Dr C: “Here’s why we must wait to hug”

There’s a lot of talk about how effective one jab is rather than two, or how much protection recovering from COVID-19 provides – Dr C explains what we know about immunity

As we roll out mass vaccinations, people could see their first coronavirus jab as a passport to freedom, but one jab is only half the dose. The stats, percentages and graphs we’re bombarded with are irrelevant – all you need to know is that if you’ve had one dose of a vaccine, you’re only halfway to being protected.

DON’T FOCUS ON STATS

At a recent press conference, Boris Johnson talked about the Kent strain being 40 per cent more deadly. That’s easy to misconstrue. When you look at the research that showed this strain is deadlier, it was only based on a few hundred people. Most of us won’t even know which strain we have because it isn’t routinely tested, and even if that stat is true, which scientists don’t know yet, a 40 per cent increase would mean 13 or 14 people per 1,000 would die of the new strain, compared with 10 people who would die of the old one. A 40 per cent increase of something that’s really small is still pretty small.

KNOW IT’S 2 DOSES!

All you need to focus on is the advice. Stats and graphs are for the scientists who are advising the government. The only numbers you need to think about are how many doses you need of the vaccine, and it’s two.

STAY VIGILANT

I want people to feel hopeful, that’s important, and the vaccines are a huge source of hope, but we still need to be patient. When you’ve had your two doses, you can start to think about what you’d eventually like to do when restrictions are lifted, or who you’d like to hug when allowed. Until then, it’s business as usual, with all the precautions: hand-washing, masks, keeping distance, and working from home if you can. We’ve got the route out of this pandemic, but we need to stay vigilant for now.

MIND THE CONFUSION

Politicians have said that by mid-February all the most vulnerable people will have been vaccinated. That drives me mad, because they won’t be fully vaccinated – most will be half vaccinated. People are also confused about whether the vaccination programme will stop the spread of the virus, and while we can’t say for certain, it’s very likely it will. That’s the point of vaccination. Firstly, to keep people alive, and secondly, to stop the spread. These vaccines and the virus are new, but we have lots of experience with similar viruses and plenty of vaccines already, and they all behave fairly similarly, so we can make good predictions. We’re all vaccinated for childhood diseases, for example, which means there are far fewer of them bubbling around in society, so we can protect vulnerable people, because they’re less likely to come into contact with it.

SPREAD SHOULD SLOW

The Oxford vaccine scientists have looked into spread. They have regularly tested vaccinated people for COVID-19 to see if they were carrying it, even if they had no symptoms, and they found very few cases.

That’s a very good sign, because asymptomatic people can spread it unintentionally, so vaccination should solve that problem, and it’s likely to be the same with the Pfizer jab.

UNDERSTAND ANTIBODIES

The other thing that’s being discussed is that people who have recovered from coronavirus will have a good level of immunity, thanks to natural antibodies. Right from the beginning of this pandemic I felt fairly sure that you’d have some protection after having the virus, the problem is that scientists can’t make statements like that without

absolute proof. A study by Public Health England, which involved nearly 21,000 NHS workers who had had COVID19, found that the vast majority had good immunity against the virus six months after catching it. Again, if you look at other viruses, that’s what always tends to happen. The body is pretty efficient, so it tends to retain immunity against something that could have killed you. That doesn’t mean that if you’ve had coronavirus and recovered, you wouldn’t get it again, though, because we’re all a little different. Many of us may be vitamin D deficient (due to a lack of sunshine), lots of us are overweight, some of us smoke – all of that will have an impact. Also, if you had coronavirus last year and you have antibodies, we don’t know if they would protect you against the newer strains. Natural immunity is complex, so it may not be as good at bringing down new variants.

PROTECT THE NHS

Vaccination is clearer. Research that looked at the Pfizer vaccine showed that when you have your full two doses, your body produces six- to 20-times more antibodies compared to what it produces as you recover from a severe case of COVID-19. That’s why we’re going for vaccines, as they are a much safer and more efficient way to protect people, and protect the NHS from being overwhelmed and unable to treat people for other serious health problems because they don’t have the beds or the staff.

SEE THE BENEFITS

As we all know, when you’re ill, you tend not to eat much, but immunity relies a lot on protein because antibodies are made of protein, so when you’re ill and off your food, your protein intake goes down and your immunity goes down with it – right when you need it most. If you’re well and you have a vaccine, on the other hand, the chances are you’ll make really good immunity. That’s another reason why it’s far better to be careful and to wait to be vaccinated than to put yourself at risk of catching coronavirus.

KEEP YOUR GUARD UP

The first vaccine gives quick protection that gradually rises as you wait for your second dose.

The second one gives your immune system long-lasting memory, so that if a year later you’re exposed to it again, you have the same efficient and quick immune response. We don’t yet know how long these vaccines will last; it may be years or we may need an annual jab like with flu – but either way, just one dose certainly isn’t enough. There is concern about spreading out the two doses. We know from other vaccines that protection doesn’t tend to fall or even plateau between doses, it tends to rise. But my worry with a long gap is that people will forget their second dose, or may even think that as they’ve had one dose they can forget all the measures to stay safe, even though they haven’t yet had the full treatment. I do want people to feel hopeful, but no one should throw caution to the wind. Change your thoughts, but not your behaviour. Dream of summer holidays, look forward to hugging family, but wait to put those things into practice.