To vaxx or not to vaxx? Is this really the question?

An open letter to all the agnostic fence sitters out there

So I was at a dinner party last night and the discussion innocently veered toward the topic of getting the covid vaccine. Now I don’t attend many dinner parties, in fact I don’t really like being around other people much, even when it is my friends. Introvert by nature, extrovert by nurture and circumstance. I am not a hermit, yet, though I often dream about embracing that lifestyle. People are just too much work, and I am lazy.  So this is how one of the attendees entered the conversation: 

"Ooh I don't know about this vaccine, I'm on the fence about it, you know what I mean?" seeking obvious confirmation from his peers.  

"Well, you're anti-vax then," blurted another friend immediately, not sardonically, on the contrary, his demeanor was sincere, bordering on the concerned. I felt the same as this other fence sitting friend of ours is highly intelligent and something of a social butterfly, as in he mingles with many different people and is someone you could imagine others looking towards as a sort of conscious Leitwolf, for lack of a better term, a thought leader of sorts.

It is these people that pose the greatest risk to our society, but at the same time also present our greatest hope and salvation.

I felt compelled to capture this little moment in time as it is presumably happening all over the globe at present, ad nauseum.

People expressing their concern over this vaccine.

Whether it is body autonomy zealots or the “world is a conspiracy of the rich trying to control the poor” soap boxers or whatever narrative is chosen. The “I studied biology and there seems to be something suspicious about the way this vaccine sailed through the regulatory process” cohort is one of the most rational sounding.

Yeah, no shit it sailed through approval, we are in the middle of a pandemic - how long do you think the authorities would keep a functioning vaccine under wraps? .. is the thought that immediately strikes my mind when I hear people airing their often banal and self-aggrandising scepticism.

Yeah, but this sceptic is a scientist

The most dangerous people in this pandemic are not the overtly paranoid rage skeptics who are peddling some sci fi nonsense about nanobots and Bill Gates wanting to control the world through 5G via this inoculation, no, the most dangerous people are the sane ones, the ones who studied science at some point in their life and can actually hold an intelligent conversation about some of the more intricate biological aspects of this situation. The ones who sound smart. You know them, because they are all over the internet right now, unbeknownst to them fueling one of the greatest misinformation campaigns in human history. The Dr this and PhD that, who studied pathology in the 1970s, yet somehow after 10 years selling real estate in Nevada, have rediscovered their scientific pedigree and feel the need to peddle their ill gained opinions all over Youtube and charge a small fortune to access their materials. Essentially making money by selling fear to the fearful.   

One quick disclaimer here about my so-called “qualifications.” I don’t claim to be a scientist though I did spend many years pretending to be one. I studied biology, worked in pathology and microbial diagnostics for the military and then graduated in 1999 as part of the first masters of science recipients in the then fledgling field of immunology. We were 34 students who graduated from Imperial College of Science, Technology and Medicine in London. It may sound auspicious that we were the “first” to get this masters degree but it really was only a formality - this was the first time the degree had changed its name from a masters in infectious disease and pathology to immunology - and yes we were the first university in the world to offer this degree.

After this, I worked at Chelsea and Westminster hospital in vaccine development, under a GSK grant, for HIV. I certainly don’t claim to know more than I do, but I did spend hours upon hours memorising the individual receptors on the cornucopia of cells that frequent the immune system - for years. These receptors are known as clusters of differentiation, or CD for short - if you have read any papers on covid, you would’ve possibly seen CD24 mentioned, because an Israeli company has now been experimenting with a new drug that could potentially help treat severe covid infections, by targeting this exact receptor. It is one of over 370 different receptors that have been discovered on immune cells to date. These receptors work together in complex ways to create signalling cascades that help the body respond to foreign pathogens.

Our immune system is a marvel, of evolution

The way the immune system works is incredible and if there is enough positive feedback on this article I can attempt to go into more depth of how it all works and why vaccines are important. But for now, let’s just leave it at this: 

We are born with DNA that encodes this intricate immune system. This DNA was inherited from our parents who inherited it from theirs and so on. Within the DNA is encoded our immune responses to every bacteria and virus that our ancestors were exposed to over the millenia. It is an incredibly intricate system that isn’t exactly fail safe but it is the closest thing we have to a perfect safety net to protect us from the trillions of microbes out there that pose a risk to our health. Coronaviruses are dangerous because they are what are termed novel and emergent  viruses, meaning our ancestors never encountered them, and as such our specialised immune cells are not capable of staging a fast response, because this response has not been encoded in our DNA that we inherited. This is where vaccines come in.

Whilst influenza has been with our species for nearly 2000 years, the first human coronaviruses were only discovered in 1965 and were relatively rare and not very contagious. Covid-19 changed all that.

There are two types of immune responses, innate and adaptive. Innate is what we were born with as the name suggests, adaptive is what we learn and develop during our lifespan. The reason why we need vaccines for emergent diseases is precisely because we did not inherit the capability to stage a quick response to these. It is as simple as that. Vaccines are an aid that make our cells mimic a scenario wherein we actually did inherit this DNA. And mRNA vaccines make this point even more vivid, which we shall explore more below. 

Herd immunity is getting a significant portion, usually 70% of the total population or more (in the case of this highly infectious delta strain, 90% is advised by most epidemiologists,) vaccinated so that the risk of this virus spreading even further is minimised. If only 50% of the population are vaccinated the chance of this virus spreading exponentially in our communities is nearly as high as if no one would be vaccinated. This is the scary thing about logarithmic scales and the speed at which this virus multiplies in any given host. This speed is curbed in any vaccinated individual with a functioning immune system. The whole mission of this global vaccination drive is to protect exactly those people for whom the vaccine won't work, the elderly, the sick and the immunocompromised. If you see a person drowning in a river, would you just keep walking on? Or would a part of your empathic forebrain compel you to jump in and help? Right, that moral compass is what should be directing you toward your immunisation station.

Addressing the vaccine agnostics out there

Sitting on the fence on this topic may be easy, but it is intellectually propagating this exact misinformation campaign that is raging through the world right now. It is lazy and dangerous as you are actively enabling the quacks, conspiracy theorists and armchair immunologists who are all posing a serious public health threat to our livelihood at the moment, by not speaking up. 

As the Bantu Proverb goes: 

“No man can paddle two canoes at the same time.” 

Having discussed this vaccine with numerous people now, I am not completely dumbfounded as to how little people actually understand immunology because it's a very complicated scientific discipline - notice how I say scientific and not medical as this distinction is important as I will reveal below. I am on the other hand, however completely and utterly dumbfounded by how much people actually 'think' they understand about immunology.

This phenomenon is referred to as self-delusion and is born of cognitive dissonance, something your brain does when it encounters information that fundamentally challenges your world view. And vaccines, like politics, money and religion seem to be one of those topics that go deep into the human psyche bringing out the worst in us. 

Yes you can still get infected when you have been administered the vaccine. This is true for every vaccine ever made. The vaccine doesn't create an invisible force field that keeps certain types of virus out, it literally just primes your immune cells to respond quicker when they do encounter that type of virus again. 

No, vaccines don't cause mutations in this virus. Mutations happen randomly in nature and are 'selected' for by being the only virus types to survive and replicate. It is completely unrelated to how antibiotics affect bacterial mutation. Penicilin is a compound isolated from a fungus, used to puncture the cell wall of bacteria, thus killing them. It actively kills the bacteria. 

Vaccines don't work like that.  

And yes this is a new and experimental vaccine that uses a novel technique to prime the immune cells. And yes vaccines used to take years to come to market. But what people fail to realise is the incredible resources now at our disposal to create these types of vaccines. The amount of computing infrastructure used to emulate the virus and every possible biochemical reaction, every potential variable in the human body, using powerful computers that we never had access to 20 years ago. The mRNA vaccine was created and tested independently in labs across 4 continents, it is an unprecedented example of cross border collaboration and innovation. It represents the culmination of 70+ years of theoretical and practical experimentation with DNA. We have been working with mRNA in clinical applications for at least 30 years.

This vaccine is an emblem as to how ingenious our species can be. 

Yes, technically you can still transmit the virus if you're vaccinated BUT..

Once you are vaccinated the likelihood of you transmitting the virus is extremely low. Your immune system has been primed which means if you get infected, in no time at all the virus will be cleared from your system - in most cases within hours, leaving the window of opportunity for transmission nearly closed. We could say that vaccinated individuals don't transmit the virus at all and would technically be right in most cases but scientists are honest and humble people, so they will admit there is a chance for infection and subsequent transmission once vaccinated but it is very very slim. Much slimmer than unvaccinated. The virus simply doesn't have the time to replicate enough because the primed immune cells get rid of it swiftly.

Viruses multiply via a logarithmic scale 1 2 4 8 16 32 --- > its called exponential growth and doesnt take long to reach astronomical numbers in the trillions. So the faster you stop this viral replication cycle the better and the less likely transmission is because the viral load is lower.

It's physics.

Now an unvaccinated individual who gets infected will have this virus multiplying for several days, reaching these astronomical numbers, making them HIGHLY contagious compared to a vaccinated individual because the immune system hasn't learned how to fight it off yet. High viral load = high transmissbility.

Again, physics.

The reason why our immune system cant react fast enough in the case of covid versus influenza is that our species has never encountered this virus before. Which means we have no aquired or inherited immunity to it from our parents, grandparents, great-grandparents and so on. As we talked about above.

These viruses are called emergent viruses. Examples of these are Ebola, HIV and Haemmhorragic fever. None of those have particularly nice reputations and for good reason. The immune system can't handle them because they have only just recently jumped the species barrier into humans.

In the case of the unvaccinated, if you are lucky enough to eventually stage an immune response without losing the function of your lungs, spleen or lymphatic system or worse dying of inflammation of the lung tissue (basically like slowly drowing in your own fluids, there is a reason waterboarding was so effective a torture method - its horrible, even for 15 seconds, anyone who doesn't believe this, put a tea towel over your mouth/nose and invert your head in the shower, see how long you last and now imagine that for days on end?? Nightmare scenario) - you will still be reinfecting people everywhere you go.

And now to the vaccine shaming that people are complaining about. The reason why people are getting shamed is that this virus has an R0 number of 8 whereas the other variant was 2. Whilst you are infected you are likely to infect 8 other people! Multiply that number up and you see the fiasco on our hands. In the case of New Zealand we do not have the infrastructure to deal with a full blown pandemic, the government knows this (i think we have 200 ventilators for both islands?) and thats why we are being so strict about lockdown and vaccination. We simply dont have a plan B. Unless plan B is mass casualties on a scale we have not seen since the 2nd world war.

We are taking the vaccine to try to eliminate the virus from our species altogether like we did with smallpox and polio. So we dont have to wear masks for the next 50 years.

The other reason why shame happens and is justified, is the following: We are a rich spoilt country that has access to this marvel of science, state of the art vaccine... other countries aren't so lucky (Taliban also doesn't like vaccines, try living in Afghanistan where polio still kills people). And furthermore within our own borders we have people who are allergic to some of the ingredients in the vaccine or are too sick and immunocompromised to take it. Or in the elderly where it will be largely useless... the reason you get vaccinated is for them too. To protect the weaker members around us.

You get vaccinated to reduce the LIKELIHOOD of transmission.

But Big Pharma are greedy and out to get us

I can understand and completely empathise with your skepticism of big pharma, big profits  and the shortcomings of capitalism. Totally get that. Having worked in the world's largest pharmaceutical company in oncology, I experienced first hand how greedy and manipulative they can be - yet I also witnessed the rigor and pedantry of the drug approval process and how these medications save lives. I ask you this, is a pandemic the right time to tear down the system, to fundamentally rewrite the governance of the free market and world economics? Is this the right way forward, now? Or should we maybe all get vaccinated first and make sure our elderly, sick and compromised friends and family are okay and then work out how to tackle greed and the inequities of free market capitalism and this twisted system?

Because I agree with you, the system sucks and needs to be overhauled - yet timing is also everything.  

You can trust the science. Just like you wouldn't question the ability of a pilot to operate a plane or for that matter, the engineering of an airplane wing to keep a plane up in the sky, you shouldn't now start questioning a scientific discipline that most medical doctors know little about. They trust the scientists who created the vaccine. As should you. Just like you get on that long haul flight without so much as batting an eyelid.  

This is not a topic up for discussion like the weather or why you don't like eating chocolate ice cream. You are not qualified to have an opinion. You are entitled to your opinion but it really doesn't mean anything, especially not in the context of a raging pandemic. Your opinion is akin to graffiti put on the wall of a public lavatory, in faeces.

It's inappropriate, gross and yes, even potentially dangerous from a public health perspective.  

Getting the vaccine is your civic duty, people. And it's free.

No one's asking you to go to war or donate a kidney, you literally just have to hold your arm out for 3 seconds. I was initially going to make this article about shit and how this daily activity is linked to Jeff Bezos, but the vaccine took precedence once again. I felt compelled to capture this dinner party encounter. Next week will be all about shit, at least I broached the subject a little bit here.  

A literary allusion of sorts. Thank you for reading and sharing this.

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Thank you very much.

Mauri Ora.

“It takes generosity to discover the whole through others. If you realize you are only a violin, you can open yourself up to the world by playing your role in the concert.”

The legend himself, Jacques Yves Cousteau.