This email is about the Covid vaccines. I am not going to go into the mechanism of the different vaccines again, but I hope to make a video soon to explain the two main groups of vaccines and how they differ.
Let’s start with the facts as we know them.
Immunization against Covid has left the realms of strictly medicine and become more political. That cat clearly is out of the bag.
I think everyone is agreed that the benefits of the Covid vaccines outweigh the risks, whichever vaccine you use. For the most part the scarcity of the vaccines does not allow for choice, however some people will still have to be picky or closely supervised.
Pfizer has been used since mid December, Moderna since January and Janssen since February.
So far 23.4% of the US population has been fully vaccinated with a total of 195 million doses having been given. Yeah, America is back leading the way with positive news about Covid for a change!
This week after 6.8 million doses the Janssen (Johnson and Johnson) vaccine was ‘paused’ because of 6 cases of a clotting disorder. This has caused quite a stir (understandably) and a similar situation happened with the Astra Zeneca/Oxford vaccine in Europe.
To put it in context, in the US annually 300,000 to 600,000 people per year develop blood clots according to the CDC. Women who use birth control pills have a 0.3 to 1% chance of developing blood clots, that is 2 to 6 times the rate of women who are not on birth control. You can compare that to one in a million chance of getting clots with the vaccine.
I must admit I am always skeptical now, when I hear that people are announcing things in an effort to be ‘transparent’ but they have not yet done the work to really deliver facts. Often people are vying for market share rather than serving the interests of public health.
We now know that the 6 cases were all women between the ages of 18 and 48. We are still waiting to hear if any of these people had underlying conditions, platelet disorders, on birth control pills or other things that increase clotting etc.
We will have to be patient and wait for the data on the 6 women.
I think pausing the vaccine was a bad idea for 2 reasons:
One, it could have been paused for women under 60 (to err on the side of caution) only, and then men could have at least continued to get the vaccine, which means we would reach herd immunity faster. People on the Indian reservations for example who have difficulty with transportation could at least get a one time vaccine and many other benefits. Some people should not take an mRNA vaccine, now once again they must wait.
Number two, what does a ‘pause’ mean? Basically bad publicity and damage to health education and the vaccine program that will be hard to undo. I, myself, would be very leery of something that had to be paused and then restarted.
The clots were seen within 3 weeks of vaccination so if you got a Janssen vaccine more than 3 weeks ago you do not need to be alarmed.
Women that got it less than 3 weeks ago need to be vigilant of any unusual symptoms and bring them to the attention of their primary care provider.
While I am on the subject of severe side effects: 2.5 million people who got Moderna and 4.7 million who got Pfizer have had severe allergic reactions so if you have a history of anaphylaxis be very careful. I worry about people with chronic autoimmune conditions getting a flare up from the vaccine activating their immune system.
Pfizer announced this week that people will probably have to get (another) booster in 9 to 12 month. Lastly, I will not be surprised if eventually people get a hybrid of different vaccines to prolong immunity …..stay tuned. But don't panic!
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