How do I approach discussing vaccine hesitancy with friends and/or family?

Vaccine concerns are understandable, and acknowledging and respecting this is important.  Most people are simply trying to make the best decisions for themselves and their loved ones.  

Ask your friend about the nature of their concerns – to better understand where they are coming from and to be able to provide the most helpful information and resources.

Some information that can be offered for the most common vaccine concerns:

• “I’m worried about rushed vaccine development” 
• • It is remarkable how quickly modern science has been able to respond to COVID-19 vaccine needs.  
  • But vaccine development really hasn’t been rushed.  Identifying that the spike protein is the target of the coronavirus and making vaccine with spike proteins began in 2003 after the first SARS, so this has actually been a 17-year vaccine development program, supported by the US National Institute of Health (NIH) initially.
  • Vaccine developers didn’t skip any testing steps, but conducted some of the steps on an overlapping schedule to gather data faster.
  • Vaccine projects had plenty of resources, as governments invested in research and/or paid for vaccines in advance.
  • Some types of COVID-19 vaccines were created using messenger RNA (mRNA), which allows a faster approach than the traditional way that vaccines are made.
  • Social media helped companies find and engage study volunteers, and many were willing to help with COVID-19 vaccine research.
  • Because COVID-19 is so contagious and widespread, it did not take long to see if the vaccine worked for the study volunteers who were vaccinated.
  • Companies began making vaccines early in the process — even before FDA authorization — so some supplies were ready when authorization occurred.
• “How do I know mRNA COVID-19 vaccines won’t mess with my DNA?”
  • mRNA is not able to enter the cell’s nucleus, where your DNA is stored.  It has no ability to change your DNA in any way.  A closer look at how the COVID-19 mRNA vaccines work can help explain this:
    • COVID-19 mRNA vaccines give instructions for our cells to make a harmless piece of what is called the “spike protein.” The spike protein is found on the surface of the virus that causes COVID-19.
    • First, COVID-19 mRNA vaccines are given in the upper arm muscle. Once the instructions (mRNA) are inside the immune cells, the cells use them to make the protein piece. After the protein piece is made, the cell breaks down the instructions and gets rid of them.
    • Next, 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.
    • At the end of the process, our bodies have learned how to protect against future infection. The benefit of mRNA vaccines, like all vaccines, is that those vaccinated gain this protection without ever having to risk the serious consequences of getting sick with COVID-19.
• “How do I know the vaccine won’t cause problems with fertility?”
  • The COVID-19 vaccine does not affect fertility. According to Hopkins Medicine, confusion arose when a false report surfaced on social media, saying that the spike protein on this coronavirus was the same as another spike protein called syncitin-1 that is involved in the growth and attachment of the placenta during pregnancy. The false report said that getting the COVID-19 vaccine would cause a woman’s body to fight this different spike protein and affect her fertility. The two spike proteins are completely different and distinct, and getting the COVID-19 vaccine will not affect the fertility of women who are seeking to become pregnant, including through in vitro fertilization methods. During the Pfizer vaccine tests, 23 women volunteers involved in the study became pregnant, and the only one who suffered a pregnancy loss had not received the actual vaccine, but a placebo.1
  • Getting COVID-19, on the other hand, can have potentially serious impacts on pregnancy and the mother’s health.
• “I’m young and healthy – if I’m low risk for severe COVID symptoms, why should I take on the risk of vaccine side effects?”
  • Unpredictability of severe disease and death: Even if you are young and don’t have any chronic health conditions, the effects of COVID-19 are unpredictable.  Compared to 5-17 year-olds (with the lowest death rate due to COVID-19 – 1 in 500,000), 18-29 year olds have a 6x higher hospitalization rate and 10x higher death rate, and 30-39 year-olds have a 10x higher hospitalization rate and 45x higher death rate.1, 2  Young, healthy people still get very sick, and some die, unnecessarily, from this disease.
  • Long-term symptoms are very common and can be debilitating, even in mild cases. There is a lot of evidence regarding prolonged, debilitating symptoms from COVID-19 infection.  Even if your illness was mild, studies are finding that up to 20% of patients experience bothersome symptoms three months or more after the onset of COVID-19 — even after tests no longer detect virus in their body.  And for those with more significant disease, up to 75% of patients experience long-term bothersome symptoms, some with quite prolonged and debilitating fatigue and respiratory complaints.  Among 1733 patients in one study who were discharged from the hospital and followed up six months later, the most common symptoms were fatigue or muscle weakness (63%), sleep difficulties (26%), and anxiety or depression (23%).
  • Reduce asymptomatic spread: Young adults are the most common asymptomatic carriers of the virus.  Your immunization goes far in protecting your loved ones and your community.
• “These vaccines are new – there just isn’t enough known about long-term side effects for me to feel comfortable.”
  • 212 million doses of COVID-19 vaccine have now been administered in the US, with continuous monitoring programs constantly searching for early warning safety signals.  The first major safety signal after months of vaccinations emerged only last week, with 6 reported cases of cerebral venous sinus thrombosis occurring between 6-13 days after vaccination with the J&J vaccine (0.000088% of recipients).  A causal relationship with the J&J vaccine is still under investigation.  In comparison, the incidence of developing significant blood clots as a result of COVID-19 infection itself is quite high – up to 30% of those hospitalized in the ICU and 8% of those hospitalized with moderate symptoms.
  • Most vaccine side effects occur within the first 2 days and are minor and expected as your immune system mounts a response.  Decades of evidence from many other vaccines tell us that any delayed effects following vaccination are rare, typically occur due to live vaccines (which the current COVID-19 vaccines are not) and typically occur within 2 months if they occur at all.
  • There is a lot of emerging evidence regarding prolonged, debilitating symptoms from COVID-19 infection.  Even if your illness was mild, studies are finding that up to 20% of patients experience bothersome symptoms three months after the onset of COVID-19 — even after tests no longer detect virus in their body.  And for those with more significant disease, up to 75% of patients experience bothersome symptoms, some with quite prolonged and debilitating fatigue and respiratory complaints.  Among 1733 patients in one study who discharged from the hospital and followed up about six months later, the most common symptoms were fatigue or muscle weakness (63%), sleep difficulties (26%), and anxiety or depression (23%)

A few helpful resources:

• https://www.hopkinsmedicine.org/health/conditions-and-diseases/coronavirus/covid-19-vaccines-myth-versus-fact
• https://www.instagram.com/unbiasedscipod/

Jennifer Abrams, MD, April 20, 2021