Covid 19 vaccination: to have or not to have

My two-cents Rx

WITH BENJ S. BANGAHAN,
M.D., FPCP, FPCCP

Never has the world been made to bear the noxiousness of this much extensive pandemic covidization more horrendously than it has been now, in which the nasty virus has  pervaded almost the whole world, killing surreptitiously and leaving some of its victims almost helpless. We had serious pandemic diseases in the past with indescribable lethality, but the extent of the areas involved was not so prevalent as the permeation undergone by this virus. Now, as we speak, it is not far-fetched to state that perhaps no country, if at  all, has been completely exempted. 

Such a unique meanness of a viral disease is enough to create an overwhelming  creepiness in anyone’s state of mind. If all people have been engulfed by fear, it is because that each one always thinks of his loved ones first and foremost  and what possible state of health they are apt to be in. Indeed this Covid 19 level of horror very peculiarly different.

Be that as it may, we have to settle in peace and quiet and deal with the problem with an unaffected presence of mind. Viruses, like bacteria, are organisms created to cause diseases, but some of them do not necessarily result that way because the human body defense system produces antibodies that are competent enough to prevent them from generating diseases, even without either vaccines or the development of clinical diseases. 

Other viruses are indeed capable of producing some mild forms of clinical symptoms, but which also activate the  human defense system into creating the appropriate antibodies that would render the diseases mild and short-lived.  It is the drastic form of viruses, the more dreadful ones, in which problems can develop and create clinical guessing games. Despite the expertise of medical science that doctors know and apply, morbidity and mortality would still be inadequately addressed. Covid-19 probably belongs here. Just as a corollary, the  Philippine statistics has observed since about more than two weeks ago that there has been large scale spread of the different variants of Covid-19, to wit: 1246 cases from Beta or South Africa variant, 1071 cases from Alpha or UK variant, 13 cases of Delta or India variant, 2 cases of Gamma or Brazil variant, and 163 cases of Theta variant discovered in Central Visayas but which is still under investigation by WHO.

Still, by tradition, the antibody, either naturally produced or man-induced through vaccines, is still the armamentarium resorted to in this face-off. In relevance to this subject, we may have to state that, comparing the antivirus drugs and the antibiotics according to the parameters of efficacy, adverse events and price, the former is  inferior and is much costlier. This is not to say that vaccines have no downsides, for there are.

Now zeroing in on vaccine production. Manufacturers from different countries have been moving double time on account of worldwide panic and general fear. The state of urgency, to some extent, has apparently pushed researchers to sacrifice the  standard length of time of each phase of investigation and tests for the purpose of coping up with the need. That is perhaps the reason why vaccines have been observed to have become immediately available one after another just in a span of even just about  two years or even less, a short time indeed compared to the standard practice of drug study, which encompasses phases I, II, III, and even including phase IV, the period of actual clinical use, which in total can translate into much longer time.  

Vaccines prevent diseases by mimicking the organisms, thereby triggering the human body to generate antibodies that bring about protection if the person gets infected with the actual virus. They differ in composition, therefore, they are also expected to differ  in the manner of triggering immune response to create antibodies. As of the last couple of days, the Food and Drug Administration (FDA) has a total of  eight (8) vaccines to which it issued emergency use authorization (EUA) and which are available in the country; they are (chronologically):

  1. BioNTech by Pfizer
  2. Oxford AstraZeneca
  3. CoronaVac vaccine by Sinovac
  4. Sputnik V by Gamaleya Research Institute Russia’s Min. of Health)
  5. Janssen vaccine by Johnson & Johnson
  6. Covaxin vaccine by Bharat Biotech of India
  7. Moderna vaccine by Moderna, NIAID
  8. Sinopharm vaccine by Beijing Inst. of Biological Products

Not all vaccines are similar. Some are to be given only to 12 years and above, others given only to 16 years and older, and they have differences in adverse events. 

The specifications of each vaccine is a must information that medical frontliners are expected be aware of. It has been the belief of most viral disease experts that Covid-19 vaccination does not mean that one cannot  be affected by the viral disease. What good effect the vaccination renders is, if  a person does catch the disease, he can handle it better, and in all probability hospitalization may be less likely, and more importantly, he has more chances of being saved from death.

The possible unpleasant side effects that might follow the vaccination, and which may become  sources of  anxiety are: tenderness, pain, warmth, reddening and swelling in the area and the vicinity of the injection; feeling of being physically weak; headache and feverishness; and musculo-skeletal discomfort. These are signs that the vaccine is actually rendering its protective effects; usually they get relieved after 2 or 3 days. Should they persist more than that, a simple pain relieving medicine may be taken. Allergic reactions may occur, and if it is manifested by difficulty of breathing, wheezing sound during respiration, swelling of the face, feeling of tightness of the throat, he/she must be immediately brought to a doctor.

Lately, a problem of some vaccines becoming the source of adverse events involving blood clotting  has been raised since the event is quite concerning. Blood clotting has been observed to occur more in the brain and abdominal areas. Accordingly, the blood clotting issue is observed in Johnson & Johnson, Oxford AstraSeneca and Sputnik V vaccines.

All post-vaccination adverse events are looked into by the entity Adverse Events Following Immunization (AEFI).

On the whole, the wisdom behind the advice for immunization is well founded on 

 medical studies, but it is just unfortunate that some adverse events are unpredictable.  While vaccination is said to be not mandatory, the government encourages the public  to submit for vaccination and be protected, which consequently also protects the families and the general population. And in that context, post-vaccinated persons  must continue wearing face masks and shields, do hand washing, avoid crowd, observe distancing and maintain good ventilation.

Maybe relevant to the issue are the frequently read posts that warn people about the cruel intention behind the creation of the virus,  as well as the wickedness of  the produced vaccines, if indeed the bases of the writers substantiate the claims. While 

some of the posts have been apparently made by respectable people in the medical field, and especially in virology, we are not, under the circumstances, in a position to establish who are speaking the truth regarding the issue. The very palpable reality is that, thousands and thousands worldwide die everyday, and the number is increasing in some areas more than it is abating. That reality is what needs being confronted in any way one can, for life is precious, and Allah swt has endowed all  His creations the intellect to engender all modalities appropriate to stymie the calamitous event, whether or not the etiologic circumstances are known.

There are times when our God-given intellect, sense of good and evil and simple  common sense can be of big help.  Māassalāma.

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