Archive for 2020

COVID-19 Vaccines- should you get one? Are they safe? Dr Malik Explains

The vaccines are available in the UK. Russia started marginally before the UK, with Sputnik-V in December 2020. Margaret Keenan, a 90-year-old grandmother, became the first to receive the Pfizer COVID-19 vaccine in the UK outside of clinical trials.

How do vaccines work?

Vaccines work by preparing a person’s immune system (the body’s natural defences) to defend itself against a specific disease.  Most COVID-19 vaccines involves generating responses to all or part of a protein (spike protein, or protein S) that is unique to the virus (SARS-CoV-2) that causes COVID-19 disease.

When a person receives the vaccine, it will trigger an immune response. It is hoped that that response is protective, and long-lasting.


What types are there?

  1. Oxford/Astra-Zeneca Vaccine: ChAdOx1-SARS-CoV-2- modified common cold virus in primates- cost possibly <$4
  2. BionTech/Pfizer: mRNA SARS-CoV-2- BNT162b2- cost possibly $20
  3. Moderna: mRNA-1273 SARS-CoV-2-cost possibly $33
  4. Russian Sputnik V: Human adenovirus based vaccine-cost possibly $10


There are others, but the UK has bought the BionTech/Pfizer vaccine initially and is rolling out the program starting with the most at risk- those >80 yrs old.  All will require two doses of the vaccine, usually 21 days apart. You will not be protected until your body has reacted to both doses.


Who should get the Vaccine?

The Joint Committee on Vaccination and Immunisation (JCVI) advises that the first priorities for any COVID-19 vaccination programme should be the prevention of COVID-19 mortality and the protection of health and social care staff. Secondary priorities could include vaccination of those at increased risk of hospitalisation and at increased risk of exposure.

The priotity list as of December 2020 was:

This priority list is as follows:

  • residents in a care home for older adults and their carers
  • all those 80 years of age and over and frontline health and social care workers
  • all those 75 years of age and over
  • all those 70 years of age and over and clinically extremely vulnerable individuals[footnote 1]
  • all those 65 years of age and over
  • all individuals aged 16 years to 64 years with underlying health conditions which put them at higher risk of serious disease and mortality
  • all those 60 years of age and over
  • all those 55 years of age and over
  • all those 50 years of age and over


Should I have it if offered?

Yes- if you are in an at risk group, then the risk of the vaccine ( which is small) is worth it.

The science behind them is strong.

The exact benefit and how long immunity will last is not certain. What is certain is that COVID-19 disease can be deadly.


I have had COVID-19- am I protected?

Cases of reinfection have now been reported world-wide- either because immunity wanes, or a new strain of virus overcomes the bodys’ immune response. You should still get the vaccine if offered to you


I am pregnant- should I have the Vaccine?

There is no trial that has looked at pregnancy- the UK advises against the vaccine in pregnancy.


Characteristics of  COVID-19 vaccine trials

Moderna Pfizer AstraZeneca (US) AstraZeneca (UK) Janssen Sinopharm* Sinovac
Vaccine name mRNA-1273 BNT162 AZD1222 AZD1222 Ad26.COV2.S Sinopharm vaccine Sinovac CoronaVac
Target enrolment 30 000 43 998 30 000 19 330 60 000 45 000 8870
Ages eligible 18+ 12+ 18+ 5-12, 18+ 18+ 18+ 18+
Protocol publicly available Y Y Y N Y N N
Notable excluded populations:
Children and adolescents Excluded Many excluded Excluded 13-17 excluded Excluded Excluded Excluded
Immunocompromised patients Excluded Excluded Excluded Excluded Excluded Excluded Excluded
Pregnant or breastfeeding women Excluded Excluded Excluded Excluded Excluded Excluded Excluded
Endpoints undergoing formal study:
Prevention of symptomatic disease in vaccine recipient Y Y Y Y Y Presumably§ Y
Reduction in severe covid-19 (hospital admission, ICU, or death) N N N N N N N
Interruption of transmission (person to person spread) N N N N N N N

Managing Severe Symptomatic Aortic Stenosis- with Dr Iqbal Malik

Severe Symptomatic Aortic Stenosis (SSAS) is a life threatening condition. Treatments include:

  1. Open Heart Surgery- Surgical Aortic Valve Replacement (SAVR)
  2. Transcatheter Aortic Valve Replacement (TAVR or often called TAVI in the UK)

This series of talks for medical professionals shows some of the issues in choosing the best treatment options. The key is informed choice. Dr Malik leads the TAVI team at Hammersmith Hospital, Imperial College Healthcare NHS Trust, London, and is a leading authority on Aortic stenosis and its treatment.

Dr Malik Performs Day-case TAVI to help a patient with aortic stenosis

TAVI (Transcatheter Aortic Valve Intervention) is a treatment for Aortic Valve Stenosis (AS).  AS can lead to chest pain, blackouts, heart failure and death if left untreated.

Mr Gilchrist had his TAVI done as a day-case procedure- Into hospital in the morning, out in the evening. Dr Malik did a series of such cases at the height of the 1st wave of COVID. It proves it can be done! In the second wave, he hopes that the NHS will not cancel as many elective cases-such as TAVI and cancer, where delays may lead to bad outcome.

Watch the procedure here.

He also published his own story in the papers:

Dr Malik helps train the resuscitation team during the COVID 19 crisis

With the number of cases of SARS-CoV-2 rising again, it will become relevant to medical professionals to protect themselves from the disease, especially during Aerosol Generating Procedures (AGPs) such as resuscitation. This video was made at the start of wave 1 of the disease in the UK< and has been seen over 100,000 around the world. Dr Malik and his team created it to help medics perform resuscitation safely.  No patient is harmed in this video- It is a mannequin!

If you want to know what happens inside the hospital- watch this:

Sadly, the training may well come in handy as cases start to rise.

Dr Malik talks about COVID-19 disease

Want to Know more about SARS-CoV-2 (COVID-19 Disease) as the second wave comes to the UK? Dr Malik has done a simple video to help you understand what it is. It was aimed at school kids who might be thinking of applying to medical schools. The information is relevant to all who want a refresher on what the Pandemic is about.

Simple measures help:

  1. Socially distance and avoid unnecessary contact and travel
  2. Hand washing
    1. Perhaps gloves when needing to touch things outside the house
    2. Avoid touching your face
    3. Face masks (more to protect others from you than you from others)