COVID-19 Vaccine Webinar Speakers Answer Your Questions

ASHG Webinar: How to Engage Community Response to COVID VaccineIn April, the Public Education and Awareness Committee organized a webinar titled, “How to Engage Community Response to COVID Vaccine” to answer the question: how do scientists engage with groups that are resistant to and frightened by the COVID-19 vaccine due to confusion or misinformation? The goal of this webinar was to equip scientists with strategies for outreach by walking through the basics of vaccine production, explain the state of the COVID-19 vaccine at the time of the webinar, and debunk anti-vaccine information with scientific facts and reasoning. After the event, speakers John P. Doucet, PhD and Pramod Mahajan, PhD revisited all questions that were submitted in the live chat. This article provides Dr. Doucet’s and Dr. Mahajan’s answers to questions that they were not able to address during the live event, as well as additions to questions they answered during the live event.

Continue reading for their answers to all questions about how to engage the community response to COVID-19 vaccines, and watch the webinar recording here. All questions below were submitted by webinar attendees and taken from the webinar report.

Question: What cells are targeted by the mRNA and DNA vaccines? Is targeting limited to immune cells? If not, what other cells may express vaccine delivered coronavirus spike proteins?

Dr. Mahajan: In the version of the vaccines that we have now, there is no specific effort being made to target the mRNA to a particular cell type in the whole body. When the vaccine is injected, it goes primarily into muscle cells, which is where immune cells might receive it and produce the protein. In respect to where the protein is produced, the cells will react to it, because the protein is not self-protein, by either degrading it when it is intercellular, or it gets cycled out. If it is cycled out it is perceived by the immune cells which then produce antibodies against it. The job of the immune cells is to perceive the threat, in this case in the form of a foreign protein. No other cell has any use for this protein that we know of at this time. As studies progress, maybe we will learn something more about interactions between the spike protein and other host proteins. Right now, there is no specific targeting. There are other ways of targeting, such as mRNA, to a particular cell type including the immune cells. That is how lots of medications are targeted to specific cancers. It may happen in the near future that a technology may allow us to target mRNA.

Question: What is the necessity of taking the vaccine if you already build some immunity by getting and surviving the Coronavirus?

Dr. Doucet: We do not know how long immunity from any source will last at this point. We certainly do not know a tremendous amount at this point about immunity from contracting the virus. As long as the immune reactions to antibody production inside the body are not dangerous and severely inflammatory, it is important for folks who have contracted the virus to get vaccinated.

Dr. Mahajan: Why not get the free vaccine and protect yourself for a little bit longer than just the immunity you have built up from contracting the virus? It is an additional tool that should be made use of.

Dr. Doucet: An additional tool against a potentially fatal disease.

Question: How can we efficiently explain to people that mRNA vaccines will not alter our DNA?

Dr. Doucet: There are only a few examples of RNA ever entering the nucleus. If it does enter the nucleus, it is usually not sufficient to be incorporated into the DNA. There are somatic mechanisms that protect us from RNA from all sources. In the lab when we used to isolate RNA in our analyses, we used to have to wear gloves to protect RNA from us because of enzymes on the surface of our skin. RNA is fragile, it is short-lived, it does not belong in the nucleus and the nucleus knows it.

Dr. Mahajan: It is practically impossible for any single-stranded RNA to be integrated into a DNA, which is a double stranded molecule. If that happens, our cells immediately perceive it as DNA damage and is very quickly removed and repaired. We study DNA damage and repair in our lab so I can say with a certain authority that this does not happen. Our cells are very smart. Our current information tells us that they will kick out the RNA quickly.

Question: Have you considered the arguments about the problems with the ‘deficit model’, that the problem is not simply a deficit of information? Some psychological studies show that simply giving facts will in some cases cause a ‘backfire effect’, where if the issue is emotional or partisan, then throwing facts in will backfire and cause people to entrench their opinions more? The examples you gave here seem to be individuals who either are unusually receptive to new ideas (college students) or are already pro-vaccine.

Dr. Mahajan: I agree it is difficult to convince those who have a pre-formed negative opinion about vaccines (or anything for that matter). My approach would be to NOT continue with the discussions (factual or otherwise), acknowledge that we understand their view, state that we disagree with their view and seek help from an individual or group that they are known to trust or respect. I learned this during a study abroad course in India. A public health research group undertook to improve health conditions (read reduce HIV/AIDS incidence) of female sex workers (FSWs) in this town. Of course, no one from the FSWs community would even meet with the researchers. They had to spend almost 6-7 years first seeking out and then training a handful of individuals from within this FSWs community to be able to even be heard by others what they were trying to do. Building that kind of trust is critical for inducing a social change that then leads to health care education. A similar approach was tried for another group in a different town and community that refused to vaccinate children. The researchers were physically beaten up, threatened with guns, and harassed before the community accepted them to the extent that the day my group visited in January 2019, a WHO team was vaccinating children in that community. I have pictures to show! Building trust and engaging the members of that same community/group which is opposing the social change is a proven approach that works. It also takes time. One webinar may not be enough.

Question: How do you respond to individuals who are fearful of potential long-term consequences of the vaccines?

Dr. Mahajan: These individuals or groups may be more open to factual data and logical arguments than the one discussed above. We may also want to draw their attention to the fact that the consequences of NOT getting vaccinated are more dreadful than the fear of unknown, unsubstantiated adverse effects of the vaccine.

Question: Do you have any experience interacting with religious groups or leaders on the topic of the COVID vaccines?

Dr. Doucet: I do not have experience interacting with religious groups, but certainly persons of deep faith. Usually what I have experienced is not a tremendous amount of adversity to getting the vaccine. I know it is out there, but I have not experienced it in the groups I have worked with so far.

Dr. Mahajan: Any time an outsider goes into a group, they should find a messenger who is accepted and trustworthy to that community. For example, during the study abroad course I conducted in India, we were visiting a small town and the World Health Organization (WHO) team was there to administer Polio vaccines. All we had heard about this town regarding vaccines was how difficult it was to administer them because a group of religious folks were against it. The team said that they simply educated folks from within the community, and the community now does all the work. So, finding the right messengers is a good way to move forward.

Question: Is there evidence about the relationship between vaccine immune symptoms like fever and the vaccine efficacy against COVID-19? Are there clinical tests available to predict how well a vaccine has worked to produce the adaptive immune capability?

Dr. Mahajan: Simple answer is yes. Depending on the virus or antigen, there are at least two different types of tests or assays available. One type of assays are designed to give you just the ‘antibody titer’ – a number indicating the level of total antibodies you have produced post vaccination. The higher the titer, the better the immune response of your body and hence better immunity. For example, it is like asking how many airplanes an Airforce has. The higher the number of planes, the better the ‘fighting power’ of the Airforce!

The second type of assays will test how good are these antibodies in neutralizing the virus. Like asking how many airplanes are capable of destroying the enemy. Usually, the two numbers obtained by these two assay systems coincide well. However, it is possible that the neutralizing antibody number is less than the total antibody titer.

Another thing to note: Antibody generation in response to a vaccine is a time dependent thing.  The antibody level increases gradually after the first dose of vaccine and reaches a peak level in 2-4 weeks and then starts to decline.  A second booster injection of the vaccine boosts the levels and keeps them high for six months to a year. The actual time and level of antibody response depends on the vaccine and the mode of vaccination etc. and therefore will be different for different vaccines. Then the antibody levels may very well be low to non-existent. However, therein lies the beauty of the ‘adaptive’ part of the immune response: the memory cells! During the vaccination and boosting part, these little cells which are part of our adaptive immune system, have already committed to memory the nature (physical and chemical structure) of the specific antigen (virus or part of the virus used for vaccination) and are prepared to produce the same immune response in terms of the specificity and the titer again as soon as the body encounters the virus or part of the virus.

These and similar assays or tests carried out on a population level will tell us how well a vaccine has worked to produce the adaptive immune capability at the individual or population level.

Question: What about risk of coincidence of RNA vaccine and a reverse transcriptase competent viral infection?

Dr. Doucet: These molecules do not have intelligence. It might see an mRNA molecule but needs directions to reverse transcribe it. mRNA does not necessarily have the signals to become substrates for reverse transcription. As long as you can explain the complete situation, I think you can convince people that that this is not logical.

Dr. Mahajan: I agree. It is a very miniscule non-existent possibility of that happening.

Question: Do you have any specific recommendations for women who are pregnant or planning a pregnancy?

Dr. Mahajan: The current data does not show any specific concerns or reasons for concerns for women who are pregnant or women who are considering becoming pregnant. So based on the current data, there are no concerns.

Dr. Doucet: There is also a recent study that confirms trans-placental immunity is conferred by pregnant women for the fetus.

Question: It is easy to say to “check your emotions at the door” but do you have any advice on how to respond when someone is adamantly against vaccinations, current facts, and common sense (and even mask wearing)?  My experience is that it seems like some of these folks are “digging in their heals” and seem to shut out any responses to the contrary.  I usually just swallow my pride and stay quiet, but am not happy doing that!

Dr. Doucet: Do not forget that the majority of a group have a lot of power. Sometimes you can depend on peer pressure to get the argument going. You can accept the fact that you might not convince the person showing resistance, but the majority of the group will be willing to listen to you. Do not forget when challenging misinformation, people’s politics are not the entire

ASHG uses cookies to provide you with a secure and custom web experience. Privacy Policy