Brian Cohen writes The Gate travel blog and has declared that he will not get vaccinated against Covid-19. I want to take his arguments seriously, because vaccine hesitancy – while continuing to decline – remains one of the major barriers to ending the pandemic.
Cohen says he doesn’t need a vaccine, and doesn’t want to virtue signal by getting one. And he has concerns. He says he is “not completely convinced that it is effective” because “we [do not] know what side effects may result in the short term and long term.”
Ultimately he says “no vaccine is guaranteed to be 100 percent effective for 100 percent of the people — and the side effects can potentially be significant.”
The ways in which this is wrong are manifold.
- These vaccines are highly effective not just in trial data but in real world data. When we talk about effectiveness like ‘95%’ (phase 3 trial for Pfizer-BioNTech) that’s just against symptoms, the vaccines are even more effective against severe disease, hospitalization, and death – the things we care about. Pfizer reports 97% effectiveness in Israel.
- These vaccines protect other people, not just yourself Pfizer reports 94% effectiveness against asymptomatic cases (so the possibility that someone is a silent carrier who spreads the virus). The CDC found that Pfizer and Moderna together were 90% effective against asymptomatic infection.
The case fatality rate for those diagnosed with Covid-19 who are over 80 years old is around 15%. Since vaccines reduce the chance you’ll spread the virus, getting vaccinated keeps you from killing grandma.
You might say but older people should get vaccinated to be protected but vaccines are also less effective in those taking certain drugs for other medical conditions. And this is a travel blogger writing, remember that vaccine availability is much greater in the U.S. than elsewhere, 80 year olds in much of the world haven’t had a chance to get vaccinated yet.
- Contra Brian, we do know the short-term side effects. For the mRNA vaccines there’s about a 1 in 100,000 risk of anaphylaxis, due to allergy to the lipid nanoparticles used to deliver the mRNA. And since that’s a known risk, vaccinated patients don’t leave immediately after getting their shot and those providing doses have medicine on hand to counteract the effects.
The most common side effect is soreness at the injection site, but some people experience headache, fatigue, and chills – especially for the Moderna and Pfizer-BioNTech vaccines after the second shot (unless they’ve already had Covid-19 then more frequently after the first shot). These generally resolve themselves within 24-48 hours.
- Risks of vaccines have to be compared to risks of Covid-19. Even rare blood clotting which has been attributed to the AstraZeneca vaccines – which isn’t approved for use in the U.S. but is approved in over 70 countries – is treatable and overall worth the risk given the effectiveness against Covid-19, especially against hospitalization and death.
Already almost one in 500 Americans has died of Covid-19, and we’re not done. And death isn’t the only bad outcome, being hospitalized is miserable, and so is having a terrible version of the flu for two weeks. While there are ‘risks’ associated with vaccines, there are greater risks associated with that which the vaccines protect against.
- Getting vaccinated reduces the risk of mutations. Covid-19, like all viruses, mutates within human hosts. The more potential hosts, the more possible mutation opportunities. If you don’t get vaccinated you’re more likely to contract the virus, and allow it to mutate in ways that could become more transmissible, lead to more severe disease, and potentially escape vaccines. Do you really want to risk moral culpability on par with the guy who first ate that bat? (I know, I know, it likely wasn’t direct bat to human transmission.)
- Brian sets an impossible standard. We haven’t followed test subjects for 20 years so by definition we cannot say based on empirical evidence what happens 20 years post-vaccination. But we do understand the science of the vaccines – viral vector vaccines deliver the spike protein, mRNA vaccines tell the body to create it – the body fights these off and then it disappears.
Moreover we have evidence of safety from over 600 million vaccine doses administered worldwide. There’s never been a vaccination campaign this closely watched in human history. Trial subjects were scrutinized to an incredible degree, did you know that one of Moderna’s phase 3 trial participants was struck by lightning and that incident had to be dismissed as not being the result of vaccination?
Brian writes that he’s gotten other vaccines, even ones that aren’t 100% protective, and against risks that are far more remote than contracting severe Covid. He says he doesn’t like virtue signaling but seems to be doing just that, against getting vaccinated for what’s a very real risk right now. That’s disappointing.
Thank goodness we’ve had access to these vaccines. Getting to shots in arms less than a year since human-to-human transmission of the virus was first identified is akin to the first moon landing. We all owe bioscience a huge debt of thanks. And Pfizer is now even prepared to file for full FDA approval, which is great because that will take off the table the misleading talking point of the anti-vaxxers that the vaccines ‘aren’t fully approved’.,