Arguably, the true turning point of this pandemic for the United Kingdom came on the 8th December when the first patient was vaccinated with the Pfizer/BioNTech mRNA vaccine. This cornerstone in the battle against coronavirus came after months of restrictions, deaths, anxiety and collective trauma in the face of uncertainty and hardship. Since then, at the time of writing, 30.6 million people have received a first dose of the two main vaccines currently being offered in the UK, the Pfizer vaccine and the Oxford – Astra Zeneca vaccine. This come amidst a spate of new coronavirus variants around the word, and a surging crisis in Europe where many previously stable countries (such as France and Germany) have been forced to reintroduce much loathed restrictions to curtail their epidemic.
Whilst the vaccinations, to many people, will feel like a vast relief, there are still risks with coronavirus affecting those who have been vaccinated. Overall, it appears both of the main vaccines currently used (hereby referred to as the Pfizer and Oxford vaccine) have a good level of protection, with each vaccine providing 95% and 70% efficacy respectively (from manufacturer’s data). Not only does this provide a good level of protection from deaths, both of these vaccines appear to be extremely effective at preventing serious illness and hospitalisation, a much-desired outcome. Lockdown continues to ease cautiously in the UK, and incredible data from the first priority group to be vaccinated has been encouraging; in mid-February, the death rate in over 80’s fell by 62%, and as similar pattern is being witnessed amongst the over 70’s and 60’s since then. In fact, the initial dose of vaccine is enough to drop the risk of symptoms to older people by 57%, rising to 85% after their second dose. This news is enough to spread real hope that, in fact, these vaccines may also prevent transmission, a novel, yet hardly undesired outcome.
Indeed, the tone amongst governments ministers and scientific advisers is that we, collectively, very much need to accept the presence of the virus into the burden of other viral pathogens we have to contend with on a long-term basis. The scientific community have been cautious and clear in their declaration that whilst the current progress made with the vaccination program in the UK is nothing short of phenomenal, extremely dangerous variants have already infiltrated our borders. Multiple rounds of surge testing in affected areas appear to have contained the new variants before they were able to establish into a more serious epidemic in local communities, howeverthe real concerns are around the South African and Brazilian variants which have tiny mutations in genetic code which provide an ecological niche for novel viruses. The current vaccines utilise mRNA technology to release the coronavirus spike proteins, so the immune system can identify the virus with no real risk of the virus causing pathology. However, mutations in gene sequencing and coding may be creating adaptations for the coronavirus to enter cells in other ways other than through a spike protein, or changing the structure of the spike protein, which renders the virus effectively untouchable as the mechanisms for neutralisations are now ineffective.
To continue, these viral adaptations, in theory, are only to evade antibodies in the blood and fluids of a patient, not other components of the immune system. New emerging data will surely shine a light on this worrying issue, with the jury still out on just how effective the current vaccines may be in the real world as most current data on new variants comes from in-vitro studies. This links in very well with a pressing matter on many people’s minds, regardless of whether they’ve had a vaccine or not, which is; if I have a vaccine, how long am I protected for? This is something pondered heavily by scientists, advisors, and not least, the government. Many viruses that we live and deal with on a daily basis require top ups and boosters, for example with influenza, or with other vaccines when people travel to high-risk areas. With the advantageous rate of transmission coronaviruses possesses, it is likely we will continue to see mutations and new variants emerging as the pandemic continues to unfold. Pfizer and the creators of the Oxford vaccine (as well as Moderna, and others) are already looking to modify their vaccines to incorporate protections for new variants, as is done with Influenza.
Vaccination is already having a profound impact on coronavirus in the UK, with half of all adults now vaccinated. This has reflected a marked drop in cases, hospitalisations, and deaths down to double digit numbers, instead of the enormous 1000+ peaks we saw in January. However, this continued success hinges almost totally on the current variants we are familiar with and protected from. In winter 2021, there will no doubt be a significant booster campaign planned to ensure all vulnerable people and adults are once again protected with updated vaccines to protect against new strains. The continued reduction in hospital admissions, cases and deaths means healthcare systems can begin to recuperate, something well in the interests of the public as a record number of patients await surgical care in long waiting lists. The threat, though, is ever present, and our success still balances on a knife edge of randomness and nature’s instinct. The deployment of mRNA vaccines means vaccines can be tweaked almost immediately, as opposed to previous technologies which involved creating whole new medicines to make any real changes. Still, we must continue with caution and remain realistic about the outcomes of this pandemic in that many things are still outside of our control. The immediate danger may have lifted, but the burden of long waiting lists and care deficits are beginning to bare their teeth, not to mention the ongoing pressure on our health services created by the need for mass vaccination, and these may prove to be a different problem entirely.