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Physicians can help patients separate fact from fiction
The onslaught of information about COVID-19 vaccines shared in the news and on social media has contributed to a cluster of myths about the vaccine that feed skepticism about its purpose and safety.
It’s normal for people to have questions about the vaccines, acknowledges Thaddeus Stappenbeck, MD, PhD, Chairman of the Department of Inflammation and Immunity at Cleveland Clinic’s Lerner Research Institute. “These are new therapeutics and it’s totally reasonable to be asking constructive questions with an open mind,” he says.
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When patients raise doubts based on fears or on erroneous information, however, physicians should be ready to listen with patience and respond with clear answers that may help build confidence. Dr. Stappenbeck’s suggested responses to some of the most common myths may help physicians build trust around the COVID-19 vaccines.
It may be important to explain to patients that, while the first vaccines for COVID-19 do involve new technology and were developed in record time, there were no shortcuts in the process.
The messenger RNA (mRNA) technology at the heart of vaccines from Pfizer and Moderna were made possible because researchers have been working on this vaccine strategy for more than three decades.
“It was a lucky thing that the technology has been robustly developed quite well over the last few years and tested in several models of infection, so we knew that it was safe and worked quite well,” Dr. Stappenbeck notes. “When COVID-19 came around, this was an obvious opportunity to use this novel technology, and vaccine developers were poised to do it.”
Confidence has been established through rigorous trials involving tens of thousands of volunteers. The prevalence of COVID-19 enabled clinical trials to collect enough data to make an initial evaluation. The U.S. Food and Drug Administration, as well as an independent panel of vaccine experts, closely scrutinized the data from those trials and deemed Pfizer’s and Moderna’s vaccines safe and effective for emergency use. Similar independent panels in several other countries are in agreement.
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Patients might need a better understanding of how vaccines prime the immune system to recognize and fight off a disease without actually causing an infection.
The first two COVID-19 vaccines that are available in the U.S. contain a strand of mRNA that instructs the recipient’s cells to make a piece of the spike protein present on SARS-CoV-2, the virus that causes COVID-19. Those protein pieces don’t harm the body, but they do trigger the immune system to mount a response to fight them off. The mild fatigue, muscle aches, headache or fever that may occur afterward are signs that the immune system is responding.
The vaccines use mRNA to instruct cells to make a piece of the hallmark spike protein found on SARS-CoV-2 to spark an immune system response. Once the mRNA does that, the body’s cells break it down and dispose of it.
“Messenger RNA is something that’s made from DNA, but it’s not designed to integrate with our DNA, and it doesn’t permanently change our genome in any way,” Dr. Stappenbeck says.
Both Pfizer and Moderna have published the ingredient lists for their vaccines. In addition to the mRNA for the spike protein, both vaccines contain lipids to help deliver the mRNA into the recipient’s cells and a few other common ingredients to help maintain the pH and stability of the vaccine. Despite theories circulated on social media, they do not contain microchips or any form of tracking device.
We don’t yet know how long natural immunity to COVID-19 lasts, Dr. Stappenbeck says. Right now, it seems that getting COVID-19 more than once is not common, but many questions remain unanswered. Experts say that it is appropriate even for those who have had COVID-19 to be vaccinated.
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While most people who get COVID-19 are able to recover, some people develop severe complications. So far, more than 1.7 million people around the world have died from COVID-19 and many more needed to be hospitalized. The disease can cause damage to the lungs, heart and brain that may also cause long-term health problems that are not yet fully understood.
The other reason to consider getting the vaccine is that it may reduce the chance of passing COVID-19 on to someone else who might be more severely affected. Widespread vaccination protects populations, including those who are most at risk and those who can’t be vaccinated. It will be important for ending the pandemic.
Masking, physical distancing and hand washing remain important even among those who have had the vaccine. Both of the authorized vaccines require two doses given three to four weeks apart to achieve the best possible immunity. “It takes at least a week to 10 days for the body to begin to develop antibodies, and then those antibodies continue to increase over the next several weeks,” Dr. Stappenbeck says.
In addition, while these vaccines were developed and tested for their ability to prevent severe illness and death from COVID-19, it’s not yet clear whether they also protect against asymptomatic infection and spread. “There will be ongoing studies to evaluate this question, but it will be some time before we actually know,” Dr. Stappenbeck says. “So after you get the vaccine, you should still take steps to protect other people who haven’t been vaccinated yet.”
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“I would love to say that we’re going to flip a switch and everything’s going to be back to normal, but it’s actually going to take a long time for us to be able to vaccinate an adequate number of people to the point at which we’d start to see the cases dropping significantly,” Dr. Stappenbeck explains.
In order to achieve herd immunity – the point at which the disease is no longer likely to spread – about 70% of the population will need to have been vaccinated or infected, he says. But the companies that make these vaccines can only make so many at a time. The vaccines are being distributed in phases, with priority given to people with greatest need. They may not be widely available to the general public until mid- 2021.
For now, patients should be encouraged to continue to do their part to help slow the spread of the virus, including wearing a mask, washing their hands and practicing physical distancing.
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