I know that we are all tired of wearing masks. It can be hot, hard to breath and difficult to speak. People feel claustrophobic or confined behind them. Personally, I, too, feel exhausted after a full day in my mask. However, they continue to serve an important role in controlling the spread of COVID … even after we are vaccinated. Evidence has proven that wearing a mask reduces the risk of infection up to 89% and can block 70% of expelled droplets and particles (CDC.org).
Both Pfizer and Moderna vaccines have been released for public use. Many are fearful or wary of them for a variety of reasons. A main concern is that they were “rushed to market.” Last week’s article dispelled many of the myths and concerns the general public is having with the vaccines. The two vaccines have been put under rigorous testing and analysis, more than most vaccines on the market today. Concerns about the vaccines are understandable, but negative outcomes have been few and far between. However, due to the timely release of the vaccines and our inability to examine long-term effectiveness, several factors suggest that wearing a mask will continue to be vital in our fight against COVID-19. Therefore, we will not be shedding our masks anytime soon.
The distribution of the vaccine requires that each vial be frozen at very cold and constant temperatures. As they thaw, they lose effectiveness. Many facilities, especially in the rural parts of the country, do not have the capabilities to properly store the vaccines under the ideal conditions. It will take time to make these vaccine storage facilities safe for COVID vaccines. But fear not, as the details and logistics improve as you read this column, the vaccine will be available to the general public soon!
It is estimated that we need 80% of the population to get vaccinated for the infectious rate to swing in our favor. This means that we need the general public to unite and work as one to fight the spread of the virus. Yes, it is scary taking a new vaccine that has no long-term data, however, with over 1.5 million dead from COVID-19 it seems this is the best option. As a community, we have to band together, trust our science and act in the best interest of all.
Do not have a false sense of the security immediately following your vaccination! Pfizer reports that “it takes a few weeks” and Moderna reports 2 weeks for people to build up an immunity of 50% after the first vaccine. The timeline repeats again after the second vaccine resulting in 95% immunity. During that time, you are still able to contract and spread COVID-19. The use of masks during this time is necessary to keep yourself and others safe.
The clinical trials conducted on the vaccines did not examine if the participants should continue to wear masks. The study only investigated if the individual built up enough antibodies to become immune themselves. Therefore, we do not know if the participants could still be carriers of the virus and continue to infect others that were not vaccinated.
Anthony Fauci, MD, director of the National Institute for Allergy and Infectious Diseases and lead member of the COVID Task Force, recently reported that there is some evidence that the Moderna vaccine may provide a vaccinated individual protection against spreading the virus. However, more time and data are required to confirm these findings.
It is important to remember that many immunosuppressed, autoimmune and pregnant individuals are not suitable for the vaccine. Until we are confident that vaccinated people are not “silent carriers” of the virus, the continued use of a mask is an important measure in protecting the most vulnerable people in our communities.
Until long-term data is available on the vaccines, we do not know how long our immune system will continue to produce antibodies. Antibodies protect us against the virus. This will be monitored as the distribution of the vaccine continues. The good news is, that we have observed individual’s immune system maintain antibodies up to six months in those who recovered from COVID-19. It is expected that the vaccine will at least mimic that immune system response.
There is some light at the end of the tunnel … 2021 will be known as the year that the world took control of COVID-19! We will be shedding our face-protecting cloth companions soon enough. For now, we must wait, stay the course and continue to wear our mask, even after we are vaccinated. As time passes, we will know more about the vaccines and many of the uncertainties in this article will be answered. Until then, mask up, get vaccinated and be safe for yourself and others.
GUEST COLUMNIST: Paul Mackarey, Jr. DPT is clinic director at Mackarey & Mackarey Physical Therapy Consultants, LLC where he specializes in the prevention and treatment of neck and LBP.
NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!” Next Week – LBP Part II of III
This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
For all of Dr. Mackarey's articles visit our website: https://mackareyphysicaltherapy.com/forum/
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice in downtown Scranton and is an associate professor of clinical medicine at GCSOM.
Visit your doctor regularly and listen to your body.
The New Year brings renewed energy in our collective efforts to win the race against a common foe. If we intend 2021 to be a year of joy and hope — we absolutely need to use all viable tools at our disposal and unite in our efforts to beat the coronavirus. One such tool is vaccines, considered one of the most important advances in modern medicine, and has been responsible for greatly improving our quality of life over centuries. Vaccines have allowed us to triumph over serious adverse diseases by reducing or eliminating many dangerous infectious diseases we don't even think about anymore.
Vaccination research and development has never stopped. Global partnerships have been formed to create faster, more efficient platforms and new technologies to help us against the onslaught of diseases like Ebola, Zika, and the coronavirus family — SARS (severe acute respiratory syndrome), MERS (Middle East respiratory syndrome), and now SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2).
The victory of vaccines, our most promising counter-pandemic measure, in our fight against a pathogen like SARS-CoV-2, the virus that causes Covid-19, relies on a critical mass of people becoming immune to the virus. This breaks the chain of transmission and, most importantly, protects the most vulnerable people in our community who cannot develop immunity through vaccination. This is called herd immunity — vaccines go beyond our individual benefit; it protects us as a community. Imagine this vaccinated community surrounding a pregnant mother who cannot get vaccinated now; she is protected through this invisible shield of the community blocking SARS-CoV-2 from reaching her.
Vaccine safety requirements are among the highest in the nation because they are widely distributed. Two vaccines (Pfizer/ BioNTech and Moderna) received U.S. emergency use approval (EUA) from the FDA. Nearly 2.8 million people in the U.S. have received a Covid-19 vaccine to date. Dr. Francis Collins, director of the U.S. National Institutes of Health, received the Moderna vaccine on December 22, 2020 — saying the two vaccines had been examined and put through more rigorous analysis than most vaccines to date. Nonetheless, some common myths are surrounding both vaccines:
Both approved U.S. vaccines contain no virus or viral particles. You are not injected with any part of a virus. The vaccines use synthetic messenger RNA (mRNA) that our cells can read to make a specific piece of the virus, which on its own cannot harm. This piece is the protein spikes on the outside of the virus, and it is what helps the virus dock onto a human cell and allows it to infect us. By allowing our cells to reproduce this spike temporarily, we teach our immune system what to look for in the face of a future coronavirus attack. This memory of what to look for provides us immunity and allows us to respond much faster.
The development of the current vaccines did not start in January 2020. Science has been paying close attention to the coronavirus family for many years. Research into the messenger RNA technology used in the Pfizer/ BioNTech and Moderna vaccines has been in development for close to 15 years. The perceived speed in getting the vaccines to the public is partly due to unparalleled worldwide emergency cooperation, free sharing of information, and new faster technology platforms. Also aiding has been billions in private and public funding, allowing vaccine firms to run preclinical and phase I, II, and III trials in parallel instead of sequentially. The FDA completed a meticulous safety review, and the independent Advisory Committee on Immunization panel scrutinized safety and efficacy data from the clinical trials.
Your cell's DNA is securely kept inside a nucleus in the cell. The snippet of mRNA that gets injected does not gain access to the nucleus and never comes in contact with your DNA. Your cell machinery translates the mRNA and manufactures the viral spike protein needed to present to your immune system. Once the instruction is read, human cells break down and get rid of the mRNA.
Currently, we don't have enough information to definitively know how long after infection someone might be protected from getting reinfected with Covid-19. Early indications suggest this natural immunity may not last very long. The CDC recommends getting vaccinated. However, if you are currently infected with Covid-19, the recommendation is to delay vaccination until the illness has resolved.
According to Dr. Anthony Fauci, Director of the National Institute of Allergy and Infectious Diseases, getting rid of public health measures like wearing a mask is only possible once there are extremely low levels of circulating virus left. For this to happen, we need 75-95 percent of people to have immunity to the coronavirus.
Both Pfizer/ BioNTech and Moderna have reported that their vaccines contain no preservatives. The vaccines are created using a novel methodology to synthesize the mRNA, encapsulated for protection in a lipid or oily shell. This technology allows the vaccine to be free from materials of animal origin, egg, and without preservatives. However, mRNA is fragile and can break down easily. Storing vaccines in ultracold environments keeps them stable and safe. Vaccines are thawed before injection.
Life and vaccines never present us with absolute safety in usage. We must acknowledge this — vaccines do carry some risks. Of the close to 2.8 million U.S. vaccines to date, very few recipients reported short-term mild or moderate symptoms that resolved without complication within a day or two. These included sore arms, redness at the injection site, headache, chills, fatigue, muscle pain, or fever — all expected indicators that your immune system is responding to the vaccine — and comparable to side effects seen with the shingles vaccine. As of December 23, 2020, the U.S. has seen 10 cases of anaphylaxis. Anaphylactic reactions can occur with any vaccine but are extremely rare. The cases occurred in people with a significant history of severe allergies and were safely managed with epinephrine, and the CDC has distributed safeguard protocols to vaccine sites.
But, compare these calculated vaccination risks to that of the virus itself — which has infected more than 83 million people globally and killed approximately 1.8 million — including more than 350,000 deaths in the United States. Now add in the devastation caused to economies and health systems. Dr. Walter Orenstein, the former director of the United States' National Immunization Program, wrote that if vaccines are not administered to the persons they are recommended for, there is zero impact. In the current pandemic, time is lives. We need an estimated 80 percent of people vaccinated to reach herd immunity to have a fighting chance to stop this pandemic in its tracks — and we need to get it done now.
We face a collective threat — a pandemic, and a moral dilemma on choosing to be vaccinated. Concerns over the vaccines' safety are understandable, but reports on negative outcomes are few and far outweighed by the benefits. This quarantine year has taught me that we are intrinsically bound to our community, only truly to thrive through community involvement and participation. We need each other, and we have an obligation to take care of one another. Getting a Covid-19 vaccine is not just about you; it is protecting your grandmother who has diabetes, your neighbor who is immuno-compromised — it safeguards everyone who is medically unable to receive a vaccine and needs you as their human shield against coronavirus reaching them. Vaccinations save lives — when your eligibility phase comes up, be a solid citizen, loving caring child, sibling, parent, and spouse…GET IT!
This column is a monthly feature of “Health & Exercise Forum” in association with the students and faculty of Geisinger Commonwealth School of Medicine.
Author: Hendrik Marais, MD, MS
Hendrik Marais, MD, MS, received his Doctor of Medicine degree from Geisinger Commonwealth School of Medicine in 2015 and his Master of Science degree in Global Medicine from Keck School of Medicine at USC in 2019. He is passionate about creating positive and empowered patient health outcomes. He grew up in South Africa and currently calls Scranton, PA home – where he enjoys cycling, swimming, and discovering the beauty of NEPA. He is a member of the American Medical Association, American Public Health Association, and the International Society of Physical and Rehabilitation Medicine. He plans to pursue a clinical career in physiatry.
NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!”
Read all of Dr. Mackarey's articles at https://mackareyphysicaltherapy.com/forum/
This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine.
