COVID-19 Vaccine: Addressing Your Concerns - Student Wellness Centre

I have already had COVID-19, why should I get the vaccine?

The answer to this is not yet fully clear as we don’t know how long COVID-19 immunity lasts post infection. However, there have been cases of people getting reinfected within 4 months following infection recovery (U of T infections disease Dr. Isaac Bogoch, on the COVID-19 vaccination distribution task force, as cited in CBC, 2021). The vaccine presents no danger if you have had COVID-19 before as it simply triggers an immune response (Health PEI senior medical adviser Dr. Michael Gardam, as cited in CBC, 2021).

What is an mRNA vaccine and does it alter my DNA?

mRNA vaccine

Image retrieved from CBC News

The vaccines approved for administration in Canada thus far are called mRNA vaccines (Pfizer and Moderna). mRNA stands for messenger RNA. It works by introducing a small, non-infectious bit of genetic instructions (CDC, 2020; Collins, 2021). That triggers the cells to make a protein, the same as the spike protein on SARS-CoV-2. The immune system then responds by producing antibodies and memory to develop and quick immune response. This is a natural process where the body undergoes the same response it would if it was introduced to a virus, so there is no intersection or interaction with DNA. This type of vaccine allows your cells to create a protein similar to that of COVID-19 and the immune system then produces antibodies to fight off the virus, should you ever be exposed to it, before you get sick.

The COVID-19 vaccine was approved so quickly. I’m worried the science was rushed and we don’t know it is safe.

Creating a new vaccine typically takes years. However, COVID-19 vaccines were approved quickly because:

They were informed by research on other strains of coronavirus prior to COVID-19, such as Middle East Respiratory Syndrome (MERS) and Sars-CoV (SARS).
They were informed by advances in science and technology built on 2 decades of research put towards mRNA vaccines prior to public use.
The urgency of the situation enabled easy recruitment of experts and unprecedented international collaboration between scientists, health professionals, researchers, industry and governments.
Due to urgency, securing funding was also quick and easy.
Research could be sped up because some phases of the trial could overlap without a fear of securing funding to proceed. (No steps were skipped during the formation or testing of vaccines).
The wait to find out who became infected after either receiving 2 doses of the experimental vaccine or a placebo, was expedited as the virus was/is rampant and common.
mRNA vaccines (Pfizer and Moderna) can be made more quickly than typical vaccines as it doesn’t take the same time to cultivate (Jarry, J., McGill science communicator as cited in CTV, 2021)
It typically takes 6 weeks post vaccination to determine side effects. 8 weeks were provided following COVID-19 vaccinations in clinical trials. This, in addition to a very large sample size offered sufficient safety evidence according to Scientists (Dr. Noah Ivers of Women's College Hospital as cited in CBC 2021)

These clinical trials have provided ample evidence, especially given how unsafe COVID-19 is, to reassure the public that the risks of COVID-19 far outweigh the risks of the vaccine. (Ivers, N. as cited in CBC 2021, Ontario Health, 2021). That is not to say that the research is complete. Side effects and adverse events will continue to be tracked by government and manufacturers (Jarry, J. as cited in CTV, 2021).

Covid-19 can’t really hurt me as I am young and healthy, why should I get vaccinated?

COVID-19 is more risky than the vaccines (Verma as cited in CBC, 2021). Long-term health effects resulting from COVID-19 don’t always appear right away (Jarry as cited in CTV, 2021). Though it is less common, young people with no underlying health issues can still end up with a severe case of COVID-19, requiring hospitalization, or in the worst case scenario death (Verma, CEO of Northern Ontario School of Medicine, as cited in CBC, 2021). Even if you are lucky and don’t get very sick, others who can get very sick could catch it from you. Herd immunity is achieved when the chain of infection is stopped because enough people are immune to the virus that it stops spreading (WHO, 2021). For COVID-19, the amount of people that need to be vaccinated to achieve this is estimated to be 60-70% (CBC, 2021). You getting vaccinated can help achieve herd immunity and keep people safe who cannot get vaccinated, like children or those with specific allergies or those within the 5% who did not develop an immune response to the vaccine (WHO, 2021).

Why would I choose to get vaccinated if I might get COVID-like symptoms as side effects? How would this benefit me?

Some of the side effects from the COVID-19 vaccine may resemble mild symptoms of COVID-19 (for example muscle aches or nausea). However, though COVID-19 can result in mild symptoms, generally the vaccine side effects are much less severe than a COVID-19 infection. Out of nearly 400 000 doses of administration of the COVID-19 vaccine in Canada as of January 9, 2021, only 0.007% experienced an adverse reaction and even fewer of those reactions were considered serious (CBC, 2021). The chances of long-term health effects, hospitalization or death are much greater with the COVID-19 infection than the vaccine (Ontario Health, 2021). The more people who get vaccinated can achieve herd immunity, which can stop the chain of infection, saving others’ lives, if not your own (John Hopkins, 2021).

What's the point of getting vaccinated if I still have to follow Public Health Guidance to socially distance and mask?

Unfortunately, you will have to follow public health guidelines in the short-term for following reasons:

Not everyone will get vaccinated at once so we will need to protect those who have not yet been vaccinated (Ontario Health 2021).
It takes time to develop an immune response to the vaccine. In other words, you can still contract the virus until you develop immunity (Chagla, Professor of medicine at McMaster University and infectious disease physician, as cited in CBC, 2021). The Moderna vaccine is 94.1% effective beginning 2 weeks after the second dose (Health Canada, 2021).
There is also a possibility, that is being studied now, that the vaccine could reduce the severity of infection in some, as opposed to preventing contraction of the disease altogether. This could lead to asymptomatic transmission (Gardam, M., Toronto infectious disease physician and senior medical adviser for Health PEI, as cited in CBC, 2021, Ontario Health, 2021).
Until research on asymptomatic transmission is more clear, time for immunity to develop is understood and vaccinations are completed, public health guidelines will have to remain in place and be gradually reduced over time (Nimjee as cited in CBC, 2021; John Hopkins, 2021).

In the meantime, you getting vaccinated will assist in speeding up this process and protect you and others from COVID-19.

Can I get COVID-19 from the COVID-19 vaccine?

The COVID-19 vaccines approved thus far in Canada do not contain any live or dead parts of the virus [Sars-CoV (SARS)] (Ontario Health, 2021). Therefore, you cannot get COVID-19 from the vaccine (Ontario Health, 2021). You could experience side effects, similar to other vaccines, like muscle aches or stiffness and these could resemble mild COVID-like symptoms (Ontario Health, 2021). However, vaccine side effects are a good sign that your body is reacting to the vaccine to produce an immune response. Expected side effects from the first vaccination are not a reason to avoid the second dose.

I don't trust drug companies. They have a bad history of profit over people so I distrust this vaccine.

It is true that many drug companies have a bad track record when it comes to promoting safety over profit, namely the opiate epidemic and the corrupt role drug companies played in this. Vaccines happen to be the least profitable type of "drug" a company can make as it actually prevents illness, reducing future medication a person may need. Vaccines are also less profitable for drug companies when countries buy them wholesale as is happening with the COVID-19 vaccines. The clinical trials to produce these vaccines have followed strict protocol and have been approved by not-for-profit governing bodies like Health Canada and other regulatory bodies worldwide. If there is not enough evidence of safety, quality or effectiveness they are not approved in Canada (Ontario Health, 2021). There is a plan in place to track all side effects and adverse events as is done with all vaccines (Ontario Health, 2020).

Can anyone get the vaccine? Or is it unsafe for certain people?

The following groups should consult with their primary health care provider before receiving the vaccine:

Children: Unfortunately the vaccines approved thus far in Canada cannot be given to children as they were excluded from the clinical trials so they are unable to get the vaccine. Their caregivers, however can be vaccinated.

Pregnant or Breastfeeding: There is no theoretical reason that the mRNA vaccines are not safe for pregnant or breastfeeding women. However, pregnant and breastfeeding women were not included in Phase III of the clinical trials. Women in this instance, will have to talk to a health care provider and weigh the benefits of a COVID-19 infection versus the potential risks of the COVID-19 vaccines. The Society of Obstetricians and Gynaecologists of Canada Statement on this for more details (Ministry of Health 2021).

Immunocompromised: This population was also not included in phase III of the clinical trials so evidence is lacking. Benefits and risks of the vaccine versus a COVID-19 infection can be weighed with a health care provider. These organizations have further statements on the vaccine they have released: Canadian Society of Transplantation, Canadian Rheumatology Association, Canadian Association of Gastroenterology (Ministry of Health 2021).

Allergies: If you are concerned about having a potential allergic reaction to the vaccine given your allergy history, you will need to discuss this with your health care provider. You may be referred to an allergist-immunologist for assessment, require medical documentation of safety prior to getting a vaccine, or you may have to wait 30 minutes after getting a vaccine rather than the typical 15 minutes required (Ministry of Health , 2021).

Why do they have to put weird ingredients in vaccines like aluminum and antibiotics?

Adjuvants (for example, aluminum salts) help boost the body’s response to the vaccine. The aluminum contained in vaccines is similar to that found in a liter of infant formula. Adults typically ingest 7-9 mgs of aluminum per day in foods like fruits and vegetables, beer and wine, seasonings, flour, cereals, nuts, dairy products (Children’s Hospital of Philadelphia, 2018).

Antibiotics: prevent contamination during the manufacturing process.

Preservatives and stabilizers: keep the vaccine stable, effective and safe when it’s being made, shipped and stored (Ontario Health, 2021)

I feel coerced to get the vaccine before I know it is the safest decision for me to make for my own body. If I had a choice I might decide to get it, but I don’t like being required to take it to attend school or work.

Thus far in Canada, the vaccine is voluntary. However, schools and workplaces will likely require vaccinations is many instances to protect their vulnerable workers. Therein lies a tension between:

Public health, directed towards protecting the greater population, many times at the expense of individual freedom and choice and
Client-centered care that ideally puts your comfort, informed choice and trauma history at the forefront.

This is an ethical dilemma that can be argued in both directions. We know, however, that public health strategies work to protect the most vulnerable in society and vaccines as a public health strategy work this way too. Though an individual choice is sometimes removed, it is in an effort to protect those who do not have a choice to vaccinate because of health reasons, age and are, therefore at greater risk of illness and death. It can still absolutely feel disempowering.

How do I know this vaccine might not be harmful to me down the road?

There are no guarantees that science is always right, there is always an element of doubt that should be respected and understood. However, we have seen the devastating evidence that COVID-19 is truly dangerous and devastating to communities and individuals all over the world and will get worse as the virus continues to spread (WHO, 2021, John Hopkins, 2020). Despite healthy doubt, scientific rigor has been performed in an outstanding effort of international collaboration of experts in their field to ensure safety, quality and effectiveness of the COVID-19 vaccine prior to approval in Canada (Ontario Health, 2021, CTV, 2020, CBC, 2021).

What are the different types of vaccines and how do they work:

Vaccines enable your body to develop an immune response and remember that response prior to contracting a virus so if exposed to the virus, the immune system reacts quickly to prevent the virus from entering the body (Ontario Health 2021).

mRNA vaccines: teach our cells to make a protein from the virus that triggers an immune response and create antibodies so that the body recognizes the virus and prevents infection. Pfizer-BioNTech and Moderna are Health Canada approved mRNA vaccines (Ontario Health 2021).

Viral Vector-based vaccines: Introduce a harmless genetically modified virus (vector) into the body. This produces a part of the SARS-CoV-2 virus that triggers an immune response but doesn’t make you sick. This form of technology was used in the Ebola vaccine (Ontario Health, 2021) and Johnson and Johnson COVID-19 vaccine not yet approved in Canada.

Virus-like particle vaccines: mimic viruses but are not infections and they trigger an immune response in the absence of any viral illness. This immune response then responds quickly to prevent future viral infections in the future. This type of vaccine has been used for HPV, Hep B and Malaria (Ontario Health, 2021).

Other Sources for Vaccine Updates:

Vaccine Rollout Schedule

Peterborough: Updates provided by Peterborough Public Health

Durham Region: Updates provided by Durham Public Health

Provincial: Updates provided by the province of Ontario

Federal: Updates provided by the Government of Canada

References:

Carter, A. (2021, January 20). Debunking myths: Ontario doctors explain why most people should get COVID-19 vaccines. Retrieved from https://www.cbc.ca/news/canada/toronto/covid-19-vaccine-debunking-myths-...

CBC News. (2020, December 11). Here's the COVID-19 vaccine rollout plan, province by province. Retrieved from https://www.cbc.ca/news/canada/covid19-vaccine-rollout-plans-canada-1.58...

CDC (2020, November 24). Understanding and Explaining mRNA COVID-19 Vaccines. Retrieved from https://www.cdc.gov/vaccines/covid-19/hcp/mrna-vaccine-basics.html

The Childrens Hospital of Philadelphia. (2014, November 04). Vaccine Ingredients - Aluminum. Retrieved from https://www.chop.edu/centers-programs/vaccine-education-center/vaccine-i...

Chung, E., & Zafar, A. (2020, December 15). Once someone is vaccinated, do they still have to wear a mask?. Retrieved from https://www.cbc.ca/news/health/covid-19-general-vaccine-faq-1.5838140

Chung, E., & Zafar, A. (2020, December 15). Can mRNA vaccines alter your DNA?. Retrieved from https://www.cbc.ca/news/health/covid-19-vaccine-clinical-trial-questions...

Collins, F., Dr. (2021, January 19). MRNA vaccine – NIH Director's Blog. Retrieved from https://directorsblog.nih.gov/tag/mrna-vaccine/

Dowdy, D., & D'Souza, G. (2020, October 14). What is Herd Immunity and How Can We Achieve It With COVID-19? Retrieved from https://www.jhsph.edu/covid-19/articles/achieving-herd-immunity-with-cov...

Health Canada. (2021, January 08). Moderna COVID-19 vaccine: What you should know. Retrieved from https://www.canada.ca/en/health-canada/services/drugs-health-products/co...

Government of Ontario. (n.d.). COVID-19 vaccine safety. Retrieved from https://covid-19.ontario.ca/covid-19-vaccine-safety

Sherwin, C. (2020, December 09). How to talk to someone who is vaccine hesitant as the COVID-19 vaccine is rolled out. Retrieved from https://montreal.ctvnews.ca/how-to-talk-to-someone-who-is-vaccine-hesita...

WHO. (2020, December 31). Coronavirus disease (COVID-19): Herd immunity, lockdowns and COVID-19. Retrieved from https://www.who.int/news-room/q-a-detail/herd-immunity-lockdowns-and-cov...

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