The COVID Vaccine: A Look at the Evidence

Have you been vaccinated against COVID-19? If not, you have company. According to a University of Miami poll, about 50% of your EMS colleagues have either turned down the shot or aren’t sure what to do.¹ Most of them believe coronavirus vaccines were approved prematurely or are worried about the injection’s side effects.

Let’s talk about those concerns, but only after setting aside politics, conspiracy theories, and opinions masquerading as facts. You’ll find plenty of those on social media. In EMS we have a higher standard: evidence. I’m going to rely on that. Please consider it.

Bad Vaccines?

At www.historyofvaccines.org, vaccine development is characterized as “a long, complex process, often lasting 10–15 years.”² So how worried should we be about a “warp speed” initiative that took less than a year? Not very, says the CDC, which reports 10 mostly minor issues with vaccines since 1955:³

1955, Cutter Labs Salk polio vaccine—About 250 people got polio from doses with live instead of dead virus. This was a big deal. The result? Stricter government oversight today. (Although there isn’t enough data yet to guarantee long-term safety of COVID vaccines, no FDA-approved candidates contain intact coronavirus—alive or dead. You won’t catch the disease from the inoculation.)

1955–63, simian SV40 virus—Concern about cancer-causing polio vaccines contaminated with SV40 turned out to be unwarranted.

1976, swine flu—Approximately one per 100,000 recipients of this vaccine developed Guillain-Barré syndrome (GBS).

1998, HBV vaccine and MS—An alleged link between the hep B shot and multiple sclerosis did not exist.

1998–99, rotavirus vaccine and intussusception—The RotaShield vaccine caused a life-threatening bowel obstruction in a few infants and was withdrawn from the market.

2005–08, meningococcal vaccine and GBS—No link was found.

2007, Hib vaccine recall—Suspected contamination of that flu vaccine did not occur.

2009–10, H1N1 flu vaccine and narcolepsy—No link was found.

2010, contamination of rotavirus vaccines—Two U.S. rotavirus vaccines contained porcine circovirus. Humans are routinely exposed to PCV by eating pork.

2013, HPV vaccine recall—A small number of vials may have contained glass particles. No health problems were reported.

Despite the compressed time frame, there’s been no evidence of significant risks with either the Pfizer or Moderna vaccines.

Vaccination Plus Virus

Even if you had COVID-19 or think you did, a British study says as little as one dose of the Pfizer vaccine offers extra immunity.⁴ That’s a good thing, because we still don’t know how many of us can get coronavirus twice.

Vaccine Side Effects

I took an informal poll among approximately 30 EMS providers who’d received at least one dose of the Pfizer or Moderna vaccine. Here are the side effects they reported:

• Arm discomfort, 22
• Fatigue, 13
• Body aches, 12
• Fever, 10
• Headache, 9
• Chills, 8
• Malaise, 5
• Sore throat, 3
• Nasal congestion, 2
• Night sweats, 2
• Thirst, 2
• “Brain fog,” 1
• Dizziness, 1

None lasted longer than 72 hours.

I’m in that group. After my second Pfizer dose, I had mild head and body aches with a low-grade fever. Tylenol took care of that. I also felt better knowing I was proactively avoiding “long COVID” (see below).⁵

Long-Term Disability From Coronavirus

It would be a mistake to focus on death (1.8% of U.S. cases) as the only serious outcome of COVID-19. Long haulers and long COVID are de facto terms for COVID-related disability and people who suffer from it. The condition is perhaps the least-publicized and least-understood outcome of coronavirus.

What does it mean to be a long hauler? Pick your favorite organ, then imagine it malfunctioning indefinitely. That’s the risk until we know more. Brains, hearts, lungs, livers, kidneys, intestines, skin, senses, joints, genitals—any of them could be affected.

“I was cleaning my gutters and forgot where I was, I forgot what I was doing on the roof,” said a 50-year-old Illinois long-hauler who’d had a mild case of COVID.⁶

“I can’t do anything right now,” a 39-year-old self-described weightlifter, kayaker, hiker, and white-water rafter stated almost seven months after contracting the disease.⁷

Several studies confirm those and other long-term consequences of coronavirus:

• 27% of 1,407 COVID-positive patients were still complaining of chest pain, shortness of breath, and other symptoms two months after initial infection.⁸
• 54% of 148 former COVID-19 patients showed evidence of myocardial injury two months after hospitalization.⁹
• 85% of 100 patients who had mild coronavirus now suffer from “brain fog,” headaches, muscle pain, and dizziness.¹⁰

“We need to take this seriously,” warns Kathleen Bell, MD, of University Texas Southwestern Medical Center. “We can either let people get worse…or we can realize that we have a crisis.”⁶

That quote is from March. I wonder how many months it will take for long COVID to be widely publicized, and how many years after that long haulers will still be sick.

Anything Else?

We haven’t covered intangibles like rights and responsibilities—your privilege not to get vaccinated even if that decision causes long-term disability or even death among family, friends, patients, and partners. That’s not evidence, so I left it out.

References

1. University of Miami Miller School of Medicine. Study finds U.S. responders have mixed feelings about COVID-19 vaccine. EurekAlert, 2021 Feb 10; www.eurekalert.org/pub_releases/2021-02/uomm-sfu021021.php.

2. College of Physicians of Philadelphia. The History of Vaccines, www.historyofvaccines.org/.

3. Centers for Disease Control and Prevention. Historical Vaccine Safety Concerns, www.cdc.gov/vaccinesafety/concerns/concerns-history.html.

4. Russell P. ‘Strong Immune Response’ from One Dose of Pfizer Vaccine: Study. Medscape, 2020 Apr 7; www.medscape.com/viewarticle/948164?src=mkm_covid_update_210326_MSCPEDIT&uac=9958MT&impID=3274953&faf=1.

5. Davis HE, Assaf GS, McCorkell L, et al. Characterizing Long COVID in an International Cohort: 7 Months of Symptoms and Their Impact. medRxiv, 2020 Dec 27; www.medrxiv.org/content/10.1101/2020.12.24.20248802v2.

6. Belluck P. They Had Mild Covid. Then Their Serious Symptoms Kicked In. New York Times, 2021 Mar 23; www.nytimes.com/2021/03/23/health/long-covid-symptoms.html.

7. Mervosh S. ‘It’s Not in My Head’: They Survived the Coronavirus, but They Never Got Well. New York Times, 2020 Sep 28; www.nytimes.com/2020/09/28/us/coronavirus-long-term-effects.html.

8. Huang Y, Pinto MD, Borelli JL, et al. COVID Symptoms, Symptom Clusters, and Predictors for Becoming a Long-Hauler: Looking for Clarity in the Haze of the Pandemic. medRxiv, 2021 Mar 5; www.medrxiv.org/content/10.1101/2021.03.03.21252086v1.

9. Beck DL. Myocardial Injury Seen on MRI in 54% After Troponin-Positive COVID. Medscape, 2021 Feb 23; www.medscape.com/viewarticle/946287.

10. Doheny K. Neurological Symptoms Frequent in Nonhospitalized COVID Long-Haulers. Medscape, 2021 Mar 23; www.medscape.com/viewarticle/947915.

Mike Rubin is a paramedic in Nashville and a member of EMS World’s editorial advisory board. Contact him at mgr22@prodigy.net.