COVID-19 Update: Monday, May 10th

An update on the risks and warnings associated with each of the vaccines. I want to provide you with some important updates regarding the vaccines, where we are with them, and possible side effects. In part, because you just need to know and in part so that when you hear it somewhere else you will have context for it.

*UPDATE: wouldn't you know that a Moderna update came out seconds after I posted this. So I have updated the Moderna vaccine info to reflect that report.

1. J&J - let's start with J&J because it had so much news coverage since "the pause." The rare blood clots some people experienced were indeed a result of vaccinating. In some people (about 5-7 out of every one million) the body will have a very rare response which will cause possible blood clots and low platelets ( a super odd combo) - this is similar to what we see in some people who receive heparin and develop a similar reaction. Those at highest risk are those under 50 (some places are saying 40 and under) and those who have been previously diagnosed with thrombocytopenia, or low blood platelets, within three weeks of vaccination. More cases have been seen in women than men but there have been cases in men. Current leanings in Europe are to vaccinate those individuals anyway but then actively monitor them for any indicators of issues. It is not yet clear if the US will take a similar approach.

2. Astra-Zeneca - AZ is having the most difficult time of the 4 vaccines familiar to the US and Europe. The vaccine has also been associated with the same rare blood clots as the J&J vaccine. This isn't completely shocking given the fact that they are both adenovirus vector vaccines. (meaning they use an adenovirus as the shell to deliver the vaccine). In addition, AZ is being monitored for a connection to Guillain-Barre syndrome (GBS). This isn't new but based on a new report that came out on Friday, they are now being asked to report on this monthly. It is something they are actively monitoring. GBS is an adverse side effect that has been associated with some other vaccines as well so it is not unprecedented.

3. Pfizer - the Pfizer vaccine labels in Europe are being updated to include a warning for people with dermal fillers. Dermal fillers are considered a type of plastic surgery in which soft, gel-like fillers are inserted under the skin to reduce wrinkles. In people with dermal fillers, it seems the vaccine can cause facial swelling. Again, this isn't a new development, but we have now seen enough of these to say it is associated with the vaccine (at least probably) and a warning should be included. As we already know, Bells Palsy is listed as a possible side effect of the vaccine as is a possible severe allergic reaction. Additionally, there have been some heart complications in some people - which are being looked at. These are quite rare and there is not yet sufficient evidence to say the effect is related to the vaccine but it is being studied. After vaccination, some people are experiencing myocarditis, or inflammation of the heart muscle, as well as pericarditis, (inflammation of the membrane around the heart). This too is not new (I have actually been monitoring this from the onset) but there have now been enough cases to warrant studying it to see if it is related. Current evidence does NOT show any connection - but we don't want to ignore it. This is something that has been actively monitored around the world but thus far of the 200 million doses given they have not found any cases where it appeared the vaccine appeared to be a trigger to the heart issue. I have not reviewed every case personally (obviously), but the ones I have reviewed did not seem directly related. Again...this is worth noting, and watching, and looking into. But I wouldn't worry just yet.

Pfizer is planning to seek full approval from the FDA (something that required them to have 6 months' worth of data to do - and now they have that). They also have been approved for those 16 and up and are working on approval for those 12 and up - and currently researching younger children as well.

4. Moderna - As we have known from the beginning, Bells Palsy is listed as a possible side effect as is a severe allergic reaction. Like Pfizer, facial swelling for those with dermal fillings is possible (there have been 3 reported cases). People getting the Moderna vaccine report more side effects after the 2nd shot than people who get the Pfizer vaccine. Fatigue is the most commonly reported symptom. There is actually nothing else to report with Moderna other than they have been asked to also monitor for myocarditis and pericarditis simply because they use the same mRNA technology as Pfizer. And like J&J and AZ are seeing similar issues (in regards to the clots) as a precaution, Moderna was asked to monitor for the heart issue as well, which they are doing.

Moderna also just released data on their clinical trials in children 12-17 indicating that the vaccine works in children and they are reporting no safety concerns.

5. General vaccine info - a question I frequently get is which is better, natural immunity or vaccine immunity. And there is not a flat answer to that. Some vaccines produce immunity that is superior to natural immunity - such as HPV. In some cases, natural immunity is superior - if you survive the infection. It truly varies by pathogen and vaccine. With the current vaccines, we do not yet know which is superior. That is something that is still being studied.

Final Thoughts: When all this started and lockdowns began rolling out, we understood the idea was to stave off the virus and pace it out so our systems weren't overwhelmed. In the US we were able to do that. There were some rough days and some places that reached the edge of capacity - but overall we achieved that goal. We paced it out, and we kept up, and we developed vaccines and treatments and we figured out how to take this virus from killing 5% of Americans who got it, to killing 1.78%. And while we would really like to see that number be even lower, we have done well and that should not be ignored. In America, places are opening, restrictions are lessening, and we are once again starting to gather together. It's time. Living in solitude is not sustainable, we need each other. Our mental health needs this. Again, I encourage you to take it slow if you need to, but it's time to emerge and let the light shine on you. Start small with a trip to the park, a visit to your favorite store, or outdoor lunch with a friend. I would continue to avoid high-risk events with large groups and of course keep those masks handy, (we aren't quite there yet - but we are on our way). For those who need no encouragement to get out there, I instead encourage you to give others the time they need to feel comfortable. Be patient with each other.