As awful as COVID-19 has been, things would have been much worse without vaccines. When SARS-CoV-2, the virus that causes COVID-19, first started spreading last spring, every human was vulnerable to it. There have been some modest improvements in the treatment of COVID-19, but people are still largely at the mercy of whatever SARS-CoV-2 has in store for them, and it has killed 575,000 people in the United States alone. In Brazil, people have been reinfected showing that even a previous infection is not a guarantee of protection raising the specter of repeated deadly waves with mutant variants. With three effective vaccines, however, the United States is on the brink of an almost-normal summer.
Miracle #1: 3 Vaccines in Less than a Year
Vaccine development often takes years. A perfect storm of factors sped up the development of COVID vaccines. First, vaccine development is typically supported by multiple rounds of fund raising with each round taking months or even years. The United States Government removed this obstacle by funding COVID vaccine development up front. Second, vaccine development in general is very sophisticated these days, and coronavirus vaccine development had been a focus of attention for years. Different groups had been working on a SARS vaccine for several years, and SARS is caused by a coronavirus that is similar to SARS-CoV-2. Finally, the clinical trials that were required to earn Emergency Use Authorizations went more quickly than anticipated because so many people got COVID-19 so quickly when those trials were running. Enough people had to get COVID-19 to show how effective the vaccines were.
Miracle #2: COVID-19 Vaccines are Really Effective
Flu vaccines are typically somewhere between 40-60% “efficacious,” yet despite that low-seeming figure are totally worth taking. Last spring the Food and Drug Administration (FDA) indicated it would authorize any safe vaccine that was at least 50% efficacious. The three currently-authorized vaccines in the United States, produced by Pfizer, Moderna and Johnson and Johnson, are between 72-95% efficacious. That’s much better than was hoped for, and a further testament to the sophistication of current vaccine development. Furthermore, although there seems to be a slight drop-off of protection against some of the virus variants, all three vaccines seems to protect against severe illness, hospitalization and death from variants. Furthermore, there is mounting evidence that vaccines greatly reduce the risk of becoming contagious. We are seeing evidence of this good news all around. Despite the proliferation of virus variants, case rates, hospitalizations and deaths have been dropping steadily for weeks
Not Really a Miracle #3: COVID-19 Vaccines are Really Safe
Vaccines work by tricking your immune system to do something it does all the time naturally anyway. By pretending to be SARS-CoV-2, COVID-19 vaccines teach your immune system to recognize and fight the real thing. Since the way vaccines work is to trigger a natural process, vaccines are among the safest medications you can take. They are certainly safer than acetaminophen (which can damage your liver), ibuprofen (which can give you an ulcer) or Benadryl (which can make you delirious). They are even safer than the normal things that trigger your immune system. Children’s immune systems develop as they get exposed to infectious agents in the environment. When your kid eats dirt, or licks the cat, or gets licked by the dog, they are training their immune systems by exposing themselves to nasty stuff that is much more dangerous than vaccines.
The typical risk of vaccines is a risk shared with all medications—the small chance that you might be allergic to something in the vaccine. This happens at a rate of about 1 in 500,000 doses. The good news is that such allergic reactions are very easy to treat. That’s why you can get a vaccine at a pharmacy—a pharmacist can very effectively treat a vaccine allergy in the detergent aisle of CVS.
Vaccines do not cause autism. That research was not just flawed, it was fraudulent. Furthermore, the processes that cause autism start in utero, way before a child receives any vaccines.
What About the Johnson and Johnson (J&J) Clotting Problem?
In early April, the Vaccine Adverse Event Reporting System (VAERS) detected 6 cases of an unusual clotting syndrome in the 8 million people who had received a J&J vaccine. First off, that’s needle in a haystack territory and a testament to how good our vaccine surveillance system is. Since then, the Centers for Disease Control (CDC) has found an additional 9 cases. The syndrome is now being called Thrombosis with Thrombocytopenia Syndrome (TTS)—in lay terms, blood clots in a person with low platelets. The syndrome can be quite dangerous because clots can form in the brain—3 of the 15 people who developed the syndrome have died. Of the 15 cases, all are women, and 13 out of 15 are women under age 50. So, the rate in women over 50 is 1 in a million and the rate in women under 50 is 7 in a million (the rate in men thus far is zero in 4 million). 7 in a million equals 1 in 142,857 doses. If you received a J&J shot every day it would take 391 years to get to 142,857 doses. That’s a very, very low risk, and even if you are a woman under 50 I think it is reasonable to chose the J&J vaccine if you have some reason to prefer it (because it’s a single dose or because is has phase 3 clinical trial data showing effectiveness in South Africa and Brazil). However, you also have options. There is now more Pfizer and Moderna supply than demand. Many places are even taking walk-ins.
Vaccines are our Ticket to Normal
Without vaccines we’d be staring at another variant-fueled surge. Instead, I’ve been able to hang out maskless in my 82-year-old mother’s apartment. We were at the mercy of the virus before. SARS-CoV-2 could be at the mercy of vaccines if enough people protect themselves with them.