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8:09 AM
September 13th, 2021

Is Hesitation for COVID Vaccination Reasonable? -- Dr. Thomas Falasca

 

 

Vaccination in One Short Sentence

 

Vaccination can save your life and stop the epidemic.

 

 

Why the Hesitation

 

“Vaccination can save your life and stop the epidemic.” Sounds great, right? So why the hesitation?

 

Hesitation stems from partial information, misunderstood information, and straight-out falsehoods. Let us examine some of the sources of hesitation and misbeliefs about vaccination.

 

COVID Vaccines Arrived in a Rush

 

Of course, after all, this is an emergency. 

That does not mean the vaccines are ineffective or dangerous. Firefighters, ambulance services, and others, rush to emergencies but their interventions are effective and essentially safe. The reason is preparation.

 

Surprisingly, preparation has been ongoing for decades because COVID is not the first corona virus with which scientists and physicians have experience. Other familiar corona viruses are SARS, or Severe Acute Respiratory Syndrome, first emerged in November 2002; MERS, or Middle East Respiratory Syndrome, identified in September 2012; and, the common cold, of long familiarity.

 

Because of this, scientists were well positioned to rapidly develop COVID-19 diagnostics, therapeutics, and vaccines. Within two weeks of COVID’s discovery, NIAID (National Institute of Allergy and Infectious Disease) had determined how the virus enters cells, and within two months, had begun trials of a treatment and a vaccine.1

 

While COVID may be new, researchers were certainly not starting from scratch!

 

 

Composition of the COVID Vaccine Is Unknown

 

This is just false. All three US vaccine makers have published the ingredients of their vaccines, available on their websites. Further, the CDC (Centers for Disease Control) website also gives the ingredients.2 

 

The COVID vaccines do not contain live virus, mercury, eggs, microchips, or human embryo tissue.

 

 

COVID Vaccines Change Your DNA

 

The three vaccines currently available in the US are Pfizer, Moderna, and Johnson and Johnson. All three are injections. All three work by instructing cells in the body to make a protein that triggers an immune response.3

 

The Pfizer and Moderna vaccines are mRNA (messenger RNA) vaccines meaning that mRNA delivers the instructions and then breaks down. The Johnson and Johnson vaccine is a traditional viral vector vaccine that uses a disabled virus that cannot replicate in the body to cause illness, a virus unrelated to the COVID virus, to deliver the instructions.7

 

DNA resides in the nucleus of the cell and these instructions, whether delivered by mRNA or disabled virus, do not enter the nucleus. They do not alter the body’s DNA.5

 

 

COVID Vaccines Can Cause COVID

 

As we have seen above, the vaccine does not contain the COVID-19 virus and cannot cause COVID. Of course, someone already infected with COVID before the vaccination might, however, begin manifesting the disease afterward. This is the difference between vaccination and cure.

 

 

Vaccines Have a Microchip to Track You

 

This is a major confusion and has been clarified by Bill Gates. The optional microchip is on the syringe label and confirms that the vaccine is not counterfeit and has not expired. It can also verify that the injection has been given. It is a method to track vaccine units, not people.5

 

 

Natural Immunity from Surviving COVID Is Superior to Vaccination

 

 

This is a falsehood for sure. The body’s immunity from infection diminishes over time. Vaccine seems to provide longer immunity than natural infection. Data suggests that recovered but unvaccinated people are 2.34 times more likely to be reinfected with COVID than fully vaccinated people.2

 

 

Vaccinated People Can Get Breakthrough COVID, so Don’t Bother 

 

No vaccines are 100% effective. Still, the 95% effectiveness of the Pfizer and Moderna vaccines is certainly impressive. It means that a vaccinated person is 20 times less likely to get infected than an unvaccinated person. Additionally, even if infected, the vaccinated person is much less likely to be hospitalized or die than the unvaccinated.3

 

Another statistic shows how small is the chance of a vaccinated person getting severely ill or dying from COVID. On August 9, 2021, the CDC indicated that 8,054 of 166 million fully vaccinated people had been hospitalized or died from COVID. That is 8,054 out of 166,000,0008 or only one in 20,750.  

 

Finally, CDC Director Rochelle Walensky indicated that 99.5 percent of all deaths from COVID were in the unvaccinated.8

 

 

 COVID Vaccines Cause Infertility

 

This falsehood was best addressed in a report from Johns Hopkins Medicine.

“Confusion arose when a false report surfaced on social media, saying that the spike protein on this coronavirus was the same as another spike protein called syncitin-1 that is involved in the growth and attachment of the placenta during pregnancy. The false report said that getting the COVID-19 vaccine would cause a woman’s body to fight this different spike protein and affect her fertility. [Nevertheless,] The two spike proteins are completely different and distinct, and getting the COVID-19 vaccine will not affect the fertility of women who are seeking to become pregnant, including through in vitro fertilization methods. During the Pfizer vaccine tests, 23 women volunteers involved in the study became pregnant, and the only one who suffered a pregnancy loss had not received the actual vaccine, but a placebo.”4

 

Both the CDC2 and WHO9 (World Health Organization) encourage women who are pregnant or wish to become pregnant to receive the COVID-19 vaccine.

 

 

Conclusion

 

We began with the question “Is Vaccination Hesitation for COVID Reasonable?” The answer is “NO!” Vaccination can save your life and stop the epidemic. Hesitation stems from partial information, misunderstood information, and straight-out falsehoods.

Hesitation exposes those who hesitate and everyone in contact with them. Hesitation buys time for the virus to mutate and become even more aggressive. There is no good reason for hesitation, so let’s face the reality and get vaccinated!

 

Thomas Falasca, DO

 

 

 

References

 

1 National Institute of Allergy and Infectious Diseases. (n.d.). Coronaviruses. Retrieved September 13, 2021, from https://www.niaid.nih.gov/diseases-conditions/coronaviruses

 

2 Pogored. (2021, August 24). Common COVID-19 Vaccine Myths Explained. Retrieved September 13, 2021, from https://health.clevelandclinic.org/common-covid-19-vaccine-myths-explained/

 

3 Mayo Clinic Health System. (2021, September 2). COVID-19 vaccine myths debunked. Retrieved September 13, 2021, from https://www.mayoclinichealthsystem.org/hometown-health/featured-topic/covid-19-vaccine-myths-debunked

 

4 Johns Hopkins Medicine. (2021, August 4). COVID-19 Vaccines: Myth Versus Fact. Retrieved September 13, 2021, from https://www.hopkinsmedicine.org/health/conditions-and-diseases/coronavirus/covid-19-vaccines-myth-versus-fact

 

5 Neelaveni Padayachee, N. (2021, August 5). Experts debunk 6 myths about the COVID-19 vaccine. Retrieved September 13, 2021.

 

6 Centers for Disease Control and Prevention. (2021, September 7). Myths and Facts about COVID-19 Vaccines. Retrieved September 13, 2021, from https://www.cdc.gov/coronavirus/2019-ncov/vaccines/facts.html

 

7 Stevens, M. (2021, May 3). Johnson & Johnson vaccine: How is it different? Retrieved September 13, 2021, from https://www.vcuhealth.org/news/covid-19/johnson-and-johnson-vaccine-how-is-it-different

 

8 Most, D. (2021, August 13). Myths vs. Facts: Making Sense of COVID-19 Vaccine Misinformation. Retrieved September 13, 2021, from https://www.bu.edu/articles/2021/myths-vs-facts-covid-19-vaccine/

 

 

Further Reading

 

UNICEF. (2021, June 01). The 12 Common Myths & Misconceptions About COVID-19 Vaccination. Retrieved September 13, 2021, from https://www.unicef.org/armenia/en/stories/12-common-myths-misconceptions-about-covid-19-vaccination

 

 

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Should We Worry about Monkeypox?

Is Monkeypox the new COVID? Find out why not! ...See More

Should We Worry about Monkeypox?

Should We Worry about Monkeypox?

 

 

What is Monkeypox?

 

Monkeypox is a viral disease, usually self-limiting and resolving in 2-4 weeks. It is similar to smallpox but is less infectious and much less lethal1. The incubation period is 4-20 days.

 

Like smallpox and chickenpox, the disease demonstrates a characteristic rash followed by eruptions.

 

The eruptions begin as macular (flat), which then become papular (raised), then vesicular (clear fluid blisters), and then pustular (pus filled). Finally, they scab and the crusts fall off. More reliably, the monkeypox rash differs from smallpox in that the monkeypox rash is accompanied by swollen lymph nodes in the neck and occasionally in the groin. These swollen nodes may sometimes measure several centimeters. Less reliably, the monkeypox rash spreads from the face and upper trunk to the rest of the body while the smallpox rash spreads from the trunk outward.

 

Other symptoms include fever, usually the first symptom, then chills, sweats, muscle aches, weakness, sore throat, cough, and shortness of breath.

 

Lastly, the evidence does not seem to suggest that monkeypox is a specifically sexually transmitted infection (STI).

 

Why “Monkey” pox

 

The name “monkeypox” is misleading since the connection with monkeys is minimal. Although first identified in laboratory monkeys in 19581, the disease seems endemic to rodents of central Africa and western Africa.

 

In 2003 an animal distributor transported prairie dogs, along with rodents from Ghana. The then-infected but pre-symptomatic prairie dogs spread the disease in the prairie dog population and a human outbreak occurred in the midwestern United States among those exposed to pet prairie dogs.

 

Transmission

 

Initial transmission from animals to humans seems to have occurred by respiratory transmission or by direct contact with skin or mucous membranes. Another possible route is by consumption of wild animals, “bush meat,” which is often undercooked.

 

Secondary transmission from human to human occurs by the respiratory route and by direct contact with skin or mucous membranes. Patients are considered infectious until the last scabs have fallen off.

 

Complications

 

The most common complication is pitted scars. However, there is also bronchopneumonia, blindness from corneal ulceration, septicemia, and encephalitis.

 

Lethality

 

Monkeypox is far less lethal than smallpox. Monkey pox lethality in Africa seems to have been at 1-10%, with more of these occurring in children and youth. On the other hand, the fatality rate from untreated smallpox is estimated to be 30%.2

 

Prevention and Treatment

 

Present data suggests that prior smallpox vaccination confers 85% immunity from monkeypox and that when infection does occur, it is milder. In fact, the Centers for Disease Control and Prevention (CDC) recommends smallpox vaccination even after exposure, ideally within 4 days, but also up to 2 weeks after exposure to a diseased animal or confirmed human case. The more recent discontinuation of routine smallpox vaccination may have contributed to the disproportionate frequency and severity of monkeypox in younger people.

 

In addition to the original smallpox vaccine, discontinued in the 1980s, and its successors, the Federal Drug Administration (FDA), in September 2019, approved a combined smallpox/monkeypox vaccine.

 

Finally, some antiviral drugs have shown evidence of effectiveness in the lab and in animal studies, but their effectiveness is still undocumented in human studies.

 

Social Implications

 

First, the World Health Organization (WHO) announced that it would rename monkeypox due to concerns that the name is “discriminatory and stigmatizing” because of the prevailing perception that the disease is endemic among people in some African countries. However, nearly all monkeypox outbreaks in Africa prior to 2022 have resulted from animal transmission to humans. Additionally, the Foreign Press Association of Africa has urged the global media to stop using images of black people in articles on the European outbreak.3 Finally, as of this writing, WHO has not yet determined a new name for monkeypox.

 

Second, several early European cases linked to a rave event in Spain and another in Belgium seem to have inspired a perception that monkeypox is a sexually transmitted infection (STI) among gay or bisexual men. However, the disease is, in fact, spread by physical contact, sexual or otherwise, with the skin eruptions of infected people.4

There sems to be nothing intrinsic to the monkeypox virus that would increase a proclivity for the gay or bisexual male population.

 

The false perception that monkeypox is an STI restricted to a circumscribed population can have both public health and clinical consequences. Regarding public health, the greater public outside the circumscribed population, feeling false security, may fail in their obligations to control the infection. Regarding the clinical arena, clinicians influenced by the false perception may be more alert to the diagnosis of monkeypox in the circumscribed population than in the greater public and so diagnose it more, resulting in a misperception becoming a self-fulfilling prophesy that narrows appropriate public health response.5

 

Monkeypox vs COVID-19 – The Good and the Bad

 

The appearance of monkeypox just now certainly prompts a comparison with COVID-19. Of course, comparisons must be tentative, as scientific conclusions evolve in accordance with the evolution of the evidence.

 

The Bad: Definitely troublesome is the fact that human-to-human spread of monkeypox has occurred in diverse locations almost simultaneously. This may result from global travel combined with a relatively long incubation period. Nevertheless, the phenomenon warrants caution.

 

The Good: Monkeypox seems less transmissible than COVID, with COVID spread primarily via the respiratory route and monkeypox spread primarily via direct contact.

 

Our experience with corona viruses spanned a few decades and with COVID-19 was nonexistent. On the other hand, our experience with pox viruses dates from the late 1700s, and with monkeypox specifically goes back 60 years.

 

The high transmissibility and difficulty in identifying mild cases of COVID made contact tracing difficult. However, the lower transmissibility and characteristic pox in even milder cases of monkeypox renders contact tracing easier and more effective.

 

Finally, in the darkest days of COVID, a vaccine was a vision. On the contrary, with monkeypox, a vaccine, and extensive experience with it, already exists.

 

Conclusion

 

We certainly do not need another epidemic. Although, currently cases are few, it is disturbing that human-to-human transmission has occurred at disparate places almost simultaneously. Additionally, scientific opinion evolves as the evidence upon which it is based develops; and this thought certainly inspires restraint in prediction.

 

However, we are cautiously optimistic about monkeypox not being a replay of our COVID nightmare. Monkeypox seems less transmissible, is more amenable to contact tracing, is much more familiar to us, and comes with a vaccine with which we already have extensive experience. We are in a much better position now than we were in January 2020!

 

Thomas Falasca, DO

 

 

References

 

1 Graham, M. B. (2022, June 16). Monkeypox. eMedicine Medscape. Retrieved June 26, 2022, from https://emedicine.medscape.com/article/1134714

2 Hussain, A. N. (2020, July 28). Smallpox Updated: Jul 28, 2020. Author: Aneela Naureen Hussain, MD, MBBS, FAAFM; Chief Editor: John L Brusch. eMedicine Medscape. Retrieved June 26, 2022, from https://emedicine.medscape.com/article/237229 

 

3 Crist, Carolyn. (2022, June 15). WHO to rename monkeypox due to stigma concerns. eMedicine Medscape. Retrieved June 26, 2022, from https///www.medscape.com/viewarticle/975681 

 

4 Heymann, D. (2022, May 24). Monkeypox spread likely "amplified" by sex at 2 raves in Europe, leading WHO adviser says. cbsnews.com. Retrieved June 26, 2022, from https://www.cbsnews.com/news/monkeypox-sex-raves-europe-world-health-organization/ 

 

5 Daskalakis, D., Mena, L., & McClung, P. (2022, June 16). Monkeypox: Avoiding the Mistakes of Past Infectious Disease Epidemics. ACPJournals.org. Retrieved June 26, 2022, from https://doi.org/10.7326/M22-1748 

 

 

What You Need to Know about Long COVID - Dr. Thomas Falasca

Long COVID symptoms, incidence, and approach.   ...See More

What You Need to Know about Long COVID - Dr. Thomas Falasca

 

Image by LJNovaScotia from Pixabay

 

 

What is Long COVID?

 

“Long COVID,” is also known as “long-haul COVID” or “post-COVID condition.” The World Health Organization (WHO) defines long COVID as the onset or persistence of symptoms related to an acute COVID infection, occurring at least three months after the COVID infection and enduring at least two months.

 

 

Symptoms of Long COVID

 

Symptoms are varied but often are of three types: 1) neurological, 2) respiratory, and 3) cardiovascular.

 

Neurological symptoms in long COVID cases are thought to be the effect of neuroinflammation. Many involve loss of smell, headache, and trouble sleeping. However, the most common symptom is fatigue, involving one-third of cases. The next most common symptom is cognitive impairment involving one-fifth of cases.1

 

Cognitive impairment typically presents itself as “brain fog,” a combination of slow thinking and difficulty remembering, especially a matter of “finding the right word.” This phenomenon of “not finding the right word” is called anomia and is important because it can be measured in neuropsychological tests. These tests show both a decrease in the number of correct answers and an increase in reaction time among patients so affected.2   

 

Neurological complications are not newly discovered consequences of viral infection. Two such complications come to mind, both identified in the early 20th century.

 

First was Guillain–Barré syndrome, first described in 1859 by Jean-Baptiste Octave Landry and identified more precisely in 1916 by  Georges GuillainJean Alexandre Barré, and André Strohl. It is a rapid-onset ascending weakness sometimes following a viral, or less frequently bacterial, infection.

 

Second was von Economo encephalitis or encephalitis lethargica, a sleeping sickness seen subsequent to the 1918 Spanish Flu epidemic and described by Constantin von Economo and Jean-Rene Cruche. The treatment of some of the victims of this encephalitis was the subject of the 1990 film Awakenings with Robin Williams and Robert DeNiro.3

 

Respiratory symptoms

 

Shortness of breath and symptoms of chronic lung disease. Air trapping often results from inflammation, edema, or fibrosis. Incidence of air trapping was 25.4% in ambulatory COVID patients compared to 7.2 % in healthy controls. It was still present in 8 of the 9 patients who underwent imaging more than 200 days post-diagnosis. Fibrosis was most common in patients admitted to the ICU.4

  

Shortness of breath, or dyspnea, is the most prominent respiratory symptom of COVID. It frequently results from air trapping. Air trapping, in turn, can be caused by inflammation, edema or airways swelling, or by fibrosis. All three of these can constrict the airways, which, for technical reasons, is worse on expiration than inspiration. Air trapped in the lungs impedes air entering the lungs, hence the shortness of breath.

 

Air trapping is prominent in COVID, affecting even COVID patients not confined to bed. In fact, 25.4% of such patients evidenced air trapping compared to 7.2% of healthy controls. Moreover, and relevant to long COVID, the air trapping was still present in 8 of the 9 patients in one sample who underwent testing at least 200 days after their original COVID diagnosis.4 Interestingly, although long COVID can occur even after asymptomatic or mild COVID-195, the most enduring complication of fibrosis was most common in patients admitted to the ICU.4

 

Cardiovascular symptoms

 

Cardiovascular symptoms of long COVID include tachycardia, exercise intolerance, chest pain, and shortness of breath.6 These can result from an inflammation of the heart muscle called myocarditis, which sometimes follows viral infections.

 

While myocarditis can sometimes follow COVID mRNA vaccination, the fact remains that myocarditis after COVID infection is six times more common than myocarditis after vaccination.7 Even then, the incidence of myocarditis after vaccination in the most vulnerable group, males aged 12-29, is only 0.0004%. For older males and for females, the incidence is only 1/20th the aforementioned rate6. Consequently, myocarditis risk from the   mRNA vaccines, Pfizer and Moderna, is minimal and certainly much less than its risk from catching COVID.

 

 

Causes of Long COVID

 

The causes of long COVID are unclear. A leading theory, adopted from our knowledge of Guillain–Barré syndrome, is that an immune reaction instigated by the virus causes the condition. Another theory is that a reservoir of the corona virus remains in the body to reactivate later. Yet another theory proposes that corona virus remnants trigger chronic inflammation8. In short, the causes are uncertain.

 

 

Frequency of Long COVID

 

The frequency of long COVID is difficult to determine accurately since some symptoms are hard to verify or possibly related to other causes. Nevertheless, the consensus is that 10-30% of those initially infected with corona will develop long COVID6.

 

Notably, people who'd had COVID were 25% more likely to develop dysrhythmias, 20% more likely to develop diabetes, 60% more likely to develop fatigue, 21% more likely to develop genitourinary conditions, 39% more likely to develop chest pains, and a full 3.88 times more likely to develop trouble with olfaction.9

 

Finally, for an estimated 37% who contract the virus, symptoms can linger for weeks, months, or even years10.

 

 

How Long Will Long COVID Last?

 

Certainly, more evidence is needed, but it seems at present that most people with long COVID will recover with time. However, such serious chronic diseases as Type 2 diabetes and pre-existing pulmonary disease could adversely affect recovery11. Finally, it seems that loss of smell can last for months to years.12

 

 

 

Anticipating and Identifying Long COVID

 

In one study, researchers identified four early things linked to greater chances that someone with COVID-19 will have long-term effects: type 2 diabetes at the time of diagnosis, the presence of specific autoantibodies, unusual levels of SARS-CoV-2 RNA in the blood, and signs of the Epstein-Barr virus in the blood.11

 

In another study, from Yale University, the researchers tasked dogs with identifying 45 people with long COVID versus 188 people without it. The dogs were accurate more than 50% of the time in identifying long COVID8.

Perhaps, learning how the dogs were able to do this can form the basis for a clinical laboratory test.

 

 

Vaccination as Long COVID Treatment and Prevention

 

Empirically, vaccination seems to alleviate long COVID symptoms in some people12,11,13. This is consistent with the theory that corona virus remains in the body in some form after COVID infecton8.

 

A second infection with COVID is less likely but possible. Although there is scant information regarding the probabilities of long COVID after a second versus a first corona infection, it seems there is some probability of occurrence. Consequently, vaccination of a previously unvaccinated COVID recoveree, can reduce the chance of a second infection with consequent long COVID.

 

Finally, the optimum way to approach a problem is not to have it. The optimum way to avoid long COVID is to avoid a COVID infection I the first place. Again … vaccination!

 

 

Summary

 

In brief, long COVID can extend for an extended period, even years, after the acute infection is over. Its symptoms can affect any area of the body, but most commonly involve the nervous, respiratory, and cardiovascular systems. Causes are unknown but may involve an immune response triggered by the COVID infection. Long COVID may affect one-third of those recovering from the corona infection. Patients with Type 2 diabetes or pre-existing pulmonary disease may be more susceptible to long COVID. Lastly, vaccination seems to alleviate long COVID symptoms.

 

 

Conclusion

 

The conclusion is simple. Long COVID is real and is troublesome. The optimal way to address a problem is not to have it. The optimal way to avoid long COVID is to avoid an initial COVID infection. To avoid an initial COVID infection … get vaccinated.

 

Thomas Falasca, DO

 

 

References

 

1 Lui, L. (2022, February 3). Cognitive impairment in long covid. Medscape. Retrieved March 23, 2022, from https://www.medscape.com/viewarticle/967633 

2 George, J. (2022, February 3). Memory, Concentration Problems Plague 70% of Long COVID Patients | MedPage Today. MedPage Today. Retrieved March 19, 2022, from https://www.medpagetoday.com/neurology/generalneurology/97763 

3 Hoffman, L. A., & Vilensky, J. A. (2017). Encephalitis lethargica: 100 years after the epidemic. Brain140(8), 2246–2251. https://doi.org/10.1093/brain/awx177 

4 Alexander, W. (2022, March 16). Air trapping: Common in patients with Long Covid. Medscape. Retrieved March 23, 2022, from https://www.medscape.com/viewarticle/970247 

5 McNamara, D. (2022, February 4). Q&A: Long covid symptoms, management, and where we're headed. WebMD. Retrieved March 23, 2022, from https://www.webmd.com/lung/news/20220204/long-covid-q-and-a 

6  ACC issues clinical guidance on cardiovascular consequences of covid-19. American College of Cardiology. (2022, March 16). Retrieved March 23, 2022, from https://www.acc.org/About-ACC/Press-Releases/2022/03/16/15/28/ACC-Issues-Clinical-Guidance-on-Cardiovascular-Consequences-of-COVID-19 

7 Wilson, C. (2021). Myocarditis more likely after infection than vaccination. New Scientist251(3346), 14. https://doi.org/10.1016/s0262-4079(21)01357-9 

8 McNamara, D. (2022, February 8). Promising leads to crack long covid discovered. WebMD. Retrieved March 23, 2022, from https://www.webmd.com/lung/news/20220208/promising-leads-on-long-covid 

9 McNamara, D. (2022, January 28). Long covid is real, and many real questions remain. WebMD. Retrieved March 23, 2022, from https://www.webmd.com/lung/news/20220128/long-covid-is-real 

10 Kalter, L. (2022, February 10). Scientists see hope in new therapy for Covid Brain Fog Patients. WebMD. Retrieved March 23, 2022, from https://www.webmd.com/lung/news/20220210/hope-for-covid-brain-fog 

11 McNamara, D. (2022, January 28). Long covid is real, and many real questions remain. WebMD. Retrieved March 23, 2022, from https://www.webmd.com/lung/news/20220128/long-covid-is-real 

12 Watto, M., Williams, P. N., The Curbsiders, J. 2022, The Curbsiders, N. 2021, The Curbsiders, O. 2021, The Curbsiders, S. 2021, & The Curbsiders, A. 2021. (2022, March 8). Long COVID: Learning as We Go. The Curbsiders. Retrieved March 20, 2022, from https://www.medscape.com/partners/curbsiders/public/curbsiders 

13 Crist, C. (2022, February 16). Vaccination reduces chance of getting long covid, studies say. WebMD. Retrieved March 20, 2022, from https://www.webmd.com/lung/news/20220216/vaccination-reduces-chance-of-getting-long-covid-studies-say 

 

 

The Vaccines Are Efficacious Weapons against COVID - Dr. Thomas Falasca

The evidence is in and indicates that the vaccines are highly efficacious against COVID ...See More

The Vaccines Are Efficacious Weapons against COVID - Dr. Thomas Falasca

 

 

 

What is Efficacy?

 

Efficacy is a measure of how well something works. Efficacy numbers of the COVID vaccines appear in print frequently efficacies are 95% for Pfizer, 94.1% for Moderna, 70% for AstraZenica (not yet available in the US as of this writing), and 70% for Johnson & Johnson. So, what do these percentages mean?

 

The Pfizer efficacy of 95% means that 95% of those vaccinated will develop the desired effect. In other words, if, in an unvaccinated group of 100 persons, 20 develop COVID, then in a Pfizer-vaccinated group of 100 persons, only 1 will develop COVID.

 

Similarly, the Johnson & Johnson efficacy of 70% means that if, in an unvaccinated group of 100 persons, 20 develop COVID, then in a Johnson 6 Johnson-vaccinated group of 100 persons, only 6 will develop COVID.

 

 

Vaccine Efficacy: Individual and Social

 

But the benefit of the vaccine is more than lowering one’s personal chances of infection to only 5% of what they would otherwise be from community exposure. For, additionally, the community exposure itself lowers when a significant portion of the community gets vaccinated. Thus, the total protection for the individual multiplies.

 

 

Efficacy: Vaccine vs “Natural” Community Infection

 

The efficacy of vaccination in producing COVID immunity far exceeds that of “natural” community infection.

 

Data suggests that recovered but unvaccinated people are 2.34 times more likely to be reinfected with COVID than fully vaccinated people.1

 

Although COVID-19 hasn’t been around a sufficient time for a long-term study, researchers from Yale and the University of North Carolina have examined reinfection data from six other human-infecting corona viruses. Their study, published in The Lancet Microbe, said, “People who don’t get vaccinated against COVID-19 should expect to be reinfected with the corona virus every 16 to 17 months on average.”2 Jeffrey Townsend, the lead study author, emphasized, “Those who have been naturally infected should get vaccinated.”

 

These findings are not surprising. First, “natural” infection has an added variable, namely, the size of inoculum infecting each patient. This may contribute to different final degrees of immunity. On the other hand, vaccination has a specific uniform dose administered to all subjects. This is one less variable in the immunity generating process.

 

Second, over the course of time, immunity to the original virus fades and, additionally, new virus variants develop. At least, through the development of booster doses, vaccines can keep up with these changes.

 

 

 

COVID Presence in Children

 

Children’s COVID vaccination sometimes receives inadequate attention because the course of COVID in children seems less aggressive than in adults. However, this deficit of attention is unjustified.

 

First, “less aggressive” does not mean “harmless.”  As of this writing, 16 Pennsylvania children have died from COVID since the epidemic began3.

 

Second, COVID among children is increasing. Among Pennsylvania children 5-18 years old, 9,214 cases have occurred during the first week of December 2021. Among children 4 years and younger, there have been 2,159 cases.3

 

Third, an increase or significant presence of disease in any segment of the population increases spread of the present variant and facilitates the development of new variants as the virus acquires more patients in which it can transform itself.

 

It is for reasons such as this that Anthony Fauci, MD, director of the National Institute of Allergy and Infectious Diseases, has said that getting children vaccinated is an important step toward achieving herd immunity.4

A consequence of this is the significance of the COVID vaccine’s efficacy in children.

 

 

 

Vaccine Efficacy in Children

 

Given the importance of vaccinating children, it is fortunate that the vaccines seem highly effective in them.

 

Pfizer recently tested adolescents ages 12-15 with the two standard 30-microgram doses of its vaccine needed for “full vaccination.” Among the 2,228 trial participants, there appeared 30 confirmed symptomatic cases in the unvaccinated group vs. 0 in the vaccinated group.5

 

In another Pfizer study, in a group of 2,000 children ages 5-11, 2/3 of the kids received the pediatric dose of 10 micrograms while the other 1/3 was left unvaccinated. While 16 children in the unvaccinated group developed symptomatic and lab-confirmed COVID-19, only 3 in the twice-as-large, vaccinated group contracted COVID-19.6

 

Finally, another Pfizer study enrolled 2,260 adolescents ages 12-15. In the unvaccinated group 18 developed COVID-19, while in the vaccinated group, there were 0 infections.7

 

 

Conclusion

 

The evidence is clear, vaccination works to reduce the illness burden in the community, as well as to reduce the probability of infection, illness, and death to the individual. Furthermore, it promises to shut down the epidemic sooner, thus precluding the virus from morphing into even more dangerous variants. Vaccination is, to borrow the words of Abraham Lincoln, “the last best hope of earth.” 8

 

Thomas Falasca, DO

 

 

 

 

References

 

1 Pogored. (2021, August 24). Common COVID-19 Vaccine Myths Explained. Retrieved September 13, 2021, from https://health.clevelandclinic.org/common-covid-19-vaccine-myths-explained/

 

2 Townsend, J. P., Hassler, H. B., Wang, Z., Miura, S., Singh, J., Kumar, S., . . . Dornburg, A. (2021). The durability of immunity against reinfection by SARS-CoV-2: A comparative evolutionary study. The Lancet Microbe,2(12). doi:10.1016/s2666-5247(21)00219-6

 

3 Woodall, C. (2021, December 13). COVID-19 in Pennsylvania: Why the state's leading doctors are imploring kids to get vaccinated. Retrieved December 13, 2021, from https://www.ydr.com/story/news/2021/12/13/covid-pa-vaccine-children-omicron/6451477001/

 

4 Ellis, R. (2021, March 31). Pfizer: Vaccine Shown 100% Effective in Kids 12-15. Retrieved December 13, 2021, from https://www.webmd.com/vaccines/covid-19-vaccine/news/20210331/pfizer-vaccine-effectiveness-kids-twelve-to-fifteen

 

5 Crist, C. (2021, November 23). Pfizer COVID Vaccine Is 100% Effective in Adolescents: Study. Retrieved December 13, 2021, from https://www.webmd.com/vaccines/covid-19-vaccine/news/20211123/pfizer-covid-vaccine-effectiveness-adolescents-study

 

6 Goodman, B. (2021, October 22). Pfizer Vaccine for Kids 90% effective in Preventing COVID-19. Retrieved December 13, 2021, from https://www.webmd.com/vaccines/covid-19-vaccine/news/20211022/pfizer-vaccine-for-kids-effective

 

8 Lincoln, Abraham. Annual Message to Congress -- Concluding Remarks, Washington, D.C., December 1, 1862

Is Hesitation for COVID Vaccination Reasonable? -- Dr. Thomas Falasca

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Is Hesitation for COVID Vaccination Reasonable? -- Dr. Thomas Falasca

 

 

Vaccination in One Short Sentence

 

Vaccination can save your life and stop the epidemic.

 

 

Why the Hesitation

 

“Vaccination can save your life and stop the epidemic.” Sounds great, right? So why the hesitation?

 

Hesitation stems from partial information, misunderstood information, and straight-out falsehoods. Let us examine some of the sources of hesitation and misbeliefs about vaccination.

 

COVID Vaccines Arrived in a Rush

 

Of course, after all, this is an emergency. 

That does not mean the vaccines are ineffective or dangerous. Firefighters, ambulance services, and others, rush to emergencies but their interventions are effective and essentially safe. The reason is preparation.

 

Surprisingly, preparation has been ongoing for decades because COVID is not the first corona virus with which scientists and physicians have experience. Other familiar corona viruses are SARS, or Severe Acute Respiratory Syndrome, first emerged in November 2002; MERS, or Middle East Respiratory Syndrome, identified in September 2012; and, the common cold, of long familiarity.

 

Because of this, scientists were well positioned to rapidly develop COVID-19 diagnostics, therapeutics, and vaccines. Within two weeks of COVID’s discovery, NIAID (National Institute of Allergy and Infectious Disease) had determined how the virus enters cells, and within two months, had begun trials of a treatment and a vaccine.1

 

While COVID may be new, researchers were certainly not starting from scratch!

 

 

Composition of the COVID Vaccine Is Unknown

 

This is just false. All three US vaccine makers have published the ingredients of their vaccines, available on their websites. Further, the CDC (Centers for Disease Control) website also gives the ingredients.2 

 

The COVID vaccines do not contain live virus, mercury, eggs, microchips, or human embryo tissue.

 

 

COVID Vaccines Change Your DNA

 

The three vaccines currently available in the US are Pfizer, Moderna, and Johnson and Johnson. All three are injections. All three work by instructing cells in the body to make a protein that triggers an immune response.3

 

The Pfizer and Moderna vaccines are mRNA (messenger RNA) vaccines meaning that mRNA delivers the instructions and then breaks down. The Johnson and Johnson vaccine is a traditional viral vector vaccine that uses a disabled virus that cannot replicate in the body to cause illness, a virus unrelated to the COVID virus, to deliver the instructions.7

 

DNA resides in the nucleus of the cell and these instructions, whether delivered by mRNA or disabled virus, do not enter the nucleus. They do not alter the body’s DNA.5

 

 

COVID Vaccines Can Cause COVID

 

As we have seen above, the vaccine does not contain the COVID-19 virus and cannot cause COVID. Of course, someone already infected with COVID before the vaccination might, however, begin manifesting the disease afterward. This is the difference between vaccination and cure.

 

 

Vaccines Have a Microchip to Track You

 

This is a major confusion and has been clarified by Bill Gates. The optional microchip is on the syringe label and confirms that the vaccine is not counterfeit and has not expired. It can also verify that the injection has been given. It is a method to track vaccine units, not people.5

 

 

Natural Immunity from Surviving COVID Is Superior to Vaccination

 

 

This is a falsehood for sure. The body’s immunity from infection diminishes over time. Vaccine seems to provide longer immunity than natural infection. Data suggests that recovered but unvaccinated people are 2.34 times more likely to be reinfected with COVID than fully vaccinated people.2

 

 

Vaccinated People Can Get Breakthrough COVID, so Don’t Bother 

 

No vaccines are 100% effective. Still, the 95% effectiveness of the Pfizer and Moderna vaccines is certainly impressive. It means that a vaccinated person is 20 times less likely to get infected than an unvaccinated person. Additionally, even if infected, the vaccinated person is much less likely to be hospitalized or die than the unvaccinated.3

 

Another statistic shows how small is the chance of a vaccinated person getting severely ill or dying from COVID. On August 9, 2021, the CDC indicated that 8,054 of 166 million fully vaccinated people had been hospitalized or died from COVID. That is 8,054 out of 166,000,0008 or only one in 20,750.  

 

Finally, CDC Director Rochelle Walensky indicated that 99.5 percent of all deaths from COVID were in the unvaccinated.8

 

 

 COVID Vaccines Cause Infertility

 

This falsehood was best addressed in a report from Johns Hopkins Medicine.

“Confusion arose when a false report surfaced on social media, saying that the spike protein on this coronavirus was the same as another spike protein called syncitin-1 that is involved in the growth and attachment of the placenta during pregnancy. The false report said that getting the COVID-19 vaccine would cause a woman’s body to fight this different spike protein and affect her fertility. [Nevertheless,] The two spike proteins are completely different and distinct, and getting the COVID-19 vaccine will not affect the fertility of women who are seeking to become pregnant, including through in vitro fertilization methods. During the Pfizer vaccine tests, 23 women volunteers involved in the study became pregnant, and the only one who suffered a pregnancy loss had not received the actual vaccine, but a placebo.”4

 

Both the CDC2 and WHO9 (World Health Organization) encourage women who are pregnant or wish to become pregnant to receive the COVID-19 vaccine.

 

 

Conclusion

 

We began with the question “Is Vaccination Hesitation for COVID Reasonable?” The answer is “NO!” Vaccination can save your life and stop the epidemic. Hesitation stems from partial information, misunderstood information, and straight-out falsehoods.

Hesitation exposes those who hesitate and everyone in contact with them. Hesitation buys time for the virus to mutate and become even more aggressive. There is no good reason for hesitation, so let’s face the reality and get vaccinated!

 

Thomas Falasca, DO

 

 

 

References

 

1 National Institute of Allergy and Infectious Diseases. (n.d.). Coronaviruses. Retrieved September 13, 2021, from https://www.niaid.nih.gov/diseases-conditions/coronaviruses

 

2 Pogored. (2021, August 24). Common COVID-19 Vaccine Myths Explained. Retrieved September 13, 2021, from https://health.clevelandclinic.org/common-covid-19-vaccine-myths-explained/

 

3 Mayo Clinic Health System. (2021, September 2). COVID-19 vaccine myths debunked. Retrieved September 13, 2021, from https://www.mayoclinichealthsystem.org/hometown-health/featured-topic/covid-19-vaccine-myths-debunked

 

4 Johns Hopkins Medicine. (2021, August 4). COVID-19 Vaccines: Myth Versus Fact. Retrieved September 13, 2021, from https://www.hopkinsmedicine.org/health/conditions-and-diseases/coronavirus/covid-19-vaccines-myth-versus-fact

 

5 Neelaveni Padayachee, N. (2021, August 5). Experts debunk 6 myths about the COVID-19 vaccine. Retrieved September 13, 2021.

 

6 Centers for Disease Control and Prevention. (2021, September 7). Myths and Facts about COVID-19 Vaccines. Retrieved September 13, 2021, from https://www.cdc.gov/coronavirus/2019-ncov/vaccines/facts.html

 

7 Stevens, M. (2021, May 3). Johnson & Johnson vaccine: How is it different? Retrieved September 13, 2021, from https://www.vcuhealth.org/news/covid-19/johnson-and-johnson-vaccine-how-is-it-different

 

8 Most, D. (2021, August 13). Myths vs. Facts: Making Sense of COVID-19 Vaccine Misinformation. Retrieved September 13, 2021, from https://www.bu.edu/articles/2021/myths-vs-facts-covid-19-vaccine/

 

 

Further Reading

 

UNICEF. (2021, June 01). The 12 Common Myths & Misconceptions About COVID-19 Vaccination. Retrieved September 13, 2021, from https://www.unicef.org/armenia/en/stories/12-common-myths-misconceptions-about-covid-19-vaccination

 

 

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