A Shot of Hope

Posted on Posted in Coronavirus, DrDownload

The first shipment of COVID-19 vaccine arrived in Richmond this week.  I’m calling it a shot of hope, and I couldn’t be more hopeful and yes, excited to get my vaccine.

As a spokesperson for the American Academy of Pediatrics, I am always careful to say when I’m speaking on their behalf and when I’m voicing my own opinion or summarizing research.  While I suspect the AAP would agree with me, this Hope blog is my understanding, my opinion and my effort to summarize the science behind the COVID-19 vaccine

It’s easier to say ‘yes’ to getting vaccinated if you understand the science behind the COVID-19 vaccine.  We can’t know everything about the new vaccine, but we do know that the benefit of its protection FAR outweighs the sore arm or the 1-in-a-million chance of an allergic reaction.  Immunology was NOT the easiest class in medical school so bear with me as I try to explain how one COVID-19 vaccine works.

Most have heard the words DNA, RNA, and protein synthesis, but what does all this have to do with a COVID vaccine? Immunity happens when the body makes antibodies, and antibodies are proteins. Vince Iannelli, MD of Vaxopedia.com fame explains:

“As an analogy for protein synthesis, (click the link for a visual) think of your DNA as a recipe book in the library (nucleus) and you use a photocopier (transcription) to get a recipe (mRNA), take it home to the kitchen (cytoplasm), and use it to make apple pie (protein/antigens).”   The coronavirus borrows our body’s protein synthesis ability to make more viruses which makes us sick, but protein synthesis is also what our body uses to make immunity and help us get better.

The first two vaccines available to protect us against COVID-19 use messenger-RNA  to trick the body into thinking it’s sick with the coronavirus when it’s really not sick at all.  The vaccine puts an mRNA “recipe” for one of the coronavirus proteins (the Spike-protein) into a muscle.  My muscle cells are beginning to make apple pie-spike proteins as we speak because I got the vaccine this morning.  My immune system is going to notice these foreign proteins and makes antibodies against them.

a schematic by V. Altounian shows how mRNA works.

Infectious disease expert, Dr. Tom Frieden explains how the vaccine works in this way: “Think of the mRNA vaccine as an email sent to your immune system.  It shows your body what the virus looks like, gives instructions for how to kill it, and then– like a Snapchat message– it disappears.”

Scientists discovered that they could use messenger-RNA to guide the immune system more than ten years ago so if you’re worried that this vaccine is too “new,” you should know that experts have been perfecting the technology for ten years.  Learn more about developing mRNA-vaccine technologies in the embedded links here if you are interested in the deep dive.

Some worry that scientists rushed the vaccine into production without rigorous study, but this is not true.  More than 40,000 volunteers were in the Pfizer vaccine study, and more than 30,000 in the Moderna vaccine trials, and you can read more about what the scientists have to do when they develop vaccines at the FDA Website.  Experts did all the same things they do in non-pandemic times to develop these vaccines, in full view of their colleagues and the media. Both studies proved how well the mRNA vaccine works and how safe it is.

In a pandemic, all the best scientists have as much money as they need and government officials are expected to be as efficient in bureaucratic stuff as possible so vaccine development can happen fast.  My dad says you can have two of these three:  Fast, Good, and Cheap.  The world has a COVID-19 vaccine that was studied thoroughly and brought to market really fast.  It’s a really good vaccine, but getting it done has not been cheap.  That’s OK with me because I can’t put a price tag on the life of my patients and my parents.

Dr. Gayle Schrier Smith and her Partners In Pediatrics

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