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  • Writer's pictureEric Knabel

Thoughts From Six Feet Away: I'm Not Throwing Away My Shot!

Things don’t seem to be going according to plan lately.


Inspiration, the fickle muse that she is, strikes at the most inopportune of times, often when plans have been made, and I finally seem to have my ducks in a row. See, I want to write lighthearted posts about the music I’m listening to, or the scattered thoughts that litter my brain. But after the great response I got from my post about our COVID journey, I’ve decided to wade into the pandemic waters again. Sometimes I feel like we’re all in a burning building, not knowing what to do, and we’re just looking for someone to stand up and say, “I know the way out – follow me.” I don’t pretend to be that person, but if I can make one person feel better about their situation, it’s worth it for me.


As medical professionals, we have undergone a wacky journey in the past year. In March and April, we were touted as heroes. At the time, I was a little embarrassed by it. Even made a blog post about it here. But then politics got involved, and our expertise has taken a back seat to a “post I saw on Facebook.” I have had actual arguments on my social media with people who claim to know more than I do about COVID-19, based on their “research.”


I have been repeatedly asked, “What’s it going to take to get back to ‘normal?’” My answer has been the same – I’m not sure, but when we learn the cost, we should pay it. When the FDA approved the use of not one, but two vaccines, I thought we were saved. Let’s all get vaccinated and put this all behind us, so we can go to movies, concerts, and sporting events again. But instead of a collective sigh of relief, I am instead hearing objections to getting vaccinated repeatedly. Somehow the beliefs of the anti-vaccine movement have infiltrated everyday thinking. I have my theories as to how that happened, but I won’t go into it here. I’ve gotten into numerous arguments with people – it’s been maddening. For those who know me, I hate invoking my credentials, and I’ve had to do it more than once.


And here is where inspiration strikes.


I believe informed decision-making is a combination of knowledge and experience. If you have one, seek the other, and if you have neither, you should listen. My opinions are based on facts obtained through application of sound scientific principles, and not Facebook posts or YouTube videos. I know some have made up their minds, and the boldly proclaim that their opinion is just as valid as mine. This post is not for you. This post is for people who are legitimately struggling and want to decide based on information, not fearmongering or politics. So I’m going to break down the ones I’ve heard, as best I can.

 

Why are we making such a big deal about this? 99% of people survive this thing!

True, for most people the fatality rate is 1%, but for those over the age of 80, it’s much higher. Let’s make this simple and do the math. As of the most recent numbers, the United States has a population of 330 million people. Put away your calculators, folks – 1% of that is well over 3 million people, assuming everyone gets this thing (which is a faulty assumption, but even half that is scary). Think of it another way – look at your friends list on Facebook, and for every hundred friends you have, pick one of them to die. Morbid, I know, but it puts it in perspective. And of those that survive, a percentage could have long term effects. I’ll get into that later.


I’m worried I’m going to get COVID from the vaccine.

This is a carry-over from the flu vaccine. It’s true that some vaccines are “live vaccines” -- weakened versions of the infectious virus, like the shingles vaccine. The COVID vaccine is not one of them. Like the flu vaccine, it contains pieces of the virus that are sufficient to generate an immune response. Think of it this way, if I put you in a room of severed arms (I know that’s unsettling, but bear with me), they will not form a person and kill you. If you get sick following the vaccine, odds are you were already sick.


I’m low risk. Even if I get it, I’ll survive.

Again, another recycled flu vaccine statement. When it comes to vaccines, it’s important that we look beyond ourselves. True, an overwhelming majority of low-risk persons who get the disease will survive, but this is where we talk about herd immunity. There are those in the population who will not be able to get the vaccine. For those people, their only hope is that most of the population is immune, and that will only occur through vaccination. As I tell my patients every flu season, I don’t vaccinate to protect me, I vaccinate to protect those who could get the disease from me.


I’ve heard about side effects, and I’m nervous about experiencing those.

I get it. I had side effects after my first dose. No one likes feeling chills and body aches. But here’s the deal –- it’s not the virus or bacteria making us feel that way, it’s our body responding to the insult. So if you’re feeling side effects from the vaccine, that’s great! It’s doing EXACTLY what it’s supposed to do. I read an account from someone in the Moderna study who said that when they got their shot and started feeling bad, they were happy because that likely meant they got the vaccine and not the placebo. That’s the attitude we all need to have.


No one knows the long-term effects of this vaccine.

When I hear this, I wonder why no one talks about the long-term risks of COVID instead. We’ve seen cardiac effects, lung problems, and cognitive declines. That’s a much scarier prospect, in my opinion. The RNA in the vaccine literally makes the protein it’s programmed to make and dies within a couple of minutes of doing that. Where is the long-term risk? I can understand the concern but think about it for a moment. How will anything long-term be known unless there is a short-term? Unless you have a Delorean, a flux capacitor and 1.21 gigawatts laying around the house, you can’t just skip ahead. Think about what came before you – people lined up for the polio vaccine, a disease that affected far fewer people than COVID-19 and no one knew what a vaccine was back then. A whole generation of people were willing to suffer life with a large scar on their shoulder to not get smallpox.


I don’t trust this vaccine. It was developed way too fast to be safe.

Not so fast, my friends. There are many layers to this one. First, the vaccine may be new, but the technology has been around for decades. This is the first time it has been used in a vaccine, but there’s no reason to doubt the technology. Yes, I know that in the past, vaccines took four years to develop, and while the “good old days” had a lot of positives, technology was not one of them. We can simply do things faster. We developed a vaccine quickly for H1N1 in 2008, and NO ONE talked about how fast that was. Related to the technology, the mRNA in the vaccine can be sequenced quickly – it doesn’t have to spend months growing on a culture medium. So the months it takes to “grow” the flu vaccine are simply not required here. Finally, you need to have an understanding about how the approval process for a vaccine works. In normal times, you develop a vaccine, then you conduct clinical trials. Once you have results, you present them to the FDA, and once you get approval, THEN you start making vaccine. That process can take a couple of years, just to get the green light to make the vaccine. However, these are not normal times. The vaccine was being produced AT THE SAME TIME that they were studying it, so that when they got permission for emergency use by the FDA, they had doses ready to go. Hear me very clearly on this one – there were no short cuts taken. The safety protocol for ANY vaccine or drug were followed to the letter. The only difference is that rather than wait for Step X to be completed before moving to Step Y, they did Step X and Step Y at the same time. Take all those factors, and what was normally a 2-3 year process now becomes a process that lasts a few months. Science is not like mowing the lawn – the consequences for doing sloppy work has huge consequences.


This vaccine is not safe. There are people dying from allergic reactions!

That’s always a concern, isn’t it? The treatment is worse than the disease? While that may have been true in the 19th century and before, it’s much less so now. There are so many controls in place to prevent that from happening. I’ve worked on clinical trials, so I’d know. Now, for the sake of transparency, the current numbers are 5.5 cases of anaphylaxis per million vaccinations. In terms of odds, that’s 1 in 181,000, more or less. That’s still concerning to some, so I’m going to compare it with some other things that we tend to take for granted.

Odds of getting murdered while living in Chicago (lifetime) – 1 in 68

Odds of getting pregnant on birth control pills – 1 in 100

Odds of dying from COVID-19 if you are infected – 1 in 100

Odds of being in a car accident on a 1000 mile trip – 1 in 366

Odds of getting struck by lightning – 1 in 500

Odds of successfully navigating an asteroid field – 1 in 3720

Odds of being hit by a car – 1 in 4292

Odds of being in a plane crash – 1 in 30,000

Odds of a serious reaction to COVID vaccine – 1 in 181,000

Odds of being struck by a meteorite – 1 in 250,000

Odds of winning the Power Ball – 1 in 292 million (yet you still buy tickets)

Bottom line: we do lots of things on a daily basis that are more dangerous than the vaccine. Be on the lookout for meteors, though.


I’m worried about the link with autism.

The vaccine is currently not approved for use in young children, not because it’s dangerous, but because it hasn’t been studied. That being said, I get the fear of autism. My son is on the spectrum. But you know what he also is? Fully vaccinated. This fear arose from a study published some years back in The Lancet, a study that has since been refuted, and the clinician who published it has been discredited. There are way too many variables in the mind of a developing child to blame autism on vaccines. It has been studied way too many times, and no correlation has been determined.


The vaccine will be worse than the disease!

This is a statement borne out of fear, and I debated even including it. The safety data speaks for itself. Ask anyone who had anything more than mild symptoms of COVID, and they will tell you that they’ll gladly accept the vaccine over having it again. I guess I have a hard time understanding how arm soreness and a couple of days of chills and aches could be worse than three weeks of being unable to get off the couch. Yes, I know there have been cases of severe reactions, and I’ll discuss those later.


I’m worried the vaccine will change my DNA.

When the general public starts getting information on genetics, this fear emerges. But this isn’t a Michael Crichton novel. The fear is that this RNA will persist and somehow make “stuff” indefinitely. The RNA in the vaccine is messenger RNA, or mRNA. Its purpose is to make the protein it’s coded to make, then die – a process that only takes a few minutes. It never enters the nucleus of the cell, where our DNA resides.


This is usually where I get into big Pharma arguments. I can’t say I disagree with anyone who has issues with big Pharma. And there is a misconception that the government made it illegal to sue the drug company over an adverse reaction. There are ways to make claims if a vaccine is produced poorly, so drug companies are not going to be reckless for the sake of profit. If they did, ALL of their products would be called into question, and their reputation would suffer. Gotta think big picture on this one – I can promise you the drug companies do. And for those who are concerned, the Novavax vaccine is not being produced by big Pharma.


I’m concerned that the vaccine was created from aborted fetuses.

All right, gather ‘round, my Catholic friends. Yes, it is true that certain vaccines were created from the cell lines of two aborted fetuses. Since that time, only the cells from these two fetuses have been used for vaccine production. That’s it. We haven’t been aborting fetuses to harvest their cells, as some claim. Fetal cells are also not being put in the vaccine. As I’m typing this, those fetal cells have prevented 10 million deaths due to vaccine-preventable illnesses and tens of thousands of abortions due to rubella – you don’t get more Pro-Life than that. But don’t take my word for it – the Vatican has issued a statement on this. Twice, in fact. The first was in 2006, by Pope Benedict. The second was just last year, by Pope Francis. The Vatican is clear on their stance that alternatives should be demanded, but in the case where there are no alternatives, the clear benefit to humanity justifies their use. Don’t look at me – I’m just repeating what the Pope said (twice). In addition, the Novavax vaccine is not using these fetal cells for research.


Bill Gates is going to make 680 billion dollars by pushing an unsafe vaccine.

Are you serious, Clark? For all the times I’ve heard this, no one has shown me how he stands to make this ungodly sum. If it’s through stock options, last I checked, that was legal. In double checking, the Gates Foundation has not invested in any of the approved vaccines. On the other hand, the Zuckerberg foundation has. Are we focused on the wrong billionaire? This is the most 2020 thing ever – my conservative friends complaining about someone making money in a free market. Cats and dogs, living together! It’s my turn to be selfish – if we can resume public gatherings from vaccine production, I don’t give a flying rip who makes money from it.


They are using the vaccine to put tracker chips in us so that we can be tracked.

This one is pretty Orwellian. Now, I would like to say that I have no doubt that nanotechnology like this exists. On the other hand, let’s look at this rationally. If your concern is that Big Brother is watching you, I would argue that the thing you’re worried about happened ten years ago. If you have a smart phone, a smart TV, or an Amazon Alexa/Google Home, you’re being monitored. Don’t believe me? Start mentioning casually that you’d really like something totally random, then watch the ads on your Facebook show you those very things. I guess what I’m trying to say is, they don’t need to use a vaccine to plant a tracker in you – they’re already tracking you.


I heard the new vaccine is only 65% effective in controlling infection. And what about these new variants?

The new Johnson and Johnson vaccine demonstrates effectiveness, but as a single dose. If you review the Pfizer and Moderna data, their effectiveness with a single dose was similar, hence the second dose, which pushed effectiveness over 90%. A friend once told me that anything above 50% is considered a success in the vaccine world. There is a race to get a single dose vaccine because they’re fighting human nature. People could potentially not show up for a second dose if they have side effects with the first. When I see patients, I cringe when I prescribe a medication that’s dosed any more than twice a day, because I know the odds of full compliance are darn near zero. J&J is doing studies on second dose regimens now.

As for variants, the vaccines are holding up against these new strains, albeit not as effective in some cases. In the future, adjustments for variants will be quick ones, and we will be able to adapt much quicker than we have in the past.

 

Sorry for the short story that this has turned out to be. I thought it was important to do this because there is so much misinformation out there. I hope this gets out and gives people some peace of mind. For those who disagree with this, you’re going to need more than anecdotal evidence or a video that has been taken down by YouTube five times. The things I’ve said can be verified easily enough. My advice remains – get your vaccine. Do it for those who can’t. Do it for those who are vulnerable. Heck, do it for those of us who’d like to see a concert in the next year. I’m sure everyone knows someone in one of those three groups. As I said earlier, the price has been given. Pay it, and let’s go to dinner and a movie.

And as always…



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