Monday, May 24, 2021

A shot in the arm

Conversations with my parents these days are only about Covid.  "There is a constant feeling of fear," my father remarked.  So did my mother.

I told them that vaccines are the key, and that there is no way out otherwise.  I drew a parallel with polio.  "They are doing research to develop tablet version of the vaccines," I told them.  Tablet is the Indian usage for a pill; to communicate, one needs to use the relevant usage.  I recall the confusion on a male student's face when as a fresh-off-the-boat student I asked him where the lift.  How would he know that I was referring to the elevator!

The tablet will be easy to administer, without the logistical hassles of the below-freezing temperatures needed for most of the Covid vaccines.  Imagine the Pfizer vaccine as a pill.  That will be a game-changer!

Pfizer’s experimental oral drug to treat Covid-19 at the first sign of illness could be available by the end of the year, CEO Albert Bourla told CNBC on Tuesday.

The company, which developed the first authorized Covid-19 vaccine in the U.S. with German drugmaker BioNTech, began in March an early stage clinical trial testing a new antiviral therapy for the disease.

Of course, there are also others in the race to develop an oral Covid vaccine.  But, until then, it will be shots.  Injections, which is the usage in India.

But, why the shots in the arm?

For one, easy access.  Imagine if every one of us has to get the injections in the buttocks.  It can't be done in the open.  I certainly do not want to reveal my bony butt to the world!

But, the buttocks too are sometimes the locations for injections.  Why the buttocks or the arm?  "Muscles make an excellent vaccine administration site because muscle tissue contains important immune cells."

Aha!

These immune cells recognize the antigen, a tiny piece of a virus or bacteria introduced by the vaccine that stimulates an immune response. In the case of the COVID-19 vaccine, it is not introducing an antigen but rather administering the blueprint for producing antigens. The immune cells in the muscle tissue pick up these antigens and present them to the lymph nodes. Injecting the vaccine into muscle tissue keeps the vaccine localized, allowing immune cells to sound the alarm to other immune cells and get to work.

Hence, the shot in the arm.

And, yes, injections in the arm are recent.  They are one of the many ways in which modern medicine has transformed our lives.  The literal "shot in the arm" that dates back to early 20th century is now also used as an idiom, as a metaphor, in discussions like a Keynesian economic stimulus program.  I suppose taking a pill will not be a powerful metaphor in the stimulus talks!

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