Tip/Thought of the Day

Vaccine Conversations With My Patients

The picture below shows the Washington Mall filled with the names of loved ones on white flags who died due to a COVID-19 infection. My heart breaks for each one.

AP Photo/Brynn Anderson

The U.S. leads the world in COVID-19  cases- 19%, and fatalities- 14%. We just surpassed 700,000 deaths. Lately I have had wonderful dialogues with patients regarding their hesitancy to getting a COVID-19 vaccine. I thought I’d share a few:

It is a HIPAA violation to demand my vaccine status

This regulation only applies to how covered entities e.g. healthcare facilities, insurance plans and their employees deal with the flow of personally identifiable information in order to maintain and protect it from fraud and theft. Organizations are free to demand vaccine status especially under OSHA guidelines that require employers to provide a safe workplace. If someone is unwilling to get vaccinated or show proof, the facility can enforce policies that ensure safety. We are expected to abide by many guidelines before we are allowed enter a facility. Shirts and shoes. Identification showing intimate details about our lives just to get an alcoholic drink or cash a check. Children and healthcare workers are required to show proof of vaccinations before they can enroll in school or stay in the workplace. 

It’s just another infringement on my civil rights

Governments have always been involved in legally regulating health issues that have a catastrophic impact on the welfare of their citizens. In 1991, when seat belts were required, the argument that it infringed on personal freedoms went all the way to the Supreme Court, and lost. So did the argument that arbitrary and random stops during major holidays to seek out drunk drivers was an infringement of our rights. We are told how high to build a fence to protect backyard pools. We can’t own a diving board anymore, something I loved as a kid, due to the high level of injury. We have always been a country that looks out for each other’s welfare. We legislate and have entire government agencies that oversees food products, health, environmental issues, medications, and toys to ensure public safety.

It came to market too fast, the messenger RNA can’t be safe

It’s been 30 years in the making. For all those decades, research has been working on creating this incredible vaccine. And just like America’s determination and success at putting the entire might, intelligence and finances to landing a man on the moon within a year, once the entire world’s focus was on fighting COVID-19, the last few pieces fell into place. This was not an overnight creation. And in the beginning, worrying you’d be a guinea pig might have been reasonable but after a few hundred million vaccines have been given, the risks and side effects are phenomenally infinitesimal. After hundreds of millions of people have been vaccinated with less then .01 severe side effects this is the most tested vaccine ever brought to market. Those of us who have taken the vaccine are proof of its efficacy and safety.

How can they mandate a vaccine? It’s my body. I have the right to decide

It’s been done many times in the past when the country’s health has been at risk. The last natural occurring smallpox infection was in 1949. It was eradicated due to vaccine mandates. I remember standing in line for hours with my grandmother in 1976 to get the mandated swine flu vaccine. It’s a routine requirement for military personnel and school children. A 1970 federal statute gave the government the authority to issue an emergency temporary standard for 6 months, to protect workers from, “grave danger from exposure to substances or agents determined to be toxic or physically harmful.” This controversy is not new. Almost 300 years ago we grappled with the same issues. Benjamin Franklin went through his own inner struggle over whether to vaccinate his sons against smallpox. In his autobiography, he voiced many of the same concerns heard now- that well-meaning people were tragically misjudging the risks and rewards, as he himself had done. That’s why he wrote for all to read,

“In 1736, I lost one of my sons, a fine boy of four years old, by the smallpox. I long regretted bitterly and still regret that I had not given it to him by inoculation. This I mention for the sake of the parents who omit that operation, on the supposition that they should never forgive themselves if a child died under it; my example showing that the regret may be the same either way, and that, therefore, the safer should be chosen.”

We don’t know the long term consequences

We never know the long term consequences until decades later. All medications and vaccines come to market after specific research guidelines. If safety protocols are passed in testing just a few thousand patients, it can go to market. Often it’s not until millions use it that underlying, unknown risks become apparent.

Zantac, an anti-indigestion medication, once thought to be so benign it has been over the counter for years, was recently pulled when it became known that the process to make the medication was possibly carcinogenic. Often that’s what it takes. Not thousands but hundreds of thousands, millions of users to find a particular concern. The swine flu vaccine, after inoculating the entire country saw a rare consequence- Guillain Barre syndrome, also seen rarely with other vaccines e.g. shingles, flu and the Johnson & Johnson COVID vaccine. But this reaction is so rare it can’t overshadow the overwhelming benefits.

Two famous anti-inflammtory agents – Bextra and Vioxx- were pulled after a million users showed sudden cardiac death concerns. Only Celebrex exists in that class today. Too late for Bextra and Vioxx, it was later proven to be a possible side effect in any NSAID, even Motrin! Yet these weren’t pulled because it was determined the risk was incredibly low compared to their benefits. That’s what it comes down to every time. Do the risks outweigh the benefits?

When it comes to the COVID vaccine with a less than .1% risk of significant side effects, with over 700,000 lives lost and more each day, our lives shut down and shut in, the only answer is an emphatic yes.

It’s the government’s way to “ chip “ and track us

Or as one 80 year old lady was sure- control us. Vaccines have been around for a long time. Why put a chip in now? And why in the COVID vaccine? Wouldn’t they have started with childhood vaccines that were mandated for decades? When I was a resident in the 1970’s rumors were rampant that chips were put into every patient who had a surgical procedure. Again it sounded a bit unlikely anyone would attempt to control people through such a hit and miss measure. A much more likely mechanism to monitor and control us would be by tracking all our moves through cell phones and social media. Oh, wait, that’s already being done! So who needs to use the vaccine?

It clearly doesn’t work, they’ve just recommended a booster

Vaccines are not bulletproof. They have never been 100% effective, meaning they never were meant to prevent a specific illness in its entirety. They have always been meant to decrease the severity or frequency of disease. Some, like the measles vaccine is 95% effective. Others like the flu shot, 60%. Even the measles vaccine required a booster after several decades. The flu mutates with every season so it requires annual updates. COVID? Who knows. Maybe we’ll need one every year like the flu. Only time will tell. But we do know that the vaccine does what it’s meant to do- prevent serious illness, hospitalization and death. That’s the goal of any effective vaccine. There have only been .01% deaths of those who contract COVID after being fully vaccinated. But that may not last if another more deadly variant mutates past the vaccine’s ability fight.

I don’t trust the government

No one is asking you to, this is not political. This is medical. Trust the science. Trust the medicinal value of what’s being recommended to save your life and all those around you. I understand the concerns and fears COVID has caused. The information is constantly changing, as are the recommendations. It easy to get overwhelmed and fed up, unsure where to turn to for the truth. That’s why fact checking and looking for reliable, unbiased resources is imperative. Talk to your healthcare provider, you trust your health to them. It’s not just your life in the balance. It’s all of ours. 



Sources:

https://www.hipaajournal.com/is-it-a-hipaa-violation-to-ask-for-proof-of-vaccine-status/
https://www.wsj.com/articles/the-long-history-of-vaccine-mandates-in-america-11631890699
https://en.m.wikipedia.org/wiki/Seat_belt_legislation
https://www.cdc.gov/smallpox/index.html
https://www.cdc.gov/coronavirus/2019-ncov/vaccines/facts.html
https://www.mayoclinichealthsystem.org/hometown-health/featured-topic/covid-19-vaccine-myths-debunked
https://www.immune.org.nz/vaccines/efficiency-effectiveness
https://ftp.historyofvaccines.org/content/articles/top-20-questions-about-vaccination
https://www.cdc.gov/coronavirus/2019-ncov/vaccines/effectiveness.html?s_cid=10464:vaccine%20effectiveness:sem.ga:p:RG:GM:gen:PTN:FY21
https://www.reuters.com/world/us/us-covid-19-death-toll-hits-700000-2021-10-01/

-Main image: AP Photo/Brynn Anderson

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