Dr. Nirav Shah answers questions about the vaccine

Oct. 2—The Sun Journal recently asked readers to share why they haven't gotten vaccinated against COVID-19. Their responses ranged from concerns about the long-term safety of the vaccines and a lack of trust in the government and pharmaceutical companies, to Facebook-fueled misinformation perpetuated by followers of the far-right conspiracy group QAnon that the vaccines were created by blood-drinking Hollywood elite as a military mind-control bioweapon.

Deep fears were exposed. One woman wrote that her severe hypochondria sends her spiraling at just the thought of getting the jab. "I am petrified to put certain medicines or foods into my body that I've not had before. I've never even received a flu shot," Jennifer Dunning said. "I want to get my vaccine, but I know I will completely freak out and have a severe panic attack and raise my blood pressure to dangerous levels."

Other responses that flooded the Sun Journal's Facebook page repeated a number of statements commonly expressed in the anti-vaccine movement.

"Because it's MY BODY AND IT IS MY CHOICE!"

"None of your business!"

"I have my own immunity!!!"

"I refuse to be a guinea pig."

"Because I'm not a government lab rat."

A number of readers revealed that they have had negative experiences with medical professionals or vaccinations in the past that made them wary of the COVID vaccine. Most said the speed with which the vaccines appeared to be developed was a red flag for them.

"I won't be getting vaccinated because studies should be done for years before determining if they are safe or not," Rachel Carll said, writing that she knew three people who have died after getting the vaccine.

The U.S. Centers for Disease Control & Prevention report that deaths from the vaccine are exceedingly rare. It has not linked any death to the Pfizer or Moderna vaccinations.

"A review of available clinical information, including death certificates, autopsy, and medical records, has not established a causal link to COVID-19 vaccines," the CDC said. However, it states that "recent reports indicate a plausible causal relationship between the J&J (Johnson & Johnson) ... vaccine and ... a rare and serious adverse event — blood clots with low platelets — which has caused deaths."

"I simply don't trust it," Isabelle Spofford said. "It is a brand-new shot. We are living in a science experiment and everyone, vaccinated or not, is playing a role."

It's true that the history of medicine and the role of the government and pharmaceutical companies in this country is long, complicated and has at times been gravely harmful, especially to vulnerable communities. And while many people see getting vaccinated as an act that is good for them as well as their community and society, others don't see it that way.

For those and other reasons, a good chunk of the population in Maine and across the country remains hesitant to get the jab. Even so, the three vaccines approved for use in the U.S. — Pfizer, Moderna and Johnson & Johnson — have been proven in all but the rarest of cases to be safe and effective at stopping COVID-19 or greatly reducing its symptoms, and are the world's best approach to ending the pandemic, according to health officials.

Spofford is correct that in the battle to end the pandemic, everyone plays a role.

Maine is the third most vaccinated state in the country with nearly 69% of all Mainers fully vaccinated, according to a vaccine tracker created by data and media company Bloomberg. Yet the virus continues to spread at a record-breaking pace in Maine, largely due to the spread of the highly contagious delta variant among "pockets" of unvaccinated people.

Last month, Maine saw the highest single-day totals of new cases, hospitalizations and individuals in critical care since the pandemic began in March 2020, exceeding records primarily set during the winter surge when vaccines were not yet widely available.

The Maine Center for Disease Control & Prevention on Friday reported 738 new cases of COVID-19 statewide. Maine has recorded nearly 100,000 cases of COVID-19 since the pandemic began and over 1,000 deaths.

"This is a crisis that's preventable," Gov. Janet Mills said at a media briefing last week.

"Truly, there is no downside" to getting vaccinated, she said. "Only a benefit — a benefit to you, to your family, to all of our children and to people you may never have met."

The Sun Journal asked readers to tell why they haven't gotten vaccinated yet in order to get a sense of what the big questions are — and answer them. And to do that, we turned to a person who has become a familiar name in homes across Maine and a trusted voice throughout the pandemic: Maine CDC Director Dr. Nirav Shah. Here's what he said:

The U.S. CDC offers a comprehensive list of vaccine ingredients on its website. One of the great benefits of the three COVID-19 vaccines is that clinical trials and real-world experience indicate that the risk of severe side effects is remarkably low, even for people who have experienced side effects with other vaccines. Maine hospitals are treating more than 200 people with COVID-19; they have admitted zero people for COVID-19 side effects. If you have questions, please talk to your medical provider.

On the question of whether people who have had COVID-19 should get vaccinated, I'll refer you to a recent commentary by Dr. Dorry Segev, a professor of surgery at Johns Hopkins. Dr. Segev writes (in The Hill):

"Every component of the immune response to the SARS-CoV-2 virus improves after vaccination, including antibodies and T-cells. In those with prior COVID-19 infection, vaccination can elicit important cross-variant neutralizing antibodies. And clinical protection improves after vaccination in people who had prior infection: In a recent study, people with prior COVID-19 who received even one vaccine dose had half the risk of a breakthrough infection than unvaccinated people with prior COVID-19. So, vaccination even helps those with prior COVID-19 (and everyone they interact with).

"Not everyone who has a case of COVID-19 will have natural immunity. In a recent Centers for Disease Control and Prevention (CDC) study of those with prior COVID-19 infection, 36% did not form any antibodies against the virus. This is in stark contrast to antibody formation in 100% of (non-immunocompromised) people who receive even one dose of an mRNA vaccine (Pfizer or Moderna), as impressively reported in the large vaccine trials. So, from a practical perspective, if a business or school is trying to figure out if someone is safe to be around, they can rest quite assured that someone who shows them vaccine proof is safe, but it would be nearly impossible to determine if someone with prior COVID-19 is safe. Beyond the logistical issues of proving that a person had prior COVID-19, how can they prove they're in the 64% who have some natural immunity?"

All the evidence available to us at this time shows that "taking your chances with COVID" poses a much greater risk than getting vaccinated. An analogy that comes to mind involves skydiving. On very rare occasions, a parachute will fail, but that does not mean I would "take my chances" by jumping out of a plane without a parachute. The vaccines are not perfect, but they are exquisitely effective at preventing death and severe harm from COVID-19, making them a far better risk reduction choice than taking one's chances with the virus.

All three of the COVID-19 vaccines underwent rigorous clinical trials and review to gain U.S. Food and Drug Administration approval or authorization. Data and research come from the private sector, government, universities and global experts. Because of the emergency posed by COVID-19, scientists and regulators cut red tape, but they did not cut corners. The mRNA vaccine technology that Pfizer and Moderna use for their vaccines has been around for decades, so it's just not accurate to characterize them as "experimental."

Worldwide, more than 3 billion people have received COVID-19 vaccines. While we are seeing more data suggesting that some patients experience long-term negative health effects after contracting COVID-19, we are not seeing any data to suggest negative effects of receiving vaccines.

First, I want you to get vaccinated because it is the best tool you have to protect yourself against the ravages of COVID-19. The predominance of the delta variant in Maine places you at greater risk of experiencing severe symptoms or death. We're seeing more, otherwise healthy, younger people ending up in intensive care and on ventilators. Simply put, the vaccines are the best tools you as an individual have against the potentially devastating effects of COVID-19.

Second, our personal choices have public consequences. The first three words of the Declaration of Independence — "We the people" — acknowledge that our democratic republic is a shared enterprise. As individuals in a society, we exercise our liberties within guardrails established to ensure a functioning society. Our choices affect others.

Right now, Maine's hospitals are treating high numbers of unvaccinated COVID-19 patients. As our dedicated health care professionals treat those patients, other individuals needing cancer treatment, cardiac care, joint replacements, rehabilitative therapy, and similarly necessary procedures are waiting longer. Personal decisions not to get vaccinated are reverberating through the health care systems in ways that cause harm to others. I don't believe that's what this nation's founders envisioned when they wrote of personal liberties. Your choice to get vaccinated is an act of service to your community.