In my last post, my COVID-19 vaccine advice was to chill. Only health care workers and the highest risk group were eligible to be vaccinated and for them the choice was easy. Others had the luxury of waiting and seeing the results in the community first. I am back for an update as vaccination is now being given to school employees and people over age 65.
The COVID-19 vaccines are certainly a staple of the news these days. Before providing an update on the vaccines, it’s important to discuss use of the news for vaccine guidance. News isn’t what it used to be. Once upon a time, people bought newspapers. No additional revenue per article read. The goal of the news was unbiased reporting, and opinion columns were clearly labeled as such. Now, people can read most news from any online source for free and the revenue comes from clicks. Their goal is to make you open up the most articles and that means reporting what their target audience wants to hear. People go into journalism not to report news, but as a form of activism. Opinion is thoroughly integrated into reporting. And that’s just the news! Social media? Yikes! People are swayed by literally random people on the internet. It is natural to favor those who say something that supports what you tend to believe, but are they actually credible?
But the fundamental problem in medical knowledge by press report is that the news tends to report…..the news. Once a topic isn’t the hot topic of conversation, it doesn’t get reported on. And the
news comes bit by bit, with confusing pieces intermittently that make it hard to put it all together. Medical evidence takes time to build towards a conclusion. But the first medical news of something gets tons of attention, and later when we really understand the truth, it doesn’t get reported at all! It’s the same thing with COVID. If people get COVID after getting vaccinated, it’s news – even if expected because people already have COVID before getting vaccinated and first show symptoms days to a week later. And the first dose of vaccine only gets to 50% protection after about 7-10 days. The gaudy 95% protection is a week after the second dose. About 1,000 nursing home residents in the US die every day, so if you vaccinate 2/3 of nursing home residents in a short period of time, some will die soon after getting the vaccine. But that’s news!
Fortunately, countries with socialized medicine tend to have good data, available quickly. About 3 weeks ago, the Israeli Health Ministry released data for people who were fully immunized (more than one week past the 2 nd dose of the Pfizer mRNA vaccine). There were 63 cases out of 428,000 people. This was found to perfectly match the 95% reduction in infections found in the clinical trials. More recently, Maccabi, one of 4 Israeli HMOs (kupot), reported 93% effectiveness, with less than 3% hospitalized among COVID-19 cases in vaccinated patients. This is especially good news for senior Haredim who have died from COVID-19 at almost 4 times the rate of other seniors. Less than 20% of hospitalized COVID patients are elderly, with more unvaccinated patients in their 30s on ventilators. In the UK, with about 7 million doses given, using both mRNA vaccines (Pfizer, Moderna), the safety results are remarkable. About 1 in 70,000 had a severe allergic reaction. These were in people with a history of severe allergic reactions. None of them died. The 1 in 100,000 cases of temporary facial paralysis or weakness occurred at the usual rate found in the population. With about 40 million doses given in the US, no new rare side-effects have occurred. Warning! Social media will claim horror stories based on content that is false, misleading, missing key information, taken completely out of context, or based on incorrect understanding of data. Why? To fill some people’s need to validate their anti-vaccine or “COVID-19 is just flu” beliefs.
There is more to unpack. There are multiple ways vaccines can help: reduce infections and thereby community spread, reduce symptomatic cases and reduce severe cases (hospitalization/death). People trying to decide whether to vaccinated often don’t have a good handle on their own true risk from COVID. But I’m at my word limit (4 minute read), so it will have to wait for my next post. Meanwhile, consult your doctor….and your Gadol! The role of hishtadlus, for example, is very important. This was the reason Rav Chaim Kanievsky gave in ruling that getting vaccinated is a chiyuv. If that’s the Gadol you usually look to, you’re set.
Do you have specific questions you’d like answered? Are there topics you’d like to see addressed with a video clip – perhaps with more detailed explanations of complex COVID-related topics? Let me know here and I’ll do my best to help.
Mendel Singer, PhD MPH
Associate Professor and Vice Chair for Education
Dept. of Population and Quantitative Health Sciences
School of Medicine
Case Western Reserve University