Aaron E. Carroll: Seven myths about the coronavirus vaccine

Don’t be fooled by bad information or irrational skepticism. Get your shots as soon as possible.

(Nolan Pelletier | The New York Times)

As the vaccines for the coronavirus become more ubiquitous, so do misinformation, myths and misconceptions about them. This is unfortunate, because these untruths delay acceptance of the vaccines, and widespread immunization is the fastest and best way to begin to return to a more normal way of life. Seven of the most common myths I’ve heard from patients, friends and colleagues follow, along with my rebuttals.

The vaccine hurts fertility, especially in young people.

For some reason, this is the most common false assertion I hear. Sometime last year, a German doctor and a former Pfizer employee raised a concern that the coronavirus’s spike protein — the material that makes up those sharp protruding bumps you see in depictions of the virus — was in some ways similar to a protein that is part of a healthy placenta’s functioning during pregnancy. Therefore, they ventured, developing antibodies to the spike protein from a vaccine could lead to antibodies that might also attack a woman’s body when she was pregnant or trying to get pregnant, leading to complications. This theory is now widely circulated.

It is mistaken. The two spike proteins are distinct, and there is no evidence that the vaccination leads to antibodies that attack the placenta.

While the Pfizer trial of its vaccine attempted to exclude pregnant women, 23 pregnant women were a part of it, probably having gotten pregnant soon after vaccination. Two adverse events were seen in the trials: a spontaneous abortion and retained products of conception (placental or fetal tissue that remains in the uterus, often after miscarriage); both occurred in the placebo group. Anthony Fauci, President Biden’s chief medical adviser for the pandemic, said on Wednesday that more than 10,000 pregnant women have received the vaccine with “thus far no red flags.”

Once you’re vaccinated, you can go back to normal, pre-pandemic life.

This is, unfortunately, not true. I cannot stress enough how amazing the vaccines are: Those that are approved are proven to prevent symptomatic disease, as well as bad outcomes like hospitalizations or death. But we don’t yet know whether they prevent asymptomatic infections. It is possible that vaccinated people could still become infected, be unaware and spread the coronavirus to others.

We hope to find out soon if this possibility is real or not; some of the early information coming out of other countries looks promising. But until we know with greater certainty, we still need everyone — even those who are immunized — to mask up, distance from others and remain careful.

When we hit herd immunity, this will all be over.

Herd immunity refers to a situation where enough protection exists in a community that exponential growth of infections is highly unlikely, if not impossible. The concept is usually discussed when diseases are rare, as with measles.

Herd immunity will protect us from large numbers of COVID-19 cases only once we have suppressed the disease. Nowhere in the United States are we near this point, though. The coronavirus is still hugely prevalent, and new variants may be even more contagious. As communities achieve herd immunity, they will see slightly less COVID-19 the next day than they did the day before. It will not disappear overnight. Herd immunity will signal the beginning of the end of the pandemic — not the day we are done with it.

Side effects of this vaccine are much more severe than those of typical vaccines.

Allergic reactions are not a reason to avoid vaccination. Very few people given the vaccine have experienced anaphylaxis, a severe allergic reaction. More have experienced symptoms like aches, chills, pain and fever, but those symptoms are not usually worrisome: They are often signs that your body’s immune system is working. More severe occurrences, like deaths in frail, older patients, need to be investigated, but it’s entirely possible that this is a coincidence and not unexpected in that population.

In coronavirus vaccine studies, Bell’s palsy has seemed to occur more often in people who received the vaccine than in those who received the placebo. (Bell’s palsy is a temporary weakness or mild paralysis, usually affecting one side of the face.) It’s important to note, however, that among the general population, Bell’s palsy appears in about 15 to 20 people per 100,000 people each year. That is a higher rate than what occurred in the trials: Four of the 30,000 people in the Moderna trial (one in the placebo group) and four of the 44,000 people in the Pfizer trial developed Bell’s palsy.

The studies were rushed, and corners were cut.

First of all, more scientists were probably working on this one thing than have ever collectively focused on any one thing in the history of the world. We should expect progress.

We also had a number of head starts. A lot of exploratory and preclinical work had already been done on coronavirus vaccines because of SARS, or severe acute respiratory syndrome. In addition, because of significant public investment and a guaranteed worldwide market, many companies immediately devoted lots of resources to this task.

To be approved by the Food and Drug Administration in the United States, vaccines must clear three phases of study. The first is small (likely tens of people) and focuses on safety. The second is larger (maybe hundreds of people), involves people who have known risks for the disease and focuses on safety and whether there is some sort of biological response (specifically, antibody production). Phase 3 involves large, randomized controlled trials (thousands to tens of thousands of people) that focus on effectiveness (that is, preventing illness) and side effects. With coronavirus vaccines, the process was highly accelerated, but all of these phases were completed and were reviewed by the Food and Drug Administration.

We’re also focusing (appropriately) on the few vaccine successes. Many companies failed or haven’t succeeded yet. Those vaccines that made it through the gantlet were thoroughly studied and found to be safe and effective.

COVID-19 is less dangerous than the vaccine.

People hear of the risks of side effects and assume they’re better off not getting vaccinated. They’re comparing those risks to perfect health instead of to the risk of COVID-19 itself. But assuming perfect health is unwarranted: COVID is prevalent and dangerous.

A vaccine that is ‘only’ 70 percent effective isn’t worth it.

As with so many things in public health, don’t let the perfect be the enemy of the good. It’s great that in trials the Moderna and Pfizer vaccines have been about 95 percent effective against symptomatic disease, but that level of effectiveness is not necessary. In trials Jonas Salk’s polio vaccine was 80 percent to 90 percent effective, and it changed the world.

This is a version of the perception problem that the flu vaccine faces every year. People refuse to get it because it’s not “good enough.” They miss that it’s “good.” The more people who get vaccinated, the more morbidity and mortality we avoid. The best coronavirus vaccine is the one you can get as soon as possible.

(Photo by Marina Waters) Aaron E. Carroll is a contributing opinion writer for The New York Times. He is a professor of pediatrics at Indiana University School of Medicine and the Regenstrief Institute who blogs on health research and policy at The Incidental Economist and makes videos at Healthcare Triage. He is the author of “The Bad Food Bible: How and Why to Eat Sinfully.”

Aaron E. Carroll is a contributing opinion writer for The New York Times. He is a professor of pediatrics at Indiana University School of Medicine and the Regenstrief Institute who blogs on health research and policy at The Incidental Economist.

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