Vaccine – yay, nay, or undecided?

[tim-blowfield]

I will get the vaccine.
I do understand that there are valid concerns of about the vaccines but the development has been rigorous. Issues do occur with vaccinations – anaphylaxis occurs occasionally and is serious but very treatable.
Will there be other ‘side effects’ – we cannot be totally sure they wont but we can be confident that they will be less common that those of the wild disease. Despite the rush to get the vaccines developed there has still been rigorous testing.
The report that MMR vaccine caused Autism was a complete Furphy by a rogue who wanted to promote his own alternative. This has done immense damage and is still being cited by anti-vaxers despite the Danish Population register showing there was no correlation.
Measles vaccine does occasionally produce serious problems but far less commonly that that produces by the wild infection – about 1000 x less often.
Vaccines have been used to eradicate Smallpox – a disease that devastated and disfigured so many. I grew up in the ’40 & ’50’s when Poliomyelitis devastated the world. The first vaccine, the Salk Vaccine – an injection, was effective but did occasionally cause neurological damage. It was later replaced by the oral Sabin vaccine which was safer. Today through vaccination Polio has almost been eliminated from the world.

[paul-met-debbie]

Generally I am pro vaccination. I can’t remember ever missing any relevant available or prescribed vaccine. Even in 1967 when in Europe there was no vaccine against measles, my parents imported a novel vaccine from the US for me. And my annual flu-shot is an automatism for me. I would not think of skipping it. And I agree with Tim that in the past, vaccines have been very succesful in contributing to the eradication of some nasty diseases like measles, mumps, rubella, polio and smallpox.

In this case however, I feel more reluctant. The covid vaccines are different, because some of them use techniques that are much less common than our normal vaccines, that mostly use the alive, weakened or inactivated virus as a vector to trigger the immune system. With some of these new vaccine platforms there is considerably less experience. That is not to say they are unsafe – only that we can’t predict the safety as well as we are used to. But I am willing to trust medical science on this. We have to keep trying new things once in a while, and this pandemic seems to be an appropriate situation.

My main hesitation however concerns the short term side effects (long term will stay unknown for a long time – that is inevitable). Yes, as Tim pointed out correctly, the covid vaccines have been tested – but only on super healthy people and in relatively small groups (compared to the enormous group that will be targeted soon). Some volunteers reported considerable side-effects, but in most cases they were relatively mild and in any case lasted only a day without permanent damage done. But there is no telling in advance how people with a less robust health condition will react. People like me.

I think it is at least questionable to start vaccination precisely in these more vulnerable groups, that have not been tested so far – what seems to be the scenario in the US and Europe. Another option would be, to first target the spreading of the virus by vaccinating the most socially active and healthy groups – young people, employed people, monitor the side effects in those large groups and only after that target the less socially active groups (elderly people, people with health problems etc.) This is what I understand going to be the Russian approach. It will be most interesting to see how this turns out. So, first administer the vaccine to people that are most alike to the tested groups. If this goes well, the support base for vaccination will only grow. Even one could presume that if a sufficiently large percentage of healthy people gets vaccinated, group immunity will make vaccination for the other most vulnerable group less important or even superfluous and we could possibly spare them the risk of vaccination, the logistic stress and the costs.

For me personally, even having “mild” side effects (comparable with having a heavy flu for one day) could turn out to be highly problematic with my poor lung function (30%), since even a mild common cold could launch me into a negative health spiral. There is a very delicate balance in my body between what my natural immune system can cope with and what medication I need to do the rest. Disturbing the immune system with a new vaccine will always be sort of a gamble. My pulmonologist agreed that it would probably be a wise option to wait how the mass-vaccination turns out regarding side effects.

Mind you: I am not a doctor and I am not advocating anything here. My situation is quite uncommon (a chronically agitated immune system and very weak lungs) and so is my viewpoint. Everyone must make a personal decision here, together with their health team. If side effects in vulnerable groups turn out manageable, I will certainly get my shot to free myself from quarantine. But I don’t have to be first in line. I can stand the current quarantine very well for some time longer and I feel pretty safe in that. When there is time, mostly in my life it was a wise thing to use it. I hope this time is similar.

[tim-blowfield]

Well said, Paul. I agree you have summed up the situation well and to take a wait and watch position is appropriate. I am a veterinarian, not a human medical practitioner so have had considerable experience with vaccines. Every CF person must seek advice from their doctors and discussion such as yours should give them confidence to ask appropriate questions and whether even mild side effects may be detrimental is one of them.