Dr. Bow Tie
COVID-19 AND VACCINEs: Young/Healthy, Prev COVID, Length of Protection, Shedding, "Stanford", J/J&J
Updated: Apr 27, 2021
Time for a round-up of some vaccine myths circulating. Let's smash some disinformation:
"I AM YOUNG AND HEALTHY, I DON'T NEED THIS VACCINE!"
We have seen time and time again that the "young and healthy" argument is incorrect. As I said last week, the latest surges predominantly affect 20-to-40-year-olds as they get together more despite inadequate vaccination rates. This virus has never discriminated, and it is not doing so now. Yes, thankfully plenty of people have been infected and have survived, but not always scot-free. People have come away with new oxygen requirements, significant weakness and pain, and even tracheostomies from being ventilated. Long COVID (Post-Acute Sequelae of SARS-CoV-2) is a very real phenomenon that is affecting a significant population of the US population. So yes, if infected, you may come away without these things, but why not take advantage of a vaccine with SIGNIFICANTLY less potential for effects (again, despite what I've had to talk about last week, the incidence of serious adverse events is so much lower with vaccinations than with the disease itself)?
"I ALREADY HAD COVID-19 AND I WAS FINE!"
We have seen that antibodies drop off significantly in the 3-6 month period after the infection resolves. Reinfections are thought to be rare, but we have never had enough testing/tracing to really be sure of that. But more importantly, infection with the wild type (original COVID-19) does not appear to protect against the new variants, which are starting to dominate the infection spikes.
It's like if you had minimal fight training but got roped against your will into an MMA match against a particularly tough fighter. You might get lucky and survive, and you'd probably learn as you went through the match and pick up some technique. But with no further training, if you go up against that fighter after THEY'VE learned new techniques and styles, you may not do so well the next time, or at the very least you might take a much worse beating.
But imagine if you trained with an expert, who showed you techniques and tactics that could be used against you, and how you might defend against them, even newer techniques that weren't around when you first heard about the other MMA fighter. You could go into that fight much more confidently, and you would be much better prepared to take on the enemy fighter. THAT'S the difference between surviving a COVID-19 infection and hoping for the best vs. getting a vaccine.
THE VACCINE ONLY LASTS 6 MONTHS!
That's a misreading of the data by the news and by "influencers." We know they last AT LEAST 6 months at this point, and we'll check again when we hit the one-year mark. And again at 2 years. And we will keep monitoring, because that's how vaccines work.
A STANFORD STUDY SAYS MASKS DON'T WORK!
Wrong. First, it's not a Stanford-affiliated journal ("Medical Hypotheses" specializes in theoretical, "radical, speculative, and non-mainstream" papers. Not where we go for real scientific conclusions). Stanford actually created a post distancing themselves from the author, who is not a physician or any kind of expert in the mask topic, and who is not actually affiliated with them. Literally every point the guy makes has already been disproven. MASKS WORK. And they cannot cause carbon dioxide toxicity or bacterial infections.
THE VACCINE IS SHEDDING AND AFFECTING THE PERIODS/FERTILITY OF OTHERS!
No. There is no biologically plausible way to do this (thankfully). I have already addressed the myth of COVID-19 vaccines interfering with fertility (they can't and don't). None of the vaccines have any capability of reproducing the virus or "shedding" antibodies - only live viruses can shed, and there is NO trace of live virus in any of the vaccines. No elements of the vaccines stick around in your body after 72 hours, either - only the antibodies your immune system creates. Tens of thousands of pregnant individuals (remember last week when I talked above v-safe and its active monitoring? Here's where it comes in!) have now received vaccines, with no adverse effects on fetuses, births, or fertility!
There have been reports of periods getting thrown off schedule or getting delayed after vaccinations. This is not necessarily unexpected since the immune response can flare up and act like inflammation (either systemic or endometrium-specific), though it is TEMPORARY. They are investigating this (studies are enrolling), but it is also confound by the fact that we are currently in the most stressful period of most of our lives (stress affects menstruation) and people are starting to get together (cycles influencing each other), among these other factors.
You know what CAN affect fetuses, and pregnancy? Actually getting COVID-19. I have seen multiple pregnant patients with COVID-19 in the hospital recently, and let me tell you, it is scary. THAT is the situation you want to avoid, and precautions and vaccines are the best way to do that.
A store in Canada actually banned vaccinated people because they fell for this myth and are worried about "shedding." This is based on nothing except social medial influencer falsehoods. This is why I go after disinformation.
WHAT'S UP WITH THE JANSSEN/JOHNSON&JOHNSON VACCINE?
After 11 days, ACIP and the FDA have elected to unpause and resume use of the JJJ vaccine. It was a vote of 10-4-1: 10 voted in favor, 4 voted to pause longer ONLY because they wanted to reinforce language about the warning to accompany it, and 1 abstained from voting due to a conflict of interest. The JJJ vaccine is once again available in the USA, and it is STILL safe and effective. As I stated last week, the rate of blood clots is about 1 (one) per MILLION doses (the rates of blood clots are higher for the general population, people on birth control, people who smoke, and most importantly, PEOPLE WHO GET COVID-19 INFECTIONS. If you get the J/J&J vaccine and you're a woman under 50, you may see a warning to watch for leg pains, shortness of breath, abnormal headaches, or chest pains for the first 1-3 weeks. Outside of that time period, there does not appear to be any worry. There has not been any formal guidance regarding those who have conditions predisposing them to blood clots, this may be forthcoming. If the mRNA vaccines are an option for you, that may be the better option, but again - the risk is still VERY low.
WHY GET THE VACCINE IF I CAN'T GO BACK TO PRE-PANDEMIC BEHAVIOR IMMEDIATELY?
We are starting to get more evidence that the vaccine DOES decrease transmission AND asymptomatic infection, meaning it decreases spread. This wasn't what we looked at with the initial trials, which is why we did not have the numbers at first. Now we are seeing that Oxford/AZ's vaccine is reducing positive PCR tests (what they measured) by 67%, J/J&J reduced asymptomatic infections by 72%, and the mRNA vaccines reduced all infections by up to 90%. The data is still evolving (some of these are pre-prints, though promising), and you can see that these numbers, like the efficacy of vaccines all along, are not 100%. As with most vaccines, the protection is not just for you. It's for everyone around you as well; we all protect each other. You all know someone who has been affected by (and probably someone who died from) COVID-19. If you don't...you do. Don't let it reach anyone else. Do not let it reach your family as it has hit so many others.
Vaccines are how we reach herd immunity and find our new normal.
The recommendations remain: Wear your masks, maintain distance with those outside your bubble, wash hands frequently, and get vaccinated!
And as always, ask questions! That's what I'm here for.
Maternal/Neonatal Morbidity in COVID-19: https://jamanetwork.com/journals/jamapediatrics/fullarticle/2779182
The "Stanford" Study: