.

Last updated: March 29, 2021

COVID-19

Table of Contents

What is COVID-19?

By gene sequencing it has been determined that COVID-19 is a new betacoronavirus closely related to the Severe Acute Respiratory Syndrome Virus (SARS) and the Middle Eastern Respiratory Syndrome virus (MERS). COVID-19 is classified as a new betacoronavirus since we have classified and kept track of other types of coronaviruses in the past; Coronaviruses are defined as a family of viruses that are known to cause different types of illnesses ranging from the common cold to  SARS and MERS. (WHO), (JOHNS HOPKINS)

Early COVID-19 timeline

 
  • The virus was first noticed as early as December 8th, 2019, in Wuhan City, Hubei Province, China
  • The first international case was reported in Thailand on January 13, 2020
  • The World Health Organization declared a global pandemic in March 2020
  • On March 26, 2020, the United States became the most infected nation globally with over 100,000 confirmed cases

(Government of Canada), (Canadian Health Care Network), (JHONS HOPKINS). 

Untitled design (92)

Incubation Period and Spread

  • COVID-19 has an estimated incubation period of 1-14 days, and most often symptoms show up 5-6 days after infection. (Government of Canada)
  • The risk of infection from an infected patient is likely to be low after 8 days, from the initial sign of symptoms. (Government of Canada)
  • COVID-19 spreads through respiratory droplets that infect through sneezes, coughs, shouts or physical touching. (Government of Canada)

Symptoms

COVID-19 symptoms might vary from person to person as some individuals might test positive but be asymptomatic. Still, it is important to know and watch out for symptoms. The following are the most common COVID-19 symptoms

  • Fever
  • Dry cough
  • Shortness of breath
  • Runny nose
  • Sore throat

(Government of Alberta)

COVID-19 Vaccinations

For information on what a general vaccination is and how it works click here.

Pfizer/BioNTech

The vaccine created by the United States Pharmaceutical giant Pfizer and German biotechnological manufacturer BioNTech is called BNT162b2 or Tozinameran. This vaccine uses mRNA to make the body create antibodies to fight against COVID-19. Tozinameran has been approved for individuals 16 years and older, approval or the use of this vaccine for people younger than 16 has yet not been approved. This Vaccine will be applied by two different doses, three weeks apart. (Government of Canada)(Business insider)

The first injection will be 52% effective after a 12 day period and the latter injection proves to be 95% effective after one week. (BBC)

As of January, 2021 the vaccine has been approved for emergency use by the World Health Organization; it has also been approved by all North American countries, the European Union and other individual countries have ordered the vaccine such as Malaysia and Israel. (Express), (Global News), (Global News), (The Washington post

Moderna

Moderna is a biotechnology company based out of the United States. Moderna has rolled out their approved COVID-19 vaccine named "mRNA-1273". The Moderna vaccine has been approved for individuals 18 years of age and older. The effectiveness of the vaccine for people under the age of 18 has yet to be proved. (Government of Canada), (CDC)

 The vaccine works through the mRNA method and consists of 2 doses at least 28 days apart. The first dose can provide 80.2% protection and the second dose 94.1%. (BBC),(CDC), (Government of Canada)

The Moderna vaccine has been pre-ordered by Canada, The United Kingdom, the European union, Switzerland, Japan, Qatar and Israel. (News week)

 

 

mRNA and how it plays a role in the COVID-19 Vaccines

Messengers ribonucleic acids or mRNA transfer information from our DNA to the cells that create proteins.

Both the Pfizer/BioNTech and the Moderna vaccines use mRNA. The vaccines are using mRNA in the following way:

  • Coronaviruses have little spikes on their surface named S proteins
  • The vaccines teaches the cells on how to create a harmless piece of the S protein
  • Once the vaccine is in the body, the cells will start to make the S protein and will start to display its new protein on the cells surface
  • The immune system will begin to recognize that the protein does not belong there and therefor will start to build and immune response to it by making antibodies

    (MAYO CLINIC)

To find out in more detail how mRNA plays a role in vaccines click here.

GAMALEYA

The Sputnik V was created by the Gamaleya Research Institute in Russia, and it was the first registered vaccine in the world. The vaccine works through an Adenoviral Vector system and it has been approved to be administered to individuals over the age of 18. (Pharmaceutical), (Sputnik V)

The Sputnik V is composed of two doses, 21 days apart from each other. The second dose is 91.4% effective against the virus. There is no public data on how effective the first dose is. (CBC), (BBC), (DDW)

As of January 2021, Sputnik V has been pre-ordered and or delivered to Argentina, Bolivia, Brazil, Egypt, India, Kazakhstan, Mexico, Nepal and Venezuela (Statista)

 

University of Oxford/AstraZeneca

The University of Oxford and biopharmaceutical giant AstraZeneca created and rolled out their COVID-19 vaccine named "ChAdOx1 nCov-19". This vaccine also works through an Adenoviral Vector system and has been approved for individuals who are over the age of 18. The vaccine will be administered in two doses 4-12 weeks apart from each other. (The Lancet), (Express)

The vaccine is 63.09% effective after the second dose. (World Health Organization

As of January 2021, the vaccine has been pre-ordered by the European Union, India, the United States, Canada, The United Kingdom, Japan, Indonesia and Brazil. (Quartz)

Johnson & Johnson

Janssen Pharmaceuticals Companies of Johnson & Johnson have created their Covid-19 vaccine the 'JNJ-78436735. This vaccine works through a non-replicant viral vector and unlike the other vaccines, it only requires one dose. The vaccine is recommended for people aged 18 years and older. (CDC)

The vaccine has a 66.3% efficiency rate and it has been highlighted that the vaccine provides its best protection against the virus two weeks after its dose. It has also been reported that no individuals who got infected with the virus at least 4 weeks after receiving the vaccine had to be hospitalized, meaning that the vaccine has high efficacy at preventing hospitalization. (CDC)

As of March 2021the vaccine has been approved and ordered by the United States, Canada, and South Africa. (Business Insider South Africa), (Johnson & Johnson), (CTV News)

Non-replicating viral vector and how it plays a role in the COVID-19 Vaccines

A Vector is a virus that lacks the properties responsible for reproduction and it transports genetic material from the virus (in this case COVID-19) into a cell.

Gamaleya, Oxford and AstraZeneca used this method in their vaccines. The vaccines are using Vectors in the following way.

  • Coronaviruses have little spikes on their surface called an S protein
  • The vaccine uses non-replicating viral vectors carrying the S protein
  • The vectors start to infect our cells with the S protein and in result our cells start to carry the S protein on their surface, along side many other proteins
  • When the immune cells detect the foreign antigen, they respond and start making antibodies
    (Sputnik V), (Gavi)

More information on how Vector based vaccines work can be found here.

Sinovac

Sinovac is a China based biopharmaceutical company that rolled out their own vaccine. As of January 2021 the vaccine is still in its late stage trials, the doses are administered 12 days apart and they prove to be 50.4% effective against COVID-19, still China has approved it for emergency use for high-risk groups in China. (NPR), (BBC News)

Brazil, Chile and Indonesia are lined up to use the vaccine. (QUARTZ)

Untitled design (91)-1

How long until the vaccine is effective at preventing COVID-19

Vaccines are never 100% effective, a small percentage of the population is not protected by the vaccine and for others the vaccine might ware out over time. (Immune)

Here is a chart on how effective the different COVID-19 vaccines are after the second dose.

Pfizer & BioNTech (mRNA) Moderna (mRNA) GAMALEYA (non-replicating viral vector) Oxford & AstraZeneca (non-replicating viral vector) Sinovac (Inactive vaccine) Johnson & Johnson (non-replicant viral vector)

95% effective

94.1% effective

91.4% effective

63.09% effective

50.4% effective

66.3% effective

Doses are 21 days apart Doses are 28 days apart Doses are 21 days apart Doses are 4-12 weeks apart Doses are 12 days apart Single dose

(Government of Canada), (BBC).

(Government of Canada), (BBC),(CDC).

(Sputnik V), (CBC), (BBC), (DDW

 (BMJ).(World Health Organization

(NPR), (BBC News)

(CDC)

 

two-sided story: Oxford/AstraZeneca vaccine

On March 11, 2021, Denmark announced a two-week suspension of the Oxford/Astrazeneca vaccine due to multiple reports of blood clotting in the country. Iceland and Norway have also followed suit, but they have not announced how long their suspension will last. Italy banned a batch of the vaccine following reports "of some serious adverse effects" and other countries have halted some or all of their AstraZeneca vaccinations, these include Austria, Latvia, Lithuania, and Luxembourg (DW), (Fierce Pharma). The European Union's medicine regulator will investigate the linkage between blood clotting and the vaccine. (CNN)

Canadian Health authorities have kept a close eye on the European investigation, and have stated that according to their independent review of the evidence, there is no indication that the vaccine caused the events. Due to the independent review and conclusion, Canada will go ahead and use its 500,000 doses of the vaccine. Still Canada has taken measures and has restricted the use of the vaccine for residents under the ages of 55 as per recommended by the National Advisory Committee on Immunization  (CTV News; CBC; Calgary Herald)

Who can get vaccinated?

Age

People 18 years old and older are able to get vaccinated with the different COVID-19 vaccines that have recently rolled out, with the exception of the Pfizer/BioNTech vaccine which also allows individuals to be 16-17 years old to also get vaccinated. (MAYO CLINIC)

Allergies

You are able to get the vaccine as long as you don't have a history of severe allergic reactions to other vaccines, injectable medication or the ingredients in the chosen COVID-19 vaccine. If you have a history of severe allergic reactions to other substances you might still be able to receive the vaccines. It is recommended that you stay supervised for 30 minutes after the injection to make sure that no allergic reaction occurs. (MAYO CLINIC)

Pregnant or breastfeeding women 

As of today, there is no research on the safety of the COVID-19 vaccines in pregnant or breastfeeding women. Still, If you fall under this category of people and you are advice on getting the vaccine, you can and should talk to your health care provider about it first and then choose whether or not you will partake in the vaccination. (MAYO CLINIC)

People with autoimmune conditions

Individuals with autoimmune conditions may partake in receiving the mRNA vaccine, as individuals within this group where eligible for the enrollment of clinical trials. Individuals in this group should be aware that no data is currently available on the safety of the mRNA vaccine on people with autoimmune conditions. (CDC)

Vaccine side-effects

Similar to other vaccines, the COVID-19 vaccine can cause mild side-effects. Potential side-effects include: 

  • Pain, particularly where the shot was administered  
  • Fever 
  • Fatigue  
  • Headaches  
  • Chills 
  • Joint pain

These side-effects are not unique to the COVID-19 vaccines, they are actually similar to the seasonal flu shot and the shingles vaccine. Though these symptoms are common, tracking and monitoring the severity and duration of the side-effects can be valuable. (AARP) 

Untitled design (93)-1

According to the CDC, more people experience these side-effects after the second-dose. However, side-effects after the first dose can still happen. (FDA) 

The following symptoms are signs of an allergic reaction: 

  • Hives  
  • Swelling of the face 
  • Rapid heartbeat  
  • Dizziness  
  • Troubles breathing 

If you are experiencing any signs of an allergic reaction, seek medical care immediately. (MAYO CLINIC) 

For more information and facts about the vaccination and potential side-effect, click here for a document provided by the CDC.  

Commonly asked questions

Why do I need two doses?

In general, when a vaccine requires two shots, it is because the first shot will prepare the body into recognizing the virus so that your immune system is ready to battle it, and the second shot will strengthen your immune system. In the case of the mRNA vaccine the second dose will assist the immune cells commit the virus's most important characteristics to memory, completing the body's protective process against the virus. To be more specific after the first dose the Pfizer vaccine proves to be 52% effective and Moderna proves to be 80.2% effective. The second dose, evens out the effectiveness of both vaccines as Pfizer improves to 95% effectiveness and Moderna reaches 94.1% effectiveness. (New York Times), (Goodrx), (BBC), (Government of Canada).

A complete summary of the Pfizer/ BioNTech trials and results can be found here.

Do I need the vaccine, if I have already had COVID-19?

If an individual has already had COVID-19 they might build some immunity to it, it is not clear what percentage of individuals develop an immunity to the virus once infected. If individuals do build some sort of immunity towards the virus they still need to get the vaccine to build an even stronger immunity towards it, and they might even need to get a follow up dose so that the body keeps its immunity at high levels. (Health), (Forbes), (CDC)

Will the vaccine be effective if a large portion of the population chooses not to get it, if herd immunity is not reached.

The vaccines will be effective for the individual who have been immunized even if herd immunity is not reached. Seeing as  5 out of the 6 major vaccines have an effective rate of 90% and higher, not reaching herd immunity will just affect those who are not vaccinated. (Stat News)

Can children take the vaccines?

People 18 years old and older are able to get the vaccinated with all approved vaccines, with the exception of the Pfizer/BioNTech vaccine that allows individuals to be 16 years and older to get vaccinated. (MAYO CLINIC), (CDC), (The Lancet

Hopefully in the near future the vaccines will be approved for teenagers and children under the ages of 16, but in the early stages they have yet not been approved. 

Why keep track of your vaccination records?

In the early stages of vaccination around the world, different countries have started to establish streamline systems on how they will keep track of who has been immunized. Some countries will rely on their national data base, others will rely on the local data bases within their country and others are establishing their new record keeping systems. (WSJ

The race between rolling out vaccination and constructing record keeping systems seems to be contradicting, and it seems unlikely that these systems will be up and running before countries around the world have completed their vaccination phases. It has also been discussed how some individuals might be restricted to certain activities if they do not have prove of vaccination, depending on which country they live in. 

The biggest restriction that could affect individuals around the world, would be the travel restrictions based on immunization, meaning that a prove of vaccination would have to be provided in order to travel to certain countries. (CNN)

To tackle these future problems a group of tech and healthcare giants have teamed up to carry out the Vaccination Credential Initiative. The group consists of companies such as Microsoft, Mayo Clinic, Salesforce and Oracle along side many others. The Initiative aims at developing a vaccination passport, in the form of an electronic document in an app, with a QR verification code. This initiative will not only be used for countries who will require vaccination documents, but also for airlines who will possibly require the same documentation. (Forbes)

Untitled design (94)

Long COVID-19

Thinking about long COVID

Long Covid refers to the long term effects that COVID-19 could have on individuals who have been infected. More specifically Long Covid, is when symptoms of covid-19 are still re-occurring 8-12 weeks after infection. (BHF)

The virus is relatively new, so we are yet to know exactly what the long term effects of someone who was infected could be. Studies have started to get some information on what the long term effects could be. It was stated in a medical conference in China that some discharged patients from Wuhan China had persistent multiorgan complications for at least 6 months after the initial contraction of the virus. (The Lancet)

Some of the medical conditions and symptoms where noted as followed:

  • Cough
  • Shortness of breath
  • Fatigue
  • Headache
  • Palpitations
  • Chest pain
  • Joint Pain
  • Physical limitations
  • Depression
  • Insomnia

 (The Lancet)

One of the biggest studies to be conducted on Long Covid can be found here, this study also found that many Long Covid patients where affected 6 months after the initial infection. (The Guardian)

Global Vaccination strategies 

England

In England the purchasing of the vaccines is the responsibility of the Department of Business, Energy, and Industrial Strategy as well as the vaccine Task Force. The responsibility for vaccine rollout has been handed to The Department of Health and Social Care, and they are working with NHS England, NHS improvement and Public Health England to to strategies and coordinate with the vaccination sites network in the country including hospitals, GP's and pharmacies. (Institute of government UK)

England's strategy is based on priority groups, their predicted timeline is as followed: 

  1. Offer the vaccine to the top four priority groups, by mind-February
  2. Offer the vaccine to the remaining priority groups, by mid-April
  3. Offer the vaccine to all remaining adults in the UK by the autumn

(Institute of government UK)

Below is the list of the priority groups listed by the U.K government. 

Capture-3

(Institute of government UK)

 

The United states

The Federal government put the different states in charge for their own vaccination strategies, still they set out a list of guidelines on how the different states should rollout their vaccinations. As of January 2021, the nation and its states are on Phase 1 of the 3 phase plan, and even though the recommendations have just been put in place, phase 1has already be revised. Below is the latest revised guidelines for phase 1. Phases 2 and 3 can be found here. (Beckers hospital)

roll out-1

      (CDC)

Canada

The Canadian government is the best vaccine stocked country in the world in reference to its population, by November 30th, 2020 Canada had already purchased/pre-ordered 414 million vaccines and the country has a population of 35.59% in it. (Launch and scale faster), (NPR).

The federal government is working alongside the provincial and territorial governments to make sure that the vaccines are distributed on time, and the provincial/territorial governments have taken the responsibility to ensure that they vaccinate their population. The federal government has set the end date to its immunization campaign, for the end of 2021 (Canadian Government)

Below is the forecasted allocation for the Modern vaccine, as show on the Canadian Government Vaccine and treatments for COVID-19: Vaccine rollout

Distribution location 11-17 Jan 1-7 Feb 22-28 Feb
Total forecasted allocations 171,700 230,400 249,600
Newfoundland and Labrador 2,400 2,800 3,000
Prince Edward Island 1,200 1,200 1,200
Nova Scotia 3,700 5,400 5,900
New Brunswick 2,700 4,300 4,700
Quebec 34,000 47,400 51,800
Ontario 56,700 81,600 89,100
Manitoba 7,400 7,600 8,400
Saskatchewan 5,400 6,500 7,100
Alberta 17,100 24,600 27,000
British Columbia 20,700 28,600 31,000
Yukon 7,200 7,200 7,200
Northwest Territories 7,200 7,200 7,200
Nunavut 6,000 6,000 6,000

The priority groups for early COVID-19 vaccination are the following. (Canadian Government)  

  • Residents and staff of shared living settings who provide care for seniors
  • Adults 70 years of age and older, with order of priority:
    1. beginning with adults 80 years of age and older
    2. decreasing the age limit by 5-year increments to age 70 years as supply becomes available
  • Health care workers who have direct contact with patients, including:
    • those who work in health care settings
    • personal support workers
  • Adults in Indigenous communities

A more detailed outline of different stages and key populations can be found in the map displayed below; Sourced through the Government of Canada: Guidance on the prioritization of key populations for COVID-19 immunization website. 

figure1-eng

 

Delaying the second dose, to ramp up vaccination

As vaccination roles out across the world, many countries are experiencing a delay in their vaccination plans.

To tackle this issue England decided to take action by implementing a delayed strategy for the roll out of the second dose of the Pfizer/BioNtech vaccine, as well as their own Oxford/AstraZeneca vaccine that they have been using.(BMJ)

The logic behind this strategy, is that with the delay of the second dose they will be able to vaccinate more people with the first dose, rather than having to use resources to vaccinate a smaller group of people with the second dose. England has delayed the second dose for the Pfizer/BioNtech vaccine by giving individuals the second dose 12 weeks after their first dose, instead of the original recommendation timeline of 21 days. (BMJ)

Canada is talking about the possible delayed of the second dose, to speed up the vaccination, using the same logic that England relies on.

Canada's national panel of vaccine experts have said that since the vaccine supplies has trickled down slowly in the country the second dose of the Pfizer and Moderna vaccines could be delayed for up to 6 weeks, instead of the original recommended 3-4 weeks. (CBC)

On the other hand the United States has strongly recommended that this will not be the case for its country, as they fear that individuals walking around only half immunized will cause more harm than good. (Science News), (Wall Street Journal)

COVID-19 Mutations

All viruses mutate over time, it is the nature of viruses to gradually change, especially RNA viruses like the coronavirus. (JOHNS HOPKINS)

The virus that started in China was the L strain and just two month later the virus had already mutated to four different strains, the V, G, GH and GR strain. The GH and GR strains are by far the most widespread around the world as they are responsible for 74% of infections. The mutations and changes in the virus are very little and therefor do not affect the research for the vaccine. (Science Daily)

A new strain of COVID-19 was reported in the media in December 2020. This new strain was found in England and it differs from the other strains as its mutation affects the S protein spikes attached to the coating of the virus, making it better at attaching itself to human cells. This means that this new strain is more contagious. The strain has been closely monitored to see if it causes more severe symptoms than other strains, and based on analysis the new strain has shown that this is not the case. (JOHNS HOPKINS)

At the start of 2021 a new mutation of the virus was spotted in South Africa. This new strain of the virus changes a part of the itself that the body's immune system gets trained to recognize after being infected or vaccinated, this means that the new mutated virus has disguised its appearance so that it is less easily recognized by the antibodies and therefor can infiltrate the immune system easier. Scientist has hypothesized that since the new mutation is not as easily recognized by the body, antibodies could be less effective in dealing with the virus. This does not mean that the vaccines will prove ineffective against this new mutation, instead they will be less effective. More studies still have to be conducted to come up with a conclusive answer on how and if this new mutation will affect the vaccines. (Stat News)

Untitled design (95)
Start tracking today