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Doc Hines - Covid Summary - 9 June 2021

Thank you to all of you who responded to my straw poll. I know my daily report goes to about 1500 people from me and is usually shared by about 30 others. It probably reaches about 10,000 people daily. I was delighted to get twice as many comments as usual but with only 62 responses I cannot make a statistically valid analysis. I can say that 29 people said “yes” they want to immunise children, and 5 said an unequivocable “no way”. Just one wanted to sit on the fence, and one raised the important question, should we delay immunising our children until adults in the rest of the world have been done. There is limited vaccine, it’s a global issue so perhaps we should do the rest of the world first. I will be interested in your thoughts about this as well.

I noted some unexpected reactions from some of you I know well, which just goes to show how divisive this issue has the potential to be.

Picking up on some answers, a common fear was overloading or damaging our immune systems. I do wonder what exactly you all meant by this. Somebody with a normal functioning immune system will have no problem developing anti covid antibodies after a routine injection. Most people with poorly functioning immune systems will still cope with the vaccine. Most of those with significant auto immune disease will also cope with it but each case needs assessing individually.

The most common anxiety was about safety and the speed at which vaccines are developed. Most take a number of years, but the Covid vaccine has been developed quickly. In fact, to meet the requirements of the MHRA they all go through exactly the same testing in the same numbers of subjects. The difference is that the testing today is all done at the same time whereas with earlier vaccine one test was done and completed before the next test started.

Vaccines are generally a very safe class of drugs, most vaccines that have been tested over the last 100 years have proved very safe. We have a good understanding of the way they work with an antigen/antibody response. There has to the best of my knowledge never been a case of a vaccine having to be withdrawn if it had passed all the pre licensing testing required.

Some vaccines like the seasonal influenza need boosting every year as the level of antibodies slowly reduce. Others like the measles vaccine will usually produce life-long levels of protective antibodies after just two doses. We do not yet know what the average rate of deterioration in antibody levels will be, it is probable with the data we have that a booster will be required every year if the disease remains active in the world. It would be fantastic if the disease were to be eradicated as Smallpox is, and polio nearly is, then we could stop giving routine boosters. I fear this is unlikely in the next few years, but ultimately possible.

We know it is perfectly possible to cope with the emerging variants by minor adjustments to the vaccine. The first round of boosters are already being made with the new variants in mind. They will enhance protection.

For many the tragedy of thalidomide remains a big fear. Vaccines work very differently to drugs like thalidomide. Much more testing is done in pregnancy today. The vaccine does not cross the placental barrier so it is extremely unlikely we will see any effects on a new born child and they will not have any protection in the form of their own antibodies.

I am delighted to say that the situation in India shows slight improvement with the number of daily new cases beginning to fall. The Indian Prime Minister has announced that the vaccine will now be free for all adults in India.

Nearer home, a landmark in Northern Ireland was reached yesterday when there was not a single case of covid 19 in any of their ITUs. Sadly it will not last.

The number of new cases in the UK are beginning to rise in a more alarming way. There were over 6,000 new cases yesterday and over 7,500 today. The rate per hundred thousand of the population has doubled in the last two weeks.

Most of the new cases are predominantly of the Delta (Indian) Variant which is spreading rapidly because it is 40% more infectious than the original Alpha or Kent Variant

If you break down the people affected, they are mostly those not yet immunised and so are largely both younger and fitter. The elderly, who have been infected are almost entirely those that were not vaccinated. They are often significantly unwell.

Because the majority of cases are in younger fitter individuals the hospitals have not yet been hit hard. Today’s figures do however show a small rise in the number of daily admissions and the number in hospitals. 154 are currently on a ventilator and we are back to over 1,000 inpatients. There have only been 6 deaths reported.

I have mentioned the regional hotspots and the sensible advice to avoid them if possible, the Mayor of Manchester is rather publicly disagreeing with the emphasis from Central Government. The scientists are quite clear, we need everyone immunised as quickly as possible, and yes I agree with most of you we should include children down to 12.

Although the NHS is not over run, with the chaos very high numbers being ill will bring, I cannot see we will be able to lift restrictions as planned. If we leave things as they are till the school holidays begin, we will have a few more weeks to immunise everyone. People need to listen to advice or guidance if they do not want legal sanctions, which we all want to avoid.

Please remember the basics, stay outdoors whenever possible and stay apart. Wear your masks in shops and on public transport. Keep staying safe and get your vaccine , especially if you have missed it.

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