By Rachel Alter, MS2:
This morning I read a story about a 29-year-old nurse, a marathon runner. I saw pictures of her traveling the world, practicing yoga, and dressed in her scrubs with a stethoscope around her neck. She appeared to be the picture of solid, young health. She died of covid-related cardiac damage in March.
As the global case count grows exponentially, I read more and more stories about my peers dying preventable deaths or living with persistent organ damage. I won’t lie, it worries me.
I, too, am a healthy, active 29-year-old. She could have been me. Or she could have been my friend Stephanie taking methotrexate, or my friend Kate who, at age 22, was diagnosed with thyroid cancer and had her thyroid removed and her parathyroid nicked in surgery so that now she must carefully monitor her calcium levels and is considered immunocompromised.
I am writing now because of a nagging concern I’ve had, and because I want to make a plea to you all as budding medical professionals: please take this pandemic seriously. I know the chance that any of us suffers long-term sequelae or worse is low, but it happens. And more importantly, we’re about to step into the world as role models. People look to us for advice about their health, and they follow our behavioral lead. If a patient’s doctor wears their mask under their nose or goes to a friend’s indoor birthday party, it must not be so bad, right?
In medicine, we have a rule: we do no harm. Part of that oath means we will follow the guidelines put in place by those who know better than we do. I know the guidelines have been confusing. I was one of those people early on asking everyone not to wear a mask because at the time, there was a significant shortage of PPE and those who worked in hospitals and other high-risk environments needed them most. It’s the advice most experts were giving. Then the scientific community learned that SARS-CoV-2 was easily spread via asymptomatic and pre-symptomatic transmission, and the guidelines changed: masks are for everyone.
As a science communicator, these rapidly changing guidelines have been tricky to navigate, especially to those with less science background. But we as medical students have more science background. It’s incumbent on us in the field to be good examples for the rest of the population so that they know how to behave responsibly in order to curb the spread of this virus.
This brings me to this: the vaccine.
I know there has been an enormous amount of hesitancy around this mRNA vaccine: was it rushed? Is it safe? What about the side effects? Was it politically motivated? Were enough minorities included in the trials? Is it going to be used as an agent of mind control?
All of these (except perhaps the last one) are valid concerns that a lot of people have had. My own mother, for a bit, wasn’t sure she wanted this one right away. But the data is clear: this vaccine is safe, it’s effective, and it’s the only chance we have to get our lives back to “normal.”
This isn’t hyperbole. We’ve seen the unsustainable nature of behavioral adjustments. People are sick of masks, they’re sick of distancing, they want to go back to school and work and their friends’ houses. Vaccines have proven, over and over, to be the safest and most effective way to mitigate viral spread. Data has found the mRNA vaccines around 95% effective after two doses, which is almost as good as the gold standard example of a working vaccine, the MMR. However, even a 100% efficacy rate will not be enough if only 50% of the population gets vaccinated. Because of the novelty of these vaccines, many are understandably worried about it.
I want to put a few of these concerns to rest.
To quote Dr. Samara Friedman, a physician who explains the speed perfectly:
“Am I concerned about the speed with which it was developed? Weren’t significant corners cut in order to get this out so quickly? No and no. What was cut out of the equation was mostly red tape, and what was added was technology and funding. We were given the genetic code by scientists in China to start vaccine production in January; before Covid was even documented to have reached our shores. From there, the vaccine was developed from the technology we had from the prior Coronavirus and cancer research, and was completed in March. Normally, there would be months of waiting for the FDA to even look at the work done prior to approving Phase 1 trials. Because of the urgent nature of this, it was essentially put on the top of the wait pile, which cut out months of waiting, but did not cut any corners. Between the Moderna and Pfizer vaccines (both mRNA, with a slightly different delivery system), they were tested in 37,000 people in Phase 3 (and an additional 37,000 received a placebo). That is on par with, if not better than the vaccines currently available.”
I’ve also heard concerns about how the vaccine may make you feel sick after receiving it. This is normal—it’s your immune system working. You cannot possibly get covid from this vaccine, as the mRNA codes for just a single protein on the surface of the virus. Further, the mRNA will not edit your DNA. As a friend puts it, mRNA is like sending a recipe via Snapchat; it’s a transcription of the master copy of the recipe (the DNA) that lasts a few hours before self-deleting.
I know this is getting long, and you have lots of important things to be doing. I am always here to talk or answer questions if you have them, as are so many physicians, scientists, and nurses in the field. I frequently find myself reminding people that physicians don’t live in a bubble: if we don’t know the answer to a question, there are hundreds of experts out there at our disposal who do and who are happy to help you.
, MSIf you have any concerns about this vaccine at all, please don’t hesitate to reach out to one of us.