Let’s get to it…
We should all have a small amount of concern associated with new variants of SARS CoV2, but we shouldn’t panic. Every time a country or region sees an increase in numbers of cases politicians are quick to blame “new variants”. Now it is possible that changes in the genetic makeup of SARS CoV2 over time might make it more transmissible or may lead to it being able to get around immunity from past infection/vaccination… but that isn’t something that has yet been proven outside of a laboratory setting.
That’s not to say that it can’t or won’t happen. In fact, I think it is very likely that it will happen at some point, after all that is what other common cold coronaviruses do already, but there is usually some degree of residual immunity from the past infection/vaccination that stops people becoming really sick with future infections.
So be aware of what is going on around the World in terms of changes in SARS CoV2, but don’t panic… at least not yet.
I do wonder (but have no proof of this) whether new variants are used as an excuse for poor policy sometimes. For example, a country relaxes its lockdown rules too early and cases start to rise… quick… blame the new variant that has become the dominant strain during that time. Have poor vaccine roll out programs so that you see third waves of infections… quick… let’s blame a new variant (especially if it is named after a country we share a border with and with whom we are arguing over Brexit/vaccines!).
Okay, you all know I am a bit of cynic, but “new variants” do seem to be being used as an excuse for when anything goes wrong a lot of the time. Yes, we should be watching what these new variants are doing, but they are not the main reason cases aren’t falling across the World… poor public health measures are.
Can I get Covid-19 more than once?
Yes, some people are getting Covid-19 more than once, but the numbers are still low. This makes sense and is nothing unexpected.
All viruses change over time, and if that time is long enough then the virus may be able to cause new infections. Most of the time these subsequent infections are much, much, milder than the original infection; as you have already got “some” immunity. In the context of the common cold coronaviruses you get a bit of a runny nose and feel under the weather for a few days. It is generally expected that SARS CoV2 will eventually become the 5th common cold coronavirus… we’ll see.
We also know that other coronaviruses don’t tend to give long-term immunity against infection, so when they are back around you get them again, but we do know that the long-term immune response is usually “good enough” to prevent severe disease in the vast majority of people.
Will the vaccine provide lifelong protection against Covid-19?
This is something we just don’t know, time will tell. However, most of the scientists and doctors think the current vaccines won’t give life-long immunity against Covid-19! Don’t panic!!!
This isn’t necessarily a problem. Those same experts also expect that the vaccines WILL PREVENT SEVERE Covid-19 in the future, even if they don’t prevent milder cases, and ultimately that is the aim of the vaccination program, not eradication. In the long-term it actually doesn’t matter if someone gets a “bit of a cold” with Covid-19 as long as they don’t become really sick with it.
Will I need a booster vaccine every year?
It may be that we will be offered frequent booster vaccines formulated to represent the Worldwide circulating variants at that time (like we do with Influenza Virus vaccines every year) but it is not yet clear if this will be necessary. It is also not clear if repeat vaccines may lead to stronger side effects from the vaccines themselves; it is possible that immune enhancement from repetitive vaccines may make this strategy unsafe but also unnecessary, as a strong reaction suggests good immunity!
Why do some people seem to get worse side-effects from the vaccines?
Quite a few of my colleagues have had pretty severe side-effects from the vaccines, with lots of pain at the infection site, fevers, joint pains, myalgias etc.; but none of them came to harm from their reactions and this doesn’t mean they shouldn’t get the vaccine. The one thing I have noticed that they all had in common is that they all actually had Covid-19 in the past!
Their “strong” reaction suggests a very robust immune response to the vaccine (which is a good thing!); the “second” dose of vaccine almost appears to be behaving as a “third dose” of vaccine or an episode of immune priming… more exposure, better immune response.
The bottom line is that previous Covid-19 IS NOT a contra-indication to vaccination, you may just feel a bit under the weather after the jab, it’s OK, just allow yourself to recover… have a cuppa tea, chocolate bar, teddy bear or whatever it is that you reach for as a comforter.
Should I be worried about the risk of blood clots associated with some of the vaccines?
This is a tricky one, as the water has become very muddy around this topic.
The only side effects that become common knowledge with any medication are those that hit the news. Seemingly no one worries about diarrhoea with antibiotics (well infection control teams might!) or blood clots with the contraceptive pill or shortness of breath with beta-blockers!! But we’ve all heard about the headline side effect with the Covid-19 Astra Zeneca vaccinations being the risk of blood clots.
The evidence is that overall about 1 in 100,000 people given the Astra Zeneca vaccine developed a clot in an unusual blood vessel such as in the abdomen or their head; they were more common in women and more common in those under 65 years old. The risk of having a clot and dying is 0.2 per 100,000. That sounds like a lot, but let’s put this into context. The odds of suffering a serious injury on the roads in the UK every year is 44 per 100,000 population, and the risk of dying in a road traffic accident is 3 per 100,000… but that doesn’t stop us getting in our cars.
Let’s compare this to our normal understanding of these rare clots. The normal incidence of serious clots outside of the Covid-19 vaccination program is up to 2 per 100,000, they are 3x more common in women than in men, and the average age is 34-42 years old. This is very similar to the rates being reported after vaccination! Therefore this makes it very hard to work out whether the clots are due to the vaccine or are just occurring naturally. The current thinking is that the vaccines do increase the risk of clots, but by how much isn’t clear.
On the flip side, the mortality from Covid-19 is about 1 in 1,000 (and much higher in the elderly or those with risk factors like obesity, heart disease and kidney disease). If there is a lot of Covid-19 around then the benefits of the vaccines outweighs the risk of vaccine complications; however, as the amount of Covid-19 drops then the risk / benefit equation shifts and the risks associated with the vaccine become too high. This is what is happening in the UK at the moment and why the under 40s are being advised to have a different vaccine from the Astra Zeneca vaccine. The incidence of Covid-19 in the UK is about 1 in 1,000 and 1 in 1,000 of these people will go on to die, this means the risk of catching and then dying from Covid-19 in the UK is currently about 1 in a million (1,000 x 1,000 = 1,000,000). That means the 1 in 100,000 blood clot risk of the vaccine is at least 10x higher than the risk of dying from Covid-19 in the under 40s in the UK, hence the current advice for younger people to get a different vaccine.
It’s the same reason why we no longer get oral live polio vaccine in the UK; the oral polio vaccine had a risk of actually causing polio at a rate of 1 in 1-2 million, but as polio now no longer occurs in most countries this extremely rare event is too high to continue to use the oral live polio vaccine (sugar cube version), we get stuck with a needle instead!
Rare blood clots have also been “described” with the Johnson & Johnson vaccine but that doesn’t seem to have caused as much of a stir in the UK. The CDC looked at it in detail and essentially concluded that it is up to patients to make their own decision about which vaccine to have, (really!? that’s not very helpful!).
Personally I have seen more severe reactions, including encephalitis and severe systemic immunological reactions, that appear to be related to the Covid-19 mRNA “style” vaccines (e.g. Pfizer and Moderna vaccines). These have been reported though the normal “yellow card” system we have in the UK for reporting these reactions. Yet you probably haven’t heard of them as they haven’t appeared on the BBC News….!!!! Basically the Covid-19 trials (for all styles of vaccines) were too small to show these “uncommon” side effects. This is why we “usually” rely on longer larger trials, but needs must and all… Did somebody yell PANDEMIC make me a vaccine!
So why all the fuss ONLY about the Astra Zeneca vaccine? Could it have anything to do with Brexit and politics? Cynical, I know!! But why have many European countries made such a noise about a vaccine developed and made in the UK during a time when those countries were unable to get their own vaccination programs up and running… I’ll leave that one for you to ponder over.
Conflict of Interest: I have had the Astra Zeneca vaccine and am due to have my second dose in 1 weeks’ time. I decided not to have the Pfizer vaccine as I did not feel they were presenting enough data even on the small numbers available.
Should I go on an overseas holiday this year?
I would love to go on holiday, somewhere warm and sunny where I can get away from it all to recharge my batteries especially out of the cold and wet British climate, but I really don’t think this will happen this year. ECIC is thinking of booking me on a week-long “subsistence farming course” in Scotland where I can stay in a tent with composting loo facilities! She clearly missed the “warm and sunny” and focused on the “get away from it all”!!!
The UK has made amazing progress with getting people vaccinated. So far 67.8% of the population has had 1 dose of a Covid-19 vaccine, and 35% have had 2 doses. On top of that the infection rates are at the lowest they have been for ages. So why spoil it now? Why not wait until we have much better vaccine coverage before we start re-introducing virus from other countries that are not doing so well, because re-introducing the virus is exactly what WILL happen.
In my opinion it would be far better for us all to “stay in the UK” this summer, keep overseas travel to an absolute minimum (e.g. none), and thereby keep the risk of re-introducing SARS CoV2 into the UK as low as possible. Let’s get through next winter without bringing the NHS to its knees AGAIN, build our immunity and resilience and AVOID another lockdown Christmas/Winter?! Surely overseas holidays can wait, what are our priorities?
Perhaps we should also start trying to help other countries around the World bring their infection rates down, rather than think about how we can go to those countries and lie on a beach.
Is a third lockdown worth a week in the sun? I don’t think it is. I say wait until 2022 for your dose of sunbathing!
So, there you have it. My opinions and thoughts on some of the current questions around Covid-19. I think we’re on a knife’s edge and need to keep going so that we don’t see another wave of infections, but what do you think…?