A vial of Pfizer’s COVID-19 vaccine is seen at Central Emergency Services Station 1 on Friday, Dec. 18 in Soldotna, Alaska. (Ashlyn O’Hara/Peninsula Clarion)

A vial of Pfizer’s COVID-19 vaccine is seen at Central Emergency Services Station 1 on Friday, Dec. 18 in Soldotna, Alaska. (Ashlyn O’Hara/Peninsula Clarion)

A physician’s perspective on COVID-19 vaccination

This virus has taken the lives of people who have given much of themselves to our community; people I have cared for for decades.

By Dr. Kristin Mitchell

In the lead-up to what is proving to be a very long winter, I heard these words from Dr. Fauci, “Hang in there, the cavalry’s coming.” By that time I had already signed too many death certificates, written too many condolence notes to grieving families, encouraged too many patients over Zoom to stay home and wear their masks to prevent life-threatening illness. I was desperate for optimism.

I have been an internal medicine physician in Soldotna since 1998. When I was in medical school in San Francisco before effective HIV drugs were developed, I took care of more dying patients than I could count. And then, suddenly, effective therapies were developed and patients began to live with HIV as a chronic illness instead of dying from it. I expected this breakthrough to be the watershed infectious disease news of my lifetime. I was wrong. The development of COVID-19 mRNA vaccines that are 95% effective in preventing a disease that has killed more Americans than died in WWII eclipses that earlier triumph. And yet, physicians and scientists struggle to communicate this successful partnership of science, government, private industry and policymakers to the public at large. The science of vaccines is complicated and the logistics of vaccine development and distribution are complex. In truth, it’s not surprising that people would have questions about how things work and whether to trust that vaccines will help keep us safe.

When I was appointed to the American College of Physicians (ACP) Immunization committee at the beginning of 2020, I did not anticipate how serious this volunteer role would become. As COVID-19 vaccines were developed through the Trump Administration’s Operation Warp Speed in record time, I delved into published Phase I through Phase III trials, listened to hours of testimony before the American Committee on Immunization Practices (ACIP), attended webinars hosted by the CDC and ACP and meetings of the State of Alaska Coronavirus response HUB, sometimes several times per week. The mountain of data was complex and new information accumulated quickly. If I’m having difficulty keeping up, I thought, what chance did my patients have of digesting this information? As public health measures including mask-wearing became politicized, I thought about how I could help keep my community safe.

I don’t relish the spotlight. I’ve been content for decades to care for my patients in my internal medicine practice and advocate for their individual health choices, teaching students and residents in clinic. But after a mid-career leadership course that involved time in Antarctica, I decided I needed to stretch beyond my comfort zone and use my scientific training to advocate for my patients’ health on a larger scale. I have so appreciated the calm, science-based presentations from Dr. Anne Zink through this pandemic; I decided I would try to help disseminate accurate information to my local community.

Here are a few take home points about COVID-19 and the mRNA vaccines:

COVID-19 is not a hoax. It is caused by a novel Coronavirus called SARS-CoV-2 and causes many changes in the body including pneumonia and blood clots that can lead to strokes, heart attacks and death. People over age 80 and people with additional health issues including obesity are at higher risk of dying, but even young healthy people and young children can have very serious, long-lasting effects after infection.

COVID-19 can be deadly. More people in the U.S. have died of this illness than died during all of WWII. This virus has taken the lives of people who have given much of themselves to our community; people I have cared for for decades.

mRNA Vaccines are 95% effective in preventing COVID-19 illness, and almost 100% effective in preventing severe disease. There have been rare severe vaccine reactions — about 11 cases of anaphylaxis per million doses of vaccine. The vaccine is much safer than getting COVID-19 infection.

You can’t get COVID-19 from the vaccines. There is no live or dead virus in the vaccines. There are no microchips or tracking devices in the vaccines. These vaccines contain mRNA, salts and sugar in a lipid envelope. That’s it.

These vaccines cannot change your DNA. DNA exists in the nucleus of the cell. The mRNA in these vaccines only gets into the cytoplasm of the cell where it acts as a blueprint for your cells to read so they can manufacture spike proteins. Once the mRNA teaches your cells how to make the spike protein, your immune system goes to work to destroy the spike proteins as well as the cells that make it.

For now, especially with the emerging threat of new, more contagious variants, we still need to protect ourselves and each other by avoiding crowds, washing hands and wearing masks.

The cavalry has come to Alaska. We are first in the nation among states in the percent of residents who have gotten at least one shot. Many health care providers and seniors have been getting vaccinated in our community. The Borough is helping people get vaccinated at the Soldotna Prep school, Nikiski, Ninilchik and Cooper Landing. Recently, my office held a vaccination clinic for our patients over age 65. People arrived with wheelchairs, walkers and canes, with oxygen and with caregivers on a snowy day. Amazingly, all 198 scheduled patients showed up, most of them early. Overwhelmingly, people were grateful that my office staff had dedicated a Saturday to vaccinating our patients. The optimism was palpable among patients and among staff. My medical assistants celebrated that they got to see people in person for the first time in months and that they had the chance to be part of the solution to this pandemic. Several of us cried.

After giving several interviews and presenting at the Borough Assembly and Kenai City Council meetings, it is clear that some of my neighbors still have questions about how these vaccines work and where they can get reliable information. Unfortunately, a few residents have taken it upon themselves to post false accusations and personal attacks. There is no call for this. We can have civil discussions in the public sphere, and we will all be better for it. After all, this is a public health battle, not a partisan one.

Staying up to date about vaccination can be a challenge. If you want to schedule a vaccination appointment or learn if you are eligible to receive a vaccine, I recommend the State of Alaska web site, covidvax.alaska.gov. If you have questions about what the federal government is doing about vaccines, I recommend the Centers for Disease Control and Prevention website at cdc.gov.

Dr. Kristin Mitchell is board certified in internal medicine and is the Kenai Peninsula Trustee to the Alaska State Medical Association

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