Guest column: A word about COVID-19 vaccines from Grand River Health’s chief of staff |

Guest column: A word about COVID-19 vaccines from Grand River Health’s chief of staff

Dr. Matthew Skwiot
Grand River Health
Dr. Matthew Skwiot. Photo courtesy of Grand River Health.

Over the past months, I have spoken to many of you who have shared concerns about the vaccine with me. I want to address some of the common themes and summarize these discussions. I also would like to summarize what we know about the risks of the vaccines and the risks of COVID-19 and put it into more easily understood terms.

The best way to decide on whether or not to vaccinate is to talk to your doctor. Your doctor has been specifically trained to understand the physiology of your body, treatments such as the COVID-19 vaccine, illnesses such as COVID-19 and, most importantly, how to weed through the vast amounts of information and misinformation. Physicians are well versed in sorting through this, taking your individual situation and helping you to make an informed decision that is best for you. For the record, no physician at Grand River has objected to the proposed mandated vaccinations.

I believe as leaders in health care for our community, we have a duty to stand up for what is clearly a lifesaving decision, even if it is unpopular. The vaccines keep your family, friends and neighbors safe. They are also the only way to get past the pandemic and the societal problems associated with it quickly. As health care workers, we all have an ethical obligation to keep our patients and each other safe.

During my discussion with various staff members, the most common themes I heard revolved around not knowing the long-term effects or the effects for pregnant and lactating women and those who are immunocompromised. I also heard a great concern regarding mistrust of Big Pharma in light of the opioid epidemic.

While the COVID-19 vaccines have not been studied for more than a year and a half, the technology has been around for over two decades and has demonstrated an impressive safety record. The COVID-19 vaccines are new and had an accelerated approval pathway, but they have still made it through the same safety and efficacy check points. The SARS COV-1 and MERS vaccines also paved the way for the COVID-19 vaccines 15-20 years ago, and we have safety and efficacy data from studies on those vaccines.

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Reviewing the latest information on vaccine safety in pregnancy, there is increasing data, and there is no indication of any significant concerns. The V Safe app that monitors symptoms after immunization has tracked 827 pregnancies to completion. There have been no reports of preterm labor, birth defects or other adverse outcomes. The Centers for Disease Control and Prevention has data from 154 pregnancies with no reports of adverse outcomes. In contrast, COVID-19 infection while pregnant has an increase in severe disease compared to age- and risk-factor-matched nonpregnant populations. There is also an increase in preterm birth and Cesarean Sections with COVID-19. Because of this, it is recommended to get vaccinated in pregnancy. This week the CDC has begun recommending that pregnant women get vaccinated, considering the above data and a recently published study that has shown a significant increase in thromboembolic events in pregnancy. These can be fatal to the mother and cause miscarriages.

Up To Date advises the following for immunocompromised people: “The potential for severe COVID-19 in this population outweighs the uncertainties.” You are way more likely to have problems with COVID-19 infection than from the vaccine.

Understanding how the vaccines work: The mRNA vaccines (Pfizer and Moderna) use the same mechanism that the virus uses. It enters and tells cells to manufacture just one piece of viral protein instead of the whole viral particle. It is actually a very elegant design, simple and using existing mechanisms. The simplicity and the use of natural mechanisms in our body also reduces the chance of some abnormal, possibly pathologic process.

The known major adverse events associated with Pfizer (Moderna is very similar) are: anaphylaxis in 5 out of 1 million cases (0.0005%), 80% of which had a prior history of some type of anaphylaxis, and almost all happened in 30 minutes; and Bell’s palsy (one-sided facial weakness that typically resolves in less than two weeks) was seen in 4 out of 18,000 cases (0.02%). No other major adverse events have been seen.

So, when considering the risks of getting vaccinated versus not getting vaccinated, it is abundantly clear (maybe 200,000 times) that the greater risk is on the side of not getting vaccinated. And that is just considering the risks to you and not to the people around you.

Let’s talk about the mistrust of Big Pharma. This is probably one of the better ones I’ve heard as it is not easily disproved with looking at numbers. It has to do with trust.

The opioid epidemic is a failure of our law-making and enforcement process. Big pharma was able to use lobbyists to influence lawmakers, FDA and CMS to push through legislation and then enforce it. It is important to note that in that situation, most physicians either actively denounced or reluctantly fell in line with policies that promoted opioid overuse. In the COVID-19 vaccine situation, almost all physicians in the world support it.

They support it because all of the data, be it high quality or low quality, points to vaccine safety and efficacy. This never would have been the case with opioids. The physiology, the medical theory and the actual practice of medicine conflicted with what Big Pharma was telling us.

Let’s look at the benefits of getting vaccinated versus not getting vaccinated. Benefits: The pandemic stops, the chance of new variants drops exponentially, there’s less need for masks, you don’t die, your friends and family don’t die and our patients don’t die. Benefits of not getting the vaccine: risk reduction, as previously discussed, and maintaining your individual autonomy. Weighing these variables, most of us would agree that it would be preferable not to die — or have a friend, family member or patient die — versus personal autonomy. Just talk to the people that have lost loved ones from COVID-19 both young and old — this is currently happening to younger (under 50 years old) people in our community. I just took care of a patient on my last shift who fits into this category. They required a heart/lung bypass and have since passed.

Nothing prepares you for the heartbreak of seeing the reality of COVID-19 wallop family members who didn’t believe what physicians and scientists have said about this disease.

As the virus has a chance to continue to replicate, it becomes more transmissible and, possibly, more lethal. Each successive wave has had a lower age of patient who is hospitalized, ends up in the ICU and dies. If you look at areas that have had low vaccination rates over the past one to two weeks, they have had a very large increase in pediatric admissions and deaths. I really hope to avoid this happening in our community.

I also want to point out that the COVID-19 vaccines, especially the mRNA ones (Pfizer and Moderna) are an incredible human accomplishment. From the safety and efficacy profiles to the speed of distribution to the actual vaccination campaigns that have been so successful and have required blood, sweat and tears from many of your colleagues. Vaccines historically have been some of the biggest advances in medicine.

The vaccines should be celebrated.

The vaccines are overwhelmingly the safest move in the pandemic. Thank you for your time.

Dr. Matthew Skwiot is chief of staff at Grand River Health.

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