With a coronavirus vaccination effort now underway, you might have questions about what this means for you and your family. That's why we're sharing, Why should I trust the coronavirus vaccine when it was developed so fast? from The Conversation. Dr. Lana Dbeibo answers that and other reader questions about the vaccine and compromised immune systems and whether to get the vaccine if a person has had previous adverse reactions to a vaccine.
Q: I fully support the use of vaccines, but I worry about possible long-term side effects with the new vaccines. How can anyone say with any confidence there will be no long-term consequences with vaccines that have been developed so rapidly?
A: There are reasons the vaccines were developed rapidly: First, the production started before the end of phase 3 clinical trials. Second, there was a lot of interest in volunteering for the trials that tested the vaccines’ effectiveness, which expedited the process. Researchers often wait many months and sometimes even years to get people to volunteer to be part of trials.
Last, there was a lot of disease in the community which made it faster to see whether the vaccine was effective. The coronavirus has caused disease in millions of people in the U.S. alone, while Ebola and Zika viruses, while extremely serious, affected far fewer.
I worry much more about the long-term effects of the virus, which can be very debilitating and start soon after the infection. We have not seen reports of major effects of the vaccine in the past few months that it was studied; if there were major effects, I believe we should have started to see them by now. This could can change, however, and scientists would update recommendations accordingly.
Q: My husband is 72 and undergoing chemo treatment for metastasized cancer in his lymph nodes. So far, treatment is showing shrinkage of tumors and no new spread. I’m 73. Should I get the vaccine?
A: There are two issues to address here. First, there is a question of whether someone who has been vaccinated could spread the disease to someone else. There is very limited data on whether the vaccine effectively limits spread of the disease, but we are waiting on studies to answer this question.
The second issue you raise is about people with compromised immune systems and whether they should get the vaccine. While the efficacy of the COVID-19 vaccines was not studied in immunocompromised people, the danger of COVID-19 to patients with a weaker immune system like your husband’s is very high. Because the benefit may exceed the risk, the Centers for Disease Control and Prevention did not list being immunocompromised as a contraindication to receive the COVID vaccine. Please consult with your physician to have a conversation about this.
Q: I have rheumatoid/psoriatic arthritis. I am taking the biologic Actemra and Solu Medrol as an infusion, monthly. I also take methotrexate twice a week. Is the vaccine considered safe for people with compromised immune systems?
A: The answer to this is very similar to the answer above. The CDC did not list having a weakened immune system as a reason not to get the vaccine, or what we doctors call a contraindication. Still, it is important for you to talk to your physician about your particular case.
Q: My 22-year-old son had a reaction to the MMR vaccine when he was approximately 6 years old. He ran a fever for several days and developed the bleeding disorder ITP within a month or two after receiving the MMR vaccine. Should he be concerned about receiving the coronavirus vaccine?
A: Having any type of allergy other than anaphylaxis, which is a severe and sometimes life-threatening allergic reaction, to vaccines or components of the COVID vaccine is not a contraindication to receive the COVID vaccine. Everyone who receives either one of the drugs that have received emergency use authorization will be monitored for 15-30 minutes in the clinic after the vaccine dose because serious reactions will happen in the first few minutes after the vaccine is given.
Q: At age 7 or 8, I received tetanus antitoxin (horse serum) and quickly lost consciousness for about four days. Subsequently, I remember having hives a few times in childhood and mild asthma until I was about 25. I do not now have significant allergies. I have had several cardiac procedures, including open thoracotomy for mitral and aortic bovine valve replacement in 2010 and a “Watchman” procedure. I have a pacemaker and daily take Metoprolol, Torsemide and penicillin g (after two episodes of endocarditis. Also a hemicolectomy for cancer. No problem with flu shots. Generally I am feeling better than I have in the past several years. I drive without difficulty. Should I get the vaccine?
A: My answer here would be similar to one answered above – having any allergy other than anaphylaxis to vaccines or components of the COVID vaccine is not a contraindication to receive the COVID vaccine. Similarly, having asthma or seasonal allergies is not a contraindication. I would recommend you consult with your doctor for specifics related to your other health issues.
And remember that scientific observations of the vaccine are ongoing. The CDC, FDA and other government agencies will update the public on significant changes if they occur.
Lana Dbeibo: Assistant professor of clinical medicine, Indiana University School of Medicine