Same Old Story-Rising Numbers-Vaccines on the Way
Well, folks, we reached a new milestone of 200,000 new COVID-19 cases in a single day last Friday, the day after Thanksgiving. The total number of Americans who have tested positive for COVID-19 is over 13 million. Global deaths are almost 1.5 million; take that in - 1.5 million human lives lost to this disease. Experts believe the rapid growth we are seeing is similar to the growth this past spring when this all started and we all locked down. However, experts are also warning that testing numbers are going to be erratic for the next week or so because fewer people get tested during the Thanksgiving holiday weekend. This might create an illusion of the disease slowing, however this battle is far from over and many more people will get sick and die.
Hope-Vaccines are on the way
As nurses who are science based, we believe in vaccination, even if there is some risk. Vaccine development often takes many years and goes through many safety checks before it is found safe for full-scale distribution. This is what we have known in all of our training. Reactions can happen at any time to anyone, as they do with any kind of treatment or medicine, but generally, vaccines are proven safe and can save lives and wipe out deadly diseases. We have successfully done this with many diseases.
Understandably, the speed with which COVID-19 vaccines have been progressing makes many people fear that the vaccines we have on the near horizon might not be safe. We get it, we are skeptical. However, vaccine science has come a long way since we learned about them back in our nursing education and given the latest technological advances, all signs point to these vaccines being very safe.
Generally speaking, a vaccine helps your body build immunity by exposing your body to some form of the disease-causing germ or something similar to it which then stimulates the immune system to produce antibodies against a future infection of the disease.
Tony Moody, M.D., associate professor of pediatrics and immunology at Duke University School of Medicine likens it to a workout for your immune system: You’re sending it to the gym and preparing it to be able to do something when it encounters the real thing in the future. That is the effect of a vaccine.
Immune System in General
In order to understand how vaccines work, it helps to understand how the immune system works. Basically, once a new infection enters your body, white blood cells fight it. There are different types of white blood cells involved in an immune response, each fighting the infection in different ways.
- Macrophages are white blood cells that swallow up and digest germs and dead or dying cells. The macrophages leave behind parts of the invading germs called antigens. The body identifies antigens as dangerous and stimulates antibodies to attack them.
- B-lymphocytes are defensive white blood cells. They produce antibodies that attack the pieces of the virus left behind by the macrophages.
- T-lymphocytes are another type of defensive white blood cell. They attack cells in the body that have already been infected.
So, when a person first becomes infected with the virus, their body will make and use all of these tools to try to get rid of the infection. Once the infection is over, the person’s immune system remembers what it learned about how to protect the body against that particular virus. The way the body does this is that it keeps a few memory cells, T-lymphocytes, that act quickly if the body comes in contact with that same virus again. When familiar antigens are detected, B-lymphocytes produce antibodies to attack them. Currently, we do not know how long the memory cells protect a person against the COVID-19.
Types of Vaccines Currently being Studied for use Against COVID-19
- mRNA vaccines contain material from the virus that causes COVID-19 that gives our cells instructions for how to make a harmless protein that is unique to the virus. After our cells make copies of the protein, they destroy the genetic material from the vaccine. Our bodies recognize that the protein should not be there and build T-lymphocytes and B-lymphocytes that will remember how to fight the virus that causes COVID-19 if we are infected in the future.
- Protein subunit vaccines include harmless pieces (proteins) of the virus that cause COVID-19 instead of the entire germ. Once vaccinated, our immune system recognizes that the proteins don’t belong in the body and begins making T-lymphocytes and antibodies. If we are ever infected in the future, memory cells will recognize and fight the virus.
- Vector vaccines contain a weakened version of a live virus—a different virus than the one that causes COVID-19—that has genetic material from the virus that causes COVID-19 inserted in it (this is called a viral vector). Once the viral vector is inside our cells, the genetic material gives cells instructions to make a protein that is unique to the virus that causes COVID-19. Using these instructions, our cells make copies of the protein. This prompts our bodies to build T-lymphocytes and B-lymphocytes that will remember how to fight that virus if we are infected in the future.
Moderna and Pfizer-Big Ones in the News
Both the Moderna and Pfizer vaccines that we have heard a lot about recently are applying (Pfizer) for or expected to apply for (Moderna) an FDA Early Use Authorization (EUA). These are the ones we will see being used in the upcoming months, both with reports of 90-95% effectiveness (discussed in prior blog). Both of these vaccines are made using this new mRNA technology. It is really amazing how far we have come by understanding genetic material. This pandemic and potential vaccines have shown this. This mRNA vaccine basically introduces a genetic code into the body for it to use to make its own (harmless) viral protein that is only found in COVID-19 infection. Then the body creates its immune response. Wow, that is amazing.
Thinking about this simply, we have genetically created material which tricks the body into thinking it needs to fight that infection and causes it to produce an immune response. That immune response arms the body against future infections. There is no risk of ever getting the infection from this genetically created protein because it is not the virus in any way. Many people fear vaccines because they are afraid that they will get the illness from the vaccine which makes sense when parts of the actual virus are used to create the vaccine. With this new amazing mRNA technology there is not any real illness ever involved so it seems much safer. We feel it is very promising and safe.
Others on the Horizon
AstraZeneca, University of Oxford and Johnson & Johnson all have vaccine candidates in Phase 3 trials that are also considered promising against COVID-19. According to the Milken Institute’s vaccine tracker, there are 237 different vaccine candidates out there in all phases of development.
According to William Schaffner, M.D., infectious disease specialist and professor of preventive medicine at Vanderbilt University School of Medicine, it is highly desirable more vaccine manufacturers working to actually produce the vaccine, and so we could more expeditiously try to vaccinate the population in the United States and beyond.
Dr. Kathleen Neuzil professor of vaccinology and director of the Center for Vaccine Development and Global Health at the University of Maryland School of Medicine agrees that more vaccine manufacturers is better for more supply and expediency. She uses the flu vaccine as an example, noting that there are multiple formulations on the market including the injectable high dose vaccine and the nasal spray vaccine, each recommended for different populations. Dr.Neuzil says We really need every person on earth, theoretically, to be able to receive this vaccine. So, to me, [having more than one option] is a positive, because we need so much.
Wear your mask, social distance care for each other…but have hope, what appear to be safe vaccines are on the way. We can and will beat this disease.
Susan Ramsey is both an attorney and an RN. Ms. Ramsey’s professional experience began as a Registered Nurse in the Intensive Care Unit at Yale New Haven Hospital. While pursuing her Bachelor’s Degree, she was a counselor with the New Haven Rape Crisis Program. During her time with the Program, Ms. Ramsey counseled sexual assault survivors and performed seminars for local police departments, universities, and high schools. During her time working as a registered nurse, Ms. Ramsey decided to attend law school. Ms. Ramsey graduated from CUNY Law School, and has practiced law in several different State and Federal Courts. She is a Florida Heath Care Risk Manager and a member of the Palm Beach County Sober Home Task Force. Ms. Ramsey actively litigates cases involving catastrophic injuries and wrongful death on behalf of survivors, cases include injuries suffered by victims of professional negligence, product liability and medical negligence.
Amie Goldberg is both an attorney and a certified APRN. After completing a Bachelor of Arts Degree at Whittier College, Ms. Goldberg attended nursing school at Emory University. Ms. Goldberg’s professional experience started as a Registered Nurse at Egleston Children’s Hospital taking care of children with congenital heart disease. After a few years, she continued working in all areas of the hospital while attending Kennesaw State University on weekends in order to get her Master’s Degree in Nursing with a specialty of Primary Care Nurse Practitioner/Family Nurse Practitioner. During her time as an APRN, Ms. Goldberg decided to attend law school at St. Thomas University in Miami, Florida. Since graduating, she has mainly practiced in the areas of personal injury and worker’s compensation, fighting for the rights of injured people. Since joining the Romano Law Group, Ms. Goldberg has been the Director of the Opioid Litigation Project. Ms. Goldberg also practices in the area of medical malpractice and nursing home negligence, bringing an inside perspective and knowledge to help get justice for our clients.