It’s Immunization Day

A young man sits down at my Covid-19 immunization station at Maine Medical Center and stares resolutely ahead, focusing on the far wall. He looks nervous. I make sure the needle and syringe are outside his field of vision. That should help. I pick up a Band-Aid from my box of supplies. It’s a Band-Aid large enough to cover a shark wound, and I wave it in front of his nose. “This is what we’ll use after the shot. You need to keep it on for one year.” He cracks a smile. I deliver the shot. A moment later he gives me the thumbs up sign and literally skips down the hallway. 

I am a volunteer Covid-19 vaccinator, overjoyed that after more than 335,000 deaths in the United States and 1.7 million deaths worldwide, two vaccines, one from Pfizer, the other from Moderna Pharmaceuticals, have been approved by the FDA to prevent Covid-19 infection. Legitimate questions remain regarding the safety and effectiveness of the vaccines, but let’s put these important issues into perspective and celebrate a remarkable achievement: After only 11 months since the first patient was sickened with Covid-19 in the United States, there is hope that the worst of the pandemic will soon recede.  

How unusual is it to have a vaccine developed and approved by the FDA in less than a year? In the case of HIV, in 1985, when I was a visiting internal medicine resident rotating through the department of Rheumatology and Clinical Immunology at Yale Medical Center, HIV-1 was universally fatal. Decades later, we have effective medications for suppressing the virus, but to date, no vaccine has been approved for general use (although several vaccines are in clinical trials) (1).

Or take malaria. In 2019, there were 409,000 world-wide deaths due to malaria (2/3 of them in children under the age of six) (2). A recently completed trial last year demonstrated that a new vaccine, Mosquirix, prevented approximately 4 in 10 predicted cases (3). It is a welcome beginning, but relatively ineffective compared to traditional vaccination against polio or measles or rubella.        

Why has science struggled to develop vaccinations to prevent HIV-1 or malaria? There is no simple answer. There may be some truth to the assertion that because malaria and HIV often infect the poor or those at the margins of society, that vaccine funding has been insufficient. But this view dismisses the work of countless, talented scientists who spent their entire careers in vaccine research and failed to unravel the mystery of HIV-1 or malaria. With recent advances in technology, the genetic blueprint of the Covid-19 virus was determined in record time, and novel strategies developed to produce new vaccines.      

And what of risk? Are the vaccines safe? Most of us accept risk within reason. Each day, we make an effort to avoid unacceptable risk. We move indoors when a thunderstorm races across the sky. We check our clothes for ticks after a hike. If we have elevated blood pressure, we consider medications to lower the risk of stroke or heart attack. Even with the risk of side-effects, the majority of us choose treatment over avoidance, action over inaction.  

In the studies leading up to approval by the FDA, the Pfizer and Moderna vaccines safety records were good, not perfect. Minor side-effects: local discomfort, muscle aching, and low-grade fevers were relatively common. By Christmas eve, after more than a million Americans were immunized against Covid-19, reports of serious side-effects have been extremely rare.   

I think briefly about the challenges of malaria and HIV and the risk verses benefits of vaccination, as I draw up my next dose of vaccine. An older nurse sits down and rolls up her sleeve. A look of contentment spreads across her face. “It’s been 8 months since I’ve been able to see my mother. She’s 94 and lives alone, and I’ve been terrified that I could be the person who infects her with the virus. I believe that the vaccine will let us get back to the business of hugging. My mother needs that; I know I do.”  

The line is long, but it’s moving along. 2021 will be a better year. It won’t be long before we can hug again. 

 

  1. Burton DR, Advancing an HIV vaccine; advancing vaccinology, Nature Reviews Immunology. 2019; Vol.19: 77-78.

2. World malaria report 2019. Geneva: World Health Organization; 2019.

3. Draper SJ, Sack BK, King CR, et al. Malaria Vaccines: Recent Advances and New Horizons. Cell Host Microbe. 2018;24(1):43-56.

43 thoughts on “It’s Immunization Day

  1. Chuck, Let’s hope so. Let’s hope the days is not far away when we can hug again. Nice that you are doing what you are doing. It’s a contribution to the world.

  2. Chuck, this is a lovely and definitely puts it all in perspective. My mother is 94 too and even with dementia, she’s been a trooper in understanding why we can’t be physically together. I can’t wait for this to end.

  3. It’s great to read some new writing from you! Thank you for volunteering to immunize folks against Covid. Happy New Year to you and Sandi!

    • Hi Joan,
      Thanks for writing. I hope you’re well. UNE’s all on-line, even my spring rheumatology section in March and April. I’m trying to figure out if there’s a way we can have you visit/teach on ZOOM to the rest of the students. Any ideas? Chuck

    • Hi Lloyd. It’s like being in a fun house. Everything is distorted and fogged up. I grope around hoping I can find an arm to inject.
      But seriously, can you send you home address on to me via e-mail? (cradis@maine.rr.com). I want to send you a copy of Go by Boat, if it’s okay. Chuck

    • Hi Lloyd. I’m not sure if what I wrote a minute ago went through….. Which was thanking you for reading some of my early writing and writing a great BLURB. Can you send me your home address again and send it to cradis@maine.rr.com ? If you’d like a copy of Go by Boat when it comes out I’d like to send it on. And please stop by Peaks again. 95 years is too long!

      Chuck

  4. Glad you are doing this, but please be safe. Hope you got your injection, too. Best for 2021 to you, Sandi and your girls and their families.

  5. Your humor is a gift to those receiving the vaccine Chuck. And thank you for the perspective gained from your information about other vaccine quests.
    Also, I love the skipping guy.

  6. You are the best. Great picture and I loved the nurse’s story about being able to hug her Mom again. My grand kids are home from college and it has been hard not to give them hugs as well as the rest of my family. Can’t wait to get the vaccine.

    Judy Fletcher

    • Judy! So good to hear from you. I miss our patient presentations so much. I hope your health is holding up and that we can all emerge on the side with a better appreciation of the progress we’ve made in vaccinations. I may circle around to you again if the patient presentations can be in person again, perhaps in the fall. Oh, one last bit of news: A book I wrote on my years practicing on the Casco Bay Islands is coming out in April by DownEast publishing. If you belong to a book club or have any connections to your local library, I’m open to talking about Island Medicine. Thanks,
      Chuck

  7. Bravo for being a Covid-19 vaccinator and for sharing the human side of a topic that tends to get overwhelmed by statistics. I think that the nurse you quoted speaks for so many of us who want to be able to travel and hug loved ones again without fear of spreading the virus.

  8. An interesting and delightful essay once again. Thanks for taking the time to share some thoughts on taking the new vaccine whether all of the potential side effects are known yet or not. And thanks, too, for sharing your expertise in doing the vaccinations. A happy and healthy new year is wished for you and your family.

  9. Your work is to save life. But be safe too. We are missing you here in Africa particularly in the Settlement. Hope this Covid19 ends so that we meet again.

    • Thanks Richard. I miss getting together for our patient presentations….. You were always awesome! Who knows? Maybe we’ll be able to get back to in-person teaching next fall at UNE. Dr. Radis

    • Thanks so much Debbie. It’s great to hear from you. Hope you and your family are well. Are you still part-time at Rheum Associates? Chuck

  10. Chuck, in 1975 you were a Swine Flu gunner. I don’t mean to pry and you certainly don’t need to answer, but I was just sort of wondering…HOW MUCH DO YOU NOW MISS THOSE GUNS? To compensate, do you fire off witticisms to every recipient, as above? Do you shoot your mouth off to the nurses? (PS – the side effect from the Swine Flu vaccine I experienced was that my hair grew out in — pigtails!)

    • In the longer version of my story, I morphed back to those Swine Flu days and compared the two epidemics. Sandi thought it would be better if I was brief and I cut a lot, which I think was better. Did you remember that after the first death from Swine Flu in the spring at a military base (with 200 other cases who recovered) there was only 1 other death. By the time the vaccine rolled out the following fall under Gerald Ford, there hadn’t been a new case for 4-6 months. A good thing that they pulled the plug on the program a few months later…. Charlie

  11. Chuck, I love how you regularly weave your vast knowledge and expertise into real anecdotes. Thanks for your volunteerism and empathy.

    • Thanks Jackson. Molly probably told you but the Dirt Bag Diaries didn’t use my essay. The woman who reviewed it did write me an e-mail and they were setting it aside and thinking about whether they might use it in a longer piece or combined with another story, but I’m not optimistic. Still…. it was a good exercise to send it along and who knows?
      Chuck

      • Thank you so much for the wonderful contribution you are making to help get this vaccine to as many people as you can. I am not surprised to learn you are doing this. Take care of yourself too.

      • Claudia, so nice of you to write. We hope it’s safe enough for you to come out to Peaks later this summer. Sandi and I would enjoy seeing you and the rest of the family very much. Chuck Radis

  12. Nice work you are doing there. May the Almighty God Bless the work of your hands and keep you safe.

    • Thank you so much Sedongo Emmanuel. I hope that the virus comes under good control soon in Uganda. I hope to return to St. Bakhita later this year if all goes well
      Dr. Radis

  13. Thank you, Dr. Radis. I am deeply appreciative of your work (& your writing) and felt honored to get the chance to see you and chat today as well as receive my first COVID-19 vaccine from you. This is the way forward.

    • Hi Tedra. Great to see you and the career path you’ve embarked on. We have a board meeting at the health center on Tuesday night so I’ll make sure everyone knows what you’re up to….. Chuck

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