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BRIEF COMMUNICATION
Year : 2021  |  Volume : 3  |  Issue : 1  |  Page : 60-61

COVID-19 vaccine: The answer to the second wave


Department of General Medicine, J N Medical College, KAHER, Belagavi, Karnataka, India

Date of Submission20-Mar-2021
Date of Decision24-Apr-2021
Date of Acceptance27-May-2021
Date of Web Publication31-Jul-2021

Correspondence Address:
Dr. Madhav Prabhu
Department of General Medicine, J N Medical College, KAHER, Belagavi, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijptr.ijptr_16_21

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How to cite this article:
Prabhu M. COVID-19 vaccine: The answer to the second wave. Indian J Phys Ther Res 2021;3:60-1

How to cite this URL:
Prabhu M. COVID-19 vaccine: The answer to the second wave. Indian J Phys Ther Res [serial online] 2021 [cited 2021 Nov 28];3:60-1. Available from: https://www.ijptr.org/text.asp?2021/3/1/60/322913



COVID-19 has taken the world by storm. This is the only pandemic that this generation has seen. So much morbidity and mortality was unknown to us as doctors too. Death and the pain of not being able to see the last remains of your near and dear ones was a feeling that brought the best to their knees. The world was brought to a grinding halt, and for the first time, people were actually locked in. The only hope that the scientific community sought was a vaccine. Everyone had only one question when would the vaccine arrive? The vaccines finally did arrive, but they carried the tags of emergency authorization only and this led to several speculations about the vaccine. This was basically due to the fast-track trials that were allowed for the vaccines.

Let's give a simplified broad overview of the vaccines and the science behind it. Vaccines are nothing but antigens which when injected into the body evoke the same immune response as that generated against a live virus. Only difference is that here the antigen is not capable of pathogenic reaction. This antigen could be a live virus with attenuated pathogenicity or could be another weak live virus with viral antigens (Covishield), and it could be a dead virus (Covaxin) or it could be specific antigens of the virus-like spike protein (Novovax) or mRNA (Moderna and Pfizer). The more antigenic is the particle, the more robust is the response.

India did get a vaccine. In fact, India got two of the best in the form of Covishield and Covovax both manufactured by Indian-based companies. But then, the vaccine arrived only with an emergency use authorization, which meant it was not for public distribution. This created doubts and speculations about the vaccine and gave rise to many a myth about the vaccine. Taking a vaccine can cause COVID infection, vaccination can cause impotency, and vaccine can cause death were a few such myths doing the rounds on social media, all of which are false. Added to this was the news that there were vaccine-related deaths which occurred in the United States of America and many European countries. People however did not recognize the fact that the vaccine used in these cases was a RNA vaccine which is not being used in India.

We, at KLE Hospital, were among the first to stay vaccinated in our Belagavi city. I was fortunately the first to receive it under the government initiative for frontline COVID warriors at the hospital. Most information that we have collected today is from the experiences of the patients vaccinated at our center.

The overall impression is that vaccines are safe. The immunogenicity or how long the immunity will last may be just a suspect. However, the adverse effects are not much recorded. What we have observed is that there is a definite local site pain, this is due to inflammation and is there in all intramuscular injections. There is generalized weakness, bodyache, and fatigue for 2–3 days, but this is usually mild and requires only hydration and a small dose of paracetamol to resolve.

There were a lot of common misconceptions that we as physicians have faced. People have often asked if vaccine needs to be given to those who have suffered from COVID-19 infection. Currently, not much is known about how good and how lasting the natural immunity acquired from COVID-19 infection could be. According to some studies, natural infection-acquired immunity is not robust and may not last very long. On the other hand, a few studies indicate this immunity could last at least for a year. The uncertainty associated with this makes it imperative that we vaccinate these people too. The immunity generated by the COVID-19 vaccine is likely to be powerful and relatively long lasting. In conclusion, it is better to get vaccination done than putting one at risk of death or morbidity due to re-infection. Vaccines can be safely given to patients who have suffered from COVID-19 infection, 4 weeks after the negative reverse transcription polymerase chain reaction test.

I am also asked if people with comorbidities such as diabetes and hypertension should be vaccinated or not. The government has emphasized the need for vaccination in these subsets of patients. We have observed a high morbidity and mortality in such patients, and hence vaccination is imperative in all these groups. In fact, the only people who may not receive vaccination may be those who are acutely sick or on immunosuppressed on medications, since they may not be able to mount an immune response. Pregnant females and children below 18 are not being vaccinated due to a lack of evidence in trials. At KLE Hospital, we have vaccinated most cases safely, even those who had a history of allergic disorders were safely vaccinated but under close supervision. There could be allergic reactions to adjuvants in vaccines, but this is rare.

People are sometimes led to think that vaccines can cause COVID infections. We have to understand that the vaccine is not the live lethal COVID virus. The vaccines are made either from dead viruses or using antigens capable of invoking a robust immune response. There is no way that any of this can cause active infection. The antigens however can cause some adverse effects such as the actual virus, for example, the recent reports of clot formation with the Oxford Astra–Zenica vaccine. There is no statistically significant number of such adverse effects and they may not be seen in the most. We do however need to remember that vaccines are not magic bullets and that protection is not immediate. The best response is 2 weeks after the second dose. Hence, there could be infections before maximum immunity after the vaccine. This coincidental infection is often perceived as due to the vaccine. Furthermore, vaccines may not always prevent infections. Till date, only the Covishield vaccine has been able to demonstrate this capacity to some extent. This is however not absolute. But, the vaccine does prevent serious infectious and deaths. This means that, even if we do vaccinate, we cannot let down our guard, we need to practice COVID preventive behavior, social distancing, and wearing a mask in public and in closed spaces. Adequate sanitization is a must despite vaccination.

Overall, the vaccine strategy adopted by the Government of India is very satisfactory. There is a third wave of COVID which is imperative upon us; it has already started in several cities in India and vaccination may be the only answer which could make this wave less fatal.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.






 

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