Should I Take the COVID-19 Vaccine?

The Pros, Cons, Risks, and Misconceptions

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.

What do we know now?

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.

How do the vaccines work?

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.

How were the vaccines developed, tested, and approved?

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!

How long does it take for the vaccine to become effective?

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.

What are the short- and long-term effects of taking COVID vaccines?

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!

When will children receive the vaccine?

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.

Should I take a pain reliever before getting the shot?

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.

If I have been infected by the COVID-19 virus, should I still be vaccinated?

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.

How long will the vaccines’ protection last?

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.

How do I obtain a vaccination?

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.

But aren’t the shots dangerous? Addressing misinformation about the COVID-19 vaccines.

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.

1. The vaccines can damage your DNA. There is no scientific evidence to support this theory. Within each of your cells, your DNA resides in a central, separate part of the cell called the nucleus. The mRNA that enters your body through the COVID vaccines remains outside the nucleus and therefore cannot alter or harm your DNA.
2. The vaccines can kill you. Of the 43,448 volunteers who participated in global Phase 3 Pfizer vaccine trials, six people died—four of whom had received the placebo (so did not actually take the vaccine), and two of whom died of natural, heart-related causes. In addition, according to the CDC, “Over 92 million doses of COVID-19 vaccines were administered in the United States from December 14, 2020, through March 8, 2021. During this time, VAERS [the CDC’s Vaccine Adverse Event Reporting System] received 1,637 reports of death (0.0018%) among people who received a COVID-19 vaccine. CDC and FDA physicians review each case report of death as soon as notified and CDC requests medical records to further assess reports. A review of available clinical information including death certificates, autopsy, and medical records revealed no evidence that vaccination contributed to patient deaths.”
3. The vaccines can cause infertility. Some rumors have postulated that the vaccines prime the immune system to mistakenly attack a protein in the placenta known as syncytin-1, stoking fears about fertility problems. In recent studies, women said they were more likely to decline shots as compared to men, and in a Kaiser Family Foundation study conducted in January 2021, twelve percent of women of childbearing age reported they were concerned that the vaccine causes infertility. Alarmed by the infertility rumor and the concerns expressed even by some of her medical colleagues, Yale University School of Medicine immunologist and professor Akiko Iwasaki and her medical team researched the claims involving the vaccine and syncytin-1 from two different perspectives. They compared the coronavirus spike protein and syncytin-1 and found very few similarities. They also examined the reactivity of about 3,000 different human proteins to the antibodies formed from COVID-19 infection or vaccination. For syncytin-1, they found no reactions. The CDC also reports that “there is currently no evidence that COVID-19 vaccination causes any problems with pregnancy, including the development of the placenta.”
4. If a woman is pregnant and takes the vaccine, it can harm the fetus. Because pregnant women were initially excluded from the Pfizer and Moderna vaccine studies, some people are concerned about the shots’ potential effects on developing fetuses. However, it’s worth noting that eighteen women who participated in the Pfizer and Moderna trials became pregnant during the trials, and no harmful outcomes were found. A small study of pregnant women who were vaccinated or infected with the virus found COVID-19 antibodies in their cord blood and placentas 86% of the time, meaning that they might also pass along COVID immunity to their babies. On the negative side, research is showing that pregnant women who have not been vaccinated may experience more serious—and sometimes deadly—side effects from being infected by COVID-19. Pfizer announced in February 2021 that it is conducting a blind study of 4,000 healthy pregnant women aged 18 years and older, half of whom received the vaccine and half of whom got a placebo. The study will monitor the women for ten months, and infants whose mothers received the vaccine will be evaluated for six months after birth. This should give us more information about the vaccine’s impacts on pregnant women. Of course, women who are considering pregnancy or who are pregnant should consult with their ob-gyn before taking any vaccine or starting any new medication, just to be safe.
5. The Pfizer vaccine is being made in Belgium without adequate safety standards. The United Kingdom secures its Pfizer vaccine from a Belgian plant; however, Americans receive Pfizer vaccines made in Missouri, Michigan, and Wisconsin. Fortunately, Pfizer had invested in building these three US plants two years before the coronavirus emerged, which aided in their ability to rapidly manufacture the vaccine.
6. The vaccines can cause Bell’s Palsy, a temporary paralysis of the face. Pfizer reported 4 cases of Bell’s Palsy during its clinical trials…a number consistent with the number of 4 cases reported per 43,448 in the general population. No link to the vaccine was determined.
7. The vaccines are unsafe because they were developed so quickly. The mRNA vaccines to fight COVID were developed faster than any other known vaccine, most of which took years to create. However, due to the huge threat to humanity posed by a worldwide pandemic, governments, pharmaceutical companies, and other organizations poured massive amounts of resources into producing a viable COVID-19 vaccine, allowing it to be developed at an unprecedented speed. The expense of rapid vaccine development was offset by billions of dollars contributed by world governments, reducing liability and possible financial loss for the pharmaceutical companies. In addition, scientists basically had a “cheat sheet” for mRNA technology used in the COVID vaccines based on decades of previous SARS research. Pfizer and Moderna were able to crank out a similar vaccine in March 2020, only a few months into the pandemic, based on what was already known from these SARS studies. It’s also critical to note that, when any new drug or vaccine is being considered, the FDA requires a “gold standard” test using randomized, placebo-controlled Phase 3 clinical trials with large groups of people. These blind studies are virtually impossible to “cheat” on. Regardless of how rapidly a vaccine has been developed, it must pass this test to be recommended by the FDA. Because the FDA approved the Pfizer, Moderna, and Johnson & Johnson vaccines, we know that they passed this rigorous testing.
8. The vaccines contain unsafe ingredients. Both Pfizer and Moderna list their vaccines’ ingredients on their websites. Outside of the main ingredient, mRNA, the Pfizer vaccine contains lipids and salts, which are commonly (and harmlessly) ingested by humans daily. As for conspiracy theories that the vaccines contain tracking devices or nanobots…we’re not going there!
9. The government will require people to take the shots. At one time, a petition with half a million signatures was circulating, voicing opposition to the US government requiring citizens to take the COVID-19 vaccine! However, this fear is unfounded. While some employers may require employees, who work in an office setting, to take the shots to remain employed, there is no government mandate to take the vaccine. The US Department of Labor has issued a statement that allows businesses to require a shot. However, some 29 states have forbidden this practice.
10. Vaccines are not needed because the coronavirus is a hoax. If a person is infected, the outcome lasts only for a few days and is no more dangerous than a cold or the flu. Unfortunately, some media outlets, conspiracy sites, social media posts, and politicians peddled a lot of inaccurate information at the start of the novel coronavirus pandemic. This led to many people who did not take the virus seriously, did not wear masks in public or socially distance, and continued to lead their lives as normal. As a result, the easily transmittable virus spread throughout the US like a wildfire, killing more than half a million people in the past 12 months. Although only 4% of the world’s population lives in the US and we have one of the most modern medical systems in the world, our country has suffered about 25% of total positive cases and 20% of deaths worldwide from the COVID-19 pandemic.

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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