2020 saw the world ravaged by Covid-19 but 2021 will hopefully see the world fight back against this virus through vaccinations.
The Pfizer-BioNTech vaccine is available currently in Ireland but the belief is that two more, Moderna and Oxford/AstraZeneca, will follow suit in time.
So as cases spiral in Ireland and hospitalisations increase rapidly, vaccines are a hot topic right now and Doctor Sean Montague has answered what we believe to be very important questions about these potentially world-changing vaccines.
The adopted Laois man, originally from Tyrone, works in Kilnacourt Surgery in Portarlington.
As we speak, the 14-day incidence rate in Laois has never been higher and Dr Montague says that his surgery queries as regards Covid-19 is extremely busy.
He said: “There is a lot more positive cases in Laois this week and we are experiencing a much higher volume of calls than before Christmas.
“That is leading then to a far higher number of people that we are sending for tests, returning positive results. Everything has gone up.
“They say that less than 10% of these new cases have been found to have the new UK variant in them – so it is still largely the original Coronavirus that is infecting people but it is circulating rapidly.
“So it is ABSOLUTELY critical that people reduce their contacts as a matter of urgency.
“It has definitely been the busiest we have been from a Coronavirus point of view since March or April of last year.”
More than 2,260 people have now been recorded as Covid-related deaths in Ireland since the pandemic began in March.
And Dr Montague, using his understanding as GP, explains how the Coronavirus ultimately leads to these people passing away – by causing a person’s immune system to damage themselves.
He said: “If the immune system doesn’t have a specific knowledge of whatever is attacking it, it tends have a non-specific inflammatory reaction causing marked damage to its own tissues.
“So the body’s immune response is not specific if it doesn’t know what is causing the harm – and that causes a lot of problems.
“Part of the treatment for the Coronavirus is to give people a steroid called Dexamethasone and the way that it works is to reduce the body’s immune system.
“A lot of the harm caused by this virus is the body’s own immune system reacting against the virus. You damage your own tissues.
“So the vaccine modifies your immune system to produce a very specific response and it attacks the Coronavirus by attacking its Spike Proteins which makes it unable to get into the cells.
“Coronavirus gets its name from Latin as Corona means crown in that language and the shape of this crown is taken on by the Spike Protein.”
Two of the vaccines that have been developed are called RNA vaccines – a brand new technique and Dr Montague, once again using his understanding as a GP, explains how they work.
He said: “There are a few vaccines that have been developed. You have the Pfizer-BioNTech vaccine and the Moderna vaccine – both of which are RNA vaccines.
“It is the Spike Protein that allows the Coronavirus to enter the body’s cell. So, if the Spike Protein can’t function then the Coronavirus can’t get into the cells, then it can’t do that much harm.
“The two vaccines mentioned earlier work through what is called ‘RNA’. RNA (ribonucleic acid) is a recipe for a code of proteins and the body recognises RNA because RNA is what is read from DNA.
“The RNA is transported into the interior of the cell called the cytoplasm. In the cytoplasm, the process of making the protein from the RNA recipe takes place.
“For the first time ever, a completely new technique, the vaccine contains RNA which codes for the Coronavirus Spike Proteins.
“When the vaccine is administrated, the cells of the immune system, take the RNA into their cytoplasm and manufacture Spike Proteins.
“This causes the body to mount a specific immunological response against the Spike Proteins on the Coraranvirus’ coat preventing the Coronavirus from entering the cells as effectively.
“It takes two weeks approximately for this process to take place.
“The body then in future recognises the Spike Proteins as something that it has to respond to so it produces antibodies and cell mediated immunity against the Spike Protein.
“When there is immunity, the Coronavirus can’t really attach into anything efficiently so it can’t get into the cell.
“Put simply, all the vaccine is is RNA coding for Coronavirus Spike Proteins wrapped in Lipid, which is basically means it is surrounded by a layer of fat.
“So it is a fairly ingenious kind of vaccine and now that they have this, the technology could transfer to be used in other diseases such as HIV which is another RNA virus. So it really is a big breakthrough.”
But are these vaccines unsafe? Will they alter my DNA? Are the government using them to microchip me and track my movements?
According to Dr Montague, the answer to those questions are no, no and no.
He said: “Some people were saying that it alters your DNA, but it doesn’t. It does not get into your DNA because DNA is different from RNA.
“In the human body, RNA is read from DNA but the process does not take place in reverse.
“It is not going to microchip you either. All it is going to do is make your cells make the Spike Protein and then the immune cells will recognise this and mount an antibody and a cell mediated response to it.”
And why do we need a second dose of the vaccine a couple of weeks after the first?
Dr Montague said: “There are immune cells in the body that are memory cells.
“So, the purpose of the second dose is to try to stimulate these memory cells to make sure that the immunity that you get lasts a long time.
“That is the rationale behind the second dose. So whatever brand of vaccine you get, you will most likely get the same brand the second time.”
The other two vaccines, the Oxford/AstraZeneca vaccine and the Sputnik V vaccine, work in the more traditional way.
Dr Montague said: “The Oxford/AstraZeneca vaccine is different because it is virus-vector vaccine.
“They attach the Spike Protein onto an Adenovirus which causes the common cold in chimpanzees – which is genetically modified so that it is impossible for it to grow in humans.
“So in the same way, the body recognises the Spike Protein on the surface of the harmless virus so it is more of a traditional type of vaccine.
“The Sputnik V vaccine in Russia is supposed to work in the same way – although we know less about that vaccine at the moment because we haven’t seen as much data on it.”
How effective are these vaccines? And if the Coronavirus mutates, will they still work?
Dr Montague said: “In trials, the Pfizer-BioNTech vaccine and the Moderna vaccine showed over 90% of effectiveness against severe and invasive Coronavirus disease.
“Because the Coronavirus is an RNA virus, it is going to mutate at a faster rate because RNA is less stable than DNA.
“But even if it does mutate, the critical feature of a Coronavirus is the Spike Protein and they are not going to change. It will no longer be a Coronavirus if it doesn’t have the Spike Proteins.
“Maybe the virus will change a little bit but following the vaccine, there should be immunity against it regardless.”
Vaccination began in Ireland before the New Year and it is hoped that 35,000 people will receive the Pfizer-BioNTech vaccine this week.
That is being targeted towards healthcare workers and the vulnerable at first.
And while the rest of us may have to wait a while, Dr Montague is convinced that there is certainly light at the end of the tunnel which is what makes it so worthwhile to adhere to social distancing and hygiene measures at present.
He said: “The problem with the Pfizer-BioNTech vaccine is that it has to be stored at -70 degrees so that will probably only be administered in specialised centres.
“The Moderna vaccine can be stored in an ordinary fridge and the hope is the GPs could get that in the middle of February.
“The EMA (European Health Authority) have not approved the Oxford/AstraZenec yet.
“But the EMA has given approval to the Pfizer-BioNTech vaccine which is currently being rolled out and they are on the verge of doing the same with Moderna.”
Further information on all of the points made by Dr Montague, check out the relevant links below:
- Understanding mRNA COVID-19 Vaccines
- Explained: a visual guide to how the Pfizer Covid-19 vaccine works
- COVID-19 vaccines: Get the facts
- Provisional Vaccine Allocation Groups
- Covid-19 vaccine: Everything we know so far about the rollout
- Covid-19 vaccine: Public Health Advice