COVID-19 Vaccines Are Safer Than COVID, Despite Adverse Events

COVID-19 is a confounding disease. On one hand, it is a global pandemic that is responsible for killing approximately 2 million people and infecting 81 million world-wide. On the other, many people who carry the SARS-CoV-2 virus never know they have it. Their symptoms may be so mild and short-lived they are barely noticed. When it comes to vaccination, therefore, many people still prefer to wait.

They reason that the deaths were the result of senescent immune systems in the elderly or to underlying conditions in all age groups. It’s no wonder younger, healthy people wonder what the fuss is about. Even some medical professionals are confused.

Meanwhile, serious adverse event related to the two recently-released vaccines are making headlines. Although the events are rare – fewer than 20 severe allergic reactions after nearly 2 million doses have been administered in the U.S. – it’s enough to make people hesitant to be vaccinated when their turn arrives.

In early December, Pew Research reported that about 60% of Americans were willing to take the COVID-19 vaccine. That’s down from 72% in May, but up from 51% in September. Several nations, including Belgium, China, France, Israel, Russia, Singapore and South Korea, have launched campaigns to encourage vaccination.

At a December media briefing by Johns Hopkins Medical School’s own COVID-19 experts, the most common answer to questions was, “We need more research.” That response is, sadly, accurate. A great deal remains unknown about the SARS-CoV-2 virus, its mutations, transmissibility and long-term effects.

Here’s what we do know:

Some young, healthy, asymptomatic people who contract the virus show signs of heart damage. The damage occurs in about 20% of people who experience mild COVID-19 symptoms and typically appears weeks or months after symptoms. Although the data was published in JAMA six months ago, it’s often overlooked by non-cardiologists.

COVID-19 also is an endothelial disease. In multiple studies, patients have shown clotting in the small blood vessels that leads to lung damage. Physicians on the front lines of the pandemic have noted COVID-19’s similarity to thrombotic microangiopathy. Halting systemic complement activation appears to be a key in stopping the disease cascade, but further research is needed.

Children can experience blood vessel damage from SARS-CoV-2. Although children are less susceptible than adults to COVD-19, researchers at Children’s Hospital of Philadelphia found elevated levels of a biomarker related to blood vessel damage in all 58 children in the study who had COVID-19 – even when they were asymptomatic or had only mild symptoms. The study, published in Blood Advances, noted that the long-term consequences are unclear at this time, but advised evaluating children hospitalized with COVID-19 for thrombotic microangiopathy and its complications.

Pregnant women and newborns are especially susceptible. Just-published research in Cell showed that during the third trimester, protective antibodies transferred from the mother through the placenta to the unborn child at a lower-than-expected rate. The antibodies that were transferred were less functional than those for other diseases, such as influenza.

SARS-CoV-2 may cross the blood/brain barrier. A study in Nature Neuroscience showed the spike protein crossed the blood-brain barrier in animal studies and was taken up by various regions of the brain. The uptake was ten times lower when the virus was administered intranasally than when administered intravenously. That same study showed it also was taken up by the lung, spleen, kidney, and liver. 

COVID-19 can be a long-haul disease. A Royal College of Physicians study, published in Clinical Medicine Journal, cited multiple studies showing that symptoms – including fatigue, shortness of breath, and chest pain – persist months after the onset of the disease. One Italian study published in JAMA showed that even 60 days later, 88% of patients still experienced symptoms. The disease clearly is more complex than initially thought, and new insights continue to emerge.

COVID-19 mRNA vaccines are 90 to 95% effective. Both the Pfizer and Moderna vaccines are mRNA vaccines, have emergency use authorization by the FDA and are being administered now and more and different types of vaccines are in clinical trials.

The two mRNA vaccines available in the U.S. were tested in approximately 30,000 people before being approved. As the FDA pointed out in announcing emergency use authorizations for the Pfizer/BioNTech vaccine and the Moderna vaccine, in addition to efficacy, “The data also show that the known and potential benefits outweigh the known and potential risks.”

Before Pfizer’s vaccine was granted emergency use authorization, the Centers for Disease Control & Prevention (CDC) tabulated all adverse effects associated with the vaccine in more than 2,000 patients seven days after injection. The most common were mild-to-moderate fatigue, headache, night-time chills, and muscle and joint pain. More people reported symptoms after the second dosage than the first. The side-effects of the Moderna vaccine are similar.

CDC data shows that vaccination side-effects typically go away after a few days. The symptoms of COVID-19, in contrast, may persist for weeks or months and may have life-long consequences.