Not all infectious diseases can be presently fought with a vaccine. The HIV, respiratory syncytial virus, and the cancer-causing Epstein-Barr virus kill millions of people every year and have no vaccine yet. Now, with the multi-country approval of Covid-19 vaccines, Covid-19 has become the 28^th vaccine-preventable human disease. Reason enough for us all to cheer the victory of science over despair… But, wait a moment… At the virtual press conference held by the World Health Organization (WHO) on December 28, 2020, the WHO Chief Scientist – Dr. Soumya Swaminathan, said, “We continue to wait for more results from the vaccine trials to really understand whether the vaccines, apart from preventing symptomatic disease and severe disease and deaths, are also going to reduce infection or prevent people from getting infected with the virus, than from passing it on or transmitting it to other people. I don’t believe we have the evidence on any of the vaccines to be confident that it’s going to prevent people from actually getting the infection and therefore being able to pass it on.”

Dr. Mark Ryan, Executive Director – WHO Health Emergencies Program, agreed with Swaminathan, “We just don’t know enough yet about length of protection and other things, to be absolutely able to predict that, but we should be able to get good control of the virus.” In an interview with Newsweek, Dr. Anthony Fauci, Director of the National Institute of Allergy and Infectious Diseases (NIAID), USA, reinforced WHO’s admission that health officials do not know if COVID-19 vaccines prevent infection or if people can spread the virus to others after getting vaccinated.

There are many amongst us who want to know and understand the complete facts, as they get overwhelmed with an overload of opinions from experts all around. So today, I bring before you threadbare – not any opinion – but excerpts and facts based on research findings from published scientific studies and literature…

Post the COVID-19 infection, people develop immune responses. Covid-19 antibodies lasted at a good level even after 6-8 months of infection. However, a natural infection may not be the choice for getting immunity because many of those (one in three) people who recover from Covid-19 have chronic complaints, including exhaustion and a racing heart, for months afterwards, including people under 35 years of age, with no previous health conditions. Several of the survivors of Covid-19 have reported symptoms similar to those of lupus and rheumatoid arthritis. Covid-19 vaccines, in contrast, carry only a few and little-known risk. So far, Covid-19 vaccines have been tested in tens of thousands of people and used on a million people, with no serious publicly reported side effects.

The COVID vaccine, launched in India on 16^th January, 2021, was first administered to healthcare / frontline workers. The second group to receive COVID-19 vaccine will be people over 50 years of age and those under 50 years with co-morbid conditions. The aim of vaccination is to build up herd immunity, where enough of the population is protected from the virus, and as a result, transmission slows down significantly to eventually kill the disease.

However, scientists are not sure about the magic number (fraction of the immune population) to obtain effective herd immunity for COVID-19. Their best estimate is somewhere around 70% of the population, which could take months (in nations with developed health system) to years in achieving the target through vaccination. This certainly is a very conservative estimate and will surely change, depending on the contagiousness of the present Covid-19 and the mutant viruses destined to emerge in the future.

Moreover, people in reproductive age, planning to have a baby in next three years, are advised to abstain from Covid-19 especially mRNA-based vaccine due to probable fear of unwanted mutations in germ cells. Currently, mRNA vaccines are not available in India.

Vaccines are primarily used for prevention of the diseases and disease outbreaks aiming for disease control and eradication. Prophylactic and therapeutic are two groups of vaccines based on its design. While prophylactic vaccines are administered as a precautionary measure to avoid the infection or disease, therapeutic vaccines are administered after the individual is already affected by the disease or infection.

As per the official Indian government MOH website, vaccination for COVID-19 is voluntary. However, it is advisable to receive the complete schedule of COVID-19 vaccine for protecting one’s self against this disease and also to limit the spread of this disease to close contacts including family members, friends, relatives and co-workers. Truth is – we are still in the infancy stage to understand the complete effect and outcome of Covid-19 vaccines in its entirety; we neither know its therapeutic value nor the disease prevention potential in detail.

The potential vaccines for COVID-19 either approved for use or in trial stage include:

1. A) INACTIVATED OR WEAKENED VIRUS VACCINES: the inactivated or weakened virus is incapable of causing disease but induces a protective immune response.
2. B) PROTEIN-BASED VACCINES: subcomponent vaccines contain harmless fragments of the virus like spike proteins or protein shells that mimic the COVID-19 virus i.e., ghost viruses or virus like particles (VLPs) are often safe and generate an immune response.
3. C) VIRAL VECTOR VACCINES: use a harmless carrier virus either natural or genetically engineered designed to carry genes to produce Corona-virus proteins in host to generate an immune response.
4. D) RNA and DNA VACCINES: a cutting-edge approach that uses genetically engineered mRNA or DNA to generate a protein, often requiring a potent delivery system and adjuvant to induce the immune system to mount a protective response.

It’s too early to know and claim if COVID-19 vaccines will either provide long-term protection or not but at present it is claimed to protect for 6-8 months after a booster vaccination. This is an assumption and based on the available data suggesting that most of those people who recover from COVID-19 develop a protective antibody titres (based on which serum therapy has been practiced across nations using convalescent serum) and cellular immune response which provides protection from re-infection for 6-8 months.

If one is taking medicines for illnesses like Cancer, Diabetes, Hypertension etc., can s/he take the COVID-19 vaccine? The official website of MOH gives a clear ‘Yes’. Persons with one or more of these co-morbid conditions are considered high risk category. They need to get COVID-19 vaccination.

WHO has advised that people with some medical conditions should not get certain Covid-19 vaccines, or should consider prolonging it. Such warning conditions are chronic illnesses or treatments (like chemotherapy) that affect the immune system; severe and life-threatening allergies to vaccine ingredients, which are rare; or those with severe illness and a high fever on the day of vaccination.

What about the possible side-effects from COVID-19 vaccine? The official MOH website assures us that COVID vaccine will be introduced only when the safety is proven. As is true for other vaccines, the common side effects in some individuals could be mild fever, pain, etc. at the site of injection. States have been asked to start making arrangements to deal with any Covid-19 vaccine-related side-effects as one of the measures towards safe vaccine delivery among masses.

Like any other medicine, vaccines are known to cause several mild side effects; similarly, Covid-19 vaccines may also induce low-grade fever, or pain or redness at the injection site. Most of the mild reactions go away within a day or a few days on their own. Severe or long-lasting side effects are claimed to be extremely rare. Vaccines are continually monitored for safety, to detect rare adverse events. Participants of several Covid-19 vaccine trials have experienced mild, lingering, and in some cases, ‘totally strange’ side-effects. A trial detailed suffering from bone-breaking chills, and a fever that went up to 102 degrees Fahrenheit within hours of vaccine inoculation. Onset of production of antibodies may also cause a low-grade or high fever, accompanied by redness and swelling at injection site.

Commonly reported side effects of the vaccines include fatigue, headache, and muscle pain. These side effects go in a day or two. However, the most-commonly reported side effect from the vaccine is an injection site reaction. It can be a little tender; it can hurt to move the arm a little bit. Some participants in trials reported chills, joint pain, or fever following vaccination. Reactions were more often reported following the second (booster) dose of the vaccine. Serious side effects as Bell’s palsy (characterized by rapid onset of mild weakness to total paralysis on one side of your face (facial hemiplegia, the 7^th nerve inflammation) within hours to days of vaccination leading to facial droop and difficulty in making facial expressions, such as closing your eye or smiling, drooling and pain around the jaw or in or behind your ear on the affected side) have been reported in 0.5% of a particular brand’s vaccine trial participants besides rare severe allergic reactions to vaccines can also happen.

Anaphylaxis, a potentially life-threatening allergic reaction, has been linked in the past to multiple types of vaccines. Severe allergic reaction after receiving the Covid-19 vaccines (1.31 per million doses) alerted authorities to closely monitor whether anaphylaxis is linked to all Covid-19 vaccines, or merely those made of mRNA. Eight people in the trials had Bell’s palsy after receiving the vaccine. Having Guillain Barré syndrome is another possibility after getting vaccine shots. It is prudent that if you have an immediate allergic reaction after getting the first dose of vaccine, you should consult your physician before getting the second dose.

Did you know that efforts to develop a Covid vaccine have been from a long time before Covid-19 became a common term? As noted by the authors of International Journal of Clinical Practice paper, previous coronavirus vaccine efforts — for severe acute respiratory syndrome coronavirus (SARS-CoV), Middle East respiratory syndrome coronavirus (MERS-CoV) and respiratory syncytial virus (RSV) — have revealed a serious concern: The vaccines have a tendency to trigger antibody-dependent enhancement.

What exactly does that mean? In a nutshell, it means that rather than enhance your immunity against the infection, the vaccine actually enhances the virus’ ability to enter and infect your cells, resulting in more severe disease than had you not been vaccinated. This is the exact opposite of what a vaccine is supposed to do, and a significant problem that has been pointed out very often earlier by research scholars. This certainly doesn’t mean the current covid-19 vaccines have the same issue as no public details have been released on the same.

A potential point of concern is the “Leaky” vaccination. When a vaccinated host keeps on shedding disease germs due to persistence of disease-causing agent without any apparent clinical disease, it is called leaky vaccination. Studies on Covid-19 vaccines at present are silent over this point. The leakiness is of concern because it increases vaccination coverage required to prevent disease spread and can also promote the evolution of the pathogen with increased virulence.

Last but not the least, to answer a very commonly asked question – Do we need to practice social distancing and use face mask even after vaccination? The answer from all the authorities is a strong YES!

Please note that this article is in no way intended to influence the decision of the readers and each individual should choose the best course of action for their health based on personal consultation with their family Physician. I wish and pray the very best for you and for all of mankind a V for victory! God Bless!!