By Alec Pruchnicki, MD
There is a lot of information about the COVID vaccines coming out in the media, so let’s sort out what’s false, what’s true, what’s missing, and, most importantly, what we should be doing.
Be prepared for false information on social media, either from anti-vaxxers who are against almost all vaccines, well-meaning but misinformed individuals, or internet trolls who are posting clickbait horror stories to get your attention. Side effects from the vaccines are just that, side effects, and have to be put in perspective. A handful of allergic reactions, or brief side effects (low temperature, arm tenderness, malaise, etc.) have to be balanced against at least 325,000 dead as of this writing. The worst recent episode of vaccine side effects came in 1976 when 40 million Americans were vaccinated against a swine flu that was relatively mild. About 500 people developed Guillain-Barre syndrome, a severe post-viral paralysis, and 25-50 died. This side effect was labeled a catastrophe, but if the swine flu had been related to the 1918 flu, as originally thought, many more could have died.
What is true is the situation we’re in. With 325,000 dead, and counting, and a mortality rate of 1-2 percent, this is no benign swine flu. It’s not as bad as the 1918 flu, at least not yet, but it’s serious enough that there is an immediate need for action.
Masks, social distancing, and some level of lockdown can all contribute to reducing the spread of COVID, but effective vaccines are needed to eliminate the virus (or do so as much as possible). To achieve herd immunity by letting it run its course can result in millions of deaths before it naturally abates. The available vaccines: both Pfizer’s and Moderna’s have been evaluated by the Food and Drug Administration and have been given emergency clearance based on the immediate need. The Centers for Disease Control, FDA, and numerous government health experts have been undermined by the Trump administration, but these sources of information are all that can be trusted other than the preliminary research of the drug companies themselves. It would be wonderful if we had more information and more time.
This virus is new and has different characteristics from other respiratory viruses. There is a lot we don’t know. Will the vaccines, or the natural immunity of people who have recovered from it, provide life-long protection like the measles vaccine, life-time protection (or in a minority of cases, for a few years) like the pneumococcal pneumonia vaccine, or only one-year protection like the influenza vaccine? Will the inflammation that COVID produces permanently damage other organs in the body in ways we haven’t discovered yet? Will there be residual damage to the lungs after the infection is gone, as there can be with emphysema, or will there be no chronic damage? It might take a long time to answer these questions.
Meanwhile, what should we do? Most public health experts advocate getting the vaccine, any vaccine, as soon as possible. If there were unlimited doses available and lots of time, we could plan more carefully, balance one vaccine’s benefits and drawbacks vs. another’s, and have everything in place like the polio vaccination programs of the 1950s and 1960s or the New York City smallpox vaccination program of 1947 (look it up). Also, although there will inevitably be more side effects (both expected and newly discovered) as millions of people are vaccinated, consider the newly discovered problems in the context of the already rampant disease and deaths.
According to the planned schedule, if there are no significant shortages of supply, I will probably be getting the Pfizer vaccine by the first week in January and will be giving it to my patients as soon as possible. I wish I had more time to review all the new findings about the disease, the vaccines, and the other environmental modifications being used to contain it. But after losing several patients, and almost losing a dozen more, I don’t think this is the time for quiet rumination. Get the vaccine when it becomes available to you unless your physician or public health guidelines give you a significant reason not to do so. And if you don’t want it, good luck.