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Published on: Apr 04, 2020
3 minute read
By: Dr Rajan Choudhary

Developing A Vaccine For COVID-19? Part 1

It is often stated vaccination has made the greatest contribution to global health of any human discovery, other than clean water and sanitation, and their impact on everyday life is immediately evident. We have managed to completely eradicate two major infections from existence (smallpox and rinderpest) , and the WHO are working towards adding polio to that list.

In these cases the numbers speak for themselves. It is estimated that the eradication of smallpox in 1980 has saved 5 million lives per year, adding up to 150 to 200 million by 2018. Common vaccination programmes for polio, measles, mumps, rubella, rabies and hepatitis A have prevented nearly 200 million cases from occurring in the US alone over the past 50 years, and 4.5 billion instances of the diseases worldwide.

We have achieved a 99% immunisation rate against polio, preventing children from suffering crippling paralysis, and only 3 countries remain. Sadly, around 1.4 million children under 5 still die from preventable diseases each year as they do not have access to these life saving vaccines, but charities and public health organisations around the world are working hard to improve access.

So what are vaccines? And how will they help is in the face of the latest pandemic? Here we will go into the challenges behind making vaccines, and why a vaccine against COVID-19 is unlikely to be ready in the next few months, or even this year.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4024226/ contribution of vaccination

https://www.who.int/features/factfiles/polio/en/ polio eradication

https://www.sciencedaily.com/releases/2017/03/170303163208.htm study article

WHAT IS A VACCINE

The human body’s immune system is incredibly smart. It is able to distinguish between infective organisms, such as bacteria, viruses and parasites, from our own body’s cells, target these invaders for destruction and keep our bodies healthy. Even better, the body remembers any previous infections it has had before, recognise these previous infections even quicker and even eradicate the disease before we know we are infected.

Vaccines target the immune system’s memory by presenting them with pieces of these infective diseases. The small amounts do not cause any infective symptoms, but if the person is infected later in life their body will mount a quicker response and prevent them from falling ill. These vaccines can contain broken up parts of the organisms, “dead” organisms or “live” versions that have been severely weakened so they cannot cause any harm.

In summary, medicines treat us when we get an infection. Vaccines make sure we never suffer from an infection in the first place.

https://www.chop.edu/centers-programs/vaccine-education-center/making-vaccines/how-are-vaccines-made Making Vaccines

THE HURDLES WE FACE IN RESEARCH

Making a vaccine is a difficult process, one that can take 3–5 years and cost hundreds of millions of dollars, sometimes billions of dollars. This is because there are many difficult steps to be taken in the process of creating a vaccine that is effective, but more importantly one that is safe.

To start with the troubling organism has to be identified. For COVID-19 it took a few weeks to recognise the virus responsible, and some time more to understand its genetic code and grow the virus in lab conditions. We then have to understand the virus, how it infects, how it causes symptoms, and how it has mutated compared to the coronaviruses responsible for SARS and MERS.

After this, we have to isolate parts of the virus our immune system will recognise. This is usually the outside coat of the virus. The DNA responsible for making these parts need to be found in the virus’ genetic code, and put inside other “skeleton” viruses. This will force the dummy virus to look like coronavirus, without the ability to infect and kill someone.

These dummy viruses can be injected into animals to see if it causes an immune reaction, whether the immune system recognises it as the coronavirus responsible for COVID-19, and whether it will protect the animal from the real COVID-19. Up to now the research has likely cost a few million dollars. The next step is when the price inflates up to billions.

If the vaccine appears safe in animals, it can be tested in humans. This can be dangerous at first, since we don’t know whether a vaccine that works in an animal will work in a human. And we don’t know if there will be any side effects to the vaccine. Human testing has to be very thorough, very careful, and safe for use. If you give too much of the virus it might make the person sick, too little and it wont immunise the person. These clinical trials can take years, and if the vaccine fails at this point its back to the drawing board, to try another step.

https://www.theatlantic.com/politics/archive/2014/10/how-to-make-an-ebola-vaccine-5-simplified-steps/454443/ ebola vaccine

Now we have a basic understanding of what vaccines are and why it takes so long to make a vaccine. In the next part we will look at why viral vaccines can cause even more problems, and how far we have come with the COVID-19 vaccine,

Dr Rajan Choudhary, London UK

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why fatigue should not be ignored

Feeling tired occasionally is a normal response to physical exertion, lack of sleep or emotional stress. However, when fatigue becomes persistent, overwhelming or unexplained, it should not be dismissed. Fatigue is one of the most common symptoms reported in healthcare, yet it is also one of the most frequently ignored.

Understanding why fatigue should not be ignored is essential because it often acts as an early warning sign of deeper physical or mental health issues.

What Is Fatigue?

Fatigue is a state of ongoing physical, mental or emotional exhaustion that:

lasts longer than expected
interferes with daily activities
does not improve with rest or sleep

Unlike ordinary tiredness, fatigue affects motivation, concentration and overall functioning.

Why Fatigue Is Commonly Ignored

Fatigue is often dismissed because:

busy lifestyles normalise exhaustion
symptoms develop gradually
people attribute fatigue to stress or ageing
rest temporarily masks the issue

Ignoring fatigue allows underlying conditions to progress unnoticed.

Common Medical Causes of Persistent Fatigue

Nutritional Deficiencies

Deficiencies in:

iron
vitamin B12
vitamin D
magnesium

can significantly reduce energy levels and cause weakness.

Anaemia

Anaemia reduces oxygen delivery to tissues, leading to:

constant tiredness
breathlessness
dizziness

It is one of the most common yet underdiagnosed causes of fatigue.

Thyroid Disorders

Both underactive and overactive thyroid conditions affect metabolism.

Symptoms include:

fatigue
weight changes
cold or heat intolerance

Thyroid-related fatigue often persists despite rest.

Chronic Infections

Low-grade or unresolved infections keep the immune system activated, causing prolonged fatigue.

Hormonal Imbalance

Hormones regulate energy, sleep and metabolism.

Imbalance may lead to:

exhaustion
poor sleep
low motivation

Poor Sleep Quality

Even with sufficient sleep duration, poor sleep quality can cause fatigue due to:

sleep apnea
frequent awakenings
stress-related insomnia

Mental Health Conditions

Anxiety, depression and chronic stress commonly present with fatigue as a primary symptom.

Mental fatigue is as real and impactful as physical fatigue.

Lifestyle Factors That Worsen Fatigue

Certain habits intensify tiredness:

irregular meals
excessive caffeine
dehydration
lack of physical activity
prolonged screen use

Lifestyle-related fatigue often coexists with medical causes.

How Fatigue Affects Daily Life

Persistent fatigue impacts:

work performance
concentration and memory
emotional regulation
physical activity
social relationships

Over time, quality of life declines significantly.

Warning Signs That Fatigue Needs Medical Attention

Seek evaluation if fatigue:

lasts more than two weeks
worsens progressively
occurs with weight loss or fever
is associated with breathlessness
interferes with daily tasks

These signs suggest an underlying issue.

Why Early Evaluation Matters

Early identification of fatigue causes:

prevents disease progression
simplifies treatment
improves recovery time
restores normal energy levels

Delayed care often leads to chronic complications.

Diagnostic Evaluation for Fatigue

Assessment may include:

detailed history
blood tests
nutritional screening
hormonal evaluation
sleep assessment

Testing helps identify root causes rather than treating symptoms alone.

Can Fatigue Be Prevented?

Some preventive measures include:

balanced nutrition
adequate hydration
regular physical activity
consistent sleep routine
stress management

However, prevention does not replace evaluation when fatigue persists.

Fatigue and Chronic Disease Risk

Long-term fatigue may be linked to:

cardiovascular disease
metabolic disorders
immune dysfunction

This makes fatigue an important early health signal.

When Rest Is Not Enough

If energy does not return after:

adequate sleep
reduced workload
lifestyle changes

medical evaluation is essential.

The Cost of Ignoring Fatigue

Ignoring fatigue can lead to:

delayed diagnosis
worsening health conditions
reduced productivity
emotional burnout

Listening to the body early prevents long-term consequences.

Conclusion

Fatigue is not merely a sign of a busy life—it is often the body’s way of signalling imbalance or illness. Persistent tiredness that does not improve with rest should never be ignored. Whether caused by nutritional deficiencies, hormonal changes, chronic stress or underlying disease, fatigue deserves attention. Early evaluation and timely care can restore energy, prevent complications and significantly improve quality of life. Listening to fatigue is an act of self-care and preventive health.

References

Indian Council of Medical Research (ICMR) – Fatigue and Lifestyle Health Report
World Health Organization (WHO) – Chronic Fatigue and Health Guidelines
National Institute of Nutrition (NIN) – Nutrient Deficiency and Energy Research
Lancet – Fatigue as a Marker of Chronic Disease Studie
Indian Journal of Medicine – Persistent Fatigue and Diagnosis
Statista – Fatigue, Stress and Health Trend Analysis

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