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  • Writer's pictureWilliam Miller, MD

To Vaccinate or Not to Vaccinate? - Part 2

Updated: Jul 14, 2021

This is the second in our two-part series on vaccinations in which we will address specific concerns about COVID vaccines. Part 1 explored the history of vaccinations.

A valid question to begin with is, “Why is it important to get as many people vaccinated as possible?” The answer, based on sound epidemiologic and virology science, is that we know this pandemic is unlikely to end until we reach heard immunity, which occurs when 80-85% of the population is immune. Approximately 30% of Mendocino residents have received at least one vaccine dose. Also, it appears that the COVID vaccines may give a stronger immunity than having had the actual infection. This may seem to not make sense, but there is a good, although complicated, explanation that has to do with how the virus evades the immune system during an actual infection.

Thinking on whether to get vaccinated falls into three categories: first are those people that are planning on getting vaccinated or already got the shot, second are those that are undecided and wish to “wait and see” and third are those that have decided not to get vaccinated. Several surveys of the US population have shown that about 60% are in the first group, about 15% in the “wait and see” group and about 15% in the last group.

In those surveys, the biggest concern is whether enough research was done to show that the vaccine is safe. Fears are expressed about this being new and untested technology. It turns out that both “new” technologies are not all that new and have been used in vaccines before COVID. The mRNA technology used in the Pfizer and Moderna vaccines has been used in vaccines against Zika and rabies. The Johnson & Johnson vaccine uses viral vector technology that has been used in vaccinating against Ebola. Research on developing a vaccine against coronaviruses like SARS-2 (the virus that causes COVID) began after the SARS-1 and MERS outbreaks about 15 years ago, both being very closely related to COVID/SARS-2.

Emergency Use Authorization given to these vaccines by the FDA speeded up the process by getting rid of much of the bureaucratic red tape that slows down bringing on new drugs. However, the same studies are required and the same stringent analysis of the data is performed. It is true that we don’t have several years of experience with these vaccines. This may be a reasonable concern. COVID is causing thousands of deaths daily worldwide and the experience we have now, which is about one year’s worth, strongly suggests that these vaccines are safe.

Another frequently raised concern is that mRNA vaccines will somehow alter our genetic makeup. This is false. Messenger RNA (mRNA), as the name implies, are instructions to a cell on what protein to make and how to make it. Our genes are DNA. DNA is what codes for mRNA, but mRNA has no way to alter a cell’s DNA. It simply doesn’t work in that direction. Further, mRNA is destroyed rapidly in our bodies as a means of quickly turning off the signal to make a particular protein when it is no longer needed. So, mRNA literally lasts only a matter of minutes to hours before being degraded.

The fear that the vaccines will implant a microchip that allows the government to track us may stem from a suggestion made in the past that microchip implants could be used as part of vaccine programs in third world countries as a means of helping health care workers know which vaccines a person has had since health records are difficult to keep in those countries. While that was an idea discussed, it has never been implemented. If you have watched the vet place a microchip in your dog or cat, you know that it is a rather large needle and the microchip is about the size of a grain of rice and is clearly visible. This is definitely not included in any vaccine, for one thing the needle is way too small. For another thing, our cell phones already track us far more effectively than any microchip, reporting all sorts of data about us to more than just the government.

Some people fear that vaccines are a plot to cause sterility in undesirable populations. Sadly, such plots have existed in the past, such as the one in which Nazi’s used radiation to try to sterilize Jews. So, it is understandable that minority populations might have this fear. Some Muslim countries have opposed Western vaccines, such as the one for polio, out of this exact fear. It is hard to persuade people against this level of mistrust. However, there is no evidence that any vaccines have this effect.

Another worry is that the vaccines will not prevent infection by one of the new variants. So far, all the vaccines appear to provide protection against all current the variants. The protection against two of the variants, B.1.351 (in South Africa) and P.1 (in Brazil) may not be as complete, however, it looks like the vaccines do help prevent a more serious illness. There have been a few reports of people getting COVID after vaccination. Almost all of these have occurred between the first and second doses or within the first two weeks after the second dose. In those cases, the vaccine did help prevent hospitalization and death. Promoting wide vaccination of the population so that heard immunity stops the pandemic will actually help to prevent new variants from developing.

There are still several important things that we do not know yet about the vaccines. The most important is how long will the immunity last? We know that the immunity is strongest in the first 3 months and appears to still be effective out to 8 or 9 months. Beyond that, we don’t have much experience since the studies using the vaccines only began about 9 months ago. It may be necessary to get a periodic booster shot. For comparison, the flu shot only gives strong immunity for about 3 months, which is one of the reasons we need a new flu shot each year. Nine months is similar to the length of immunity we are seeing from the actual COVID infection as well. In other words, people who have had COVID may be at risk to get it again over time. This is another strong argument for obtaining heard immunity as soon as possible. For this reason, it is recommended that people who have had COVID still get vaccinated.

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