COVID-19: Three Years Later (Pt. 5: UPDATE YOUR VACCINE!)
The public health emergency (PHE) has been officially declared over. Great - problem solved, right? Well, not quite. The pandemic has not ended - just the PHE. In the wake of that, though, people have started to try and rewrite the history of the last three years. A great many people, including physicians, have found a platform in contrarianism. The truth about COVID is that it's hard, and it DID change things, and it IS still around and making people sick (and dead). There is a path to instant fame in using your platform to peddle pseudoscience and "easy" cures that have no evidence basis, and to question the actual science (which is fine if you're willing to listen to the answers) while touting their own "research" with complete confidence (when even just a little scrutiny shows glaring flaws, but if you call that out they pivot to myths and grift - that's the difference. Scientific communicators like me who actually follow evidence also acknowledge the research's flaws). Let's set the record straight.
Okay, this is what you've been waiting for all week. A year or two ago, if you had asked me if we would need annual vaccines for COVID-19 like we do for influenza, I was still holding out hope that we would not. But my hope rested on enough people getting vaccinated. My hope rested on effective messaging from the CDC and the presidential administrations (both Trump and Biden). My hope rested on things that did not happen. Still, I am not here to admonish (not with this essay, anyway, and not regular people - the administration and CDC are a different story).
We are in a different place now, and new variants of concern have arisen. I again reiterate that while it is not the same as 2020, COVID-19 is still dangerous, especially due to its potential for neurologic and vascular complications as well as long-term effects. Infection-mediated and vaccine-mediated immunity (both of which are natural, since they are still YOUR immune system) both provide protection, but vaccines provide it without the same risk of illness (and subsequent spread to others), and complications. Vaccine-mediated immunity is also more reliable and predictable than infection-mediated. There is also concern that immunity from previous infections or vaccinations will not be as protective against newer variants, which is why we need updated vaccines. And now they are here!
The FDA and CDC announced two weeks ago that the new updated COVID-19 vaccine, a monovalent targeting XBB1.5, has been approved. Even better, Moderna announced data that show effective protection against the other variants of concern as well!
The 2023-2024 COVID vaccine should be available at pharmacies now! These will be Pfizer and Moderna, available for ages 6 months and higher. Novavax approval (for their updated vaccine) is, I'm sure, just around the corner. You can get it now, and it will be especially important for school-age children going back to school or anyone who works in close quarters with others. If you're planning to wait a bit, keep in mind any holiday or other large gatherings you have coming up because it takes two weeks for the immunity to fully develop (the antibodies to form).
If you have recently had a COVID-19 infection, the current thinking is that you can wait the ~3 months to get vaccinated (because you probably got infected with one of the current variants of concern), but again, it will be wise to Re-up that immunity before a big holiday gathering.
A note: Now that the PHE is over, there is now the concern that some folks may have to pay for the vaccines. The Biden administration's initial deal for free vaccines is coming to a close. HOWEVER - the vaccinations are covered by insurance! And if you do not have health insurance, the department of Health & Human Services has created the Bridge Access program.
There is a conversation to be had about the greed of Big Pharma and how unfettered capitalism has no place in healthcare. However, the pharmaceutical industry is also who funds much of the research to drive innovation such as new vaccine technology and meds. Both of these things can be true, and we can acknowledge the contributions of Big Pharma even as we call out their greed. And no, that does not make me a shill. You can actually look up, on OpenPayments by CMS, how much money I get from pharmaceutical companies, how much of a financial conflict of interest I have - spoiler alert, it's 1-2 lunches. Now go look up grifters like Peter McCullough who like to accuse the rest of us being Pharma shills. Go on. I'll wait.
While I'm waiting, let's debunk:
Myth: Vaccines cause worse side effects than COVID!
Nope. Below I have linked one of several studies showing no major increase in serious adverse events. There were a handful of studies that claimed to show big increases in myocarditis, but they counted asymptomatic elevations in troponin enzymes - literally temporary lab test abnormalities that resolve on their own and would never be noticed because they weren't causing a problem. This is not to say that serious myocarditis cannot occur from the vaccine - but it is extremely rare. It is much more likely to occur from COVID-19 itself, or many other viruses.
Even the blood clots are not as much of a concern as originally thought. Those were only seen in significant amounts with the J&J vaccine, which is NOT an mRNA vaccine. The mRNA vaccines did not have any proven causation with blood clots!
Every doctor acknowledges that medical treatments have side effects, but despite millions of doses given out (and carefully observed), serious side effects remain extremely rare. For those that do occur, we acknowledge them, and use other strategies - and it is for those who cannot receive the vaccine that the rest of us should, to create that protection for all, imperfect though it is.
Several bad actors out there have taken it upon themselves to find any unexpected death or death in a young person and blame it on the vaccine (see Damar Hamlin). They do this with zero proof and there is usually different cause of death already known. They do this because they are ghouls who are trying to gain money or clout.
To further prove that point, I've linked a piece in which Jamie Foxx had to literally address false claims made by terrible grifters who claimed he had a blood clot or other reaction to the vaccine - without any evidence.
Myth: I don't need vaccines, I have hydroxychloroquine and ivermectin!
This has been debunked multiple times. We tried both of these medications because they had some level of in vitro effect on SARS-CoV (the original SARS virus, in petri dishes). We tried them in hospital settings on an emergent basis and then we tried them in formal trials in many different situations (inpatient, outpatient, early, later, high dose, low dose) and none of the trials showed a real effect. Most recently, a pre-print article demonstrates how two studies from Brazil (which showed ivermectin having positive effects) were riddled with statistical artifact (present as a result of the statistical analysis, not an actual effect) and methodological errors.
Myth: The only reason we don't use HCQ and IVM is so doctors can cash big pharma checks!
Both drugs are great for their intended purpose. Believe me, if we could repurpose a drug, we would - contrary to myth, doctors do not get paid specifically to use certain drugs - only to provide evidence-based and value-based care. Using old drugs for newer diseases is great when it can happen. That is not the case for hydroxychloroquine or ivermectin here. Neither drug works against COVID-19.
Myth: The vaccines shed and can create effects in those around the vaccinated.
Simon Goddek, a PhD in Biochemistry, has a built a platform insisting that he got myocarditis without ever getting vaccinated because it shed onto him from a vaccinated friend.
Naomi Wolf, who is a PhD in English (which is a great achievement, but she undermines it by pretending her doctorate is in medicine and poses as a medical doctor to propagate disinformation) also claims that women are experiencing disruptions in menses because of vaccine shedding.
Now, we already knew that the vaccine may cause rare and TEMPORARY alterations in the menstrual cycle (some missed a couple of periods, often no more than 1 but max was 3 in rare cases), but you have to actually get vaccinated. The mRNA COVID vaccines contain no live virus, which means there is nothing to shed to cause any effects. The mRNA circulates through the body, but cannot shed out of it.
Safety in the mRNA vaccines:
Pre-print on Ivermectin studies' flaws: https://www.medrxiv.org/content/10.1101/2023.08.10.23293924v1
New monovalent 2023-2024 COVID-19 Vaccine: https://www.cdc.gov/vaccines/acip/meetings/slides-2023-09-12.html