What should everyone know about Michigan

Corona vaccination - you should know that about it

Why do I have to be vaccinated twice?

The double vaccination is necessary to ensure that the best possible protection against the virus is built up in as many people as possible. The second vaccination takes place after three weeks (Biontech / Pfizer) or four weeks (Moderna) or, in the case of Astrazeneca, after nine to twelve weeks.

The first vaccination with one of the vaccines from Biontech or Moderna already means that half of the expected Covid-19 diseases can be avoided. In the first week after the second vaccination, this rate increases even further, up to 95 percent.

The Astrazeneca agent showed an effectiveness of around 60 percent in the tests. However, this is a conservative value. Depending on the dosage and the time of the second vaccination, the value could be significantly higher. The first data on this are already available, but have yet to be checked by other scientists. The vaccine from Astrazeneca prevents severe disease and deaths just as well as the mRNA vaccines.

The Belgian company Janssen, which belongs to the American company Johnson and Johnson, has developed a vaccine that only needs to be injected once. The vaccine is also approved in the EU, but the first deliveries have been postponed until it is clear whether the vaccine - like the Astrazeneca vector vaccine - can cause dangerous sinus thromboses in the brain.

If I had Corona, don't know anything about it and then get vaccinated - is that a problem? Or if I've just got infected and don't even notice anything ...

This question can be answered clearly: If someone who has already had Covid 19 disease is vaccinated, the vaccination is not harmful. In the worst case scenario, vaccine reactions that are slightly stronger, such as flu-like symptoms, could occur. In the best case, the immunity is reinforced.

However, the Standing Vaccination Commission recommends that people who have already been laboratory-confirmed infected with the coronavirus should not be vaccinated for six to eight months. According to Stiko, this is not because it could be dangerous, but because there is still a lack of vaccines and those who have recovered already have immunity.

Vaccinating someone who has just been infected without knowing about it can help a little in warding off the attacking virus, but it may not necessarily prevent the disease. Because the full protection of the vaccine does not build up for all vaccines until several weeks after a total of two vaccinations.

Can I still be contagious to others despite being vaccinated? Do I still have to wear a face mask after the vaccination?

The studies that are available on the already approved vaccines from Biontech and Moderna clearly show that they can prevent disease with Covid-19. However, this does not rule out the possibility that a person who has been vaccinated can absorb the virus into his or her body despite the vaccination and can therefore be contagious for others. It is then said that the vaccinated person is only "clinically immune".

“Sterile immunity”, on the other hand, means that the immune system completely eliminates all coronaviruses in the body. The vaccinated person then does not carry the virus and consequently cannot pass it on.

According to media reports, an as yet unpublished Israeli study for the vaccine from Biontech recently showed that the agent can also significantly reduce the transmission of SARS-CoV-2. According to this, the vaccine can prevent transmission of the virus by 89.4 percent - including asymptomatic cases.

However, sterile immunity has not yet been proven for the other vaccines. Therefore, vaccinated people should continue to wear a face mask. If there are still frequent infections by vaccinated people, it will be more difficult to achieve herd immunity in which the virus can no longer circulate across the population.

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What do the percentages for effectiveness mean?

The figures on effectiveness come about as follows: The participants in the vaccination tests are divided into two groups. One group actually receives the vaccine by injection, while the other only receives a placebo, which is an ineffective solution. All of this happens double-blind, which means that neither the participants nor the study leaders know who belongs to the placebo group and who to the vaccine group.

Then the waiting begins for the first cases of illness to appear among the participants. As soon as a certain number of diseases has occurred, it is "unblinded" - that is, it is counted how many of the sick come from the placebo group and how many of them were in the group of the vaccinated. If 100 sick people in the placebo group face only 5 Covid-19 cases in the vaccination group, the vaccine has obviously protected 95 people in the vaccination group from the disease. Its efficiency is thus 95%.

Does the vaccine also work against mutated coronaviruses?

The coronavirus is constantly changing. The vaccine developers at Biontech tested their vaccine on various mutants during the trial phase. It was equally effective in all cases.

In mid-December, new variants of the coronavirus were reported for the first time in England and South Africa, which are said to be significantly more contagious due to mutations. These two mutated viruses show changes in what is known as the spike protein. This protein is the spiky attachment on the virus envelope that enables the virus to enter human cells.

The effectiveness of the Biontech vaccine is almost unchanged against variant B.1.1.7, which was first observed in England. This was tested using blood samples from 16 subjects. No human data are yet available on mutant B.1.351, which was discovered in South Africa. According to Biontech boss Uğur Şahin, however, initial laboratory data indicate that vaccination protection against this variant has been weakened.

According to a press release from Moderna, their vaccine also seems to work very well against B.1.1.7. According to laboratory tests, the protection against B.1.351 is probably significantly lower. According to the company, the vaccination protection is still sufficient.

AstraZeneca's remedy should also work well against B.1.1.7. As far as B.1.351 is concerned, it looks as if mild disease courses can hardly be prevented. However, the study was small and there are still no findings on severe courses. According to experts, there is no reason to believe that these can no longer be prevented. More research is needed.

The effectiveness of vaccines against new mutations is constantly being tested. In a previously published study from India, for example, the Indian vaccine Covaxin was shown to be effective, albeit weaker, against variant B.1.617, which was first discovered in India. The study also looked at whether antibodies from people who had coronavirus infection with the original virus were effective against the variant. The results were similar to those for the vaccine.

For the variants B.1.427 and B.1.429, which were first discovered in California, it could be shown that the mRNA vaccines from Biontech and Moderna are still effective - albeit to a limited extent.

So far, vaccines seem to be effective against the variants. In the opinion of most experts, it is not yet necessary to adapt the vaccines. So far, reduced protection through vaccines or immunity after an infection usually only means that an infection with a variant is more likely again, but that there is still good protection against a serious illness.

These findings coincide with what we already know about cold viruses. Children become infected with it more often and become more ill. This is because this is usually your first contact with the virus. If they catch it again later, the virus may have changed a bit, but the immunity of the first contact protects against a more severe course.

Another study shows that infection with other (corona) cold viruses could protect against a severe course with SARS-CoV-2.

How quickly can the vaccine be adapted to a new virus variant?

The vaccines are still helping at least partially against emerging variants. As soon as the need to improve the vaccine is recognized, according to experts, a new, improved vaccine for mRNA agents (such as those from Biontech and Moderna) can be developed within six weeks.

In addition, there is the change in production and approval. According to the Paul Ehrlich Institute, this could take place within a shorter period of time if the vaccine was changed, since the basic data would not change. Exactly how long the approval process will take and what specific requirements will be placed on a converted vaccine are currently being discussed.

With vector vaccines like the one from AstraZeneca, the process could take longer. The company recently announced a new generation of vaccines for the fall, which should better protect against variants.

How high are vaccines typically?

In the case of the first two vaccines against Covid-19 approved in the EU, efficacies over 90% were reported. For comparison: Measles, mumps and rubella also have values ​​of over 90%, and measles even 98 to 99%. These vaccines are therefore very effective.

With the flu vaccination, on the other hand, the effectiveness varies from year to year and can sometimes be as low as 20%. But: the flu is not about pushing the influenza virus out of the population - it changes far too quickly for that. It appears in a new form every year. In order to be able to make the flu vaccine available on time every year, one has to estimate the change in the influenza virus in advance and that does not always work equally well. Hence the low efficiency of the flu vaccination.

The only goal of the flu vaccination is to protect as many people as possible with a vaccine. Achieving herd protection, in which a high effectiveness of the vaccine in combination with a high level of vaccination coverage of the population also ensures the protection of the unvaccinated, is not possible with the flu. Whether or when this will be possible for Covid-19 remains to be seen.

How long does the vaccination last?

It is still unclear. This question can only be answered after some time has passed. The first participants in the large test studies in the final phase 3 of vaccine development were vaccinated in the summer, i.e. less than a year ago. The company Biontech, for example, will now monitor its test groups for almost another two years. Other vaccine developers will think the same way. It is hoped that the protection will last at least these two years if it goes well, but also significantly longer.

According to initial observations from Moderna's ongoing Phase 3 study, the US pharmaceutical company's vaccine lasts for at least six months. Biontech reports something similar about its vaccine.

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Can it be that it doesn't work for me at all?

Yes, the immunization may not work (completely) with the vaccination. The effectiveness of the vaccines is very high, so that only a few percent of those vaccinated will not have any effect. At least against severe courses, however, all previously approved agents protect very, very well.

But vaccination is not just about protecting yourself. When a large number of people get vaccinated, the herd immunity effect occurs. The pathogen finds too seldom new, not yet vaccinated people to be able to spread further uncontrollably. However, individual, regionally limited corona outbreaks can still occur.

In order to achieve herd protection quickly, it is important that many people can be vaccinated with a vaccine that is as highly effective as possible in a short period of time. Herd immunity in the community protects the individual who may not have been vaccinated as well as a successful vaccination.

The Paul Ehrlich Institute estimates that at least 60 to 70 percent of the population in Germany must be vaccinated in order to achieve herd immunity against the Sars Cov2 virus. However, it still has to be researched to what extent people who have been vaccinated are still able to pass on the virus. Should this be the case on a large scale, herd immunity would only be achieved, if at all, at a higher vaccination rate in the population.

What side effects can a vaccination have?

At the puncture site, there may be redness, swelling and also slight pain. Fatigue, headache and body aches, nausea, chills and occasionally fever are also some of the side effects that can occur in the first three days after the vaccination. Because when the immune system is cranked up, the body makes no distinction between a real infection and that which has only been "simulated" by vaccination. Therefore, some side effects correspond to the symptoms of a mild infection.

A serious side effect of vaccinations can be anaphylactic shock. This is a massive allergic reaction throughout the body, which can be life-threatening and which starts immediately after the vaccination. That is why vaccinated people remain under observation by medical staff for a few minutes after the vaccination, who can inject an antidote in an emergency. When the Biontech vaccine was used in Great Britain and the USA, four cases of such anaphylaxis were reported in around 200,000 vaccinations in the first few days. Three of the four people had suffered such shocks on other occasions. People who are prone to severe allergic reactions should therefore seek advice from the vaccination center before vaccination.

With Astrazeneca's vaccine, thrombosis, especially sinus thrombosis in the brain, appears to be a very rare side effect. Very rare side effects occur in less than 1 in 100,000 people treated. If a mechanism proposed by Andreas Greinacher of the University of Greifswald for the development of these thromboses is confirmed, then these could be treated with an already known therapy.

In the case of the vector vaccine from Johnson & Johnson, such sinus thromboses could also occur in very rare cases. This is currently being investigated in the USA. Until this is clarified, the vaccine will no longer be used in the USA.

Other very rare side effects will not show up in the statistics until several million people have been vaccinated. Long-term effects of the vaccination, if they exist, still have to show up. However, vaccines are broken down again quite quickly in the body. Therefore, undesirable side effects that appear months or even years later are not to be expected.

Will the corona vaccination make me react more strongly to other virus infections?

Theoretically it is possible that so-called undesirable infection-intensifying antibodies are formed as a result of vaccination. The Paul Ehrlich Institute states that this is a "theoretical risk" and is therefore researching the corona vaccine candidates precisely under this question. The vaccine developers themselves also have to carry out investigations. So far, there is no evidence that the vaccination increases an infection with another virus - neither in animal experiments nor in vaccinated people, according to the Paul Ehrlich Institute. So far, no such infection-enhancing antibodies have been observed in other mRNA vaccine candidates for other infectious diseases.

How much is the body affected by the vaccination? Does an "mRNA vaccine" mean that we are injected with genetically modified vaccine and our DNA is modified?

No, our genome is not changed by the vaccine. The mRNA vaccine works like this: mRNA stands for "messenger RNA" and this term precisely describes the task that mRNA molecules have in body cells. They are the messengers inside the cell. The mRNA swims in the cell fluid to those cell components that are responsible for producing proteins and tells them which proteins they are supposed to produce.

mRNA vaccines are artificially produced messages that induce the cell to produce those parts of the virus with which the immune system can adapt to the later defense of the real virus. If a complete coronavirus then appears, the immune system is already on its toes due to the training on the previously manufactured virus parts and prevents the outbreak of the Covid 19 disease. Or at least ensures a significantly easier course than with unvaccinated people.

In addition, the mRNA molecules do not penetrate the cell nucleus and they do not stay in the cell for a long time, but rather break down again within a few days. Just like RNA produced by the body itself does.

In the AstraZeneca vaccine, on the other hand, part of the coronavirus DNA is inoculated. In order for this to be transcribed into mRNA, it has to get into our cell nuclei. But here, too, experts consider it very unlikely that the coronavirus DNA could be integrated into our own.

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Should children also be vaccinated against the new coronavirus?

Vaccine tests on children are subject to much stricter rules than those on adults. Among other things, because the immune system of children and adolescents is not yet fully developed. This means that it is always first tested on adults and only finally on children. The vaccine was therefore first approved for adults. There are now studies from Biontech and Moderna with children from the age of twelve. Astrazeneca is planning a study with children from the age of six and Biontech will also soon test on children under the age of twelve.

Initial results from Biontech and Pfizer seem to indicate that the vaccine from Mainz is even more effective in adolescents between the ages of twelve and 15 than in adults. However, for ethical reasons, the studies on children and adolescents are carried out differently than on adults. Therefore the data cannot be compared easily. From the results it is clear, however, that the vaccine is also highly effective in adolescents.

There may be exceptions for children who belong to the high-risk group - such as children with multiple disabilities and children with really serious chronic illnesses. If the risk is carefully weighed up, it is possible for doctors to undertake off-label use - i.e. vaccination without approval for children - in these particularly vulnerable children.

Apart from that, most children and adolescents do not belong to any risk group. They usually do not suffer particularly badly from Covid-19 and many of them do not even notice that they have been infected.

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Can a herd protection effect be triggered at all with the vaccines that are now available?

Herd protection means that people who cannot or do not want to be vaccinated are nevertheless indirectly protected by the fact that there are already many people who have been vaccinated. With a high level of immunization in the population, a virus can no longer spread widely because its chances of finding the next unvaccinated carrier in good time before it is destroyed by the immune system of its current carrier are poor.

According to media reports, an as yet unpublished Israeli study for the vaccine from Biontech recently showed that the agent can also significantly reduce the transmission of SARS-CoV-2. According to this, the vaccine can prevent transmission of the virus by 89.4 percent - including asymptomatic cases. This means that herd immunity can be achieved with this vaccine. Provided that the population is highly immunized, such vaccines then enable the best possible herd protection for all those who cannot be vaccinated for medical reasons or who do not want to be vaccinated.

For the other vaccines, this question has not yet been clarified. Of course, if the virus can still be passed on by vaccinated people, then the vaccine is not ideal for building up herd immunity. This is a problem that the vaccine developers have in mind. They hope, however, that people who may carry the virus despite being vaccinated are at least not as infectious as those who have not been vaccinated.

More contagious variants, vaccines that are less effective than hoped and a low willingness to vaccinate could also mean that herd protection is never achieved. Nevertheless, the number of new infections will decrease significantly as a result of the vaccinations. This can already be observed in countries with high vaccination rates, such as Israel, the USA or the UK.

If the virus is becoming more contagious, but does not cause the disease to develop more severely - why is that still a problem?

Infection with the British coronavirus variant B.1.1.7 is not per se more deadly than one with the conventional virus, but the mutant is more contagious. That means: Although these viruses do not cause a more severe clinical picture, they can infect more people at the same time. They are causing an increase in the serious Covid-19 cases to be treated in hospitals at the same time. And that in turn can overload the health system.

Being more contagious also offers the virus the advantage of being able to test even more people at the same time to see which mutations can make it even more contagious. A vicious circle of a higher infection rate, resulting in a higher mutation success and, in turn, a higher infection rate, etc. This means that the number of infections and the number of deaths continue to rise. So the virus variant is ultimately more deadly.

To prevent this fateful spiral, there is only one means, as long as large parts of the population are not vaccinated: contact minimization.