Up until this current coronavirus pandemic, the world record for how quickly a vaccine could be bought to market was a mere four years and was proudly held by the Mumps vaccine.
So, to have multiple Covid-19 vaccines come to market within a year of this coronavirus being discovered is a remarkable feat. It was only because of the severity of the pandemic that the authorities allowed shorter vaccine trials to be done, but worryingly for us the public, this means that we have extremely limited safety data for these vaccines. In addition, companies like Pfizer and Moderna have embraced the new and untested ‘mRNA’ vaccine technology, which has left many people understandably nervous to step forward for the jab. As I experienced a couple of months ago, to stand in a queue for a vaccine that firstly has limited safety data and secondly is using untested new technology, really focuses the mind as to what might be the right thing to do. This article will take a deep dive into the question that I get asked every day: “Should I go for the jab or not, doc?”
Let’s unpack some of the main concerns that people have had about the Covid vaccine and then look at some of the figures to see how effective the vaccine is proving to be:
- The ‘Virus escape’ theory
At the end of 2020, we had the second wave of Covid-19 and people started to mention the term ‘virus escape’. Originally, we had hoped that once you’d survived Covid, you would have immunity to the virus and not get it again. Once countries had enough infections, we would then get herd immunity and the pandemic would disappear. However, a few months after lockdown had ended, we ramped up into the ‘second wave’ and worst of all, some people who had contracted Covid in the first wave, became ill again with this new variant. What was going on?
The ability of a virus to mutate, sidestep our immune defenses and then re-infect people is termed ‘viral escape’. The concern about this escape ability is that new strains might be more virulent (cause a nastier infection) than the original infection. Thankfully so far this hasn’t proven to be the case: The Alpha variant was certainly more contagious (infects more people) than the original virus. More recently, the Delta variant has proven even more contagious than the Alpha, as it sweeps through the UK and USA. However, there is no strong evidence to suggest that either of these new variants are any more virulent than the original. 1However in theory, the more people a virus infects, the greater is the chance that a nasty new variant could develop. Rather like the wildfires of California – the more the virus is left to spread, the more out of control it could get.
- Antibody-dependent enhancement (ADE)
This mouthful of a phrase really refers to what most of us know as a cytotoxic storm. We have all heard how some Covid patients could drown in their own lung fluid because of a cytotoxic storm. This happens because their immune system over-reacts and pours fluids into their lungs in an over-enthusiastic effort to kill the virus. Rather like an allergic response that can make water pour out of the eyes and the nose, ADE in a Covid patient can flood the lungs in an over-exuberant reaction to remove the virus.
However, what is disturbing is that past attempts to develop vaccines against other coronaviruses (SARS and MERS-CoV) have resulted in ADE reactions in the animals that the vaccines were being tested on. 2Hence the concern that our current, minimally tested Covid vaccines might cause ADE in those of us who have had the vaccine.
So that begs the question, did the French Nobel Laureate, Luc Montagnier really put out the now infamous tweet to suggest that everybody who has had the vaccine would die from an ADE reaction? He has certainly expressed grave concerns about Covid vaccinations in a couple of video interviews, but according to a Reuters report, the tweet was a fake.3 If you put the controversial tweet aside, it is still reasonable to be concerned that the vaccine could turn our immune systems rogue. What we need is data in vaccinated people to show that this is not happening.
- How effective are Covid-19 vaccines?
In December 2020, the first brave pioneers lined up around the world to get their Covid jabs. I say ‘brave’ because at that stage there were a lot of things that we didn’t know about the vaccine: We didn’t know if a vaccine could cause the virus to ‘escape’ and create stronger variants; We didn’t know if a vaccine would cause ADE cytotoxic storm reactions in people; We didn’t even know whether the vaccines would work.
Now, nine months later, with 60% of the UK fully vaccinated, we have some figures from a fairly large country for us to work with. Let’s take a look at them.
During the second wave, when the UK was unvaccinated, the number of new Covid-19 cases peaked at a weekly average of over 30 000 a day. If we compare this to the current third wave in the UK being driven by the Delta variant, but with 60% of the adult population fully vaccinated, the number of cases is pretty similar, peaking with a weekly average of over 30 000 new cases a day.4
What does this tell us? It tells us that you can still get and spread the Delta variant even if you have been vaccinated.
If we look now at the number of reported Covid-19 deaths in the second wave, it peaked at nearly 36 deaths per 10 million population5. Here is the good news. The deaths in the third wave were dramatically slashed from 36 to 2 deaths per 10 million population.
What does this tell us? It tells us that although people can still get mild Covid-19 infections, the vaccine has effectively protected the population from severe infection and death.
However, the inquisitive sceptic in me is questioning this number: this might be the number of Covid-19 deaths registered, but what if deaths were over-reported in the second wave and under-reported in the third wave? To answer this question, we need to look at the total number of deaths, otherwise known as the ‘excess deaths’ in England and Wales. This adds up all of the deaths due to any cause. If you look at Figure 1, you will see that there is a spike of excess deaths in the first wave, a spike in the second wave, but no spike in the third wave.
Figure 1: Excess deaths in the UK in the first, second and third wave6.
What does this tell us? It confirms that our earlier figure of very low Covid-19 deaths in the third wave is accurate. The vaccine has indeed been effective in preventing serious infections and deaths.
Further good news is that, on July 19, the UK embraced Freedom Day by removing masks and opening pubs, theaters and sports venues. The naysayers predicted that the numbers of Covid-19 cases would soar as society opened up, but since then the numbers have continued to plummet.
However, this needs to be tempered with statistics from other countries: Chile and Uruguay both used the Chinese Sinovac vaccine and are now struggling with a third wave. Israel is having less than perfect results and questioning whether they need to add a booster shot. However, some of the vaccinated USA states are showing excellent results.
One can see from these figures that although new variants like Delta are able to infect vaccinated populations, there has been no sign so far of a super-variant developing. In fact, the opposite is true in that the vaccines are proving to be so effective that they have all but stamped out serious infection and death.
One can also see that the prediction that vaccines would cause immune systems to become confused, resulting in ADE and flooding of the lungs has also not happened. The ICU admissions have been low and infections have been mild.
Lastly, if one looks at the VAERS statistics of adverse events, it shows that there have been occasional blood clots in people with vector vaccines (Johnson & Johnson vaccine), occasional auto-immune problems in mRNA vaccines (Pfizer) and a few deaths post vaccines. However, the overall safety profile of these vaccines is proving to be very good7. This narrative isn’t over yet, but so far it is a good news story.
Should people be forced to vaccinate? No.
Should people be restricted from travel if they don’t have a vaccine passport? No.
It is important that we respect individual decisions to vaccinate or not, but nowadays when I get asked: “Should I go for the jab or not, doc?” My answer is that it is important to maintain a healthy lifestyle to keep your immune system strong, but rather like a judge might say on the X-Factor show: “It is a yes from me.”
– by Dr Duncan Carmichael
1Kathy Katella. 5 things to know about the Delta variant. Yale Medicine. July 2021: https://www.yalemedicine.org/news/5-things-to-know-delta-variant-covid
2Ricke D O. Two different antibody-dependent enhancement (ADE) risks for SARS-CoV-2 antibodies. Front Immunol. Feb 2021: https://doi.org/10.3389/fimmu.2021.640093
3Fact check – There is no evidence to suggest COVID-19 vaccines will kill people by causing antibody-dependent enhancement, current evidence demonstrates the opposite. Reuters. May 26, 2021:
4Nick Ferris. How the UK’s Covid-19 vaccine rollout has dramatically reduced deaths. NewStatesman. 5 July 2021.
5Ibid, Nick Ferris
6Deaths registered weekly in England and Wales, provisional. Week ending 16 July 2021. https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/bulletins/deathsregisteredweeklyinenglandandwalesprovisional/weekending16july2021
7Selected adverse events reported after COVID-19 vaccination. https://www.cdc.gov/coronavirus/2019-ncov/vaccines/safety/adverse-events.html
