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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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Pale Skin Symptoms: Causes, Health Conditions, and When to Seek Medical Care

Skin colour provides important clues about internal health. When the skin becomes noticeably lighter than usual, it may indicate an underlying medical condition. Pale skin symptoms, also referred to as pallor, are commonly associated with reduced blood flow, low hemoglobin levels or impaired oxygen delivery to tissues.

In India, pale skin is frequently linked to anemia, nutritional deficiencies and chronic illnesses, making early recognition essential.

What Is Pale Skin?

Pale skin refers to:

lighter-than-normal skin tone
reduced redness
pale appearance of lips, gums or nail beds

It can affect the entire body or specific areas such as the face or hands.

Common Pale Skin Symptoms

Typical signs include:

pale face or complexion
pale lips or tongue
light-colored gums
pale nail beds
cold hands and feet
fatigue and weakness

These symptoms often occur together.

Most Common Causes of Pale Skin

Anemia

Anemia occurs when hemoglobin levels are low.

This reduces oxygen delivery to tissues, causing:

pale skin
fatigue
breathlessness
dizziness

NFHS-5 reports anemia affects a large proportion of Indian adults, especially women.

Iron Deficiency

Iron deficiency is the leading cause of anemia.

Contributing factors include:

poor dietary intake
blood loss
absorption problems

ICMR identifies iron deficiency as a major public health issue.

Poor Blood Circulation

Reduced circulation causes:

less blood reaching the skin
visible pallor

Conditions such as heart disease or shock impair circulation.

Acute Blood Loss

Sudden blood loss from:

injury
gastrointestinal bleeding
heavy menstrual bleeding

can cause rapid pallor and weakness.

Chronic Diseases

Chronic illnesses such as:

kidney disease
liver disease
cancer

often cause anemia and pallor over time.

Infections and Inflammation

Severe infections cause:

blood vessel constriction
redistribution of blood flow

This leads to pale or clammy skin.

Nutritional Deficiencies

Deficiencies of:

vitamin B12
folate

affect red blood cell production and cause pallor.

Hormonal Imbalance

Conditions like hypothyroidism reduce metabolic activity, causing:

pale, dry skin
fatigue

Thyroid disorders are common but underdiagnosed.

Genetic Conditions

Inherited disorders such as thalassemia affect hemoglobin production, leading to chronic pallor.

Pale Skin in Children and Older Adults

Children:

may develop pallor due to iron deficiency or infections

Older adults:

often develop pallor due to chronic disease or nutritional deficiency

Both groups need careful evaluation.

Warning Signs That Need Immediate Medical Attention

Seek urgent care if pale skin is associated with:

sudden weakness
chest pain
breathlessness
fainting
rapid heartbeat

These may indicate serious medical emergencies.

How Pale Skin Affects Daily Life

Persistent pallor often causes:

low energy
reduced physical endurance
difficulty concentrating

Quality of life may decline without treatment.

Diagnostic Evaluation

Doctors may recommend:

complete blood count
iron studies
vitamin B12 and folate levels
kidney and liver function tests

Identifying the cause is critical for treatment.

Role of Preventive Health Checkups

Preventive screening helps detect:

early anemia
nutritional deficiencies
chronic disease

Early treatment prevents complications.

Management and Treatment Options

Treatment depends on cause and may include:

iron or vitamin supplementation
treatment of underlying disease
dietary correction
medical therapy for chronic conditions

Self-treatment without diagnosis should be avoided.

Lifestyle Measures to Prevent Pallor

Helpful strategies include:

balanced diet rich in iron and vitamins
adequate hydration
regular health monitoring
treating infections early

Lifestyle changes support long-term health.

Importance of Early Detection

Ignoring pale skin delays diagnosis of:

anemia
internal bleeding
chronic illness

Early recognition improves outcomes.

Conclusion

Pale skin symptoms are more than a cosmetic concern. They often signal anemia, poor circulation, nutritional deficiencies or underlying medical conditions. While temporary pallor may occur due to minor causes, persistent or sudden pale skin requires medical evaluation. Early diagnosis, preventive health screening and appropriate treatment can restore normal skin tone, improve energy levels and protect long-term health.

References

Indian Council of Medical Research (ICMR) – Anemia and Nutritional Deficiency Reports
National Family Health Survey (NFHS-5) – Anemia and Adult Health Data
World Health Organization (WHO) – Anemia and Circulatory Health
Lancet – Pallor, Anemia and Chronic Disease Research
NITI Aayog – Preventive Healthcare and Early Symptom Detection

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