“What would you do, professor?” It’s a question you may have heard from your students. As a health education professor, it’s one I’ve heard a lot in the past year. It started with students’ anxieties about the beginning of the pandemic and continued until the end of last semester, when a student asked me about the COVID-19 vaccine. “Would I take it?” she wanted to know.
Vaccination, like all health decisions, is a personal decision, one taken while weighing risks and benefits. However, unlike most medications, it has an effect not only on the recipient, but also their community and society at large, by providing protection to those around them – this is the concept of herd immunity. Vaccine hesitancy is at an all-time high and the World Health Organizations considers it to be a growing threat to human health. While some people do not get vaccinated because of lack of access, many others are hesitant or outright refuse because of fears, lack of trust in scientists, doctors and government, or the large volumes of mis- and disinformation when it comes to vaccine safety and effects.
One common thread about the COVID-19 vaccines is that they were developed too fast and not enough testing has been done. It’s important to understand that scientist having been developing the “new” technology used in creating these vaccines for many years; they were also able to draw on prior research into corona viruses. Although the Pfizer and Moderna vaccines are the first mRNA vaccines to be approved for use in humans, scientists have been working on this idea for 30 years. Scientists also benefitted from the continual advances in our ability to genetically sequence quickly.
Another two vaccines which will likely come up for approval soon (from AstraZeneca/Oxford and Johnson & Johnson) are based on an inactivated adenovirus to deliver information to our cells – these are called viral-vector vaccines. Adenoviruses have been used in prior vaccine development, for example a tuberculosis vaccine and an Ebola virus vaccine. There are several other vaccine candidates in the works that use different technologies, but none of them are truly new in vaccine development.
Briefly, vaccines work by teaching your immune system what to attack. The ways this teaching works differs. Some of the first ways humans attempted to do this is to take body fluids from a person who was sick and applying them to healthy individuals. Over time, scientists learned how to create vaccines from weakened or dead pathogens. As technology improved, so did the mechanisms. The mRNA vaccines currently in use in the US work by delivering the messenger-RNA to cells, which then make the spike protein found on the outside of the coronavirus (SARS-CoV-2). The immune system then mounts a response to this spike protein with antibodies and T-cells. The viral-vector vaccines use a different virus (adenoviruses usually cause colds) to deliver DNA, which in turn instructs your cells to make the protein from SARS-CoV-2. Then, your immune system can mount a response to those proteins. Other processes currently in development use proteins from the virus, inactivated virus or attenuated virus to teach your immune system. Different companies all over the world are in various stages of development, and countries like Russia and China are already using some of these vaccine types in the population.
In the USA, prior to approval, all vaccines must go through the FDA process. This includes animal trials and human participant trials in different phases. While the Pfizer and Moderna vaccine are approved under emergency use authorization, they nevertheless went through the usual process of testing vaccines and providing all evidence to the FDA for review. The data are then typically published in peer review journals – here is the Pfizer study and here is the Moderna study.
Teaching about vaccines and COVID19. It is not just biology.
In this time of uncertainty and crisis, our students will look to us to address the events of the world. I believe it is our responsibility to provide students with accurate information, and to add context relevant to the courses we teach. Most disciplines can add to the conversation around the pandemic and vaccines and provide much-needed context to students. Below are just some of the ideas I’ve considered – other faculty can no doubt find their own ways to have these conversations.
In basic science and biology classes we can talk about how the vaccines work in the body. Probably all health sciences instructors are already talking about the vaccines in our classes, as it is very important to address vaccine hesitancy among the future healthcare workers we are training. Math classes can discuss how scientists calculate efficacy in clinical trials. It would also be quite easy to discuss issues of decision making, beliefs, and influences of social networks in psychology classes. Sociology has an important role to play in providing context about groups that have been impacted most heavily by the pandemic, especially people of color. It would also be important to acknowledge the lack of trust in Black communities and among people of color because of unethical medical and public health actions in the past. This is something that history, ethnic studies and philosophy classes can address, while also looking at the ramifications of past pandemics like the flu of 1918. Economics and accounting classes can consider the cost-benefit analysis of getting the population vaccinated and the effect of further lock-down measures on the economy. Humanities and arts classes can allow students creative ways to express their feelings about the pandemic and the disruptions and grief it has caused. Of course, a lot of art and writing has already been made in response to pandemics and human fears about disease. Media studies and communication classes can talk about how information has been made available from the beginning of the pandemic and the most effective ways to communicate with the vaccine hesitant.
Likely, we will all continue to face the ramifications of COVID-19 for many years to come. It is vital that we have these conversations with students to prepare them for a world changed by the pandemic.