By Dr. Julie McIntyre
Hallelujah! It’s a scientific miracle!
We have a safe and effective vaccine against COVID-19 within one year of the arrival of the coronavirus. Previously, the shortest time a vaccine took to be developed was four years. If this doesn’t instil confidence in the scientific process, I don’t know what will!
Despite this joyful news, according to an Angus Reid Poll released January 11, only three in five or 60 per cent of Canadians say they will get the vaccine as soon as they can. Although this is up from 39 per cent a few months ago, we’ll need more than this to achieve robust herd immunity. Still, more than 10 per cent say they will refuse it.
I’ve been a family doctor for 30 years and worked through the Swine Flu, H1N1, and SARS in Toronto. Those were scary times, but this pandemic takes scary to a whole new level.
In order to help dispel some vaccine hesitancy, I’d like to counter some common myths about the COVID-19 vaccine with facts. The facts are supported by evidence that can be found at many sites. I got most of mine via the Centre for Effective Practices, an evidence-based knowledge translation organization for primary care in Canada which is supported by, among others, the Ministry of Health and LTC, and the Ontario College of Family Physicians. However, for more clarification, please discuss any specific concerns with your health care professional.
Myth #1: “I may catch the disease from the vaccine.”
Fact: There is no live vaccine or whole virus particle in the vaccine, so you can’t “catch” COVID-19 from it. The active ingredient is the mRNA (or messenger RNA) which is like the recipe for making the spike protein that is on the outside of the virus. Once our body’s immune system meets the spike protein, it starts making antibodies against it and they will be around to fight the real virus, if we are exposed to it.
Myth #2: “This mRNA vaccine technology is too new to be safe.”
Fact: mRNA technology has been used for at least 10 years in animal studies of vaccines for rabies, Zika, influenza and for some cancer drugs.
Myth #3: “The vaccine roll-out was too fast to be safe.”
Fact: It’s because the mRNA technology was around that the vaccine could be developed so quickly. It’s like the mRNA vaccine is a CD player that can play any type of music: rap, jazz, or classical. The scientists just needed a Coronavirus CD to put on the player they already had. It took two years to find the viral sequence for the HIV-AIDS virus and, in 2003, a few weeks to find the SARS virus. In January 2020, it took only 40 hours after the arrival of the tissue samples.
No safety steps were skipped. The speed was also partly due to unprecedented collaboration and funding, which should warm our hearts.
Myth #4: “The vaccine hasn’t been sufficiently tested to know if it’s safe and effective.”
Fact: Actually, many vaccines are used after trials on 5,000-6,000 people. The Pfizer and Moderna vaccine trials had over 70,000 participants. By now, millions of people have been vaccinated. Israel, which had the most extensive and rapid vaccine roll-out has found after observing over 200,000 vaccinees, that the infection rate has dropped from 33-50 per cent two weeks after vaccination with only 0.6 per cent noting side effects such as soreness at the injection site, mild headache, achiness, and malaise. Apparently, only 20 people need to get the vaccine to save one life. That’s an amazing ratio for any vaccine or treatment.
Myth #5: “The vaccine may mess with my genes or DNA.”
Fact: Humans don’t have the enzymes to convert RNA to DNA, so this is not possible. The mRNA never enters the nucleus of our cells where our genetic material, i.e. our DNA is kept. In fact, after the protein is made, the mRNA starts being degraded within hours of delivering the recipe, so it’s out of the body relatively quickly.
Myth #6: “The vaccine might have dangerous ingredients.”
Fact: Substances that have been of concern in previous vaccines are not present in the COVID-19 vaccine. Specifically, there is no thimerosal, formaldehyde, egg, or aluminum in it. There are also no pork by-products, fetal cells, or micro-chips!
Myth #7: “I may get terrible side effects.”
Fact: So far, with the extensive testing that’s been done, side effects, as mentioned, appear to be mild and short-lived. If a high fever or significant flu-like symptoms arose shortly after vaccination, a COVID test should be done since it’s more likely you’d be sick from COVID than having side effects to the vaccine.
Myth #8: “Pregnant and breast-feeding women and people with immunosuppression should not get the vaccine.”
Fact: Since these groups were not involved in the trials, we don’t have data to support safety in these groups. However, because of the way the vaccine works, they should be safe in these groups of patients. Individuals in these groups are therefore instructed to discuss vaccination with their health care providers (HCP)
Unfortunately, because so many HCP are completely overwhelmed with the current crisis, they haven’t had the chance to be fully informed about vaccine safety and may just advise avoidance. However, the risk of COVID disease in most of these cases exceeds the risk of harm. Individual consideration needs to occur.
The concern with vaccines in pregnant and breast-feeding women is largely around live vaccines which may rarely cause the disease in the vaccinee (and baby) and with other vaccines where it wasn’t studied in this group and so we have insufficient data to support its safety. The flu shot has been studied enough to know it is safe and effective and therefore highly recommended in pregnant and breast-feeding women. Eventually, these probably will be in the same classification. The other thing about the COVID vaccines is that they have very few additives, as I listed, to be concerned about reacting to. The only additive that’s even remotely associated with an allergic reaction is polyethylene glycol. If you were one of the rare individuals that had a severe allergy to it, apparently you’d know it because it’s in so many things (the coating of ES Tylenol, Advil, laxatives like Laxaday and Restoralax) and you’d have already seen an allergist. The bonus of pregnant women getting the shot is that the antibodies should pass to the babies who will therefore have some protection when they arrive in a world where COVID is still around.
The highlighted references below can provide further documentation, if needed. The bottom line is that they should each talk to their doctors (and maybe offer these references if the doctors recommend avoidance of the vaccines).
Why has this been in the news? Pregnant and breastfeeding individuals require special considerations for COVID-19 vaccination. Because they were not included in the Phase III clinical trials, there is no data on adverse outcomes of the vaccines on this patient population at this time, though mRNA vaccines are not hypothesized to be a risk to the breastfeeding infant (MOH, 2021; NACI, January 12, 2020; SOGC, 2021; OSOG/OMA-OG, 2021).
Taking this into consideration, a number of professional organizations have decided that due to the known health risks of contracting COVID-19, it is recommended that pregnant and breastfeeding individuals should be vaccinated as long as a risk assessment deems that the benefits outweigh the potential risks (MOH, 2021; NACI, January 12, 2020; SOGC, 2021;OSOG/OMA-OG, 2021 ).
I have tried to bust a few myths for you around the COVID vaccine so that when your turn comes, you’ll roll up your sleeve, gladly! You don’t necessarily have to cry with relief as one of my frontline health care workers did, but I hope you will be full of gratitude.
I also hope you’ll direct that gratitude to the scientists and their supporters who developed the vaccine in record time, to the essential workers who have kept the supply chains open, and to the frontline health care workers who were burning out in large numbers even before the pandemic hit. Help decrease the chance that they’ll have to make a life or death decision about you, your loved one, or anyone else.
The bottom line: Please, for all our sakes, GET THE VACCINE!
Until then, “stay positive and test negative!”
Dr. Julie McIntyre is a family physician in Toronto
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