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From the Desk of Dr. Moser: The Disease Can Kill You But You Don’t Want the Vaccine?

We’re a year into the most serious pandemic in our lifetimes. It’s infected over 26 million and caused or contributed to the deaths of over 440,000 people in the U.S. alone. Those numbers will be higher when you read this.

We now have two vaccines with a very high effectiveness rate of 94% and others being processed for approval. It will save many lives and avoid much suffering. But it could save a lot more than initial data is suggesting it will. Why? Because a significant number of people to whom it is offered aren’t taking it. 

There are a few situations where one shouldn’t — a history of severe allergic reactions (anaphylaxis) or a current active COVID infection. There are reasons to delay — by 30 days after you’ve recovered from COVID or 90 days if you received a monoclonal antibody infusion. And then there is a slew of reasons that don’t stand up to facts or risk comparison against the disease itself. Let’s look at some of them and why avoiding the vaccine is almost always a bad idea.

“COVID-19 is a hoax.”

There are apparently still people who believe this. No one in our ICU does. It’s real and it’s bad.

“I refuse to be a “‘guinea pig.’”

The vaccines have been thoroughly tested in people within the time frame available. 43,000 people participated in the clinical trial for the Pfizer vaccine alone.  But if you feel it is still “experimental” and choose not to receive the vaccine, you will be a “guinea pig” anyway. How? You will be in the control group — people who didn’t take the vaccine — to compare rates of infection, morbidity, and mortality against those who took it.

“Development of the COVID vaccine has been rushed, so it’s unsafe.”

The vaccines have been developed and produced in record time. That’s a tribute to the pharmaceutical industry, which had been working toward mRNA vaccines for years. It was able to build on that foundation while rapidly expanding production facilities. Recruitment of volunteers for clinical trials was successful enough to complete the normal three phases in reduced time and gain approval in the U.S., U.K., and elsewhere. Results indicate that all versions are safe and effective. 

However, at present over 13,000 people per day are dying from COVID-19 worldwide. It would have been irresponsible and unethical to withhold the vaccine for a couple years to collect more data while so many preventable deaths continue. Long-term follow-up studies are ongoing. Meanwhile, the more-infectious British strain is predicted to become dominant in the U.S. by March and further increase the infection rate. Data so far indicates that it and other mutated strains are covered by the vaccines.

“All vaccines are bad.”

Vaccination grew out of the use of a mild disease, cowpox, to prevent a related but severe and often fatal disease, smallpox. That was 1796. So the principle is not new, and many advances have been made in this and other vaccines over the last 224 years. As a result, smallpox, once a leading cause of death on the planet, has actually been eliminated.

However, there is a social movement that first came about in the late 1800s and was recharged by a thoroughly discredited 1998 paper in the journal Lancet, which later retracted it due to falsified data. It claimed that vaccines cause autism. No matter how many times studies have disproved it, the anti-vax movement persists. Followers refuse all vaccines including measles, a vaccine-preventable disease that killed over 207,000 unvaccinated people worldwide in 2019. If you are persuaded by this anti-scientific movement, just know the risk you take.

“The risk of the vaccine is higher than the risk from COVID-19.”

No. The vaccine can cause minor discomforts and fatigue for about 24 hours. Rarely, someone develops a serious allergic reaction, just as some people get from peanuts, shellfish, bee stings, etc. Those who have other such serious allergies may choose to forego the vaccine. If a serious reaction happens, it’s within minutes of the shot, is treated on-site, and goes away with treatment. 

On the other hand, COVID-19 is a bad crapshoot. Yes, the overall risk of death is under 1% — though it’s much higher if you are chronically ill or over 65. But as many as 20 percent of those who recover have persistent shortness of breath, cardiac, or intestinal symptoms, severe fatigue, loss of taste and smell, and neurologic symptoms. And youth and health are not guarantees against mortality. Many who have died were young and otherwise healthy. The disease is unpredictable and, for those who are dragged into such a tragic course, it’s unstoppable. As the vaccine becomes available, such deaths will be preventable. But only for those who are vaccinated.   

“I’ll wait for herd immunity and I’ll be protected.”

No, you won’t be protected. “Herd immunity” is not immunity, it’s just low probability. It applies when a large majority of a population — usually over 90% — have become immune by vaccination or by surviving the disease. So there are fewer individuals capable of becoming infected and passing it on to you. But if you are exposed, you are still fully susceptible. If you like high-risk games of chance, perhaps you’ll like that approach. If you don’t, the 94% effectiveness of the vaccine is a better choice.

“I’ve heard it will make women infertile.”

Also no. That’s an anti-vax rumor without evidence. How can we be sure of that since the vaccine has just come out? The basis of the rumor is that a short segment of amino acids in the virus’s spike protein is the same as a segment in syncytin 1, a human protein that supports placental implantation. The vaccines stimulate antibodies against the spike protein, so the rumor is that those antibodies will cause a failure of implantation and therefore infertility. 

However, the virus also has the spike protein along with other viral proteins that provoke an immune response, and women who have recovered from COVID-19 have developed antibodies against them all. If the rumor were true, those women would have become infertile or experienced a high rate of pregnancy loss. That hasn’t happened. There are complex immunologic explanations for why it hasn’t, but the bottom line is that COVID-19 doesn’t make women infertile and neither will the vaccine. By contrast, though, the vaccine won’t put your life at risk.

“I already had COVID-19. I don’t need it.”

Antibody response to having COVID-19 is highly variable. Antibody levels sometimes drop to undetectable and people have had second episodes of the disease. People who have had COVID-19 are advised to receive the vaccine, which provokes a stronger and longer-lasting antibody response than the disease does, when it has been 30 days since they recovered.

If you decide against taking the vaccine…

Best wishes for your avoidance of COVID-19. The vaccine is the only true protection we can offer. If you’re still undecided, you owe it to yourself and your family to research the facts further. Don’t let indecision make the decision. If you have taken or plan to take the vaccine, congratulations on a wise decision. Either way, please keep wearing your mask and keep a safe distance when around others.

About Dr. Joseph Moser

Dr. Moser headshotDr. Joseph Moser is the Chief Medical Officer at University of Maryland Charles Regional Medical Center. He has over 40 years of experience in the healthcare field and now oversees all of UM Charles Regional Medical Center’s doctors on staff.

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