My Clinical Reasoning in Taking the COVID-19 Vaccine – The Virus and Risk Evaluation By Dr. Sanil Rege

Posted on: September 2, 2021
Last Updated: November 3, 2021

This video outlines Dr. Sanil Rege’s decision making process to take the COVID-19 vaccine.

This video is not medical advice.

The video covers:

  1. Structure and Entry Mechanisms of the Virus
  2. The Immune Response – Cellular and Humoral immunity
  3. Principles of the Vaccine
  4. Risk Evaluation

Structure and Entry:

The Coronavirus (SARS-CoV-2) is a RNA virus which at the microscopic level, engages ACE2 as an entry receptor and employs the host cell enzyme, Transmembrane Serine Protease 2 (TMPRSS2) or furin for spike protein priming.

Once inside the host cell, the foreign viral RNA ‘hijacks’ the host cell machinery inducing it to produce RNA and proteins that produce new viral particles. These viral particles will then exit the cell to infect new cells.

Immune Response:

The Phagocyte will engulf the virus. It will then take parts of these antigens to the surface and take it to a T lymphocyte – mainly the T-helper cell – and present the antigen to the T cell, but it usually does this in the context of the MHC.

The T helper cell then gets activated. It will then bring in other B cells. B cells are essentially two types – the plasma cell, which produces antibodies and the memory cell, which will recognise similar antigens for the future so that it does not have to go through all of these steps again. This is the basics of the immune system.

Vaccine Principles:

Most candidate COVID-19 vaccines are designed to elicit immune responses, ideally mediated by neutralising antibodies against the SARS-CoV-2 spike (S) protein. For examples the mRNA vaccines deliver the code to manufacture the spike protein with the body’s immune response producing neutralising antibodies against the spike protein. Subsequently the memory cells will mount an attack to the spike protein should the virus be encountered through infection.

Risk Evaluation:

Risk evaluation should take into account 3 aspects :

  1. Probability of Exposure
  2. Average Consequences of Exposure: A survey of 3000+ people with COVID – For the majority of respondents (90+%), the time to recovery exceeded 35 weeks. During their illness, participants experienced an average of 55.9 symptoms, across an average of 9.1 organ systems.
  3. Severe Consequences: Acute Respiratory Failure, Pneumonia. Acute Respiratory Distress Syndrome, Acute Liver Injury, Acute Cardiac Injury, Death.

Read more:

COVID-19 and the Brain – Pathogenesis and Neuropsychiatric Manifestations of SARS-CoV-2 CNS Involvement