Provider Practice Essentials registered nurse continuing education

Covid-19: Should I Take the Vaccine?

I’ll sum up my opinion on vaccination in three words, and then explain why this one is similar, but different, and equally important. 

Those three words:  Smallpox, Polio, and Ebola. Yes- you read that correctly- I am comparing a common type of respiratory coronavirus with the deadliest virus known to mankind, the most debilitating neuromuscular disease we have ever overcome, and perhaps the most frightening contagious process in human history. 

If you recall, in a prior post on this topic, we discussed COVID-19 as being highly transmissible and easy to overwhelm our healthcare system – which it has. We also discussed public reaction, fear, and the psychological impact that lockdowns, quarantines, and isolation would cause- which it did.  And finally, we discussed how the fear of the virus and its spread  would lead to worsening fear, and public outcry for herd immunity and safety- which it has. 

So here we are.  10 months after the pandemic was declared and the numbers keep rolling in. As of today’s count over 320,000 people in the United States have died from COVID-19.  For those of you quick with a calculator, that’s less than 0.01% of our 330 million person population.  Ok, to be fair, that’s over a 10 month period. If we annualize these numbers, we may be at .012% of our population. To put it in perspective, that’s roughly 1 out of 10,000 people.  Put another way, if you live in a small town less than 10,000 people in size, statistically speaking you may never know someone who dies from this disease. So why the big deal?

  • Population redistribution. People travel. People are relocating, and population shifts are occurring.  Large cities like New York and densely populated areas like California have been overwhelmed by this pandemic. Transmissibility has been fast and these are areas that simply don’t (and won’t) have the capacity to handle a large outbreak of cases. Some who have not yet had the disease have had enough, and are leaving these areas in droves with the intent of finding a better, “safer” place to live. Look at the influx to Florida as an example. We may now be one the newest New York suburbs.  As more people continue to leave these areas, the densely populated centers of cosmopolitan living will begin to spread their way throughout America.  If you live in those sparsely populated areas, they may be passing through your town, into your stores, into your gas stations, and passing on disease. They may also be relocating permanently.  This is not to suggest that anyone from New York has the disease, but any new addition to a given population, even if passing through, is an addition, and a statistical data point to consider.
  • Who spreads COVID-19?  A recent study from the University of Central Florida identified that the stereotypical super spreader is a 20 year old male with a stuffy nose.  Well, great.  Winter months, seasonal allergies, healthy young people who go outdoors, and no other symptoms except for the sniffles. What could go wrong?  Combine that with the overblown fear of children in school, mass COVID spread to the younger kids, and all of the fear that stoked, and what do we do?  Again, look at the statistics – anyone who can spread this virus in the community will, if given the chance – even if they don’t know it. While the young may sniff this off as allergies, those who have risk factors may end up in the ICU because they waited in line together at Starbucks.  That’s the way this virus works. 
  • Civil Disobedience.  Everyone these days seems to have chosen a side, and whether you are pro mask, anti mask, living a life that matters, sharing a holiday with your family and friends, or lobbying Molotov cocktails at your local small business storefront in a major metropolitan area, odds are you’re involved in what are known as a “super spreader event,” where multiple people inherit the virus and then move elsewhere in a population to spread it to even more people.  We are humans. Social creatures of habit who seek out and join others with like interests and ties. Isolation is killing us, and who we are. It has turned some of us into who we “were,” and for even more, it has irreversibly changed who we will be. Our own children are beginning to show a degree of desocialization never before seen.  We have proven as a society that regardless of what we as free Americans are told, we will do what we want, and push back harder against the authority that suggests otherwise.  This whole “I do what I want” mentality is perhaps the biggest driving force to take the new vaccine. People want to go back to life as they remember it, and can’t tolerate the mental change needed to consider the life we will actually have when this is all over. 

So now to the big question – Should I get the vaccine?  Somehow, in the middle of this pandemic, we also experienced an election. While politics have greatly divided our nation even further, there is an increasingly growing movement to “listen to science!”  While this may imply that science has been placed on the back burner to manage our crisis, it is important to note that had we listened to “science” as a strict guide to our nationwide management of this crisis, everything would have closed. People would have been barricaded in their homes, and the host would have been completely isolated from the virus until it ran out of people to infect because they were locked in their homes. Clearly the scientific approach would not have gone over well. 

Public Health departments and experts exist to bridge the gap between pure science and human reality. Vaccination programs have always been, and will always be designed to deliver science to the masses. They will always be a Public Health endeavor, and a hybrid between a scientific lab bench and a government-regulated initiative.  If there is anything that science has told us, it’s that vaccination immunity is controlled, longer lasting, and most effective to manage disease transmission. Period. There has has not been promising evidence to demonstrate that those infected with COVID-19 have lasting immunity.  This was mentioned in our blog article in March 2020 and holds true today. The only effective method of antibody formation and retention is through vaccination. Even those who have had the virus should be vaccinated as well. 

There is a fear that the mRNA component of the vaccine may be harmful.  This is not founded in science.  The virus is based on this molecule, and the vaccine is designed to target this part of the viral machinery and prevent its infection in our cells, stopping its replication. From a scientific point of view, it’s an amazing solution that was created and delivered in record time. This should not be reason to strike fear in anyone.  It was sound science that created the vaccine, and a sound public health policy that delivered it to the masses. 

Messenger Ribonucleic Acid, or mRNA is a part of ever cell in our body. It’s entire purpose is to create proteins when the cells are given signal to activate them. In this case that signal is the spike protein of the coronavirus, which under normal circumstances attaches to a receptor in the outside of our cells and triggers mRNA to make more coronaviruses.  By isolating this receptor, and determining the sequence of the mRNA, the drug companies have managed to create an mRNA that triggers the creation of only the spike protein, and not the virus itself. As a result, once you receive the vaccine, the mRNA becomes activated, and floods the bloodstream with thousands of spike proteins, which in turn activate many other cells to do the same thing. As more of these spike proteins circulate, the immune system is activated to create antibodies to these proteins, and our immunologic protection builds up without an active infection. Actually, it’s a very elegant solution, with minimal downstream effects.  As our body begins to create, store, and remember the spike protein sequence, infection with the actual virus becomes an impossibility. 

It’s important to consider a few things, notably that mRNA has nothing to do with Deoxyribonucleic Acid, or DNA, which lives in the nucleus of our cells. This material is the genetic material that defines who we are, and does not interact with mRNA.  In fact, mRNA doesn’t even exist in or enter the cell nucleus. This means that there is no scientific basis or reason to suspect that the mRNA in a vaccine can mutate our DNA or alter our identity. If you are worried about the vaccines creating a zombie apocalypse, I’m sorry, but this just isn’t going to happen!  There does not appear to be any danger to humans who get this vaccine, and all of the reactions that have been reported are mild at best (things like welts at the inoculation site), which can happen from any process that breaks the skin. 

Perhaps the most compelling reason to get the vaccine is to contribute to the general wellness of society as a whole. But if that’s not enough reason for you, let’s revisit those three words at the top. Smallpox killed 3 out of 10 people before it was eliminated. Polio condemned those who acquired it to a 15-30% case fatality ratio, and Ebola outbreaks caused a hemorrhagic fever with a 90% mortality. All three of these illnesses have been controlled and all but eradicated by vaccine administration, and that has saved countless lives. In fact, were it not for vaccines for these diseases, we would still be facing waves of mass graves, iron lungs, and children and parents living in fear and in isolation. Oh wait- that’s what the COVID vaccine is also here to prevent.  This is an important and critical time in Human history, and each of us needs to take a long distance, realistic view of which side of history we want to be on.  Personally, as a physician, a husband, and a father, I prefer to be on the side that allows us to live active, healthy lives both physically and mentally, and I view this vaccine as a way to do my part in this endeavor. 

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