In 1995 I was a mid-career scientist and physician at the University of Michigan who had previously worked for 14 years in the Army on biodefense, vaccines, and immunological diseases. After duty in Desert Storm and the issues surrounding anthrax in that war, I was well aware of the difficulties in trying to produce a vaccine for any illness. I had read Richard Preston’s book the Hot Zone and understood the limitations of studying deadly infectious diseases (including one scientist who lost a leg due to an inadvertent laboratory needle stick). Therefore, I was entirely dismissive about the new movie “Outbreak” in which characters made an antidote in days to save an entire California community from an Ebola-like disease.
Fast forward to this year as I laid out my own expectations for COVID-19. When the pandemic first became prominent in February and March, my belief was that we would slog through the first few years of this new illness and hopefully develop drugs that could manage it. Long term there was hope of immunity because of infection, but since the actual mechanisms of illness from this virus were unclear, I was not sure how many people would die or how long the pandemic would continue.
The last idea I would ever entertain was that, before the year was out, there would be a 95% effective vaccine that would be commercially available, and I would be fortunate enough to receive this vaccine. No one in their right mind with any type of medical research background would have expected that.
Totally against my wildest expectations, this afternoon I received my first shot of the Pfizer vaccine. Thinking through the history of vaccine development, it struck me that this was truly a miraculous event.
I view myself as incredibly fortunate that I was prioritized to get the vaccine at this early point. I am old (over 65), have a congenital cardiac anomaly and take lots of medications that put me at significant risk from this infection. Despite these issues, I have continued to see patients throughout the epidemic whenever our clinics were allowed to be open. Importantly, most of my patients have immune problems and are probably at greater risk from an infected physician than I am from them.
The biggest question I had in this was whether or not I was truly deserving to get the vaccine at this time. We have all observed such incredible human suffering from this disease, and it highlighted the in equities in our health care system. I have good access to medical care and was fortunate to be able to do most of my non-patient related work remotely. Many of my colleagues of similar age have decided either to retire or at least to stop seeing patients during this time. Was it reasonable for me to continue to see patients, put myself at risk, and accidentally gain priority access to the vaccine?
The only reasonable response I could think of comes from another movie, “Saving Private Ryan.” A dying captain John Miller (Tom Hanks) whispers to Private James Ryan (Matt Damon), “make sure you earn this.” To make sure I earn this vaccine, I have taken a role in research concerning immunity associated with COVID-19 infection and also will help investigate some of the allergic adverse reactions to this vaccine. I plan on continuing patient care as long as I am able and as long as I am useful to my patients (thanks to the Allergy Division for supporting that). I won’t take for granted the opportunity this vaccine affords me, nor forget the number of individuals who were sickened or died during the time it took to develop it.
One thing we should all remember is the effort required to get these vaccines. A friend said, “We should give a Heisman Trophy for this vaccine.” However, rather than being an individual effort, like a spectacular 100-yard run, it is countless people, each of whom advanced the effort a few inches until we reached the end zone. Many did not even work on COVID-19; some of the work came from SARS or even more basic studies in vaccine technology and genetics.
The best way to “earn” this vaccine, however, is to get it as soon as it is available to you. Each vaccinated person is someone who won’t get sick and wind up in the hospital putting others at risk. Stop being scared by media reports of rare adverse events from this vaccine; we can treat those and will figure them out. Remember, no one has died or been irreversibly injured from the vaccine, while we lose thousands a day from the infection.
This is really the only way to end the pandemic. Please get the vaccine.