It's been over a month since I've posted. This is mostly because I've been putting in a lot of hours at work, but also because for the past few weeks I felt like I needed a break, and after my last post I was hoping I could take that break. I went back to wearing bow ties and collared shirts at the hospital instead of scrubs, and there was a glimpse of hope with the vaccines. However, the vaccines are currently being outpaced by rising infections. As we reopened everywhere and in many places without restrictions, more opportunities for spread presented themselves, as predicted. People are traveling more, too - often going to places with less masking and then returning home. The infections are rising most in those aged 20-40 - a younger population than the last three waves, partially because they're the ones gathering the most. And to reiterate, the variants are here. B-1.1.7 specifically is wreaking havoc in Michigan and many other places, including infections in Western New York, where I live. Now that vaccines are available to everyone 16 and up in most places, and soon to be available to those aged 12-15, we can hopefully try to catch up, but so many people are still hesitant to take the vaccines, citing concerns about adverse events. I want to discuss vaccine adverse events in general, but today's news takes precedence.
The biggest point? Every single serious adverse effect people want to attribute to vaccines is much more likely from COVID-19 itself. Protect yourself against COVID-19.
I have talked about the common reactogenic and other side effects of vaccines in previous essays. However, a couple of specific concerns have arisen:
Blood Clots Most of you have read the news that AstraZeneca's vaccine and now Janssen/Johnson & Johnson's have seen cases of blood clots associated with the vaccines. AZ was not yet available in the US and JJJ has paused their vaccine to investigate. DO NOT PANIC IF YOU GOT THE JJJ VACCINE. There have been six (6) cases of these blood clots (a serious but potentially treatable type called cerebral venous sinus thrombosis) out of 6.8 million doses. We are pausing the vaccine to investigate the association, and if the vaccine actually is causing the clots. This remains a RARE and POTENTIAL (not proven) side effect. The fact that we are pausing now should be further reassurance to those who claim the vaccines were "rushed" or thrown together. Every step of the way, we have been vigilant and have investigated potential issues like this when they arise. Plenty of people have gotten the JJJ vaccine with no sign of blood clots, but if this investigation changes recommendations, then I will be among those who report it and what to do next. Perhaps we will still use these vaccines but undergo some preliminary testing first, to screen out those with greater potential for clots; or it may be like the rotavirus mentioned above and the formula will change. I don't have those answers now, and no one else does, either. But that's what is being investigated. These two vaccines are viral vector vaccines. They are made with the modified disabled versions of adenoviruses (a cause of the common cold) presenting the information to the immune system to recognize the spike protein. There is a lot of speculation going on about the mechanism of action. I won't get into that because I don't want to confuse the picture, but we can talk about that at some point. A pattern of blood clotting has NOT been seen with the mRNA vaccines (Moderna and Pfizer), which are 95% of vaccinations in the US. Remember, you are much more likely to get blood clots from COVID-19 infection than from the vaccine that prevents it.
For now, the best vaccine is still the one first available to you (as of this writing, that is only the mRNA vaccines). If you have a condition (temporary or permanent) that makes you more susceptible to blood clots (a clotting disorder, for example), vaccine recommendations may change as we get more data. As of now, I don't have the evidence to recommend anything there.
Kassidi Kurill This is an incredibly tragic story. A 39-year-old woman was hospitalized and died of fulminant liver failure, with her body shutting down within 48 hours of hospitalization. Her death also took place 4 days after she received the second dose of the COVID-19 vaccine. It's hard not to attribute her death to the vaccination, given the timing. An autopsy was done, as it should have been. Kurill's father has elected not to release more details, but they were not able to find anything more to connect her death with the vaccine. As I have stated multiple times already, we will see every adverse effect around vaccine dosing under significant scrutiny. Kurill's case is extremely sad, and my heart goes out to her family, dealing with the loss of a mother, a daughter, a person. But we're at almost 80 million people fully vaccinated in the USA. Over 180 million shots have gone into arms. If this was something we could attribute to a vaccine, we would have seen more cases like Kurill. We have not - I won't downplay the tragedy of her death, but just as her family is not downplaying the importance of getting vaccinated, neither will I.
The recommendations remain: Wear your masks, maintain distance with those outside your bubble, wash hands frequently, and get vaccinated!
