Positive after vaccination - How does it work?

We all have been eagerly waiting to get the vaccine to end the mayhem created by the corona virus. We would all like to believe that vaccination is the only way to stop the disease from spreading. Is that completely true, though?

As per the experts, vaccination doesn't mean the end of the virus. Vaccination solely guards your body against the dangerous effects of the virus. The infection can occur at any time, vaccination just helps in warding off the serious issues that it might trigger. People who have been vaccinated also need to abide by all safety measures to prevent contracting the virus. These people can even transmit the virus to others.

What this means is that for a vaccination to declare that is works, all it has to do is to prevent you from getting a severe infection. It may not prevent you from actually getting the virus in the future, although there are ongoing studies to prove just that. 

In the next few months, Pfizer and Moderna are expected to release data that should indicate how often vaccinated people become infected by the virus, even if they have no symptoms. The companies have been testing participants in their vaccine trials for antibodies to a protein called N that is part of the corona virus but not part of the vaccine. Finding those antibodies would mean that a vaccinated person has been infected by the virus.

So what exactly did they study when the made the vaccine?

The Pfizer and Moderna trials tracked only how many vaccinated people became sick with Covid-19. The study essentially took 2 groups and put them into a placebo group and a vaccine group and studied the risk of people getting sick with the corona virus without actually studying if the vaccine would prevent the infection in the first place.

 

Having said that, the vaccine will offer some protection from getting the virus. The way it works is this. The vaccine provokes the immune system of the receiver to make antibodies against the virus. Once the antibodies are formed, the immune system is primed to attack anything that remotely resembles the corona virus so that if you do get exposed and the virus does enter your system, it should be attacked by the antibodies.

 

How does this differ from immunity obtained after being infected?

In most respiratory infections, including the new corona virus, the nose is the main port of entry. The virus rapidly multiplies there, jolting the immune system to produce a type of antibodies that are specific to mucosa, the moist tissue lining the nose, mouth, lungs and stomach. If the same person is exposed to the virus a second time, those antibodies, as well as immune cells that remember the virus, rapidly shut down the virus in the nose itself before it gets a chance to take hold elsewhere in the body.

 

Vaccinated people may still harbour the virus in their nose and throat and these people who may not develop any symptoms could possibly be transmitting the virus without ever knowing it. It would only depend on whether the virus can replicate faster, or the immune system can control it faster.

 

What are breakthrough cases?

Breakthrough cases are those cases that test positive even after receiving the vaccine and can be either symptomatic or asymptomatic. This might occur in those people whose bodies cannot produce a robust reaction to a vaccine. Breakthrough infections are generally mild and do not require hospitalizations. Some people may have no symptoms at all and may be discovered only through testing. Absence of symptoms actually means that the vaccine is doing exactly what it is supposed to do: prevent people from getting sick, even if it does not fully block the virus from infecting them. If vaccinated people become silent spreaders of the virus, they may keep it circulating in their communities, putting unvaccinated people at risk.

 

Why are vaccinated people are testing positive for the virus?

 

- They are not following the precautionary measures such as wearing masks in public, sanitizing hands, maintaining social distancing and ignoring the other safety protocols as advised by the health ministry

- Not following the after vaccination rules as told by the doctors (eg alcohol consumption, taking immunosuppressive drugs)

- Not getting the second dose on time or not getting the second dose at all

- Barrier in immunity (may not mount a good enough immune response)

As of now, the only way to be absolutely sure of not getting the infection is to continue to follow strict hygiene measures in terms of hand washing and sanitizing, respiratory hygiene including wearing a mask at all times when outside your safe zone or in presence of strangers, covering your mouth and nose when your cough or sneeze, not rubbing your eyes, nose or mouth under any circumstances. These measures have to continue until a larger segment of the population is vaccinated and the transmission chain can be effectively broken.

Corona Paranoia - Myth Busters!

"I have a fever since two days, am I going to die of Coronavirus?"

Not every fever is Covid-19, other infections still exist for us;

Malaria, typhoid, dengue and regular flu viruses still hover around,

Don't let this fear of COVID drive you into the ground.

"I've been coughing since the past 1 month, am I losing my lungs?"

Unlikely even though the pollution is almost gone to its lowest rungs;

Most likely it's a regular cough or your smoking habit or even reflux,

Don't let it make you isolate yourself from family, that really sucks!

"My nose is running, I've been sneezing a lot, have I got it?"

Yes, you have, the common cold that is, still far more likely;

Don't ignore it but don't go into a frenzied meltdown just yet,

Get yourself to a doctor and place a well calculated bet!

"My whole body aches, my joints are sore, this is the virus for sure!"

Of course it is a viral illness, but not all of them are Corona remember;

The old viruses are still as just as infective as they once were,

Take regular treatment, stay home, stay safe and have no fear.

"I've got this rash on my skin, I read that this could happen too?"

Sure it can, especially if you avoid bathing in the lockdown;

Maintain hygiene, eat well, stay hydrated and do what you should do,

It's mostly a fungal infection, it'll spread quick and make you frown!

"There is no way I can eat ice-cream, are you mad, I'll get sick!"

You might if you can't handle cold things, but not from the virus you picked;

There is no harm in eating an ice cream in the summer, just stay cool,

Know your body and don't believe in rumours, don't be a fool!

"I went for a walk, now I have to strip, bathe and drown in sanitizer and scrub"

Calm down, my friend, wash your hands, by all means use a good handrub;

But try and think, were you in contact with anyone or anything, 

If not, don't worry, your risks are as minimal as the bathroom sink!

"There is no way I can order food from out, I'll get infected!"

Sure you can, but mostly it'll be a bad tummy that will put you to bed;

Food is prepared at a temperature that kills most viruses and bacteria,

The same risks stay as before, ordering in keeps the same criteria.

"I don't believe a word you're saying, this is just to fill your blog"

Probably true, you've got better sources I'm sure that you can log;

Like that whatsapp forward, facebook post or youtube video that you see,

and then, Google is always there for Doctors with whom you disagree!  

Abscess Drainage without Antibiotics?

I just read a paper this morning that gave conclusive evidence that antibiotics do not work after an Incision and Drainage procedure for an Abscess. That was rather surprising to me. How can a cavity that's filled with pus (essentially teeming with bacteria and what not) not respond to the very things that were invented to destroy said bacteria and what not!

The data suggested that there was no difference in the healing process in the placebo group and the group that received the antibiotics. They also report that the incidence of further infection was not affected by the antibiotics. So, 7 days after the incision, patients were no better no worse. I'm not so sure thats a good thing!

Taking this scenario and applying it in India would be akin to shutting your practice down. Why? Simple. Your patients will think you've lost it! "My doc is so stupid he didn't even prescribe me antibiotics". In a country that is widely known for abusing over the counter drugs, we have our chemist friends that happily dispense all antibiotics over the counter as well and almost no one I know asks for a prescription. Knowing this, do you think that even if I don't prescribe an antibiotic, I won't be asked for it? Wouldn't it just be bought anyway to 'be safe'?

Pharma companies - Lets not even get started there. They must already be conduction 'trials' to disprove this theory. Be realistic, if you won't prescribe antibiotics for an infection, what else is left??? (Of course, I'm generalising!)

                                                          

How about you? Would you feel comfortable not taking any antibiotics after getting a surgical procedure on your body to remove pus from an abscess cavity?? 

I want comments on this one!

Asses can be stubborn!

Sometimes, I think medicine is just being re learnt and that our ancestors knew everything there was to know, without the genetic testing and millions in research being spent today. All they did was study nature.

Take for instance the fact that Asses are the most stubborn creatures out there! Now, I know you're thinking what the hell does this have to do with medicine. I'm getting there...

A Pilonidal sinus (a small opening at the cleft of the buttocks which usually results from hair in that area getting into the skin and causing an infection and a break in the skin) is an incredibly intelligent disease which chooses that particular region of the body which would be the most stubborn to heal (namely the Ass). It is more common in males (more males are asses than females), has been known as jeep's bottom and truck driver's disease (these particular male drivers are known to behave like asses) and occurs in hairy young men and hardly ever once you cross the age of 40 (need I say more).

Over the years, I've seen patients with pilonidal sinuses getting operated, choosing conservative treatments, trying ayurveda and homeopathy, lasers, photocoagualtion, cryosurgery and everything else you can think of. It just does not heal and though the recommended treatment is surgery, there is a 20% chance of it recurring. This increases if you close the wound. So what I'm saying is that it needs to be left open to heal, which can take about 8 weeks. 8 weeks of discharge, slime, pus, hair, blood with no riding on a bike or driving a car. Stubborn isn't it.

Funnily enough, the thought that came to my mind when I first read about it was whether the ass in humans was named after asses in nature based on this disease? Another thing, asses almost never ever suffer from pilonidal sinuses. So, who's the real ass here??