Vaccine Hesitancy

Vaccine Hesitancy

Anand Swaminathan, MD and Celine Gounder, MD

Myth: “The vaccines were developed too fast, and this technology is too new.”

• The technology for mRNA vaccines (Pfizer, Moderna) has been researched for decades.1
  • These types of vaccines were originally being developed for HIV, influenza, cancers
  • Check out The Daily Podcast: The Unlikely Pioneer Behind mRNA Vaccines
• Adenovirus vector vaccines (J&J, Astrazeneca) have also been in development for many years.1
• Researchers were already working on vaccine models for other coronaviruses similar to SARS-CoV-2, expediting the process.1
• Money was allocated quickly and didn’t require lengthy application processes.1

Myth: “The vaccines may have long-term harm that we don’t know about yet.”

• Significant vaccine side effects for all other vaccines have presented within 2 months of vaccination.
  • This is why the FDA required 2 months of data before authorizing emergency use.2
• Vaccines as a class are not known to cause long-term side effects.
• However, COVID-19 has well established long-term effects on multiple organ systems (cardiac, renal, neurological, etc.).

Myth: “The vaccines are changing my DNA.”

• It is impossible for the vaccines to change your DNA.3
• The mRNA from the vaccines never enters the nucleus of the cell where DNA is found.3

Concern: “I’m worried about anaphylaxis.”

• The risk of anaphylaxis from the Pfizer or Moderna vaccine is rare at a rate of 0.0005%.4
• Anaphylaxis is linked to polyethylene glycol (PEG) in these vaccines -- most people who are allergic to this compound are likely already aware of the allergy.
• Luickly, the J&J does not have this preservative and is safe for patients with known allergy to PEG.

Concern: “I’m worried about blood clots.”

• The risk of blood clot in the J&J vaccine is extremely low, at 0.0003% as of May 2021.5
• The risk of blood clot from COVID, in hospitalized patients, is ~ 20%.6
• You are 10x more likely to be struck by lightning than to get a  blood clot from the J&J vaccine.

Concern: “Will the vaccine cause infertility?”

• A former Pfizer researcher initiated a rumor and claimed placental proteins were similar to COVID spike proteins, which has been debunked.7
• The vaccine can trigger an immune response which may cause a transient change in a woman’s menstrual cycle. These have been anecdotally reported, but no long lasting effects on menstrual cycle or fertility have been seen.8

Myth: “Kids don’t get that sick from COVID, so the vaccine is riskier.”

• Over 300 children have died from COVID in the United States.9
• Around 30% of teens requiring admission end up in the ICU.10
• COVID has been known to cause multiple long-term problems in children as well as other acute syndromes.

Concern: “The vaccine can cause myocarditis in my child.”

• Update to audio: Myocarditis from vaccination is extremely rare, at a rate of 40.6 cases per 1 million (0.004%), after the second dose of mRNA vaccine.11
• Myocarditis is common in COVID.

Myth: “I already had COVID, I don’t need a vaccine.”

• Immunity from natural infection may not be as robust or long-lasting.12
• The vaccine will help protect from variants far more than natural infection.12

Concern: “Am I going to need a booster?”

• Boosters may be needed if new variants evade our current vaccines.
  • However, we can avoid these mutations all together if everyone gets vaccinated and we prevent the virus from spreading and mutating.

1. Ball, Philip. “The Lightning-Fast Quest For COVID Vaccines - and What It Means for Other Diseases.” Nature News, Nature Publishing Group, 18 Dec. 2020, www.nature.com/articles/d41586-020-03626-1. 
2. Center for Biologics Evaluation and Research. “Emergency Use Authorization for Vaccines Explained.” U.S. Food and Drug Administration, FDA, 20 Nov. 2020, www.fda.gov/vaccines-blood-biologics/vaccines/emergency-use-authorization-vaccines-explained. 
3. “Myths and Facts about COVID-19 Vaccines.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 7 July 2021, www.cdc.gov/coronavirus/2019-ncov/vaccines/facts.html. 
4. Shimabukuro TT, Cole M, Su JR. Reports of Anaphylaxis After Receipt of mRNA COVID-19 Vaccines in the US—December 14, 2020-January 18, 2021. JAMA. 2021;325(11):1101–1102. doi:10.1001/jama.2021.1967
5. Shimabukuro, Tom. Advisory Committee on Immunization Practices, 2021, Update: Thrombosis with Thrombocytopenia Syndrome (TTS) Following COVID-19 Vaccination, www.cdc.gov/vaccines/acip/meetings/downloads/slides-2021-05-12/07-COVID-Shimabukuro-508.pdf. 
6. Malas, Mahmoud B., et al. “Thromboembolism Risk of Covid-19 Is High and Associated with a Higher Risk Of Mortality: A Systematic Review and Meta-Analysis.” EClinicalMedicine, vol. 29-30, 1 Dec. 2020, p. 100639., doi:10.1016/j.eclinm.2020.100639. 
7. Stecklow, Steve, and Andrew MacAskill. “Special Report: The Ex-Pfizer Scientist Who Became an Anti-Vax Hero.” Reuters, 18 Mar. 2021, www.reuters.com/article/us-health-coronavirus-vaccines-skeptic-s/special-report-the-ex-pfizer-scientist-who-became-an-anti-vax-hero-idUSKBN2BA179. 
8. “Covid-19 Vaccination Considerations for Obstetric–Gynecologic Care.” ACOG, 30 July 2021, www.acog.org/clinical/clinical-guidance/practice-advisory/articles/2020/12/covid-19-vaccination-considerations-for-obstetric-gynecologic-care. 
9. “Provisional COVID-19 Deaths: Focus on Ages 0-18 YEEARS.” Centers for Disease Control and Prevention, 2021, data.cdc.gov/NCHS/Provisional-COVID-19-Deaths-Focus-on-Ages-0-18-Yea/nr4s-juj3. 
10. Kim, Lindsay, et al. “Hospitalization Rates and Characteristics of Children Aged 18 Years Hospitalized with LABORATORY-CONFIRMED Covid-19 - COVID-NET, 14 States, March 1–JULY 25, 2020.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 13 Aug. 2020, www.cdc.gov/mmwr/volumes/69/wr/mm6932e3.htm?s_cid=mm6932e3_e&deliveryName=USCDC_921-DM34906. 
11. Gargano, Julia, et al. “Use of Mrna Covid-19 Vaccine after Reports of Myocarditis among Vaccine Recipients: Update from the Advisory Committee on Immunization Practices - United STATES, June 2021.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 8 July 2021, www.cdc.gov/mmwr/volumes/70/wr/mm7027e2.htm?s_cid=mm7027e2_w. 
12. Mandavilli, Apoorva. “People Who Have Had Covid Should Get Single Vaccine Dose, Studies Suggest.” The New York Times, 23 June 2021, www.nytimes.com/2021/02/19/health/covid-vaccine-single-dose.html?action=click&module=RelatedLinks&pgtype=Article. 

Epidemic Podcast: https://www.justhumanproductions.org/podcasts/epidemic

The Daily Podcast: The Unlikely Pioneer Behind mRNA Vaccines