With the commencement of vaccination in Greece and around Europe, starting with heads of State, we thought appropriate to inject some basic facts and truths into the public discourse.
The following questions and answers relating to Covid-19 vaccination in Greece, also contain useful information for those in the diaspora who want some answers to basic questions, such as the safety and availability of the vaccine.
With so much misinformation circulating on the internet from non-experts, Greek City Times felt it appropriate to clear the air, and provide our readers some immunity from fear, misinformation, and misguided advice.
Vaccines are made to treat diseases that cannot be controlled by other public health measures alone. Their goal is to reduce and eliminate diseases with high communicability, with serious effects on human health, with high mortality, with a high burden on health systems, but also with adverse economic effects on society.
Coronavirus SARS – CoV-2 is a new virus that within a year of its appearance has dramatically affected the lives of all people worldwide. It has a high transmissibility so that it is impossible to control only with the application of other, better known to all of us, public health measures, in many cases seriously endangers the health of the sick, can lead to loss of many human lives while still healthy, affects significantly testing everyone’s daily lives, testing health systems and creating irreparable economic impacts around the world.
Many SARS – CoV -2 coronavirus vaccines are currently in clinical trials. How effective a vaccine is always depends on the particular vaccine, the proper administration of the vaccine, and factors that affect each individual’s immune response. The first vaccines to be approved appear to be quite effective, up to 95%. The competent control mechanisms approving the marketing of vaccines prioritize the efficacy and safety of vaccines.
No vaccine is 100% effective. So in some cases one can get the new coronavirus even though the vaccine was given. Therefore, citizens should continue to take the recommended precautions to avoid infection, ie vaccinated people should continue to use a mask, social distance, regular and meticulous hand hygiene and cleanliness of the area where they live or work. Vaccines against COVID- 19 seem to reduce the risk of getting the disease. Each vaccine has been tested in more than 20,000 people in various countries and has an acceptable safety profile. It takes a few weeks for someone to develop immunity and be protected after the vaccine is given. Some people may get COVID- 19 despite being vaccinated, but the disease may be less severe.
New vaccines, as shown by clinical trials, reduce the risk of developing symptoms and possibly the risk of serious viral illness. This is very important, because at the same time the risk of illness, the risk of loss of human life and possibly the risk of long-term complications caused by the virus in some patients, such as complications of the cardiovascular and respiratory systems, are reduced.
A similar experience of such effectiveness exists with other vaccines that have been used for years in medicine. For example, the H 1 N 1 flu vaccine is not as effective every year in controlling the disease. Various factors, such as the ability of the virus to mutate, the strain of the virus that will prevail each year, the geographical area, can affect the effectiveness of the vaccine in controlling the disease. But even less effective vaccines in the past seem to reduce the overall risk of serious illness in the general population.
We do not yet know if those who are vaccinated with the new vaccines may become infected with the virus and be asymptomatic, so they can still transmit the virus under these conditions. That is why it is important even for those who are vaccinated to apply the rest of the public health measures against the new virus, ie the use of a mask, the observance of social distance, the regular and meticulous hand hygiene and the cleanliness of the place where they live or work. At present, clinical trials show that the new vaccines provide more protection against COVID- 19 disease than significantly reduce the risk of transmitting the virus. It remains to be seen whether the new vaccines that are expected to complete the necessary clinical trials will be effective in reducing the transmission of the virus.
None of the vaccines to be studied and approved for coronavirus SARS – CoV -2 contain the whole virus. Most vaccines used in medicine now contain only parts of the virus that are capable of producing protective antibodies against the virus to the person to be administered. Thus the vaccinated person is in no way at risk of getting sick from the coronavirus due to the vaccine.
However, there is a possibility that he has already contracted COVID- 19 and may not have realized it if the symptoms become apparent only after vaccination. Although a mild fever may occur within one or two days of vaccination, any other symptoms of COVID- 19 (such as persistent cough, high fever, or fever lasting longer, numbness, tastelessness) should remain home and plan to do a lab test.
It is not yet sufficiently known how long natural immunity lasts in people who have been exposed to the coronavirus and have been asymptomatic or ill. However, it is not yet clear whether people exposed to the virus should be vaccinated against the SARS – CoV -2 coronavirus.
Although there have been cases of other coronaviruses in the past (in 2003 – Acute Respiratory Syndrome (SARS) and in 2012 – Respiratory Syndrome MERS – CoV), no vaccines were developed for these viruses. This made it more difficult to prepare a coronavirus vaccine, as there was no previous experience. At the same time, the preparation and approval of a new vaccine involves many stages and control mechanisms in order for the vaccine to be effective and safe to use. The techniques for making different vaccines may differ and as knowledge progresses it evolves according to the latest scientific data.
Throughout the history of vaccine production, new techniques have always been applied with the goal of their effectiveness and safety. In each new technique that is applied, the stages of quality control and approval remain as the preparation of a new vaccine has as its primary concern the protection of public health.
Indeed, the new pandemic from the new coronavirus SARS – CoV -2 and its significant effects on human lives have put great pressure on the development of a vaccine against the new virus as soon as possible. For this reason, the processes of its production and approval were accelerated as much as possible and companies involved in its production from various countries were financed. However, the stages of evaluation of the effectiveness and safety of the vaccine and the competent control mechanisms are never bypassed as the production of the vaccines always complies with these two inescapable parameters: their effectiveness and safety.
Current data from clinical trials show that new SARS – CoV -2 coronavirus vaccines that are in the final stage of approval or have been approved have an acceptable safety profile.
Most side effects of vaccines occur in the first weeks to months after administration and control mechanisms require that this period be passed in clinical trials before the vaccine undergoes further testing and approval.
Like all known vaccines, the new ones against SARS – CoV -2 can have side effects. Most of them are mild and short-lived, and do not appear in all. Such side effects are a feeling of pain and tenderness in the hand where the vaccine was given that tends to get worse about 1-2 days after the vaccine, a feeling of tiredness, headache, general pain or mild flu-like symptoms. Although a fever is not uncommon for two to three days, the high temperature is unusual and may indicate disease COVID -19 or other infection. An unusual side effect is lymphadenopathy.
Resting and taking a regular dose of paracetamol help one feel better. Symptoms of side effects usually last less than a week. Mild symptoms after the first dose are not a contraindication to a second dose vaccination, which is necessary for better protection against the virus. If the symptoms worsen or there is concern, it is advisable to inform the treating physician in order to have a proper evaluation.
Most vaccines for the new SARS – CoV -2 coronavirus that are approved by the relevant control mechanisms are administered in two doses with an interval of 21-28 days in order to be effective. There is a vaccine in a phase 3 clinical trial administered in a single dose. The vaccines that will eventually be approved for marketing in Greece will determine in how many doses they will be administered and with what interval.
It takes about two weeks for an antibody to develop antibodies after a vaccine has been given. If the vaccine requires two doses for an adequate antibody response, then the total time it takes for the vaccinated person to be shielded against the virus is, taking into account all of the above, about 5-6 weeks.
It is not yet clear how long the immunity offered by the vaccine against the new coronavirus lasts. It is a new virus and a new vaccine and with the data from the clinical trials so far we do not know the duration of protection it offers us. With the release of the new SARS – CoV -2 coronavirus vaccine and the vaccination of more people we will soon have more data to answer this question.
Both the duration of natural immunity, ie immunity after infection of the individual with the virus, and the duration of immunity resulting from vaccination with the new vaccine against the new coronavirus are under investigation and new data are expected over time.
Tests should be performed to determine if the SARS -2- CoV coronavirus vaccine is safe to be given with other vaccines and if the two vaccines do not interfere with each other’s immune response. It is possible that some of the subsequent clinical trials of coronavirus vaccines will include co-administration with other vaccines, and in particular with the influenza vaccine.
It is not known at the moment. By licensing a vaccine, we only have information on the duration of immunity for the duration of the clinical trials. For example, if the first subjects in the study were vaccinated in July 2020 and the vaccine received marketing authorization in December 2020, we will only have information on the immune response up to 5 months after vaccination. The manufacturer will probably continue to monitor the vaccinated for several months or more, so that over time, we will have a better picture of the duration of immunity. With this information, we can better understand if vaccines against COVID- 19 require annual administration such as the flu.
Yes, one should be able to continue normal activities as long as one feels well and continue to take precautions against coronavirus. If his hand is particularly sore, he may have difficulty lifting it. If one feels unwell or very tired one should rest and avoid the use of machinery or driving. The pregnancy process should be avoided for two months after vaccination.
Clinical trials for vaccines target specific population groups and are not performed from the beginning for all. The SARS – CoV -2 coronavirus vaccines, which will be approved for marketing and disposal by the competent control mechanisms, will determine in which categories of individuals the clinical trials have been performed and accordingly the decision has been made by the competent committee of vaccination experts (National Commission Vaccines) who will be preceded by vaccination in Greece.
For example, there are currently no clinical trials in pregnant women and children, so these populations are excluded from vaccination at this stage.
The purpose of the COVID- 19 vaccine is to give priority to those at high risk of developing the disease and to have serious complications if they do. These include health and social services staff, the elderly and nursing home staff, and patients and staff of care facilities for the chronically ill and rehabilitation centres.
Finally, as clinical trials progress and our knowledge increases about safe administration and in other categories of people, vaccination will be expanded to protect the health of all citizens.
COVID- 19 vaccines should be thoroughly tested in children under 18 years of age before they are given to this group, as we cannot assume that they will work in the same way in children. This is especially important as it has been observed that children are not affected in the same way by coronavirus infection.
Clinical trials in children are likely to be performed in fewer people than in the 30,000 trials in progress in adults, but many children will need to undergo clinical trials to ensure they develop immunity and have no side effects.
In addition, both groups (adults and children) should be monitored continuously after vaccinations are approved to record rare side effects that go undetected until several hundred thousand or several million doses of the vaccine have been given.
The requirements for who can participate in a vaccine clinical trial vary depending on the company that performs them, the disease against which they are immunized, and the different types of autoimmune diseases. Often the first clinical trials are the most restrictive, so that the data are not affected by other conditions. In the future, scientists and healthcare providers will collect data for different subgroups.
In some cases, specific clinical trials will be performed, but often information about healthy adults can tell what to expect about different conditions. Because often groups of people with a specific condition can be small, no formal clinical trial can be performed, but experience with similar vaccines and understanding of the effects of the disease on the immune system can help make risk / benefit decisions. Over time, as more people with the disease are vaccinated, more data accumulates. Post-licensing monitoring systems provide opportunities for real-time monitoring of these subgroups.
In any case, it is necessary to personally communicate with the treating physician and discuss with him about the benefits of the vaccine in relation to the patient’s health condition.
Vaccines against coronavirus SARS – CoV -2 have not yet been evaluated during pregnancy, and it remains unknown whether they are excreted in human milk. Until more information is available, the following should be kept in mind:
Vaccination for the new SARS – CoV -2 coronavirus will not be mandatory.
Vaccination is a very important public health measure. The distribution of SARS – CoV -2 coronavirus vaccines in Greece will be free.
The Ministry of Health through the media and its website continuously inform citizens about that later on the way to becoming the vaccination.
According to the National Plan vaccination coverage COVID -19, a citizen can participate in vaccination through immaterial prescription or for those who are not registered in the intangible prescription through the online platform. There will also be a special call centre for this purpose.
The vaccination will take place in one of the 1018 vaccination centres (health centres, regional clinics) that are distributed throughout the territory so that no part of the country is left uncovered.
The vaccination of the health workers working in Hospitals will take place within the Hospitals.
Special mobile teams of medical staff will be responsible for vaccinating people living in closed structures, for example in nursing homes, care facilities for the chronically ill and rehabilitation centres, and in reception centres for migrant refugees.
Because some of the vaccines must be stored in a very low temperature freezer, it is not possible to get the vaccine in private clinics or pharmacies.
If someone is not well, it is best to wait until they recover to be vaccinated, but this should be done as soon as possible. One should not make an appointment for a vaccination if one is self- isolated, or waiting for a COVID- 19 test or is not sure if they are healthy.
He should be ready to schedule the second dose of the vaccine after 21-28 days depending on the vaccine given. It is important to get vaccinated with both doses of the same vaccine to get the best possible protection.
New vaccines for coronavirus SARS – CoV -2 do not replace other public health measures at this stage of the pandemic. First, vaccination of a large percentage of the population takes time. We also need to see what percentage of the population will eventually be vaccinated and know even more about how the new coronavirus is transmitted.
It is not yet known what percentage of the population should be vaccinated with the new vaccines to ensure the immunity of the herd, in other words we do not know how many need to have become ill and have been vaccinated in total so that the new coronavirus is not transmitted.
In addition, more data are needed on the effectiveness of new vaccines against SARS – CoV -2 to reduce the risk of transmitting the virus until the competent authorities lift other public health protection measures against the new, highly transmitted, this virus.
Therefore, with great care, the vaccinated should continue to use a mask, social distance, regular and meticulous hand hygiene and cleanliness of the area where they live or work. An opposite practice can lead to a new outbreak of cases, an unfortunate fact as humanity has already been severely tested by this pandemic.