COVID-19 Vaccine: Thoughts from a scientist, an MD, two (semi) anti-vaxxers…and me!

UPDATE #1:  Video here with my response to some of your comments.

UPDATE #2: Here are our thoughts on the Johnson & Johnson vaccine.

UPDATE #3: No, this is not a sponsored post. (I’ve been asked by more than a few people if big pharma paid me!)

When I asked you guys if you’d like to know my stance on the Covid-19 vaccine, including what my scientist husband thinks, I didn’t predict the massive response. I read all 250+ of your emails, some of which included ten or more questions!

1. Diane Sixsmith, MD (my mother-in-law). Diane spent more than 30 years as a hospital emergency department physician, including as chairwoman of the Department of Emergency Medicine at The New York Hospital Medical Center of Queens. It should also be noted that my MIL is crazy brilliant (like, was valedictorian in every school she ever attended) and she’s also a generally a low-intervention type of doctor. In all my years of motherhood, she’s only once suggested that we actually needed antibiotics. She’s an open-minded clinician and appropriately skeptical of big pharma. It somehow feels relevant to mention that she breastfed her youngest child until she was four years old.
2. Daylon James, PhD (my husband). Daylon is an Assistant Professor of Stem Cell Biology in Obstetrics & Gynecology—as well as the New York State-certified Director of the Reproductive Endocrinology Lab—at Weill Cornell Medical College. Daylon is by nature a skeptic (sometimes maddeningly so!), and is on board with all of my evidence-based natural parenting choices (such as un-medicated birth, extended breastfeeding, etc.). He supported my decision to space out some of the vaccinations we gave our own children when we became parents.
3. Suzanne & John Goss (my parents). These two are my co-founders of Gimme the Good Stuff and Certified Holistic Health Coaches. They have spent 45 years researching and testing out all manner of alternative and natural health theories. In the 1980s, they also were probably what we’d now call anti-vaxxers, although they never self-identified as such. They are both a wealth of knowledge and my guideposts for parenting, diet, and all-around wellness.
4. Maia James (me!). You probably already know more than you want to about me, and I mostly did the asking during this conversation—but I will pipe in with my own opinions in the transcript below. Here’s everything I’ve previously written about vaccines.

So let’s get to it!

Q: Do you all plan to get the Covid vaccine for yourselves and your children? Or do you plan to wait and see how it goes first?

Suzanne: I do intend to take the vaccine when it is offered to me. I have some concerns about vaccinations in general—I’ve never even gotten a flu shot! A global pandemic is an extenuating case, though. In general, I question a lot of mainstream medical recommendations, especially pharmaceutical ones—because there is so much money behind the industry. But this is different—we know the very real risks of Covid-19, and I have repeatedly read that scientists have been studying how to create a vaccine for this type of disease for many years. I still do question the number of vaccines that kids receive, and if I were still the mother of young children, I’d want to see how the trials go before vaccinating my own kids. When Maia was six weeks old and had her first checkup, the doctor gave me a pamphlet about all the shots she would be getting and I was horrified when I read the list of potential side effects! I refused all the shots and began to do a ton of research. I then found an MD who was more holistically minded, and he told me to get a certain subset of vaccines that he felt were critical. So my kids had very limited, delayed vaccination. Of course, Maia then got to college and decided to go and get them all in what was perhaps mostly teenage rebellion!

John: Hundreds of thousands of people have already received this vaccine—all those who enrolled in the trial as well as the Phase 1 recipients. So by the time most of us get this shot, there will have been at least a million other people walking around having been vaccinated months before. There is also the social responsibility factor—we can’t all sit back and wait until everyone else gets it, and we need to do our part to stop this pandemic.

Maia: I will definitely will get the vaccine as soon as it’s available for “young” healthy people like me. I normally am skeptical of new, fairly untested medications, but if this is what is needed to put the world back on its axis, I am basically like, “sign me up.” Daylon and I have talked about the kids—he agrees with me that because the (known) risks of Covid seem to be very minimal for kids, we will wait as long as we can to vaccinate our children. Daylon does worry about long-term unknown risks from kids who have gotten sick with Covid. We have one friend whose daughter has lingering neurological issues. I guess we will have to see how the pediatric vaccine trials go before I will commit to when I’ll allow my kids to be injected.

Note: I’m not even publishing Diane and Daylon’s response to this–they are both getting the vaccine with no hesitation!

Q: What are the ingredients in the vaccines for Covid-19? How safe are the ingredients?

Daylon: The specific ingredients in vaccines are proprietary, but having worked with modRNA, I can guess that the components are single strands of messenger RNA (mRNA) that has been modified to make it get into cells without causing them to self destruct. I know that the Pfizer and the Moderna vaccine also use lipid nano-particles (charged nano-particles of fat, not the grey goo of nanotech sci-fi infamy) to encase the modRNA and make it easier to enter your body’s cells/tissues. I would bet that the additives that have historically inspired fear and dread (mercury/thimerosol, etc.) are not a part of this vaccine because the only effective means of preservation are maintenance of freezing or ultra-cold temperatures.

Maia: You you guys know how much I hate “proprietary” ingredients or materials! In my opinion, all ingredients in vaccines (or any pharmaceutical for that matter) should be available to the public.

Update since this conversation took place: Moderna and Pfizer vaccine ingredients are now available. While the chemical names here look long and scary, there isn’t any thing TOO terrifying in either vaccine. I, of course, don’t ever love PEG chemicals, and that appears in both. More on this later.

Q: What exactly is mRNA and how can we feel okay about it when it’s never been used in a vaccine before?

Daylon: mRNA is ubiquitous in the cells of our bodies and the cells of all living organisms. It is a fundamental building block of biology. Viruses are also made of RNA, and eons of evolution have trained the cells of organisms to recognize RNA from outside of the cell as a viral attack, and to self-destruct as a result. But as a therapeutic, RNA is amazing: it translates directly into the bioactive molecules that is codes for; it is not a self-perpetuating material like normal RNA viruses, so it cannot “cause” coronavirus; and it is ephemeral, so leaves no trace after it has been translated into its bioactive payload. The “mod” part of modRNA stems from the fact that among the bases that make up any strand of RNA (A, U, G, C), the “U” or uracil residues are replaced with a “pseudouridine” that makes these modRNAs unrecognizable to the “self-destruct” machinery that usually protects from the action of viral RNA. The bottom line is that the modRNA is a molecule that is effectively indistinguishable from natural mRNA in terms of toxicity.

Maia: I’ve picked Daylon’s brain about this at length, and also done a bunch of my own reading—because doesn’t something that’s basically a virus’s DNA just sound terrifying? I’m now actually convinced this technology is safer than the older means of creating vaccines, and that moving forward we will see all new vaccines being made this way. For parents that can be a little vaccine hesitant (myself included), this will be a double-edged sword; I predict lots more vaccines in the coming years.

Q: How is the Pfizer vaccine preserved? Is there mercury? What about the Moderna?

Daylon: These are both preserved by ultra cold temperatures, so there should not be no need for more traditional preservatives (like the controversial thimerosal).

Q: Are the vaccines a live attenuated vaccine?

Daylon: No. Neither Pfizer, AstraZeneca, nor Moderna are live vaccines. I don’t foresee any of the Covid vaccine candidates being live virus.

Q: How can we trust the safety of any vaccine when it hasn’t been tested long enough to know of any dangerous long-term side effects?

Daylon: The vaccines that use the mRNA (as described above) were able to be produced so quickly because as soon as we received the virus’s sequence from scientists in China, we had a blueprint (basically a map) of all the viral components which could be copied to create the vaccine. The technology has been in development for more than decade. So with the coronavirus that causes Covid-19, scientists read the genetic sequence of this specific virus, and plugged it in to the vaccine. The discovery process for a vaccine is actually very short because you copy the virus that already exists—as opposed to trying to come up with a therapy for most illnesses. In the past, the modalities have been less effective (the original smallpox vaccine, for instance, was literally just tiny amount of smallpox). The technology over the last century has been incrementally improved to the point that we longer have to introduce a living organism into the body. The safety trial had the required phases (1, 2, and 3)—and all the data was released and is still available. The bottom line is that yes, I trust the process. There were simply no red flags during the trials or regulatory process, which is also part of the reason this has gone so quickly. I am more comfortable taking this vaccine that is made of something (RNA) that exists in nature versus a drug that has to be taken chronically and is usually something the body has never seen.

Maia: One thing that really strikes me here is that with vaccines the therapy IS the disease. Imagine trying to come up with a treatment for say, lupus. Where do you even begin? With vaccines, you’re putting something “natural” into the body. Maybe we should be less worried about vaccines than we are about the medications we take on a daily basis.

John: I am in general very skeptical of “big pharma.” I have never gotten the flu shot, but from all the research I’ve done, it seems this RNA technology may actually make this a safer option.

Q: What is the probability of adverse side effects, especially for my son, who has had bad reactions and febrile seizures after a vaccine in the past?

Diane: Having a reaction to one vaccine does not necessarily mean you will have a reaction to another—it depends on the ingredient in the vaccine. For example, just because someone is allergic to peanuts doesn’t mean they will also be allergic to almonds. Many people have mild reactions to vaccines—these are minor, expected, and show the body is successfully making an immune response to the vaccine as it is supposed to. Pain, redness, and swelling at the injection site are all normal reactions, as are flu-type symptoms such as muscle aches and low-grade fever. Reactions beyond those are very rare.

Daylon: I think it’s important to recognize that some side effects occur as a result of your immune response to the vaccine. These can be acute, like the patients with histories of highly allergic reactions, or they can be normal consequences of the vaccine provoking an immune response. Indeed, early reports from people who have received the vaccine suggest that after the second dose the inflammatory response is significant. Popular media and disinformation campaigns have made “vaccine side-effects” virtually synonymous with “autism spectrum disorder.” There is no scientific basis for this potential or similar neurological complications stemming from this vaccine. On the contrary, I am personally terrified of the cryptic neurological sequelae of Covid-19!

Q: How far out from giving a vaccine do side effects usually show up? Are we pretty much in the clear if we have people a few months out from getting vaccinated and no serious side effects have shown up, or do we truly need to wait a much longer period of time?

Daylon: I believe the criteria for the phase three trial required waiting three months after initial dose for reporting of side effects, and given that first patients received their doses July 27th and the trial wrapped in mid-November, this lines up. I don’t think there is a scientific basis for thinking that side effects of the vaccination would present themselves beyond the short term (days to weeks). In ten days there will be zero trace of that RNA in your body. That’s why it has to stay ultra cold; it’s incredibly fragile. I feel that any poor outcomes would almost certainly happen quickly.

Diane: Most side effects occur in the first two days and they are local pain at the injection site, muscle aches, low grade fever. So far there are not any long term effects but of course most people in the trials have only had 3-4 months since having been given either vaccine.

Q: I have an auto-immune disease and am worried that this puts me at extra risk of a severe reaction to this vaccine.

Diane: There is no reason having an autoimmune disease will make the vaccine less safe for you. In fact,  you may be more at risk from Covid than someone without an autoimmune disease. However,  if you are on immunosuppressive drugs for your autoimmune disease, you should seek advice from your treating physician.

Q: My daughter has egg and dairy allergies; would this be safe for those with allergies?

Diane: So far, six people in the U.S. apparently had a severe allergic reaction to the vaccine. Hence people with a history of anaphylaxis (a severe allergic reaction) may want to wait until more information on this becomes available.

Maia: Felix is allergic to peanuts, but because he’s never had an anaphylactic reaction, he is considered at normal risk with this vaccine. I may decide to lurk around the pediatrician’s office for a half hour after he gets jabbed to make sure nothing happens, because I have read that if an allergic reaction is going to happen, it’ll happen very quickly.

Suzanne: I react to bee stings and penicillin, so I would certainly let my doctor know this before getting the vaccine. Because I’ve never had anaphylaxis, I’m not worried enough about a possible reaction to not get the vaccine.

Q: Would this vaccine produce life long immunity or would it be like the flu shot that is required year after year?

Daylon: This remains to be seen, but I doubt one vaccination (even if it’s two doses) will confer lifelong immunity. The virus will—like all virures—mutate, but studies do suggest that the minor mutations won’t mean the vaccine won’t work. I don’t think we will need to come up with a new vaccine each year the way we do with the flu shot, but we will just have to see.

Diane: The vaccine trials showed that the vaccine provided protection in at least 95% of patients. The assumption is that it will prevent Covid-19. How long that protection lasts is, at this time, unknowable. Some vaccines, such as measles, presumably produce lifetime immunity. Tetanus, on the other hand, needs to be renewed every 5 to 10 years.  It remains to be seen with Covid, but in the current pandemic with widespread passage from person to person, even a few months of immunity is extremely valuable.

Q: What do you make of people being infected with Covid more than once and the fact that natural antibodies seem to disappear over time?

Daylon: Antibodies do become undetectable, but you have to think of those as just soldiers on the field–and if you’ve been infected with this coronavirus, your body has the ability to deploy more soldiers. Our immune system is multifaceted—it’s just that antibodies are the easiest part to measure via a blood test. I think even if antibodies have disappeared, it would be highly unlikely to become reinfected with this strain of Covid-19; all evidence suggests that the vast majority of people should be able to mobilize an effective immune response for years after establishing initial immunity.

Diane: There are only a handful of cases—maybe 5—of documented reinfection among the tens of millions of cases of  worldwide, and even those may be dubious or reflect a rare mutant virus. Hence the likelihood of getting ill with this Covid strain again is infinitesimal. Even so,  apparently people in the high risk groups, front line health care workers and nursing home residents, who have had Covid, will still get the vaccine to boost their immunity and provide further protection in case natural immunity to Covid is not robust.

Maia: If I had been infected with Covid-19 already, I would feel comfortable waiting on the vaccine. I don’t personally feel that people who have already recovered need to rush out to get this shot. In fact, if they hold back, that means more doses for those who are still vulnerable!

Q: Isn’t natural immunity just as valuable or even more important than vaccine immunity? My family is healthy and we take care of ourselves–I worry more about the vaccine for us than I do about the disease.

Daylon: Natural immunity is not necessarily better or stronger than vaccine immunity, and moreover, I don’t think it’s worth the risks that come with being infected with Covid-19. The unknown risks of Covid really concern me—this disease has existed for one year, and I worry about what we will see in ten years from people who have been infected.

Suzanne: With many diseases, I would prefer natural immunity rather than an injection. When it comes to Covid, though, I don’t think it’s worth the risks. I usually defer to the wisdom of the body, and I understand why anti-vaxxers say we should trust our bodies. But we are in the middle of a global pandemic, and dealing with a brand new virus. Perhaps because I eat well and exercise I could handle the disease and emerge with natural immunity. But I also recongize that this is a privileged position. We are part of a community and we do have some responsibility to protect people who may not have the resources to live a perfectly healthy life. Perhaps even more importantly, it is possible to be healthy and also become very ill from a new virus—just consider what happened when Europeans arrived here in the 1500s and infected Native Americans with flu and smallpox. I imagine that most Native Americans ate very clean food and were fit and had high vitamin D levels! But the simple fact that the viruses were new and no one had any immunity was enough for them to devastate the population.

Maia: Just because diseases are “natural” doesn’t mean that they are benign. We know that HPV can cause cervical and other cancers. Hepatitis B can cause liver cancer. HIV is, of course, a virus.

John: Your natural immunity is fending of things all the time that we aren’t even aware of. I’d like my body to also fight this off without my even being aware–and I’d rather do that via the vaccine than by getting Covid.

Q: If we opted to not vaccinate – or, let’s say we get vaccinated but we decide not to vaccinate our kids – what does that mean for herd immunity? At what point are most of the unvaccinated people actually protected – what is the statistic and when would we reach it?

Daylon: There are various estimates for what the threshold percentage is for herd immunity, but I don’t put much stake in any single number. The fact is that the threshold is highly dependent on how transmissible the pathogen is. For example in the case of measles, it is estimates that more than 90% of the population must be vaccinated to interrupt the chain of transmission. Then there are other variables like vaccinating in the midst of a pandemic as opposed to prophylactically. Ultimately the only answer that makes sense to me is that we need as many people as it is possible and prudent to vaccinate. I don’t think we will really have an idea about the threshold for herd immunity until the pandemic is behind us.

John: Since the beginning of this pandemic, there have been those in favor of a “let it rip” strategy. I don’t think there is really a herd immunity “debate”—we all want herd immunity, whether through vaccination or natural infection. It’s a question of how we get there—and in my opinion, the vaccination is likely to be the safer path, and one with many fewer lives lost in the process.

Q: What do you think about this vaccine for pregnant or nursing women?

Daylon: If it were my wife, my calculation of the risk would be that the vaccine is better than the disease during pregnancy. There is an identifiable risk of Covid-19 to pregnant women, and that concerns me.

Diane: The vaccine was not tested in pregnant or nursing women, but the manufacturers plan to do further testing. Right now, ACOG recommends that Covid-19 vaccines “should not be withheld from pregnant individuals” and should also “be offered to lactating individuals similar to non-lactating individuals when they meet criteria for receipt of the vaccine.”

Maia: I think this is a hard one. There are vaccines that are not recommended during pregnancy (like varicella and MMR), although the risks of these are called “theoretical.” If I were pregnant, I suppose I would have to evaluate my personal risk of catching Covid (based on how isolated I could be, what the community transmission was in my area, and so on). Of course, I know that my husband would want me to get it, because he’s concerned about what risks Covid-19 itself might pose to a pregnancy. If I were nursing, I would feel comfortable getting the vaccine.

Q: If we have a choice of which vaccine to get, is there one you would recommend over another?

Daylon: I like both the Moderna and Pfizer and would choose these first. This is based mostly on my judgement of their efficacy and the mode of treatment. As a comparison, the AstraZeneca vector is based on adenovirus, which is also safe in my opinion, but may not be as effective in eliciting a vigorous immune response. Some studies have shown that because the actual adeno-based vectors themselves are designed from the adenovirus that causes the common cold, some individuals may have varying levels of pre-exisiting immune response to the vector, thereby mitigating the amount of corona spike protein that is created by the adenovector to elicit a constructive immunity to Covid-19.

Diane: I doubt there will be a choice in the early months of which vaccine to take. It will depend on supply and what regions get what, so I think you get what you get until the spring when perhaps there may be more options. After that, unless new information surfaces, I think either vaccine is acceptable with very similar efficacy.

John: Based on my research, I’d prefer one of the mRNA ones—so either the Pfizer or the Moderna.

Maia: I also want one of the RNA vaccines, and I’ve researched the ingredients of both in the hopes of being able to determine if one is better than the other one. The good news is even the worst ingredients in both are rated about a three out of ten on EWG’s hazard scale. These aren’t “Good Stuff,” and nothing I generally recommend even in something like body lotion (for instance, polyethylene glycol), but fortunately neither has some of the ingredients in conventional vaccines that concern me most (such as aluminum). The two RNA vaccines have slightly different ingredients, but neither one seems safer than the other. UPDATE: I do have a preference, actually.

Q: I’m very nervous about the possibility of forced vaccinations. Can you speak to this?

Daylon: I don’t see that happening. Even within my hospital, they are recommending it for all employees, but not requiring it.

Suzanne: I’ve read that they cannot force a vaccine that it’s still under emergency approval. And a vaccine has never been forcibly given to all people.

John: There’s not one politician that’s talking about forced vaccination. At the institutional level, sure—schools may eventually require a Covid vaccine, or it may be required for travel. But it doesn’t seem likely that they will come banging on doors to inject people.

Q: What source does Dr. James get his information from? Curious what third parties, etc. he trusts on the information he reads regarding the vaccine and analyzing the study results. Same question to the rest of you! 

Daylon: I am basing my opinions on the clinical science studies that have been filling the medical/scientific journals as well as the foundational science that has been done on corona and other viruses, generally, as well as the technologies (adeno-associated vectors and modRNA) that I have grown familiar with in my own research. People should know that all of the media reporting is a distillation of firsthand science that is being done for the first time on a novel coronavirus. While there have been previous coronaviruses (MERS, SARS1), these have not had the same scale of infection, and thus only a small proportion of the scientific focus. As such, the scale of the research interest and effort with this coronavirus is unprecedented and vastly exceeds any knowledge we may have gained from previous studies. Given this tremendous volume of research, there is a lot of media distillation that may misrepresent the totality of our understanding. We must be careful to support every claim with evidence from a primary source. I rely on peer-reviewed work from the most reputable journals, and when there is no peer-reviewed study available I have relied on preliminary data, when available, and my intuition when not.

Q: Is there any evidence that the Covid-19 vaccine contains a tracking microchip that will be implanted into my arm if I get this vaccine?

Daylon: No.

Diane: No.

Maia: No.

Suzanne: No.

John: No.

What do you guys think? I expect a heated debate on this, so please comment below!

Maia, Founder & CEO