MythBusters of the Covid Vaccine By Karen Schaeffer, MD, & Ellie Carmody Stone, MD, MPH
With facts and rumors swirling about the new vaccines on the market combatting Covid-19, we present to you six common misconceptions along with the true facts behind the vaccines.
Myth #1: I can get Covid from the vaccine.
The Facts: The coronavirus vaccines cannot give you Covid-19. There are several different types of vaccines in use for other viruses. Live vaccines, like those for polio or varicella (chicken pox), are weakened versions of the virus itself. In very rare circumstances, these can be reactivated and cause or spread the disease.
The Covid vaccines are very different. These vaccines do not contain a live virus. Current vaccines in distribution work by delivering the messenger RNA (mRNA) strand that codes for a piece of the Covid “spike” protein to our body’s cells. Our cells then use this genetic template, or instruction manual, to make the spike protein piece using the body’s own cellular machinery. The protein is displayed on the cell surface, where it is recognized by the immune system, and we begin to generate immunity and make antibodies, similarly to what happens in natural infection with Covid-19. If your body sees this protein again (i.e. if you get exposed to Covid-19 in the future), your antibodies and other branches of your immune system would protect you.
Myth #2: The Covid vaccine has not been tested enough to prove it is safe.
The Facts: All vaccines receiving authorization in the United States have been tested in preclinical, phase I, II and III trials to determine safety and efficacy. This sequence upholds the gold standard for testing of new vaccines and medications in the field of medicine. Phase III trials have blinded, placebo-controlled, randomized controlled trials, constituting the highest standard of clinical research methods. These trials have each involved over 30,000 participants for each vaccine candidate, conforming to the number necessary to carefully observe adverse event (side effect) patterns and determine efficacy with a confident level of precision. Multiple layers of scientific review have ensured us that research results are valid and trustworthy.
with all vaccines, allergic reactions to the Covid-19 vaccines do occur, but these appear to be rare. Like any other medication that comes out, more information will be gathered over the next year or so as millions of people receive these vaccines to ensure their continued safety. The important thing to remember here is that the risks of allergy or long-term side effects from the vaccines are very low, but the risks and long-term effects of getting coronavirus are known and significant, including lung damage, permanent loss of sense of smell or taste, cognitive changes, vascular damage, and even death.
Myth #3: If I have had Covid, I do not need to get the vaccine.
The Facts: We don’t know how good our body is at creating a long-lasting immune response to Covid-19 infection. Some people create a robust immune response, whereas others do not. Some people have clearly gotten Covid-19 more than once. The large Phase III trials of U.S.-authorized Covid-19 vaccines included some people with prior evidence of SARS-CoV2 infection. Evidence of prior SARS-CoV2 that hadn’t been known to study participants was discovered by checking antibodies on the first day that they were enrolled and received their first injection. Among these with prior SARS-CoV2, fewer cases were detected in the vaccine group than the placebo group, suggesting that these vaccines may reduce the risk of reinfection in those who have already had Covid-19. Since we do not know how long the immune response to natural infection lasts, because the response varies from person to person, and because these vaccines may reduce risk of reinfection, the CDC recommends people who had Covid-19 in the past still get vaccinated.
The CDC does provide the following caveats: Anyone currently infected with COVID-19 should wait to get vaccinated until after their illness has resolved and after they have met the criteria to discontinue isolation. Since current evidence suggests that reinfection with the virus that causes COVID-19 is uncommon in the 90 days after initial infection, people with a recent infection may delay vaccination until the end of that 90-day period if desired.
Myth #4: My community has “herd immunity” so I don’t need to get the vaccine.
The Facts: “Herd immunity” is a term that got thrown around a lot at the beginning of the pandemic. The idea of herd immunity is if enough people are immune to the virus, the virus can’t continue to circulate. If the virus can’t maintain a toehold in a community, even those who don’t have antibodies are protected by the community’s (i.e., the herd’s) overall immunity. The problem with this reasoning is simple: we have not yet reached the level required to achieve herd immunity. Earlier in the pandemic, some mathematical models estimated that around 30% of people would need to possess immunity to provide herd immunity. Now that we know more about the virus, most estimates are that herd immunity would be reached when 70-80% of individuals are immune, either by having had the virus already or by being vaccinated against it. It is also important to know that “herd immunity” does not mean that everyone in the community is completely protected, even though that may be the goal. Because of this, it is not sufficient to rely on “herd immunity” to protect you unless you cannot be vaccinated, such as someone with a known allergy to something in the vaccine or if you would not form an adequate immune response with the vaccine due to an immune deficiency.
Myth #5: The Covid vaccine causes infertility and miscarriages.
The Facts: There is no evidence that the Covid vaccine affects fertility. The Covid vaccine uses our own cell machinery to create the single spike protein shared by the Covid virus. If this protein caused infertility or miscarriages, the Covid virus itself would cause these, which it does not. As does the Covid virus itself, the vaccine contains a short part of an amino-acid sequence shared by syncitin-1, a protein important in placental attachment. But the spike protein and syncitin-1 are not remotely the same protein. The antibodies produced against the Covid-19 spike protein will not block syncitin-1, as it is not at all similar enough for the antibodies to recognize. We have not seen an increase in first-trimester pregnancy losses in those with Covid-19 infection, suggesting that there is no association between antibody to spike protein and placental attachment. In the vaccine trials, there were pregnancies that occurred, and these happened at similar rates between the vaccine and placebo groups. This lends further evidence that the vaccine has no association with fertility.
The American Society of Reproductive Medicine has published a statement supporting the use of the vaccine in women trying to become pregnant and in women undergoing fertility treatments.
Myth #6: The vaccine changes your DNA.
The Facts: The Covid vaccine uses a molecule called mRNA (messenger RNA), which, while related to DNA structurally, does not actually get anywhere near our DNA. It is not DNA even though the words are similar.
We actually have lots of mRNA in our own bodies. Our DNA is packaged off in the nucleus of our cell. RNA is like the imprint of DNA. When our body wants to make proteins, it copies one piece of DNA into a strand of RNA which is removed from the nucleus. Outside of the nucleus, this RNA gets turned into proteins. This vaccine delivers the mRNA into this outside portion of cells, and it gets turned straight away into proteins. It does not interact with, integrate into, edit, or alter our DNA.
Here’s to wishing all those who are ill a complete and speedy recovery and a refuah shelaima.
Karen Schaeffer MD and Ellie Carmody Stone MD, MPH are members of the Jewish Orthodox Women’s Medical Association (JOWMA).
For more information about Covid-19 and the Covid vaccine, check out JOWMA’s Preventative Health Podcast, available on all major podcast platforms. Or call the JOWMA Preventative Health hotline at 929-443-9868.
Karen Schaeffer, MD, is a surgical intern at Tulane University. She also writes for NoiseFilter Podcast which posts daily updates on Covid-19 and helps to promote access and understanding of news about the pandemic.
Ellie Carmody, MD, MPH is an Assistant Professor, Division of Infectious Diseases at NYU School of Medicine. She serves as Director of the Infectious Diseases Clinic at NYC Health + Hospitals / Bellevue.