Dr. Saif Darwish is a community doctor in the UAE, working in the realm of preventative medicine to protect people from getting diseases. He talked to Livehealthy’s Arabic podcast about the different Covid-19 vaccines and why we should trust them.
What does a community doctor do?
Community medicine has nothing to do with sociology or therapy. Some think that we work as family counselors, which we don’t. It can be seen as preventative medicine. Our goal as community doctors is to protect people from various diseases. We define our specialty as complete physical, social, psychological and even spiritual wellness. It is not just about finding solutions to diseases, but trying to prevent them.
In the past, people were not aware of the importance of community doctors but with the emergence of pandemics such as the current one, they have learned how essential we are. The truth of the matter is that the people who were leading the response to this pandemic were community doctors and public health specialists. We are involved with vaccinations, for instance.
What about people who are hesitant about getting vaccinated?
In the history of humanity and epidemics, we have only managed to conquer one disease: smallpox. How did we do it? With vaccination. Smallpox used to cause deformities and led to many deaths. There was a worldwide epidemic but in the 1980s, the world defeated it. The last person to contract smallpox was a man named Ali in 1979 in Somalia.
We can say that we are also close to eliminating several other diseases, such as polio, measles, whooping cough and rubella [also known as German measles]; we don’t hear of cases of those illnesses like we used to. We can say we have them under control because they are more rare.
Usually, a vaccine prevents or reduces the spread of a disease but does not reduce its severity in the patient. But the Covid-19 vaccine is different. When faced with a new disease that we haven’t studied sufficiently, vaccines may reduce severity, but the goal remains to prevent anyone contracting the virus .
With vaccinations, you get the development of herd or community immunity. As long as there is community immunity, people will not get the disease. If someone hasn’t had the vaccine but there is overall community immunity, that person will not get infected.
What makes the coronavirus different?
The key point is that Covid-19 is a new disease and so is the vaccine. They are both still being studied around the world. With a new vaccine, there is always room for improvement. Some types of viruses have an amazing ability to change. It’s a phenomenon known as antigenic shift. For example, the influenza virus changes every year so every year we have a new flu vaccine.
Every 20 to 30 years there is a total change in a virus, which has the potential to lead to a global pandemic. The virus mutates and breeds with other strains and a new disease emerges. This is basically what happened with Covid-19. The disease was discovered in chickens and isolated around the 1930s. Then in the 1960s, they discovered that this virus could infect people.
From the 1960s until the beginning of this century, the virus mainly caused nothing more than a common cold. When people had a cold, it was often from the coronavirus.
In 2002, a mutation occurred, which caused an epidemic but did not turn into a global pandemic. It was just an isolated epidemic that occurred in China and Hong Kong and was present in almost 11 countries. That was the SARS virus and by 2005 to 2006 it had been contained.
Around 2014 the disease re-emerged in Saudi Arabia, the UAE and the Arabian Gulf and it was linked to camels and they called it Middle East Respiratory Syndrome, or MERS. The virus had appeared in a new form.During that period, scientists were working on some vaccines, but the virus was eliminated quickly, there was no pandemic, so we didn’t need them. The virus remained isolated.
The thinking was that MERS was only transmitted to people who work with camels but doctors at the time said it would be a disaster if it spread among humans. Then in 2019, that is exactly what happened.
The virus changed and appeared in an altered format, a result of intermarriage between strains of the coronavirus. When people who are not closely related marry, their children look different and their health is better. This same interbreeding between different virus strains in many different animals led to Covid-19.
Would it have been possible to produce a vaccine for those earlier viruses?
As I said, when MERS was around, there was research being done on a vaccine but at a certain point, it stopped. When Covid-19 appeared and spread, they were able to build on the pre-existing MERS research. The virus is not entirely new and the vaccine is not entirely new either.
When SARS and MERS emerged, lots of pharmaceutical companies invested in research so when Covid-19 hit, we were not starting from zero.
Producing a vaccine takes a certain mechanism or recipe. If you have the mechanism, you can apply it to any other virus or vaccination. Sinopharm, for example, uses a well-known mechanism, which is to kill the virus and put it in the human body as a dead virus. We know this mechanism. The difficulty lies in making a new mechanism.
How do the different types of vaccines work?
Currently, there are 200 Covid-19 vaccines undergoing the third phase of clinical trials around the world. There are different ways of making vaccines but this time round, we have used three methods for Covid-19.
The first method is the one with the deactivated virus, used in Sinopharm.
The second mechanism was used in the Sputnik V and AstraZeneca vaccines. These both take the S protein, a part of the coronavirus that does not cause disease, and inject it into another, weak virus that has been stripped of the ability to cause illness. Then we inject this new, harmless virus containing the S protein into the human body. The body recognizes this new virus as coronavirus and builds antibodies to fight it.
The third mechanism, used by Pfizer and Moderna, is fairly new and depends on mRNA [messenger MRNA].
RNA [Ribonucleic acid], is responsible for producing proteins. It consists of several sections, one of which is mRNA.
Pfizer and Moderna used mRNA to produce the harmless protein on the coronavirus spike. With those vaccines, it is not the protein itself that is injected into the body, it is the protein-making “factory” – the mRNA.
Once inside the body, it begins to manufacture the S protein. The body thinks it is fighting the coronavirus and starts producing antibodies. Many people are wary of this type of vaccine, because they think it hasn’t been tested. Some even believe it can manipulate DNA.
In fact, this method has been tested for more than 20 years, but it was only used previously to treat cancer. It has a lot of research around it. It’s now being used for the coronavirus and it’s working.
The goal of all vaccines is to make antibodies, whatever the method. Many people don’t realize that viruses are living organisms, because they can’t move or travel of their own volition. They spread through us, when we cough or sneeze or touch.
Is any one vaccine better than the others?
Personally, I think they are all excellent. For a vaccine to be approved, it has to undergo difficult vetting, especially because people always have doubts about vaccines. We try to make sure people have no reason to doubt.
Doctors are always afraid of producing a bad vaccine, so there is a first, second and third stage of testing before any vaccine is fully accepted. After the three stages of testing we are sure a vaccine is safe for use.
But when it comes to governments and which vaccine to go for, different variables come into play, such as price differences and agreements between countries and pharmaceutical companies. Prices and financial resources have a significant impact on these decisions. Most countries are distributing vaccines free of charge, so the price at which a country can buy the vaccine is important.
There are other logistical factors. For example, the Pfizer vaccine must be stored at -70°C, which requires a huge capacity to maintain the right conditions. But the Sputnik vaccine is stored at 3°C, so if a country doesn’t have the capacity to store vaccines at -70°C they are more likely to not buy the Pfizer vaccine. Countries make choices according to their capabilities.
How was it possible to conduct tests in such a short period?
Historically, the longest time taken to develop a vaccine was four years. With the coronavirus we completed the process in almost nine months. The vaccine that took four years to produce was made in 1967. Science has taken thousands of leaps since then. Scientific development today is unprecedented and the world has the potential to achieve it. Experience and speed do not affect effectiveness and efficiency.
The vaccine is safe. Pregnant and breastfeeding women should not have it out of extra caution because no testing is done on pregnant women, and nor should anyone who is on medication that reduces immunity. Otherwise, everyone should have the vaccine. That’s my message: have the vaccine.
Lina Elmusa is a literature and coffee lover. She tries to understand the world through language. She's currently exploring the world of media at livehealthy.ae.