I received my first dose of the Pfizer-BioNTech coronavirus vaccine on a Wednesday, as soon as a vaccination slot opened up at my hospital. That jab started a countdown in my head:
- The standard 15 minutes to watch out for allergic reactions to the vaccine.
- Twenty-one days until I get the second dose.
- Then seven more days for the main event, the show we’ve all been waiting for: 95% efficacy.
Part of me felt relief. An end to a long chapter of global suffering finally seemed within reach. But another part of me felt a new incarnation of fear. As we get closer to the finish, how many people will last long enough to be rescued?
I became a doctor seven months ago at the crest of the first deadly wave of the pandemic when time was of the essence — so much so that I graduated medical school early to help in the intensive care unit of a New York City hospital. Now, I wonder, “Can I go another 28 days without getting infected? And in the meantime, how many people will die in the meantime while they wait for a dose of the vaccine reserved for my arm?”
Time is on my mind these days. The minutes I spend with one patient seem subtracted from another. And when I ask people about their coughs, aches, or shortness of breath, I need to know when they started, whether they come or go, whether they’re worse in the morning or at night. Their timing matters. Some diseases, like Covid-19, can manifest almost overnight. Others, like diabetes, heart failure, and cancer, take far longer before making themselves known.
Sometimes I wonder, in the time between time, whether my patient’s illness begin when I became a doctor? Or might it have started earlier, on my first day of medical school? Did it take shape when the idea of becoming a doctor first inspired me as a boy? How long have my patients’ diseases been waiting to meet me, and how long have I been preparing for them?
A lot of digital ink has been spilled on the “unprecedented pace” of developing these vaccines, which has been both a source of national pride and a cause of concern to those hesitant about a rushed injection. Some folks want to wait and see. They want more time.
But these vaccines hark back to the early 2000s with the SARS vaccine research program and were refined after the first reports from Saudi Arabia of Middle East respiratory syndrome (MERS), another relative of Covid-19. And the science that underwrites them was established even longer ago, with the understanding of mRNA and ribosomes and, even further back, with the notion of DNA as the precursor to proteins — long before I was born.
On my first day as a doctor, all of my patients had Covid-19. Most were intubated; some had spent months on a ventilator. Few woke up. Among the handful who made it off their ventilators, some experienced prolonged delirium, and it took days to retrain their muscles for speech.
“It’s time,” one of my patients said, the first words he had whispered. “It’s time,” he repeated, “for me to die.”
The Covid-19 unit in our emergency department is filling up again. Just a few weeks ago, one physician at a time was enough to staff it with crucial nursing support, but the influx of patients is outpacing us. We need help from a vaccine. Vaccines are the endgame.
I feel a deep gratitude toward the thousands of people who participated — and those who continue to participate — in vaccine trials. They have risked their health and given their time to provide a measure of certainty to those, like me, who benefit from getting a Covid-19 vaccine. In the auditorium where I received the shot, I had a glimpse for a moment into a time when Covid-19 will feel as archival as the 1918 flu, because so little of our lives will resemble it. It will be a time we hardly think of anymore.
That time is coming. I’ll be counting it down.
Adam Lalley is a first-year resident in emergency medicine at Maimonides Medical Center in Brooklyn, N.Y.