Despite the availability of a safe and effective vaccine, this pandemic persists, in part due to resistance to the vaccine. While I do not support vaccine mandates and believe in personal freedom of choice in health matters, it is important that people make sure they are basing their decisions on sound information. Unfortunately, the issue of whether or not to be vaccinated often has been politicized, rather than being fairly evaluated medically.
The Gateway physicians and our local hospitals have cared for a number of patients with COVID-19. Most had mild cases and recovered, but a significant number succumbed to it or are left with lingering symptoms. For this reason, I think I speak for all the Gateway physicians when I say that we strongly recommend getting a COVID-19 vaccine unless you have a legitimate medical contra-indication. The only definite contra-indication is a severe anaphylactic reaction after a previous dose or component of the vaccine. Other reasons to be cautious about the vaccine include a history of immediate allergic reaction to other vaccines or injectable therapy, or moderate to severe acute illness. I would encourage you to discuss your particular situation with your physician.
With that being said, different physicians have likely based our support for the vaccine on different sources. Even as a physician, the data and information can be overwhelming so it is helpful to rely on sources you can trust. I wanted to share with you how my husband and I came to the decisions about this vaccine for ourselves and our children. We reviewed information from the CDC, and sought input from trusted colleagues and organizations such as the Catholic Medical Association and American College of Pediatricians.
There were 4 questions we felt were important to consider for these vaccines, and perhaps in many other areas of medicine and life:
- Is it safe?
- Is it effective?
- Are there any moral reasons to refuse it?
- Is it necessary?
1-Are they safe? Despite these being “new” vaccines seemingly quickly developed due to the pandemic, the safety of the mRNA vaccines has been extensively studied as they have been in development since the 1970’s. Just to briefly summarize how all vaccines work- they stimulate our own immune system to develop antibodies against the disease. Other vaccines have used live or inactivated viruses or part of the virus to accomplish this. These vaccines are a little different in the way they stimulate the immune system. The Pfizer and Moderna use messenger RNA wrapped in a coating. When it is injected, it gives cells instructions to make a “spike protein” that stimulates the body to build T and B lymphocytes against the protein and hence against the virus. The body’s cells then destroy the genetic material from the vaccine. The Johnson and Johnson vaccine uses an altered adenovirus to accomplish the same end.
Mild side effects are common. Cases of anaphylaxis have been reported very rarely and for this reason all patients are monitored after receiving the vaccine. More serious side effects including inflammation around the heart are rare and do not seen to cause long-term symptoms. Rare cases of Guillain-Barre syndrome (164 cases/19.5 million doses) and thrombosis (7 cases/1 million doses) after administration of the Johnson and Johnson vaccine have also been reported. Deaths have been reported but not proven to be linked to the vaccines. Even if all the reported cases of death were directly due to the vaccines, it would be a fatality rate of .0019%.
2-Are they effective? The vaccines were first studied in animal trials, then human clinical trials and now of course more data is available as the vaccines have been widely administered. All data has demonstrated between 69-95% efficacy against symptomatic lab-confirmed COVID-19 cases in adults age 18 and above. In addition, the Pfizer vaccine has shown high efficacy in ages 12-17. Studies also showed >89% efficacy against severe infection and no deaths in vaccinated individuals in the trials. These numbers are being borne out in larger population studies. The vaccines do not seem to be quite as effective in preventing infection with some of the new variants, but still are quite good at preventing severe infections and death. In comparison to other vaccines, this efficacy data is quite good.
3-Are there any moral reasons to refuse it? The main concern here is that historically, parts of aborted fetuses have been used in the development of some vaccines. For those who have a moral objection to abortion such as myself, this was an important consideration. I would encourage all to discuss with their own spiritual advisors, but I was reassured by this statement from the Congregation for the Doctrine of the Faith. “…those who are vaccinated can do so in good conscience with the certain knowledge that the use of such vaccines does not constitute formal cooperation with abortion.”
To be clear, the Pfizer and Moderna vaccines do not use any of the cells from aborted babies in their manufacture. There are vaccines being developed with no reported relationship to aborted fetuses which is encouraging and those who are concerned about this issue should support those efforts.
4-Is the vaccine necessary? This was an important question we considered. As physicians who were offered the vaccine very early on, we felt it was our duty and was necessary so we could continue safely caring for patients. For our children, the issue was not so clear given that the disease poses a very low risk to them. However, considering all of the above, as well as the fact that they could potentially spread the disease to someone who was not protected, swayed us in favor of encouraging them to get the vaccine also. Those individuals who are not protected include those who have a legitimate reason for not getting the vaccine, as well as those who are immune-compromised and might not have good protection despite getting the vaccine.
In summary, I am confident that these vaccines are safe and that the rare serious side effects are an acceptable risk given the known morbidity and mortality of this disease. To address other concerns that have been raised, there is no evidence that these vaccines lead to fertility problems, or that they can alter an individual’s DNA. Again, I would encourage you to continue educating yourself and discuss any concerns with your physician.