“Vaccination can help mitigate the effects of long COVID and is yet another sound reason for people to get vaccinated and Member States to not give up”-World Health Organization, May 10, 2022[1]
Dear Editor,
Bawaskar and Bawaskar assess post-immunization COVID-19 at a peripheral center of Raigad in Maharashtra and report their observations in their case report, which is published in April 2022 issue of the Journal.[2] They mention which vaccines the cohort received during the period that belongs to the height of a massive second wave of COVID-19 in India.[3] Our scientific community is grateful to the researchers for meticulously recording, saving, tabulating, and then sharing their findings in an easy-to-understand way so that we can quickly derive some useful lessons, learn from the data, and plan in a better way for the future eventuality.
Nevertheless, there are a few findings that I am unable to reconcile with my working experience while serving at the COVID hospital of my institution. Many hospitalized patients used to have sore throat,[4] fatigue, running nose, or malaise and that is a nationwide experience.[5] I am unable to find such entries in Table 4. Moreover, a few patients being asymptomatic with a fall in oxygen saturation detected on pulse oximetry is a chance finding. When a throat sample is sent for reverse transcriptase-polymerase chain reaction (RT-PCR) for this reason, then only we used to know about the existence of the infection in that subgroup.[6] However, the data in the table do not clarify about the presence of such cases discovered in this study.
A positive point here is that the authors laboriously recorded the vaccination status of every patient, which otherwise may not be practiced around.[7]
Under the heading of “Introduction,” the investigators mention various myths prevalent in folklore that may not be correct. A myth is there about the vaccine and it needs to be emphasized that the jab saves us from hospitalization and death.[8] As three patients were reported to have died in the study, it is for this reason I am interested to know the gap between immunization and their disease onset. As 2 weeks duration is needed for immune response to kickstart, I want to know if the patients got ill enough to be hospitalized before that period or later on.
A patient with COVID-19 has all the risk of dying otherwise and vaccines train their immune system to fight against the microbe in the eventuality of a real infection. However, their age, comorbid conditions, the status of organ failure, pregnancy, and immunocompromised conditions put them at heightened risk.[9] Vaccines cannot protect them from everything but have greater value when such risk factor is/are present.[10]
Hence all these complexities should be adjusted in the Discussion piece of the study to draw correct lessons. When someone puts on a safety shield, it protects him; however, if the person succumbs, the onus may not lie on the shield but somewhere else. The person already may be too frail to generate an adequate immune response for fighting against the virus to begin with. If we want vaccine hesitancy to go away, all relevant observations should be analyzed in a truthful manner with complete transparency and all sides should be listened to. If we want conspiracy theorists to lose the game, openness is the key.
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References
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