As COVID-19 case numbers climb and vaccination rates remain largely flat, there is a renewed push to vaccinate those who remain hesitant.
President Joe Biden earlier this month enacted far-reaching federal vaccine requirements while the number of people 12 and older in Michigan who have gotten at least one shot lingers around 61%.
Since the start of this month, the number of eligible people vaccinated in Michigan increased about 1.5%.
Meanwhile, officials worry about illness trends. Hospitalizations are on the rise. The healthcare system, burdened by staffing shortages, is feeling strained as fall and winter approach.
Doctors here answer some lingering and oft-repeated questions about the vaccines.
Were these vaccines developed too fast, and are they safe?
This is a common question, health professionals said.
There were good reasons to expedite the vaccines development, said Dr. Elizabeth Lloyd, pediatric infectious disease expert at Michigan Medicine’s C.S. Mott Children’s Hospital in Ann Arbor. “So, the fact that we were able to make these vaccines quickly shouldn’t be of concern.”
Scientists already knew much about coronaviruses. There are several that regularly circulate and generally cause mild cold-like symptoms, Lloyd said during a live question and answer session hosted by Michigan Medicine last week. There also is the original severe acute respiratory syndrome (SARS) that emerged in China in 2003 and is closely related to the current coronavirus, and the Middle Eastern respiratory syndrome (MERS) first reported in Saudi Arabia in 2012. Both have high mortality rates, motivating vaccine exploration.
“So, we were able to build on that research… We were able really to accelerate because we knew a lot about vaccines for coronaviruses already.”
The world is in a state of emergency, and this inspired unprecedented cooperation and information sharing, she said.
While the speed was new, the steps followed were not. The vaccines went through all the required safety checks, Lloyd said.
And safety monitoring did not stop there; it continues. About 181 million people in the United States and 4.9 million people in Michigan are now fully vaccinated.
The immunization effort began about 10 months ago.
“I think if you look at the history of vaccination, there’s probably been no vaccine that’s been under more scrutiny and under more of a microscope than the vaccines for COVID-19,” Dr. Liam Sullivan, infectious disease specialist at Spectrum Health, based in Grand Rapids, said earlier this month.
Most of the usual side effects are consistent with what is typical with any vaccine -- arm pain, low-grade fever, body aches or fatigue, he said.
Serious and rare side effects have been associated with the Johnson & Johnson vaccine, administered far fewer times in Michigan than the two-dose Pfizer and Moderna vaccines. These include thrombosis, when blood clots block veins or arteries, and thrombocytopenia syndrome, a condition characterized by a low blood platelet count. However, those most likely to experience such side effects have been identified and are steered away from the Johnson & Johnson vaccine, Sullivan said.
“I think the safety profile of these vaccines has been excellent from the start and they continue to be excellent going forward,” Sullivan said.
But what about long-term side effects?
Biologically, it doesn’t make sense for side effects from a vaccine to pop up later than about six weeks after immunization, Lloyd said.
“We know historically, from all the other vaccines that we use, that if you are going to have some sort of reaction or side effect, it will happen in that first kind of period of weeks after your vaccine,” she said.
“If there is going to be a side effect, we would have generally seen it by now.”
What is mRNA and how does it work?
This is a type of genetic material included in the Pfizer and Moderna vaccines. There is some concern it will have impact on human DNA. This is not the case, Lloyd said. “It doesn’t even go into the area where our DNA is within the cell. It kind of stays on the outside.”
COVID-19 mRNA vaccines give instructions for cells to make a harmless piece of what is called the spike protein, found on the surface of the coronavirus causing COVID.
The cells then display the protein piece on its surface. The immune system recognizes it doesn’t belong there and begins building a response and making antibodies, according to the CDC.
Lloyd explained it this way: The body uses the cell’s machinery to make copies of the coronavirus spike protein and the immune system responds to that protein. If a person were exposed to the coronavirus, the body then recognizes and attacks it.
Once the body uses the mRNA to make these proteins, the mRNA is degraded within a couple of days. “It has no impact on human DNA,” she said.
Does the vaccine work? Look at the break-through cases.
No vaccine is perfect, and the COVID-19 vaccines were never designed or expected to prevent all infections.
“In many ways, it is doing exactly what it is intended to do. It is preventing people from progressing from mild disease to severe disease,” said Dr. Russell Lampen, an infectious disease specialist at Spectrum Health.
The vaccines are keeping people out of the hospital, which is the primary goal, he said.
Break-through infections remain rare and serious disease among vaccinated is even more rare, Lampen said.
About 8% of people hospitalized for COVID-19 from mid January to early September have been fully vaccinated. About 6% of deaths were among fully vaccinated people, according to the latest Michigan COVID data and modeling update.
The number of break-through cases has increased with the number of vaccinated people and as the delta variant became dominate.
Vaccinated people, when infected, are able to clear the measurable virus in their noses and throats more quickly than those who are unvaccinated, Lampen said. “Making them less contagious to people around them in their household and less contagious to people in their community.”
Do healthy people need to get vaccinated?
Older people and people with medical issues are more likely to develop severe complications associated with COVID-19, so some younger, healthier people seem to believe there are immune or in some ways, protected against COVID-19, Lampen said.
However, younger people are coming into hospitals as the highly contagious delta variant continues to spread. “An we are seeing people who really do not have any significant medical conditions that are coming in with severe illness. Now well it’s less common than what we’re seeing in older people, it’s not a complete abnormality, and so nobody is really safe from some of the complications.”
There is also risk of long-term symptoms. People with mild COVID-19 can still develop persistent issues, such as tiredness, difficulty breathing, chest or stomach pain, headache and a fast-beating or pounding heart, mood changes, and changes in smell or taste, according to the CDC.
Read more on MLive:
Michigan reports 5,616 new coronavirus cases, 68 deaths Thursday, Sept. 16, and Friday, Sept. 17
FDA advisors decline to recommend vaccine booster for general public
Court precedents appear to back Biden’s national coronavirus vaccine order, legal experts say
What we know about the Mu variant, and why delta remains biggest COVID-19 threat
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