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Mythbusting the COVID-19 vaccines 2.0

Nine months after they were authorized, confusion about COVID-19 vaccines persists. To help overcome hesitancy, let’s start with the facts.

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When it comes to encouraging COVID-19 vaccination, the person who has the most influence might be you.

Survey findings published in the New England Journal of Medicine reported that health care professionals are the most trusted source of vaccine information and can help counter the common misperceptions that are fueling vaccine hesitancy.

As a follow-up to my earlier presentation, Mythbusting COVID-19 Vaccines, this article goes deeper into these misperceptions, and how to address some of the myths that patients, and even our own co-workers, may believe and which have made them reluctant to get the COVID-19 vaccine.

False. The vaccines had a head start and lots of financial resources. Working with pharmaceutical companies, the government agreed to invest in vaccine development and take on some of the financial risk. This allowed multiple groups of scientists to work on the problem at the same time and vaccines to be mass-produced while clinical trials were still underway.

In addition, scientists have been developing mRNA technology (the basis of the Pfizer/Comirnaty and Moderna vaccines) and viral vector vaccines (Johnson & Johnson) for decades in anticipation of quickly developing a vaccine in the event of a pandemic.

False. The clinical trials were large — about 40,000 people in each trial — and included a mix of people of different ages, ethnicities and with diverse medical conditions.

The development of these vaccines was akin to a moon shot in that it took teams of experts, single-minded focus and enough resources to produce a safe and effective vaccine in a relatively short period of time.

But none of the normal testing and review process was skipped, nor corners cut in the development and testing of these vaccines. And as a double check, the CDC has asked the hundreds of millions of Americans who have now received one or more doses of these vaccines to report on any symptoms they have following vaccination. This has allowed us to identify even very rare side effects of these vaccines as quickly as possible. This data has proved beyond a doubt that not only are these vaccines very effective, they are also extremely safe.

False. Clinical trials rated the vaccines’ efficacy at about 95%, which means participants in the clinical trials were 95% less likely to get sick from COVID-19 if they were exposed. Because these clinical trials occurred during a distinct period of time, they are a snapshot — the real-world effectiveness of any vaccine is always going to be a little different from the results we saw at a set point in time. Real-world vaccine effectiveness is influenced by other factors, such as how many people in a community are ill and can expose others to the virus, the variants of the virus, in addition to other factors — like the strength of the immune system of the person receiving the vaccine.

We know from studies that these vaccines have good efficacy in adults, including the elderly. However, like many of our other vaccines, they are not as effective in people whose immune systems are highly compromised because of cancer, prior organ transplants, immune-suppressing medications or other similar conditions.

Yet just as seatbelts and airbags can’t eliminate the risk of being involved in a car accident, but can dramatically improve your chances of surviving one, vaccines can’t prevent you from the possibility of exposure to COVID-19, but can significantly reduce your risk of harm from this infection — for both persons with and without medical conditions that affect their immune system.

In short, no vaccine can offer complete protection against infection to every person who receives it. But even with the newer variants spreading in the US at present, we continue to see a difference in who is getting severely ill from COVID-19. The vaccines continue to provide excellent protection and dramatically decrease the risk that you will become severely ill, be hospitalized or die if you are exposed to this virus and become infected.

False. These concerns are understandable because pregnant women are rarely included in studies of any medication or vaccine that hasn’t already been approved for non-pregnant adults. This said, there is accumulating evidence of the vaccines’ safety.

Young women also may have heard misinformation about a potential risk of infertility. This seems to have stemmed from rumors online attributed to a former Pfizer employee who was not involved in this or other vaccine projects. The former employee conjectured that a similarity between spike protein encoded by mRNA in the vaccines was similar enough to a placenta protein that it would provide a cross-reactive response.

At first, that may seem scary. But while the exact sequence of some of the building blocks of the spike and this placental protein may be the same, the end structure and shape of them is very different. One way to think about this is to compare two animals — for example, an elephant and a mouse. They share some identical sequences of DNA, but their end structure and shape is so very different we would never mistake one of them for the other.

False. Although this concern is understandable since this is a relatively new vaccine and COVID-19 is a new disease, adverse side effects from vaccines typically present within six to eight weeks of vaccination. It’s highly unusual to see vaccine-related side effects that arise after that length of time. In the past 10 months, hundreds of millions of people have been vaccinated in the United States alone, and we haven’t seen problems from longer-term (beyond eight weeks) side effects, despite robust monitoring to actively watch for them.

Those monitoring systems have identified some risk with blood clots and Guillain-Barre in the Johnson & Johnson vaccine. Statistically, however, you’re twice as likely to be struck by lightning as to have a complication such as a blood clot, and Guillain-Barre syndrome can occur with many viral infections, as well as after some other commonly used vaccines.

In most instances the risk of this developing these side effects is much higher if you get the disease itself, than experiencing them as a side effect of vaccination.

Similarly, we have seen an increase in myocarditis and pericarditis (inflammation of the heart and the surrounding sac it rests in) with the mRNA vaccines, particularly in young men. But we knew this was a complication of COVID-19 since the beginning of the pandemic (seen in about 2.3% of college athletes in one study). And just like with blood clots or Guillain-Barre, the risk of vaccine-induced myocarditis is much lower with about 12.6 cases per million in persons aged 12-39 after the second shot of an mRNA vaccine (about 0.001%).

False. If you’ve ever had a pet who is microchipped, you likely already know that the “tracking device” is about the size of a grain of rice and can be felt under their skin. Given that these vaccines come in transparent vials, and our needles are nowhere near large enough to insert anything like this under the skin, you can rest assured there are no microchips in the vaccines.

False. Natural isn’t always better. Your body uses a shotgun approach to create antibodies to a virus. Many of these antibodies may be directed to parts of the virus that don’t actually incapacitate it or prevent it from infecting your cells.

Vaccines, on the other hand, use just one critically important viral protein — the spike protein — to train the immune system. This targeted approach means more of the antibodies produced will be effective at blocking this essential part of the virus and works like sticking bubble-gum in a door lock. The key that fits that lock (the spike protein) can’t be turned, and the virus can’t open the door to gain access into your cells.

Antibodies are only one of the body’s defenses, though. And while we still have more to learn about how natural and vaccine- induced immunity to COVID-19 compare, an increasing number of studies show that the people who have the best protection are those who have both had the infection itself and then were also vaccinated once they recovered from it.

For those who were unfortunate enough to have already had COVID-19 but were fortunate enough to have recovered from it, that is great news. For the rest of us, waiting to become infected instead of getting protection from the vaccine is a very risky proposition and not one worth the chance of severe illness or death that comes along with it.

Tags: covid-19, Kirsten Schutte, MD, rumor, vaccine myths
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