Urology pearls

Building a fence against COVID-19

Shahar Madjar, MD, Journal columnist

In my previous article two weeks ago, I wrote that there are three forces shaping a pandemic–the virus, our immune system, and our behavior.

Coronavirus is new and virulent. Our immune system can’t recognize the virus from previous encounters and therefore it responds in a non-specific, inefficient way resulting in severe disease and at times in death. We can blunt the rate of transmission by adjusting our behavior–mask-wearing, hand-washing, and social-distancing. And now, we have to make a critical decision: to take the vaccine, or not to take it, that is the question.

The first vaccine to be approved by the FDA is made by Pfizer. This vaccine works by tricking the body. The vaccine isn’t a live virus. It isn’t even a structural part of the virus. It is just a piece of the genetic material within the virus–short chains of mRNA (messenger RNA). These chains of genetic material made in the lab are like beads that you would string on a necklace. These beads are called nucleotides. The chain of nucleotides is a code.

Our cells read the RNA code. It isn’t a new process for the cells because humans, like the coronavirus itself, use RNA as a template for the synthesis of their own proteins. But the RNA in the vaccine doesn’t code for a human protein. It codes for a viral protein. And more specifically, it codes for the viral spike protein–a club-shaped molecule that projects from the surface of the virus and gives it its characteristic shape.

Once the body is producing the viral protein, the virus is no longer unrecognizable to the immune system. By tricking the body into making the viral protein, we train the immune system to recognize the virus. From the time of vaccination, any exposure to the real coronavirus will result in a swiftly identify the virus as an enemy. The immune system will be prepared. It will counter-attack the virus and eliminate it before it causes any trouble.

This sounds like science fiction. But it is science! In an article in the prestigious New England Journal of Medicine, Fernando P. Polack and his colleagues describe the results of a multinational, randomized study conducted on 43,448 participants. Half of the participants were injected with the vaccine and the other half with placebo. After two doses of the vaccine were given, there were only 8 cases of Covid-19 in the vaccinated group compared with 162 cases of Covid-19 in the group that received the placebo. This means that the vaccine was 95% effective in preventing Covid-19.

This large-scale study also proved that the Pfizer vaccine is safe. Some of the participants who received the vaccine experienced mild to moderate pain at the injection site, fatigue, and headache. These side effects are a result of the normal response of the immune system to the vaccine. In the study, these side effects were temporary and, overall, well-tolerated.

I told you that the third force to shape a pandemic is our behavior. It is perhaps the strongest of all forces. By taking the vaccine, each individual protects themselves. At the same time, each additional person taking the vaccine also serves as a partial wall–another picket in a long picket fence–defending us all, as a group, against the spread of the disease.

There is no amount of logic that would convince the unprepared, resistant mind. Some of you may be convinced to take the vaccine by the strength of scientific arguments or by the data I just presented. For others, the decision may be more of a gut-feeling process. Perhaps seeing your neighbors, celebrities, and leaders taking the vaccine would do the trick. Perhaps you will take notice of what I have described here and of my own actions:

Within the next several days, the Pfizer vaccine will be distributed throughout the country. Health care workers, physicians included, will be among the first to be offered the vaccine. And I will be the first in line to take it!

Editor’s note: Dr. Shahar Madjar is a urologist at Aspirus and the author of “Is Life Too Long? Essays about Life, Death and Other Trivial Matters.” Contact him at smadjar@yahoo.com.


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