CATES: To vaccinate or not to vaccinate

I will be very blunt. I know there are many, many opinions out there about vaccination, but for me and for the people I love, I always default to “get vaccinated’. If someone asks me, “should I get vaccinated,” unless they have a severe reaction to vaccines in their past, I always say, “yes.” I do that for several reasons, but the biggest is the people I have taken care of over the course of my career who did not get vaccinated for diseases that then affect them for the rest of their lives. Polio for instance can be hugely debilitating, from issues with walking to things much more severe like breathing issues to the point where people end up on ventilators for the rest of their lives. The risks of fully approved vaccines versus the benefits fall heavily on the benefits side every single time for the average person.

I wish it weren’t the case, but most things in healthcare are not really choices between absolute good and absolute bad, they are a choice between which side of the risk/benefit equation do you fall. For instance, let’s say you have bad arthritis in your knee, and your doctor recommends that you talk to an orthopedic surgeon about a knee replacement. The benefits of such a surgery are big, better mobility and less pain just to name two. But there are also risks, all surgery can have complications that can result in bad outcomes, for a knee surgery, it could mean for instance, you don’t heal correctly and you end up not being able to use that leg at all, or the pain gets worse. Fortunately, those risks are very low, and we do thousands of knee replacements in the United States every year with absolutely no issues, and the people who have those surgeries go on to have much better quality of life. But there are people out there, who because they have a high risk of not healing, for instance, where the risk of knee replacement surgery is going to outweigh the benefits.

Vaccinations, even the approved ones carry that same risk/benefit balance, which is why herd immunity is so important. For most of us the benefits outweigh the risks, but for some, it’s the other way around. The COVID vaccinations, however, have been released as “emergency use authorizations (EUA),” not as fully approved vaccines. Which does change that risk/benefit scale. With those vaccines, we know the biggest benefit of the COVID vaccinations: decreasing COVID infections, deaths, and all the collateral damage done by this pandemic. We do know most of the risks: the side effects can be uncomfortable for some, and a few people have severe reactions. While the side effects vary in severity, severe reactions that last more than a day are rare, as are reactions. That is why the vaccines were released as EUA drugs. We know they are safe because the risks are minimal and we know the benefits are many. What we don’t know and why it is not a full approval, is all the potential risks, or even all the benefits.

For instance, no one really knows how long the immunity supplied by the vaccine will last, experts suspect that unless the virus mutates in a way that changes the structure that defines it as a coronavirus in some way (those spike proteins that give it the crown appearance) immunity should last a very long time, but we don’t know for sure length of immunity, especially if it is for a long time is a benefit.

We are still learning on the risks. We know enough to say they are safe, but we just don’t know everything. One of those risks that has possibly come up is an issue with blood clots forming after the Johnson & Johnson vaccine. For that reason, the Food and Drug Administration (FDA) and the Centers for Disease Control and Prevention (CDC) put a pause on the Johnson & Johnson COVID-19 vaccines on April 13. They did that to give everyone some time to figure out if this was the vaccine, or if it was something else. As of April 12, over 6.8 million Johnson & Johnson vaccines had been administered since its EUA release, and only 6 people, all adult women under 40, developed these clots. Which means the risk is still very low, even if it is related. It might not be. That is what the experts need to find out. That way, if it is related, those people who have a higher risk, can then decide where on the risk/benefit scale they fall with the Johnson & Johnson vaccine. The Moderna and Pfizer vaccines, which are most of the vaccines given here in the Permian Basin, have not had these issues.

Knowing all that, even with the EUA, I will still say “get vaccinated” to everyone I know who is not at risk for reaction to the Moderna and Pfizer COVID-19 vaccines. At this point the Johnson & Johnson vaccine is a wait and see on the risks and benefits. But, just to emphasize how important I think these vaccines are, I have been vaccinated myself, as has everyone eligible in my family. Please look at the risks and benefits for yourself and for those around you, and if you haven’t gotten a COVID vaccination, please consider getting one.