By Mike DuBose
Since early 2020, when COVID-19 first presented itself in America, disorganization, manipulation, and mixed messages about the virus have run rampant. As a result, many individuals find it hard to determine what information is true and what is not. Since it is a novel—or new—form of coronavirus, scientists are essentially learning about it along with the rest of us, meaning that scientific research on the virus has changed over time, further stoking confusion and distrust. The evolving nature of knowledge about the coronavirus also presented difficulties as I was writing this column. However, I focused on consistent research, looking for trends across many studies (rather than single sources) to ensure that I shared reliable information. I also used only reputable websites and research from organizations like Harvard, Johns Hopkins, Emory, and other university medical schools; the Centers for Disease Control and Prevention (CDC); and the Food and Drug Administration (FDA) as a basis for this article.
Coronaviruses are a large family of different viruses, some of which simply cause illnesses like the common cold in humans. However, the coronavirus at the heart of the current pandemic, SARS-COV-2 (also known as COVID-19), is much more serious. According to the Coronavirus Research Center at Johns Hopkins University, there have been over 30 million confirmed cases of coronavirus in the US as of this writing, and more than 550,000 Americans have died. COVID-19 was first detected in November 2019 in China, although we will likely never know its exact origins. We do, however, know some facts about how to prevent the spread of this serious virus. At this point, we have all been informed that we should: wear quality masks when in public, wash or sanitize our hands frequently, avoid being in enclosed environments with others outside of our homes, practice social distancing, and avoid touching common surfaces, like doorknobs, where the virus may live. (Click here to read my other articles on the coronavirus and for more in-depth examinations of masks and other COVID prevention strategies.)
Promisingly, in the last few months, several vaccines against COVID-19 have been authorized by the CDC and FDA—and many more are in the works. According to the New York Times, there are over 150 vaccines being developed and tested worldwide. Seventy-five have reached the stage where they are being tested in humans, and another 78 are under investigation with animals. Worldwide, six COVID vaccines have been approved for full use. The most common vaccines that are being dispersed now in America are the two-shot Pfizer and Moderna vaccines, as well as a one-shot Johnson & Johnson vaccine that came onto the scene in March.
The CDC reports that nearly 10% of the US population has been fully vaccinated as of March 15, 2021, with nearly 20% of the population having received at least one dose. These numbers will continue to grow as vaccines become available to more people, and recent polls have indicated generally positive views of COVID vaccinations. Pew Research Center data published on March 5th indicates that 69% of American adults intend to get the COVID vaccine or have already received it. (Fifteen percent of respondents in that survey said they would “probably not” get the vaccine, and 15% said they would “definitely not” take it.) Gallup polls found similar results in February, with 71% saying they would take the shots and 29% saying they would not. However, in one study by Harvard University, published in early March, about 41% of respondents said they would refuse the vaccine!
Clearly, although more and more people are accepting the idea of a COVID vaccine, some are still apprehensive. To determine if it’s a good idea to get the vaccine, it’s helpful to step back and seek a broad understanding of the situation with an open, inquisitive mind. Let’s examine how these vaccines were developed, how they work, who should (and should not) take them, and their potential side effects. We’ll focus mostly on the Moderna and Pfizer vaccines, since they have been available longer and therefore more information about them is known.
The Pfizer and Moderna vaccines use what is called “messenger RNA” (or “mRNA”) technology, which has been around for two decades and has successfully been used to fight cancer, HIV, SARS, Zika, Ebola, and rabies. Unlike flu shots, where a weakened or inactivated virus is injected into our bodies to trigger an immune response that in turn creates protective antibodies, mRNA vaccines contain pieces of genetic code. They are engineered to “teach” human cells to make something resembling the spike protein found on the surface of the coronavirus. In other words, they prime our immune systems to fight against the actual COVID-19 virus in the event we are exposed. Because the COVID-19 vaccines utilize mRNA rather than the virus itself, it is impossible to contract coronavirus from the vaccine.
Pfizer, which is headquartered in New York, began developing its COVID-19 vaccine with Germany-based partner BioNTech in March 2020. The leaders of BioNTech, Ugur Sahin and Ozlem Tureci, had experience with mRNA technology, having previously conducted research on developing cancer immunotherapies using mRNA. Moderna’s vaccine also relies on mRNA, and it was also created through a collaboration with the US National Institute of Allergies and Infectious diseases.
Although most vaccines take years to develop, both the Pfizer and Moderna vaccines were completed and approved by the FDA in less than 12 months. Pfizer tested the vaccine in small groups of people, and researchers carefully reviewed each patient seven days after the vaccination. Since there were few side effects and the vaccine appeared to be effective against COVID-19, the manufacturer began a global trial, where large groups of people were vaccinated and studied. The Pfizer-BioNTech partnership enrolled 43,448 volunteers in a blind study at 155 sites throughout the world. Half of the participants unknowingly received the actual vaccine, while the other 50% received a placebo or fake vaccine. Moderna conducted a similar process culminating in a blind study with 30,000 volunteers, so, between the two pharmaceutical companies, about 73,448 people participated in this project.
In both cases, researchers meticulously studied the vaccines’ effectiveness, as well as any infections, side effects, or concerns experienced by each participant. The findings were presented to an independent group of public health scientists at the FDA called the Vaccines and Related Biological Advisory Committee. These experts specialize in immunology, virology, infectious diseases, pediatrics, vaccine development, and vaccine safety. The evidence presented to the committee indicated that both the Pfizer and Moderna vaccines were about 95% effective in preventing COVID-19 starting 21-28 days after taking the 2nd shot, which is better than any non-COVID-19 vaccine developed thus far!
The Johnson & Johnson vaccine differs from the others in that it is one dose and utilizes a specific virus type called Ad26 rather than mRNA. It was tested in 44,000 people in the US, South Africa, and Latin America, and most of the assessments were months later in the pandemic than the Pfizer and Moderna vaccines, which started testing in the spring and summer. The overall global efficacy of Johnson and Johnson vaccine was 66% against moderate COVID-19 illness, although it was 85% effective against severe disease and hospitalization. However, in trials, it was found to be 100% effective at preventing death, as no one who received the vaccination died from COVID-19.
Independent committee members approved the Pfizer vaccine for emergency use in a vote of 17-4 on December 10, 2020. The four members who voted “no” reported that, while they supported the use of Pfizer’s vaccine in adults, they were concerned there was insufficient evidence to support giving the vaccine to youth under the age of 18. One week later, the committee voted unanimously (with one person abstaining) to recommend use of the Moderna vaccine as well. The Johnson & Johnson vaccine was approved for emergency use on February 27, 2021.
In clinical trials involving more than 117,000 participants who took the Pfizer (43,448), Moderna (30,000), and Johnson & Johnson (43,783) vaccines, the efficiency rating varies. The Pfizer vaccine was rated 95% effective and Moderna (94%), while the one-shot Johnson & Johnson was 66%. The J&J was 85% effective at reducing moderate-severe infections and some reports say that Johnson & Johnson is exploring if a second shot might increase its effectiveness.
Regardless of the vaccine you choose, if you pick a two-shot option, be sure to get both shots of the same type. You should also schedule the appointment for your second shot within the time frame recommended by the manufacturer (21 days for Pfizer and 28 days for Moderna). Also, protect the vaccination documentation you are given after completing your shots (I recommend making several copies as well and place them in safe places). It may one day serve as your ticket to enjoy domestic and overseas travel!
You will be maximally protected from coronavirus infection starting two weeks after you have received your last shot. Until these two weeks have elapsed, keep in mind that it’s still possible to get sick with the coronavirus before the vaccine has become fully effective! Even then, you have a 5% (or more, if you take the Johnson & Johnson vaccine) chance of becoming infected with the coronavirus, but to a lesser degree as compared to those without a vaccination.
In addition to examining research on the topic, I also interviewed many people who had been vaccinated against coronavirus as I was writing this column. Many reported no side effects; others experienced moderate issues; and a very few were significantly sick. Most of the COVID-19 vaccines’ short-term side effects occur 1-3 days after taking the vaccine and last only for a few days. They include soreness and redness around the vaccine site, fatigue, fever, chills, headache, body aches and pains, nausea, headaches, and swollen lymph nodes. (Although the side effects can be uncomfortable, they are a positive sign that your immune system is working to generate an immune response.) For most people, side effects are most pronounced after the second shot of the two-dose vaccines, because the immune system is prepared and ready to fight the intruder!
If you have experienced any side effects with other vaccines, you should take caution and consult with your doctor and/or allergist before taking the COVID-19 vaccine. Stay for at least 15 or more minutes at the vaccine location after you have received your shots. Although it is unlikely to happen, if you have a severe allergic reaction called anaphylaxis (hives, wheezing, difficulty breathing, fast or irregular heartbeats, swelling, tightening of the throat, dizzy, abdomen pain, nausea, and/or low blood pressure), you want to be close to medical professionals who can assist you!
While youth are less affected by COVID-19, they can still become infected by it, transmit the virus to others, or even die. The American Academy of Pediatrics and the Children’s Hospital reported that as of January 14, 2021, about 13% of all COVID-19 cases were children (2.5 million). CDC data reports that there have been 78 total deaths from COVID-19 among children 4 and under and 178 in youth aged 5-17, although those numbers do not account for all deaths reported from the US. Another major concern is that children can suffer from a potentially debilitating disease associated with COVID-19 called multisystem inflammatory syndrome, or “MIS-C.” There have been 1,659 cases of MIS-C in children and 26 deaths associated with it as of January 8, 2021, according to data from the CDC.
The existing COVID-19 vaccines in the US have not been approved or studied in children under the age of 16, although Pfizer has begun a study of the vaccine’s effects with 2,259 children aged 12-15. Based on current reports, it appears that adolescents may receive the vaccine in late summer or fall and younger children in the winter of 2021 or spring of 2022, depending on the results of clinical trials.
Experts, including those from the Mayo Clinic, recommend avoiding over-the-counter (OTC) pain relievers like Advil before taking the COVID vaccine. This is because OTC drugs can cause the immune system to produce a weaker response to the vaccine. Experts have mixed opinions about taking a pain reliever immediately after the vaccine shots, but most agree that it is acceptable to take a pain reliever a few days afterwards.
Some of those who survived the 1918 flu epidemic still had antibodies in their bodies in their nineties! Unfortunately, there is strong evidence that the coronavirus will not go away and will be with us for years to come, although to a lesser degree. Scientists don’t know how long natural immunity lasts after being sick with the coronavirus, but it does not seem permanent. Some speculate that the immunity period is 3-8 months, but it also appears to vary among different people. It’s possible to contract the virus more than once, like University of South Carolina coach Frank Martin, who tested positive for the virus in May 2020 and then seven months later in January 2021.
Therefore, it’s recommended that you still get vaccinated for COVID-19 even if you’ve already had it. Currently, the CDC recommends that people who have been infected with the virus and had the monoclonal antibodies or convalescent plasma treatments should wait 90 days after a negative test before beginning their vaccine regimen, even if they have antibodies detected in the blood. Others who were infected and did not have these treatments should take the vaccines when it’s their turn after testing negative.
Some research has indicated that individuals who have been infected and recovered from COVID-19 may only need one vaccine shot, but additional study is needed.
At this point, we do not know how long the vaccines will work. In addition, the new coronavirus variant from South Africa, known as B.1.351, could diminish the effectiveness of the current vaccines. The CDC reports that another variant of COVID-19 from the United Kingdom, known as B117 (50% more transmittable as compared to the American variant), will most likely become the dominant strain in the US beginning in March 2021. Studies thus far have confirmed that the Pfizer vaccine should work against this UK strain.
Both Pfizer and Moderna are working on the possibility that a third booster shot may be required as new virus variants emerge. Scientists speculate that getting a third shot would flood the human immune system like soldiers being dispersed onto a battlefield to increase the immune system’s effectiveness. Hopefully, by then, we will have many outlets to secure a third shot.
Currently, researchers are reporting that while the number of those infected with COVID-19 and related hospital cases had decreased by the end of February, March-May remain an unknown period. Many scientists are concerned that highly contagious COVID-19 variants could lead to another surge in the US. Consequently, they recommend that the public remain vigilant and continue practicing social distancing and other preventative measures. There is also hope that warm weather will promote more people going outdoors, reducing the spread of the virus in close quarters indoors.
Some of those who have had their COVID vaccinations said it was a simple process, but for others, it was frustrating and complicated. Experiences varied according to the organization that administered the shot, even within the 1a priority group. As more people become eligible for and obtain vaccinations, the process will hopefully become more standardized.
At this time, individuals seeking vaccinations usually must go online through an invitation from a hospital or pharmacy and complete a form that is submitted to the CDC’s vaccination portal, called “VAM.” If your application is accepted, you will be invited to schedule your first vaccination shot, choosing from a range of dates and times. As of March 2021, almost all vaccination sites require appointments. However, scheduling protocols have varied by provider: through the Medical University of South Carolina (MUSC), participants could schedule a shot directly and even make an appointment for a second shot at the same time, whereas other locations required that recipients obtain the first shot before scheduling a second one. Once you have your shot scheduled, it’s worthwhile to schedule another for a backup date and time with a different provider since vaccines often are in short supply and appointments may be canceled (I experienced this).
To help South Carolinians get their shots, the SC Department of Health and Environmental Control (DHEC) has developed a COVID-19 hotline. It is open seven days a week from 7 AM to 7 PM, but I recommend calling the number (1-866-365-8110) as early in the morning as you can. Operators can see all sites statewide and assist you with making an appointment.
IMPORTANT NOTE: Vaccination providers are seeking volunteers, regardless of age and even with little or no experience, to help the public in a variety of positions (like directing traffic) at vaccination sites. In exchange for volunteering for six hours, you can receive two vaccine shots for free, even if you are in one of the lower priority groups. To find these opportunities, type “volunteer at vaccine sites in (your city and state)” into Google. In Columbia, SC, you can volunteer through www.prismahealth.org/coronavirus/COVID-19-vaccine/volunteer or https://scdhec.gov/COVID19/COVID-19-vaccine/COVID-19-vaccination-volunteers.
For a variety of reasons, some individuals are afraid or hesitant to receive COVID-19 vaccinations. I have been told by friends and readers that they were not going to take the vaccines because there was insufficient evidence about long-term effects; was developed in too short an amount of time; and was released too soon for political reasons. There also exists a growing, organized movement by anti-vaccine, extremist, and anti-government proponents to influence others to avoid the shots. This movement has convinced some people that the vaccine is “evil” and/or contrary to our rights as Americans, to the point that groups have stormed several vaccination sites to prevent vaccinations, requiring law enforcement intervention.
While researching this column, I examined articles and posts on various conspiracy websites, Facebook, Twitter, other social media platforms, and news outlets to understand the most common misconceptions about the COVID-19 vaccines and their origins. Some of the information was poorly written and obviously untrue, but some of it was deceptively convincing and cited well-credentialed professionals, including medical doctors and scientists. As the Washington Post reported in 2020, many of these articles and social media posts include just enough science to make them convincing. And, as reported in the March 8, 2021 Wall Street Journal, “Russian intelligence agencies have mounted a campaign to undermine confidence in Pfizer and other Western vaccines, using on-line publications that in recent months have questioned the vaccines’ development and safety, US officials said.”
Having some reservations regarding the COVID-19 is understandable. However, when one deeply examines the body of verified, impartial, and scientific research based on many decades of vaccine testing and development, one will find answers to most of the questions and concerns being raised. Let’s examine some common misconceptions about the mRNA based COVID vaccines, along with what scientific literature and independent, expert research says about each.
Important! It’s true that 80% of COVID cases result in mild to moderate symptoms and many people begin to feel better in one or two weeks…but the tragically high death tolls for the other 20%, who get much more serious cases, show us how dangerous this highly contagious virus truly is. Another urgent concern is the lingering damage the virus can inflict on the body far into the future. A new study published in JAMA, an international peer-reviewed general medical journal, found that 30% of COVID-19 patients reported symptoms nine months after being infected that, in some cases, could be permanent. Long-term symptoms include shortness of breath, fatigue, sleeping disorders, fevers, gastrological problems, anxiety, depression, and brain fog (memory loss, difficulty in concentrating, and other neurological problems). Consequently, patients may have a mild-moderate case and think that they have recovered, only to experience significant problems later down the road. The US government is so concerned about these “COVID long-haulers” that it is launching a study of how the virus can cause damage over time, with some issues surfacing later in life.
The bottom line: We now know much more about the prevention and treatment of the novel coronavirus than we knew in March 2020. However, there are still a lot of unknowns, especially as new coronavirus variants, such as the South African version, appear. Whether our existing vaccines can contain the new variants or how long they will protect us is still yet to be seen.
We all miss eating inside our favorite restaurants, going to movies, and visiting with our relatives and friends. However, for us to do these things safely means that 80% or more of Americans must have been infected by the virus or have taken the vaccine to reach “herd immunity” when the virus cannot find hosts for infection.
Through extensive research and careful study, I’ve come to the conclusion that, while there may be some risks to taking the vaccines, the immediate and lingering, long-term problems COVID-19 can cause within the body far outweigh them greatly! Therefore, I’m advising all my friends, family, and loved ones to get the shots. To end the pandemic and find our “new normal,” let’s heed the old saying: “It’s all for one, and one for all!”
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Mike DuBose has been an instructor for USC’s graduate school since 1985 when he began his family of companies. He is a contributing guest author for Midland's Biz and is the author of The Art of Building a Great Business. Please visit our blog for additional published business, travel, and personal articles, as well as health articles written with Surb Guram, MD.
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