Deciding

I have always been skeptical of new medical developments. So, when I heard about this Covid immunization being rolled out so quickly based on Messenger RNA, my knee jerk reaction was a quiet wince. For some reason, the hottest new treatment often becomes the fastest recalled drug.

But then I did some studying. Not on Facebook, not in chatrooms, but looking for reputable, balanced reports. Most folks aren’t much attracted to balanced information these days. Call me a dinosaur.

It turns out this mRNA technology has been around for a while. I hope you remember your high school biology. DNA was discovered in the 1950’s. Messenger RNA (mRNA) was discovered in the 1960’s. DNA stores the record of what proteins your cell should build. MRNA carries that record to the protein building factories.

Thirty years ago, it was shown you could inject mRNA into mice muscle and the cells would make the protein message. In 1993 they even showed they could immunize mice against influenza with mRNA.

So where has this technology been for the last thirty years? No surprise, they’ve been trying to make a profit. They’ve been trying to match this new technology with a disease; one with a big return on investment. Most licensed drugs that use mRNA are for inherited metabolic diseases. The patients live a long time, will need the drug for their lifetimes, and it works. Demand is predictable.

There’s not much profit in the immunization business. Most flu shots are made in chicken eggs or other cells; there is one that is approved that is recombinant. MRNA medicine developers just haven’t seen much profit in the flu shot market. But now, a pandemic comes along.

It turns out you can make mRNA pretty fast. And that’s what we need: lots of doses, well distributed. Idaho is set to get 14,000 doses in the initial shipment. If Moderna gets their vaccine approved Idaho should get 89,000 doses before Biden’s inauguration. The FDA rushed emergency use approval last week for Pfizer’s shot, reportedly with a White House gun at their head. That inspires confidence.

First priority for the shots (you need two, weeks apart) are health care workers and nursing home residents. Idaho has about 80,000 heath care eligible, 20,000 nursing homes residents. So, you can see we might be a bit short to start with.

If it keeps snowing like this in North Idaho, we might need a dog sled team to deliver them.

Many questions linger. Will immunity last, will it be protective? Will there be long term side effects? Since we haven’t taken the time to study these questions, we will be finding them out in real time. In our own experiences.

The real question that nobody can answer is, will people be willing to get immunized? In this atmosphere, maybe not. The numbers have bounced around a bit in a running Gallup poll. The most recent numbers show about 60% say YES, but 20% say NO and 20% maybe. Of course, the analysis of these choices makes good speculation.

We have a lot of information at our fingertips. I just looked all this stuff up about mRNA vaccines on my laptop. Remember, I avoided Facebook and chatrooms and hyperbolic sites. But most people don’t make important decisions based on information.

Last month, Covid was the leading cause of death in Idaho. We have been seeing, week on week, a steady rise in cases, and deaths. Remember, deaths lag cases. December, January, despite the snow and cold will be grim in this state.

I can’t escape my skeptical nature. But I can manage it. Information, study and reflection help me manage. I am in the “health care worker” category, and I’m in the age group most likely to have a serious infection. I will take the shots when they are offered. But I might not be in the front of the line.

About ddxdx

A Family physician, former county coroner and former Idaho State Senator
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