Thank you for reading this. First of all, I want you to know that I understand your confusion, your fear and your reservations about the vaccines. This is complicated stuff and unfortunately, there are people who are intentionally trying to mislead people and others who are not intending to pass along false information, but doing so because they themselves have been mislead or lied to.
Unfortunately, some have promoted a false narrative for political gain, while having access to testing that the general public does not have, while having access to medical care and medications that many in the general public do not have access to and while getting vaccinated, often before much of the general public had access to vaccines, and then being unwilling to admit that they have been vaccinated or unwilling to answer the question as to whether they have been vaccinated. It was easy for them to promote doing away with public health protections or downplaying the pandemic, when they themselves knew they had far more protection than most of their constituents.
So, let me provide full transparency about me:
- I am a life-time Republican. I am a fiscal conservative. When it comes to managing a public health emergency, I do not support Republican or Democratic leaders; I support my country, my state, science, truth and leading by example. If leaders do the same, I will praise them. If leaders don’t, I will criticize them regardless of their party affiliation.
- I am retired. I am not financially impacted by whether anyone gets a test or does not, whether they are hospitalized or not, or whether they are vaccinated or not.
- I receive no payments from any pharmaceutical company and never have, even while I was in medical practice.
- To my knowledge, I do not have any stock in any pharmaceutical companies. The reason I qualify this is that I do have mutual funds that are managed by others. If they do invest in a pharmaceutical company, I am not aware of it and I couldn’t tell you which one.
- I currently serve on the Governor’s Coronavirus Work Group, but I receive no compensation for that role.
- I have advised the West Ada School District in the past, but despite their offer to compensate me for my time, I declined it.
- I have received two doses of the Moderna vaccine. Some of my family members have received Moderna and others have received Pfizer.
- I have no intention of running for any elected office. I have had people ask me to serve on the Central District Health Board, school boards and to run for governor. I have declined each.
My motivations for spending so much time in so many different ways to try to help our state through this pandemic and provide people that are interested with good information is (1) I am a Christian and I believe that the Bible teaches us that we should care for one another and put others ahead of ourselves; (2) I am a physician and it pains me to my core to see needless illness, suffering and death; and (3) I am an American and an Idahoan and I want to see our country and state prosper.
Now, I know a lot of people have made their minds up, are not open to discussion and get upset when people discuss vaccination. This article is not intended for that audience. On the other hand, I have spoken with dozens of people who are somewhat skeptical and some that are very skeptical. I have listened to their concerns and answered their questions the best that I could. The vast majority of these folks have followed up with me and indicated that they did go ahead and get vaccinated after our discussions. So, I am going to share some of those questions and my answers below, because it is likely that if they had these questions or concerns, there are others with the same questions or concerns.
- Concern: The vaccines are experimental.
Response: The Pfizer, Moderna and J&J vaccines are not experimental. Vaccine opponents have carefully selected words that are calculated to provoke an emotional and negative response from those they hope to influence. Labelling the vaccines “experimental” is intended to scare people. The clinical trials for these vaccines were conducted last year. At that time, they were experimental. These vaccines are no longer considered experimental by physicians, scientists, the FDA and the courts, where plaintiffs unsuccessfully asserted that the vaccines were experimental.
In the United States alone, about 340 million doses of vaccine have been administered. The Pfizer vaccine is being used by 111 countries. The Moderna vaccine is being administered by 61 countries. The J&J vaccine is being administered in 33 countries. If these vaccines were experimental, these would be the largest clinical trials ever conducted, a reason to trust them even more.
So, if you decide not to be vaccinated, at least do not use the false narrative that the U.S. vaccines are “experimental” as your reason.
2. Concern: We don’t have long-term studies on the safety of vaccines.
Response: Minor vaccine reactions (sore arm, redness at the injection site, fever, aches and rashes) generally occur within hours to a few days, but almost always occur within 12 days of vaccination. Serious vaccine reactions usually manifest themselves within hours to days, and almost always within 35 days of the vaccination. Thus, the FDA required a minimum of two months of safety data prior to issuing Emergency Use Authorization for the vaccines.
Because of the size of the trials, the studies were designed to identify adverse effects of the vaccines that occur at the rate of at least 1 in 30,000 or 1 in 40,000 people vaccinated. However, the FDA has continued to monitor the safety of vaccines following the grant of Emergency Use Authorization, such that now we are identifying adverse effects that occur at a rate of 1 in a million or 1 in 10 million vaccinees.
Keep in mind, that we have administered about ten times more COVID vaccines than the number of all other vaccines that we administer in an average year in the U.S. Thus, we don’t need longer term data to identify adverse effects in adults and any adverse effects that we do identify as we have additional time to vaccinate more people will be events that occur at extraordinarily rare levels. Keep in mind, while there have been rare serious adverse events reported with the COVID vaccines, these have largely been events that occur at much higher frequency in those who become ill with COVID.
As we are seeing a surge in new cases across the country due to delta, if you choose not to be vaccinated, at least do not be misled by claims that we need more data or longer-term studies to assess the safety of these vaccines. We have all the data that we need to make a safety assessment of these vaccines, and in every case, the FDA, the CDC, the Advisory Committee on Immunization Practices, and public health and infectious disease experts have concluded that the benefits outweigh the risks.
3. Fear: I don’t want to get the vaccine because I am scared of the side effects.
Response: I can certainly understand this. Most people, like my wife, have very mild side effects. Some, like me, have 1 – 3 days of feeling ill or like they have the flu. Obviously, no one wants to go through these side effects, but again, one should compare the potential side effects to the potential illness with COVID. While many people with COVID have mild symptoms, there are others who experience extreme distress and require hospitalization and some will require a ventilator to breathe for them.
4. Confusion: I am young and healthy, so I don’t need to be worried about getting COVID.
Response: I can certainly understand this sentiment. The fact that you are young and healthy does mean that you are very unlikely to die from COVID. On the other hand, there are many bad things that can happen to you even if you survive. The adverse effects that many fear with the vaccines occur far more often in people who are ill with COVID. With the alpha and now the delta variants, hospitals across the country and world have reported having younger people hospitalized, as well as in the ICU, including young adults in their twenties, thirties and forties. We also see up to a third of young people developing long-COVID following infection, even when that infection was mild. These are often young adults who were active and fit, who are experiencing severe limitations to their activity and exercise tolerance months following the infection.
So, even if you remain unconvinced that the benefits of vaccination outweigh the risks of COVID, please get vaccinated to lessen the possibility that you will infect someone you know and care about who might be at much higher risk for a severe outcome if they get infected.
5. Confusion: I had COVID, so I don’t need the vaccine.
Response: While having COVID does provide some degree of immune protection against re-infection for most, but certainly not all, persons, there is growing evidence that the degree of immune protection is inferior to that provided by vaccines. As we see more and more variants of concern, we have less and less confidence that natural infection will provide people the same degree of immune protection that the vaccine will. Therefore, we recommend that everyone who has previously had COVID get vaccinated once they recover from their illness.
6. Confusion: I can wait and then if I get sick, I can get vaccinated.
Response: This is incorrect. First of all, we do not vaccinate people against COVID who are sick from any infection. Secondly, if you are sick with COVID, it is too late for the vaccine to prevent you from becoming severely ill. The vaccine takes at least a week to produce the kind of immune response that we are looking for. While with previous variants and strains of the virus, even a single dose of vaccine would produce a significant amount of protection, with delta, we are finding that a single dose provides very little protection. Because both doses are required to achieve a robust immune response, we are generally looking at a period of 4 – 6 weeks from the first dose of the series until someone will be maximally protected against the delta variant.
So, if I am persuading you to get vaccinated, please do so ASAP and be sure to go back for your second dose as soon as it is time for it.
If one of the things holding you back from getting vaccinated is the thought that you have time and can get it once you get sick, please know that it is likely it will be too late by then. Please get protected now.
7. Concern: Some are concerned that vaccine “breakthroughs” mean that the vaccines don’t work.
Response: Vaccine breakthroughs are expected. We have known since the clinical trials that the vaccines would not be 100% effective, even though they are not far from it. The key is whether the vaccines can prevent severe illness, hospitalization and death. So, look at the deaths in the US from COVID and May and June. More than 99% of them occurred in the unvaccinated. It you look at the fully vaccinated rate in the U.S. of around 50%, you would expect the deaths to be about 50% in vaccinated persons and 50% in unvaccinated persons if the vaccine was not effective. The fact that deaths from COVID among the vaccinated are less than 1% confirms that these vaccines are highly protective, even if some persons get breakthrough infections.
I hope that if I have addressed your concern, you will get your first dose of vaccine this week. If you still have a concern, an unanswered question or a fear that I have not addressed, write a comment and tell me what that concern or question is and I will do my best to get you an answer.
I care about you. I do not want you to get infected or to inadvertently infect someone else. I want life to get back to normal, but we can’t get there if we allow this virus to continue to spread unabated, continuing to develop new and more threatening variants.
76 thoughts on “A Note to Those who are Confused, Afraid or just Uncertain about Whether to Get the COVID Vaccine”
I read everything that you write or tweet and I so appreciate this particular piece. It is an important message. Thank!
Thanks, Bill! I am flattered and that means a lot to me!
Dr. Pate: your honesty is exemplary – this is the single best commentary addressing this. Bravo!
Thank you, Joe! I look forward to talking to you soon!
Dr Pate, thanks so much for the deep dive covering all the questions and concerns from those folks still on the fence about being vaccinated. I am hopeful it will result in more undecided folks getting vaccinated.
Thanks, Jim. So far, between this and my other efforts, I think we have about 25 folks who were waiting that are getting vaccinated now. I am so pleased – it may have saved some of their lives. Be safe!
Thank you Dr. Pate. My husband and I were struggling with the unknowns and did not plan to be vaccinated until we learned more about them from a trusted source. You simply and brilliantly answered every question we had and the fact that you and your family received the vaccinations has us fully on board now! Thanks again!
Awesome! I am so pleased to hear that Please get your first dose ASAP this week. And, send me a note to let me know how everything goes. And, if you have more questions, let me know. Be sure to go ahead and schedule your second dose while you are there for your first to make sure that you get the full series to have the best possible protection against delta.
Thank you for this helpful post. I am primarily hesitant due to the potential for blood clots or other serious adverse effects. Prion disease also worries me. I have read from numerous places that the spike protein in the mRNA vaccines can potentially cause clotting and coagulated blood through the body. Take this article from Northeastern University about spike proteins. If the spike protein in COVID creates blood issues, and the vaccine causes the body to make spike protein, couldn’t this cause major issues?
I would love help sorting through this! I really want a vaccine but am very scared to take it.
I understand. The blood clots are scary. So several points to help you. First, the blood clots have been an issue with the J&J vaccine, but not the mRNA vaccines. Thus, with the hundreds of millions of doses of the mRNA vaccines we have administered (these are the Pfizer and the Moderna vaccines), we have not seen this problem. Further, infection with COVID actually causes a greater frequency of the clots than even the J&J vaccine. So, if you are concerned about blood clots, the answer is to get vaccinated, because you are at far more risk of blood clots with COVID (that is what the article is referencing) than you are with getting vaccinated. And, for your vaccine, choose Pfizer or Moderna and then you don’t even have to worry about blood clots.
Thanks for following the blog and thanks for writing in to me about your concern, a rational concern, but one we can definitely overcome with this information! I hope you will go ahead and get the Pfizer of Moderna first does this week. Let me know if you do. Be safe!
By the way, you don’t need to have any concerns about prion disease. Prion diseases are scary, but they are impossible to get from the vaccine. That is misinformation that some have been peddling, but it is 100% false.
Hi Alyssa. The study you reference was done prior to delta emerging in the U.S. It is true that we saw remarkable protection after a single vaccine dose against the wild-type virus and alpha. However, delta has much more immune evasion capabilities. The efficacy against delta with only a single dose drops down into the 30s. Thus, it is critically important to get the second dose. The new “booster” dose that Moderna is testing sounds like it won’t really be a booster – which is a dose of the same vaccine in order to increase the immune response – but rather a tweak to the vaccine that would be directed at the delta variant. The effectiveness of that “booster” may be dependent upon being fully vaccinated; I just don’t know and we probably won’t know for a couple or several months. I think right now it is dangerous to have only a single dose of the Moderna or Pfizer vaccine and I highly recommend that you go ahead and get your second dose. You can take acetamenophen or non-steroidal antiinflammatory medications if you do have bothersome fever or aches and pains after the second dose. I can almost guarantee that these symptoms are nothing in comparison to what you might experience with COVID. Let me know what you decide! Take care and be safe!
Hi Dr. Pate,
Thank you so much for your response and insight into the already old research I was relying on.
The Delta variant is taking hold in Connecticut and I do plan to get my 2nd dose of Moderna on Friday, as soon as I finish a round of antibiotics for an ear infection. I want to avoid a double dose of ear ringing that I am experiencing from the antibiotics (temporarily I hope) and potentially by the Moderna vaccine.
Some of my anxiety about receiving the 2nd dose of Moderna is because I thought each dose was 100 micrograms (which seemed excessive); but I was mistaken, it is only 50 micrograms each. It makes me feel a little more comfortable that the dosage is only 20 micrograms higher than Pfizer-BioNTech.
Per your recommendation, I have Tylenol on hand to take if I experience any symptoms.
I will continue to avoid crowds and will always wear a mask in public indoor spaces.
Thank you again for your blog and individual responses. You are so wise and helpful!!
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Dear Dr. Pate,
I did get my 2nd dose of Moderna over 6 weeks ago thanks to YOU! Despite my fear and anxiety, I had no side effects except for a little pain at the injection site for a few days.
Would you mind deleting my previous comments (as I don’t know how)? I was confused about vaccine dosages and I worry about confusing your readers. I also don’t want to scare anyone into not getting both doses of the Moderna vaccine as it is highly protective.
At the same time, would you be kind enough to explain the differences in dosage between the Pfizer and Moderna vaccines, and provide your expert opinion as to the differences in efficacy between the two vaccines? And if you have time, I would really love to know your thoughts on the booster shot.
Thank you SO much!
Hi Alyssa. I am so pleased that you did get fully vaccinated. I am not sure I can delete your prior comment, but if I can, I will.
There is a difference in the dosage of mRNA between the two vaccines. They both have very similar efficacy data, but there have been some studies suggesting that Moderna may provide a bit better protection against infection, but that is not our primary objective – our primary objective is prevention against severe disease, and in this regard the two vaccines appear very similar. It could be that the slightly better protection from infection with Moderna is the higher mRNA dose or it could be the slightly greater spacing between the two prime doses. However, based upon what we know today, both vaccines are extremely effective.
There are some who should get boosters. Certainly those with moderate to severe immunodeficiencies or those with moderate to severe states of immunocompromise should get a booster and get it now.
We expect to have a recommendation from the FDA and CDC as to exactly who else should get a booster if they received the Pfizer vaccine in the next week. That same recommendation for Moderna is likely to be coming within a few weeks.
I understand your fear of side effects upon receiving the second dose. I too held this fear until I changed my mindset. I decided to embrace not feeling well. I made soup, picked out some movies to watch, and looked forward to resting for a day or two. I actually began to look forward to my second dose. The only side effect I had was a sore arm. Because I had prepared so well, I was quite disappointed.
That is good to hear! I now have two reports of very minor side effects from Moderna (yours and the other from an acquaintance who also had Covid a few months ago). Prior to a few days ago, I had only heard horror stories about Moderna’s more severe side effects (chills, fever, body aches, diarrhea, ear ringing). I am super sensitive and anxious, so even my experience with a sore arm from the first dose made me nervous. But I can handle that again on the 2nd dose. Thanks so much for writing and making me feel more comfortable.
Dr Pate, thank you for this well researched and well written blog on the important matter of vaccines. Very helpful! I greatly respect and appreciate your leadership.
Thank you, Tracy! And thanks for being a loyal reader of my blog!
Why does it take so long for FDA approval on other vaccines if we have enough data already for the COVID vaccines. I understand we have vaccinated many more people with COVID vaccines, so why doesn’t the FDA gives its approval and take of the “experimental” label?
That is an excellent question and I share your impatience and frustration. The delay is not out of the ordinary, it is just that we are all anxious for it to come. The delay in getting full approval is not because of the efficacy or safety being in significant question. The FDA has more data on these vaccines than on any other medication or vaccine I can think of that they have approved in the past. However, I do think the FDA is aware that the public’s trust in them was somewhat eroded last year by some missteps the FDA and its director made last year, and given the fact that they want to reassure the public about the FDA’s process, I am sure they are being careful and thorough. There are also a lot of other information that the FDA has to establish for the approval that are rather mundane – storage conditions, shelf-life, etc. Simply stated, I don’t think the hold up is a safety concern, it is just that it is a lengthy process even under the best of situations.
Dear Dr. Pate,
Thank you for your article, I hope it convinces others to become vaccinated.
I am vaccinated, with both doses of the Moderna vaccine. I thought it was important for me to be protected, but not only for myself, but for family members who have underlying conditions.
I know this is an mRNA vaccine. I don’t quite understand what that means, so wonder if my own genetic material is affected by this vaccine formulation. Is there any affect on my own DNA/RNA from this vaccine, long term?
Excellent question. No effect, whatsoever. So, mRNA stands for messenger RNA or messenger ribonucleic acid. messenger RNA is something normally in our bodies and we make lots of it. It carries the recipe for making a protein to a factory in the cytoplasm of our cells. Think of a cell like when you crack an egg and empty is into a pan. There is a yolk and that represents the nucleus of the cell. That is where your DNA is. The white part of the egg would represent your cytosol, which is where this machinery is that makes proteins according to the directions provided by the mRNA.
So, with this vaccine, we use messenger RNA and we code the recipe for making the spike protein. The mRNA from the vaccine enters the cell (the egg in our analogy) and it goes into the white part (cytosol), but never enters the yolk where your DNA is. Even if it were the case that it got into the nucleus (the yolk), which it doesn’t; DNA alters the mRNA; mRNA does not alter DNA.
The mRNA from the vaccine tells the machinery in the cytoplasm (white of the egg) to make spike protein; the spike protein is then moved out of the cell (the egg), where it will now stimulate your immune system, because your body does not normally make spike protein and your body’s immune system recognizes it as foreign and something it should attack. This way, you make antibodies and prime certain other parts of your immune system to quickly attack spike protein whenever it sees it again (with an infection) without you ever having had to be infected. The spike protein is not a virus and it can’t cause the infection or cause you to infect anyone else. The mRNA from the vaccine is then quickly destroyed by the body, so it does not hang around. mRNA is actually very fragile and easily destroyed, which is why you have heard about the sub-zero temperatures we have to keep it at and why we have to use up the vial of vaccine the same day we thaw it for use or throw whatever is left away.
So, congratulations on getting vaccinated and don’t spend one more moment worrying about any alterations to your DNA. That is disinformation that some are circulating to try to scare people from getting vaccinated.
Thank you. I’m glad you are well and have a mission in your retirement. My goodness. Lisa Boesen
So good to hear from you. I hope you are well! Thanks for following the blog!
Will side effects be worse if you are not in good health to begin with? Cirrhosis, obesity…?
That is a great question and I don’t have scientific evidence to answer it with, but interestingly, we saw that older individuals were much less likely to have significant side effects than younger people, which leads me to think that someone with the conditions you describe might actually be expected to have fewer side effects. On the other hand, keep in mind that those are the people more likely to develop severe COVID if infected.
I have three concerns with the mRNA vaccines if you don’t mind addressing:
1) I read that it’s best to wait 12 to 18 months from when they started to administer the vaccine (dec 2020) as any long term effect takes about that long to show up. So we will start to see more issues with those that are vaccinated around Nov 2021 to June 2022. Other vaccines have 10 years of long term data.
2) The vaccines can trigger auto immune diseases such as lupus which runs in my family.
3) The vaccine alters and weakens your immune system therefore your body won’t be able to fight other viruses / diseases as it’s only now set up to focus on fighting Covid
These are great questions.
1. This is not correct. In fact, I can’t think of any vaccine where an adverse effect showed up more than 3 months after the date of vaccination. It almost always occurs, if one is going to occur, within 35 days. What whoever told you this might be talking about is that we do see rarer and rarer adverse effects show up over time because of more people being vaccinated. For example, This time last year, we were able to identify adverse effects that showed up at a frequency of 1 in 30,000 or 1 in 40,000, because that is the number of people in the clinical trials. What we are seeing now is adverse effects that show up with a frequency of 1 in a million or 1 in ten million because we have now vaccinated hundreds of millions of people around the world. It is not that an adverse event is occurring 10 months after someone got vaccinated, but that we are finding very rare adverse effects in people recently vaccinated. However, one has to remember that this frequency makes them very rare and most of what we have seen are things that occur with much greater frequency if you do get COVID.
2. We have not seen the vaccines cause lupus, but we have seen rare cases where it produces an autoimmune disorder involving platelet-factor IV. However, this is rare and this is another situation where the same thing happens with COVID infection, but at a much higher rate. Certainly talk to your physician, but generally speaking a family history of lupus would not be a contraindication or even a significant concern to getting vaccinated.
3 This one is categorically false. The vaccine actually strengthens your immune system. Your immune system does not shift its focus from one organism to another, but rather will create special reserves in case they are needed while continuing to fight other invaders. In fact, the opposite is true. If you are not vaccinated against either COVID or influenza or both, an infection with both of these viruses appears to be far more likely to overwhelm the immune systems of the unvaccinated.
Dear Dr. Pate,
I am a patient of Dr. Joe Galatti. I heard about your blog from his newsletter. I am fully vaccinated since April with the Pfizer vaccines. I love your explanations and find them very reassuring. However, I have several family members who are refusing the vaccine and I am very concerned for them.
My biggest concern is for my two grandchildren under the age of 12 who are 3 and 5 and attend school. There is currently no vaccine for them and I worry they could be infected by those who don’t receive the vaccine.
There are two primary reasons my family members won’t be vaccinated that aren’t mentioned in your blog.
1) Think it is a hoax
2) Trying to conceive a child
What are your thoughts on each of these?
Hello from a former Houstonian and I am so pleased you follow Dr. Galatti’s radio show and now my blog!
I share your concerns. Actually, the greatest concern is that the children will get infected and bring it home to unvaccinated adults who have a much higher likelihood of becoming severely ill. It is very sad to see how many children have lost one or both parents since the start of this pandemic.
The first one – it is a hoax – is the hardest. That means that they have shut their minds to all objective information sources. Even many of the folks promoting misinformation and falsehoods believe COVID is real. My only success in this area (and they are few) is trying to find out who they trust who did have COVID – President Trump, Herman Cain, Phil Valentine, etc. There also are some Republican leaders who have gotten vaccinated themselves and who are encouraging others to get vaccinated. So, pointing out that they acknowledge COVID and that they had COVID (Herman Cain died, so he can’t, but Phil Valentine is trying to get the word out that he was wrong while he is still currently hospitalized with COVID) might help.
As for the second, that is much easier. COVID in a pregnant woman clearly leads to more severe disease for the mother and can be a threat to the baby. There is a tragic story in the media about a father who did not take COVID seriously and did not get vaccinated, who got sick, infected his pregnant wife who became critically ill and they lost the baby. The best time to get vaccinated is before you become pregnant.
Thank you for your quick response! I will share your comments!
As it turns out, our daughter is 6 weeks pregnant and that’s why she isn’t getting the vaccine. She thinks she can get it after the first trimester. Is there any data on this? Also, the father refrained from getting the vaccine because he heard it affected fertility. What data is available to support this fear?
She can and should get vaccinated now. The American College of Obstetricians and Gynecologists recommendations state: “ACOG recommends that pregnant individuals be vaccinated against COVID-19. ACOG recommends that lactating individuals be vaccinated against COVID-19.” https://www.acog.org/clinical/clinical-guidance/practice-advisory/articles/2020/12/covid-19-vaccination-considerations-for-obstetric-gynecologic-care. Unfortunately, COVID causes more severe disease during pregnancy, which can threaten the well-being of both mother and baby. If your daughter remains dissuaded from getting vaccinated until her second pregnancy, it is essential that she and any household members sequester themselves to the greatest extent possible. That would mean no visitation with anyone outside of her immediate household, including family members who do not live with her and anyone outside the home, even if vaccinated.
The claims about fertility were based on a theoretical concern expressed by some anti-vaccine advocates in Europe and this misinformation took off once their letter became public. Claims linking COVID-19 vaccines to infertility are unfounded and have no scientific evidence supporting them.
Thank you again! Her doctor recommended waiting till 2nd trimester, not pregnancy. Not sure why. I think there were concerns about the vaccine causing a miscarriage. Any truth to that?
I have not seen any reports of vaccine-induced miscarriages. So far, studies of the Pfizer and Moderna vaccines in pregnant women have not revealed any concerns. Those studies are still underway. It appears that the vaccines are safe in the first trimester, but I can certainly understand her doctor wanting to await the completion of more studies. On the other hand, we do know that COVID has the potential to cause more severe disease in pregnant women. So, lots of things need to be balanced here – does she have other underlying health conditions that might increase her risk further if she were infected? What level of disease transmission is there in the area where she lives? Is she able to work from home and avoid exposures to the virus? Are other household members able to work from home? Are the other household members all vaccinated? Etc. So, until her OB indicates she can get vaccinated, make sure she and any household members are doing everything they can to decrease the risk. Once the OB gives the okay, get vaccinated ASAP, but remember that with delta, she will not be adequately protected until 1 -2 weeks following the second dose, so she still needs to maintain extra protective measures until that time.
Dr. Pate, I am in my 50s and recovering from Covid (thankfully). I never want to experience that again. Now that I’ve had it, do I have to wait 90 days to be eligible for a vaccine? Also, it seems like you prefer mRNA vaccines over the J&J. I really think I want the J&J vaccine because it’s one dose, it seems more like a “traditional” vaccine, and my parents got it and are doing well. I’d love to hear your thoughts. Thank you so much!
I am so sorry that you got infected, but grateful you are recovering.
You do not need to wait 90 days. (That was the guideline last year, and I can explain why if you are interested, but it is no longer the guidance.) We only recommend that you wait at least until your fevers have resolved and you are at least to the point where you would say you are close to fully recovered. We just don’t want to add a vaccine to someone who is still sick from COVID in a significant way.
I am certainly okay with you getting the J&J vaccine and I understand why you would want it. I do prefer the mRNA vaccines (Pfizer and Moderna), especially because we have more data about their effectiveness against delta. So, if it is a matter of you will get vaccinated if it is J&J, but won’t go through it if it is Pfizer or Moderna, then, yes, please get J&J. However, if you are willing to get vaccinated with Pfizer or Moderna, that is what I would do.
Thanks for following the blog! I hope you continue to recover and never have to deal with COVID again!
Thank you for this information. I am a kidney transplant of seven years and I have great kidney function right now. I am concerned with interfering with my kidney. It’s my understanding that transplant patients do not receive the same level of protection as a non-transplant patient. Would you please advise of what your opinion is and any information you may have on this subject. Thanks again!
Congratulations! That is wonderful and a good reminder to all about how important organ donation is.
We do have a few studies done looking at the immune response in those who have had a solid organ transplantation, such as a kidney. It is clear that those who have been transplanted and are on immunosuppressive treatment do not respond as well to the vaccines as those who are not immunocompromised. How poor the response to the vaccine is likely depends upon whether you are on immunosuppressive therapy that primarily suppresses the humoral immune system (antibodies) or the cellular immune system (T-cells) and how high the dosages of the immunosuppressive medications are. Obviously, the worst response is when transplant patients are on medications that suppress both parts of the immune system. Therefore, transplant patients, while we believe are going to have some degree of protection from the vaccines, need to exercise additional layers or protection such as mask wearing, distancing, avoiding large gatherings, etc. Further, the greatest risk may be those who are parents of children who have not been or cannot be vaccinated who will be attending school where the school has decided not to require masks of all students when indoors. One study showed that infected students infected 53% of household members.
There are studies going on right now to look at whether a third dose of vaccine will improve the response for transplant patients and it looks encouraging. I think many physicians are going ahead and giving many of their transplant patients a third dose, so this might be a good topic for discussion with your transplant physician. Good luck and be safe!
Thanks for your response.
I have a grandson who’s been back in daycare since May 2020. He’s now 3 1/2 years of age. He’s lived with me through this past February but I pretty much see him daily. My family has had Covid but I never have. My nephrologist has sent me for antibody testing twice and I have none. I slept with my wife every night she was ill. I hate to get the vaccine there is a possibility that i am immune some how. Any answers for me please? I get flu vaccine yearly, I’ve had my shingRX and pneumonia shots. This does worry me since you see suits for medications which have been out for several years.
1. I think you belong in the category of extremely lucky rather than immune. We have known for some time that not everyone who gets infected spreads the virus; in fact, much larger numbers of people tend to be infected by a very few percentage of those with infection. We are gaining more understanding of this, but it certainly is not understood well. While lucky, I wouldn’t count on this for your strategy. An example that I sometimes give reporters is that let’s say that I get drunk and drive and I have done that 5 times and never got in a wreck. The correct conclusion from that is not that driving while drunk is safe. I also want to impress upon you not to use your experience from last year and even the first part of this year as your reference for how things will be for the remainder of this year. We have a variant that is far, far, far more contagious. People who have done high risk things (e.g., going to bars, COVID parties, etc.) and gotten away with it may find that their luck runs out with this new variant. The fact that your antibody level to this virus is undetectable certainly argues strongly against you being immune to COVID. Even if you previously did have COVID, we suspect that the immunity from prior infection is going to be less and less effective against delta and the variants to come.
2. I understand your concern about seeing lawsuits against the makers of medications for adverse effects. However, there is a big difference. People continue to take medications, most often daily, sometimes more, for years. Over time, these medications can build up or react with a medication that is added at a later time. That is not what happens with vaccines. You get the vaccines and then that is it for a year, 10 years or perhaps your lifetime. We tend to see all the adverse effects within 35 days of vaccination, whereas we can see problems from medications far into the future as people continue to take the medications.
I hope this helps and I hope you reconsider and get vaccinated, but if you don’t, I hope you continue your lucky streak. I love the slots and my lucky streaks have never lasted very long!
Hello Dr. Pate,
Thanks for your care for all people and especially for Idahoans. My note isn’t directly related to this blog post, but I did find it a useful read for persuading those in my circle to get vaccinated.
I’m in Eagle and have kids in the West Ada district, where I know you were (are?) a largely ignored voice of reason. Thank you for the fine work you did/are doing there. I’m unsure if you’ve seen the letter from our new superintendent, Dr. Bub, that went to parents today stating the district’s formal response to new masking guidance. It’s too big to post here (I can share it elsewhere if you’d like to see it). The letter acknowledges the recent guidance from the CDC and AAP for masking in classrooms. Yet it uncoincidentally ignores the CDH’s support for these guidelines. It also ignores the CDC’s current status of Covid transmission in Ada county (which reached “High” today) as well as the fact that the Delta variant is far more contagious and likely more resistant to vaccines than previous variants. I’m unsure why the district insists on ignoring the authorities on Covid risk, but I suspect it has something to do with a vocal parent group who — for whatever reason — seems to hate masks but insists that their kids be at in-person school.
I intend to write Dr. Bub and I’ve seen the two studies you posted on Twitter earlier today. I will be sure to use those as sources. I wonder if there’s more authoritative data you can share. And I’d love any advice you can offer in dealing with the superintendent and the board. It seems they respond to volume but not reason.
I share all your sentiments and thank you for this kind note. I think West Ada has fired me (if you can fire a volunteer), because they just stopped inviting me to meetings or asking for my opinion. That is fine. Except that I think that they have also fired the volunteer doctor they asked for guidance after me. I don’t know who they are getting advice from now, and perhaps the answer is that they aren’t getting advice. Of course, you can only continue to shoot the messenger for so long.
I am as perplexed as you as to why they make the decisions they do. Largely, that confusion is because they do not use good governance practices. They don’t explain their framework for making decisions, nor the reasoning behind the decisions. I have talked to a number of board members and leaders about it, but to no avail. I am fine if they use someone other than me for advice, because it took up a lot of my time and energy, and frankly, I am glad to have that time back. I just hope that they have some credible expert providing them with advice.
I was a bit surprised by Dr. Bub’s response, because generally, if things go wrong, boards fire the CEO, or in this case, the superintendent. it is also foolish to take these steps for the vocal parents, because if you bring back students recklessly (there are lots of safe ways to bring them back that I had hoped they would work on over the summer, but they never even asked!), you get a widespread breakout (we have seen facility attack rates with delta of 20 -33%) and, of course, with that magnitude, everyone will have to go remote. Those parents will be upset then, too, and certainly won’t be coming to Dr. Bub’s defense just because he did what they wanted against all public health and medical advice.
But, yes, I can give you more info. I plan to write a blog piece this weekend to present the data and make the concerns more clear. I thought that the CDC’s change in position was good, but I did not think their messaging was. I’ll try to fill in the blanks and explain why we all should be concerned. So, check back later this weekend. I hope to have two new blog posts, and one should provide you with what you need.
Thank you. Complicated stuff, but you’re helping laypeople like myself have a grasp on it and make more informed decisions. We will be holding both the board and Dr. Bub accountable for the health and well being of West Ada students and families. I appreciate your help.
You are most welcome! Take care and thanks for following the blog!
I am new to your blog but loved the honesty and caring it portrays. I know this may make you laugh, but I have a sibling who will not get vaccinated. Why?… Because it’s the sign of the beast in the book of Revelations! I mean Holy Cow! I can’t seem to change his mind. Any suggestions?
I didn’t laugh, because I have actually had others express the same concern. So, yes, I have the same suggestion that I gave to the others who expressed this concern (and it convinced them all to get vaccinated). A clear reading of the Bible will provide the needed reassurance that the vaccine is not the mark of the beast. Since it appears to be a concern of more people than I thought and since I have not seen this addressed elsewhere, I will post a blog piece this weekend to provide the explanation.
I hope you are signed up to receive notifications of when I post a new article, but if not, be sure to check back by the end of the weekend and I will have your answer written out (it is a long answer!).
i have asthma allergies and am very allergic to the flu shot. i am 85 years old. i take care of a handicapped son and iam a widow. i am very concerned about taking the vaccine. please give me your opinion
Hi Ms. Fontenot,
Thank you for this question. Allergies to the flu shot would be unlikely to present a problem for this vaccine, but since I don’t know the exact nature of the allergy, be sure to ask your physician. I think that there are two important reasons for you to get vaccinated against COVID. One is that you are in a very high risk age group should you get infected, and with the delta variant circulating, unless you plan to be a recluse, you are highly likely to get infected. The second reason is what I take is the dependency of your son on your care. Obviously, if you get COVID, not only would you pose a risk of infecting your son, who also may be high risk depending upon the nature of his handicap, but if you were not to survive the illness, it sounds as though your son might have to rely on other sources of assistance.
Thanks for your question and for following the blog. Please let me know what you and your doctor decide and how everything goes!
Please give us the real “skinny” on these stupid masks.
Will do. I am working on two blog posts this weekend and this will be one topic. Thanks for the question and thanks for following the blog.
See the blog post I just published this evening.
The CDC website says that there is no data on the safety of the vaccines in people with autoimmune conditions. I have autoimmune conditions and am not taking any immunosuppressive medications. I have been waiting for some information to be published on this and have seen none. I would be very interested in your thoughts on this. Thanks!
You are correct. We don’t have a lot of info about the safety of vaccines in those with autoimmune disorders, other than the fact that given the prevalence of these conditions and the numbers of people vaccinated, surely many have been vaccinated and we have not seen any safety signals that I am aware of. On the other hand, we have seen studies on the risk of COVID in these patients. It appears that those with underlying autoimmune conditions are at higher risk for more severe disease with COVID and that those with autoimmune disorders affecting the musculoskeletal system, such as systemic lupus erythematosis, may be among those with the highest risk.
So, I can understand your concern about the lack of data specific to autoimmune conditions, but if I were making the decision for myself or a family member, since your risk of more severe COVID may be elevated, since we are facing a surge of delta in the US, since delta is far more contagious and causes more severe disease than prior forms of the virus, I would definitely get vaccinated and ASAP, especially if you have not had problems with other vaccines and your doctor does not have a good reason why you shouldn’t.
Take care and let me know what you decide and if you get vaccinated, how that goes.
Good morning Dr. Pate,
What are your views of the June 11th edition of Science Advances peer reviewed work of mRNA? It suggests mRNA does Re-write DNA (or now error ridden DNA).
Hi Tom. I hadn’t previously come across that article, so I looked it up. Perhaps I did not find the article that you are referring to, but the one I saw was looking at a DNA polymerase that can use RNA (not mRNA) to repair DNA. I’m assuming given that you have raised this here in this context that you are concerned that this means that the mRNA vaccine can alter one’s DNA. That would not be true and is not what the study is talking about. The DNA polymerase is in the nucleus and the mRNA from the vaccine is in the cytosol. The SARS-CoV-2 virus and the mRNA uses an RNA polymerase, not the DNA polymerase that this study refers to. So, no implications here from that study for the safety of the mRNA vaccines. Thanks!
Than you for your post, I really want to know the risks/benefits! My only question is if it is safe, why is it still not FDA approved?
I think formal approval is imminent (within weeks). The hold up is not over any concerns about efficacy or safety. If there were concerns about these, the FDA would have revoked its emergency use authorization, as it did for hydroxychloroquine. In this case, the FDA must inspect the manufacturing, verify the storage requirements, etc. This is what is pending. The FDA has made clear that there are no concerns about efficacy or safety. If you haven’t already been vaccinated, please do so ASAP, because remember, with the delta variant, you need both shots for full protection, which means it will take 5 – 6 weeks even if you get vaccinated tomorrow.
I just stumbled upon your blog while I was doing more research about covid. I am not yet vaccinated. My main concern is long term side effects. I was treated for lymphoma when I was younger, several years ago. I have been gratefully healthy minus anxiety, fatigue and muscle weakness.
As chemo may have changed things in my body and there will be need for monitoring as I get older. I understand or at least have been told that if I get infected with Covid it may be harder to beat. However, I feel my immune system is strong. My fear is introducing yet another strange material to my body at this point in my life and developing another disease or complication. Any thoughts? My doctors have simply just said get it and didn’t help address my fear. Appreciate your thoughts.
Hello Dr. Pate,
I am a 49 y/o female, diagnosed with SLE 5 years ago. I currently take 400mg of hydroxychloroquine a day. I had Covid in October 2020 and recently had my antibodies tested. The test came back negative. I have talked to my rheumatologist & she made me aware that there hasn’t been much research on those with autoimmune diseases. She would not advise me either way on getting the vaccine & told me to make my decision after doing my own research.
I am considering the vaccine due to the Delta variant, however I have a couple of questions:
1) Thank God, my SLE has been under control since I began treatment. I have only had 4-5 “flares” in the last 5 years. I’ve always avoided supplements that claim to boost the immune system. Will the vaccine boost my immune system to the point of causing it to turn on me & cause a flare?
2) Does the vaccine cause your body to recognize the virus if you become infected and know to attack it? If so, even though my antibodies are negative, would my memory cells recognize the virus if I became infected again?
Thank you in advance for any insight you can provide. I really appreciate it.
Hello there! Do you use Twitter? I’d like to follow you if that would be ok. I’m absolutely enjoying your blog and look forward to new updates.
Yes, you can follow me at @drpatesblog.
Dr. Pate, thank you so much for this blog, the information and being able to ask a person of your stature and knowledge is invaluable! My question concerns clotting, which I know you addressed earlier, but a little more involved. Someone I am acquainted with, refuses to be vaccinated, and who claims to have researched this very thoroughly and is adamant about his findings says the vaccines have heavy metals in them, which causes the red blood cells to become elongated and that in turn causes blood clotting. Ordinarily I wouldn’t give this conclusion any feet, but I heard yesterday about a man who is fully vaccinated but is in the hospital, with Covid-19, in critical condition, with a blood disorder, so one immediately, connects vaccine, blood disorder, and metal. The report didn’t say if the blood disorder was a condition prior to the pandemic or not. This person is also a M.D. Just when I feel I have decided to get vaccinated I hear about a case like this. My adult daughter is vaccinated and has never tried to push me to get vaccinated because she knows it is a decision I have to make, although she says it would give her peace of mind, especially since we live 2500 miles a part. Thus I wanted to ask you specifically about this issue and abide by your thoughts and advice. I am so thankful for your blog, it is a blessing to myself and hopefully hundreds of thousands of others.
Thank you, Terry. I am happy to put your mind at ease that your friend is mistaken, at least with respect to the Pfizer and Moderna vaccines. Neither has heavy metals in them and neither causes changes to your blood cells that would promote clotting. All completely not true. It is misinformation that is circulating on social media.
Unfortunately for the man you mention and many others, COVID infection does promote blood clots. But, that is the infection doing it, not the Pfizer or Moderna vaccine.
I hope that you will get vaccinated ASAP, because unfortunately, things are getting bad. These vaccines are safe and effective. I have been fully vaccinated with Moderna and I am planning to get my third dose in October.
Thanks for your kind comments and thanks for following my blog!
Thank you for your continued help. I’m so glad to have a place to go to get the difficult questions answered. As I’m sure you’ve seen, Pfizer today announced that it’s releasing data on its vaccine trial in children between ages five and 11. This is of particular importance to many parents, myself included. Our 10 year old is going to public schools and we are very worried about her COVID exposure risk. We have been eagerly awaiting more information on this vaccine and are hopeful that it will reach EUA status soon.
However, with the release today I am now concerned to see that the size of the trial was only 2,268 participants as opposed to the 40,000-plus participants in the adult trials. It seems to me that a trial this small will do little to reveal the potential rare side effects that were discovered in the adult and teen trials. Myocarditis in young men comes to mind.
Another concern is the waning effectiveness of the current vaccines against Delta in adults. Given that we’ve already seen reduced efficacy against Delta are we likely to see even greater reduced efficacy against future variants? And how should the unknowns of vaccine side effects be weighed against a vaccine with potentially reduced effectiveness against COVID going forward?
Can you comment on how confident parents should be in giving their kids this vaccination with such a small trial size? What would you do it you were me?
Great questions. It is not uncommon at all for us to enroll smaller numbers of participants in younger ages after we have done extensive studies in large numbers of older children and adults.
Keep in mind that adverse effects, like myocarditis, are far less common with the vaccine than with the disease, and unlike myocarditis caused by the disease, we have seen that the myocarditis induced by vaccine is generally very mild and resolves within days.
You are correct that we may see less efficacy in the future with new variants, especially if they acquire immune evasion capabilities. However, that is the beauty of the mRNA vaccines. We can change them within a matter of weeks. So, if we see a variant that can completely evade the vaccine, we can develop a new one. But, COVID is a huge threat right now. We need kids vaccinated ASAP because they are playing a significant role in the transmission of the disease and here in Idaho, we have implemented crisis standards of care. I will be encouraging my children to get their children vaccinated the day this vaccine does become authorized for 5-12.
Thank you ever so much, Dr. Pate. As usual, your blog provided sound, understandable, and credible information that is most helpful, and will save many people if they heed it, from the extreme suffering and possible death from this awful virus. I thoroughly appreciate all you are doing to help us Idahoans and our country to beat this virus and minimize the harm in the interim.
Thank you so much!
Simple question: Do you recommend that I get a booster shot?
Here are some facts: I’m a 47-year-old male in extremely good health. I’m very active (between eight and 12 hours of activity weekly) and have no known health issues. I got my second shot of the Pfizer vaccine on April 21. The only one of the CDC’s recommendations that might make me qualify is that I have two kids in school, one of whom isn’t yet vaccinated (but will be soon).
I see people who are younger, more fit, and arguably with less exposure to COVID getting boosters. Every single person I know that has had COVID in the last few months was vaccinated, which I find very concerning. Of course, that’s only anecdotal evidence, but it’s troubling nonetheless. It makes me think that either vaccine effectiveness is seriously waning or all the doubters are actually right. I don’t believe that’s the case, but it’s still a struggle given the way COVID has unfolded in front of me.
I can’t possibly be the only one struggling with these concerns. Perhaps your answer will help a bunch of us.
The booster is not officially authorized for your age group and health status. Pfizer is making a request that the FDA grant authorization for your age group, so that might be coming before long. Certainly, most of the experts I talk to would likely tell you that it is fine to go ahead and get a booster; it is just not the official recommendation at this time.
Thank you! 🙂
Happy New Year, Maia, and thank you for following my blog!
Hello Dr. Pate,
I am vaccinated and boosted as well as my husband. Our young son is vaccinated. We believe in vaccines and doing what the medical community tells us. But some of my close friends have decided that to take the booster isn’t helping anyone since there are so many Covid cases among fully vaccinated and boosted people – my dad has Covid right now. Can you help me to explain the statistics of why to get the vaccines and booster? The whole government conspiracy theory is creeping in with some of my closest friends. Any advice would be much appreciated.
I am terribly sorry that it has taken me so long to get to your question. Boosted individuals have a reduction in deaths due to COVID of 96% compared to the unvaccinated and a reduction of hospitalization of 93% compared to those who are unvaccinated in all age groups over age 18. This has been true for both Delta and Omicron. I hope this helps. Thanks for following my blog.