One of the main reasons for the current low uptake of the COVID mRNA bivalent booster (less than 43 million doses administered) is the scary anecdotes of side effects overreported in the media.
These stories are not effectively countered by presenting unexciting low-risk data, or the equally boring but true knowledge that the more immunity you have the better off you are against COVID’s short- or long-term side effects. You will likely get less sick and you will recover more quickly and completely.
But fear of a rare side effect overcomes reasoned reassurance every time.
There is also some evidence that the mRNA vaccines still decrease viral load and therefore slow spread at least short term, but of course, no one is megaphoning this important data. Perhaps the whole idea of countering emotion with logic is destined to fail because emotion is a far more powerful response deep in the human brain. Perhaps the emotional narrative of teens rarely developing myocarditis from the jab (latest Israel data of 4.8 cases per 100,000 persons) can only be countered by the far the more common devastating stories of heart or lung or brain problems from the virus itself.
In my practice, I have certainly seen many cases of the latter and none of the former.
When the COVID mRNA vaccines first came out, a cardiologist in Florida I knew took the first dose and developed transient one-sided facial paralysis, known as Bell’s Palsy. It went away after two weeks; he delayed his second shot only a week and had no significant side effects at that time. Despite his concern over the first shot, he pushed ahead for the second, because of his fear of the virus itself and his knowledge (gleaned from clinical trials) that the vaccine was highly effective. He was far more afraid of the virus than he was of the vaccine, even after it gave him a significant side effect.
Flash forward two years to a time when there is a great and largely irrational fear of the vaccine, and too little fear of the virus, even though the latest subvariants continue to cause short- and long-term problems, from neurological to pulmonary to cardiac. Meanwhile, an obsessive focus on the rare side effects of the vaccine has been dilated in social media and on TV. Fear of the vaccine and vaccine fatigue have led to poor uptake of the latest booster (less than 43 million doses given out of 171 million procured by Health and Human Services), despite the fact that though vaccine effectiveness appears to wane over time it is brought back by additional doses. There is still plenty of reason to get boosted, especially if you are elderly and/or have underlying health problems.
Fear of the vaccine has also been fueled in part by a misunderstanding of VAERS, the Vaccine Adverse Event Reporting System that the Centers for Disease Control and Prevention uses to track potential side effects that may or may not be associated with the vaccine. It is a way to track data and create a starting point for further investigation, it by no means indicates that the vaccines are unsafe. In fact, multiple studies and real-world analyses continue to show that they are safe.
Recently, a patient of mine came to see me with a facial droop (Bell’s Palsy) after receiving a vaccine. My office manager was certain that it must be from the COVID vaccine, but it turned out that the only vaccine she’d received recently was the flu shot. She got better too, and her experience was a reminder that all vaccines have side effects, and the utilization of a particular vaccine should be based on a real-life cost/benefit analysis. In each case, the central question is which is more of a risk — the virus, or the vaccine you are using to slow or stop it?
Unfortunately, some of the anti-vax arguments used against the COVID vaccines (not only the exaggerated side effect risk but also questions why a healthy young person should get one when their risks of mortality and serious illness from the disease are supposedly low) appear to have already led to an erosion in vaccine compliance for several of our essential vaccines from flu to measles to polio. This is a tragic trajectory that could get worse.
Vaccines are our greatest preventive public health tool after clean water. They need to be treated with the respect and compliance that they have earned.
Marc Siegel MD is a professor of medicine and medical director of Doctor Radio at NYU Langone Health. He is a Fox News medical correspondent and author of the new book, “COVID; the Politics of Fear and the Power of Science.”