Trust Science (and Marion with a Needle)
MEDICAL AND MENTAL HEALTH UPDATE
As we continue to process the events happening around the country—from egregious examples of overt racism to protests and riots to the ongoing global pandemic—I’d like to highlight a small glimmer of hope on this Wednesday.
There’s some exciting news about the potential for a coronavirus vaccine as Dr. Fauci announced yesterday. While I am not holding my breath just yet, we MAY have a vaccine available in the early part of 2021.
As you know, researchers and scientists around the world (specifically in the US, UK, and China) are working tirelessly to develop various vaccines. The top candidate right now is the vaccine made by biotech firm Moderna which just this week entered into phase II of testing which means the clinical study is expanded and vaccine is given to people who have characteristics (such as age and physical health) similar to those for whom the new vaccine is intended.
Of course there are no guarantees, but if the trial goes as planned—where healthy human test subjects do develop neutralizing antibodies to the novel coronavirus—then at the end of the summer, phase III would start. Phase III is when the vaccine is given to thousands of people and tested for efficacy and safety. Then presumably by the end of 2020, we would have a good sense of whether it warrants widespread manufacturing and distribution.
In theory, if we had a 100% safe, effective, universally available, and free vaccine, we could all get immunized and would be more free to congregate with friends, get back to work, and salvage our economy. Not to mention we would save suffering and lives.
Is that even possible?
First, let’s visit the science of vaccines.
Recall from biology class that the immune system acts as our body’s defense system. When a virus (or bacteria) enters the body, our immune system is triggered to make antibodies to fight off the outside threat. And in most cases, our bodies recover from infection just fine (sometimes with the help of medication). However, when our immune system has never seen nor had time to prepare for a threat like the novel coronavirus, the time spent mobilizing defenses can be lethal.
This is where a vaccine comes in.
Vaccines contain the same germs that cause disease. But they have been either killed or weakened to the point that they don’t make us sick. Some vaccines contain only a part of the disease germ. When injected into a healthy subject, a vaccine helps the body mount an immune response so that when the real thing comes along, the body is ready to fight infection.
But unfortunately, it's not that simple. So what are the potential problems with a vaccine?
As above, new vaccines must go through many phases and trials over months/years to ensure their safety, efficacy, and accuracy. Our first goal in medicine is to “Do No Harm,” so anything we inject into a healthy person must be rigorously studied and proven first to be safe.
Vaccines and human beings don’t always work well together. It’s impossible for a vaccine to be 100% effective for a number of reasons. For one, our individual bodies can react in unique and sometimes unpredictable ways. For example, some patients with certain immune deficiencies or cancer don’t always mount the appropriate/desired antibody response from a vaccine. And some patients are allergic to vaccines or cannot take them because of a compromised immune system.
Viruses are clever. A virus can outsmart its host and mutate. And if this novel coronavirus behaves like other coronaviruses (the ones that can cause the common cold) or the seasonal flu, the immunity from a vaccine likely will not be that durable. In other words, an antibody response would last only a few months, and a new vaccine would be needed and delivered periodically (just like the flu shot is reinvented and administered annually).
And just like we see inequalities around us every day, there are significant barriers to healthcare access in the first place in this country (geographic, physical, socioeconomic, etc.) that prevent many people from getting needed preventative care, including vaccination.
MENTAL/BEHAVIORAL HEALTH IMPLICATIONS of the above:
Know that researchers are working around the clock for our health and safety.
There is reason to believe that once a vaccine is approved, there is a strong likelihood that it will be widely available as an essential public health measure.
We mustn’t let the perfect be the enemy of the good. Just because a vaccine isn’t 100% effective at preventing illness in the recipient, as long as it's generally safe, it can mitigate symptoms and severe complications and may save someone else’s life, if not your own.
We must trust science. When we refuse vaccination, we put ourselves and others at risk. Every year people refuse the flu shot, even though the flu kills approximately 30-40,000 Americans annually. Please trust facts and experts, and please disavow false information and the people who spew it.
Let's AGAIN acknowledge that emotional health informs our physical health in our day-to-day lives. And if you need a reminder of how normal you are in your current state of stress, feel free to revisit my COVID 201 classes where I review the “anatomy” of anxiety. After all, all human beings are wired for survival, and it’s only natural to have emotional and physical reactions to threats to our health and safety.
Ask for help when you need it. Whether it’s taking a walk, phoning a friend, reaching out to a therapist, or calling your doctor, remember it’s normal to need help and a sign of strength to ask for it.
Pictured here is my awesome senior lab employee Marion administering my Tetanus booster just this morning! While I was tempted to yelp and cry like a baby as the needle went in, Marion’s calm demeanor was the perfect medicine.
I will see you tomorrow. Until then, be well.