Dispelling myths about COVID-19 vaccines
How to respond to antivaxxers and WhatsApp postfactualists
Myth: Before COVID-19 there were no vaccines that prevented diseases caused by coronaviruses.
This is incorrect. There are vaccines for deadly diseases in animals that are caused by coronaviruses.
There were no vaccines for diseases in humans caused by coronaviruses, but there’s never really been quite the need for a vaccine to prevent a coronavirus-caused disease like this either. No coronavirus has ever caused a pandemic. The first truly deadly coronavirus disease to emerge in modern times in humans was SARS. There were excellent vaccine development programs underway. And then SARS was controlled. All of this happened under a year. So, the impetus to financially support the development of a vaccine and the means to test it vanished.
The second deadly coronavirus disease to emerge in modern times in humans was MERS. This is spread by limited transmission from camels to humans and sometimes from humans to humans. It does not spread as easily as SARS-CoV-2. A MERS vaccine was under development. In fact, the first COVID-19 vaccine that went into trials (Moderna) was developed using a techniques that were being used to create the MERS vaccine.
Myth: We don’t even have a vaccine for the common cold, so it’s not possible to create one for COVID-19.
"We don't have a vaccine for the common cold" has been a common refrain for almost an entire year now.
"Is one even necessary?" I would counter.
Developing a vaccine costs billions of dollars. Who would fund a vaccine for the common cold? The common cold is not caused by one virus, but instead by over 100 different viruses. Vaccines are usually very specific to their pathogens (though sometimes they can have off-target effects). A vaccine for a disease that has mild symptoms, kills virtually no one, and is caused by scores of viruses is not worth the effort.
The truth is that there are an inexhaustible number of health-related areas of possible research and development, but only a certain number of treatments and vaccines that make it to market. That is because there is never an inexhaustible source of people or funds for projects. Pharmaceutical companies move ahead with what is possible, but also by what is potentially profitable.
Myth: If scientists couldn’t create a vaccine for HIV/AIDS in over 35 years, it’s not possible that they made an effective one for SARS-CoV-2.
I’ve seen this a lot on the internet over the past few months mostly by people who never cared to think about HIV/AIDS or viruses before before the current pandemic. My snarky response would be to tell them to buy the latest edition of Principles of Virology which just got published. There are more viruses than there are any other kind of biological entities. They’re not like Dilip Kumar in a double role in Ram Aur Shyam. (But seriously, get both volumes of Principles of Virology. It is an amazing textbook).
It is true that we don’t have a vaccine for HIV/AIDS and that’s not from a lack of trying. HIV is a formidable adversary. Vaccines are created to mimic the immune responses of patients. There’s no documented case of an HIV-infected person developing an immune response that spontaneously clears the virus. So for an HIV vaccine to be effective, it would have to work better than natural infection. HIV also has a very high rate of mutation making it hard to pin down with one drug or vaccine.
That’s not the case with SARS-CoV-2, which causes an acute infection and has a lower mutation rate. Most people clear the virus in a few weeks, though they may suffer lingering sequelae (Long COVID) even after the virus is gone.
Myth: There’s no point in getting a COVID-19 vaccine if it works for only six months.
What is the basis for saying that the COVID-19 vaccine will work for only six months?
SARS and MERS antibodies were detectable from recovered patients 1-2 years later. There have been multiple studies that have detected antibodies and T-cells at six months after SARS-CoV-2 infection. In addition, there’s another study by Dr. Shane Crotty and colleagues that predicts that immunity might last a year based on the persistence of antibodies and T-cells. The immune response has not been detected after a year, because these patients were not infected a year ago. Hardly anyone on the planet was. We simply do not know how long a vaccine offers protective immunity because participants in phase III trials only got either a shot or a placebo less than a few months ago.
And even if we found out that a vaccine only prevented infections for six months, and immune responses waned, it is possible that infection after getting vaccinated would be milder. It is much better to have an asymptomatic or mild infection than to end up in a hospital or dead.
Myth: There is no point in getting a vaccine for a disease in which 99.6% of people recover.
I’d like the people who are insinuating that COVID-19 is not a serious disease to muster the courage to say this directly to healthcare workers who are on the frontlines, those who have lost loved ones, and those who are struggling to recover from Long COVID. If the infection fatality rate is 0.3% then it is still at least an order of magnitude greater than the seasonal flu. Millions of people will die without a vaccine. Because a small percentage of a large number is still a large number.
Here’s another way of looking at it. 98% of those who were infected with the polio virus also had mild or no symptoms. I would not roll the dice on getting a preventable potentially fatal disease on anyone if there were safe and effective vaccines.
Myth: RNA vaccines are not safe. They integrate into genetic material and do crazy stuff.
It is the goal of clinical trials to determine safety. No vaccine is safe a priori. We still need to see the data for the Pfizer and Moderna RNA vaccines, and they will need to go through peer-review in scientific journals. In the US, they will be submitted to the FDA for approval. In addition, safety data will be tracked for years to come. But so far, they seem to be well tolerated at the doses they that were administered to the people who got them. The data for these particular vaccines have not been peer-reviewed. But recently there was an excellent study published in Immunity that showed that mRNA vaccines represent a great new class of vaccines for SARS-CoV-2 infections.
The second statement is easier to address. I realize that whenever anyone brings up the word genetic it stokes fear in people who don’t know the difference between germline and somatic cells. This is a failing of our education system, but suffice it to say for now that messenger RNA does not integrate into DNA. And it certainly doesn’t get passed on to offspring. It is used by the cellular machinery to make proteins. With an RNA vaccine, there’s no actual part of the SARS-CoV-2 virus that is injected into people. Perhaps the best analogy was provided by Dr. Shane Crotty—
RNA is like snapchat messages that expire.
As Dr. Florian Krammer pointed out on Twitter, this is not the first time that RNA vaccines have been tested on people.
Myth: Cold chain management makes it impossible to immunize millions of people with RNA vaccines.
Having vaccines that need to be frozen certainly makes it more difficult. But impossible? No, not impossible. The MMR vaccine for mumps, measles, and rubella also requires a cold chain. That vaccine is also administered in two shots. The difference is there’s an established manufacturing and distribution network, and the entire planet doesn’t need to be immunized at once.
And that’s why we need many different vaccines.
This particular newsletter is an expansion of a Twitter thread I did back in April:
The pre-order link for the hardcover “COVID-19: Separating Fact from Fiction” is now available on Amazon’s Indian site.
It’s been four months since I started my newsletter (and this is the 13th edition). In general, interest has started to plateau. I might experiment a bit with format, topic, and frequency. I am also planning on having a few guest posts as well. That said, I have no immediate urge to move to a paid format.
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Very well-rendered