My COVID Moment of Doubt

Side effects of the second COVID shot can include swollen arm, whininess, and couch immobilization. (Image from Wokandapix via Pixabay)

This week I offer you a slightly disjointed, slightly feverish reflection—partly because it was #DoNothingForTheClimateDay this week, and partly because I got my second COVID shot (yes, on #DoNothingDay—bad scheduling on my part) and spent Friday sprawled out on the couch, achy and feverish (100.7°F at the peak).

I admit there was a moment I wondered whether I should get my second shot. The day before mine was scheduled, my wife got hers. She woke up at 3am freezing and feverish. I spent the next minutes covering her in more blankets and the next day caring for her. And worriedly I tried to fall back to sleep, wondering why does this happen?

So, knowing I was hours away from my own reckoning, as best as I could, I researched this, at least enough to feel comfortable getting my second shot.

I had a couple of worries still unresolved:

  1. Do other vaccines cause such strong side effects? If not, why is this one so intense?
  2. What is the vaccine doing to the body to cause such intense side effects?*

I’m sure many of you have already read much about the vaccine, about how vaccines trigger our natural cytokine response, etc. So this is not an essay that’ll spend many words addressing this. But the answer is yes, the shingles shot has pretty bad side effects too, and “reactogenicity” is a natural part of vaccines—you want your immune system to respond. Though scientists do not quite know how much of this is necessary. As this Nature article explains:

“Summary of expected biological mechanisms underlying the development of reactogenicity symptoms.” From “The how’s and what’s of vaccine reactogenicity.” Nature, 2019.

“Reactogenicity symptoms are an outworking of the expected immune response that occurs in response to vaccination…. While we know that a certain level of inflammation is needed to trigger an effective adaptive immune response, we do not yet know how to quantify that level, or predict how this translates into reactogenicity.” (It concludes with a note that in the future they may even be able to develop “less reactogenic vaccines” or identify which individuals are likely to experience more severe symptoms after vaccination.)

But ultimately, I knew I couldn’t learn enough to truly understand the vaccine (“dammit Jim, I’m a writer not a virologist!”**) and so, I put my faith in the medical system and got the shot. I was miserable Friday, which I spent prone half sleeping and half watching crappy dystopian movies. The film theme certainly wasn’t planned but my son and I watched a new kid’s cartoon where robots take over the world—at least until one kooky, lovable family saves everyone. Worse, when trying to still be productive, I watched Friends of God, a documentary about evangelical Christians in America that had I gotten as a Netflix DVD three months ago but couldn’t will myself to watch. (This actually felt pretty dystopian too as creationism was touted as evidence-based and evolution as a devilish conspiracy.) But after a full day of rest, by Saturday I woke up feeling mostly better—other than the swollen lymph node in my armpit on the side I got my second shot (which also turns out to be a common side effect, though not regularly mentioned).

Sustaining Faith in an Unperfect System

What was interesting is how hard I found it to put my faith in the medical system (made significantly worse by my wife’s reaction the day before I got my shot). The long history of medical abuses, pharmaceutical company abuses, government abuses—these add up and wear on one’s psyche. As do dystopian stories about using vaccines to sterilize people. In one AP article from this past week, Dr. Kizzmekia Corbett, an NIH immunologist scientist who helped lead the development of the Moderna shot, is quoted responding to the question whether COVID-19 vaccines will cause infertility. “Whoever started that rumor, shame on you.” You’d think someone would have briefed her on the TV show, Utopia, so she knows where that’s coming from. (Editor’s note: done!)

Effective advertising and recruitment of influentials plays a key role in encouraging vaccination. (From the CDC Public Health Image Library)

Compare our current vaccine hesitancy—the AP article includes poll results that 34 percent of unvaccinated Americans definitely won’t get the shot—to the 1950s response to Polio, as this NPR article details. Then, people were eager to get their vaccines—for an equally scary disease (in absolute numbers COVID-19 is causing an order of magnitude more in annual deaths, however, that could be because there are more people today and living more densely).

Even after tragic missteps, faith remained strong. Once, live virus was accidentally put into the vaccine in one of the six laboratories manufacturing it, giving 200,000 kids a live dose of polio, leading to 40,000 of those getting polio, 200 being paralyzed, and 10 dying). But quickly the laboratory that was to blame was taken out of production and quality control was increased at the other five labs—and parents “jumped right back in” to getting their kids vaccinated. Small missteps like the Johnson & Johnson vaccine contamination at Emergent Biosolutions and the small number of deaths from blood clots seem to not have shaken confidence that much in the vaccination process, as responses were quick and effects were contained, but I can’t imagine what would happen if something on the scale of the polio mix-up happened today.

But I think transparency has helped keep faith solid, at least in the majority of individuals, and there is still a residual trust (combined with a strong fear of COVID) to drive vaccination efforts forward. And as a few friends joked with me (both fathers already and done reproducing), if they become infertile, that’d be a bonus—one that future vaccines perhaps could integrate as an optional add-on!

Joking aside, it has been interesting to feel the internal conflict and witness others who are not conflicted but “adamant” in their unwillingness to get the shot. One key lesson of this pandemic (along with the many, many, many, many others) is that failing to rebuild our understanding of and trust in science—which will not be easy considering how strongly certain belief systems conflict with scientific literacy—is going to make future pandemics (and other crises like climate change) all the more difficult to prevent or treat.

It’s worth noting that there’s long been a fear of vaccination—not just today (and by comparison, infertility certainly seems preferable to birthing cows from all orifices!) From The History of Inoculation and Vaccination for the Prevention and Treatment of Disease (Science History Institute Digital Archive)

Endnotes

*Actually I had a third more complicated and worrying question: when does your ribosomes stop making mRNA? (Translation: could this new type of vaccine cause a long-lasting problem as cells keep manufacturing this mRNA?) That seems like an important question that no one has talked about (presumably because scientists know that this isn’t an issue). I found only a very brief answer specifically regarding the COVID vaccine: “The mRNA is degraded quickly by normal intracellular processes. The cell breaks down and gets rid of the mRNA soon after it has been translated by the ribosome. ” But this website, Cell Biology by the Numbers, describes how mRNA naturally breaks down over time, is diluted as cells divide, and is destroyed as cells die, so that put my mind at ease.

**Then again, Bones was a medical doctor, and could have been a virologist, so maybe that reference doesn’t really work!

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