How safe would be Covid-19 vaccines?

When Dr David B Agus, MD, a top notch American physician and author tweeted, “First vaccine approved!! So happy! Such a big step forward. Thank you scientists, clinicians and especially the patients in the clinical trials. Light at the end of the tunnel”, it raised questions as to when someone will become immune to coronavirus after receiving the vaccine. Tehelka’s Sunny Sharma compiles the information in question-answer form. It is learnt that thousands of COVID-19 vaccines have arrived in many countries and in India, these would be available in a few weeks from now and from there they will soon start going into people’s arms. Dr Agus is a Professor of Medicine and Engineering at the University of Southern California. He is co-founder of Navigenics, a personalized medicine company and Applied Proteomics, as well as a CBS News contributor.

Q&A

Dr David B Agus

MD, a top-notch American physician and author

Edited Excerpts from an interview •

When does one get immunity?

So the data we have now is that it’s one week after the second shot. Remember, with the Pfizer vaccine, the second shot is at Day 21, and so a week later, you become immune.

By far which vaccine has been approved?

So far, the Pfizer vaccine is the only one that has been approved for emergency use. But others are on deck.

Coming back to the previous question, when will one get complete immunity and need not wear the mask?

With the Moderna shot, it is Day 28 (for the second shot) — a week later, you are immune.  But you can still transmit the virus — don’t get me wrong. You still need to wear a mask after your vaccine until the numbers fall in the country.

Is there a choice to chose vaccine and how safe are these?

Yes, people will have a choice as to which vaccine they receive, but both the Pfizer vaccine and the other two on deck soon to be approved are safe and work well. There is no question you will have a choice as more are approved. The hope is Moderna is approved this weekend, and AstraZeneca, a week or two thereafter. And so you’ll see that when your number is called — when your particular group is going to be vaccinated — you can go to a hospital and get a particular vaccine. It is your choice.

How to ensure the safety of the vaccine?

I will tell you that they all are fantastic. All three of them block hospitalization. All three of them are remarkably safe.  To set all your doubts to rest, I will myself take the first vaccine that will be available to me because the sooner one gets a vaccine, the sooner someone can prevent serious illness and prevent spreading the virus to others they care for.

Has there been a tearing hurry to rush with vaccines?

Many have expressed concern that the vaccines might have been rushed.  Some top medical journals observed that earlier in the pandemic, the previous record for vaccine development was four years for the mumps vaccine in 1967. Some experts warned that the 12- to 18-month forecast timeline for a vaccine earlier in the pandemic was optimistic and might not be realistic. But the fact that a vaccine has arrived in such a short time should not be cause for alarm.

The vaccines weren’t really rushed. It’s just that technology and science got better. So we can develop things much, much more quickly, because, over a period of a decade or two, we got good at this.

There have been conspiracy theories in social media about the vaccines. What do you say?

Some have also bandied about conspiracy theories about the vaccine, such that it contains a microchip, could be used to track people, or might alter people’s DNA. Those claims are being shared out there on the internet, but are all resolutely false. There is no microchip. There is no preservative in this vaccine.

It is a pure vaccine. And an RNA vaccine cannot change your DNA. It doesn’t change fertility or anything of the kind. They are safe and they work.

Additionally, senior doctors from the PGI Chandigarh- Prof JS Thakur, Dr Arpit Gupta, Dr Nusrat Shafiq, Dr Shubhmohan Singh, Dr RPS Bhogal, Dr Arnab Ghosh, Dr Sai Chaitanya Reddy, Dr Ronika Paika and Dr Deepti Suri gave their inputs to Corona Prevention & IEC Committee, PGIMER Chandigarh. They clarified that novel coronavirus is a coronavirus that has not been previously identified. The virus causing Coronavirus disease 2019 (COVID-19) is not the same as the coronaviruses that commonly circulate among humans and cause mild illness, like the common cold. The new virus has been named “Severe Acute Respiratory Syndrome Coronavirus 2” (SARS — CoV-2). The new virus & disease were unknown before the outbreak began in Wuhan, China, in December 2019 which has subsequently spread worldwide.

Significantly, the Post Graduate Institute of Medical Education and Research (PGIMER) has administered doses of Oxford-AstraZeneca on 100 volunteers as a part of human clinical trials and there has been no major side effects among the volunteers so far. Interestingly, a 64-year-old senior professor of the institute has also volunteered for the trials. “Since I am a
patient of hypertension and diabetes, I wanted to see how patients of my age would respond to the potential vaccine,” the professor said.

The World Health Organization also answers to some commonly asked questions.

With adequate levels of hygiene, sanitation and clean water, is there still a need for vaccination?

Vaccines are necessary — and good hygiene, sanitation, clean water, and nutrition are insufficient for stopping infectious diseases. If we don’t maintain optimum rates of immunization or “herd immunity”, the diseases prevented by vaccination will return. While better hygiene, sanitation and clean water help protect people from infectious diseases, many infections can spread regardless of how clean we are. If people are not vaccinated, diseases that have become uncommon such as pertussis (whooping cough), polio and measles, will quickly reappear.

Are vaccines safe?

Vaccines are safe. Any licensed vaccine is rigorously tested across multiple phases of trials before it is approved for use and regularly reassessed once it is on the market. Scientists are also constantly monitoring information from several sources for any sign that a vaccine may cause an adverse event. Most vaccine reactions are usually minor and temporary, such as a sore arm or mild fever. In the rare event, a serious side effect is reported, it is immediately investigated.

It is far more likely to be seriously injured by a vaccine-preventable disease than by a vaccine. For example, in the case of polio, the disease can cause paralysis, measles can cause encephalitis and blindness, and some vaccine-preventable diseases can even result in death. While any serious injury or death caused by vaccines is one too many, the benefits of vaccination greatly outweigh the risks, and many more illness and deaths would occur without vaccines.

Do vaccines provide better immunity than natural infections?

Vaccines interact with the immune system to produce an immune response similar to that produced by the natural infection, but they do not cause the disease or put the immunized person at risk of its potential complications. In contrast, the price paid for getting immunity through natural infection might be cognitive impairments from Haemophilus influenzae type b (Hib), birth defects from rubella, liver cancer from hepatitis B virus, or death from complication due to measles.

Do I need to be vaccinated against diseases that I do not see in my community or my country?

Although vaccine-preventable diseases have become uncommon in many countries, the infectious agents that cause them to continue to circulate in some parts of the world. In a highly inter-connected world, they can cross geographical borders and infect anyone who is not protected.

Two key reasons to get vaccinated are to protect ourselves and to protect those around us. Successful vaccination programmes depend on the cooperation of every individual to ensure the wellbeing of all. We should not rely on people around us to stop the spread of disease; we, too, must do what we can.

Can a child be given more than one vaccine at a time?

Scientific evidence shows that giving several vaccines at the same time has no negative effect on a child’s immune system. Children are exposed to several hundred foreign substances that trigger an immune response every day. The simple act of eating food introduces new antigens into the body, and numerous bacteria live in the mouth and nose. A child is exposed to far more antigens from a common cold or sore throat than they are from vaccines.

The key advantage of having several vaccines at once is fewer clinic visits, which saves time and money. Also, when a combined vaccination is possible (e.g. for diphtheria, pertussis and tetanus), that will result in fewer injections and reduces discomfort for the child. A number of steps can also be taken to reduce pain at the time of vaccination.

Do I need to be protected against influenza through vaccination?

Influenza is a serious disease that kills between 300 000 to 500 000 people worldwide every year. Pregnant women, small children, elderly people with poor health and anyone with a chronic condition, like asthma or heart disease, are at higher risk for severe infection and death. Vaccinating pregnant women has the added benefit of protecting their newborns (there is currently no vaccine for babies under 6 months).

Seasonal influenza vaccines offer immunity to the 3 most prevalent strains circulating in any given season. It is the best way to reduce your chances of severe flu and of spreading it to others and have been used for more than 60 years. Avoiding the flu means avoiding extra medical care costs and lost income from missing days of work or school.

What preservatives are used in vaccines?

Thiomersal is an organic, mercury-containing compound added to some vaccines as a preservative. It is safe and the most widely-used preservative for vaccines that are provided in multi-dose vaccine vials. There is no evidence to suggest that the amount of thiomersal used in vaccines poses a health risk.

What about vaccines and autism?

The 1998 study which raised concerns about a possible link between measles-mumps-rubella (MMR) vaccine and autism was later found to be seriously flawed and fraudulent. The paper was subsequently retracted by the journal that published it. Unfortunately, its publication set off a panic that led to dropping immunization rates, and subsequent outbreaks of these diseases. There is no evidence of a link between the MMR vaccine and autism or autistic disorders.

Google comes to the aid of media in a crisis situation

Tech Giant Google, through a Journalism Emergency Relief Fund, has taken an initiative to provide financial aid to media houses across the globe who are struggling to continue operations due to the ongoing coronavirus pandemic. 

Tehelka acknowledges the financial aid by Google which proved to be of help to editorial colleagues during the crisis situation. Indeed an applaud and appreciation worthy initiative by Google!