Issue link: https://maltatoday.uberflip.com/i/1324024
9 maltatoday | SUNDAY • 3 JANUARY 2021 INTERVIEW understandable, but misplaced product's safety and efficacy: which has been proven through all these studies. As things stand, the vaccine has been rolled out, and has already been admin- istered – in Malta as elsewhere – on a small number of patients. On the basis of what you've seen so far: do you think the decision to approve the vaccine was justified? Is the vaccine actually work- ing? Up to now, we have not seen any severe side-effects in Malta; and even looking at the thousands of people who have been vaccinated in other countries, there were no reports that were worrying. Obviously, however, there is a degree of risk involved in everything we do in life. What is important, then, is that we try to reduce the risk as much as possible. In this case, the balancing act is between the ill-effects of COVID-19, as opposed to the possible ill-effects of the vaccine itself… The problem there, however, is that while we all know the ill-effects of COV- ID-19… the possible side-effects of the vaccine remain unclear. There have been reports of allergic reactions, for instance. How serious would you say these possible 'ill-effects' might be? Unfortunately, the issue of allergies has been blown out of proportion. What hap- pened in the UK, for instance, is that – a couple of days into the vaccination pro- cess – there were a few severe reactions. Now: when it comes to the COVID-19 vaccines, there are only two major, ab- solute contra-indications [i.e., reasons not to take the vaccine]: the first is when someone gets a severe reaction to the first dose – and by 'severe', I mean 'needing hospitalisation'; the second (which is re- lated) is whether the recipient is known to have any allergies to any of the compo- nents of the vaccine. Compared to other vaccines, however, this one has far fewer components that are known to cause allergic reactions. It has no egg components; no anti-biotics… so while the risk of allergic reactions re- mains a factor – it always does - it is ac- tually much lower, in this case, than with other vaccines: including, for instance, the influenza vaccine… Let's turn to how it actually works. My limited understanding is that the COV- ID-19 is 'mRNA-based'; and that the vaccine operates by emulating the prop- erties of m-RNA, to induce the body's immunity system to recognize its pres- ence, and respond accordingly. This has led to the assumption that the vaccine may end up 'modifying our DNA'… with possibly frightening consequences. Are these concerns in any way justified? For a vaccine to 'modify our DNA'… it has to enter our genetic make-up in the first place. What does that mean? Let me explain it this way: the cell is generally shaped like a 'ball'… and inside this ball, there is another sphere called the nucle- us. That is what contains our genetic ma- terial. Now: these 'messenger-RNA' vaccines do not enter the nucleus. They stay outside the nucleus, in a jelly-like sub- stance known as the cytoplasm. And af- ter they've done their job, of producing the shell of the coronavirus, they are de- stroyed within a couple of days. So our clear understanding, as things stand, is that these these m-RNA vaccines cannot affect our genetic make-up. This issue has obviously also been carefully considered by the regulatory bodies. It's worth mentioning, however, that there are other vaccines – some of which are still awaiting approval – and these may use other methods. But the ones which are available in Malta – namely, the Moderna and Pfizer vaccines – are both m-RNA-based. All the same, however, it appears that this approach to vaccination – which is unlike the traditional models – has never been used before. What makes medical science so sure that it will work according to plan? It is true that we are talking about a new, ground-breaking technology; but it is equally true that the scientists did not start from 'ground zero'. COVID-19 is not the first disease to be approached this way: m-RNA-based technology has already been used in the case of influen- za, the Zika virus, and in other areas of medical research, such as cancer treat- ment. The difference, however, is that it has not so far been tested on thousands of people. But this also has to be seen in the con- text of the entire world having been brought to its knees. To put it another way: it is like being chased by a rabid dog, and your only option, to avoid get- ting bitten, is to climb a tree. You have to decide: are you going to climb that tree… with the risk of being bruised by a branch? Or possibly falling out of it? Or do you stay there, and wait to get at- tacked by the dog? I, for one, would certainly take the deci- sion to climb the tree. Because at the end of the day, this is about risk assessment. To use another analogy: it's like crossing the road. Do you decide not to cross a road, because there is a chance of being run over? Or do you look right and left, and assess the risk before taking the de- cision? It's the same with this vaccine; and any vaccine, for that matter… Meanwhile, we are hearing of 'vari- ants' of this virus… including a more infectious strain, originating in the UK, which is now present in Malta. Is there any reliable evidence that the vaccine will work against new (and future) var- iants, too? Up to now, what we know about these new variants is that they are more infec- tious; but they do not cause more severe symptoms. In other words: we are still talking about the same virus… only, a var- iant that spreads more easily. So there is no real reason to suppose that the vaccine should be any less effec- tive. At least, not in the case of the vari- ants we know about so far. All this can change, however. We might face new variants that do cause more se- vere symptoms; or which, for instance, affect younger people. Even if that does happen, however, it doesn't mean that the vaccination 'will not work'. Having said this: we still need more studies today. And studies are still being carried out, all the time. It's an ongoing process… One last question: our hopes of a 'return to normality' depend largely on the suc- cess of this vaccine. All things consid- ered: how hopeful are you, in reality? At this stage I would say that I am op- timistic: the reason being that we have followed this very closely over the past 11 months; we have met the regulatory bodies online; we have seen the evidence, and the studies… and in conclusion, everything is pointing towards a safe and effective vaccine, which is going to be a game-changer, and eventually bring an end to the pandemic. PHOTO: JAMES BIANCHI / MALTATODAY