We have all been getting a lot of questions about Pfizer's Covid-19 vaccine which should be getting distributed this week in our community. Hoag will have access to these first doses available to health care workers and I think all the PACWHA doctors signed up as fast as they could!
I was extremely hesitant about the vaccine a few weeks ago, but given the recent surge of Covid cases, my fear of Covid and spreading it to patients and family members currently outweighs any fear of the vaccine. In addition, the numbers and data are really reassuring. Like everything in life, you have to evaluate the risks versus benefits, hopefully I can provide some clarity on these for you.
#1 ) Does the vaccine cause female infertility? I literally heard this today and was shocked! My thoughts on this, first of all how can we know this when we haven't even had this vaccine or the real COVID virus for a year and it takes at least a year to diagnose female infertility. Let's face it, we don't know if COVID (the actual virus) changes fertility rates but there is absolutely no evidence to suggest the vaccine causes infertility. I am going to just tell you that current leading researchers say the science is lacking. I, for one, have realized during this year there are some crazy "expert" doctors out there who need to go back to Biology 101. They may have gone viral (because they are crazy and feed on people's fears instead of their common sense) but trust your judgement. The man who started this theory about the vaccine left Pfizer in 2011 so there might be some other motives there.
If you are interested in more please listen to this: https://zdoggmd.com/vaccine-sterilization/
#2 Is the vaccine safe? Did it get developed too fast? The real benefit is that after 2 doses there is a 95% efficacy rate, our normal seasonal flu vaccine is about 60% effective. Let's review the data: 43,000 random volunteers from around the country were randomized into two groups placebo and vaccine group. 8 people in the vaccine group got it and 162 people in the placebo group. 8/162 = 0.095 subtracted by 1 = 95% efficacy. Immunity begins 12 days after the first dose, and 2 doses are recommended 21 days apart. If you combine all the different companies more than 70,000 people participated their Phase 3 trials. And all will be followed for 2 years.
For you technical statisticians out there read this : Harvard Business Review Article.
Basically it is extremely unlikely that this difference is related to chance, so there is good efficacy. Supposedly, nothing was rushed in the development of the vaccine and scientists have been working on these vaccines for 30 years, they just started manufacturing this particular one before the Phase 3 trials had data that it worked. No safety steps were compromised and we have two month safety data which confirms minor side effects. Compared to the actual disease associated with COVID-19, these seem small. The most common side effects appear to be fever, and body aches, pain at the injection site and these generally resolved in 2 days.
More safety questions answered by experts ( real ones) : https://www.medscape.com/viewarticle/942483#vp_1
Some interesting history https://historyofvaccines.blog/2020/07/29/what-is-an-mrna-vaccine/
#3 Is the vaccine safe in pregnancy or breast feeding? The bottom line is that we don't have a lot of data on this. However because the vaccine is not a live virus ( such as Measles, Mumps Rubella or MMR) there should be no risk to developing fetus and even less risk to breastfeeding mothers. mRNA vaccines are are quickly degraded by cells and do not enter the nucleus of the cell ( that's where the DNA is). Because pregnant women may be at higher risk of hospitalization and mechanical ventilation and adverse pregnancy outcomes the thought is that the benefits outweigh the risks for those at high risk at contracting the actual COVID-19 disease. The major organizations that help us evaluate treatments in pregnant women have come out with statements saying that is unfair to exclude high risk women from the vaccine simply because they weren't included in trials when the theoretical risk is not there. Therefore, frontline healthcare workers who are pregnant are encouraged to talk to their physicians in a shared decision making model to decide whether they should get it. All the PACWHA physicians support pregnant high risk patients getting this vaccine.
Please review this PDF for a nice algorithm for shared decision making:
Here is the link to register for the Cover vaccine registry if you are pregnant or breast feeding and receive the vaccine.
or email covidvaccpregregistry@uw.edu
#4 Who should not get the vaccine? It seems like there is a small risk of severe allergic reactions, so those who have a history of anaphylaxis ( extreme swelling, hives, throat closing, unable to breath) or severe allergic reactions to vaccines should not get this vaccine. Also those who have had COVID within 90 days should probably not get it since they seem to have enough of their own antibodies. I am waiting for more data regarding re-infection.
Assess your risks and decide whether the potential benefits outweigh them:) I don't think the general public will even be offered the vaccine until late Spring or early Summer.
Please continue to social distance, wear your mask. There is a real virus and it makes some people very sick, the hospital is full right now and all elective cases have been cancelled.
I am sooo pumped to be over this pandemic! Hooray for science and technology. I am scheduled Thursday morning and will keep you all posted!
