Guest columnist Dr. David Gottsegen: How to end the pandemic

  • David N. Gottsegen David N. Gottsegen

Published: 6/21/2021 6:51:32 PM

At first it was a feeding frenzy to get the COVID vaccine. Now officials can’t give them away. From shotguns in West Virginia, to free joints in Washington, to Anheuser Busch’s promises of beer, to lotteries in Massachusetts, states and the Biden administration are desperately trying to reach the goal of 70% of Americans vaccinated by July 4.

Massachusetts is the second most fully vaccinated state — just behind Vermont — but vaccination rates are slowing, as is the case in the rest of the country. Less than a third of adolescents (age 12-17) have received a COVID vaccine nationwide.

I’ve spent hours with my adolescent patients and their parents encouraging them to get one of the COVID vaccines approved for their age group. But despite my best efforts, a good number of them have declined. Parents and teens are hesitant about the vaccines for many reasons — that the shots are relatively new, that they have had the disease and think they are already immune for life, that COVID rates are declining, that there is a risk of allergies, myocarditis (inflammation of the heart) and even infertility, and that many people feel sick after the getting the shots.

COVID vaccines have now been given to over 177 million Americans with only one confirmed death, from the Johnson & Johnson vaccine. The Vaccine Adverse Events Reporting System, or VAERS, lists 5,208 reported fatalities as of June 11, but those deaths can be of any cause — a car crash, heart attack and so on. And anyone is free to report anything, including one person who said that he turned into the Incredible Hulk, and another who made up a death. The CDC has reviewed each one of these reported casualties and found them not related to the vaccine.

Rates of COVID are declining, but new deadly versions like the Delta variant are surging in India and South America. Remember in early 2020 when COVID was only raging through China, and then Italy? Those variants can easily make their way here.

One recent study from Washington University showed that 11 out of 15 COVID survivors had evidence of long-lasting strong immunity to the disease in their bone marrow. That led a few experts to say that people who have recovered from the disease may not need more than one dose of the vaccine — not that they can avoid them altogether.

According to published data, there is a very small risk of serious allergic reactions to the Pfizer vaccine (5 in a million) and the Moderna (2.5 in a million); the individuals who had these allergic reactions were treated and went home.

Who should not get the COVID vaccine? Only people who had a serious reaction to a previous COVID vaccine, or who are allergic to a component of the vaccine.

There have been 475 cases of reported myocarditis, most of them mild, in teens and young adults under 30 who have received the Pfizer or Moderna vaccines — out of 20 million doses given to this age group. Compare this to published studies that show that up to 60% of COVID survivors may suffer from myocarditis. This is particularly true of young adults. Because of this, the American Academy of Pediatrics recommends that all children who have had COVID come to the office to be screened for cardiac problems before returning to competitive sports.

The Pfizer and Moderna vaccines use messenger RNA that cause immune cells to produce antibody against the spike proteins of COVID. The mRNA does its work and vanishes within two weeks. It does not enter the nucleus of cells. To say that it can affect a person’s fertility is pure fantasy.

COVID vaccines do make many people feel lousy for a couple of days. But most vaccines have these same side effects. The antibody response from vaccines often triggers very mild symptoms of the disease itself, which is why a person might feel “flu-y” after a flu vaccine. But they almost certainly will be protected from dying from influenza.

There are other issues too. I have talked to a few parents about the risk of death from the vaccine. I explain that even if all the deaths reported in VAERS after the COVID jab were due to the vaccine itself, the risk of dying after getting the shot is about .003%. Compare that to the overall risk of dying from COVID: 1.8%.

Psychologists point out that numbers in general are too abstract for most people. Studies show that people do not have nearly as much of an emotional reaction to reading about 5,000 people dying for example, than reading a personal story about one person dying. So, if a person has been fortunate enough not to have experienced the serious illness, long-haul symptoms from COVID , or to have had a loved one sicken or die from the disease, they may not understand or care about the statistics that get showered on us in the news.

Finally, scientists and doctors are usually poor communicators. Scientific research has led to constant alteration of recommendations. This can be confusing. And the public health community and the governor’s office in Massachusetts has done a shoddy job of communicating with local health care professionals.

The message should be simple. Almost all of the epidemic infectious diseases of the 20th century in developed countries like the U.S — from smallpox to polio — have been eradicated in developed countries by vaccines. Vaccinations are leading to dramatically lower rates of COVID. Vaccinations are the reason that businesses are reopening. Vaccinations are the reason that the lost year for kids — a time of isolation, and skyrocketing rates of anxiety, depression and obesity — is at last coming to an end.

There is risk involved in any medical intervention, and in anything we do in life. But the risk from the COVID vaccine is much less than the suffering and death that may come from the disease. Trust in your health care provider. Trust in science. And remember that we’re in this together. By getting the vaccine and having your children get it, you are helping yourself, them, and our community.

Dr. David Gottsegen works at Holyoke Pediatric Associates and lives in Belchertown.

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