The COVID-19 vaccine is coming: Will people be forced to take it, and is it safe?

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ST. GEORGE — In the next two weeks, it is expected that the first vaccines to innoculate against COVID-19 will be given to doctors, nurses and other frontline workers at Dixie Regional Medical Center who deal directly with coronavirus patients.

Photo illustration. | Photo iStock/Getty Images Plus, St. George News

They will be the first in line for what will ultimately be a vaccine that will be available to everyone over 18 in Southern Utah by this summer.

The arrival of the vaccine brings for some the hope that there is an end point to a pandemic that has infected eight of every 100 Southern Utahns in nine months.

But it also brings questions. Will the vaccine be safe? Will people be forced to take it? Will it be effective?

Jennifer Harrington, an associate professor of nursing at Dixie State University, said the fact that the medical workers that are irreplaceable are being provided the vaccine first should be evidence enough that it is safe. And she said she would like to be among the first to get the vaccine herself.

“We’re not going to put our frontline workers in harm’s way. Anything we put in our body is going to have an effect. … Water, a baby aspirin, it all has an effect. But these are the best minds, the best scientists who worked on this. I will have no qualms with being the first in line,” Harrington said. “If we can get the right percentage who have immunity, this will shut the virus down and get us back to a sense of normalcy, which we’re all anxious for.”

Will people be forced to take the vaccine?

A big hurdle standing in the way of wide use of the vaccine is the public’s acceptance of it. 

One fear expressed by those opposing vaccines has been from a civil liberties perspective, similar to the criticism of the mandatory mask mandate, including a concern that people will be forced to take the vaccine. 

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But at least initially, even the medical staff at Dixie Regional will not be required to take the vaccine. 

“The vaccine will not be mandatory,” Dr. Tamara Sheffield, community health and prevention medical director for Intermountain Healthcare, said as far as Dixie Regional staff are concerned. “It will not impact their job status in any way.”

From a state perspective, Utah Gov. Gary Herbert said he also wants to leave it up to Utahns whether to take the vaccine. 

“We have no plans to mandate it, but I think most Utahns will take the opportunity to protect their loved ones,” Herbert said. 

However, one group that can still mandate vaccines, according to Herbert, are private employers who already make other vaccinations a requirement of employment. 

“I think it would be within their constitutional rights as employers to require vaccines,” Herbert said. “The public sector would be more difficult. That’s something we’re going to be wrestling with.”

Another group that presently requires vaccinations are schools. Because the timetable leaves school-age children among the last to get the vaccine, that may be a decision that will be made in the next school year, though Herbert emphasized that the same exemptions currently present to allow students to attend school without vaccinations would apply to the COVID-19 vaccine.  

Will the vaccine be safe?

Besides civil liberties, even those who are for vaccinations overall may be hesitant if they don’t feel confident about their safety.

A graphic shows the differences between an mRNA-based vaccine and traditional vaccines. | Photo courtesy of Pfizer Inc., St. George News | Click to enlarge

Both of the vaccines expected to be approved, by drugmakers Pfizer and Moderna vaccines, will be utilizing new technology different than any other vaccines previously created.

Instead of using an inert virus to stimulate the immune system like traditional vaccines, the COVID-19 vaccines utilize genetic engineering and nanotechnology to use modified proteins that block the ability for the virus to attack healthy cells. 

The building blocks of protein have been created in a lab and don’t come from animals or other humans. One of the advantages is, unlike traditional vaccines created from inert viruses, it is easier to produce and in larger quantities. This means after the first thousand doses are given to frontline medical workers at Dixie Regional in two weeks, medical officials don’t think it will take long to have more supply and move on to the other phases of vaccine distribution.

Modified messenger RNA (mRNA) enter cells and enable them to create the antibodies that will protect the cells from COVID-19. It is the effect of giving the human body a foolproof battle plan to stop any coronavirus invasion.

“We’re mirroring what would naturally happen in your body. This is a wall of protection,” Sheffield said. “With the COVID virus, when it wants to invade your body, it uses a spike protein. When you’re able to create a spike protein and create antibodies, it neutralizes the action of the virus itself. The virus cannot inject itself into the cell.”

The idea of genetic modification has also provoked fear in some. Dr. Andrew Pavia, chief of pediatric infectious disease at University of Utah Health, said there is nothing to fear. He said while mRNA sounds similar to the DNA building blocks of life, adding mRNA is no more harmful to DNA than adding a few more grains of rice to a teriyaki bowl will change its flavor.  

Photo illustration. | Photo iStock/Getty Images Plus, St. George News

“I’m not concerned that it’s genetic material,” Pavia said. “MRNA is a very different genetic code. It is not the basic code of life. It is the template for manufacturing proteins. It’s the make-up of the machinery. We feel pretty good about that.”

Dr. Eddie Stenehjem, medical director of antibiotic stewardship for Intermountain Healthcare, said people don’t need to be afraid of something being put into their bodies that will reorganize their DNA or other mutations.

“This isn’t DNA, this is RNA. This isn’t human DNA or animal RNA,” Stenehjem said. “RNA doesn’t become part of your genome. This doesn’t become part of your DNA. This is essentially the blueprint of how to make a protein.”

However, while it’s proven effective, the vaccine in trials has had short-term side effects that have not been seen to cause any kind of permanent damage but can cause discomfort for 24 to 48 hours.

For that reason, the plan at Dixie Regional will be to vaccinate workers at the end of their weekly shift to create as little impact as possible if medical staff need to take a day or two to recover. 

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The side effects aren’t caused by COVID-19, but in the body’s immune system going into overdrive. That could include a day or two of muscle aches, headaches and fever. 

“These are a little more reactogenic compared to the typical flu shot,” Stenehjem said. “There are a large percentage are going to feel feverish for 24 to 48 hours and that’s just the immune system kicking into gear.”

Stenehjem said in the trials there have been no side effects seen beyond those first two days, and he added past vaccine research has shown that any long-term effects would be seen in the first two months.  

“And that hasn’t happened,” Stenehjem said. “The only long-term effects we anticipate are people not getting COVID-19.”

Dr. Kristin Dascomb, medical director of infection prevention employee health at Intermountain Healthcare, added that other than dealing with possible side effects for 24 to 48 hours, those receiving the vaccine will not be contagious and won’t need a quarantine period after taking the vaccine. 

How long will the vaccine be effective?

As it is just over a year since the virus was first discovered and a few months of vaccine trials, there is no way to know just how long the COVID-19 vaccine will be effective. There is no way to know if this will be a vaccine that needs to be taken yearly, needs occasional booster shots or has long-term effectiveness like the measles vaccine.  

A chart showing how “herd” or “community immunity” works. | Image courtesy of Vaccines.gov, St. George News | Click to enlarge

“We have only short-term data,” Pavia said. “We know it will last for months, but whether that is two years, four years or more, we won’t know until we have many more years under our belt. Science is about what we can learn, not about what we think we know.”

For that reason, even if the vaccine is widely taken this summer, health officials still say there will still be another few months of wearing masks and social distancing until it is clear COVID-19 is no longer a major threat. 

But Pavia said it has already proven that the vaccine will create more antibodies than those who have had the virus already in the system. That lack of antibodies in those already infected is why people are now being infected with COVID-19 for a second time and why, Stenehjem said. Any kind of “herd immunity” will require a strong vaccine as opposed to just exposing everyone to the virus. 

“There’s no ability to generate herd immunity if you lose that immunity,” Stenehjem said. ” Getting herd immunity from infections instead of vaccines means hundreds of thousands of people dying as opposed to nobody dying. That argument has no basis at all.”

Editor’s note: A Cedar City man who has been part of the vaccine study said it made him feel ‘crummy’ for two days, but he said everyone should take it. Look for this story soon in St. George News.

COVID-19 information resources

St. George News has made every effort to ensure the information in this story is accurate at the time it was written. However, as the situation and science surrounding the coronavirus continues to evolve, it’s possible that some data has changed.

Check the resources below for up-to-date information and resources.

Southern Utah coronavirus count (as of Dec. 9, 2020, seven-day average in parentheses)

Positive COVID-19 tests: 14,416 (266.3 new infections per day in seven days, falling since Dec. 8)

  • Washington County: 11,337 (194.1 per day, falling)
  • Iron County: 2,367 (56 per day, falling)
  • Kane County: 243 (8 per day, rising)
  • Garfield County: 254 (1.6 per day, falling)
  • Beaver County: 215 (6.6 per day, rising)

New infections for major Southern Utah cities (numbers released ahead of Southern Utah numbers):

  • St. George: 135 (steady)
  • Washington City: 36 (falling)
  • Hurricane/LaVerkin: 20 (falling)
  • Ivins City/Santa Clara: 24 (steady)
  • Cedar City: 30 (falling)

Deaths: 105 (1.6 per day, rising)

  • Washington County: 88 (3 new: Hospitalized female 65-84, hospitalized female 65-84, hospitalized female 65-84,) 
  • Iron County: 8 (2 new:  Hospitalized female 65-8, male 65-84 unknown location)
  • Garfield County: 6
  • Kane County: 1
  • Beaver County: 2

Hospitalized: 52 (steady)

Active cases: 4,503 (rising)

Recovered: 9,808

Current Utah seven-day average: 2,892 (falling)

Copyright St. George News, SaintGeorgeUtah.com LLC, 2020, all rights reserved.

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