By LeAnn R. Ralph
COLFAX — Did you know that the new technology of mRNA (messenger RNA) used for the COVID-19 vaccines is actually not a new technology?
A group of doctors from Mayo Clinic held an online forum August 26 to talk about vaccine misinformation and to answer questions from listeners.
Work on mRNA started in 1990, and the technology is being used in many trials for different infectious diseases and also is being used to treat some cancers, said Dr. Muhanad Mohamed, chair of the Division of Infectious Diseases.
The vaccine specific for COVID-19 using mRNA was developed rapidly, but no steps were skipped, he said.
Misinformation — People who are vaccinated can still get sick with COVID-19, so I don’t need to get vaccinated.
Being vaccinated for COVID-19 is like wearing your seat belt, said Dr. Adel Zurob, medical director of Critical Care.
Would you tell your 16-year-old child to get in the car and drive without a seat belt because your 16-year-old might get in an accident anyway, so why bother with a seat belt? he asked.
The New York Times reviewed COVID-19 cases in 40 states from January through June. Those who are not vaccinated have a 32 times higher risk of being hospitalized than someone who is vaccinated and have a 13 times higher risk of dying than someone who is vaccinated, Dr. Zurob said.
Think about a match and pile of dry firewood. If the match is lit and thrown into the pile of firewood, some of the pieces of firewood will begin to burn, and then other pieces of wood will catch fire, until finally, the whole pile is on fire, he said.
The pile of firewood is us and the people around us, and the fire is the COVID virus, Dr. Zurob said.
What happens if a lit match is thrown into a pile of wet firewood? he asked.
The COVID-19 vaccines are the water that makes the firewood wet so it does not catch on fire, Dr. Zurob said.
Misinformation — I already have had COVID-19 and have recovered, so I don’t need the vaccine.
People who have previously been infected can become re-infected and get sick again, Dr. Zurob said.
If someone is not vaccinated, that person is two and a half times more likely to get COVID-19, but the risk of catching COVID is much smaller in people are vaccinated, he said.
Also, a second COVID infection in someone who is not vaccinated tends to be much more severe than the first infection, Dr. Zurob said.
Vaccines kill people
Misinformation — More people have died from the vaccine than have died from the virus.
More than 600,000 deaths from COVID-19 have been recorded in the United States so far, and as of August 23, there have been 363 million doses of vaccine administered, said Maggie Peinovich, senior manager of Pharmacy.
To date, 6,968 people who were vaccinated and who died have been reported on the Vaccine Adverse Event Reporting System (VAERS), but that does not mean they died from a COVID-19 vaccine, she said.
Any death of someone who is vaccinated is reported on VAERS, even if they died in a car accident, but there are not reported deaths caused by a vaccine, Peinovich said.
There was a pause in administering the Johnson & Johnson vaccine because three people died from blood clots — but 1 out of 512 Americans have died of COVID-19 or 614,531, she said.
Misinformation — Children don’t get sick with COVID-19 and do not need the vaccine.
So far, 4.5 million children in the United States have tested positive for COVID-19, said Jodi Wiechmann, nurse administrator.
The Delta variant of COVID, which is the strain circulating now, is making more children more sick, she said.
Last week, 181,000 children were sick with COVID-19, and this particular surge is still on an upward swing, Wiechmann said.
The concern now is about school. Children aged 12 to 17 can be vaccinated, but children under 12 cannot be vaccinated, and they should be wearing masks, physically distancing and washing their hands frequently, she said.
This week, 1,900 children were hospitalized with the Delta variant, Wiechmann said.
Misinformation — I am allergic to eggs, so I should not get the vaccine for COVID-19.
The vaccine for COVID-19 does not contain any eggs, and it does not contain any of the other components of other vaccines that can cause people to have an allergic reaction, such as formaldehyde, said Dr. Adela Taylor, Allergy and Immunology.
To date, there has been one anaphylactic shock reaction to a COVID-19 vaccine, she said.
Misinformation — The vaccines for COVID-19 cause miscarriages or infertility.
The vaccines for COVID help someone’s immune system develop antibodies to the spike protein of the SARS-Co-V2 virus, said Dr. Blenda Yun, Obstetrics and Gynecology.
The spike protein allows the virus to attach to the respiratory tract.
There is also a spike protein that helps implantation rates for embryos in the uterus, she said.
Although both are called spike proteins, they are not at all genetically similar. They just happen to both be in a very broad category called spike proteins, Dr. Yun said.
Question — Does COVID feed on the inflammation already present in the body?
People can have a weakened immune system caused by an inflammatory condition. The U.S. Food and Drug Administration has approved a third dose of the Pfizer and Moderna vaccines for immunocompromised people, Dr. Mohamed said.
The virus will induce further inflammation, he said.
The virus damages tissue and can induce a reaction so severe, an intense inflammatory reaction, that it damages the lungs and other organs, Dr. Zurob said.
Medications given for COVID-19 modify the immune response so our immune system does not attack us, he said.
Question — Why not use an actual virus in the COVID-19 vaccines?
The mRNA technology has been available a long time, and traditional vaccines have been available a long time, Dr. Yun said.
The mRNA vaccines are like a Post-It note. The mRNA is the piece of paper, and the vaccine part of it is the COVID-19 written on the paper, she said.
The mRNA has been used for a long time, but now we’re just writing something different on the pad of paper for COVID, Dr. Yun said.
Also, COVID is active all year while influenza is seasonal. Flu vaccines, which use the virus itself, have to be developed the year before with the hope that they will be targeting the actual virus that is circulating by the time the vaccines are ready. As a result, flu vaccines are only 40 to 60 percent effective, she said.
Question — Why is natural infection with COVID not better than getting a vaccine?
Why is being infected with the COVID virus not enough to not catch it again? The virus changes. Right now the Delta variant is circulating, but there were other variants before this, Dr. Zurob said.
The vaccines stimulate the immune system to make antibodies and to activate other immune mechanisms. If you are vaccinated, the odds are better that you will not get sick again. Nothing is 100 percent foolproof, he said.
People are at risk of being re-infected with any of the variants, and the vaccines help for not getting re-infected, Dr. Zurob said.
Delta is very infectious and is more likely to spread if people are not vaccinated — it is more likely to set the whole pile of wood on fire, he said.
Setting the whole pile of wood on fire would overwhelm the hospitals and would put businesses in danger of not being able to operate, Dr. Zurob said.
Delta has changed the game. It is much more aggressive, Dr. Yun said.
School and masks
Question — Why are schools going back to in-person classes but they are not requiring masks?
Children under the age of 12 cannot be vaccinated yet, and the best way to protect them is for everyone to wear a mask and to use the other strategies, such as social distancing and hand washing, Wiechmann said.
There has been an increase in hospitalizations among children who are infected with the Delta variant, she said.
Question — Why not treat influenza with an mRNA vaccine?
Pfizer was already working on a mRNA vaccine for influenza when COVID emerged, Dr. Yun said.
The company quickly switched over to working on a vaccine for COVID, which is one of the reasons the vaccine was able to be developed so quickly, she said.
One interesting development is there were fewer cases of influenza last year because people were wearing masks, frequently washing their hands and keeping farther apart from each other, Dr. Mohamed said, noting that he saw only one patient last fall with influenza.
Question — Why not use monoclonal antibodies instead of vaccine?
If people were not vaccinated and the monoclonal antibodies were used, instead, to treat people after they got sick, how would any health system be able to respond to millions of people getting sick? Dr. Zurob asked.
The hope is that the monoclonal antibodies will turn around a case of COVID-19 so it is not so severe, he said.
The monoclonal antibodies do not always work, and the key is prevention, Dr. Zurob said.
You would need to have monoclonal antibodies every three months. The vaccine is only one time per year, or maybe twice, Dr. Mohamed said.
People in the United States are fortunate to have easy access to the COVID vaccines, Dr. Zurob said.
You can go into Walgreens, Walmart and many other places and get vaccinated, he said, noting there are millions of people around the world who do not have easy access to the vaccines but would take advantage of getting vaccinated if the vaccines were readily available.
Western Wisconsin has a vaccination rate similar to states that are seeing surges in COVID-19, such as Florida and Texas, said Dr. Richard Helmers, critical care specialist.
With such a low vaccination rate, there is concern that Wisconsin will experience the same trajectory that other states with low vaccination rates are now experiencing, he said.
Question — Is it realistic to try to reach herd immunity?
Before the Delta variant emerged, Israel had a vaccination rate of 70 percent, and the Delta variant still took hold there, Dr. Zurob said.
At this point, it will probably not be possible eliminate every infection, but the odds of individual survival are better the more people who are vaccinated. More people will survive with the vaccines, he said.