Clinical Immunisations And Vaccinations Update Day: Fill & Download for Free

I’m gonna tell you a story, which you’re gonna initially read as aversion to a vaccine.Stick with me though, because I’m gonna bring it around to why we need it.So I’m about one or two years old, about to get my Measles Mumps and Rubella vaccination. I’m developing fine, all’s looking OK with me.I’m a fairly noisy baby who needs constant attention from mum and dad.All pretty normal.And then I get my MMR vaccination.I was too young to know what actually happened. All I have is my parents’ stories to go on. But after the vaccine, I became withdrawn and mute. They described it as a switch being flicked in me, it was such an instant change. Several doctors had said that I was autistic, though a child specialist informed my parents that it was more “traits” that I had, as opposed to fully-fledged autism (though, considering that autism is on a spectrum, I was and am a good ways away from neurotypical). There was talk of putting me into an institution for me to grow up, with special-needs workers to take care of me where my parents might not be able to.We don’t know what’s caused it. I’m still not fully convinced that it was the vaccine at all. My parents think that it was the vaccine that had an effect on me (they’re not antivaxxers, they just think that I had a bad reaction to it). But the point is that something ended up happening to me around the time I had my MMR vaccination.I’m twenty-four now, and it’s only thanks to my parents’ hard work and dedication that I’m not a totally invalid mute. We may have our squabbles and our differences, major blow-ups over philosophy debates and religious issues, but they refused to cash in on what happened to me and focused entirely on making sure that I was able to function in the world, and for that they have my eternal gratitude. Because of their effort, I went on to get my first-class undergraduate degree in Law and Spanish from the University of Glasgow, then my Masters-equivalent Diploma in Professional Legal Practice from there too, and I’m currently doing a PhD on AIs and personhood.Mum and Dad praise God for my recovery.I thank them.We’ll never know for sure, but there’s enough circumstantial evidence that indicates that the MMR injection had enough of an impact on me to send me into a weird mental state, one from which I was unable to communicate with anyone, one from which I was being considered for being institutionalised. My parents, the ones who never left my side since my birth, are convinced that the starting point in all of this was the vaccination. Humans are pattern-seeking animals with a bad habit of seeing conspiracy where there isn’t one, but my parents aren’t stupid.They’re iffy where science clashes with religion, but there’s nothing in the Bible about vaccines, unless you’re a kook who equates them with the Mark of the Beast.I’ve never wrote about this properly before. It feels weird talking about it now. And I’m still not fully recovered. I have an awful laugh that never quite got fixed, which I have to consciously temper. I have a tendency to hyperfixate on things, beyond the norm. I have trouble with social signs. My brain is a very literal machine, great at finding symbolism and metaphor in stories but not so much in finding hidden signals in real life. People are a struggle for me to relate to; I empathise, but it’s not the same as a relational understanding of them. This is why I despise the likes of John Searle’s Chinese Room experiment: he proposes that a machine-learning automaton can never be conscious, but my learning was far more mechanical than most. By the end of the process that took me from mute to scholar, I am now about as conscious as the illusions that our brains give us of conscious phenomena allow me to be.Hence where my PhD interest in AI and personhood comes from.So there’s enough there to suggest that a vaccine had an impact on me, whether that was through my brain or my development or whether I just didn’t like a needle and proceeded to wither into myself for years. I don’t know what happened, and I can only go by what my parents have told me. But the records from the doctors’ visits and the specialist clinics set out my symptoms (if not the cause) in black and white ink. I can still feel the effects of whatever did happen to me, and my family lived through all of it in trying to get me back to the soulless husk of a Scottish twenty-something with darkened heart and vantablack humour who writes to you on Quora today.So trust me when I say that I have very good reason to be wary.I could use this as an excuse to refuse another vaccine.But I’m not interested in doing that at all.Everyone’s allergic to something.I’m allergic, for instance, to suncream. It’s a really weird allergy to have, and I’m glad I don’t live in a hot country because of it! I just have to stick to the shade when the sun comes out in Scotland (like it ever does), and when I was living in Spain for a year I just had to stay indoors for as long as I could. Visiting Toledo was nice, though I did end up with sun poisoning from the exposure on one of the hottest days in that Spanish summer, so the after-effects weren’t much fun to deal with!One of my cousins has to carry around a card with her so that people can read her allergies, there’s that many! It makes finding a place to eat which will cater for her somewhat awkward, but it’s worth it to spend time together. Having said that, life would be a helluva lot easier if we didn’t have to try and work around our allergies, and I’m pretty sure she’d agree with me on that front.Vaccines are overwhelmingly safe to use. There are limited cases, like mine, where the vaccine has a bad effect on its recipient. But shaky evidence of the links between vaccines and autism aside, that’s on the same level of unfortunate as someone eating peanuts when they didn’t know that they were allergic to peanuts.Do you wanna know how they differ?You don’t need to eat a peanut to save lives.You can avoid a peanut and put nobody at risk.But this vaccine will be saving lives.We are all in this pandemic together. When the vaccine becomes available, it’s in our individual and collective best interests to take it. None of this “Mark of the Beast” bullshit, none of this “microchipping” nonsense. None of Letitia Wright’s crying out over Luciferase being used as a component in checking that the vaccine is safe. No “it’s gonna give your kids autism” as a disingenuous scaremongering tactic ripped out of the pages of Andrew Wakefield’s ‘research’ (a loose term at best for that charlatan). Zip and nada. We’re getting this vaccine because it’s going to save lives, because it’s going to stop a global pandemic which has brought the world to its knees.I want to be able to hug my gran.I want to be able to go out to Glasgow.I miss in-person lectures and meetings with my supervisors.I want to see my friends and find out how they’re doing face-to-face.I can’t do any of that until we’re cleared, though.And to be cleared, I need to take the vaccine.Now, one thing about my autistic traits is that they allow me to see things pretty much in terms of risk versus benefit. A small number of people may have a bad reaction to the vaccine. We don’t know the precise numbers of issues here. But there’s always gonna be those one or two cases that have a bad impact, which’ll fuel the antivaxxer movement to no end when they find one of these cases who are willing to step forward and attempt to take healthcare away from everyone else who needs it. Such a move is selfishness in the absolute extreme, and I can’t abide by it.My story isn’t going to hold people back from getting this vaccine. I won’t allow it to. If anything, I want people to take one simple lesson from my experiences. We’re all in this together. None of us had a choice in whether or not we were born, and it sucks when we have to put the collective first, but this is one of those times in which we have to do that. If there’s an ill-effect, then I’m sorry, but it’s either that or the world remains in lockdown. We owe it to our friends, our families, our relatives, and everyone we know and love to take this vaccine and to roll the dice on it, with the most excellent odds of there being no lasting damage. If the MMR did do something to me to trigger my issues, I’m still proud to have taken it, because taking it was the socially-responsible thing to do.I don’t want people to get measles, mumps, or rubella.I don’t want people to get COVID-19.We’re all a part of the human race, and we owe things to each other.We owe one another duties of care and trust and responsibility. We’re bad at caring for one another, and we’re very quick to make our judgements based on poor science and improbable odds. But studies done over millions of children have found absolutely no link between vaccines and autism, these tests have been done over and over again, and even if I am a weird outlier in their studies (which I’m still not fully convinced about, considering that there could have been a myriad of other reasons for my autistic onset), one odd in a million is not a bad deal in the slightest.It’s damn near miraculous odds, in fact.Bear in mind what the MHRA Chief Executive Dr June Raine said upon their board’s approval of the Pfizer vaccine for use in the UK:We have carried out a rigorous scientific assessment of all the available evidence of quality, safety and effectiveness. The public’s safety has always been at the forefront of our minds – safety is our watchword.I’m really pleased to say that the UK is now one step closer to providing a safe and effective vaccine to help in the fight against COVID-19 – a virus that has affected each and every one of us in some way - and in helping to save lives.We are globally recognised for requiring high standards of safety, quality and effectiveness for any vaccine. Our expert scientists and clinicians worked tirelessly, around the clock, carefully, scientifically, robustly and rigorously poring over hundreds of pages and tables of data, methodically reviewing the data.Vaccines are the most effective way to prevent infectious diseases. They save millions of lives worldwide.Want to hear more directly from her mouth?Here you go:The benefits of the Pfizer/BioNTech vaccine "far outweigh any risk", says Dr June Raine from UK regulator MHRAIn terms of other Covid vaccines, "further rolling reviews" are ongoing https://t.co/xL3BV4dr2M pic.twitter.com/ks9AvCVsWJ— BBC News (UK) (@BBCNews) December 2, 2020I’m trusting in the head of the UK’s medicinal regulatory body, I’m trusting in Dr Raine as its Chief Executive, a woman who is noted by her colleagues as having devoted her whole life to public health, over the rambling freak-outs of Karen on Twitter who’s “done her research”, any day of the week, month, or year.Dr Raine had the guts to stand up on national television to inform Prime Minister Boris Johnson and Minister for Health Matt Hancock that the UK’s speedy turnaround of the vaccine’s approval had nothing to do with Brexit, which the Conservative Party were trying to peddle as a win for their deranged nationalism (despite Pfizer being an American company with a Belgian site for vaccine production, while their partners BioNTech are German in origin):We have been able to authorise the supply of this vaccine using provisions under European law which exist until 1 January. Our speed, or our progress, has been totally dependent on the availability of data in our rolling review and the rigorous assessment and independent advice we have received. So I hope that clarifies the point about the European relationship.What a woman!I may not trust the Tories, but I do trust Dr Raine.So I’m pretty content to roll that dice and take the vaccine for COVID-19.If you decided to have kids, you consented to this sort of thing when you brought them into the world. You don’t get to protect them in bubble wrap forever, even if you’d like to. Maybe you thought that your family would never live to see a full-scale pandemic, but you did, and that was too myopic a worldview to have.That’s harsh, but it’s the truth.You and your families need the vaccine. There are cases like my own and that of Robert Fletcher, a UK man who suffered brain damage from the MMR vaccine and received a £90,000 pay-out in compensation, but our cases are not the norm. Millions of kids receive their inoculations, and they come out absolutely fine. If you choose to have a kid, you are choosing to roll that dice; I know myself that I have no interest in having kids, just in case my symptoms are hereditary, but I encourage taking the COVID-19 vaccine because it is the socially responsible thing to do.If you’re a kid, I’m sorry to say this, but we need everyone to play their part.I’m sorry that the world is so messed up, I’m sorry that we couldn’t get people to stay in their homes for long enough to stymie the virus. I’m sorry that monsters decided that their right to go out of the house without a mask was more important to them than life itself. I’m sorry that people felt so strongly about masks that they compared themselves to anti-Nazi freedom fighters when protesting against them. I’m sorry that people just had to take advantage of any shred of nice weather to venture out to beaches.I’m sorry that there’s millions of COVIDiots out there.I’m sorry that Dominic fucking Cummings exists.(If you’re not a Brit, or if you don’t know much of British politics, look up Cummings and his little road trip to Durham on Google. It’s one hell of a wild ride.)I’m sorry that the world is so pent up on capitalistic ecological suicide that the only way for the Earth to get a respite was to see us inside due to a deadly virus. I’m sorry, but humans are the worst things to happen to this planet in its 4.543 billion years of existence, and that we can’t even take a simple vaccine without politicising it or wrapping it up in the latest iteration of the Satanic Panic.I’m sorry that the COVID-19 vaccine has been turned into something so scary, that so many people refuse to take it on principle. Antivaxxers use stories like mine to make a general case for the billions of people whose lives this will save. They don’t actually care about people like me; all they care about is pushing their pseudoscience in an effort to look relevant or cool or cutting edge, promoting homeopathy or crystal healing or prayer as their solution instead of vaccinations founded on science.I’m sorry that it’s all come to this.But we need this vaccine before anyone else dies. We need widespread immunity. We need to be able to go outside again, and we need to be able to do that safely. Our lives, our health, our economy, our geopolitics, everything depends on this.This is a community effort, and we have to roll the dice.Even if you’re scared.Otherwise we’re never getting out of this mess.“Vaccines are the Devil’s work!”“They’re planning to mind-control you!”“Something something George Soros!”“Take a vaccine and you’ll be dead in weeks!”Yeah?Well, I’m the vaccine outlier here.There are people with far greater medical credentials than I will ever have, but there literally isn’t a single person who outranks me in these stakes. That sounds arrogant, but if the theories surrounding what happened to me are correct, then there really isn’t much higher you can go above that. I’ve been through the one in a million odds, I’ve rolled the dice, I’ve done all of that and got the T-shirt. If you’re an antivaxxer reading this, you’re dealing with your every wet dream right here in this answer; a real-life case of someone with whom the MMR vaccine didn’t quite agree.The one in a million.But unfortunately for those antivaxxers, I actually have a voice.And I’m using it to tell you to take the bloody vaccine.UPDATE 09/12Two health workers in the UK have suffered from an allergic reaction to the vaccine. This is not abnormal; as I have already stated in this and other posts, every form of treatment carries a risk of the chemicals not agreeing with the person taking them.The authorities in the UK are advising that people with histories of severe allergic reactions should not be taking the vaccine in light of this evidence, and this is a competent reason to not take it. In vaccination processes, large-scale immunity results in herd protection for those who cannot take vaccines; I lack some vaccines due to my own experiences with them, so I rely on others being immunised to protect myself.Professor Stephen Powis (national medical director of NHS England) has said this:As is common with new vaccines, the MHRA [Medicines and Healthcare products Regulatory Agency] have advised on a precautionary basis that people with a significant history of allergic reactions do not receive this vaccination, after two people with a history of significant allergic reactions responded adversely yesterday. Both are recovering well.[1]And the BBC’s health and science correspondent James Gallagher said:This is a story to assess with your head and not your gut.No effective medicine is without side effects so you have to balance the risk and the benefit.Remember, one in a thousand people in the UK have died after being infected with coronavirus this year and that figure is rising daily.Two people, out of thousands immunised yesterday, had an allergic reaction which they recovered from.Such reactions can happen with any vaccine and are treated with drugs such as steroids or adrenaline.[2]Bear the advice in mind, but don’t panic. Every treatment carries risks. If you have a known history of allergic reactions, listen to whatever advice is given by the nurses and give honest answers to their questions. So long as you’re paying attention to the guidance, and you’re keeping updated on developments as they arise, you should be absolutely fine. Stay safe and informed, don’t fall into some antivaxxer rabbit hole on Twitter and YouTube, and listen to the scientific and medical experts as the moving picture goes forward.They’re experts for a reason.UPDATE 13/12I apologise for disabling comments.More than a few antivaxxers have attempted to piggyback off of this answer to share their idiocy. I should have seen this coming, but I kept the comments open regardless because I don’t like turning them off. I tend to turn off comments for social justice answers, owing to Quora’s racists, but not for science; I can’t be awake at all hours to delete links to their conspiracy theories, though.If you wanted to leave a nice comment, consider it kindly received.If you’re an antivaxxer, fuck the fuck off.Footnotes[1] Allergy warning after reaction in two NHS staff given Covid vaccine[2] Covid-19 vaccine: Allergy warning over new jab

Many Hepatitis B (HBV) carriers are asymptomatic and unaware they're HBV positive. This is accompanied by ignorance that HBV can spread sexually (horizontally) (1, 2, 3, 4, 5, 6). One case report from Japan suggests this can even happen several decades later (7). Thus, HBV continues spreading to sexual partners. HBV's also transmitted vertically (perinatally from mother to child during birth or through breast milk) (8, 9), another seriously worrying issue for an HBV positive adult.Sounds like you're already several steps ahead. You know your HBV status and likely intend to proactively minimize risk to your future spouse and children, else you wouldn't be asking this question. Certainly, no bar to marriage and children since prophylaxis, i.e., disease prevention, to protect spouse and children greatly reduces their risk of HBV infection.What type of prophylaxis? Answer depends on your status: asymptomatic, chronic carrier, HBsAg+, HBsAg+ and HBeAg+, liver function test results, presence/absence of anti-HBV antibodies, to mention some of the most important factors. Attending physician should screen and periodically perform risk assessment to determine whether situation mandates spouse and child prophylactic vaccination alone or Rx with hepatitis B immunoglobulin and anti-virals as well. This means regular screening for you, the index case, your spouse and future children.What are rates of sexual transmission from infected to uninfected partner? What does HBV prophylaxis consist of for high-risk individuals (partners and children of HBV positive individuals) and how effective is it? These are some of the most pertinent questions for which the scientific literature has some answers.Rates of sexual transmission vary in different studiesAs few as ~5% in an Israeli survey (10).As many as 65% within two years of marriage in a Chinese survey (11).In an Iranian study (12),~65% in husbands of infected wives~46% in wives of infected husbandsMore efficient female-to-male HBV transmission has also been reported in Turkey (13).Selective vaccination of high-risk groups in Netherlands reduced HBV transmission (14). High-risk in this study meant men who have sex with men, drug users, commercial sex workers, heterosexuals with frequent partner changes.What about child/children? Vaccinate or vaccinate plus hepatitis B immunoglobulin post-birth? Decision depends on results of regular screening and risk factor assessment during pregnancy by attending physician (15).HBV vaccine is most effective in preventing vertical transmission when 1st dose is given within 24 hours of birth (16).2nd vaccine dose should be within 10 weeks of 1st dose, especially if hepatitis B immunoglobulin isn't given at birth (17).Timing is also important for hepatitis B immunoglobulin to be effective. Works best within 48 hours after single unprotected sexual exposure or parental exposure, not much use if given after >7 days (18).Treat pregnant mother with anti-viral as well? Again, decision needs to be made after consulting attending physician and is based on mother's HBV infection level. Is infection asymptomatic or chronic?For e.g., anti-viral lamivudine's effective in mothers with high levels of HBV viral DNA in the 3rd trimester (19).OTOH, if mother is circulating HBV antigen positive, i.e., HBsAg and HBeAg, 70 to 90% of her children will become HBV infected without immunoprophylaxis (20) while 5 to 20% children will be infected if mother is HBsAg+ but HbeAg- (21), i.e., much higher % children become infected if mother's positive for both HBsAg and HBeAg compared to HBsAg alone (22). At birth HBV vaccine of children born to HBsAg+ mothers greatly reduces transmission, >50 to >80% depending on vaccine used (23).So, this brief summary shows several options available to you and your future spouse and children. As well, many if not most countries have adopted universal childhood vaccination against HBV so children would anyway get vaccinated. Depending on your infection status, regular monitoring and risk assessment by attending physician would suggest whether spouse and children would need additional prophylaxis (immunoglobulin, anti-virals).Bibliography1. Inaba, N., et al. "Sexual transmission of hepatitis B surface antigen. Infection of husbands by HBsAg carrier-state wives." The British journal of venereal diseases 55.5 (1979): 366-368. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1045683/pdf/brjvendis00035-0054.pdf2. Alter, Miriam J., et al. "Hepatitis B virus transmission between heterosexuals." Jama 256.10 (1986): 1307-1310.3. Ko, Ying‐Chin, et al. "Female to male transmission of hepatitis B virus between Chinese spouses." Journal of medical virology 27.2 (1989): 142-144.4. Alter, Miriam J., et al. "Importance of heterosexual activity in the transmission of hepatitis B and non-A, non-B hepatitis." Jama 262.9 (1989): 1201-1205.5. Davis, L. Gray, DavidJ Weber, and StanleyM Lemon. "Horizontal transmission of hepatitis B virus." The Lancet 333.8643 (1989): 889-893.6. Struve, Johan, et al. "Heterosexual contact as a major route for transmission of acute hepatitis B among adults." Journal of Infection 20.2 (1990): 111-121.7. Okamoto, Daisuke, et al. "Molecular analysis of the interspousal transmission of hepatitis B virus in two Japanese patients who acquired fulminant hepatitis B after 50 and 49 years of marriage." Journal of medical virology 86.11 (2014): 1851-1860.8. Toy, Mehlika, et al. "Transmission routes of hepatitis B virus infection in chronic hepatitis B patients in The Netherlands." Journal of medical virology 80.3 (2008): 399-404. http://repub.eur.nl/pub/51635/110607_Toy-Mehlika.pdf#page=199. Cheung, K. W., M. T. Y. Seto, and S. F. Wong. "Towards complete eradication of hepatitis B infection from perinatal transmission: review of the mechanisms of in utero infection and the use of antiviral treatment during pregnancy." European Journal of Obstetrics & Gynecology and Reproductive Biology 169.1 (2013): 17-23. http://www.pfizerpro.com.co/sites/g/files/g10020151/f/publicaciones/2013_169_1_Towards-complete-eradication-of-hepatitis-B-infection-from-perinatal-transmission-review-of-the-mechanisms-of-in-utero-infection-and-the-use-of-antiviral-treatment-during-pregnan.pdf10. Zamir, D., C. Zamir, and S. Rishpon. "Epidemiology of hepatitis B virus infection among family members of chronic carriers in Israel." The Israel Medical Association Journal: IMAJ 3.5 (2001): 338-340. http://www.forum.ima.org.il/FilesUpload/IMAJ/0/57/28988.pdf11. Hesketh, Therese. "Getting married in China: pass the medical first." BMJ: British Medical Journal 326.7383 (2003): 277. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1125129/pdf/277.pdf12. Roushan, Mohammad Reza Hasanjani, Minoo Mohraz, and Ali Akbar Velayati. "Possible transmission of hepatitis B virus between spouses and their children in Babol, Northern Iran." Tropical doctor 37.4 (2007): 245-247.13. Erol, Serpil, et al. "Intrafamilial transmission of hepatitis B virus in the eastern Anatolian region of Turkey." European journal of gastroenterology & hepatology 15.4 (2003): 345-349.14. Hahné, Susan, et al. "Selective hepatitis B virus vaccination has reduced hepatitis B virus transmission in the Netherlands." PloS one 8.7 (2013): e67866. http://www.plosone.org/article/fetchObject.action?uri=info:doi/10.1371/journal.pone.0067866&representation=PDF15. Wong, VivianC W., et al. "Prevention of the HBsAg carrier state in newborn infants of mothers who are chronic carriers of HBsAg and HBeAg by administration of hepatitis-B vaccine and hepatitis-B immunoglobulin: double-blind randomised placebo-controlled study." The Lancet 323.8383 (1984): 921-926.16. Lee, Chuanfang, et al. "Effect of hepatitis B immunisation in newborn infants of mothers positive for hepatitis B surface antigen: systematic review and meta-analysis." Bmj 332.7537 (2006): 328-336. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1363909/pdf/bmj33200328.pdf17. Tharmaphornpilas, Piyanit, et al. "Increased risk of developing chronic HBV infection in infants born to chronically HBV infected mothers as a result of delayed second dose of hepatitis B vaccination." Vaccine 27.44 (2009): 6110-6115. http://thaigcd.ddc.moph.go.th/uploads/knowledge/4e27af902aa5b.pdf18. Zuckerman, J. N. "Review: hepatitis B immune globulin for prevention of hepatitis B infection." Journal of medical virology 79.7 (2007): 919-921.19. Xu, W‐M., et al. "Lamivudine in late pregnancy to prevent perinatal transmission of hepatitis B virus infection: a multicentre, randomized, double‐blind, placebo‐controlled study." Journal of viral hepatitis 16.2 (2009): 94-103.20. Stevens, Cladd E., et al. "HBeAg and anti‐hbe detection by radioimmunoassay: Correlation with vertical transmission of hepatitis B virus in Taiwan." Journal of medical virology 3.3 (1979): 237-241.21. Mahoney, Francis J. "Update on diagnosis, management, and prevention of hepatitis B virus infection." Clinical microbiology reviews 12.2 (1999): 351-366. Update on Diagnosis, Management, and Prevention of Hepatitis B Virus Infection22. Chen, Huey–Ling, et al. "Effects of maternal screening and universal immunization to prevent mother-to-infant transmission of HBV." Gastroenterology 142.4 (2012): 773-781.23. Xu, Zhi-Yi, et al. "Prevention of perinatal acquisition of hepatitis B virus carriage using vaccine: preliminary report of a randomized, double-blind placebo-controlled and comparative trial." Pediatrics 76.5 (1985): 713-718.Thanks for the A2A, Pratap Singham.

Even though the coronavirus vaccine developed by American pharma giants Pfizer and BioNTech will be rolled out next week elsewhere in the world, it is unlikely to be available in India anytime soon. Before its arrival, the vaccine needs to clear clinical trials in the country. As per updates, neither Pfizer nor BioNTech have asked the Central government to hold such trials. This clearly reflects that even if Pfizer partners with an Indian company now, it will take some time for the vaccine to be available in the country. However, it will not be available anytime soon.Covid-19 is a very smart virus, it goes to your lungs before being symptomatic and we have individuals who are asymptomatic and you can see patches in their lungs at the CT scans directly. It really bypasses a person's defence mechanism, which means that you not only have the virus in your nose or throat but it has gone right into your lungs. A virus which can do that, have varied presentations and cause such a systemic manifestation is something we have to be wary of. It will stay around for sometime and we will have to live with it and control it. India will look for cheaper alternatives to Pfizer and assured safety from any vaccine clinical trial studies. India will not push the vaccine needles in a break-neck hurry and invite public wrath. It will adopt slow, steady and doubly cautious approach for mass immunizations.The mRNA Pfizer vaccine will need to be stored at minus 70 degrees; this is becoming a challenge even in the US, while in India a national rollout of something like this will be impossible. This is why most national immunisation programmes, especially in countries like India, would look to choose a vaccine that is easier to administer. The vaccine may run into logistical issues on account of cold storage — the candidate reportedly needs to be stored at temperatures below -90°F. This would require an ultra-cold storage system, as storing it at refrigerated temperatures reportedly for more than two days may render it ineffective.This means major constraints in storage and distribution in countries like India, which is still mapping and scaling up its cold storage footprint to store even vaccines at refrigerated temperatures. Even countries with more robust cold chain systems may have to invest more to adhere to these stricter conditions. Moreover, Pfizer vaccine needs to be covered in dry ice for 10 days during transport. This is also difficult. India does not have minus 70 degrees Celsius ultra cold storage system at present to make available Pfizer in local medical shops.