COVID-19: The Disease of Disinformation (Or: My Greatest Hits, Remastered)
In my last post, I discussed how dangerous the Delta Variant is and how much it's spreading (currently on the rise in EVERY STATE and around the globe). The only protection we have against it are the mitigation measures we have used the whole time (masks+distance+hand-washing) and the vaccine ("natural immunity" from previous COVID-19 infection does not work against Delta). The longer we go without high full vaccination/immunization rates, the more variants will evolve and one may escape our vaccine.
The Surgeon General recently released a 22-page advisory finally intended to confront what too many of us in healthcare (but not enough) already knew. Nearly equal to the dangers of COVID-19 is the pandemic-level spread of disinformation (intentional spread of false information disguised as scientific communication). I’m not talking about those folks who are skeptic about vaccines because of previous health scares or who have been mistreated by the healthcare system, because I want to talk to you about those things non-confrontationally. That’s made harder because there are too many "influencers" (even in the science community) who make money or clout from spreading meme-worthy falsehoods to enhance their own brand (one is even decrying the current vaccines because he is creating his own!).
All of the scientific communicators I share with you share science for science's sake. Some of them have paid partnerships, but they separate those from their scientific information. This is as opposed to Del Bigtree, Joseph Mercola, and others in the Disinformation Dozen or "America's Frontline Doctors" (paid by right-wing "news" source Breitbart) who deliberately sow mistrust in evidence-based medicine for their own gain.
I have talked about most of this misinformation before, but there are updates on some of the topics. My childhood musical hero Richard Marx just released a memoir and accompanying soundtrack with remastered version of his greatest hits. Allow me to do something similar here. Let's mythbust:
"The Vaccine Was Rushed!" - NO, IT WASN'T
Every vaccine went through extensive trials (Pfizer 44,000, Moderna 30,000, J&J 60,000, same with AZ), and now we’ve seen millions of real-world doses. No part of development, from initial laboratory science to animal studies to the trials on human participants, was rushed. Remember, Emergency Use Authorization still requires Phase I, II, and III trials. The only difference between it and full FDA approval is that EUA only needs 2 months post-trial monitoring data. So how did this move so fast?
Unlike with previous vaccine and other drug development, there was no waiting on grant applications/funding approval, on “profitability estimates” and pharmaceutical company personnel, on indifference or waning interest, or on recruitment (people volunteered!). As Dr. Mark Toshner said: "It's not ten years [to develop a vaccine] because that is safe, it's ten hard years of battling indifference, commercial imperatives, luck and red tape" (I still don't like the lack of Oxford comma there, but again I let the article speak).
Further, mRNA vaccines have been around for over a decade - this is not new technology!
“We don’t know about the long-term effects!” – YES, WE DO
I once again cite Dr. Paul Offitt, who states that any major side effects of vaccines occur within 6 weeks of dose (remember how EUA requires 2 months of monitoring? Is that a coincidence? Nope). Further, you've seen how careful this process is. You’ve seen the vaccine distribution get paused for further assessment.
I have been vaccinated since January 19th. We've delivered hundreds of thousands of doses in the US since September 2020 (the initial trials) and MILLIONS worldwide, with close monitoring of any adverse effects. No new effects have started more than a few weeks after vaccination (and most actually-attributed effects were within a few days of the shot).
Long-term side effects from previous vaccinations have been exceedingly rare (see my previous posts on why VAERS needs to be taken with a grain of salt). And remember, the long-term effects of COVID-19 infection are infinitely more dangerous. These include death, of course, but that is (as I have repeatedly said) not the only bad outcome. There are now studies showing increased use of outpatient services, chronic respiratory symptoms, tracheostomy holes, chronic fatigue, diabetes, heart failure (including from myocarditis), and every other body system (even in patients who are not hospitalized).
"COVID Doesn't Affect Kids!" - YES, IT DOES
4 million children have been infected and/or tested positive since the pandemic started. 15,000 American children have been hospitalized, and at least 300 have died (>100 were less than 5 years old). This. Is. Not. Okay.
See my previous posts for information from me as well as my friends/colleagues in the pediatrics world regarding Multisystem Inflammatory Syndrome in Children and Post-Acute Sequelae of COVID-19 (which also affects children). The original COVID-19 did seem to affect children less, but the new variants Gamma and Delta have hit our youngest loved ones much harder.
When can kids <12 be vaccinated?
Unfortunately not until midwinter. The trial is still waiting to detect more cases (of a predetermined number deemed necessary to see enough cases to determine efficacy), and the FDA has asked for 4-6 months of post-trial monitoring (even for EUA). We must protect our children. That means every adult who can take the vaccine SHOULD take the vaccine, and every child and teenager over 12 years old should also get vaccinated. This ALSO means universal masking in schools until vaccines become widely available. States are trying to eliminate this measure, but for the sake of our children it remains essential protection.
The rumor on a message board (not an actual paper): The spike protein is similar in structure to placental protein syncytin-1, so a vaccine against the spike protein may attack the placenta.
The real: The proteins are not that similar (your immune system is smarter than that)! Further, syncytin-1 is created BY the placenta, so no part of the vaccine can cross the placenta to attack syncytin-1 or inhibit placental growth. And NOW, we have proof that NO vaccine elements can cross the placenta, only the antibodies your immune system creates, which is supposed to happen!
A recent NEJM article featured 827 participants in which they measured pregnancy events between vaccinated and unvaccinated individuals (preterm birth, spontaneous abortion, congenital anomalies). Rates of these events were the same or less in vaccinated pregnant people. Since then, multiple studies (small and large, epidemiological and prospective) have confirmed this! As of March, we’ve vaccinated >60,000 pregnant people (so obviously even more now) with no vaccine adverse events (and believe me, we've watched very closely). They also studied outcomes in in vitro fertilization and male fertility with similar results.
Note: Uterus-owners' periods have been thrown off-schedule for 2-4 cycles, but always temporarily (I have met people who have experienced this). This may be stress-induced (we're all coming back to "regular life" after a damned pandemic), or may be related to fevers, but it is not permanent! We have seen NO effect on fertility (and many people have gotten pregnant after the vaccine or have gotten vaccinated while pregnant and delivered successfully).
Remember, COVID-19 disease can actually cause much worse damage to fertility and pregnancy, and even erectile dysfunction.
None of the US vaccines contain any live virus, which means they are safe in the immunocompromised. However, those with autoimmune disease or on treatments for them may have a decreased ability to create an immune response with the vaccines. This varies depending on condition and/or treatment. The most likely to struggle with antibody creation include those with solid organ transplants, blood/hematological cancers, or on anti-CD20 therapies like rituximab. These are the folks who may benefit from a booster, and also why the rest of us MUST get vaccinated.
Definition: myo-: muscle; -card-: heart, -itis: inflammation (inflammation of the heart muscles), most commonly caused by viral infections (SARS-CoV-2, Coxsackie, others). There were concerns about this happening related to the vaccine. After significant observation and monitoring, we saw 594 cases out of 180 million vaccine doses (1st or 2nd). That's about 12.6 cases per million doses. This is so thankfully rare, it may not happen any more frequently with the vaccine than outside of it.
Who is susceptible? Mostly Men under 30, within 1-4 days of vaccination. Most cases are self-limiting/easily resolved, and a vast majority recover from all symptoms - many are not hospitalized at all. Most cases of myocarditis (vaccine-related or not) are never seen by a physician because they are so mild.
Blood Clots, or Vaccine-Induced Immune Thrombotic Thrombocytopenia
There were incidents of cerebral venous sinus thrombosis and other blood clot events that were concerning for an association with the Janssen/Johnson & Johnson vaccine. These were also incredibly rare. We even paused distribution of J&J vaccines just to make sure!
The mechanism of action is thought to be similar to heparin-induced thrombocytopenia (low platelet count), which creates anti-PF4 antibodies vs. platelets. In the US, we have seen 38 confirmed cases out of 12.6 million doses (1st or 2nd), or roughly 3 cases per million doses. Once again, mercifully rare!
Shedding - THE VACCINES DO NOT
There is no biologically plausible way to do this. Only live viruses can shed (for example, herpes), and NONE of the vaccines available in the United States contain live virus. Moreover, no vaccine elements remain in your body after 72 hours, only the antibodies/immune protection they create!
Stores banned vaccinated people because of this “shedding” myth, which is based on nothing except social media influencer falsehoods. This is why I go after disinformation.
Masks - THEY STILL WORK
L.A. County was forced to go back to indoor masking due to the surge in Delta Variant COVID-19 cases. This surge is happening in every state, so we may see more mask mandates (even for the vaccinated) return in the coming months. I KNOW...but this is the nature of the pandemic. Do you want to shorten the required time for mask mandates? Get vaccinated! The vaccines protect against delta and other variants!
"Well, if vaccines are so effective, why can't I just let those who want the vaccine get it?"
See all of the above. No treatment/intervention is 100% effective. The Delta variant is already known to bypass "natural immunity" from previous infection, and may cause breakthrough COVID-19 infections in the vaccinated. However, in vaccinated individuals, the infections are MILD. The vaccines were designed to keep people out of the hospital (reducing the burden on healthcare systems and on the human body) which is exactly what they are doing!
In the meantime, if you are not vaccinated, WEAR A MASK in public, and get vaccinated. Unfortunately, masks may be needed even by the vaccinated until more people are vaccinated. Remember, we are not all protected until we are all protected.
And remember, masks have been consistently shown to protect others AND the wearer!
A Little Bit of Politics
The Tennessee Department of Health halted all vaccine outreach to kids due to GOP pressure. They fired their Medical Director of Vaccine-Mediated Disease and Immunization Programs, Dr. Michelle Fiscus, who has been a champion of public health during the pandemic, and are ending vaccine events at schools (which are how adults got vaccinated). They are also stopping the sending of reminder postcards for second doses. I do not understand why Tennessee has decided to just go completely anti-vax, but it disgusts me.
Further South, Ron DeSantis (who is vaccinated) is selling “Don’t Fauci My Florida” merchandise, while his state suffers the 2nd-highest rate of new infections, and its death rate is twice the national death rate. People praised DeSantis for defying lockdowns and other guidance, but he seems to be actively working against his own constituents now.
Congresswoman and harasser of fellow Congressmembers Marjorie Taylor Greene is making up statistics about vaccine effects.
Ted Cruz (who is also vaccinated) tried to blame the rise of Delta on illegal immigrants (while others are blaming India and other non-American countries). This is, of course, incorrect, as we know this disease is spreading among ANYONE who chooses not to vaccinated or cannot yet be vaccinated. The pandemic is global, and people are traveling again - this is spread through any number of vectors. Racism does not help us fight COVID-19. Vaccination does, and we are not all protected until all of us are protected (vaccinated).
Finally, recently Laura Ingraham hosted a panel on which Peter McCullough, a cardiologist, intentionally told outright lies. He downplayed Delta infection severity AND vaccine efficacy against the Delta variant, and none of his statements were based in fact. He essentially committed malpractice, and I will say that with my whole chest.
Keep in mind that Ingraham, Rupert Murdoch, and the rest of the Fox News crew were among the earliest vaccinated (as was Donald Trump). It was also leaked that Fox News implemented its own company-wide vaccine passports! Why would they do that and then tell you not to get the vaccine?
The Republican party and Fox News repeatedly demonstrate that they do not actually care about the American people, or anyone in the world. They only care about their own fame and power. I, on the other hand, care about everyone reading this, and I am here to sort through misinformation and fight disinformation. I have no agenda and I am telling you to get the vaccine. I am also here to answer your questions.
Antibodies in Pregnancy/Breastfeeding
Dangers of COVID-19 In Pregnancy: