With all the talk about the latest developments regarding the COVID-19 vaccine, there seems to be more questions than answers in the minds of the general public.
For myself, I have a fairly extensive range of clinical experience. I've worked in hospitals and clinics (among other places) since I was nineteen, but even I was fixated on one particular point: this vaccine seemed to make it to public use awfully quickly.
The way I saw it, I felt like the companies involved in its development may have cut some corners in their efforts to get the vaccine out as soon as possible. It never even occurred to me to consider the sort of resources and manpower behind it. It was an "all hands on deck" sort of pursuit, and what it left us with was multiple options for a viable and effective vaccine.
This edition of Monday Morning Mentions belongs to someone with whom I've spoken at length, in the past, and has recently received the COVID-19 vaccine himself.
A couple of years ago, I interviewed former Cardinals, Mets, and Braves first baseman-outfielder Mark Hamilton, who was about to complete his medical degree and take the boards. Now he's an internal medicine resident and specialist in interventional radiology at Long Island Jewish Medical Center, based in New York. Dr. Hamilton studied neuroscience at Tulane University, in New Orleans, as an undergraduate.
He was kind enough to once again share a bit of his time and insights, answering a few basic questions about the COVID-19 vaccine.
Clinton Riddle: I was hoping to ask your thoughts on a few details that have concerned me about these vaccines. My first concern is the time it took to get them to the market. Does it seem to you that maybe these companies might have cut some corners in order to rush these out to people who badly need them?
Dr. Mark Hamilton: No. I do not believe corners were cut. What we saw was an arms race. Vaccines, unfortunately, have been an extremely unprofitable endeavor in the past 30 years. The profitable endeavors have been the next drug for chronic conditions like hypertension. As such, high powered pharma companies have simply not prioritized vaccine research. This pandemic and the public and private money invested into developing a vaccine has changed that paradigm.
Theses companies dropped everything they were doing and put all resources into development. It’s simply amazing what unlimited resources can do.
The vaccine itself is extremely simple and something people have been wanting to do for years. The challenge was stabilizing it for delivery. The science is high-school level. They have since animal tested and human tested. And FDA Phase 1 and 2 tested.
The only step that was skipped was Phase 3, which specifically takes time by design. I believe it to be safe, and its simplicity, to me, makes that even more likely.
The vaccine itself is just a fat membrane around a completely naturally-occurring product. It causes the body to produce the protein from the virus that the neutralizing antibodies need to be produced against. Extremely precise. Guaranteed to give the outcome desired.
Can I say what the vaccine impacts are ten years down the road? No. But I would expect much, and I will say that contracting COVID means the same genetic material from the vaccine enters your body anyway (just with the rest of the virus and risks that come with infection).
CR: Interesting. So it stimulates the production of components of the immune response which will show an affinity to the proteins in the viral shell of this strain of COVID, thereby causing those vaccinated to develop antibodies?
Dr. H: Correct. It delivers the genetic code for a single protein that is on the virus and make your own cells make that single protein. Your body recognizes it as “non-self”, and attacks it.
That attack stimulates the immune systems and results in durable antibodies against that specific protein. So if you come in contact with the virus, your immune cells already know and have antibodies against the protein on the virus surface, thus preventing full-blown infection before it begins.
CR: It sounds astoundingly simple.
Dr. H: And they specifically chose the protein that binds the virus to our cells. So now the virus cannot enter cells very well. It’s been a pipe dream for decades to do vaccines this way, but the development would cost billions and the result was simply not profitable enough to invest in it. Until now.
Incentivize Big Pharma, and they deliver.
CR: Amazing. Did this require protein sequencing to be carried out first, or is the surface protein of this strain of coronavirus similar enough to other forms of the virus?
Dr. H: Yes. Sequencing first. But that had been underway since the virus was identified. This surface protein is unique to COVID (SARS-COV2). But the virus is very similar to SARS from 2001.
Reverse sequencing is easy. We’ve had that tech since the 1940-50s.
CR: True but I thought it took a lot longer. I had no idea.
Dr. H: Not really. Sequencing like this is simple. We had the genetics sequences within one week of identifying the virus as novel.
CR: Wow
Dr. H: Selecting a target and comparing it to prior viruses took a bit longer. But not that much time.
You just had to know what you were looking for. At first, in China, they had no idea what the hell was causing the infection. Took longer to identify the virus itself than sequence it and computer model it’s proteins.
CR: With its similarity to SARS c. 2001, was this an offshoot of that particular strain?
Dr. H: Hard to say. It’s a coronavirus. There are thousands of them. Only a few impact humans.
CR: True. Did they develop a vaccine for SARS? I can’t remember. Seemed like it barely touched us, comparatively.
Dr. H: No. Tried and failed. But they only tried conventional methods. Which are harder. More guess work. The big issue was figuring out mRNA delivery and stabilization. But like I said, before (COVID-19), it wasn’t profitable to figure that part out. Vaccines are not money makers. You get one shot, and then you're done. Hypertension drugs (for example) you take everyday for the rest of your life
CR: Makes one wonder how many diseases we could vaccinate against, if money weren't the primary impetus.
Dr. H: I feel this will open many doors. I hope, at least. But again, they won’t bother if it won’t make them money...a sad reality.
These companies can not only say they are the ones who solved the problem, but a crazy amount of public and private money was given to them to solve it. (They) demonstrated that they could do something others couldn’t.
(For more information on vaccine development, human immunological response, and other details involved with the research and development of new treatments, a good place to start is Merck Online, which covers a broad range of medical topics. It's long been a go-to for young doctors and medical students, and most definitely an old favorite of mine.
(Also, fda.gov released a fact sheet regarding the COVID-19 vaccine, and what prospective recipients need to know before receiving it. )
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