By Godwin Dixon, Dr. Caren Reaves, Dr. Melinda Balarbar, Dr. Joseph P. Santiago, Dr. Kenneth Adams
The Cross Timbers Gazette asked us to weigh in on the issue of vaccines and quite frankly we agreed with trepidation.
Why? Because the subject of vaccines has become a hot button topic that has gotten people on both sides of the argument really upset.
But we wrote it because scientists are now saying that the long-term health problems of COVID survivors (even those with minor symptoms) is expected to be “the next big health crisis” that America faces.
The newspaper asked us to summarize the issue in approximately 500 words for the print version and this is what we wrote:
Should you get vaccinated? Absolutely. Barring a medical condition that would prevent you from getting vaccinated (of which there are very, very few), we strongly urge everyone to get vaccinated.
Why get a vaccination for something that only kills 1.7 out of every 100 it infects? For starters, 1.7% is a lot. AT&T stadium, where the Dallas Cowboys play, holds 105,000 fans. 1.7% of that is 1,785. Now comes a new study showing increased death rates within 6 months of COVID infections (even mild ones), of 19 per 1,000. That increases the death toll by 196, up to 1,981 of those at the game.
Would you go unprotected to a Cowboy’s game if you knew that 1,981 fans would die?
However, death is not the only really dangerous part of COVID. We are now seeing that 8-10% of those who catch COVID are having long term medical problems and the belief is that this virus will cause problems for years and for many, even for the rest of their lives. Low energy, brain fog and many, many more conditions.
Adding in those who sustain long term damage to the football game analogy – would you go to the game unprotected if you knew that 1,981 fans would die AND 8,400 – 10,500 additional fans would have long-term damage/problems?
Most of us have long forgotten about the SARS virus that infected so many in 2003. Almost 20 years later, those who caught it haven’t forgotten as they are still 2x more likely to be hospitalized for pneumonia and 5x more likely to catch a cold.
Think about other viruses that stay in your body for life. Chicken Pox often comes back decades later as the extremely painful condition known as Shingles, and you now take a vaccine to prevent that. Herpes is another common virus with no known cure that can last for years or be lifelong.
You don’t want a virus to infect you for the long term – and COVID seems to be doing just that. The vaccine is your best bet to avoid infection and/or re-infection.
Each of us has gotten the vaccine, each of us have made sure all of our family members have gotten vaccinated (from our kids to our parents). Why did we feel comfortable doing so?
Because the mRNA vaccine technology (Pfizer and Moderna) was not rushed. It is proving to be safe. Even the risks of the J&J vaccine are incredibly miniscule. And we know COVID is not safe, far from it.
As a country (and world) we were just really fortunate that the timing was about perfect for mRNA vaccine technology, just at the time experts had perfected better vaccine production technology, through supercomputing analysis, the mRNA platform was coming into its own. In the same way that super-computing speeds up the development of new cars, planes and other technology, it has done so with vaccines.
First conceived in the 1990s, mRNA has been a major focus of scientists over the last 10 years to fight Ebola, Influenza, HIV and Zika virus. The difficulties in developing those vaccines taught us so much that when COVID came along, the mRNA was developed and ready to go.
Expect many more breakthroughs due to mRNA and just like Jonas Salk is a legend for saving the world from Polio, Google the name Katalin Kariko if you want to learn more about the person whose work is saving us now.
But 500 or so words does not tell the full story so for the online version he said we could write more – and so we did. We hope it is helpful.
Let’s start with stating the obvious – most of us do not like the idea of getting another vaccine.
Whether you are pushing back from feeling guilted or coerced, or don’t trust the science of a vaccine that has only now been in use for a year – or you just don’t want to risk feeling lousy after getting it or you hate needles, there are a lot of reasons people have for not wanting to get the vaccine.
And then there are those who have either had COVID and expect their antibodies to now protect them or are just extremely healthy and don’t feel they are at risk.
None of us want to get any more vaccines then we have to – but then again, none of us wanted COVID either. And knowing that COVID is now causing long term damage in 8-10% of those who catch it, and possibly more, makes us look differently at the vaccine.
And then there are the millions of Americans who have been very eager to get the vaccine, even going to great lengths to get it. Many had seen a loved one get very sick or die from COVID. Others had friends or family dealing with the long-term damage the virus can cause – and wanted protection from that. Or they had loved ones who were at risk, and didn’t want to compromise them, or they just wanted to do what they felt they could to help America get past this.
There are many personal reasons why so many have been eager to get the vaccine.
And then there are those who realize that now that 230 million doses have gone into the arms of Americans and worldwide 1.04 billion vaccine doses have been administered – we have a lot of proof that it is quite safe and saving lives.
So how do we know that it is “quite safe”? Well as a general rule, if a vaccine has problems, they show up quickly (the first 6 weeks). Unexpected negative side effects of the COVID vaccines have been VERY rare, and they have been taken very seriously. The J&J vaccine had extremely rare side effects (a rare type of blood clots in about 5 in a million) and was paused until the risks were fully understood.
To put that 5 in a million in perspective, COVID causes those same rare blood clots in 39 per million. They also show up in women who get birth control pills (not related to the vaccine), so just know they sometimes happen – but are extremely rare.
So the takeaway here is – they are watching the results of the vaccine very, very carefully and so far the negatives have been extremely rare (i.e. it is proving to be very safe).
So how long have we been giving the vaccines? The vaccine has been in the arms of the first test group in Germany since April 29th of last year and May 5th in America. So we have a full year of experience backing up the safety of the vaccine, and now with over 1 billion doses given, we have a lot of success. Dr. Caren Reeves, who helped with this article, was a part of the Pfizer test group.
But before we go into the data, let’s start with a brief overview of vaccines. Something most of us haven’t thought much about since our kids got them as little ones, or we travelled abroad and had to get them to protect us from whatever we could face in that country.
Vaccines have transformed our lives for the better. They are considered a big part of the scientific advances in public health that have helped life expectancy in America rise from 49 years to almost 79 years in the last century.
100 years ago humans lived on average 30 years less, because so many people died of viruses that we now have vaccines for. Our world is full of nasty viruses, part of the reason that we have all had so many vaccines as children. Prior to vaccines many people died from diseases that are now exceedingly rare (Rubella) or even completely wiped out (Smallpox).
If you were born in the early 1940’s or earlier, you remember the terror of Polio, followed by the miracle of the Polio vaccine that stopped the Polio virus from continuing to cripple so many children as it did in the 1950’s. You may or may not know that Rotary members raise funds every year for vaccines and have contributed $2.1 billion to fund vaccinations worldwide.
You know Rotary members and may be one yourself, and vaccines are their number one effort year in and year out. In 2020, largely through their efforts, Africa was finally declared polio-free and now only Afghanistan and Pakistan remain Polio hot spots. But like any virus, if we stop vaccinating we run the risk of letting it come back and it is projected that if Polio vaccine efforts stopped, within 10 years Polio would again be paralyzing 200,000 children a year. Ongoing vaccinations is key to keeping viruses at bay.
The truth is that there are a lot of nasty viruses in our world. And a strong immune system is often not enough to protect us – but when our immune system is helped by vaccines, we are protected.
If you are older than 49, you probably have a mark on your arm from the Smallpox vaccine – something that is no longer needed because we wiped Smallpox out, through effective vaccination programs. That is what we are now trying to do with COVID vaccines.
Yet in spite of the success of those programs, there were many good people who were hesitant to take those Smallpox vaccines at the time, even though we now know just how safe and effective they were. There were years where Smallpox killed hundreds of thousands – and yet people were still scared of getting a vaccine and even rioted to protest. It took a lot of convincing, but in time, everyone got vaccinated and the virus was fully defeated.
So we share that to say – that the current concerns with getting vaccinated are nothing new, this is human nature. Lots of us are skeptical of new things, don’t like to be told what to do – and most of us are not too thrilled with needles!
But these are extreme times as we are in the midst of the COVID-19 pandemic, a once-in-a-century health crisis.
You have to go back to 1918/1919/1920 and the Spanish Flu epidemic to find a time when such a serious health threat existed. COVID has been credited with infecting 150 million people and the deaths of more than three million people worldwide. And infecting 33 million Americans and the deaths of almost 590,000 Americans. By comparison, the Spanish Flu epidemic killed 675,000 Americans so we may soon top that.
But the fear of death does not concern many because they correctly point out that 98.3% of those infected survive. But death is not the only bad outcome of COVID infections.
Although many who catch COVID only have minor symptoms, estimates are that 8-10% of those who have had COVID, will have ongoing problems, some of them severe. Heart damage, lung damage, brain fog, basically damage to all of the organs has been well documented and this is a nasty virus that can wreak havoc in your body.
Do you remember all of the delays last football season? The reason the Big 10 delayed their football season was heart issues in a number of football players who caught and recovered from COVID.
Several new studies have just come out highlighting the long-term damage caused by even minor cases of COVID. A recent German study following 8,679 hospitalized COVID survivors found that one out of four of them were hospitalized again within six months of their COVID diagnosis. The top reasons were respiratory difficulties followed by neurological problems followed by cardiac problems. This study is still under peer-review but is being fast-tracked because of the importance of this data.
A recent VA study of 73,000 veterans who got COVID, including many with mild cases, had the same results. They too found that the veterans were treated for long term problems, and just like the German study they were primarily respiratory issues, neurological/cognitive issues and cardiac issues.
Having long-term problems with your breathing, your brain and your heart are all quite bad – you don’t want that. The study noted that they saw problems in practically every organ and that the long-term impact of having had COVID will be “our next big health crisis.”
And then finally, another new study just published is now showing that death rates, six months after infection, are much higher (59%) for those who had and recovered from COVID versus those who never caught it.
This is a nasty virus that you just don’t want.
In the coming years, one of the first questions the doctor will likely ask you when you come for a visit will be – did you get COVID in 2020/2021, because of the long-term health problems that they are already seeing present in a large number of those who have caught COVID.
So what can you do to keep from getting COVID? Well social distancing and mask wearing were our only options until the vaccine came out and I think it is safe to say we are all pretty sick of doing both of those.
The new COVID vaccines have proven very effective at preventing COVID-19 infections, as high as 94% (which when compared to the flu vaccines 40-60% effectiveness) is outstanding.
The vaccine protects you.
So let’s look at the questions/concerns about the vaccines and try to give you the information to make the right choice for you – while also telling you why we made the decisions we did.
Pfizer/Moderna are both mRNA technology. What is that? Is it even a vaccine? Has it been thoroughly tested and is it effective?
What it is: Traditionally vaccines would either inject you with a weakened virus or a dead virus to teach your body to recognize and fight it when it saw it. There were risks with that approach and it wasn’t always effective so new and better approaches were developed – namely mRNA.
You have probably heard about the Spike protein that the COVID virus has – well the mRNA vaccine shows your body that protein and teaches it to destroy it – all without injecting you with any virus.
Is it even a vaccine? Absolutely yes. Vaccines contain an agent that resembles a disease-causing micro-organism that stimulates the body’s immune system to recognize it as a threat and destroy it. The mRNA does this through the spike protein.
Has it been thoroughly tested: Yes. To be granted an FDA Emergency Authorization Use it had to be held to the same rigorous safety and effectiveness standards as all other types of vaccines in use in the U.S.
And remember – over a billion doses have already been given. With that many doses, will there be some negative reactions – of course, but they are exceedingly rare. 1,000,000,000 is a staggering number of doses already given and if there were material problems, we would know it by now.
So has anyone died since getting the vaccine? Yes, of course they have. The majority of those who have gotten the vaccine are in the highest risk groups, i.e. those at greatest risk of dying and many in that group died before getting the vaccine and some died afterwards. Was it related? The experts believe likely no. Are there always rare exceptions – of course, but by and large no legitimate study has tied the two together for anything other than rare outliers.
So is the vaccine effective? Through the first year of use the Moderna and Pfizer vaccines have been shown to be remarkably effective, protecting 90-94% of those who have received the vaccine from catching COVID and far greater than 99% from being hospitalized or dying.
And they are even proving to be quite effective against the variants – even those that are wreaking havoc in India and Brazil and are already arriving here in the U.S.
Vaccine experts are incredibly excited about mRNA technology and believe this to be the next great breakthrough in modern science. After 30 years of development it was being used to fight cancer and other conditions, and was quickly adjusted for COVID with great success. (So no, it was not a new technology)
So how does protection from the vaccine compare to protection from having the virus? To date, estimates are that protection from having had COVID should last 6-8 months on average, although there are a number of people who have been re-infected before that. Moderna believes their vaccine will give years of protection and of course Pfizer, also mRNA, should be similar. Time will of course tell, but the experts believe the protection will be more complete than for those who have recovered from COVID.
Should you get the vaccine even if you have had COVID? Yes. Remember President Trump recovered from COVID last October and under the guidance of medical experts was himself vaccinated in January. Experts believe that the protection from the vaccine is superior to protection from having had the infection alone.
How long should you wait? If you were treated with monoclonal antibody treatment – wait 90 days after recovery. If not, 10 days after your symptoms started (i.e. as soon as you are recovered) you should get the vaccine.
What sort of reactions can you have to the vaccine and is it worse if you have had COVID? Just like COVID itself, some who get the vaccine get by with no problems, some have mild reactions and some are hit hard.
No matter whether you have had COVID or not, expect that you could feel really lousy for a day, or two (and in rare cases a few additional days). The difference is, the reactions to the vaccine are pretty much always short lived and don’t cause lasting damage like the virus is doing.
In summary – get the vaccine when you can afford to be out of commission for a day or two.
Can getting the vaccine cause infertility? Absolutely not. This is another conspiracy theory that has been making the rounds but has been completely discredited.
This is a good time to pause and discuss conspiracy theories. They are rampant these days and spread much faster through the internet. Years ago, conspiracy theories had to travel through the mail and be photocopied and were much harder to pass along. Now anyone with a video camera and editing skills can create something online that looks compelling. A good rule of thumb to follow is – legitimate medical data comes in peer-reviewed studies presented in white papers, conspiracy theories come in internet videos.
So let us close with saying that this is a critical time for us all. If enough of us don’t get vaccinated, COVID will continue to infect large numbers of people, have more mutations and become more dangerous. And a lot more of us will suffer.
Each of us (Godwin, JP, Caren, Melinda and Ken) know many people suffering long term problems from the virus – and every one of them wishes they could have had the protection of the vaccine to have prevented this.
At the end of the day, you have to make the individual choice of whether to take the vaccine. We strongly encourage you to get vaccinated and hope this data and discussion help you make your decision. This is an important one.
More research is below:
This column was written by Godwin Dixon, a career senior care professional and former CEO of the Presbyterian senior care system in Dallas. He is co-owner of Teresa’s House – Craig Ranch, McKinney, one of the only senior care communities to have never had a resident COVID case. He wrote this in collaboration with Dr. Caren Reaves, a private practice physician associated with HCA and THR/Presbyterian systems who was a part of the Pfizer clinical vaccine studies, Dr. Melinda Balarbar, a Family Medicine physician with Baylor Health Texas providing outpatient evaluation and care for local COVID 19 patients, Dr. Joseph P. Santiago retired from 20 years of practice last year with Baylor to help Native American communities address large health disparities that have been accentuated in the pandemic, and Dr. Kenneth Adams, Chief Medical Officer for United Healthcare Medicare Advantage for Texas.