Pfizer/BioNTech and one from Moderna.
These vaccines are both built on the same type of “messenger RNA” (mRNA) platform that has existed for over a decade and has been used in both cancer and vaccine research previously. It was waiting and ready when the pandemic hit at the beginning of the year.
These mRNA vaccines were produced from synthetic genetic material designed to teach our bodies to make a single protein from the virus, the so-called spike protein that enables the virus to attach to and infect our cells.
The mRNA message is encased in a greasy “lipid” sphere envelope that carries the message into human muscle cells. Once inside the cell, the message is used by the cell to create the viral protein to train our immune system to recognize it so that if exposed to the actual virus, our body can defend itself.
The mRNA never enters the cell nucleus (where our DNA resides) and therefore does not affect our genes. Moreover, the mRNA is rapidly degraded within hours after it has done its job.
Both the Pfizer/BioNTech and Moderna vaccines have been extensively studied, following all the scientific rigor applied to other vaccines. The time to produce the candidate vaccines was reduced because it did not require the growth of live virus – only the sequence of one viral protein.
Moreover, much was already known about that coronavirus spike protein from previous coronavirus epidemics over the last two decades, including the closely-related SARS and MERS outbreaks. As a result, scientists had a “head start.”
The safety profile of both COVID-19 vaccines is similar to one another and to other vaccines. The most common side effects include arm pain, headache, muscle or joint pains and fatigue. When they occur, these so-called “reactogenicity” symptoms are typical of the normal and desired immune response to the vaccine.
While serious adverse events have been quite rare in clinical trials, scientists are studying the occasional reports of anaphylaxis from Europe and the United States. Precautions are in place for those most at risk. Most importantly, the U.S. has the most robust vaccine safety monitoring system in the world.
As a front-line health care worker, I have already received my vaccine, and I can’t wait until there is adequate supply for everyone, including my family. That said, the initial focus will be on those most at risk.
We finally have a new tool in our toolbox, along with the still-important public health tools of mask wearing, physical distancing, hand hygiene and avoidance of gatherings. This new tool holds promise of ending the pandemic if enough people are willing to get vaccinated.
Dr. Matthew A. Clark is a board-certified physician in internal medicine and pediatrics practicing at the Ute Mountain Ute Health Center in Towaoc.
