It’s hard to believe that Christmas is almost upon us. The sounds of Boney M playing in the malls will officially summon in the countdown till the holidays. As everyone eagerly awaits the festive season and makes plans to meet with family members last seen before the pandemic began, I want to draw your attention to an important question we need to address before we embark on all our planned festive activities……to vaccinate or not?
If you have very firm views on vaccination and are not looking for any alternative viewpoints, don’t read any further. If however, like most of the patients I’ve been consulting with, you find yourself on the fence and uncertain about whether you should vaccinate, then please spend the next few minutes to continue reading in order to make an informed choice about this very important public health question.
I present my patients with scientific and factual information that I have available, discuss any questions they might have and ask them to review all the information they now have available to them in order to make an informed decision regarding vaccination. Not surprisingly, most of them were unaware of a lot of the factual information but had a plethora of social media advise and dire warnings from friends or family, who mostly had no medical background. Most of them, were less undecided following our discussion, as most of their inherent fears regarding the vaccine had been addressed.
Here’s some of my patients’ questions that were contributing to their vaccine hesitancy:
1. “I’m scared of the side effects, especially clotting.”
My response: Based on the data below, your chance of developing a blood clot after vaccination is 0.05 per 1 million with Pfizer and 3 per million with J&J. To put this in perspective, you have a much higher risk of having a clot from having Covid infection than you do from the vaccine, with some studies published in the Lancet showing risks of >20% among Covid patients.
2. “I am pregnant and am scared what side effects the vaccine will have on the pregnancy.”
My response: Pregnancy is itself a risk for having blood clots. Pregnant women are 4-5x more at risk of having a clot compared to non-pregnant women and risk of clots with Covid infection is also higher. Covid vaccine can be given during any stage of pregnancy and lactation. The vaccine has been found to be safe during all stages of pregnancy and protects you from getting the Covid complications and hospitalization during pregnancy.
3. “I have immunity issues and am scared the vaccine will affect me badly.”
My response: The vaccine is most beneficial in preventing severe Covid infection and hospitalization amongst vulnerable patients with chronic diseases and immunocompromised status such as patients with hypertension, diabetes, COPD, asthma, autoimmune diseases, HIV, TB.
4. “I’ve got very ill with flu after taking flu vaccine before, so am too scared to take the Covid vaccine. I’ve heard that people have gotten Covid infection from taking the vaccine.”
My response: We are currently using vaccines with 2 different types of technology, viral vector vaccine (J&J) and mRNA vaccine (Pfizer).Neither vaccines contain any SARS-CoV-2 particles and hence cannot cause Covid infection. Vector vaccines use a different harmless virus called a vector to deliver messages to your body, to teach it to make copies of the spike protein. In the case of the mRNA vaccines, it uses messenger molecules called mRNA which have been created in a laboratory. The mRNA gets destroyed within a few days of being injected and cannot change our DNA or enter the nucleus of our cell where our DNA is kept. These mRNA have instructions to teach your body to make the spike protein. The spike proteins once made, get displayed on our cells surface. When our immune system comes in contact with these foreign spike proteins, it gets activated and starts to make antibodies. Should you get exposed to the real SARS-CoV-2 virus, your body now has antibodies that have already been produced and is able to fight off the infection. It is normal to have symptoms of muscle pain, headache, mild fever, nausea and fatigue when your immune system is activated. It actually means the vaccine is working and these symptoms usually settle down within a few days.
5 “I’m scared of the long-term effects the vaccine might have on me.”
My response: I’m scared of the long term effects Covid infection can have on you. Vaccination can reduce the risk of having long Covid symptoms.
6. “I’m not worried about getting Covid, I think I’ll be fine.”
My response: Nobody is able to predict how the Covid infection will affect them, although most people are more likely to experience asymptomatic or mild disease.The hospital stats below confirms that vaccination does protect against hospitalization and death.
7. I’m not against vaccinating, but I don’t really think it’s necessary for me to vaccinate either.”
My response: By vaccinating, you are protecting yourself and those vulnerable around you. When you are vaccinated, you are less infectiousness with less viral load and therefore have less ability to infect those around you, even if you get Covid. By surrounding yourself with vaccinated people, you are less likely to be at risk of getting an infection. Hence, in a work environment and crowded areas during the festive season, the more people are vaccinated, the less risk of the infection spreading within these groups. This means even if you are asymptomatic and not having symptoms, your chance of infecting other vulnerable people around you without you even knowing it, is much less.
8. Why should I get my kids vaccinated if most kids don’t seem to get severe Covid?”
Vaccinating children provides the benefits of less severe disease, less chance of long Covid and less transmission to vulnerable adults/ friends/ teachers that they interact with. As in adults, the risk of heart inflammation (myocarditis/pericarditis) is very small, with most cases being mild and resolving completely. The benefit of vaccinating still far outweighs this risk, as the risk of getting myocarditis from Covid infection itself is far greater. There has been no evidence of the vaccine affecting growth or puberty. The vaccine can cause an irregular menstrual cycle due to the immune response, but this regulates within 1-2 months. Children aged 12 and above can consent for their own medical treatment, and don’t require parental consent to get the Covid vaccine. As a precaution, it is best for teens to avoid strenuous exercise activity for 1 week following their vaccination.
For parents wanting further clarity regarding the benefit of vaccinating their kids I would suggest reading this post by Dr Sheri Fanaroff, which tackles the numerous questions parents will want answered before vaccinating their child.
I hope the above explanations have provided some clarity regarding some of the questions that is contributing to vaccine hesitancy. We all have a role to play in protecting ourselves and the people around us as we head towards the festive season, as risk of exposure and infection will be high again. Vaccinate today and save our summer!
(Sources: https://www.cdc.gov/coronavirus/2019-ncov/vaccines/different-vaccines/mrna.html; https://www.unbiasedscipod.com/; www.westerncape.gov.za; https://sacoronavirus.co.za/2021/10/18/should-my-teen-have-a-vaccine; https://imginn.org/niniandthebrain/