In early January, Nali Gillespie watched her social media feed fill with vaccine selfies: photo after photo of peers at other medical schools across the country proudly posing next to a syringe with their dose of either Moderna or Pfizer Covid-19 vaccine .
But Ms. Gillespie, who is in her third year at Duke University School of Medicine and focused more on research than clinical training, knew she wouldn’t be able to join them just yet.
Since she only volunteers to go to an ambulance once a week, she is less exposed to Covid patients and waits in line behind classmates who work in intensive care units and emergency rooms.
“You hear that in some schools, students are getting their second dose and then there are some of us who are not even scheduled for our first,” said Ms Gillespie.
When she does her weekly shift, she knows that she is still prone to exposure to the coronavirus. “You are becoming increasingly aware that an asymptomatic patient can come into the clinic and you see them in a small exam room,” she said. “The risk is very real.”
In December, the Centers for Disease Control and Prevention announced guidelines prioritizing who should receive vaccines first at the start of the rollout. Although the guidelines were broad, medical students learned that they could join the first wave of healthcare workers, particularly those involved in caring for Covid patients. However, the rollout has varied widely across the country’s 155 medical schools, each of which has prioritized based on the availability of vaccine doses in their state.
This has created stress for some medical students as they continue their clinical rotations. Although some schools prohibit students from treating Covid patients, enforcing this rule can be difficult, especially in asymptomatic cases.
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Answers to your vaccine questions
If I live in the US, when can I get the vaccine?
While the exact order of vaccine recipients may vary from state to state, most doctors and residents of long-term care facilities will come first. If you want to understand how this decision is made, this article will help.
When can I get back to normal life after the vaccination?
Life will only get back to normal once society as a whole receives adequate protection against the coronavirus. Once countries have approved a vaccine, they can only vaccinate a few percent of their citizens in the first few months. The unvaccinated majority remain susceptible to infection. A growing number of coronavirus vaccines show robust protection against disease. However, it is also possible that people spread the virus without knowing they are infected because they have mild symptoms or no symptoms at all. Scientists don’t yet know whether the vaccines will also block the transmission of the coronavirus. Even vaccinated people have to wear masks for the time being, avoid the crowds indoors and so on. Once enough people are vaccinated, it becomes very difficult for the coronavirus to find people at risk to become infected. Depending on how quickly we as a society achieve this goal, life could approach a normal state in autumn 2021.
Do I still have to wear a mask after the vaccination?
Yeah, but not forever. The two vaccines that may be approved this month clearly protect people from contracting Covid-19. However, the clinical trials that produced these results were not designed to determine whether vaccinated people could still spread the coronavirus without developing symptoms. That remains a possibility. We know that people who are naturally infected with the coronavirus can spread it without experiencing a cough or other symptoms. Researchers will study this question intensively when the vaccines are introduced. In the meantime, self-vaccinated people need to think of themselves as potential spreaders.
Will it hurt What are the side effects?
The vaccine against Pfizer and BioNTech, like other typical vaccines, is delivered as a shot in the arm. The injection is no different from the ones you received before. Tens of thousands of people have already received the vaccines, and none of them have reported serious health problems. However, some of them have experienced short-lived symptoms, including pain and flu-like symptoms that usually last a day. It is possible that people will have to plan to take a day off or go to school after the second shot. While these experiences are not pleasant, they are a good sign: they are the result of your own immune system’s encounter with the vaccine and a strong response that ensures lasting immunity.
Will mRNA vaccines change my genes?
No. Moderna and Pfizer vaccines use a genetic molecule to boost the immune system. This molecule, known as mRNA, is eventually destroyed by the body. The mRNA is packaged in an oily bubble that can fuse with a cell, allowing the molecule to slide inside. The cell uses the mRNA to make proteins from the coronavirus that can stimulate the immune system. At any given moment, each of our cells can contain hundreds of thousands of mRNA molecules that they produce to make their own proteins. As soon as these proteins are made, our cells use special enzymes to break down the mRNA. The mRNA molecules that our cells make can only survive a few minutes. The mRNA in vaccines is engineered to withstand the cell’s enzymes a little longer, so the cells can make extra viral proteins and trigger a stronger immune response. However, the mRNA can hold for a few days at most before it is destroyed.
In some facilities, such as the Duke School of Medicine, students working in intensive care units and emergency rooms were placed in priority group 1A with the highest level, while everyone else was told they would be vaccinated under group 1B. At the Yale School of Medicine, all medical students, regardless of their exposure to patients, were told that they would be vaccinated in reverse alphabetical order (“by the first letter of their last name starting at the end of the alphabet”).
“Those in the later stages of the alphabet were happy, but a little confused by how arbitrary it was,” said Sumun Khetpal, a fourth-year student.
Students at Texas College of Osteopathic Medicine in Fort Worth said they had received no notice from the school for weeks when they would receive their vaccines. Some drove around the state for hours looking for private pharmacists who would give them shots. And at the University of Pittsburgh Medical School, students said they also had to “take matters into their own hands” and contact private pharmacies to inquire about a vaccination since they were not told until last weekend how to get vaccines their school.
“The CDC guidelines did not have the granularity that hospitals and schools need to make decisions,” said Dr. Alison Whelan, Scientific Director, Association of American Medical Colleges. “There was considerable variability in the absence of a national plan.”
In addition to the confusion, vaccines have been assigned to states based on population, which does not always reflect the population of health care workers, added Dr. Janis Orlowski, Chief Health Care Officer of the association, added. There are 21,000 medical students in the country.
There is a sense of guilty relief for some of them to have received the vaccine knowing that some of their colleagues have not yet done so.
“One of my close friends is a dentist and has a regular mouth, but she didn’t get the Covid vaccine,” said Azan Virji, a sophomore at Harvard who got his first dose late December. “It feels like there is an inequality.”
Even so, Mr Virji said he had treated Covid-19 patients many times and felt a weight lift because he knew he was now vaccinated.
“My parents in Tanzania may not have access to this vaccine until 2022, and now I’ll be one of the first to have access,” he said. “It’s bittersweet, but it’s important that I feel calmer in the hospital.”
