Nurse Melissa Valentín shows a dose of the Pfizer-BioNTech COVID-19 vaccine to be applied to medical personnel at the Ashford Presbyterian Community Hospital in San Juan, Puerto Rico, Tuesday, December 15, 2020. (AP Photo / Carlos Giusti)
We have been waiting for it since the first news of the coronavirus hit our consciousness. A vaccine, a cure, a way to allow us to take a shot, pill, or poultice that would reestablish our supremacy over this unseen enemy of humanity. It has finally arrived. However, with it has come controversy, doubt, and even utter contempt for its availability and use. Why? Why would good people be so opposed to such a thing? That is a complicated question that is too difficult to address here in totality. Some fear the science, some deny it, others have politicized the issue so much that it is one of stubborn partisanship rather than rationality.
So, I will state it plainly here.
I am a psychiatrist, a trained physician, and I am taking the vaccine.
Many of the doubts from even well-intentioned people have some validity. How do we know that it is safe? Anti-vaxxers have cast some doubts but so have the leaders of our communities and our country. No consistent message concerning this crisis has been proffered since it began. Admittedly, the process of releasing the vaccine has been accelerated due to necessity, but not to the point of negligence. Far from it. The technology being applied with the COVID-19 vaccine is technical, complicated, and difficult for to understand. However, it is also vetted, tested, effective and safe.
The reality is that the vaccine process itself was developed in the 1990s, and by the early 2010s, vaccines were developed but never approved for Rabies virus, Zika virus, and others. In 2019, the FDA approved the viral vector vaccine for Ebola. So, this is not a rushed, untested, and risky technology. Quite the contrary. It should have been already available had we not previously succumbed to political expediency and profit-driven business decisions.
How does it work? The technology of this vaccine is information-based. They took a piece of the genetic code of the spike of the virus and used that in the vaccine vector based on mRNA technology. That information then directs our body to elicit an immune response that will attack the virus once it infects our body and better defend against the virus itself.
Essentially, a natural form of anti-virus software that is stored inside of our cells. It is an elegant though complicated solution to help hack our own body’s immune system and help it along. The prior explanation is quite simplistic, but the technology behind is quite cumbersome and technologically challenging to produce.
This technology provides hope for many with currently untreatable illnesses and our long-term health on the plus side. For example, it could be used to provide the code that stimulates a person’s immune response for specific and individual cancers. It would then turn it on so your body can fight it internally. It then basically allows you to inject a vaccine that is specific to your cancer. Potentially, revolutionary technology that may save many lives, help our overall health, and move us forward as a society since “treatment” of any illness would become genuinely personalized. It, therefore, has ramifications well beyond the current crisis.
The U.S. does not have an excellent historical record concerning vaccines. Many were untested or tested unscrupulously in the early days of medicine on an unwitting population with long-term adverse side effects. Recent anti-vaxx political movements are also against any such technology and have a loud public voice. Add to those conspiracy theories, politicization, and just plain misinformation and disinformation, and we have a difficult time convincing the populace of its necessity.
Yes, there have been some negative side-effects. However, all meds have along with them some inherent risk. Just read the labels on any over-the-counter medicine that you buy. That being said, this vaccine has a relatively low negative response. Additionally, very high-precautions are being taken at all distribution sites. With EMS at the ready, one must wait for 15 minutes before an inoculated person can leave the vaccine center.
One of the riskier side-effects is an allergic reaction. So far, out of the hundreds of thousands of vaccinated, there have been very few cases of such allergic reactions, so it is overall safe. Regardless, like all vaccinations or medications, it is a risk management assessment.
Do the dangers of side-effects outweigh the benefit of taking it or the risk of NOT taking it?
Every time you visit a prescriber for any treatment, you have to make risk management decisions; every substance or procedure has three primary considerations:
- The benefit of taking a medication, vaccine, or undergoing a procedure
- The risk or the medication, vaccine, or procedure
- The risk of doing nothing
Our job as health professionals should never be to tell anybody what to do about their treatment; our job is to provide our patients with an explanation of the condition treated and present them with honest treatment options based on the three considerations.
It is the patients’ decision to accept, question, debate, and authorize any treatment recommended. We do not dictate treatments; we provide options.
We are obligated to provide our patients with evidence-based, fact-based information and not unsubstantiated “Beliefs.” Practicing medicine is a science and an art, but not a religion or cult.
Incredibly, there is a very intense, small portion of the medical community who is also counter to this. It is remarkable in that they deny their education, training, and experience for something less logical. Indeed, their arguments against the vaccine are far from substantiated and border on the insane.
Sadly, because they are a doctor, they will affect other peoples’ views, impeding their patients’ health. And that is dangerous. When we take our Hippocratic oath as doctors, we all swear to “do no harm,” physically as well as informationally.
A recent video from an anti-vaxx doctor went viral, spreading misinformation and disinformation to millions. People are not seeking reasons to take the vaccine, but some seek to find reasons not to. There is a paradoxical tendency, even in the light of facts, to NOT want to take it. This is why the medical community needs to set aside politics, beliefs, and conspiracy theories and focus on science and communicate that to their patients, friends, and families.
The job then comes to help facilitate the patient making an informed decision based on science and facts. That is a tough thing to do. To change a “belief” rather than a base of knowledge with new and updated data is challenging because it is based on a belief system rather than facts and current reality. If we were all like Mr. Spock and behaved using pure logic, this would be a no-brainer. Since we are not, it is not.
The reality in the States is that, eventually, we always end up doing the right thing, but frequently for the wrong reasons. To that point, I think the thing that is going to convince people is money and finances. We have tried rationality based on empathy and care for others, and as usual, it did not work.
That is what guides our country.
Basically, how much is it worth to you?
How much does it cost you if you get sick and can’t go to work?
What if your employer requires it?
This will be more evident as more people get vaccinated, and those people do not get it and are less restricted than their counterparts. Of course, some consistent and trusted communication from leadership would help too.
Presidents, governors, mayors, community leaders, physicians, friends, and family would help us all to do the right thing if they would get all the facts.
Most of the population will not get the vaccine until late this year and next year. Mainly because of a limit of access and prioritization. Some of the most vulnerable, those in poverty, are also the most hesitant to do so.
Unfortunately, due to their working, living, and other situations, they are the same people who are currently passing the virus along at a high rate. It will take time for many to come to the simple conclusion that has to date been denied, that we are all in this together.
Masks, social distancing, and most importantly the vaccine, are how we can all help each other to get back to some form of normalcy.
So, my advice to you as a physician—get the shot(s). If you choose not to get vaccinated, please follow the guidance and guidelines to keep yourself from getting infected. We respect everybody’s decision.
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Dr. Lauro Amezcua-Patino is the clinical voice of The Only You (Solo Tú), a podcast dedicated to simplifying the complex issues of the mind and mental illness. Originally from Mexico, Dr. Amezcua-Patino has been practicing in the metropolitan Phoenix area for over 30 years. Twitter: @SuSaludMental.
