Vaccines – A Covid Addendum

There’s a lot of chatter about the Covid-19 vaccines that are being rolled out. In this post, I’m going to address and amplify some of the science heads on.

Background (i.e. why should you believe me?)

I work at the Broad Institute of MIT/Harvard, a biomedical non-for-profit that is developing a completely open-source (i.e. available to everyone free) platform for biomedical research. We are one of a handful of organizations – including many other not-for-profits – working to understand and find treatments for Covid. Curious? Check out the website for more about Covid-related work the Broad Institute is doing.

Understanding what was at stake, my company was one of the first to go fully remote on March 4, 2020. For the past year and a half, I’ve been privileged to attend numerous in-house talks and workshops with people at the cutting edge of the Covid pandemic: experts in epidemiology, researchers, clinicians, and researcher-clinicians, and many others. I’ve drawn much of this information from those.

TL;DR. The Covid vaccines are a shining example of collaborative, well-funded science at its best. If adopted widely and quickly, vaccines can save countless people from needlessly suffering and dying, and get us all out of the pandemic and on with our lives. I hope I can  help nudge the vaccine-hesitant to give it a go.

Why “developed in record speed” doesn’t mean cutting corners

There are a few reasons these remarkably effective vaccines took months, not years, to develop – and it has nothing to do with skimping on safety.  We had a very memorable talk at the Broad specifically about the speed of vaccine development – these are the points I took away from it.

1. The usual impediments to drug development were absent

Typically, companies are scrambling for funding for vaccine research, and lining up enough money to pay for expensive trials takes time. Funding to overcome Covid was immediately available and in sufficient quantities to pull together all phases of trials – something that usually takes years. (side note – the downside of this is that funding and resources for other very important science was put on hold – diverted to Covid research. Researchers literally left their labs to work remote with sensitive experiments intact. It will likely take years to recover from this).

2. We had a head start (we knew what we were looking for)

A lot of work was done years ago to identify marker traits for the viruses responsible for SARS (2003) and MRS (2012). Because of that, researchers knew very precisely what part of the virus genome to look for for a unique marker. When China sequenced the Covid virus (mapped out the exact genomic code of the virus), researchers got to work to figure out what piece to use to make an effective vaccine (see #4 below). You can think of it like the researchers started the race partway to the finish line.

3. Scientists all over the globe collaborated to find a cure

This is almost unprecedented, and it is something that my science-research colleagues have commented on again and again and again. It is what science is supposed to be, but often isn’t (because scientists are people, too, and want to be recognized as the “first” to discover something. And because drug companies also want to be first).

4. Phase III trials went quickly in the US because the virus was out of control

This is kind of a sad one, but it makes sense. In order to prove a vaccine is effective, you have to see how it prevents the disease compared to a placebo in phase III clinical trials. Unlike in the 50s and 60s, when the polio and MMR vaccines were being developed and kids in the two groups were actively given the virus (no longer considered ethical, but welcome at the time), people in the Covid studies had to get Covid just like the rest of the population. If rates had been contained, like they were in some other countries, it would have taken much longer to get conclusive data (i.e.  enough people who got Covid in the placebo group) to know the vaccines were effective. As it was, phase III trials went very quickly. This Wired article is an interesting read about this effect.

Not convinced they’re effective?

From the NYT Morning Edition newsletter (01-19-2021 – I can forward to you): “If anything, the 95 percent number understates the effectiveness, because it counts anyone who came down with a mild case of Covid-19 as a failure. But turning Covid into a typical flu — as the vaccines evidently did for most of the remaining 5 percent — is actually a success. Of the 32,000 people who received the Moderna or Pfizer vaccine in a research trial, do you want to guess how many contracted a severe Covid case? One.”

The data continues to roll out about how effective these vaccines are. It’s truly a scientific miracle.

Vaccine Science – how do vaccines work?
spoiler alert: it’s your own body!

Like most vaccines, the Covid vaccine harnesses the body’s immune system. It is the exact opposite of artificial.

I find many people who object to vaccination don’t understand how vaccines work. It’s not a huge surprise – it might not be taught (or taught well) in school, and there’s certainly a lot of information available that’s just plain wrong but looks convincing enough online.

What all vaccines do is train your body to fight viruses (and cancer!). The viruses have evolved to attack sneakily (i.e. to circumvent that body’s immune response), which is why you need the vaccine. How do vaccines do this? By introducing your body to something that is close enough to the disease so that your body builds up a defense (“antibodies”), but isn’t actually harmful like the real virus. Any vaccine makes you a little sick like the actual disease does – that’s your body learning to fight. But unlike the virus, the vaccine is “attenuated” (i.e. watered down) somehow so that it doesn’t cause all the awful stuff that comes with the disease. And when the actual disease enters your body, your own immune system is ready! Your immune cells recognize the bad guy immediately and attack it effectively – squashing it.

How an mRNA vaccine is different… but even less dangerous

The mRNA vaccine uses a different “tool” to teach your body’s own immune system what the “enemy” looks like. Unlike a traditional vaccine, which uses a dead or watered down version of the actual virus proteins, an mRNA vaccine uses messenger RNA, the mirror image of DNA that the body uses to make copies of cells. mRNA is a natural part of biological systems – the part that is present only when proteins are being produced. What’s kind of magical about RNA is it’s half the protein – enough of the Covid virus to teach the body to recognize and fight off the virus, but it’s not actually the protein that causes the damage. There is no way you will get Covid from an mRNA vaccine. Just like there’s no way to get rich from a pile of counterfeit $100 bills!

On a side note, if you understand how vaccines work, you can see that concerns about the long-term risks of treatment are… kind of a red herring. Do you worry about the risks down the line of your body fighting off a cold this winter? It’s true that vaccines have added ingredients, but it’s kind of a one and done thing. It’s not the same as chemotherapy or taking a regular dose of Advil, where chemicals build up in your body over time and it’s important to understand how those chemicals affect things when the levels accumulate.

mRNA does not manipulate your genes in any way

Yes, it’s something that is related to genes, genetics and cell reproduction, but it’s only used to teach your body to do its work. It’s not changing any of the genetic code in your own body.. You could kind of think of it like if I sent you a jpeg of my mom so you could recognize her when she got to the airport before I arrived. You’d immediately know who she was when she showed up – and I have no doubt you would greet her with your boundless love and energy. But the file I sent you doesn’t somehow affect all the other pictures you have stored on your computer.

In the case of Covid, there is a very particular molecular protein we kind of knew about from previous coronavirus work (see #2 – why we had a head start). The vaccine teaches your body to recognize and fight off that protein image, so when it encounters an actual Covid virus, it knows how to fight it off.

mRNA vaccines have been used for decades to cure some cancers!

mRNA is not a radical, experimental, new technology. It has been used for more than a decade in some of the most amazing cancer treatments (see this Nature article, this overview, and this article on treating melanoma). Moderna (a small biotech company that is down the street from where I work) was founded on this technology (see this article for other vaccines they’re working on) and it has finally come to fruition for them. Yay!

I hope that a personal email from someone you trust will at least make you think hard about what external forces have conspired to make you so suspicious of a truly life-saving treatment. I will add that for those in the world who see firsthand the suffering of people dying of a preventable disease, being able to refuse a vaccine is a tremendously privileged place to be. I am guessing that you, like me, have not seen unimaginable numbers of young people die or be crippled by polio, measles, mumps, etc.

	The Great Vaccinator (true and fascinating story)
	For a delightful recounting of the story of the single man responsible for most of the vaccines we use today for preventable childhood diseases, check out this podcast – Radiolab: The Great Vaccinator.

Not getting a vaccine is a privileged choice

It is only when the vast majority of a population has access to and accepts an effective vaccine that pockets of people are able to refuse it at all – they’re safe because others accept the responsibility of herd immunity.

The idea that vaccines “cause” autism is based on one flawed study ( the man who wrote the original article in the Lancet journal faked the data and was subsequently barred from practicing medicine or publishing). See this article, or this one, or this one.

Or just Google “do vaccines cause autism.” Then make sure to look with a critical eye at the sources for the articles that claim it does versus those that refute the claim.

And, in closing, the world would be a sadder place without you in it. Truly. Especially if the reason you were no longer in it was because you (or too many others) refused a life-saving treatment. Get the Covid vaccine!