I am writing this email in response to ‘What is the scientific rationale for vaccination? | Law Ka-chung’.

For some background, I am a microbiologist at HKU, and I have to say that just about everything in this article is factually wrong to the point where it could kill people. Below is my response, the main thing I ask is that you make sure all the links are preserved, either as links or as footnotes, so people can verify every claim I make themselves. Anyhow…

This is in regard to a recent op-ed piece about vaccination published here. With all due respect, nearly every claim in it is factually incorrect. Let’s start with Israel - it’s abundantly clear there is a vaccine effect:

-- note that cases, hospitalizations and deaths have all been starkly dropping since the January peak, and at the start of March, deaths dropping the fastest. This makes sense, as Israel, like many other countries, has the elderly vaccinated first, and the single greatest risk factor for COVID-19 death is age (your risk doubles approximately every 6.6 years older you are). And sure enough, this caused the death rate to plummet, and confirmed cases were kept up due to the virus principally circulating in a younger cohort. That being said, vaccination is catching up to even them, and at this point Israel’s COVID-19 positivity rate is just 2.4%. despite basically complete reopening. Yes, the lockdown has been lifted for everything but bars and nightclubs a few days ago. And yet, there is no spike, but just continued falling, which brings me to another point: it takes time to notice effects of any COVID-19 intervention because SARSCoV2 has a long incubation period (1-2 weeks) and then it takes generally at least two weeks for the severe cases to hit ICU, and then deaths happen 5-7 days after that. So for the typical deaths, they contracted it as a general rule around a month ago. So some patience is needed to see vaccine effect.

This is made more complicated by the fact that in many of the most hard-hit places, the UK and Israel being two of them, they got hit almost entirely by B.1.1.7, the infamous “UK variant”, which has been confirmed greater spreading by 70% - 90% and now also has been shown to have a 50% greater risk of severe disease and death. So you have to count a more virulent virus into the picture as well. And yet despite this, cases continue to fall dramatically.

The same can be seen for the UK, by the way:

in fact the UK has a lower death rate than Germany despite a month ago having about 2x the incidence rate:

Also, the USA has had about 21% of their population vaccinated, which is half of your 40%. Even combining this with the recovered population of about 22 million (which is almost certainly an undercount, but not too drastic), we only get at best a little under a third of the population there having any form of immunity, which is very far from estimated herd immunity thresholds which are all 75% or above. Despite this, cases have swiftly fallen from about 250k/day back in January to about 50k/day now, with deaths falling from over five thousand a day back in January to around 1750 a day now, which is still an untold tragedy. But to say that this is not a dramatic drop in morbidity over just two months, despite minimal lockdowns or similar, is just cruel. The vaccines are literally saving countless lives.

Now, let me answer your seven questions:

1) We didn’t “know nothing about this”. Dr. Yongzhen Zhang posted the full genome of SARSCoV2 on Jan 11, 2020, and you’ll discover many of the vaccine firms (BioNTech, Moderna) started basically working on vaccines immediately. Secondly, SARSCoV2 is, in the end, quite similar to SARS Classic, and much of our knowledge transfers... for instance, prefusion stabilization, an important tiny modification, to the Spike antigen so it stays in the correct form longer when produced, was the result of research into MERS-CoV a few years ago. Coronaviruses are all very similar and also they are quite vaccinatable. Trust me when I say that we got off really lucky... if this were, say, something that behaved more like HIV or Hepatitis C, we might not have had a viable vaccine for it even 5 years from now.

In other words, it’s a combination of years of basic research all coming together into a desperately needed application, by people who reacted quickly, and a healthy dose of virological luck.

2) I’m not entirely clear about what your point is. That 98.5% of the population is still susceptible to the virus. That isn’t going to change outside of infection or vaccination. Also, the 95% figure is protection against any symptoms... what’s more important is the figure of 100% (yes, one hundred percent) protection against any form of severe disease. In other words, if you are vaccinated, two weeks after your immunization, you can relax in that you will not die of this disease; you will not get sent to ICU; you almost certainly will escape “Long COVID-19” sequelæ. And there’s a very strong chance you won’t even get a case of the sniffles.

I don’t know about you, but I think the difference between “there’s a chance at any moment I’ll contract this horrible disease” and “I will not die of this disease, and I almost certainly won’t catch it at all” is a pretty huge. It is to me at least. I got vaccinated recently, and of course I am not changing any of my behaviors (and nobody should until a sufficiently large amount of the population gets vaccinated), but the realization that 14 days from my first vaccination I no longer have to constantly worry is incalculable levels of relief.

3) Again, I think you are completely misunderstanding how viruses spread. Those 95%+ groups of people aren’t IN THE CLEAR, they’re SUSCEPTIBLE. The goal of vaccination is to vaccinate before they get exposed to the virus for the objective of reducing infection and eliminating disease.

4) Again, this means that most of our population is SUSCEPTIBLE, not IMMUNE. Also, I will take a moment to say our low incidence rate isn’t something to take for granted, it doesn’t magically happen, it’s the result of countless hours of effort from an overworked CHP, HA and HKUmed/CUHKmed groups, and I will say that I am far from alone when I say that I am barely holding myself together. Constant vigilance isn’t something one can keep up indefinitely, 14 months is already impossibly draining.

5) Yes, the deaths from COVID-19 were absolutely from COVID-19, this is incontestable. Please, watch ‘Death, Through a Nurse’s Eyes’ on New York Times to realize the grim reality of what a COVID19 ward is like. Dying of this virus is terrible and the way you wind up dying from it looks extremely consistent.

Also let me say that even if you don’t die of COVID-19, that doesn’t mean you’re in the clear; you generally are left with lung and heart damage the extent of which we don’t quite know yet but is quite concerning (upticks in cardiovascular symptoms in people who have recovered from COVID-19 is extremely high, and furthermore, a staggering amount of young patients are left with a post-infection illness known as “Long COVID-19”, which is debilitating.

As for the deaths potentially linked to the Sinovac vaccine, I agree strongly that usage of Sinovac should be paused and that this looks genuinely bad. But that badness extends only to Sinovac, and not to any of the other vaccines widely used anywhere in the world, and definitely not to Pfizer/BioNTech, which has an amazing safety record worldwide.

6) Again, your argument only applies to Sinovac. Pfizer/BioNTech has seen half of Israel vaccinated, millions of people in the USA vaccinated, and hundreds of thousands in Singapore vaccinated, with absolutely no signs of increased death or morbidity... In fact deaths have fallen everywhere, and they’ve fallen the fastest in the groups prioritized to be vaccinated, despite those groups being precisely the most likely to die of COVID-19. Again, I cannot understate how wonderful this is. Countless lives have been saved.

7) That holds only for Sinovac; for Pfizer/BioNTech, it is just the instructions to build one part of the virus, similarly for Oxford/AstraZeneca (but packaged differently there); for Novavax, it’s just that one part of the virus, not at all the same thing. Furthermore, all of these vaccines have been tested in the elderly and shown to be safe and effective for Pfizer/BioNTech.

Finally, let me say that you can read up on the full details and contents and safety of the Pfizer/BioNTech vaccine here: Medicines and Healthcare products Regulatory: Agency Public Assessment Report - Authorisation for Temporary Supply and all the raw clinical data from the PhaseIII can be found here: https://clinical-information.canada.ca/ci-rc/item/244906

Personally, I got the vaccine a few days ago and there were basically no side-effects, just some mild arm pain. It works well and is extremely safe and has been shown to cut infection by 95%, severe disease 100% and even has been confirmed to reduce transmission by 94%.

Now that the government has opened up vaccination to a very large group of the population, I urge everyone in the strongest terms possible to get the Pfizer/BioNTech vaccine.

Let me also add that until we get most of the population vaccinated we will be stuck with travel restrictions, 599G, ambush lockdown-tests and other ineffective-but-cruel interventions our government ultimately does to oppress us. This is the only way to get rid of all of that.

As for Sinovac, I cannot recommend it to anyone at this point in time.

As for your conclusion, it is just silly to say that we have new pandemics periodically because new viruses emerge. Our vaccines have saved countless lives to the point where they are the single most valuable medical tool in all of recorded history. They’ve even wiped one disease out completely (Smallpox) and almost done the same to another (Poliomyelitis). Measles, probably the most contagious human virus in existence, has been contained to all but flare-ups in places where people refuse vaccination, which not only has dropped measles deaths to very tiny amounts, but also reduced all-cause childhood mortality due to how measles infection clobbers recent immune memory.

Pretty much the reason why so many people think transmissible diseases are largely a thing of the past is vaccination enabled us to contain or even outright eliminate so many terrible diseases that caused untold levels of death and morbidity.

But that doesn’t mean that new viruses don’t emerge periodically - we saw two examples of that, with SARS Classic in 2003, and SARSCoV2 in 2019. Thanks to basic research, we were able to rapidly develop vaccines to the latter, and in a few months, assuming people get vaccinated, we will make COVID-19 deaths a thing of the past.

But that requires getting vaccinated. Please, Hongkongers, I urge you, book an appointment, roll up your sleeve, and get a shot. If we all do, we’ll finally be safe.

To close, I am happy to answer questions at [email protected] or on my twitter https://twitter.com/wanderer_jasnah. Public outreach is very important to me and I will do my hardest to answer any questions I get. Please, don’t be shy of asking if you have any questions or concerns or want to know more about SARSCoV2 or our vaccines or virology in general!

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