One local doctor’s vaccine opinion: Reward vs. risk a ‘very personal’ choice

Pfizer BioNTech COVID-19 vaccine at Desert Valley Hospital on Thursday, Dec. 17, 2020 in Victorville, CA.
Pfizer’s COVID-19 vaccine. (Irfan Khan/Los Angeles Times)
(Claire Henry/Dignity Health)

CONTRIBUTOR’S COLUMN: Santa Cruz doctor Dan Spilman shares his thoughts about the safety of COVID-19 vaccines. “The politicization of the management of this virus, not to mention the politicization of the vaccine, defies the decades of trust our community has had for the scientists and physicians.”

The COVID-19 pandemic has been quite the conversation starter in my medical office the past nine months. And now, with the recent release of the Pfizer vaccine and soon the Moderna version, those questions have swerved toward vaccine safety and whether we should be vaccinated.

For each of us we need to look at the cost of getting sick vs. the cost of having a vaccine reaction. How would getting COVID affect you and those in your family? Do you have high-risk members at home? What would be the cost of two weeks of home isolation for you or those you may infect?

Are you willing to accept that even if you have a mild infection you could have longterm respiratory issues? This must be balanced against the vaccine risks which currently are pretty rare but with time more will be discovered.

In fact, I received the vaccine last Thursday and except for a few hours of fatigue and body aches I didn’t have any other reactions. I placed myself on the vaccine list as soon as it was available so that I could protect not only myself but those I care about, my family, my office staff and my patients.

I have always been an advocate for vaccines, and I even worked on the development of one for ear infections during my residency in the 1990s. I understand how nervous people are about vaccination and I’m not blind to the controversy of this vaccine especially with the political bias we see in the news.

Vaccines have made an incredible impact on health care, perhaps the most powerful medical tool we have developed to save lives and prevent serious diseases. Most people are unaware that the smallpox virus had a mortality rate of up to 30% and devastated native American and Hawaiian communities.

That virus has been declared extinct all because of global vaccination. In the 1950s there was a polio pandemic leading to paralysis and death of thousands of children. A mass vaccination program has made that virus unknown to our children today.

The politicization of the management of this virus, not to mention the politicization of the vaccine, defies the decades of trust our community has had for the scientists and physicians. The achievement of creating a vaccine to combat a novel virus in just months is an incredible feat of science.

Using snippets of RNA to get our body to create the antigen that spurs an antibody response will probably revolutionize vaccines. This is not happening a moment too soon because this might just be the beginning of a new era of novel viruses that we’ll need to fight.

Even more remarkable is that of the 30,000 people in each of the studies, there have been very few reactions and a remarkable 95% protection. By comparison, the flu vaccine is only about 30% to 60% effective.

Yet, I expect in the coming months, as millions of people are vaccinated, we will see some severe reactions and probably even some deaths. So how does one weigh whether to vaccinate or not?

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In general vaccines are very safe, but so are airplanes, cars, and the food in our stores and restaurants. People are injured, sickened and die every day. So, the real question is what risk is each person willing to take, including the risk of not doing something? I was excited to get the vaccine and finally felt like I was taking some control of this situation. But I was aware of the risks such as facial paralysis and anaphylaxis.

Bottom line: the science tells me there is going to be a small risk of severe reactions.

My decisions for recommending surgery parallel my recommendation about vaccination. If you suffer a complication from the vaccine or any other medical treatment you need to be able to say up front that you accepted the risks knowing that they were rare.

We do this multiple times a day, every time you get in your car or even walk across the street you implicitly accept risk.

How each of us proceeds is very personal, but I suggest that before one makes a decision you filter out the politics and fear-mongering and look at the situation logically: The virus has killed 1.7 million people worldwide and, left unchecked, will kill millions more.

Dan Spilman
(Via Dan Spilman)

Dan Spilman, M.D., is a Santa Cruz-based head and neck surgeon.