Some have wondered about the safety of the COVID-19 vaccine and whether it’s wise to get it. I’ve personally chosen to be vaccinated and am recommending the vaccine to virtually all my patients. I’ll explain the reasons I’ve made these decisions by addressing several of the concerns many people express regarding the COVID vaccine.
Some people are concerned about the risk of experiencing a serious allergic reaction, or anaphylaxis, with the vaccine. The Centers for Disease Control and Prevention (CDC) reports that this serious allergic reaction, which develops within the first 15 to 30 minutes after receiving the vaccine, has been occurring with a frequency of 2.5 to 4.7 cases per million vaccines.1 This is an exceedingly rare and treatable complication of any vaccine.
Just for comparison, if 1 million people were to get COVID, one would expect between 5,000 and 10,000 deaths from the disease.2 So the risk of dying from contracting COVID is thousands of times higher than the risk of having a serious immediate reaction (not death) from getting the vaccine.
From December 14, 2020, through August 9, 2021, more than 356 million doses of the COVID-19 vaccines were administered to about 198 million people in the United States (342 million doses of the Pfizer and Moderna vaccines and 13.9 million doses of the Johnson & Johnson [J&J] vaccine).3
During this time the Vaccine Adverse Events Reporting System received 6,631 reports of death among people who received a COVID-19 vaccine.4 CDC and FDA physicians review each case report of death as soon as notified, and the CDC requests medical records to further assess reports. A review of available clinical information—including death certificates, autopsy, and medical records—has thus far revealed evidence suggesting that the vaccination contributed to fewer than 10 of these deaths.5 (Remember that thus far those in the older age groups are much more likely to have received the vaccine, and older people die from heart attacks, cancer, chronic lung diseases, pneumonia, hip fractures, and strokes even after they’ve been vaccinated, just as they did before the vaccine came out.)
As of July 8 in the United States, 38 cases of blood clots with four deaths have been reported, mostly in women under the age of 50.6 These blood clots have appeared almost exclusively in the 12.8 million persons receiving the J&J vaccine, and the vaccine is likely causal. This serious adverse event is called “thrombosis with thrombocytopenia syndrome” (TTS), which involves blood clots with low platelets. Platelets are a type of blood cell that helps blood to clot. These blood-clot cases have occurred five to 42 days after the J&J vaccine was administered in the United States and after the AstraZeneca (AZ) vaccine was administered in Europe. These two vaccines are very similar in the mechanism of action.
As of July 12, no cases of TTS have been reported with the Pfizer vaccine, and two cases have been reported with the Moderna vaccine.7 These numbers appear to be no higher than would be expected by chance.
Another condition that appears to be triggered by the J&J vaccine is Guillain Barré syndrome (GBS), a rapidly progressive muscle paralysis condition that’s usually reversible with treatment, although recovery often takes many months. In the United States, as of June 30, about 100 cases of GBS have been reported within two weeks of vaccination with the J&J vaccine. There has been one death.8
As of August 6, again in the United States, 1,253 cases of myocarditis and pericarditis have been reported (730 of these have been confirmed).9 Myocarditis is inflammation of the heart muscle, and pericarditis is inflammation of the lining around the heart muscle. The most common symptoms have been chest pains, shortness of breath, and rapid heartbeat. This has occurred mostly in younger men and usually within a few days of the second dose of the Pfizer or Moderna vaccine. Most have responded to treatment with anti-inflammatory medication and rest and have quickly felt better. There have been no reported deaths so far.10
It’s worth noting that thrombosis is a very common complication of COVID-19, with blood clots occurring in 3 to 9 percent of patients hospitalized with moderate COVID and in 20 to 40 percent of those with severe disease.11 These include clots in veins, lungs, and arteries supplying the brain and the limbs. So the risk of blood clots from the COVID-19 infection is actually much higher than the risk of blood clots from the J&J and AZ vaccines, and blood clots are not a concern with Pfizer or Moderna vaccines.
GBS is a recognized complication of COVID-19, perhaps as rare as it is with the vaccine. And myocardial injury is very common with COVID-19 infections, often associated with severe outcomes as compared to the much more benign myocarditis and pericarditis seen with vaccinations.12
Just for the sake of comparison, suppose that the government is not being honest, and all of the 6,631 total deaths reported by the Vaccine Adverse Events Reporting System were indeed the direct result of the vaccine. (Let me emphasize that this is just hypothetical; I believe the CDC and FDA are being honest with the country, including the open reporting of the side effects listed above.) Let’s compare 6,631 deaths “after the vaccine” with what would happen if, instead, 198 million unvaccinated people had contracted COVID.
The case fatality rate (confirmed infections/confirmed deaths) for COVID in the United States stands at 1.7 percent.13 Since there are many people who get COVID but aren’t tested (some studies suggest that there are twice as many people who have COVID antibodies from previous infection compared to those who have actually gotten tested and tested positive), we could estimate that the risk of dying from contracting COVID in the entire population is 0.8 percent, and perhaps up to 2 percent in the older population, which comprises many of the people who’ve received the vaccines so far.
“I’ve personally chosen to be vaccinated and am recommending the vaccine to virtually all my patients.”
So if 198 million people (many of them older) were to contract COVID rather than getting the vaccine, there would be 1.6 to 3 million deaths. As it turns out, however, they were vaccinated, and there have been about 1,600 deaths—1,587 of them breakthrough COVID infections despite the vaccine, and fewer than 10 deaths from the vaccine.14 Even in the women under 50 who received the J&J vaccine (the highest risk group), the death rate from vaccine complications is only about one death per 1 million vaccine doses.15
One could also compare 6,631 deaths “from the vaccine” (in reality, fewer than 10) with 618,591 real deaths from COVID thus far in the United States (as of August 15, 2021).16 So the statistical odds of doing well are vastly in favor of the vaccine. And with the vaccine supply as ample as it is, one can choose which vaccine to receive if there is concern about potential risks associated with a specific available vaccine.
We also need to consider what my vaccination could mean for someone else. Let’s suppose that all the older people get vaccinated, and all those with other health risks get vaccinated. The trouble is that at least 6 percent of the people who get the vaccine won’t actually generate a satisfactory immune response. This is even more likely in older people and those on immune-suppression medications necessary to treat a number of health conditions, including cancer, rheumatoid arthritis, Crohn
’s disease, lupus, multiple sclerosis, myasthenia gravis, and polymyositis—just to name a few. In fact, a recent study suggests that 77 percent of multiple sclerosis patients who take one of the common immune treatments and 96 percent who take another common immune treatment developed no measurable response to the vaccine.17 So now, these older people or the immune suppressed have done everything they can to protect themselves—but many of them are still vulnerable (and they may not know it). So if I decide not to be vaccinated and then catch COVID, I can transmit the disease to one of these friends, grandparents, or patients of mine. And then they can come down with severe or fatal COVID, even though they’ve been very vigilant. We shouldn’t make them live in solitary confinement forever!
From a public health perspective and in compassion for the vulnerable, it still makes sense to seriously consider getting the vaccine even if you’re young and healthy and not worried at all about getting COVID. What I choose affects those around me. It isn’t just my health I should focus on.
Last, but not any less important, I’ve had patients tell me that they’re “just going to put myself in God’s hands” and not get the vaccine. But I must ask, Would it indicate a lack of faith if you had colon cancer or breast cancer and you allowed a surgeon to remove the tumor? Or you developed epileptic convulsions and decided to take medicine to prevent the convulsions? Or you decided to vaccinate your child to prevent her from getting polio? Or would it be better to “put all these in God’s hands” as well?
Could it be that God has revealed these “discoveries” to our world for our benefit? This is, in fact, what I believe.
I’d like to encourage each of us to get the vaccine. The FDA has now approved the use of the Pfizer vaccine for COVID-19,18 which should also help to eliminate doubts some people may have of its safety. I believe the benefits for all of us far outweigh the risks.
Richard Sloop is a neurologist living in Yakima, Washington.
