Biomedicine (Taipei). 2022; 12(3): 1–4.
- Published online 2022 Sep 1. doi: 10.37796/2211-8039.1371
- PMCID: PMC9629406
- PMID: 36381188
Covid 19 vaccines and the misinterpretation of perceived side effects clarity on the safety of vaccines
a,bRaymond D. Palmer
- Full Spectrum Biologics, South Perth, WA, 6151, Australia
- Full Spectrum Biologics, WA, 6102, Australia
- Find articles by Raymond D. Palmer
- [E-mail address: moc.em@remlap.yar.
- Received 2022 Mar 12; Revised 2022 Apr 20; Accepted 2022 May 4.
- Copyright © the Author(s)
This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
Abstract
In the era of Covid 19 and mass vaccination programs, the anti-vaccination movement across the world is currently at an all-time high. Much of this anti-vaccination sentiment could be attributed to the alleged side effects that are perpetuated across social media from anti-vaccination groups.
Fear mongering and misinformation being peddled by people with no scientific training to terrorise people into staying unvaccinated is not just causing people to remain susceptible to viral outbreaks, but could also be causing more side effects seen in the vaccination process. This brief review will offer data that may demonstrate that misinformation perpetuated by the anti-vaccination movement may be causing more deaths and side effects from any vaccine.
A mini review of published literature has been conducted and found that mental stress clearly causes vasoconstriction and arterial constriction of the blood vessels. Therefore, if subjects are panicked, concerned, stressed or scared of the vaccination, their arteries will constrict and become smaller in and around the time of receiving the vaccine. This biological mechanism (the constriction of veins, arteries and vessels under mental stress) is the most likely cause for where there has been blood clots, strokes, heart attacks, dizziness, fainting, blurred vision, loss of smell and taste that may have been experienced shortly after vaccine administration. The extreme mental stress of the patient could most likely be attributed to the fear mongering and scare tactics used by various anti-vaccination groups.
This paper does not aim to rule in or out every side effect seen, but it is highly likely that many apparent side effects seen shortly after a subject has received a vaccine could be the result of restricted or congested blood flow from blood vessel or arterial constriction caused by emotional distress or placebo based on fear around vaccines.
Keywords: Covid 19, Vaccines, Side effects, Misinterpretation, Ischemia, Stress, Cardiovascular
Introduction
Vaccines introduced in late 2020 or early 2021 were closely watched, scrutinised, and monitored by the world’s mainstream population due to their fast to market delivery. Subsequent health concerns were quickly made public across social media and news outlets driving further vaccine hesitancy. One of the most common health concerns was that various types of Covid 19 vaccines were causing strokes or blood clots. The science for the vaccines causing blood clots has not been found, but other causes for this cascade from vaccines to blood clotting events may be found in existing medical literature.
Covid 19 vaccines use many of the same ingredients that have been safely used for many years, with the only major difference being the mRNA [1,2]. However, anti-vaccination sentiment and side effects are at an all time high, and this may point to a statistical significance.
Vaccines include antigens that produce an immune response which is adept at providing protection from disease [3]. However, reactogenicity from vaccines is very rare according to Herve et al. and mostly associated with mild irritations or other discomfort at the site of injection. Once vaccine antigens enter the body, they are distinguished as pathogens by the body’s immune system, the pathogen-associated molecular patterns (PAMPs) or damage-associated molecular patterns (DAMPs), pattern-recognition receptors (PRRs), including Toll-like receptors (TLR) that are located on peripheral circulating immune cells [3,4].
Even though the likelihood of mental stress causing strokes, heart attacks or blood clots may at first appear unlikely, a brief investigation of current medical literature clearly shows that simple tasks under clinical observing conditions such as public speaking can induce serious adverse outcomes [5]. Krantz et al. demonstrated that subjects with ischemia from mental stress experienced cardiac episodes more frequently than subjects without mental stress ischemia (8 of 34; 23%; p = 0.048).
Mental stress-induced myocardial ischemia (MSIMI) is a condition where blood flow to the heart is restricted due to emotional distress. MSIMI has been found to be more severe in females when peripheral blood vessels are constricted [6]. If MSIMI results in ischemia, it can also double the chance of a heart attack or death in subjects where heart disease is present [7]. Jiang et al. found a significant increase in nonfatal and fatal cardiac events in subjects with MSIMI.
It has been found that the level of microvascular constriction but not the angiographic burden of coronary artery disease (CAD) is correlated with MSIMI [8]. Patients with CAD and exercise induced ischemia (EII) with the existence of MSIMI were highly predicted to undergo a loss of life event [9].
Visceral arteries are also implicated in constriction from mental stress. Notably the renal artery showed decreased blood flow during mental stress testing [10]. The superior mesenteric artery (SMA) did not display any significant difference according to Hayashi et al. The findings of renal artery constriction also may lead into serious downstream kidney events. This data clearly indicates that mental stress can prevent blood flow far beyond the cardiovascular system inducing many other aberrations.
Adverse cardiovascular events that were reported from Covid 19 vaccines have been monitored closely by The World Health Organisation (WHO) [11]. Of those events, palpitations (717(14.74)), increased heart rate (439 (9,03), flushing (592(12.17) and tachycardia (798 (16.41)) were all reported as having the highest rate of incidence. However, Kaur et al. does not find any causality from the vaccines listed. Furthermore, restricted blood flow or blockages caused by MSIMI inducing vasoconstriction could be the smoking gun in all the aforementioned conditions such as palpitations, increased heart rate, flushing and tachycardia [12,13].
Vaccines monitored by Kaur et al. were Comirnaty (BNT162b2), Moderna COVID-19 Vaccine (mRNA1273), COVID-19 Vaccine AstraZeneca (AZD1222); also known as Covishield, Sputnik V, COVID-19 Vaccine Janssen (JNJ-78436735; Ad26.COV2.S), CoronaVac, BBIBP-CorV, Epi-VacCorona, Convidicea (Ad5-nCoV), Covaxin, CoviVac, ZF2001.
Moreover, vasoconstriction could also result in hyperpnea, postural faint, light headedness or dizziness which have all been included as possible side effects from the Covid 19 vaccines [14,15]. Post vaccine smell and taste disorders have also been implicated as side effects of Covid 19 vaccines, however both these disorders may be attributed to blood flow disorders from mental stress induced vasoconstriction [16].
The litany of suspected or perceived side effects discussed here from Covid 19 vaccines correlates firmly with well-established vasoconstriction disorders where blood flow is reduced or blocked completely. MSIMI is found in 70% of people with CAD [17], and it is predicted that approximately 16.3 million Americans above the age of twenty have CAD. Notably The American Heart Association (AHA) reports that approximately 82.6 million people in the United States have some form of cardiovascular disease [18]. When MSIMI is combined with these conditions, it presents a further aggravated risk for mortality.
The data presented herein, poses an interesting question, is the fear mongering around vaccines causing many of these perceived side effects by inducing unnecessary stress in vulnerable people? Is the movement and character of anti-vaccination information that may strike fear into the general population causing anxiety and vascular constriction resulting in pathologies such as dizziness, hypernea, fainting, blood clotting, stroke and heart attack? The science discussed here clearly establishes that anxiety and fear causes vasoconstriction disorders, and that a particular movement that is trying to save people with a profound lack of scientific and medical training (the anti-vaccination movement) from vaccine side effects may actually be the entity causing the majority of side effects.
Sullivan et al. had demonstrated that MSIMI was found to be more dangerous in females when peripheral blood vessels were constricted. When females underwent a tonometry exam the average ratio was associated at 0.11–0.35, just over a threefold ratio [6]. The Centre for Disease Control (CDC) also found that there was approximately between a three and fourfold increase in females reporting adverse side effects than men from the Covid 19 vaccine [19]. The numbers reported from the CDC were 4296 adverse side effects from females, and 1056 from men. The parallel in this data is quite clear, and may profoundly exonerate Covid 19 vaccines as ground zero for the perceived side effects and implicate the well established and studied condition of MSIMI and other blood flow conditions as the smoking gun.
Apart from MSIMI and other cardiac impairments discussed here, the placebo effect is also a strong marker in potential side effects, as the belief in detrimental side effects (the nocebo effect) can cause detrimental side effects [20]. It has also been shown that the placebo effect can be so powerful that it can affect end-organ functions that are controlled by the autonomic nervous system [21]. Both the placebo and nocebo effect are both noted here due to MSIMI being caused by mental stress, that is the connection between mental state and biological disorder which is already well established across the literature. This shows major cause for concern where fear mongering around vaccines is being perpetuated, as those with expectations of getting adverse side effects may increase their risk of experiencing adverse side effects [22].
Obesity may also play a role in poor outcomes for Covid 19 vaccines [23]. Obese subjects also appear to be at higher risk of MSIMI [24] which is consistent with this paper’s findings. An increase in adverse reactions was also found in obese subjects when using the Pfizer vaccine [25]. Obesity or poor arterial health may heighten the chances of a vaccine side effect.
Conclusion
This mini review finds that subjects with a history of heart disease, obesity, poor health combined with extreme stress or fear of vaccines should visit their medical practitioner and discuss the use of therapies or medications such as vaso or arterial dilators or possibly anticoagulants prior to their vaccines, as these measures under professional guidance may assist in maintaining healthy blood flow through a subject’s system and may offer benefits to ensure adverse reactions from underlying health conditions are not confused with adverse reactions from vaccines.
All data or claims of adverse reactions from vaccines should first be weighed against a subject’s health history with a focus on their vascular and arterial systems, cardiologic fitness and propensity for mental stress induced ischemia.
This brief review is not exhaustive but finds that it is highly probable that many adverse reports from recent vaccines are associated with vasoconstriction in conjunction with MSIMI or CAD.
This paper also presents the opportunity for governments to peer back into the claims of adverse vaccine side effects and weigh up the volume of existing health conditions that many of those subjects may have had. If it can be established in a high volume of cases of apparent side effects that CAD, HD, MSIMI or EII were present, then the adverse reactions can be laid against emotional distress or anxiety as opposed to the vaccines. The cause or source of that emotional distress and fear must then be investigated, recognised, and managed for future vaccination programs. Humanity on average has experienced a viral outbreak every two years for the last decade. So, managing this alarmism over perceived vaccine side effects is paramount in delivering fast to market solutions for future vaccination programs.
Limitations of study
This review is limited by primarily focusing on vasoconstriction conditions caused by a stress response, and also by a lack of large-scale clinical trial studies to determine whether using novel combinations of vasodilators or anticoagulants with vaccines could reduce vaccine side effects, which may also assist in clarifying whether side effects were emanating from vaccines or conditions such as MSIMI. Further investigation into whether side effects could be attributed as a stress response is required.
Footnotes
- Dates Written - Monday, 22 November 2021.
- Contributors - Raymond D Palmer.
- Conflict of interest - Raymond D Palmer is Chief Science Officer of Full Spectrum Biologics.
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Other Formats
Note: Kaiser Permanente study done for CDC. Data is unavailable. Suggests Vaccinated persons have up to 70% lower mortality (excluding Covid-19) than unvaccinated. Speculates on on why. Leaves impression that Covid Vaccines are elixirs of life.
On October 22, 2021, this report was posted online as an MMWR Early Release.
Stanley Xu, PhD1; Runxin Huang, MS1; Lina S. Sy, MPH1; Sungching C. Glenn, MS1; Denison S. Ryan, MPH1; Kerresa Morrissette, MPH1; David K. Shay, MD2; Gabriela Vazquez-Benitez, PhD3; Jason M. Glanz, PhD4; Nicola P. Klein, MD, PhD5; David McClure, PhD6; Elizabeth G. Liles, MD7; Eric S. Weintraub, MPH8; Hung-Fu Tseng, MPH, PhD1; Lei Qian, PhD1 (View author affiliations)
Summary
What is already known about this topic?
Although deaths after COVID-19 vaccination have been reported to the Vaccine Adverse Events Reporting System, few studies have been conducted to evaluate mortality not associated with COVID-19 among vaccinated and unvaccinated groups.
What is added by this report?
During December 2020–July 2021, COVID-19 vaccine recipients had lower rates of non–COVID-19 mortality than did unvaccinated persons after adjusting for age, sex, race and ethnicity, and study site.
What are the implications for public health practice?
There is no increased risk for mortality among COVID-19 vaccine recipients. This finding reinforces the safety profile of currently approved COVID-19 vaccines in the United States. All persons aged ≥12 years should receive a COVID-19 vaccine.
Related Materials
By September 21, 2021, an estimated 182 million persons in the United States were fully vaccinated against COVID-19.* Clinical trials indicate that Pfizer-BioNTech (BNT162b2), Moderna (mRNA-1273), and Janssen (Johnson & Johnson; Ad.26.COV2.S) vaccines are effective and generally well tolerated (1–3). However, daily vaccination rates have declined approximately 78% since April 13, 2021†; vaccine safety concerns have contributed to vaccine hesitancy (4). A cohort study of 19,625 nursing home residents found that those who received an mRNA vaccine (Pfizer-BioNTech or Moderna) had lower all-cause mortality than did unvaccinated residents (5), but no studies comparing mortality rates within the general population of vaccinated and unvaccinated persons have been conducted. To assess mortality not associated with COVID-19 (non–COVID-19 mortality) after COVID-19 vaccination in a general population setting, a cohort study was conducted during December 2020–July 2021 among approximately 11 million persons enrolled in seven Vaccine Safety Datalink (VSD) sites.§ After standardizing mortality rates by age and sex, this study found that COVID-19 vaccine recipients had lower non–COVID-19 mortality than did unvaccinated persons. After adjusting for demographic characteristics and VSD site, this study found that adjusted relative risk (aRR) of non–COVID-19 mortality for the Pfizer-BioNTech vaccine was 0.41 (95% confidence interval [CI] = 0.38–0.44) after dose 1 and 0.34 (95% CI = 0.33–0.36) after dose 2. The aRRs of non–COVID-19 mortality for the Moderna vaccine were 0.34 (95% CI = 0.32–0.37) after dose 1 and 0.31 (95% CI = 0.30–0.33) after dose 2. The aRR after receipt of the Janssen vaccine was 0.54 (95% CI = 0.49–0.59). There is no increased risk for mortality among COVID-19 vaccine recipients. This finding reinforces the safety profile of currently approved COVID-19 vaccines in the United States.
VSD, a collaborative project between CDC’s Immunization Safety Office and nine health care organizations, collects electronic health data, including information on vaccines, for specific studies. In this cohort study of VSD members aged ≥12 years, vaccination status through May 31, 2021 was determined. Index dates were assigned to all persons on the basis of the distribution of vaccination dates among vaccinated persons.¶ Person-time for unvaccinated persons included unvaccinated person-time before COVID-19 vaccination among COVID-19 vaccinees, and unvaccinated person-time of persons who did not receive a COVID-19 vaccine by May 31, 2021. To ensure comparable health care–seeking behavior among persons who received a COVID-19 vaccine and those who did not (unvaccinated persons), eligible unvaccinated persons were selected from among those who received ≥1 dose of influenza vaccine in the last 2 years. Separate unvaccinated groups were selected for mRNA and Janssen vaccines.** Deaths were identified through VSD, which captures hospital deaths and deaths reported to health plans. In this study, non–COVID-19 deaths were assessed because a protective effect of COVID-19 vaccination for COVID-19–related deaths was expected. Non–COVID-19 deaths were those that did not occur within 30 days of an incident COVID-19 diagnosis or receipt of a positive test result for SARS-CoV-2 (the virus that causes COVID-19) via reverse transcription–polymerase chain reaction or rapid test.
Standardized mortality rates (SMRs) (deaths per 100 person-years) were calculated and compared with a rate ratio test between vaccinated and unvaccinated groups (6); a population of VSD members who were enrolled in December 2020 was used as the standard population. Overall SMRs were reported separately for Pfizer-BioNTech, Moderna, and Janssen vaccines. Poisson models were used to calculate overall aRRs and 95% CIs adjusted for age, sex, race and ethnicity, and VSD site. SMRs and aRRs by age, sex, and race and ethnicity were also calculated, adjusting for other demographic characteristics. Analytical units were aggregated counts of deaths and person-years by vaccination status, age, sex, race and ethnicity, and VSD site. All analyses were conducted using SAS statistical software (version 9.4; SAS Institute).†† This work was reviewed by CDC and VSD sites§§ and was conducted consistent with applicable federal law and CDC policy.¶¶
The cohort consisted of 6.4 million COVID-19 vaccinees and 4.6 million unvaccinated persons with similar characteristics as the comparison groups. Among 3.5 million Pfizer-BioNTech vaccine recipients, 9.2% were aged 12–17 years, 69.4% were aged 18–64 years, 54.0% were female, 42.7% were White persons, 21.4% were Hispanic persons, 16.6% were Asian persons, and 5.1% were Black persons (Table 1). Among 2.6 million Moderna vaccine recipients, 71.7% were aged 18–64 years, 54.5% were female, 44.2% were White persons, 23.1% were Hispanic persons, 14.2% were Asian persons, and 5.6% were Black persons. Among 342,169 Janssen vaccine recipients, 87.5% were aged 18–64 years, 4.1% were aged ≥75 years, 48.0% were female, 45.1% were White persons, 20.3% were Hispanic persons, 13.4% were Asian persons, and 6.1% were Black persons.
After excluding COVID-19–associated deaths, overall SMRs after dose 1 were 0.42 and 0.37 per 100 person-years for Pfizer-BioNTech and Moderna, respectively, and were 0.35 and 0.34, respectively, after dose 2 (Table 2). These rates were lower than the rate of 1.11 per 100 person-years among the unvaccinated mRNA vaccine comparison group (p <0.001). Among Janssen vaccine recipients, the overall SMR was 0.84 per 100 person-years, lower than the rate of 1.47 per 100 person-years among the unvaccinated comparison group (p <0.001). Among persons aged 12–17 years, SMRs were similar among the Pfizer-BioNTech vaccine recipients and unvaccinated comparison groups (p = 0.68 after dose 1 and 0.89 after dose 2). SMRs were also similar between Janssen vaccine recipients and unvaccinated comparison groups among Asian persons (p = 0.11). Among other subgroups defined by vaccine received, age, sex, and race and ethnicity, COVID-19 vaccine recipients had lower SMRs than did their unvaccinated counterparts (p <0.05).
The overall aRR among Pfizer-BioNTech vaccine recipients compared with the unvaccinated comparison group was 0.41 (95% CI = 0.38–0.44) after dose 1 and 0.34 (95% CI = 0.33–0.36) after dose 2 (Table 3). Among Pfizer-BioNTech vaccine recipients aged 12–17 years, mortality risk among vaccinated and unvaccinated persons was similar after dose 1 (aRR = 0.85; 95% CI = 0.38–1.90) and after dose 2 (aRR = 0.73; 95% CI = 0.33–1.64). Among other age groups, aRRs ranged from 0.35 (95% CI = 0.29–0.42) among persons aged 45–64 years to 0.46 (95% CI = 0.39–0.54) among persons aged ≥85 years after dose 1, and from 0.28 (95% CI = 0.25–0.31) among persons aged 45–64 years to 0.39 (95% CI = 0.36–0.43) among those aged ≥85 years after dose 2. Similar aRRs among vaccinated persons compared with the unvaccinated comparison group were observed for recipients of the Moderna vaccine, ranging from 0.31 (95% CI = 0.26–0.37) among persons aged 45–64 years to 0.46 (95% CI = 0.31–0.69) among persons aged 18–44 years after dose 1, and 0.28 (95% CI = 0.26–0.32) among persons aged 65–74 years to 0.38 (95% CI = 0.29–0.50) among those aged 18–44 years after dose 2. The overall aRR for Janssen was 0.54 (95% CI = 0.49–0.59), and age-stratified aRRs ranged from 0.40 (95% CI = 0.34–0.49) among persons aged 45–64 years to 0.68 (95% CI = 0.56–0.82) among persons aged ≥85 years. Across vaccine type and dose, males and females had comparable aRRs. All vaccinated racial and ethnic groups had lower mortality risks than did unvaccinated comparison groups.
Discussion
In a cohort of 6.4 million COVID-19 vaccinees and 4.6 million demographically similar unvaccinated persons, recipients of the Pfizer-BioNTech, Moderna, or Janssen vaccines had lower non–COVID-19 mortality risk than did the unvaccinated comparison groups. There is no increased risk for mortality among COVID-19 vaccine recipients. This finding reinforces the safety profile of currently approved COVID-19 vaccines in the United States. The lower mortality risk after COVID-19 vaccination suggests substantial healthy vaccinee effects (i.e., vaccinated persons tend to be healthier than unvaccinated persons) (7,8), which will be explored in future analyses. Mortality rates among Janssen vaccine recipients were not as low as those among mRNA vaccine recipients. This finding might be because of differences in risk factors, such as underlying health status and risk behaviors among recipients of mRNA and Janssen vaccines that might also be associated with mortality risk.
Among persons aged 12–17 years, mortality risk did not differ between Pfizer-BioNTech vaccinees and unvaccinated persons; only 12 deaths occurred in this age group during the study period. The unvaccinated group might be more similar to the vaccinated group in risk factors than are vaccinated and unvaccinated adults. Stratified analyses by age, sex, and race and ethnicity showed that vaccinated adults had lower mortality than did unvaccinated adults across subgroups.
The findings in this report are subject to at least four limitations. First, the study was observational, and individual-level confounders that were not adjusted for might affect mortality risk, including baseline health status, underlying conditions, health care utilization, and socioeconomic status. Second, healthy vaccinee effects were found in all but the youngest age group. Such effects were also found in a cohort study conducted in a nursing home population, which reported substantially lower aRRs for 7-day mortality among vaccinated residents after dose 1 (0.34) and dose 2 (0.49) as compared with unvaccinated residents (5). Lower rates of non–COVID-19 mortality in vaccinated groups suggest that COVID-19 vaccinees are inherently healthier or engage in fewer risk behaviors (7,8); future analyses will address these issues. Third, although deaths associated with COVID-19 were excluded, causes of death were not assessed. It is possible that the algorithm used might have misclassified some deaths associated with COVID-19 because of lack of testing or because individual mortality reviews were not conducted. Finally, the findings might not be applicable to the general population. The VSD includes approximately 3% of the U.S. population, and is representative of the general population with regard to several demographic and socioeconomic characteristics (9). Other studies have already demonstrated the safety of COVID-19 vaccines authorized in the United States.
Despite these limitations, this study had several strengths. First, this was a cohort study with a large, sociodemographically diverse population, and it encompassed a study period of >7 months. Second, VSD sites were able to capture COVID-19 vaccines administered not just within but also outside their health care systems, including COVID-19 vaccine doses recorded in state immunization registries, allowing for more complete ascertainment of vaccination status. Third, the assignment of index dates allowed COVID-19 vaccinees to contribute unvaccinated person-time before vaccination, thus avoiding immortal time bias (10), which can confer a spurious survival advantage to the treatment group in cohort studies. Index date assignments made the follow-up period comparable between COVID-19 vaccinees and their comparators and helped control for seasonality and general trends in mortality.
CDC recommends that everyone aged ≥12 years should receive a COVID-19 vaccine to help protect against COVID-19.*** This cohort study found lower rates of non–COVID-19 mortality among vaccinated persons compared with unvaccinated persons in a large, sociodemographically diverse population during December 2020–July 2021. There is no increased risk for mortality among COVID-19 vaccine recipients. This finding reinforces the safety profile of currently approved COVID-19 vaccines in the United States.
Corresponding author: Stanley Xu, Stan.Xu@kp.org.
1) Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California; 2) CDC COVID-19 Response Team;
3) Health Partners Institute, Minneapolis, Minnesota;
4) Institute for Health Research, Kaiser Permanente Colorado, Denver, Colorado;
5) Kaiser Permanente Vaccine Study Center, Kaiser Permanente Northern California, Oakland, California;
6) Marshfield Clinic Research Institute, Marshfield, Wisconsin;
7) Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon;
8) Immunization Safety Office, CDC.
All authors have completed and submitted the International Committee of Medical Journal Editors form for disclosure of potential conflicts of interest. Runxin Huang reports support for attending meetings or travel from Dynavax Technologies. Nicola P. Klein reports institutional support from Pfizer, Sanofi Pasteur, Merck, GlaxoSmithKline, and Protein Science (now Sanofi Pasteur to support vaccine studies). Elizabeth G. Liles reports research contracts from the National Human Genome Research Institute and Pfizer. Kerresa Morrissette reports research contracts from the National Institutes of Health, GlaxoSmithKline, and Merck Sharp & Dohme Corporation, outside the submitted work. No other potential conflicts of interest were disclosed.
* https://covid.cdc.gov/covid-data-tracker/#vaccinations
† https://ourworldindata.org/coronavirusexternal icon (Accessed September 21, 2021).
§ Among nine VSD sites, (all health care organizations), data is included from seven sites: Kaiser Permanente (KP) Southern California, Pasadena, California; KP Northern California, Oakland, California; KP Colorado, Denver, Colorado; KP Northwest, Portland, Oregon; KP Washington, Seattle, Washington; HealthPartners, Minneapolis, Minnesota; and Marshfield Clinic, Marshfield, Wisconsin. Harvard Pilgrim Health Care Institute, Boston, Massachusetts, did not participate in this study because it is not a data-contributing site; Denver Health, Denver, Colorado, did not participate in this study because of limited resources.
¶ Persons who were vaccinated during December 14, 2020–May 31, 2021 were included in the vaccinated group. In each VSD site, age group, and sex stratum, the distribution of vaccination dates of dose 1 were obtained and used to assign index dates to all persons. Among vaccinated persons, if the index date was before the vaccination date of dose 1, follow-up started on the index date, and persons in this group contributed both unvaccinated person-time (from index date to the day before vaccination date) and vaccinated person-time (from vaccination date); if the index date was on or after the vaccination date of dose 1, follow-up started on the vaccination date, and persons in this group only contributed person-time after vaccination. Follow-up ended upon death, disenrollment from health plans, receipt of a COVID-19 vaccine for unvaccinated persons during June 1, 2021–July 31, 2021, or end of follow-up (July 31, 2021), whichever occurred first.
** All available eligible comparators were used for analysis of mRNA COVID-19 vaccines. Because the Janssen COVID-19 vaccine was authorized months after the mRNA COVID-19 vaccines and demographic characteristics of Janssen versus mRNA COVID-19 vaccine recipients might differ, a separate group of comparators was selected for Janssen vaccine recipients on the basis of calendar time and demographic characteristics of Janssen vaccine recipients. Because the number of Janssen vaccine recipients was smaller, four eligible comparators were randomly selected for each vaccinated individual to achieve optimal statistical power.
†† The procedure STDRATE was used to conduct rate ratio tests, and the procedure GENMOD was used to fit Poisson models.
§§ All activities were approved by the institutional review boards at some participating institutions or as public health surveillance activities at other participating institutions.
¶¶ 45 C.F.R. part 46.102(l)(2), 21 C.F.R. part 56; 42 U.S.C. Sect. 241(d); 5 U.S.C. Sect. 552a; 44 U.S.C. Sect. 3501 et seq.
*** https://www.cdc.gov/coronavirus/2019-ncov/vaccines/recommendations/adolescents.html (Accessed October 13, 2021).
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- Baden LR, El Sahly HM, Essink B, et al.; COVE Study Group. Efficacy and safety of the mRNA-1273 SARS-CoV-2 vaccine. N Engl J Med 2021;384:403–16. https://doi.org/10.1056/NEJMoa2035389external icon PMID:33378609external icon
- Food and Drug Administration. Janssen COVID-19 vaccine Emergency Use Authorization letter. Silver Spring, MD: US Department of Health and Human Services, Food and Drug Administration; 2021. https://www.fda.gov/media/146303/downloadexternal icon
- Finney Rutten LJ, Zhu X, Leppin AL, et al. Evidence-based strategies for clinical organizations to address COVID-19 vaccine hesitancy. Mayo Clin Proc 2021;96:699–707. https://doi.org/10.1016/j.mayocp.2020.12.024external icon PMID:33673921external icon
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TABLE 1. Demographic characteristics of COVID-19 vaccine recipients and unvaccinated comparison group — seven integrated health care organizations, United States, December 14, 2020–July 31, 2021
Characteristic
No. (%)
mRNA vaccine*
Janssen vaccine
Pfizer-BioNTech vaccine recipients
Moderna vaccine recipients
Unvaccinated comparison group†,§
Janssen vaccine recipients
Unvaccinated comparison group†
Total
3,452,126 (100.0)
2,604,066 (100.0)
3,243,112 (100.0)
342,169 (100.0)
1,346,445 (100.0)
Age group, yrs
12–17
316,587 (9.2)
NA
311,445 (9.6)
NA
NA
18–44
1,322,147 (38.3)
951,899 (36.6)
1,153,735 (35.6)
141,317 (41.3)
558,996 (41.5)
45–64
1,072,819 (31.1)
913,075 (35.1)
987,703 (30.5)
158,157 (46.2)
624,106 (46.4)
65–74
440,879 (12.8)
454,391 (17.4)
468,679 (14.5)
28,721 (8.4)
109,143 (8.1)
75–84
219,888 (6.4)
216,968 (8.3)
233,870 (7.2)
9,835 (2.9)
37,745 (2.8)
≥85
79,806 (2.3)
67,733 (2.6)
87,680 (2.7)
4,139 (1.2)
16,455 (1.2)
Sex
Male
1,586,867 (46.0)
1,185,265 (45.5)
1,395,196 (43.0)
177,867 (52.0)
696,190 (51.7)
Female
1,865,259 (54.0)
1,418,801 (54.5)
1,847,916 (57.0)
164,302 (48.0)
650,255 (48.3)
Race/Ethnicity
Hispanic
738,931 (21.4)
600,654 (23.1)
871,863 (26.9)
69,602 (20.3)
329,921 (24.5)
White, non-Hispanic
1,472,716 (42.7)
1,151,826 (44.2)
1,397,345 (43.1)
154,188 (45.1)
585,489 (43.5)
Asian, non-Hispanic
573,754 (16.6)
369,069 (14.2)
432,782 (13.3)
45,909 (13.4)
200,430 (14.9)
Black, non-Hispanic
175,066 (5.1)
145,127 (5.6)
189,592 (5.8)
20,996 (6.1)
73,174 (5.4)
Multiple races/Other/Unknown
491,659 (14.2)
337,390 (13.0)
351,530 (10.8)
51,474 (15.0)
157,431 (11.7)
Abbreviations: Janssen = Johnson & Johnson; NA = not applicable.
* Among Pfizer-BioNTech COVID-19 vaccine recipients, 2,980,152 received the second dose by May 31, 2021; among Moderna COVID-19 vaccine recipients, 2,362,157 received the second dose by May 31, 2021.
† Unvaccinated comparison group included unvaccinated persons and COVID-19 vaccine recipients before COVID-19 vaccination. The assignment of index dates allowed COVID-19 vaccinees to contribute unvaccinated person-time before vaccination, thus avoiding immortal time bias.
§ mRNA vaccines included Pfizer-BioNTech and Moderna COVID-19 vaccines.
TABLE 2. Number of deaths and standardized mortality rate (deaths per 100 person-years) not associated with COVID-19 among COVID-19 vaccine recipients and unvaccinated comparison groups, by age, sex, and race/ethnicity — seven integrated health care organizations, United States, December 14, 2020–July 31, 2021
Characteristic
No. of deaths* (standardized mortality rate per 100 person-years)
mRNA vaccine
Janssen vaccine
Pfizer-BioNTech vaccine recipients†
Moderna vaccine recipients†
Unvaccinated comparison group§
Vaccine recipients¶
Unvaccinated comparison group§
After dose 1
After dose 2
After dose 1
After dose 2
Overall**
1,157 (0.42)
5,143 (0.35)
1,202 (0.37)
4,434 (0.34)
6,660 (1.11)
671 (0.84)
2,219 (1.47)
Age group,†† yrs
12–17
2 (0.01)
3 (0.01)
NA
NA
7 (0.01)
NA
NA
18–44
20 (0.02)
73 (0.02)
24 (0.03)
57 (0.02)
161 (0.07)
19 (0.04)
63 (0.08)
45–64
117 (0.16)
409 (0.13)
123 (0.16)
421 (0.17)
910 (0.51)
130 (0.25)
497 (0.66)
65–74
235 (0.79)
994 (0.62)
249 (0.63)
920 (0.58)
1,407 (2.13)
144 (1.49)
466 (2.77)
75–84
338 (2.32)
1,591 (1.89)
376 (2.00)
1,425 (1.77)
1,861 (6.34)
176 (5.59)
549 (9.13)
≥85
445 (7.90)
2,073 (6.85)
430 (7.16)
1,611 (6.57)
2,314 (18.76)
202 (15.35)
644 (23.76)
Sex§§
Male
587 (0.49)
2,584 (0.41)
640 (0.45)
2,352 (0.42)
3,265 (1.30)
326 (0.96)
1,102 (1.68)
Female
570 (0.35)
2,559 (0.29)
562 (0.30)
2,082 (0.28)
3,395 (0.96)
345 (0.75)
1,117 (1.31)
Race/Ethnicity**
Hispanic
144 (0.36)
584 (0.29)
197 (0.35)
701 (0.33)
1,230 (1.07)
92 (0.91)
365 (1.24)
White, non-Hispanic
781 (0.47)
3,560 (0.39)
732 (0.39)
2,804 (0.37)
3,993 (1.17)
416 (0.85)
1,364 (1.58)
Asian, non-Hispanic
72 (0.23)
408 (0.23)
67 (0.18)
317 (0.21)
460 (0.78)
56 (0.83)
157 (1.09)
Black, non-Hispanic
84 (0.54)
300 (0.37)
130 (0.65)
340 (0.44)
623 (1.53)
65 (0.99)
187 (1.97)
Multiple races/Other/Unknown
76 (0.38)
291 (0.28)
76 (0.32)
272 (0.29)
354 (0.82)
42 (0.68)
146 (1.22)
Abbreviations: Janssen = Johnson & Johnson; NA = not applicable.
* Number of deaths as of July 31, 2021; deaths that occurred ≤30 days after an incident COVID-19 diagnosis or receipt of a positive SARS-CoV-2 test result were excluded.
† Vaccinated with mRNA COVID-19 vaccines during December 14, 2020–May 31, 2021.
§ Unvaccinated comparison group included unvaccinated persons and COVID-19 vaccine recipients before COVID-19 vaccination. The assignment of index dates allowed COVID-19 vaccinees to contribute unvaccinated person-time before vaccination, thus avoiding immortal time bias.
¶ Vaccinated with Janssen COVID-19 vaccine during February 27, 2021–May 31, 2021.
** Overall mortality rates and race- and ethnicity-specific mortality rates were age- and sex-standardized.
†† Age-specific mortality rates were sex-standardized.
§§ Sex-specific mortality rates were age-standardized.
TABLE 3. Adjusted relative risks for mortality of COVID-19 vaccine recipients and unvaccinated comparison groups*— seven integrated health care organizations, United States, December 14, 2020–July 31, 2021
Characteristic
Vaccine type, aRR, (95% CI)
Pfizer-BioNTech
Moderna
Janssen
After dose 1
After dose 2
After dose 1
After dose 2
After dose 1
Overall†
0.41 (0.38–0.44)
0.34 (0.33–0.36)
0.34 (0.32–0.37)
0.31(0.30–0.33)
0.54 (0.49–0.59)
Age group,§ yrs
12–17
0.85 (0.38–1.90)
0.73 (0.33–1.64)
NA
NA
NA
18–44
0.37 (0.24–0.57)
0.36 (0.28–0.46)
0.46 (0.31–0.69)
0.38 (0.29–0.50)
0.55 (0.36–0.82)
45–64
0.35 (0.29–0.42)
0.28 (0.25–0.31)
0.31 (0.26–0.37)
0.33 (0.29–0.37)
0.40 (0.34–0.49)
65–74
0.39 (0.33–0.47)
0.32 (0.29–0.35)
0.32 (0.27–0.37)
0.28 (0.26–0.32)
0.50 (0.39–0.63)
75–84
0.38 (0.33–0.46)
0.32 (0.29–0.35)
0.32 (0.27–0.38)
0.29 (0.26–0.32)
0.58 (0.48–0.71)
≥85
0.46 (0.39–0.54)
0.39 (0.36–0.43)
0.38 (0.32–0.45)
0.35 (0.31–0.39)
0.68 (0.56–0.82)
Sex¶
Male
0.41 (0.37–0.46)
0.35 (0.33–0.38)
0.36 (0.32–0.40)
0.33 (0.31–0.35)
0.52 (0.46–0.60)
Female
0.41 (0.36–0.45)
0.33 (0.31–0.36)
0.33 (0.29–0.37)
0.30 (0.28–0.32)
0.56 (0.49–0.64)
**Race/Ethnicity****
Hispanic
0.36 (0.30–0.42)
0.29 (0.26–0.32)
0.33 (0.29–0.39)
0.31 (0.28–0.34)
0.58 (0.46–0.73)
White, non-Hispanic
0.44 (0.38–0.50)
0.37 (0.34–0.40)
0.35 (0.30–0.40)
0.32 (0.30–0.35)
0.53 (0.46–0.61)
Asian, non-Hispanic
0.31 (0.25–0.39)
0.32 (0.28–0.36)
0.23 (0.18–0.30)
0.27 (0.23–0.30)
0.68 (0.52–0.88)
Black, non-Hispanic
0.38 (0.31–0.47)
0.27 (0.24–0.31)
0.42 (0.35–0.49)
0.29 (0.25–0.32)
0.47 (0.36–0.63)
Multiple races/Other/Unknown
0.46 (0.36–0.60)
0.35 (0.30–0.41)
0.40 (0.30–0.51)
0.36 (0.30–0.42)
0.52 (0.38–0.71)
Abbreviations: aRR = adjusted relative risk; CI = confidence interval; Janssen = Johnson & Johnson; NA = not applicable; VSD = Vaccine Safety Datalink.
* Unvaccinated comparison groups included unvaccinated persons and COVID-19 vaccine recipients before COVID-19 vaccination. The assignment of index dates allowed COVID-19 vaccinees to contribute unvaccinated person-time before vaccination, thus avoiding immortal time bias.
† Overall relative risks were adjusted for age, sex, race and ethnicity, and VSD site.
§ Relative risks by age were adjusted for sex, race and ethnicity, and VSD site.
¶ Relative risks by sex were adjusted for age, race and ethnicity, and VSD site.
** Relative risks by race and ethnicity were adjusted for age, sex, and VSD site.
Suggested citation for this article: Xu S, Huang R, Sy LS, et al. COVID-19 Vaccination and Non–COVID-19 Mortality Risk — Seven Integrated Health Care Organizations, United States, December 14, 2020–July 31, 2021. MMWR Morb Mortal Wkly Rep 2021;70:1520–1524. DOI: http://dx.doi.org/10.15585/mmwr.mm7043e2external icon.
Could the mystery be revealed here? Perhaps you may notice how this article artfully omits an obvious possibility.
TOKYO (AP) — Almost overnight, Japan has become a stunning, and somewhat mysterious, coronavirus success story.
Daily new COVID-19 cases have plummeted from a mid-August peak of nearly 6,000 in Tokyo, with caseloads in the densely populated capital now routinely below 100, an 11-month low.
The bars are packed, the trains are crowded, and the mood is celebratory, despite a general bafflement over what, exactly, is behind the sharp drop.
Japan, unlike other places in Europe and Asia, has never had anything close to a lockdown, just a series of relatively toothless states of emergency.
Some possible factors in Japan’s success include a belated but remarkably rapid vaccination campaign, an emptying out of many nightlife areas as fears spread during the recent surge in cases, a widespread practice, well before the pandemic, of wearing masks and bad weather in late August that kept people home.
But with vaccine efficacy gradually waning and winter approaching, experts worry that without knowing what exactly why cases have dropped so drastically, Japan could face another wave like this summer, when hospitals overflowed with serious cases and deaths soared — though the numbers were lower than pre-vaccination levels.
Many credit the vaccination campaign, especially among younger people, for bringing infections down. Nearly 70 percent of the population is fully vaccinated.
“Rapid and intensive vaccinations in Japan among those younger than 64 might have created a temporary condition similar to herd-immunity,” said Dr. Kazuhiro Tateda, a Toho University professor of virology.
Tateda noted that vaccination rates surged in July to September, just as the more infectious delta variant was spreading fast.
He cautioned, however, that breakthrough infections in the U.S., Britain and other places where inoculations began months earlier than in Japan show that vaccines alone are not perfect and efficacy gradually wears off.
Japan’s vaccinations started in mid-February, with health workers and the elderly first in line. Shortages of imported vaccines kept progress slow until late May, when the supply stabilized and daily inoculation targets were raised to above 1 million doses to maximize protection before the July 23-Aug. 8 Olympics.
The number of daily shots rose to about 1.5 million in July, pushing vaccination rates from 15% in early July to 65% by early October, exceeding the 57% of the United States.
Daily new cases surged just weeks ahead of the Olympics, forcing Japan to hold the Games with daily caseloads of more than 5,000 in Tokyo and around 20,000 nationwide in early August. Tokyo reported 40 cases Sunday, below 100 for the ninth straight day and lowest this year. Nationwide, Japan reported 429 cases Sunday for an accumulated total of about 1.71 million and 18,000 deaths since the pandemic began early last year.
So why the drop?
“It’s a tough question, and we have to consider the effect of the vaccinations progress, which is extremely big,” said Disease Control and Prevention Center Director Norio Ohmagari. “At the same time, people who gather in high-risk environments, such as crowded and less-ventilated places, may have been already infected and acquired natural immunity by now.”
Though some speculated that the drop in cases might be due to less testing, Tokyo metropolitan government data showed the positivity rate fell from 25% in late August to 1% in mid-October, while the number of tests fell by one-third. Masataka Inokuchi, the Tokyo Medical Association deputy chief, said falling positivity rates show infections have slowed.
Japan’s state of emergency measures were not lockdowns but requests that focused mainly on bars and eateries, which were asked to close early and not serve alcohol. Many people continued to commute on crowded trains, and attended sports and cultural events at stadiums with some social distancing controls.
The emergency requests have ended and the government is gradually expanding social and economic activity while allowing athletic events and package tours on a trial basis using vaccination certificates and increased testing.
To speed up inoculations, former Prime Minister Yoshihide Suga, who left office recently, expanded the number of health workers legally eligible to give shots, opened large-scale vaccination centers and promoted workplace vaccinations beginning in late June.
Kyoto University professor Hiroshi Nishiura told a recent government advisory board meeting that he estimates vaccinations helped some 650,000 people avoid infection and saved more than 7,200 lives between March and September.
Many experts initially blamed younger people, seen drinking on the streets and in parks when the bars were closed, for spreading the virus, but said data showed many in their 40s and 50s also frequented nightlife districts. Most serious cases and deaths were among unvaccinated people in their 50s or younger.
Takaji Wakita, director of the National Institute of Infectious Diseases, told reporters recently he is worried people have already resumed partying in nightlife districts, noting that the slowing of infections may have already hit bottom.
“Looking ahead, it is important to further push down the caseloads in case of a future resurgence of infections,” Wakita said Thursday.
On Friday, new Prime Minister Fumio Kishida said a preparedness plan to be compiled by early November would include tougher limits on activities and require hospitals to provide more beds and staff for COVID-19 treatment in case infections soar in a “worst-case scenario.”
He did not elaborate on details.
Many people are cautious about letting down their guard, regardless of the numbers.
Mask-wearing “has become so normal,” said university student Mizuki Kawano. “I’m still worried about the virus,” she said.
“I don’t want to get close to those who don’t wear masks,” said her friend, Alice Kawaguchi.
Public health experts want a comprehensive investigation into why infections have dropped off.
An analysis of GPS data showed that people’s movements in major downtown entertainment districts fell during the most recent, third state of emergency, which ended Sept. 30.
“I believe the decrease of people visiting entertainment districts, along with the vaccination progress, has contributed to the decline of infections,” said Atsushi Nishida, the director of the Research Center for Social Science & Medicine Sciences at the Tokyo Metropolitan Institute of Medical Science.
But people headed back to entertainment districts as soon as the recent emergency ended, he said, and that may “affect the infection situation in coming weeks.”
By MARI YAMAGUCHI October 18, 2021
AP journalist Chisato Tanaka contributed to this report.
“I’ve been reading…” That was the response I received from one of the staffers of Skeptic magazine when I asked why she wasn’t vaccinated. My query came on the saddest day in our 30-year history—we were mourning the death of Pat Linse, the Art Director, co-founder of the magazine and the Skeptics Society, and my business partner, friend, and confidant of three decades. Pat was 73, overweight, and in poor health, so she was in the high morbidity cohort for contracting the SARS-CoV-2 virus that produces the COVID-19 disease. As she was herself vaccinated, socially isolated, and hyper-vigilant about outsiders coming into the office, I just assumed everyone else in the office was vaccinated.
Pat’s cause of death was not COVID-19. Nevertheless, Skeptic has been at the forefront of debunking conspiracy theories and quackery related to the pandemic, so the discovery that one of our staffers had not been vaccinated was troubling. “I read about people having seizures, getting violently sick, having heart attacks, and even dying from the vaccine,” she explained. “And getting injected with a foreign substance like that just doesn’t seem like a healthy thing to do.” Her reasons for being vaccine hesitant are not unique and are shared by tens of millions of people, who have also “been reading.” Google readily provides a massive trove of misinformation, disinformation, lies, damn lies, and distorted statistics.
I was so distraught that I forgot the overarching mission of the Skeptics Society, captured in Baruch Spinoza’s maxim “I have made a ceaseless effort not to ridicule, not to bewail, not to scorn human actions, but to understand them,” and I shamed her for putting the lives of those around her at risk (I later apologized). In keeping with the findings of psychological science,1 my shaming made her even more resistant as cognitive dissonance kicked in,2 and so the subsequent deluge of data, anecdotes, and analogies didn’t help at all. Not a few people with whom I shared this story expressed their opinion that I am the one who is confused about the science. So let me use this personal experience to address three of the most important underlying concerns that I think drive vaccine hesitancy.
1. Doubts about the vaccines themselves
The vaccine hesitant may be compared to spectators at a witch burning, more concerned about women being witches (believed to cause plagues, among other catastrophes) than about the inquisition burning people alive. It’s an imperfect analogy, since rare vaccine side effects are real and witches aren’t. But the point remains: during a pandemic, it is important to focus on the real, not the imagined threat.
Here’s another comparison to put the risk-benefit calculation into perspective: According to the National Highway Traffic Safety Administration, 38,680 people died in automobile accidents in the US in 2020. Yet few people think twice about going for a drive, and will sometimes do so while texting, eating, drinking alcoholic beverages, and fiddling with sound and nav systems. By comparison, according to the CDC, COVID-19 killed 345,000 Americans in 2020 alone, making it an order of magnitude deadlier than driving. So why are some people hesitant to protect themselves from a lethal disease but not from injury in far less common traffic accidents?
What about allergic reactions to the vaccine, known as anaphylaxis? According to the CDC, the rate of anaphylactic reaction from the vaccines is roughly two per 1,000,000 people, or 0.000002. By comparison, according to the CDC, the death rate from lightning strikes in the US is roughly one per 500,000, or 0.000002. So, you have the same chance of dying from a lightning strike as you do from going into vaccine anaphylactic shock, and yet we’ve seen no corresponding run on lightning rods. (And that’s assuming that after you received the vaccine you promptly left the facility rather than waiting 15 minutes, as instructed, so that you can be treated in the event of an allergic reaction. I waited 30 minutes after my vaccine stabs just in case, as several years ago I went into anaphylactic shock from a bee sting and now carry an EpiPen with me on bike rides.)
Another possible side-effect of the vaccine is thrombosis, or blood clotting, which is a serious health risk. According to the CDC, two confirmed cases of thrombosis have resulted from administration of the Moderna vaccine out of 328 million doses worldwide, which would be roughly the equivalent of getting struck by lightning 300 times in one year. The risks of myocarditis and pericarditis are slightly higher—there have been 716 reports of incidents (not deaths) out of over 300 million doses. There is no evidence whatsoever that the vaccines cause infertility in women.
All told, the CDC reports that, out of 346 million doses of COVID-19 vaccines administered, they received reports of 6,490 deaths affiliated with the vaccines, “even if it’s unclear whether the vaccine was the cause.” Let’s take that number as a worst-case scenario and divide it by 346,000,000—the risk of dying from a COVID-19 vaccine is 0.000018, again, roughly the rate of being stuck by lightning. You are far more likely to drown in your bathtub or pool or die in an airplane crash, tornado, hurricane, or earthquake, not to mention succumb to heart disease, cancer, stroke, diabetes, lower respiratory diseases, nephritis, influenza and pneumonia, homicide, and suicide, causes of death to which most of us don’t give a second thought.
Many people have an understandable aversion to being injected with a derivative of a virus designed to train the body for combat with the fully armed viral enemy. The very idea engages our disgust emotion and negativity bias, in which bad is stronger than good (and in many cases a lot stronger). Bad smells, for example, elicit far more animated facial expressions than good or neutral odors.3 Negative stimuli have a stronger influence on neural activity than positive stimuli.4 Bad information is processed more thoroughly than good information.5 Traumatic events leave traces in mood and memory longer than good events.6 There are more cognitive categories and descriptive terms for negative than positive emotions.7 Evil contaminates good more than good purifies evil, as in the old Russian proverb: “A spoonful of tar can spoil a barrel of honey, but a spoonful of honey does nothing for a barrel of tar.”
COVID-19 vaccines, however, are completely different from any that came before as they contain no traces of the SARS-Cov-2 virus. As the CDC explains, unlike previous vaccines that inject “a weakened or inactivated germ into our bodies,” these new messenger RNA (mRNA) vaccines “teach our cells how to make a protein—or even just a piece of a protein—that triggers an immune response inside our bodies. That immune response, which produces antibodies, is what protects us from getting infected if the real virus enters our bodies.” Once the mRNA instructions are inside the muscle cells of your upper arm, the cells use them to make the protein piece. Then, “the cell displays the protein piece on its surface. Our immune systems recognize that the protein doesn’t belong there and begin building an immune response and making antibodies, like what happens in natural infection against COVID-19.” If you felt ill after your second jab, as I did for a day, that is your body building immunity to the disease.
This is not only the fastest vaccine ever developed, it is also the most effective with the lowest rate of side effects ever recorded (with the usual caveats here that we don’t know the long-term consequences yet; then again, we have some confidence in the long-term consequences of COVID-19, and they aren’t good, starting with death). In the long history of medical inventions, this vaccine could well be the most miraculous, and as an atheist I don’t toss that word around lightly. To date, if you are vaccinated, there is a 99.999 (yes, three nines!) percent probability that you will not be hospitalized or die from COVID-19. Arguments that the vaccination process itself is leading to new strains of COVID were refuted by a July 30th, 2021 study published in the journal Nature that concluded: “As expected, we found that a fast rate of vaccination decreases the probability of emergence of a resistant strain,” and that “a period of transmission reduction close to the end of the vaccination campaign can substantially reduce the probability of resistant strain establishment.”
A final objection to vaccines is that the death rate from COVID-19 is so low that it’s not worth the risk of getting vaccinated. As of August 12th, 2021, 619,723 Americans have died out of the 36,446,791 reported COVID-19 cases, or 0.017. Compare that to the aforementioned worst-case vaccine death total (which is probably an order of magnitude too high) of 6,490 out of the 346 million vaccine doses, or 0.000018. That’s three orders of magnitude lower. If a person’s house is on fire they don’t stop to worry about the possible consequences of inhaling fine particles from the fire extinguisher chemicals. In other words, get vaccinated!
So, with all this information a few keystrokes or TV remote clicks away, why on Earth isn’t everyone clamoring to get vaccinated?
2. The politics of vaccination
A hint was on display in the first week of August, when a 31-year-old unvaccinated man named Daryl Baker was hospitalized by COVID-19. Asked to explain his reasoning by a local TV crew, with his wife and six-year-old son looking in through a window, he said, “I was strongly against getting the vaccine … because we’re a strong conservative family. But that little boy out there is a reason to have the vaccine.” Well, quite.
Then there is the “I’m unbreakable” belief, an example of which can be found in Travis Campbell, a 43-year-old man hospitalized by COVID-19 and now pleading on social media: “We just thought we were invincible and we weren’t going to get it. I’m testifying to all my bulletproof friends that are holding out, it’s time to protect your family.” He added “I have never been this sick in my life! My whole family has COVID. I truly regret not getting the vaccine … I’m over the stupid conspiracies. It’s time to be rational and protective.”
As of this writing, Baker and Campbell are recovering. But an unvaccinated 45-year-old Texas Republican official named H. Scott Apley succumbed to the disease five days after attacking vaccines on his Facebook page. He is survived by his widow Melissa and their infant son Reid. This entirely avoidable tragedy occurred after Apley invited people to a “mask burning” party at a bar, compared mask mandates to Nazism, described a program intended to incentivize vaccination as “disgusting,” and responded to Baltimore health commissioner Leana Wen’s announcement about the Pfizer vaccine’s stunning efficacy with this tweet: “You are an absolute enemy of a free people, #ShoveTheCarrotWhereTheSunDontShine.”
When I shared Apley’s story on Twitter, I proposed that “Instead of dancing on his grave for being an anti-vaxxer, let’s work toward encouraging the vaccine hesitant to hesitate no longer. Conservatives: family values include protecting your family from deadly viruses and staying alive for them.” A Kaiser Family Foundation study ranking vaccination rates and views by demographic group, placed Democrats at the top, with 86 percent having received at least one dose, and Republicans near the bottom, with only 52 percent at one dose. Astonishingly, 23 percent—more than one-in-five—of Republicans say they will “definitely not” get vaccinated.
The Skeptic Research Center recently collaborated with Dr. Kevin McCaffree and Dr. Anondah Saide to survey over 3,000 Americans on their beliefs and attitudes on 29 different conspiracy theories. Our study found a moderate-to-large correlation between the belief that “Political and medical elites are hiding the truth about the harmful role of vaccines in causing autism in children” (an older conspiracy theory) and belief that “COVID-19 was developed in a Chinese lab and Chinese officials have covered it up” (r = .39). It also found large correlations between that older conspiracy theory and belief that “5G cell phone towers reduce our immune function and increase our risk of COVID-19 infection” (r = .60), “The COVID-19 vaccine contains tiny computer chips to help make government surveillance of people easier” (r = .63), and that “Political and medical elites are hiding the truth about how the COVID-19 vaccines cause magnetic reactions” (r = .69). The only one to show any political difference was the Chinese lab origin conspiracy theory, with Democrats more strongly disagreeing with it, compared to Republicans, who were nearly seven times more likely to agree with it. Encouragingly, most people we asked rejected the conspiracy theory that COVID vaccines cause magnetic reactions, because we made that one up.
Historically, as far back as the late-19th century (the Vaccination Act of 1898 included a “conscience clause” for parents to opt out of vaccination), fears about vaccination have been disproportionately entertained by liberals (a recent holotype is Robert F. Kennedy Jr., whose anti-vaxxer beliefs are so extreme that his own family felt compelled to disown his views). So, it is disconcerting to see conservatives assume the vaccine hesitancy mantle, especially since Republicans boast about being the pro-life party.
3. What does “freedom” mean in a civil society
At a fundraising event on July 23rd, 2021 sponsored by the Alabama Federation of Republican Women, Representative Marjorie Taylor Greene (R-Ga.) said this from the podium: “You lucky people here in Alabama might get a knock on your door because I hear Alabama might be one of the most _un_vaccinated states in the nation.” Greene is not known for being a stickler on checking facts, but in this case she was right. According to the CDC, Alabama is tied with Mississippi for the lowest percentage of fully vaccinated citizens at only 35 percent. Her remarks produced cheers from the audience, to which she added: “Well, Joe Biden wants to come talk to you guys … What they don’t know is in the South, we all love our Second Amendment rights, and we’re not really big on strangers showing up on our front door, are we?”
A viewer of mine secretly recorded this video of @mtgreenee hinting at using guns to shoot door-to-door vaccinators at an event in Alabama recently pic.twitter.com/cjmUJ8UWI9
— David Pakman (@dpakman) August 3, 2021
Greene’s barely veiled suggestion that citizens take up arms against public health officials is surely rhetoric meant to swell campaign coffers, but the incident illuminates a deeper explanation for vaccine hesitancy—a misplaced understanding of freedom. When the Biden administration announced its plan to require federal employees to either get vaccinated or obtain regular negative COVID tests, Larry Cosme, president of the Federal Law Enforcement Officers Association, expressed this misunderstanding of freedom as follows: “Forcing people to undertake a medical procedure is not the American way and is a clear civil rights violation no matter how proponents may seek to justify it.”
No it isn’t. As the appellate attorney Chris Truax explains, “Every school district in every state in America requires children to be vaccinated to attend public schools. Most states offer exemptions in some cases … But there is no question that states and school districts have the legal authority to demand that school children be vaccinated.” Truax tracks the legality of vaccine mandates back to 1905, when the US Supreme Court determined in Jacobson v. Massachusetts that “mandatory vaccinations were perfectly constitutional and an important tool of public health. Henning Jacobson, an early anti-vaxxer, refused to be vaccinated for smallpox. Just like anti-vaxxers do today about the COVID vaccine, he argued that the smallpox vaccine didn’t work.” The court determined otherwise, siding with “high medical authority” that vaccines do, in fact, work.
What about the freedom of choice protected by the Constitution? “We are unwilling to hold it to be an element in the liberty secured by the Constitution of the United States,” the justices held, “that one person, or a minority of persons, should have the power thus to dominate the majority when supported in their action by the authority of the State.” Otherwise, they concluded, “the spectacle would be presented of the welfare and safety of an entire population being subordinated to the notions of a single individual.” As the preamble to the US Constitution makes clear:
We the People of the United States, in Order to form a more perfect Union, establish Justice, insure domestic Tranquility, provide for the common defence, promote the general Welfare, and secure the Blessings of Liberty to ourselves and our Posterity, do ordain and establish this Constitution for the United States of America.
Pandemics can decimate a population—historically, between 10 and 50 percent of entire populations have been killed by plagues.8 That certainly qualifies as a threat to our domestic tranquility and general welfare. After all, it’s hard to be free when you’re dead. Civil society is based on the fundamental premise that we give up certain liberties to secure tranquility, defense, welfare, and greater liberty, such as the freedom from fatal diseases. To paraphrase a classic libertarian line, the freedom to sneeze and cough your virus ends at my nose.
We all gladly give up the freedom to drive on any side of the road we want for the security of relatively safe passage on our highways. We routinely agree to and abide by laws regulating the safety of food, drugs, trains, planes, and automobiles, so that we can eat, travel, and medicate with confidence. And while I wouldn’t say we are all happy to give up our hard-earned money through taxation so that the government can fund a public sanitation system that reduces the risk of us dying through communicable diseases, most of us recognize the economist Thomas Sowell’s trenchant observation that “There are no solutions. There are only trade-offs.”9
With this understanding of the underlying motivations of vaccine hesitancy, we can solve the collective action problem of ending the pandemic in the simplest and safest way possible: Get vaccinated!
Michael Shermer is the publisher of Skeptic magazine, host of The Michael Shermer Show podcast, and a presidential fellow at Chapman University. He is the author of Why People Believe Weird Things, The Believing Brain, The Moral Arc, and Heavens on Earth. His latest book is Giving the Devil His Due. His next book is on conspiracies and conspiracy theories. You can follow him on Twitter @michaelshermer.
Feature image: Melbourne, Australia. 20th Feb 2021. Anti-vaccination protesters gather in Fawkner Park to condemn the coronavirus jab in the name of medical freedom. Jay Kogler/Alamy Live News
References
1 Two recent summaries of the research on the psychological underpinnings of science denial include: Science Denial: Why it Happens and What to Do About it by Gale M. Sinatra and Barbara K. Hofer (Oxford University Press, 2021) and How to Talk to a Science Denier by Lee McIntyre (MIT Press, 2021)
2 Mistakes Were Made but Not by Me by Carol Tavris and Elliot Aronson (Houghton Mifflin Harcourt, 2007)
3 Gilbert, A. N., A. J. Fridlund, and J. Sabini, J. 1987. “Hedonic and Social Determinants of Facial Displays to Odors.” Chemical Senses, 12, 355–363.
4 Ito, T. A., Larsen, J. T., Smith, N. K., & Cacioppo, J. T. 1998. “Negative Information Weighs More Heavily on the Brain: The Negativity Bias in Evaluative Categorizations.” Journal of Personality and Social Psychology, 75, 887–900.
5 Brickman, P., Coates, D., & Janoff-Bulman, R. 1978. “Lottery Winners and Accident Victims: Is Happiness Relative?” Journal of Personality and Social Psychology, 36, 917–927.
6 Cahill, C, Llewelyn, S. P., & Pearson, C. 1991. “Long-Term Effects of Sexual Abuse which Occurred in Childhood: A Review.” British Journal of Clinical Psychology, 30, 117–130.
7 The Emotions by Nico H. Frijda (Cambridge University Press, 1986)
8 Plagues and Peoples by William H. McNeill, (New York: Anchor Books, 1976)
9 A Conflict of Visions: Ideological Origins of Political Struggles by Thomas Sowell (William Morrow, 1987)
No evidence ivermectin is a miracle drug against COVID-19
By BEATRICE DUPUY December 11, 2020
CLAIM: The antiparasitic drug ivermectin “has a miraculous effectiveness that obliterates” the transmission of COVID-19 and will prevent people from getting sick.
AP’S ASSESSMENT: False. There’s no evidence ivermectin has been proven a safe or effective treatment against COVID-19.
THE FACTS: During a Senate hearing Tuesday, a group of doctors touted alternative COVID-19 treatments, including ivermectin and the anti-malaria medication hydroxychloroquine. Medical experts have cautioned against using either of those drugs to treat COVID-19. Studies have shown that hydroxychloroquine has no benefit against the coronavirus and can have serious side effects. No evidence has been shown to prove that ivermectin works against COVID-19.
Dr. Pierre Kory, a pulmonary and critical care specialist at Aurora St Luke’s Medical Center in Milwaukee, described ivermectin as a “wonder drug” with immensely powerful antiviral and anti-inflammatory agents at the hearing before the Senate Homeland Security and Governmental Affairs Committee.
Clips of Kory’s comments on ivermectin during the hearing were shared widely on social media with one clip receiving more than 1 million views on YouTube.
Ivermectin is approved in the U.S. in tablet form to treat parasitic worms as well as a topical solution to treat external parasites. The drug is also available for animals. The U.S. Food and Drug Administration and the National Institutes of Health have said that the drug is not approved for the prevention or treatment of COVID-19. According to the FDA, side effects for the drug include skin rash, nausea and vomiting.
Dr. Amesh Adalja, an infectious disease expert at Johns Hopkins University, said most of the research around ivermectin at the moment is made up of anecdotes and studies that are not the gold standard in terms of how to use ivermectin.
“We need to get much more data before we can say this is a definitive treatment,” he said. “We would like to see more data before I recommend it to my patients.”
Kory told the AP that he stands by the comments he made at the hearing, saying that he was not trying to promote the drug but the data around it.
In June, Australian researchers published the findings of a study that found ivermectin inhibited the replication of SARS-CoV-2 in a laboratory setting, which is not the same as testing the drug on humans or animals. Following the study, the FDA released a letter out of concern warning consumers not to self-medicate with ivermectin products intended for animals.
“It is a far cry from an in vitro lab replication to helping humans,” said Dr. Nasia Safdar, medical director of infection prevention at the University of Wisconsin-Madison Hospital.
The discussion about the drug in the Senate hearing has some experts worried that Americans will start buying up ivermectin out of desperation. Despite a majority of evidence showing hydroxychloroquine is not an effective COVID-19 treatment, there was a rush on that drug earlier this year after President Donald Trump called it a cure. That depleted supply for those who needed the medication to treat lupus and other conditions.
In March, an Arizona couple attempted to self-medicate and took chloroquine phosphate, an additive used to clean fish tanks that is also an ingredient in hydroxychloroquine. The woman became gravely ill and the man died.
“If there is one thing we have learned in the pandemic is that we cannot jump the gun as far as determining or making assumptions about the effectiveness of potential agents,” Safdar said.
This is part of The Associated Press’ ongoing effort to fact-check misinformation that is shared widely online, including work with Facebook to identify and reduce the circulation of false stories on the platform.
Rebellion is in the air. On November 17 of last year, the “Gilet Jaunes” movement spontaneously erupted in France, in reaction to a planned tax on diesel fuel. Over 300,000 people took part in demonstrations across France, with actions ranging from blocking roundabouts to vandalizing banks, shops and luxury vehicles. As I write these words, the movement is still holding demonstrations across France every Saturday.
Almost as spontaneously, a youth movement calling itself Extinction Rebellion came into being in the UK, and held its first “Rebellion Day” on the same day that the Gilet Jaunes first shook France. This initial action, which blocked London’s five main bridges, was much smaller and lower key than the Gilet Jaunes protests, but by April 2019, non-violent civil disobedience protests brought large sections of London to a halt, and resulted in the arrest of over 1,000 demonstrators.
These movements are superficially diametrically opposed: one was provoked by measures to address climate change, the other is demanding action on climate change. However, they are united by one key detail. The policy action that the Gilet Jaunes oppose, and the policy inaction that Extinction Rebellion deride, are both the products of economists—and most specifically, the economist who was awarded the Nobel Prize in Economics for his work on Climate Change, William Nordhaus.
The Gilet Jaunes rebellion was sparked by the proposed introduction of a carbon tax on diesel fuel—and this is precisely the method that Nordhaus and most economists recommend to use to combat Climate Change.
Extinction Rebellion was sparked by the failure of policymakers to do anything substantive to prevent Climate Change, and are demanding policies that would cause net CO2 emissions to fall to zero by 2025:
Government must act now to halt biodiversity loss and reduce greenhouse gas emissions to net zero by 2025…
The truth is that the climate and ecological emergency poses an unprecedented existential threat to humanity and all life on Earth.
Rapid, unprecedented changes to many aspects of human life – energy use and supply, transport, farming and food supply, and so on – are now needed to avert global climate and ecological catastrophe.
Globally governments have been unwilling to tackle a problem of this magnitude. In 2015, the UN Paris Agreement on Climate Change was signed by world leaders to limit global warming to 2°C above pre-industrial levels. However, scientific evidence now tells us that our leaders have not taken enough action and we are still on a path to reach 3-4°C, which will be catastrophic to all life on Earth. https://rebellion.earth/the-truth/demands/, May 3rd 2019
Nordhaus agrees that man-made Climate Change is happening—he is not a “Climate Change Denialist”. However, his research actually encourages policymakers not to take the action that Extinction Rebellion demands, or anything like it. He instead recommends managing Global Warming so that the Earth’s temperature will stabilize at 4 degrees above pre-industrial levels in the mid-22nd century.
Nordhaus also argued that the policy Extinction Rebellion recommends, of restrict Global Warming to 1.5 degrees—even if it is done over the next century, rather than the next six years as Extinction Rebellion demands—would cost the global economy more than 50 trillion US dollars, while yielding benefits of well under US$5 trillion.
How is it possible that the optimal temperature for the planet is 4 degrees above pre-industrial levels—and that damages from that level of warming would amount to under 10% of global GDP—when it would also be “catastrophic to all life on Earth”? How is it possible that Global Warming of 1.5 degrees would reduce global GDP by a few trillion US dollars—less than 5% of what it would have been in the absence of Global Warming—while the policies to achieve that limit, even if executed over a century rather than just five years, would cost over ten times as much?
It isn’t. Instead, either Extinction Rebellion’s claims are vastly overblown, or Nordhaus’s estimates of the economic damages from Global Warming drastically understate the dangers.
Both are possible, of course. But categorically, Nordhaus’s estimates of the potential economic damage from Global Warming are nonsense. They are also one of the key reasons why policymakers have not taken the threat seriously. If Extinction Rebellion is going to make policymakers take Climate Change seriously, then one of their first targets must be Nordhaus and his DICE model.
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