COVID-19 vaccine: answers to questions you may have

A further explanation of the COVID-19 Coronavirus vaccine via Questions & Answers. To ensure correctness, I have transcribed and translated a Dutch video with Professor Marjolein van Egmond of the Amsterdam UMC (University Medical Centers) that I completely agree with. In addition I give some of my own thoughts. I hope that this will answer some of the questions and/or take away the doubts you may have on Coronavirus vaccine and vaccination in general.

How does vaccine work?

“The first COVID-19 vaccines that have been developed are genetic RNA-vaccines. The RNA vaccination consists of a genetic code for the spike protein. These are those funny protuberances of the Coronavirus that are used to enter our cells. The vaccine therefore looks-like the Coronavirus, but is only a very small piece of it and not the entire virus.

When someone get the vaccine, the security guards of the immune system see that there is an intruder and eliminate it. If the real Coronavirus then tries to penetrate, it will also be recognized and immediately eliminated. You are then immune.”

Will the vaccine change my DNA?

“Some people are concerned that the RNA vaccine can also change DNA. That is not true. The DNA is stored in a kind of safe in your cells. And the RNA vaccine can penetrate cells, but it doesn’t have the key to the safe. So the RNA vaccine really cannot change your genes.”

What are the vaccine’s side effects?

“Many people are concerned about the side effects. And whether these have been well researched in all haste? To date, nearly 40,000 people have had these RNA vaccines. And at least they haven’t had any serious side effects.

In the short term you will see that these people can get a red spot at the injection site, a little muscle pain, a little headache or a little increase. We often see this with other vaccines, and it is actually a good sign. Because this means that the entire immune system has started working. If you have a bad cold you also get an increase and that is because the immune system works just a little better at a high temperature.”

What about long-term side effects?

“What about long-term side effects? With vaccines you really only have short-term side effects. We never actually see long-term side effects. That’s because the vaccine is only in your body for a very short time. It is a training for your immune system that is immediately activated and then the body breaks down the vaccine.

This means that the vaccine will not be in your body for years to come, so that all kinds of long-term effects can suddenly appear later. We do not suddenly see all kinds of long-term effects with other types of vaccinations. So it would be very strange if it were the case with this vaccine.

That does not mean that we cannot look into the future. We can never guarantee it 100%. It could also be that there is a super rare side effect of, for example, one in 100,000 people. For example, a person may be allergic to a component of the vaccine. In extremely rare cases, the immune system can also get confused by a vaccine. Then auto-immune symptoms can arise, in which the immune system accidentally attacks your own body.”

Put in perspective

“But we already know that this chance is in any case less than 1 in 40,000 because none of the test people in the clinical trials has had these kinds of side effects so far. And perhaps the chance is much smaller, but we will only know that when many more people have been vaccinated. And to put this in perspective, the odds of being seriously injured in a traffic accident are 1 in 800 in The Netherlands.

You also have to compare the risk of side effects against the risks of the disease itself. Based on various studies, the chance of dying from COVID-19 is on average 1 in 100. This is lower for younger people, but much higher for older people. There is also a chance that you will suffer from chronic complaints after COVID-19 infection. Such as fatigue, shortness of breath, chest pressure, headache and muscle pain. Even 6 months after you have had the disease. And beware: these really aren’t just problems for older people. Younger people have also developed these complaints.”

Can a vaccine so quickly developped be safe?

“You often hear: but these vaccines have been developed so quickly that it can never be safe, can it? Yes, it can. Normally the process is actually much too slow. In the Western world we had no problems with infectious diseases for years. That was a developing world problem. It is blunt, but that meant there was less motivation for the West to invest a lot of time and money there.

Now it has been said: but this Coronavirus is our problem! Billions are being invested and everyone is abandoning everything to work on this vaccine. And yes, things will go much faster. You can see that in the assessment. Normally, we wait for the entire investigation to be completed, and then it goes to the authorities all at once.

Now they are already looking at the laboratory tests and the results of the first phase, while the rest of the research continues as usual. The supervisors also deploy extra manpower to assess all files, so that the process goes faster.”

How long will the vaccine work?

“How long does such a vaccine actually work? What is the duration of immunity? Well that’s impossible to say at this point. We will need to wait and see. But such a vaccine could possibly give a better immune response and a longer immune response than the Coronavirus itself. One person hardly gets sick from the virus, while the other person gets much sicker.

And usually your immune system reacts more strongly if you have been sicker. But with a vaccine you can make sure everyone gets the same dose and you can play around with it a bit. For example, by giving a second shot after a few weeks to boost your immune system even more.”

What if the virus mutates?

“You may wonder: what if the virus changes? Well, a virus actually always changes, we call that mutation. The flu virus is a champion of change. But not every virus mutates (changes) equally. And usually those little changes don’t mean anything at all. The immune system still recognizes it.

But it is something to keep a close eye on. And that’s the beauty of these RNA vaccines. By changing a little bit of the vaccine’s RNA, it looks exactly like the virus’s RNA again.”

Scientists are researching the new variant of Coronavirus that was found in the UK recently. “I would be surprised if vaccines work much less well against this variant,” says virologist Marion Koopmans (Erasmus MC).

Is the vaccine 100% safe?

“Of course you want to hear that the vaccine is 100% safe. But 100% safe just doesn’t exist. It is important that you compare the small risks of the vaccine against the risks of the disease itself, and the many deaths that are saved by a vaccine. It’s entirely up to you whether you want to get vaccinated, but at least I will!”

And I will to! This is the end of the transcripted and translated video with Professor Marjolein van Egmond of the Amsterdam UMC.

Dutch video

If you are Dutch, you might just want to watch the Dutch video yourself. Et voila!

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Hereunder some additional information based on my own professional experience with vaccines in general and my thoughts on the Coronavirus vaccine based on that.

Duration of Immunity (DOI)

Many people wonder: how long the Coronavirus vaccine will protect us against the virus? In other words: how long will the vaccine keep you immune for COVID-19? Medically we express this as the Duration of Immunity (DOI) of a vaccine. The DOI of the Coronavirus vaccine is currently not known yet, as the professor explained above. Because I work with vaccines I have some experience with it, including the process of prolongation of DOI post-launch. It does not necessarily have to be or go like that, but it is a possible scenario, based on my professional experience with other vaccines.

First of all, the DOI can vary per vaccine and per producer. I know that sometimes, especially when the launch of a vaccination cannot wait any longer for example due to a new epidemic, a vaccine gets launched with a relatively short Duration of Immunity (DOI), for example 6 or 12 months. That would be then the DOI that has been proven at that point of registration to be able to launch a.s.a.p.

Post-launch, the clinical trials and studies continue to see and prove whether the DOI is actually longer than initially registered for (within the current Marketing Authorization), or any – in case the DOI is not known yet at time of the initial registration (which is very exceptional).

Once the follow-up studies are finished, and (a longer or any) DOI is proven within the given rules, the producer can apply for a change of the Marketing Authorization with the (longer) DOI. I have coordinated such process for work, from a relatively short DOI to longer DOI of a certain vaccine, which took place a few years post-launch. This is a possible scenario for the COVID-19 vaccine, time will tell.

It typically takes a few weeks for the body to build immunity after vaccination. That means it is possible that a person could be infected with the virus that causes COVID-19 just before or just after vaccination and get sick. This is because the vaccine has not had enough time to provide protection. Read more here.

Centers for Disease Control and Prevention

Vaccination of children (NL)

In The Netherlands, the vaccination discussion is not new. Before COVID-19 arrived, a very interesting bill initiative was submitted in order to regulate that childcare centers may refuse unvaccinated children. The House of Representatives (Tweede Kamer) has agreed to that bill mid-February 2020. Currently this bill is – as far as I could find online – still with the Senate (Eerste Kamer). Schools are not allowed to refuse unvaccinated children due to compulsory education (5-16 years).

I estimate the chance that the Coronavirus vaccine will become mandatory for children in daycares in The Netherlands as very small. In any case, children seem to be a low group for COVID-19 infection. In addition, making such a vaccine mandatory for daycares would entail additional complexity. Such as requiring the vaccine to be included in the national vaccination program and to be proven safe for young children.

Vaccination is not mandatory in The Netherlands and it is up to parents to determine whether they have their children vaccinated or not. Most parents decide to comply with this advice; in the Netherlands, on average about 94% of the children have been vaccinated against diseases such as measles, mumps and rubella.

As a child, I was vaccinated according to the Dutch national vaccination program, and I am glad to! Thank you parents for protecting me against those awful diseases.

Some Dutch parents choose not to have their children vaccinated for religious or ideological reasons, such as reformative people, who mostly live in the so-called ‘Bible Belt’ area, between Borsele and Staphorst. In 2013 there was a measles epidemic in this area due to low vaccination rate. Some other people do are against vaccination for other reasons, Anti Vaxxers or anthroposophical people for example. A worrisome social problem that requires attention and education.

I truly hope that this article has helped to answer questions and/or take away any doubts you may have (had) on the Coronavirus vaccine and vaccination in general. Please feel free to comment below if you have something useful to add. Should you have any medical questions, please consult your GP (huisarts).

COVID-19 and travel

Read more about this topic in the following articles:

• No panic! My uncensored plea to get vaccinated against COVID-19
• How COVID-19 turned my promisiing Iceland trip into an odd soap opera
• To travel or not to travel? Corona and other disasters lead to travel dilemma
• Corona: can I go on holidays this summer or book a trip for later this year?
• Flight cancelled, airline voucher, refund and other travel hassle due to COVID-19

No-one asked me to write this article. I transcripted and translated the video concerned to the best of my knowledge and ability. I am 100% supporting this video but I am not a professor or doctor myself. The second part is my own insight/opinion based on professional experience in pharma business practice. No rights can be obtained from this article. The disclaimer of this website is applicable.