The coronavirus pandemic has changed our world. This has been a hugely challenging time for all of us. Due to the basic nature of airborne viruses – they spread easily and are largely resistant to medical treatments such as antibiotics – our options are very limited. For the most part we have used public health measures like distancing, mask-wearing, lockdowns, etc. We all know that these measures are imperfect, onerous, and unsustainable, even if they may be necessary at times. But the one big hope, discussed from the very early stages of the pandemic, was and is, vaccination…

The basic idea is to achieve herd-immunity – once a large percentage (60% is often mentioned) of a population is immune to a virus, the virus gradually dies off as it finds too-few susceptible hosts (a virus cannot survive without a host). Herd immunity can be achieved through natural infection or through vaccination. Since natural infection is clearly dangerous (millions have died worldwide), vaccination seems the best option.

So the world’s medical scientists have made extraordinary efforts to develop vaccines in record time.  The first vaccines were developed, tested, and approved for use, within a year (by end 2020). This is a remarkably short time-period for this type of work. Many countries began vaccination programmes in late 2020 and nearly all countries have vaccination programmes underway as at mid 2021.

South Africa has experienced delays (for various reasons and including some controversies that we will not go into here) in rolling out a vaccination programme. As at mid 2021 only some 3m (5% of population) South Africans have been vaccinated but the rollout is speeding up.

Vaccines have been in use worldwide for many decades. Vaccines have an excellent track record of safety and efficacy. Illnesses like smallpox, rubella, measles, have all been eradicated or weakened through effective population-wide vaccination programmes. Is it common practice for babies to be vaccinated against a number of important conditions and this is routinely done during the pre-school years.

No medicine, or vaccine, can really be said to be 100% safe. There are always risks and unknowns and so we must make balanced judgements, weighing benefits against risks.  The idea of 100% benefit and 0% risk is simply unrealistic (and does not exist with a single modern medication really, nor with just walking out your front door). That said, medical science is a powerful tool and researchers diligently look and test for adverse or dangerous effects. In the case of COVID vaccines, the base technologies used are not brand-new really. The basic research and laboratory techniques have been in use for decades in most cases. Obviously things have been fast-tracked, and it’s theoretically true that this might increase the risks. But researchers have not skipped any safety-testing we are told. We know that very few risks have been identified and these have only been seen in very small numbers of people – the rate of adverse effects appears to be in the region of 5-10 cases per 1m vaccinations (0.0005 to 0.001%).

There is a risk of allergy to vaccines. Severe allergic reactions can include widespread skin rash, red swollen eyes, breathing problems, etc. In severe cases this can be life threatening and may require hospital admission. Anyone who has previously had an allergic reaction, to a vaccine, should consult medical advice before having any vaccine. Anyone who develops any itch, skin rash, wheezing, or other allergic symptoms, within hours of being vaccinated, should seek medical care urgently. That said, these remain risks that affect very few people (well under 1%) and need not concern the vast majority of us. Importantly, “general” allergies like allergy to animals, grasses, pollen, etc, does not appear to increase the likelihood of a vaccine allergy.

There are three vaccines in use currently. The Pfizer and Moderna vaccines use bits of genetic-code (mRNA) to instruct our bodies to create antibodies against coronavirus. The Johnson & Johnson vaccine uses a “viral vector” (weakened virus that cannot cause illness) to trigger the production of antibodies.

Since the coronavirus mutates quite readily we have already seen several variants. These variants  can produce slightly different clinical effects and some variants spread more easily than others. Vaccines may be varyingly effective against different variants and in some instances a vaccine may be considered ineffective against a given variant. This adds a worrying layer of complexity and change over time, and is certainly occupying the minds of experts worldwide. The DELTA variant is being widely seen in South Africa in June 2020. This variant seems to spread some 50% faster than the variants we have seen before. It is not yet clear is the delta variant creates more severe disease. All vaccines in use currently are effective against the delta variant.

The basic and simple truth seems to be that medical science has worked extremely hard here, and we can all be thankful. Vaccines are perhaps imperfect but the benefits appear to outweigh any risk, by a large margin. There are complexities and the picture will continue to change over time. But at this time we encourage readers to be vaccinated. We encourage readers to be vaccinated with whichever vaccine is available to them. Anyone who is anxious about the risk profile should speak with their doctor of course. Anyone who has had vaccine-allergies should be especially cautious. For most of us  it is a matter of getting the jab and getting on with life, we hope.