THE DOCTOR IS IN--Before I start on any update on the several vaccines we have, and those we will have, I want to make something clear:
What happened at Dodger Stadium was a TRAVESTY!
For those anti-vaxxers who blocked and postponed (or even drove away) those who were in line for a vaccination in Dodger Stadium, I'm just sorry that it wasn't a martial law scenario...because then the wholesale arrests could have been performed.
1) In short, IF YOU'RE AN ANTI-VAXXER, THEN DON'T GET IN THE WAY OF ANYONE WHO WANTS A VACCINE!
2) In short, both former President Donald Trump and current President Joe Biden have and are fighting for the development of these vaccines...so why would any of their supporters get in the way of their administration or access?
3) In short, the more individuals who get the vaccine, the more likely someone will get a bad allergic reaction, or even die. Ditto for penicillin or sulfa antibiotics--some people die from allergic reactions to medications that have benefited more people than I/we can possibly count.
Also ditto for the number of those who drive automobiles every day...because every time we get in a car, we might die in an accident. And the laws of statistics state that the risk of dying (or at least just being in an accident) goes up each additional time we get in a car.
Let's review my last article, which bemoaned how little we know about the virus we're contending with:
1) Viruses aren't alive--so how do we kill something that isn't alive? You can't!
2) Either natural immunity, or vaccination to promote natural immunity, is the only way a person can overcome that virus--that's why we don't use antibiotics for viruses. So all we can do is vaccinate or hope that the virus goes away on its own, or we naturally develop "herd immunity" to the virus. Of all the three scenarios, only vaccination appears to be likely to save us.
3) It's usually NOT the virus, but your own body's responses to that virus, that hurts you, makes you feel lousy, or even kill you--if this virus causes you to go into a "cytokine storm" caused by a host of cytokines (molecules we make to crank up our immune system against viruses, and which can also cause autoimmune syndromes), then YOUR OWN BODY CAN KILL YOU.
4) Hence, we have a lot of data, but it's all over the place.
5) Some people will respond to a given antiviral drug, while others will absolutely not.
6) The same drugs that are used to suppress or modulate the immune system will save a person's life, or even protect them from the severity of the virus if they get it.
7) Anyone can get nailed by COVID-19's ability to cause a person's immunity to kill that person, but if you're overweight, male, have atrial fibrillation, diabetes, or any other comorbidities, you will be more likely to be seriously harmed by COVID-19.
8) If you get exposed to a teeny, tiny amount of virus (an inoculum), your body will have a better chance of overcoming or walling off the virus--it's been estimated that up to one-third of us are already immune to the virus, but who or how long the immunity exists is entirely unknown.
How does this happen? The analogy is that of being shot with a 22-caliber pistol. One shot usually doesn't kill you...but ten-twenty shots almost certainly will kill you. Hence, incidental exposure is much more survivable that concentrated "super spreader" events with intense exposure.
9) The Moderna and Pfizer vaccines only exist because their mRNA technology, never used before, allow vaccine formations to be created faster than ever in our history. They are custom-made for a given virus (such as, in this case, the spike proteins of COVID-19), and because they immunize a person from the genetic material and entire spike proteins of this virus, that person is by far more likely to be immune from any new mutations of the virus.
10) The likelihood of somebody getting an allergic reaction to a vaccine, or even having a major event, is exceedingly smaller than getting COVID-19...and many of the side effects of the Moderna of Pfizer vaccines occur because your immune system is being revved up, and because they're WORKING!
And that last point (point #10) is one I want to emphasize and elaborate on in this article:
1) What happened in Orange County to a 60-year-old X-ray technologist who died after his second Pfizer vaccine, is certainly scary to hear about. but the deceased, who had high blood pressure and was slightly overweight--was personally ALSO a proponent of the vaccine--is both unlucky but is also an outlier, and he faced and faces the same risks we all do.
And if I am another outlier to the millions of those globally who will benefit from these vaccines, then so be it. If I die--so be it! Because Life Is Fatal, and the risk of dying or being permanently disabled by COVID-19 is much greater!
There are rashes, allergies, and sore arms that will almost CERTAINLY occur with vaccinations, but these are almost ALWAYS annoying but harmless.
I look forward, as a physician, to my second Moderna dosing this Saturday, and while I don't welcome the sore arm and sleepiness from that shot I also know it's my immune system revving up to give me a year or more of protection from the virus...kind of like your muscles ache after a good workout when you're out of shape--NO PAIN, NO GAIN! So...WHO CARES?
In short, if you want to ignore the hundreds of thousands of individuals who have benefited from both the Moderna and Pfizer vaccines, and focus on one unlucky individual, just don't ever take any medication, and just never get into a car...because, they, too have risks.
2) For those lucky to have their first Moderna or Pfizer vaccination, the questions of availability of the second vaccination are particularly concerning, due to the uncertain sufficiency and access of vaccination dosings.
There are many vaccinations that require two or more dosings/shots, including Chickenpox/Shingles and Hepatitis B. The Pfizer/Moderna mRNA vaccines, like those others, require the first shot to prime the immune system, while the second shot is needed to ramp up the quality and quantity of antiviral antibodies.
3) We can't have uncertainties as to who is truly protected and who is not once the first dosing is administered.
Similarly, the usual allergic response to penicillin or other medications is NOT with your first dosing, but with your second or later dosings. Hence the second dose should not be delayed any later than 42 days after the first dosing. It's damned tough for those still waiting for Dose #1, but to truly make sure that those who begin the vaccination process are truly protected, they've GOT to get Dose #2.
The J & J vaccine is reported to be 66% effective in protecting people from moderate to severe disease in late-stage trials. The bad news is that this vaccine is potentially less effective than the Pfizer and Moderna vaccines (95% effective), but the good news is that it only requires one shot.
Furthermore, there was a global protection effectiveness ("efficacy" is the term used in the medical world) of up to 85% globally, with the effectiveness being 72% in the U.S. That number dropped to 57% in South Africa, and the difference probably reflects the new mutations/variants of COVID-19 in different parts of the world.
The mechanism of action is to deliver a human adenovirus (we've all had these with our colds throughout our lives) that expresses the spike protein of COVID-19...and by the way, to put things into proper perspective, 70% protection is usually and historically considered to be PRETTY DARNED GOOD.
5) As I've stated several times before, Governor Newsom of California should have resigned, and needs to be recalled, simply because he is up to his neck with the blood of dead Californians who needed his honest leadership, and with respect to the physical and economic health of Californians. Ditto for many of California's mayors to resign as well!
Governor Gavin Newsom had a good start to his response to the COVID-19 pandemic in the spring of 2020, and worked well with both medical experts and then-President Trump to confront the virus...but since then he's "over-closed" the economy, and showed tremendous hypocrisy in his handling of the virus.
Enter late 2020 and early 2021:
a) Evening and late-night curfews to prevent the spread of the virus?
b) Allowing Big Hollywood to stay employed while innumerable restaurants and small businesses were shut down in their safe and law-abiding outdoor practices?
c) Imposing restrictions that even Law Enforcement refused to enforce because they were blatantly unconstitutional...and scientifically worthless?
d) Most importantly, Newsom's famous gaffe in NOT wearing a mask with California Medical Association and other lobbyists at the French Laundry?
e) Not only did these stupid ideas shatter our economy, but more importantly a huge number of Californians threw up their hands and had big gatherings during the holidays, and probably engaged in unsafe practices (REMEMBER: human beings are both simultaneously intellectual/rational and emotional/irrational animals).
f) And Californians died aplenty because of a lack of honest, trustworthy, and even-handed/credible leadership: CALIFORNIANS NEED TO BE VACCINATED FROM GOVERNOR NEWSOM!
6) With respect to our current reality, the bad news is that while L.A. County and other areas are suddenly allowing outdoor dining, perhaps because of the Newsom Recall effort, or perhaps because of lowering death rates from COVID-19, we're still doing stupid stuff like banning restaurants from having their TV's on.
So we're still in the Land Of Stupid with respect to opening our economy and allowing our collective mental and economic health to survive in 2021.
7) But the good news is that Blue Shield of California has been tapped to run California’s COVID-19 vaccine system which is an admission of what we knew all along: that front-line medical professionals, and NOT politicians and their well-paid medical "experts", are the best people to handle medical issues.
There will be second and third and other waves of vaccines, and it's safe to presume that our knowledge of vaccines will ramp up as much as will our immune systems once we get them. Historically, this will be as huge a leap in biological technology as were antibiotics in World War II, ICU's during the Vietnam War, and battlefield medicine developed in the Afghanistan conflict.
Because we are now in a different type of war, and unfortunately wars appear to be the best ways to ramp our knowledge of health, biology, and other sciences/technology forward.
And don't be afraid if we have to take new Coronavirus vaccines every year...because after all, don't we take annual flu vaccines because THOSE viruses mutate every year as well?
We will survive this pandemic as a nation, and as a world!
But while we vaccinate ourselves in our arms/shoulders with these state-of-the-art vaccines, we must vaccinate ourselves in our brains against all the misinformation promoted by those who have NO scientific understanding, and misinformation promoted by politicians and their enabling "faux-experts" who are crazymaking all of us!
(Kenneth S. Alpern, M.D, is a dermatologist who has served in clinics in Los Angeles, Orange, and Riverside Counties, and is a proud husband and father to two cherished children and a wonderful wife. He was termed out of the Mar Vista Community Council (MVCC) twice after two stints as a Board member for 8-9 years and is also a Board member of the Westside Village Homeowners Association. He previously co-chaired the MVCC Outreach, Planning, and Transportation/Infrastructure Committees. He was previously co-chair of the CD11 Transportation Advisory Committee, the grassroots Friends of the Green Line (which focused on a Green Line/LAX connection), and the nonprofit Transit Coalition, and can be reached at [email protected] The views expressed in this article are solely those of Dr. Alpern.)