The Future of Immunization - a look at RNA Vaccines

Polio, measles, smallpox. Many people today don't give these deadly diseases a second thought. Since the development of the polio vaccine in the 1950s, immunizations have prevented many devastating viral infections.​​

Humans have been creating vaccines for years, and we get at least one every year when flu season comes around. What’s special about the COVID shot?

Traditional vaccines are developed using a deactivated part of the targeted virus. Essentially, the vaccine tricks your body into thinking that you are infected. When the body detects the deactivated virus, it sends an immune response to fight off the “infection”. As a result, your body produces antibodies specific to that antigen, so that if an actual infection takes place, your body can initiate a much quicker immune response. The COVID-19 vaccine is different because it’s an RNA vaccine. The process used to develop this shot is drastically different from that of prior vaccines, and it could be the future of immunizations.

So what the heck is RNA?

Every person has a unique set of DNA that codes for genes. Genes determine everything from the color of your eyes to any allergies you might have. RNA is produced from DNA, and instead of being a code for genes, it codes for proteins. Your body uses proteins to do pretty much everything. RNA is a set of instructions that tells your body exactly how to make all these proteins. When you get an RNA vaccine, it gives your body a set of instructions to make a protein found on the surface of the targeted virus. Upon detection of that protein, the body initiates the same immune response as the one traditional vaccines generate, providing you with antibodies.

So if both types of vaccines have the same end result, antibodies, then why does the difference matter?

Before COVID-19, the fastest record for vaccine development was in the 1960s when the mumps vaccine was rolled out in just four years. Typically, traditional vaccines take up to a full decade to get developed and approved for clinical use. RNA vaccines are both faster and cheaper to develop. The COVID-19 vaccine was created in a year, at a record-breaking speed. Developing an RNA code is easier than deactivating a virus. In comparison to traditional vaccines, RNA vaccines can be adapted to different viruses much more easily. All researchers have to do is change the code and tell the body to make a different protein, as opposed to finding and deactivating a whole new virus. This can make the whole development cheaper and more efficient since the process does not require animal cells to hold deactivated viruses. The production takes only a few minutes as opposed to weeks.

If RNA vaccines are so much better, why haven’t we seen them before?

The short answer is we had, but they were overlooked. Labs have been researching RNA vaccines for years, with many ready to start human trials when the pandemic began. The newfound urgency gave rise to much greater research efforts. The demand and funding increased virtually overnight; the research paid off, and the COVID-19 vaccine was approved. RNA vaccinations are safe, and they work. The success of the Pfizer and Moderna vaccinations could mean a new future for the RNA vaccine and the development of vaccines in general.

It's worth noting that there were some special circumstances around the coronavirus vaccine. Due to the tremendous pressure for the speedy development of a vaccine, researchers had access to far more funding than they usually did. Congress gave the Department of Health and Human Services around 6 billion dollars for research on the coronavirus, in contrast to the 23 million they designated in 2019 for the Ebola vaccine. Additionally, COVID-19 is part of a family of viruses, the Coronaviridae. Scientists already had some understanding of how this family worked, which would have made the whole process easier. These factors likely contributed to the speed the COVID-19 vaccine was approved, but still, if the RNA method could lower development time to anything less than ten years it’s an improvement.

The COVID-19 vaccine has been saving lives, and those vaccinated are less likely to contract or spread the disease. And even if they do get it, their symptoms are likely to be significantly less severe. Regardless of the circumstances that set COVID-19 apart, the success of the vaccine shows that RNA vaccines can be developed faster and more efficiently without risking the health of patients.

References

[1]https://www.contagionlive.com/view/hhs-funding-backs-additional-year-of-ebola-vaccine-manufacturing

[2]https://crsreports.congress.gov/product/pdf/IN/IN11556

[3]https://www.nature.com/articles/d41586-020-03626-1

[4]https://www.news-medical.net/health/The-Future-of-Vaccines.aspx

[5]https://www.aamc.org/news-insights/mrna-technology-promises-revolutionize-future-vaccines-and-treatments-cancer-infectious-diseases

[6]https://www.historyofvaccines.org/timeline/all

[7]https://www.cdc.gov/coronavirus/2019-ncov/vaccines/facts.html#:~:text=The%20mRNA%20vaccines%20do%20not,it%20on%20their%20surface.

[8]https://www.path.org/articles/mrna-and-future-vaccine-manufacturing/

Unethical Health Practices in US Prisons

The criminal justice system is littered with inequality: from predatory probation and parole, racial disparities in sentencing, and blanket impunity for police violence, many working in this space find it so morally repulsive that it’s sometimes referred to as the criminal “injustice” system (Harvard, 2021). This broken system is not free of ethical problems in a medical context, with utter neglect often assigned to the health of those held within prisons and jails. Incarcerated people are viewed as completely expendable: subhuman objects with an expiration date that has been predetermined through cruel and inhumane practices. As a consequence of this, their fundamental right to access equal and fair healthcare is undermined. Lawmakers have done little to no work to address these deep-rooted issues, and the onus is on us within the medical field to raise the alarm and stop the blatant mistreatment of our brothers and sisters within US correctional facilities.

According to a report from The Correctional Association of New York, incarcerated women face a tremendous lack of access to basic reproductive healthcare (Center for Reproductive Rights, 2014). 54% of women reported not getting sufficient sanitary products each month, with instances of women using notebook paper and torn shower curtains to wipe themselves when they had their periods (Marusic, 2019). Even more alarming, a whopping 85% of pregnant women reported being shackled during their pregnancies (The Guardian, 2020). Women (particularly pregnant women) occupy an already marginalized status, and the brutal disregard for their humanity which is present within the criminal justice system is a deep moral stain on our society. Those in the medical community should call attention to the debilitating health effects that such practices can have, and ensure that lawmakers pass laws protecting the humanity and health of incarcerated women.

The disregard for health doesn’t stop there, with incarcerated people being denied access to the very rehabilitation that they need in order to return as functioning members of society. According to a study done at the Public Policy Initiative, while approximately 65 percent of prison inmates in the US meet the diagnostic criteria for addiction, only 11 percent of those individuals receive any form of treatment while in prison (National Center on Addiction and Substance Abuse, 2010). The result of this lack of rehabilitation has been devastating, especially in that it has exacerbated recidivism rates and done absolutely nothing to address the addiction that leads to some drug-related crime in the first place.

Approximately 95 percent of incarcerated addicts will return to substance abuse after their release from prison (Martin, 1999). On top of this disturbing statistic, 60 to 80 percent of them will commit new drug-related crimes, yielding an enormously high recidivism rate and increasing the burden on an already strained criminal justice system (Marlowe, 2003). When considering the disproportionate enforcement of drug laws on minority and socioeconomically deprived groups, the criminalization of drug use is even more unjustified. Prison does little to address drug-related crime, and without rehabilitation, does absolutely nothing to address underlying issues such as addiction and dependence.

The solution to this problem is obvious: prison is not the place to send our suffering addicts. Drug use should be universally decriminalized, and addicts should be offered treatment services rather than overly-punitive, ineffective, expensive, and inhumane prison sentences. After empirical success in Portugal, drug decriminalization was implemented in Norway, the Netherlands, and Oregon (among other countries and localities) (Slade). The medical community in Canada has called for such decriminalization, and we should follow suit in the US (CBC, 2020).

The medical community should urge lawmakers to dramatically restructure how society views criminal justice. Pregnant women should not be shackled. There should be a concerted and deliberate shift of onus on rehabilitation rather than deterrence. Women should not be forced to create makeshift menstrual products with notebook paper. Most of all, the criminal justice system must be dramatically restructured to finally start treating our incarcerated people as just that: people, not subhuman and expendable objects.

References

1. Harvard University. (2021, August 20). Criminal injustice. Harvard University. Retrieved October 31, 2021, from https://www.harvard.edu/in-focus/unequal/criminal-injustice/.

2. Center for Reproductive Rights. (2014). Reproductive Injustice: Racial and Gender Discrimination in US Healthcare. Center for Reproductive Rights. Retrieved October 31, 2021, from https://tbinternet.ohchr.org/Treaties/CERD/Shared%20Documents/USA/INT_CERD_NGO_USA_17560_E.pdf.

3. Marusic, K. (2019, June 11). The sickening truth about what it's like to get your period in prison. Women's Health. Retrieved October 31, 2021, from https://www.womenshealthmag.com/life/a19997775/women-jail-periods/.

4. Guardian News and Media. (2020, January 24). Pregnant and shackled: Why inmates are still giving birth cuffed and bound. The Guardian. Retrieved October 31, 2021, from https://www.theguardian.com/us-news/2020/jan/24/shackled-pregnant-women-prisoners-birth.

5. The National Center on Addiction and Substance Abuse at Columbia University. (2010). Behind Bars II: Substance Abuse and America’s Prison Population. The Hill. Retrieved October 31, 2021, from https://thehill.com/sites/default/files/behind%20bars%20ii%20report%20final%202-24-10_0.pdf.

6. Steven S. Martin, C. A. B. (1999). Three-year outcomes of Therapeutic Community Treatment for drug-involved offenders in Delaware: From prison to work release to aftercare - Steven S. Martin, Clifford A. Butzin, Christine A. Saum, James A. Inciardi, 1999. SAGE Journals. Retrieved October 31, 2021, from https://journals.sagepub.com/doi/abs/10.1177/0032885599079003002.

7. Marlowe, D. B. (2003, August). Integrating substance abuse treatment and criminal justice supervision. Science & practice perspectives. Retrieved October 31, 2021, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2851043/.

8. Slade, H. (n.d.). Case study - transform drug policy foundation. Transform Drug Policy Foundation. Retrieved October 31, 2021, from https://transformdrugs.org/assets/files/PDFs/Drug-decriminalisation-in-Portugal-setting-the-record-straight.pdf.

9. CBC/Radio Canada. (2020, July 25). Amid 'horrific' spike in opioid deaths, doctors call for decriminalization, regulation of Drugs | CBC Radio. CBCnews. Retrieved October 31, 2021, from https://www.cbc.ca/radio/day6/portland-protests-how-covid-affects-weather-forecasts-canada-s-opioid-crisis-love-on-the-spectrum-and-more-1.5660707/amid-horrific-spike-in-opioid-deaths-doctors-call-for-decriminalization-regulation-of-drugs-1.5660720.

Long-Covid: Should We Be Worried?

It’s 2021, and, for many of us, it is starting to feel like we are getting past the toughest part of the Covid-19 pandemic. People are getting vaccinated, and while mask mandates are still encouraged and enforced in many areas, they are starting to become less prevalent in vaccinated populations. This is what we’ve all been wishing for since the pandemic first began. Unfortunately, this is not the case for many patients and victims of Covid-19. Long Covid: what is it, what causes it and who does it affect?

Long Covid typically refers to symptoms that persist past 12 weeks after infection. These symptoms range from mild to severe and can have a detrimental effect on the patient’s health, as some patients are left unable to accomplish simple tasks such as showering or sleeping properly. Other markers of Long Covid can include tiredness, shortness of breath, heart palpitations, chest pain, changes to taste or smell, problems with memory and concentration, or joint pain. Additionally, several studies have reported up to 200 varying symptoms [1].

Even more concerning, doctors are not completely sure of what causes these symptoms. Several possibilities and theories are swirling around the medical community. For example, one prevalent hypothesis holds that it is caused by the patient’s immune system working overdrive to try to fight off the virus, leading the immune system to attack normal tissue that helps us perform daily functions. This is a terrifying thought; our immune systems are supposed to defend our body and tissues, not be the reason we are getting sick. Another theory posits that part of the virus stays in our bodies for months after, causing these lasting effects known as Long Covid for some. It is still too early to specify the exact cause, and several doctors believe that it could be a combination of several possibilities. Preliminary data is showing that this could be the case [2].

Regardless, Long Covid is something to be fearful and aware of, as it could affect any Covid-19 patient. The effects of Long Covid seem to be prevalent within all age groups, however, it is not yet statistically known how Long Covid affects children versus adults. For example, it has been observed that children display fatigue, depression, shortness of breath and other long-haul symptoms [3], but this is something that warrants further study. In addition to physical symptoms, the severe mental toll of Covid-19 cannot be ignored.Whether it be due to isolation or actually contracting the virus, and what that means for one’s health, it is important to pay attention and take care of your mental health throughout this pandemic process.

Long Covid is a scary reality for all of us, and it is key to remember that no one is alone in this battle. We are all struggling. We are all trying to make the best out of a horrible situation. Long Covid may still be a mystery, but we are all faced with its possible implications.

References

[1] Schraer, R. (2021, September 17). Long covid: What is it and what are the symptoms? BBC News. Retrieved October 22, 2021, from https://www.bbc.com/news/health-57833394.

[2] Marshall, M. (2021, June 9). The four most urgent questions about long covid. Nature News. Retrieved October 22, 2021, from https://www.nature.com/articles/d41586-021-01511-z.

[3] Covid 'long haulers': Long-term effects of COVID-19. Johns Hopkins Medicine. (n.d.). Retrieved October 22, 2021, from https://www.hopkinsmedicine.org/health/conditions-and-diseases/coronavirus/covid-long-haulers-long-term-effects-of-covid19.