There is finally some very good news in this troubled year: Pfizer’s COVID-19 vaccine has been approved in the US, UK and Canada. About 3 million Americans will get the vaccine in the coming weeks. But about 30% of Americans say they are afraid to get the vaccine. They cite fears the vaccine will cause disease worse than the virus itself, or even that the vaccine will cause a COVID-19 infection.
Misinformation propagandists and anti-vaxers who spread conspiracy theories have a huge advantage: They do not have to verify their claims, they only need to sow doubt.
The vast amount of misinformation on social media is especially daunting for our public health workers. With our current national leadership politicizing the pandemic while fanning the flames of fear, mistrust, and misinformation, our public health workers face an ever- more daunting challenge to dispel those fears.
It is true that many questions remain about the vaccine:
- How do we vaccinate enough of the US population to put this fire out?
- How long will immunity last after vaccination?
- How many years until the world population has reached sufficient immunity to eliminate the virus, as it did with the H1N1 virus that caused the 1918 Spanish Flu pandemic?
Here are the questions our patients ask and here are our evidence-based answers:
Will the vaccine give me COVID-19?
No, there is no intact virus in the vaccine. While other vaccines contain either the killed or weakened virus, Pfizer’s COVID-19 vaccine contains only messenger RNA (m-RNA). The m-RNA relies on our immune system to generate the virus’ spike-protein (S protein) and then mount its own immune defense to the virus. Since this mRNA is only antibodies to be made against the S protein, infection via this mRNA vaccine is impossible.
Was the vaccine made in a hurry, without proper testing?
While Operation Warp-Speed did fast-track vaccine development, mRNA-based therapeutics have been studied since the 1970’s. The science behind the mRNA platform for vaccines began in the 1990s. This technology, along with our government’s allowing parallel clinical testing trials, enabled Pfizer (and other developers) to clinically test their vaccines at a much faster rate than historically possible.
The first clinical human trials on mRNA vaccines began in March 2020. Pfizer has refused all government financing. Therefore they were able to develop their COVID-19 vaccine much faster than other, government funded developers. Pfizer avoided the bureaucratic roadblocks and took all the financial risks of ramping-up production long before it was approved.
How do we know a COVID-19 vaccine is safe?
Pfizer’s phase-3 human trial on 43,000 people began on July 27th, 2020. The UK rolled out vaccinations on December 8th. UK health officials have reported that two healthcare workers vaccinated in the initial rollout of the Pfizer vaccine had what seems to have been a severe allergic response. Both recipients had a prior history of anaphylactic allergic responses and carried Epi-Pens. They both recovered. During the trial, allergic reaction rates were 0.63% in the vaccine group and 0.51% in the placebo group.
Will the vaccine give me lasting immunity?
We just don’t know. Study subjects only go back to March, and whether the 95% effectiveness of the vaccine will persist will not be known for many months. But the data thus far indicates that immunity can last at least 10-months. And because the vaccine’s antibody response generates neutralizing antibodies, the protection occurs on exposure. The virus’ ability to enter cells is blocked, preventing replication.
When will the vaccine be available for me?
The US government pre-ordered 100 million doses but, for some reason, passed on Pfizer’s offer to reserve another 100 million doses. This is difficult to justify, since Pfizer reserved the initial 100-million doses without any prepayment. They also offered to reserve another 100-million doses without any pre-payment.
Because of the administration’s failure to commit, Pfizer accepted pre-orders from other countries. They have advised US public health officials that additional COVID-19 vaccine doses will not be ready for distribution in the US until late June or early July 2020.
So, unless you are a health care worker, live in a nursing home, or have qualifying co-morbidities, you will have to get in line to receive the vaccine. While it’s likely that Moderna’s, and other vaccines will become approved and available, Pfizer’s will be the most thoroughly tested and vetted vaccine available in 2021.
What if there are serious side effects? When will we know?
So far, the most common side effect is an achy, flu-like feeling. This is actually a good sign because it shows that the immune system is building antibodies. If we go by the rollouts of previous vaccines, virtually all of the serious side effects were seen within the first two months of vaccination introduction. With case surveillance at an all-time high, we will know what (if any) severe reactions are caused by the vaccine by the end of February 2021. What we can expect is that there will be rare, vaccine-related illness in a subset of the world’s population.
What about children and pregnant or lactating women? Will they be vaccinated?
Although the COVID-19 vaccine trials included participants from many different age groups and backgrounds, children and pregnant or lactating women were not among them. Pfizer gained approval in October to include participants as young as age 12 years, but not for pregnant and lactating women.
The good news is that data has now emerged showing less than 3% of infected pregnant women transmit COVID-19 to their developing fetus. In addition, pregnancy complications from maternal infection are rare. A recent study found that children under twelve are five times less likely to contract or spread the virus compared to adults.
As a nation, we have crossed a sad threshold: As predicted by the CDC, the Thanksgiving holiday surge raised COVID-19 mortality to over 3000 deaths per day and climbing. The United States has surpassed 300,000 deaths from the virus, making COVID-19 the leading cause of death in the US.
Fortunately, vaccination is not our only opportunity to reduce our risk of COVID-19 illness. Just having adequate vitamin D intake has recently been shown to reduce COVID-19 mortality by fourfold.
Having a healthy immune system is your responsibility. For recommendations, use the evidence-based strategies found in Your 2020-21 Winter Survival Guide and Immune System Boosters: 8 Ways To Support Your Innate Immunity.
This is my advice after 42 years of practice in Lake Oswego: Keep yourself as healthy as possible during these trying times. Get plenty of refreshing sleep, wear your masks indoors and outdoors when in public and get vaccinated. Be part of the solution by checking your sources and stand up to all the misinformation rampant on social media.