It’s been a long time again since “pen to paper” on this blog – my daughter manages every week on her Tall Blonde Tales – lifestyle and cooking stuff – but then she is the younger generation plugged into the internet of things. As the old guy, the Indiana Jones equivalent – I do all the interesting stuff; I just don’t always remember to write it down to share. So here we go…….

This SARS-CoV-2 coronavirus has been with us for about a year and half now – truly a global pandemic having cost millions of lives and devastated countries, economies and families. We are in the midst of the third covid wave in South Africa and it would seem there are some learnings we have adopted and some that still elude those in charge. The conversation today is not the “Brazil versus Sweden” one (although that would be an interesting academic debate) – but rather my favourite myth busting approach now that we have covid vaccines in play and the tide is starting to turn.

Since Wakefield (a surgeon btw) started the anti-vax brigade with his fraudulent nonsense about autism in 1997, immune medicine has been making a good recovery and saving millions. All the global activity around coronavirus vaccines and their successful deployment finally probably warrants a brief unpacking of how these technologies work.

Remember that a vaccine is basically some protein or infectious agent stimulating the human body’s own protective immune response, thereby creating a prepared “ready to respond” scenario if a person is exposed to that particular agent. They’ve been around since the end of the 18^th century (so a lot longer than antibiotics actually) when Jenner used a cowpox viral inoculation to protect a child against smallpox. One hundred years later, around the start of the 20^th century, Pasteur’s work spearheaded using live attenuated viruses and protection against cholera and anthrax was developed. Specific to SARS-CoV-2, there are a number of traditional and new style vaccines in play. The trick includes achieving all the “vaccine ideals” of minimal side-effects, efficacy beyond a season and in most recipients, easy storage and transport and manufacture, etc.

The well established method of inactivating a virus to make the vaccine is being employed by a number of pharma companies (eg in China). This is how vaccines to influenza, hepatitis A and rabies are made. The actual pathogen is cultivated in large quantities (often in chicken eggs) and then inactivated. Thus it won’t actually cause disease but it will trigger an immune response. Many of the SARS-CoV-2 vaccines are protein-based, meaning they use just elements of the virus (no actual genetic material). These protein or subunit vaccines work similarly to the inactivated or attenuated vaccines by exposing the immune system to the viral proteins without causing disease. They can’t cause disease as the virus cannot replicate. Hepatitis B, shingles and the bacteria pertussis that causes whooping cough (yes, we can make some vaccines against bacteria, not only viruses) are vaccinated like this. Then we get viral vector vaccines – that actually use another non-replicating virus to deliver the SARS-CoV-2 genetic material to the human cells to trigger the immune response. Like a very clever camouflaged transport mechanism. The viral DNA is copied by the host. An adenovirus (which can also cause a cold, or pink eye, etc) is typically used for this and is being employed by AstraZeneca, University of Oxford, Johnson & Johnson and the Russian labs. The adenovirus has some code missing so it cannot replicate, but some of the vaccines may require a booster dose. Viral vectors have been around for decades, specifically for trying to get gene therapy right to treat certain cancers. J&J used their platform to make the Ebola vaccine this way. One could skip the viral vector delivery and administer actual viral genetic material (eg RNA) to trigger immunity. These are like the the ones from Moderna and Pfizer. The genetic sequence of SARS-CoV-2 was identified at the beginning of 2020 already and thus getting the first commercial mRNA vaccines was an incredible milestone.

More simply put – a lot of good science has gone into the development of these vaccines – and you, yes you – should be getting one as soon as possible. In many countries, the vaccines are already widely available thankfully. In some – like South Africa – there is still a phased approach mostly due to supply constraints. At least healthcare workers, the elderly and teachers have already mostly had the jab.

Every week I get asked to do some or other presentation to the “anti vaxxers” – so let me just summarise as bluntly as possible.

• no, you cannot get cancer from the covid (or any) vaccine. There is no logic to link a natural boost or stimulation of immunogenicity and abnormal cell growth.
• no, the government (or aliens, or anyone else) isn’t tracking you via a microchip implanted at the time of vaccine
• all the current major vaccines have a reasonable degree of protection against the current strains of the virus. One should appreciate that the variants we are seeing of the SARS-CoV-2 virus (alpha through lambda and counting) are normal viral behaviour. Many viruses change (or mutate) as a natural survival mechanism, and thus will select out the more transmissible, more “infectious” or more “successful” versions. Over time, newer versions of the vaccines will simply play catch up to deal with the newer versions of the virus. The seasonal ‘flu vaccine is a good example.
• there are various “side effects” or complications listed with the various vaccines. These are generally extremely rare (such as clotting disorders or myocarditis) and should be viewed in the context of the millions of vaccines safely administered and compared to many other medications or activities that have risks attached to them (such as driving a car or taking oral contraceptives or antibiotics or eating shellfish). Honestly, unless you are actually and unusually allergic to some of the carrier materials in the vaccine (eg polyethylene glycol) – there is no sensible reason to avoid getting the covid vaccine.