It may be National Immunisation Awareness Month only in the US, but for us living in the UK it has been almost a month since the fabled ‘Freedom Day’. The COVID-19 vaccinations are increasing every day and despite the doomsday scenarios postulated by various experts, things seem to be calming down on the surface and infection rates are starting to fall. Places are open and people are starting to travel.
Vaccines have been around for a while, but how have they helped us fight against various illnesses and how well are we doing in our fight against COVID? Let’s find out.
Brief History of Vaccines
A long time ago, the Chinese recognised that people who had been sick with smallpox were immune to reinfection. They came up with various ideas of how to expose people to smallpox so that they are not susceptible to it later (Needham, 2000).
Though incomplete, that is usually considered the first idea for what we now consider a modern vaccine. It’s not clear how effective the early efforts were, and there is still contention over just how early this practice started. The earliest record of inoculation, as vaccines were called in the beginning, was in the 10th century during the Song dynasty (Magner, 2009).
Officially, Edward Jenner started testing his theory about smallpox immunity in 1796. Two years later he published “An Inquiry into the Causes and Effects of the Variolae Vacciniae”. While it was followed with some controversy, by 1801 his report was translated into six languages and over 100,000 were vaccinated against smallpox (Wikipedia 2021).
After Jenner’s discovery the interest in bacteriology grew and many developments followed. Understanding of antitoxins, viruses and bacteria led to vaccines against anthrax, typhoid, cholera, rabies and more in the between 1885 and 1930s.
By the mid-20th century, activity was bustling for vaccine research and development. Innovations led to vaccines for common childhood diseases like mumps and rubella (The History of Vaccines, 2021).
In 1959 the World Health Organisation (WHO) called for the eradication of smallpox because it was still endemic in 33 countries. In 1980 the WHO officially declared the world free of smallpox.
In 1974 a universal goal was established to protect children by vaccination against six main preventable diseases: measles, poliomyelitis, diphtheria, pertussis (whooping cough), tetanus and tuberculosis. Levels of protection are varied, but most show that there has been a decline in most diseases due to vaccination.
Now, innovative techniques continue to drive research into vaccines. It includes genomes and DNA technology as well as new delivery techniques. The targets have expanded, and some research is branching out into non-infectious conditions like allergies.
How are vaccines tested in the UK?
Based on the past year, many people are understandably concerned about how well vaccines are tested before they are released to the public. This is especially true for new vaccines like Pfizer or AstraZeneca which were made quickly to combat the COVID-19 pandemic.
The standard for vaccines is much higher than it is for most other medicines. This is because vaccines are the few treatments that are given to healthy adults and children. As a result, the level of acceptable risk is much lower than other treatments and a vaccine must go through seven stages before it gets released to the public.
Within those seven steps all vaccines and trials administered in the UK must meet the standards set out by the following authorities:
- International Conference on Harmonisation of Good Clinical Practice
- Declaration of Helsinki (1964, 2008)
- EU Clinical Trials Directive
- The Royal College of Paediatrics and Child Health (RCPCH)
Additionally for the UK, individual approval for vaccines and trials must be given by the MHRA as well as the NHS Research Ethics Committee, NHS Research and Development office and the Health and Safety Executive (HSE) (Vaccine Knowledge Project, 2021).
COVID 19 And Vaccines*
According to the NHS adults aged 18 and over can get a COVID vaccine (NHS 2021) and there is on-going discussion as to how young this should be extended (Elgot and Adams, 2021). In the UK there are currently 3 types of vaccines available:
In the UK there have been 85.5 million doses given*. Of those, 38.6 million adults are fully vaccinated which accounts for 58.1% of the population. We are more than halfway there however, which is a tremendous achievement and the main reason for the reduction in infection rates.
Globally vaccination rate is much bigger. Across the world, 4.25 billion people have been given a vaccine and 1.16 billion are fully vaccinated. However, relative to the population that is only 14.9% so there is still a long way to go (GoogleNews, 2021).
It has been a month since all UK restrictions have been lifted. Bars, cafes, and restaurants can operate at full capacity. Clubs are also open fully. After an initial peak in reported positive COVID 19 cases after the first week since the lockdown has lifted, there has been a slow decrease in new cases reported each day.
There have been 21,466 new cases of COVID reported in the UK on August 3rd. Worldwide there are currently nearly 200 million cases being reported. Most new cases are being reported in the US with 149,788 new cases as of 3rd August (GoogleNews UK, 2021).
*Data accurate as of 04/08/21
What is long COVID?
As great as vaccines are at protecting us against the severe symptoms of acute COVID-19 infection they are not 100% effective. While most people feel better in a few days, and make a full recovery within 12 weeks, other people are not so lucky and continue to experience symptoms months after their initial infection. This is called ‘long COVID’ (BHF, 2021).
What are the symptoms of long COVID?
According to the NHS, common long COVID symptoms are as follows (NHS, 2021a):
- Shortness of breath
- Chest tightness or pain
- Problems with concentration or memory
- Sleep issues
- Heart palpitations
- Joint pain
- Anxiety or depression
- Tinnitus or earaches
- Stomach aches, loss of appetite, nausea
How to know if you have long COVID?
There are two stages to long COVID:
- Ongoing symptomatic COVID where symptoms of this virus last for 4-12 weeks
- Post-COVID syndrome where symptoms last for more than 12 weeks and cannot be explained through another diagnosis
If you feel like you have any of these you should contact a health provider. They will carry out or refer you to do some tests to check your symptoms and rule out any other potential conditions. Some tests that they may do include:
- Blood tests
- Blood pressure and heart rate
- Exercise tolerance test
- A chest x-ray
After these tests your practitioner will be able to discuss what the next steps are. You can get additional advice from various health professionals about managing your symptoms, physical health, and mental health. If you need more care, there are also facilities provided for that as the NHS has created specialist long COVID clinics (BLF, 2021).
Long COVID Health Assessment
As mentioned, most people who have had COVID will recover and return to normal very quickly. Others may see some side effects long after they are no longer sick.
Fatigue, breathlessness, chest pains, joint/muscle pain and palpitations are just some symptoms that you may experience post-COVID. To minimise the potential long-term COVID effects, Echelon Health has created a structured and personalised plan to help you detect any issues.
The Long Covid Assessment (LCA) is one of the most comprehensive assessments available anywhere today because it takes an extremely detailed look inside your body to find out what is really happening under the surface.
The LCA includes:
- A detailed medical questionnaire
- Pre-consultation to determine current symptoms
- Comprehensive blood tests
- Cardio Pulmonary Exercise Testing (CPET)
- CT Chest Scan
- CT coronary + CT Pulmonary angiogram (subject to symptoms)
- Follow up consultation.
Contact us today and we will be happy to help!
Article reviewed by Paul Jenkins MA MD FRCP.
Needham, Joseph. (2000). Science and Civilization in China: Volume 6, Biology and Biological Technology, Part 6, Medicine. Cambridge: Cambridge University Press. p. 154.
Magner, L. N. (2009). A history of infectious diseases and the microbial world. ABC-CLIO.
The History of Vaccines (2021). The history of Vaccines. Available at: https://www.historyofvaccines.org/timeline#EVT_100335 (Accessed 19/10/2021).
Wikipedia (2021). Vaccination. Available at: https://en.wikipedia.org/wiki/Vaccination#History (Accessed 19/10/2021).
Vaccine Knowledge Project (2021). How vaccines are tested, licensed and monitored. Available at: https://vk.ovg.ox.ac.uk/vk/vaccine-development (Accessed 19/10/21).
NHS (2021). Coronavirus (COVID-19) vaccines. Available at: https://www.nhs.uk/conditions/coronavirus-covid-19/coronavirus-vaccination/coronavirus-vaccine/ (Accessed 19/10/2021).
GoogleNews UK (2021) Coronavirus (COVID-19). Available at: https://news.google.com/covid19/map?hl=en-GB&mid=%2Fm%2F07ssc&state=7&gl=GB&ceid=GB%3Aen (Accessed 04/08/21).
BLF (2021). What to expect with long COVID care in NHS? Available at: https://www.blf.org.uk/support-for-you/long-covid/long-covid-care-in-the-nhs/what-treatment-can-I-expect-if-I-have-Long-COVID-symptoms (Accessed 19/10/2021).
BHF (2021). Long Covid: the symptoms and tips for recovery | BHF. Available at: https://www.bhf.org.uk/informationsupport/heart-matters-magazine/news/coronavirus-and-your-health/long-covid#Heading4 (Accessed 19/10/2021).
Elgot, J. and Adams, R. (2021). UK doctors alarmed at ‘shambolic; rollout of Covid jabs for children. Available at: https://www.theguardian.com/society/2021/aug/05/uk-doctors-alarmed-at-shambolic-rollout-of-covid-jabs-for-children (Accessed 19/10/2021).