When the first case of SARS-CoV-2 (COVID-19) was identified in the United States on Jan. 20, 2020, very little was known about the novel coronavirus, except for the bits of data and information emerging from China and other nations across the world.
Few imagined the political and economic upheaval which followed dwarfed in importance only by the quantity of human suffering and lives lost. Notwithstanding that the nation’s response was mired in the political struggles of a presidential election year, the world’s scientists came together with drive, purpose, and conviction to develop vaccinations to combat this virus.
While there are other vaccines being studied against SARS-CoV-2, to date, two have received the FDA’s Emergency Use Authorization (EUA); vaccines in other trials, which use slightly different technology, are not yet approved. Pfizer and BioNTech and Moderna’s vaccines are based on mRNA technology and have demonstrated 95% and 94% efficacy, respectively. The efficacy is astonishing, given that last summer, scientists indicated that they would be satisfied with a vaccine that could demonstrate 50% to 75% efficacy. These vaccines are the first vaccines to receive an EUA using mRNA technology.
The fact that these are the first mRNA vaccines has caused fear and trepidation in some individuals, who have expressed safety concerns.
The technology that led to the production of these mRNA vaccines is NOT new. For over a decade, mRNA technology has been used in clinical studies involving cancer vaccines. Additionally, other groups have studied mRNA to develop vaccines against other viruses such as MERS, RSV, and Zika. These vaccines and their products do NOT alter an individual’s DNA once inoculated.
The mRNA in the vaccine enters a cell’s cytoplasm where it interacts with another type of RNA called tRNA. This interaction produces a protein resembling the spike protein on SARS-CoV-2. Once that protein is displayed on the outside of the cell, it triggers an immune response which leads to the production of antibodies and a sustained immunity to the virus.
There is simply no ability of the newly created protein or the vaccine’s mRNA to be targeted to or interact with cellular DNA, which is housed in the nucleus and is surrounded by a discriminating nuclear membrane. Unless individuals have a specific allergy to the components of the particular vaccine, the CDC recommends broad vaccination.
Cognizant that data in the individual groups are limited, included in those who may receive the vaccine are those who are pregnant, breastfeeding, immunosuppressed, have autoimmune conditions, or have previous allergies to other vaccinations. Trial results have allayed concerns about fertility and the vaccine. The Pfizer and BioNTech data show roughly an equivalent number of pregnancies during the trial period in both the vaccine and placebo groups, and there are simply no data to support the hypothesis that vaccine administration could result in long-term infertility.
Another issue that has gotten a lot of attention in the media is the emergence of new strains and mutations of SARS-CoV-2. This is a common occurrence with viruses. Despite these mutations, we recommend individuals be vaccinated. The scientific community is paying meticulous attention to viral strains and if changes to the vaccine will be necessary.
Thanks to the scientists and companies who have created these vaccinations, we stand poised to see an end to this horrific tragedy – one that has stolen from us moms, dads, sons, daughters, grandparents, and friends.
Given different regional emphases, priority groups for vaccine receipt vary across the nation and the world.
We urge all people to identify what group they are in and, once the vaccine is available to their assigned group, to take the requisite steps to be vaccinated. Assist family members, friends, and members of faith communities to make appointments for vaccinations if they are not internet savvy. If there were ever a moment each of us could directly make a difference in someone’s life, this is it.
We make a special plea to those in the Black and brown communities who remain scarred by historic injustices by the medical and scientific communities. Please do not reject this vaccine. Rejecting vaccination will only widen the injustices and expose your families to more heartache should they contract SARS-CoV-2.
People who have already suffered from infection with SARS-CoV-2 should also get the vaccine. There is no indication, to date, that natural infection with SARS-CoV-2 will convey long-term immunity. The best weapon against contracting this terrible virus again is vaccination.
The world is weathering a protracted, deadly storm which has left destruction in its path – in every corner of society. However, we must seize this moment and see the sun on the horizon and imagine the emerging beautiful rainbow which will come once the vaccine is spread widely across the globe.
(Philip Otterbeck, M.D., is chair, Department of Medicine, at Richmond University Medical Center. Marianne LaBarbera, M.D., is president of the hospital’s medical staff.)