This post will attempt to answer the following questions:
- Should you get vaccinated?
- How do you evaluate the risk of the vaccine?
The pandemic roller coaster of emotion can be jarring at times. The past week was more illustrative of this than any thus far. It was a whiplash of the best and worst moments of the pandemic. I should have known it would be a difficult week when a grieving family member was carried out of the ICU shouting expletives at our team for failing to save her mother. She was just one of the eight COVID deaths (plus two non COVID deaths) we had over the course of the week. I had never lost that many patients in one week before and, while none of the deaths were a surprise, the sheer number was more than unsettling. There was a pall over the entire unit.
We were desperate for anything that would shine a bit of light in our dark week and it came Friday morning. The rumors had been circulating of the coming vaccine for several days but nothing official had been reported until out of the blue word came through that they were setting up to deliver the first doses in the downstairs conference room. Before I even finished reading the text I bolted out of the ICU and headed downstairs like a kid chasing an ice cream truck. I was in luck and ended up being the first in the health system to get the Pfizer vaccine. I never had a second thought.
I suppose I understand the concern some people have about the vaccine but I have been a bit surprised at how many people have asked me sincerely if I was going to get the vaccine when it came out. I had never considered it a question but, since I get the question a lot, I thought I would give you my reasons.
The vaccine is our only way out of the pandemic
There have been those who have suggested that we let the virus pass through society until we develop herd immunity from natural infection. In early October, a libertarian think tank and a small group of scientists released a document called the Great Barrington Declaration. In it, they call for a return to normal life for people at lower risk of severe COVID-19, to allow SARS-CoV-2 to spread to a sufficient level to give herd immunity. People at high risk, such as elderly people, it says, could be protected through measures that are largely unspecified. While on the surface this seems like a good idea, when you delve a bit deeper you see how catastrophic this plan would be. The biggest problem, aside from the fact that no viral epidemic has ever been fully controlled through natural infections, is that millions would die and our healthcare system would collapse. You can’t really fully protect the high risk population which is much larger than just the elderly. The biggest risk factor for severe disease aside from age is obesity, which means 40% of the population is high risk. How are you going to protect them? Those are just some of the problems, for more on why the Great Barrington Declaration is wrong, read this article from Nature.
What this means is that the only way that we get out of this pandemic is through widespread vaccination. It is the only path to herd immunity that will succeed and also not look like a horror film. This means that the faster we get the shots out and in people’s arms, the faster this will all be over. If large populations of people wait or don’t get the vaccine at all, COVID will remain active and this nightmare will last longer.
The vaccine will protect you
The data from the Pfizer and Moderna trials were as good as could have been hoped for (read more about that here). The evidence clearly shows that the vaccine works and does so in every subgroup studied.
People have asked me if I will still get the vaccine even though I already had COVID. The answer is yes. I asked this question to a vaccine expert who told me I should for a few reasons. First, it is not clear how long people are immune after infection. It may be that, with a mild case such as I had, immunity is not as long-lasting as can be induced with a vaccine. The vaccine could be more effective at producing long-term or more robust immunity than natural infection. While my case was mild, it is not something I want to go through again, especially if it may be more severe next time. I would also like to avoid having to isolate and put my family through quarantine. The exception is people who have been infected within the past 90 days. They are going to be pushed back in line a bit.
You should fear the side effects of not getting the vaccine
The biggest concern people have about the vaccine is the risk of an unknown serious adverse reaction. While this fear is understandable it needs to be put in the proper context. Every time you put a medication in your mouth – and this includes vitamins and other supplements as well – you are taking a chance that you may have a serious side effect. There is nothing you ingest for which this is not true. You could get E. coli from your lettuce or salmonella from your chicken. Fear of what might be does not stop us from getting into our cars or getting drunk in a bar. These vaccines are being studied with a greater scrutiny than any vaccine or medication in the history of medicine.
What’s more, you must remember that there is an unknown long-term risk of not getting the vaccine, namely, of getting COVID-19. The real question of vaccine safety is:
Is the risk of the vaccine more or less than the risk of COVID-19?
While the long-term risks of the vaccine cannot be known, it has been given to several thousand people and there have been no serious adverse effects linked to the vaccine. We also have a long history of vaccine safety with other vaccines. Vaccines are among the safest pharmaceuticals ever created. Sometimes it is hard to evaluate risks in terms that feel real. We have a general sense of certain risks and seeing how the potential risk of a vaccine compares to other risk is helpful.
|Risk of serious Adverse Event|
|Risk of being struck by lightning in any year||1 per 700,000 people1|
|Oral Polio Vaccine||1 in 750 000 doses for the first dose2|
|Measles||1 in 1 million doses2|
|DTP||1 in 750 000 doses2|
|risk of being hospitalized from a car accident||6 per 1,000 people4|
Now compare that to the estimated risks per million people of dying of COVID-19:
Keep in mind, this chart assumes 225,000 deaths and we’re already above 330,000 and it’s not even January, so the numbers are likely to be double that. What’s more, this is the risk of dying. If you were to include the risk of serious adverse effects of COVID-19 such as severe debilitation, renal failure, chronic respiratory failure, and the “long-hauler” symptoms , the risks are much, much higher.
By the time the vaccine becomes available to the average American, millions of people worldwide will have received it and there will be ample data showing safety beyond the tens of thousands who have received it in clinical trials where no serious adverse events have been linked to the vaccine. Even if these are some of the most unsafe vaccines ever created and there are several hundred serious adverse reactions in the US, your chances of something bad happening to you are far lower if you get vaccinated than if you don’t. That is true for young adults and becomes more important as age increases.
It’s the RIGHT thing to do
We all take for granted the blessings of living in a country that is free and prosperous in a time of unprecedented peace and security. We have access to wealth, health, technology, recreation, and peace unparalleled in human history. As bad as the pandemic is, when compared to other pandemics in history, this is child’s play.
The reason we are blessed in such a way is that for generations people have been willing to sacrifice for their country, neighbors, friends, and family. People have flung themselves onto beaches blanketed with enemy gunfire, stood face to face against hate-filled racist mobs, and run into falling towers.
More germane to the moment, people take the risk to help others who are sick with COVID-19. It is difficult to describe the dedication of nurses and other caretakers working on the front lines in terms that does justice to their sacrifice. They wear their PPE for hours at a time day in and day out and never complain they can’t breathe. They spend hour upon hour caring for the scared and suffering souls who are forced by this horrible disease to endure its tortures alone. They clean them when they are dirty, feed them when they cannot feed themselves, and hold their hands while they are dying.
Through the seemingly endless days since last spring I have never heard a nurse say that they want to wait and see how it turns out for other nurses before they take on the risk. They take the risk for total strangers and they would take the risk for you without ever questioning what it meant for them. There was a time early on in the pandemic where banners were flying and the words of support were endless, but as time as faded on and people have “had enough,” the words of support have faded and turned into empty platitudes.
Now is the chance for everyone else to return the favor and make one small sacrifice, take one small risk. Do it for them. Do it for your grandparents, your neighbors, and for complete strangers. Do it for yourself. Now is your chance to be a hero.