Thanks to Ricki and the Guelph Kit Mask Squad for making me a personalized mask. These ladies have made over 11,000 cloth masks. Not sure which smile I like better. Silly.
A beautiful young 21 year old patient of mine needed her diphtheria/pertussis/ tetanus vaccine updated today. Left deltoid, 0.5 ml, intramuscular injection...done in a couple of seconds. I have never payed such close attention to a vaccine injection before and I have given hundreds. But it dawned on me how little fluid ( just 1/2 a millilitre, a tsp is five millilitres) that is required to prevent diseases that cause severe illness or death. I have never seen a case of diphtheria or tetanus. Thirty years of practising medicine in the developed world and I have not seen a case. I have seen pertussis. It's nasty. We had an outbreak in unvaccinated and under-vaccinated kids years ago in Ontario. It is called the 100 day cough. I remembered kids being completely exhausted from coughing day and night for weeks and weeks. Just 1/2 ml of this golden liquid has prevented so much illness and saved so many lives.
The COVID 19 vaccine will be like this. Such a small amount of fluid will end a global pandemic that has erased many of the things we remember as normal.
The leading vaccine candidate in the world is Oxford University's AZD1222 vaccine ( yes, it already has a title). Developed by Oxford University, the vaccine has been given to half of the 1,000 participants. This is fascinating. They used a chimpanzee cold virus, which cannot cause illness in humans as a vector for a piece of the COVID 19 virus. Essentially, they attached one of those spiky things that cover the COVID 19 virus to a chimpanzee cold virus and injected that into humans. Why do that? Because the human immune system is a complicated, wonderful, intricate system that will see the spike, and mount an immune response to it. The spike can trigger your body to respond but because it is not a whole COVID 19 virus, it cannot cause COVID 19.
The hope is, that our immune system will be tricked, in a way, into making antibodies, structures that kill viruses, that will kill COVID 19 without needing to be exposed to the whole virus. Love this stuff. Many effective vaccines have been developed using this technique.
And guess what? In the early phases of this scientific trial, people who received the vaccine have developed antibodies to COVID 19. This particular vaccine appears to trigger the two major arms of our immune system which is a big deal. It may not only block COVID 19 from causing infection but it seems to trigger the immune system to fight the virus by making antibodies.
Next step: onto a phase three trial ( not to be confused with the phase three re-opening plan) which will involve many more study participants. You need thousands of them in order to prove that the vaccine is effective and safe. It is a huge and expensive undertaking. It is the expense that has made vaccine development in the past very slow, not the science. We have the technology to make effective and very safe vaccines in under 18 months. Now we have the financial resources to make it happen.
The world must wait for the results of this phase three trial and others that are being developed. If everything goes perfectly, a vaccine may be available in the first third of 2021.
There is a global vaccine working group that is watching all of this very closely.
This is the link to the Lancet Medical Journal article that describes this trial for the geeky nerds that would like to know the details: https://bit.ly/2E44eEt
Suffice it to say, that a vaccine will come but not for months. Our greatest threat now is not COVID 19. Canada has it under good control. It is the threat that complacency and carelessness will erase the progress we have made by not following public health guidelines. New daily cases are increasing nationwide. Dr. Bonnie Henry used the words, "explosive growth" as a real possibility if we let our guard down.
Stay six feet apart. Avoid all gatherings where social distancing is not possible. Wear a mask in all public spaces. Keep your social bubble to under 10 people only. Blending bubbles to include 15 or 20 close social contacts will have catastrophic consequences. Lets avoid another lock down.
Stay the course. Stay strong and resolute. We are winning but the battle is far from over.
Anne-Marie
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