Iowa Specialty Hospital

COVID-19 Update from Dr. Michael McLoughlin 1/6/2021

January 6, 2021

Today’s COVID update is going to be addressing a bunch of random questions about the COVID-19 vaccinations that have been posed to me.

1)  If we receive an initial dose of the COVID vaccine, how can a person be certain there will be a second dose available in 21 or 28 days when the next one is due? Like most things in life, it’s difficult to be 100% certain but the production and distribution of vaccine is expected to be increasingly consistent as we get further from the holidays. Most importantly, it isn’t likely to matter to a person’s long-term immunity if the vaccine is given a few days or weeks late. This happens frequently with other vaccinations that require a series without any ill effects. I recommend getting the vaccine as soon as it is available and not worrying about it if unforeseen circumstances affect the timing of the second dose a little.

2)  I’ve heard that there are concerns about the vaccine causing infertility in women of child-bearing age, is there any truth to this?  In short, no. This myth seems to have been started by a physician and former scientist that once worked at Pfizer who have a history of putting out misleading information and is based on the idea that the spike protein from the new coronavirus has similarity to a protein called Syncytin that plays a role in the human placenta. The myth suggests that because these proteins are similar, the vaccine teaching the immune system to recognize the spike protein of the coronavirus will also be teaching it to recognize the Syncytin protein and could lead to the immune system damaging the placenta. There are at least two major problems with this idea. First, if this actually occurred, infection with COVID-19 itself would lead to damage to the placenta because the immune system learns to attack the spike protein through natural infections also. We have not seen any reason to believe this happens. Second, the spike protein and the Syncytin protein aren’t actually very similar. There are more reasons this is extremely unlikely but we’ll leave it at that. A nice explanation for those who want to read more is here: https://www.usatoday.com/story/news/factcheck/2020/12/14/fact-check-no-evidence-covid-19-vaccine-causes-infertility-women/3884328001/

3) I’ve heard about a new strain of COVID-19 that may be more contagious, will the vaccine prevent it? Or are we going to have to make a new vaccine for multiple different strains?  There is a strain of COVID-19 that MAY be more contagious than prior strains. The strain is currently called “SARS-CoV-2 VOC 202012/01” (which means the first variant of concern from December 2020) or “B.1.1.7.” This strain was first detected in the United Kingdom about the time that they were seeing a large increase in cases, which is why there is concern about it spreading more easily. As you all know, we also had a very large increase in cases 6-8 weeks ago and this wasn’t associated with any different strain. Therein lies the challenge – is it really because of the new strain or is it because people changed their behavior and because many respiratory viruses transmit more easily in cooler and drier weather? I don’t think we should jump to conclusions and think this is still likely to be a coincidence as much as any real change in the infectiousness of the virus itself. In any case, there is no reason to think that the vaccine won’t prevent this strain along with all the others that have been seen to date. It’s normal for there to be hundreds of slightly different strains of a virus, but most are not consequential to how dangerous a virus is. Coronaviruses do not tend to mutate as rapidly or as significantly as influenza is able to (this unique ability of influenza is what makes it so hard to create an effective vaccine for it). Now here is perhaps the most important point. The best way to prevent a virus from mutating is to have everyone get vaccinated and end the pandemic. When a virus is widespread there are uncountable numbers of virus particles in the thousands of people it is infecting each day. Every one of those has some chance of mutating. If there are no new infections happening and our immune systems have killed all the viral particles, there can’t mutate. The more infections there are, the greater the risk that a significant mutation occurs (like one that allows the virus to evade the vaccine). Nothing of this sort appears to have happened yet.

4)    Why should I even bother getting the vaccine if I could still transmit the virus after I receive it?  This one is two parts, but a pretty easy answer. First, once you’ve received the full immunity benefits from the vaccine, it is pretty unlikely that you’ll be able to transmit the virus without getting sick yourself. If your immune system identifies and kills all the virus, you aren’t going to be able to transmit it. There is still a theoretical risk that vaccinated individuals could develop asymptomatic infections and spread COVID-19 to others unknowingly, but this is really unlikely. Scientists keep mentioning this possibility because scientists are a cautious bunch that like to prove things before saying them too strongly (this is a good thing!). In the short-term we also still want people to keep wearing masks after having had the vaccine (see my prior update for the explanation of why).

The second part of the answer is even easier. Because it protects you! Even young and relatively healthy people do get severely ill from COVID. We have admitted at least 7 patients under the age of 40 to the hospital because of COVID here at Iowa Specialty alone. One of these patients ended up on heart/lung bypass at the University of Iowa. We won’t have final numbers for some time, but the best information we have indicates that over 16,000 patients in the US between the ages of 25 and 44 will have died from COVID-19 in 2020 (see https://www.nytimes.com/2020/12/16/opinion/covid-deaths-young-adults.html for a nice explanation). It’s less common for younger and healthier people to get severely ill from COVID-19, but it definitely happens way more frequently than other preventable diseases.

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