“So what do you think about the vaccine?” I heard this countless times in the past couple weeks. I am a healthy skeptic so I know why I am being asked. My replies surprise some. It has been a little over a week since I shared some Sars-cov2 insights with you and it sparked questions about the vaccine(s).
Amid all the political banter about operation warp speed, what seems to have been missed is some definition. On November 9th, Pfizer stated their vaccine is 90% effective. Then, within a week Moderna said their vaccine is 94.5% effective. So, on November 17th Pfizer updated their data review and stated their vaccine is 95% effective.
It sounds like a couple kindergarteners claiming the biggest sand castle.
Part of the flexible interpretation revolves around the definition of “effective”. Of course there is no trial that has been for more than half a year or so. Therefore, metrics have been simplified for these two vaccines. “Effective” means a reduction in severity of COVID symptoms with resultant reduction in hospitalizations and death. Pretty good metrics, I agree. The missing pieces are here:
Does a vaccinated person with milder COVID symptoms remain similarly contagious?
Does the vaccine prevent infection from the virus or modify the severity and response when you get infected?
Does the vaccine have substantive impact on one who recovered from prior COVID?
The vaccine trials will continue to track volunteers for a couple more years so we will hopefully have answers later. This vaccine is not therefore a panacea, preventing SARS-cov2 infections, therefore distribution is rightfully being partitioned to those most exposed to the virus and most at risk of severe illness.
Here are the questions I have received this week…
1 – Does the vaccine work? – The two vaccines above clearly make COVID far less severe, especially for those at risk of severe illness or death. So YES, it works. (Older in age, high blood sugar, central obesity, hypertension, male gender—race plays a role but data may reveal other discrepancies of obesity and diabetes – the complexity is hashed out here a little better here. https://usafacts.org/articles/health-by-race-asthma-obesity-vaccination-life-expectancy-black-hispanic-white/)
I know there have been cases of repeat infections in people, but that is not the rule which bodes well for the vaccine efficacy and COVID illness recovery.
2 – Is the vaccine safe? Yes, it appears safe. There have been about 6 notable allergic reactions following the first 128,000 doses in the U.S. and no allergic response in the 20,000 people in the study cohort. The reaction is likely due to the ingredient PEG-2000, a compound used in other medicinal formulas including many OTC laxatives. There is no link to food allergies or allergies to antibiotic classes in these six allergic responses. People who’ve had a serious allergic reaction to any injectable medicine or vaccine in the past should consult their doctor per the CDC
3 – Will I get the vaccine? Not in the near future, but let me explain.
I am fortunate to live with no underlying illness and have the capacity to remain in strong nutritional and metabolic health. I am 53. I would be near the bottom of the vaccine priority. Remember, we have no evidence that the vaccine reduces my chances of infecting another person, so I still need to remain at distance and with face covering during any endemic or pandemic period. Dr Jay Bhattacharya wrote an article in the Wall Street Journal recently clarifying, in my opinion too, how we could smartly allocate the first 50 million vaccines to best clear us from the worst confines of this virus. Those under the age of 65-70, those who recovered from prior COVID and those without pre-existing COVID-risk-conditions should.
Dr. Bhattacharya does not have the numbers high enough though. Even if we quickly deployed 100 million vaccines (which is 200 million shots) as President Elect Biden promises to do by the end of April, that still does not cover the 80 million front line essential workers and 50 million people over the age of 65. I and my kids are properly not on that list, nor would we be on the next list either. But I will be eager to see my mother, in her early 80s get the vaccine. I have diagnosed plenty of people in under the age of 50 with obesity, hypertension and type 2 diabetes—so policies need to be more nuanced than fixating merely on age.
For those getting the COVID vaccine – here are three of my take-home recommendations
- Treat yourself kindly. The vaccine does not carry “live virus”, but your body does mount an immune response in multiple locations like mucosal tissues of the gut and respiratory tract as well as in the bloodstream. So rest, treat yourself as if you are sick for one or two days if possible.
- There has been ample research to display how low vitamin D is associated with worse illness, but we don’t know exactly why. However, we do know that many nutrients are critical to immune health, like vitamin D and zinc. Assure core nutritional support especially in weeks before and after vaccination.
- Limit the use of pain medications like ibuprofen and acetaminophen. I’d encourage you to discover the therapeutic benefit from alternating hot and cold in a bath or shower. And did I mention rest? There is mixed data but it is clear that your immune response, the critical reason you get a vaccine, can be blunted with the use of NSAIDS. https://pubmed.ncbi.nlm.nih.gov/27246296/