Covid vaccines: the top 10 myths — part 2

This feature addresses the main misunderstandings and misinformation around the coronavirus vaccine. This is part 2 of a two-part feature by Paul Clarke.

Myths 1―5 are covered in Part 1 of the feature.

This two-part article examines the 10 main reasons being advanced by people who are either hesitant about getting jabbed or ideologically opposed to the whole idea of vaccination. It looks at the basis of these objections, considers if they have any reasonable standing and examines the scientific and statistical arguments that governments and health authorities have used to promote greater vaccine take-up.

Myth 6: I have already had Covid-19, so don’t need to be vaccinated

This seems a fair assumption, given that one of the ways of fighting infectious diseases in the past was to build up “herd immunity”, whereby a high enough percentage of the population have been infected and the survivors have built up enough antibodies to deny the disease the chance to spread. Vaccination is of course a far more effective method and results in far fewer deaths. However, thousands of people caught Covid before the vaccination roll-out, so, as this means they would have built up antibodies by recovering, why do they need extra protection?

It is important to point out that evidence is still being collected in this area and some small studies have indicated there is little difference in the level of protection while others, particularly in the United States have said that the vaccine is more effective at targeting the receptor binding domain (RBD) and thereby preventing the virus from using its spike protein to bind to cellular receptors in the human body.

Elsewhere, the BMJ has reported on a study which examined the antibody responses in 109 people: 68 of them had never had Covid-19, whereas 41 had previously tested positive. The antibody concentrations of those who had previously had the disease were 10 to 20 times those of people who had never been infected; two weeks after a single dose of vaccine, people who had previously had Covid-19 had antibody concentrations that were up to 10 times higher than the levels seen in uninfected people who had received two doses of the vaccine.

According to an article in Nature, a growing number of studies suggest that many people who have been infected with the coronavirus might be able to safely skip the second jab of any two-dose vaccine regimen. These studies show that people with previous exposure to SARS-CoV-2 tend to mount powerful immune responses to single shots and gain little added benefit from another injection. France, Germany and Italy are among the countries now advising only one dose of vaccine for people with a healthy immune system and a confirmed previous diagnosis.

It is important to note that this is largely because of the need to make the most of limited supplies and not for any reasons of safety. A single dose of the vaccine is still required in those instances and there is certainly no indication that having the second dose causes any ill effects. Having both jabs may be an excess of safety but in the present circumstances that may well be better than the alternative. Certainly, the World Health Organization (WHO) and other public health agencies think so as, having considered the evidence, they recommend that those who have recovered from Covid-19 still get vaccinated.

Myth 7: The vaccine has side effects that can make you seriously ill

The point has been made several times already that, contrary to many of the assertions made on Twitter and Facebook, neither the pharmaceutical companies involved nor any of the national public health authorities have ever denied that there have been occasional side effects of vaccinations. While the great majority of these are of the sore arm/low-grade fever type that thousands of people have noted after their annual flu jab, a very small number have been serious to the point where there have been deaths.

As described earlier, cases of myocarditis and pericarditis have been reported and there have been issues with blood clotting — although it remains to be proved that these were caused by the vaccine; given the large numbers of people involved, problems with blood clots could be expected in a percentage of them even without the vaccine. The current reported rate in the UK for blood clotting after being vaccinated is around 15 cases per million first doses given. The reported rate for both myocarditis and pericarditis is one in one million doses of the Pfizer/BioNTech vaccine (you have far more chance of being struck by lightning) with the risk higher in younger men, more likely to occur after the second dose and mostly occurring within 14 days of getting the vaccine.

Questions have also been raised about possible dangers for people with allergies but the NHS advice on this point is clear. Most people with allergies (including food or penicillin allergies) can be vaccinated against Covid-19, although they should tell healthcare staff before they are vaccinated if they have ever had a serious allergic reaction (including anaphylaxis). Serious allergic reactions to the vaccines are very rare, the NHS notes, and usually happen in minutes. Staff giving the vaccine are therefore trained to deal with this eventuality and to offer immediate treatment.

Public Health England (PHE) analysis released in June 2021 showed that vaccines have prevented 14,000 deaths in older adults between 8 December and 30 May. Protection against symptomatic cases of the Delta variant after two doses were between 77% and 82% and there was a 94% reduction in hospitalisations. An April 2021 study by the University of Oxford showed a 65% fall in Covid-19 infections after a first dose of the AstraZeneca (Oxford) or Pfizer-BioNTech vaccines.

In other words, the vaccines work; they massively reduce the risk of having to be hospitalised or of dying; and the risks of suffering serious side effects are vanishingly small. As every serious study has repeated, however, if you do something hundreds of millions of times and there is even a one in a million chance that something will go wrong then there will be a few serious complications and even deaths. That these sad incidences are then used by online conspiracy theorists to “prove” that they are right, and to persuade others to step away from a demonstrably life-saving programme, is reprehensible.

Myth 8: I have underlying health conditions — the vaccine will make them worse

As we have seen in this review, the arguments used against vaccination tend to fall into a spectrum from the ludicrous (Bill Gates wants to take over the world) to the reasonable and deserving of consideration. This last question falls firmly into the latter category. If someone already has a serious health problem, to the extent that they have been warned to self-isolate for many months, is the vaccine more of a risk for them than for the general population?

In a thorough investigation of this area, the NHS has worked with a number of health charities to examine the situation for those suffering from a wide range of illnesses including cancer, diabetes, asthma, epilepsy, kidney disease, HIV, heart disease, lung conditions, lupus, multiple sclerosis and sickle cell. In all cases it has not only recommended that people be vaccinated but, in many cases, included them in the list of high-risk individuals who should be given priority. This is because people who are defined as clinically extremely vulnerable (CEV) are considered to be at high risk of severe illness from Covid-19. As with the general population, therefore, the risk analysis indicates that the small likelihood of the vaccine causing severe side effects is more than offset by the protection the vaccine gives from catching Covid with the resulting strong possibility of hospitalisation and even death.

When allocating people into priority groups in the early days of the vaccination programme, the Government noted that many individuals considered CEV were in the oldest age groups and should be among the first to receive the vaccine. Given the level of risk seen in this group as a whole, the remainder of the CEV group were to be offered vaccine alongside those aged between 70 and 74.

As NHS Inform Scotland said: “There are very few people who cannot get the coronavirus vaccine. You should only not get the vaccine if you've had a confirmed anaphylactic reaction to: any of the ingredients in the vaccine; or a previous dose of the vaccine”. The coronavirus vaccine is even suitable for people with disorders of the immune system, it emphasised.

Myth 9: I’m young and fit, I don’t need the vaccine

Another assumption towards the reasonable end of the spectrum. With the early emphasis on age in assigning people to priority groups for vaccination, younger people could reasonably feel that their chances of catching the disease were relatively low. Even then, their stronger immune systems should surely ensure that they would suffer only mild symptoms. At first, this seemed a valid argument and most of the pressure on younger people to be vaccinated, when this became possible, focused on their social responsibility to prevent the spread of infection to other (older) people — the “don’t kill your granny” argument.

As the pandemic progressed, however, it became clear that people in their 20s, 30s and 40s could indeed catch the virus with some developing severe and lasting symptoms, particularly if they were living with obesity, diabetes or high blood pressure (hypertension). One US study shows that, of more than 3000 adults aged 18 to 34 who contracted Covid-19 and became sick enough to require hospital care, 21% ended up in intensive care, 10% were placed on a breathing machine and 2.7% died. One UK newspaper reported the case of a 42-year-old mountain-climbing father who told doctors that he had refused the vaccine because he was “superfit and healthy” and thought that, even if he became infected, he would only suffer a mild illness. He died four weeks after contracting Covid. Before he was ventilated he told his consultant that he wished he had been vaccinated. That he wished he had listened.

In August 2021, the new NHS chief executive urged young people to get the Covid jab as figures revealed that those aged between 18 and 34 now made up more than 20% of those admitted to hospital with the virus. Amanda Pritchard said that this figure had risen from 5.4% at the peak of the winter wave in January. “There is no doubt that the NHS vaccination programme is having a major impact”, she said, “keeping around 52,000 people out of hospital and saving an estimated 60,000 lives. However, we must not forget that there are more than 5,000 people who are seriously ill in hospital with Covid and more than a fifth of those admitted are young people”.

NHS England said one-third of 18- to 29-year-olds had still not had at least one dose of the vaccine — a figure that falls to one in 10 for the whole adult population. The latest data from the Office for National Statistics (ONS) show that coronavirus in England is now largely an infection among young adults, with cases in 16- to 24-year-olds almost six times more common than in 50- to 69-year-olds.

Myth 10: The virus doesn’t exist

Virus? What virus? Perhaps the strangest “theory” of all is that Covid doesn’t exist but is instead the invention of a rich and powerful cabal seeking to profit from the resulting pressures put on people to tackle the non-existent pandemic. This seems to require people to believe that national and international news sources are all part of the conspiracy and that every report from hospitals that they see on television is faked and the exhausted doctors and nurses merely actors. Indeed some believers in the theory actually broke into hospitals seeking to film empty wards to prove that the reports of the NHS being overrun were fake news.

A “holistic psychiatrist” who has appeared as an expert on panels for Gwyneth Paltrow’s lifestyle brand Goop, told her followers that the virus is “not real” because she doesn’t believe in “germ-based contagion”. Facebook and Instagram removed her posts which included a statement that deaths attributed to the virus are “likely being accelerated by the fear itself”. She is not alone, as a simple internet search reveals hundreds of posts, websites and threads all dedicated to the belief, as one site puts it, that “the easiest way to control the masses is to fill them with fear and dread of some non-existent enemy, whether human or not. We would need to come up with a legitimate sounding name for this new killer virus, like the ‘Novel Coronavirus’, for instance”.

Once it spread to the QAnon movement, which believes that President Trump is waging a secret war against elite Satan-worshipping paedophiles in government, business and the media, then it was clear that reasoned argument was never going to win the day with the hundreds of thousands, if not millions, of people who subscribe to such beliefs. If you are prepared to accept that Hilary Clinton was part of a paedophile ring that was run from a pizza restaurant, then believing that a virus that has killed thousands of people around the world is just a scare story must be fairly easy.

It is not only in the United States that thousands of people subscribe to this theory; there have been rallies across the UK, including in Birmingham, Bristol and Manchester, where hundreds have marched under QAnon symbols (and the slogan: “It can’t be a conspiracy if it’s true”). That people cling on to these beliefs is also sadly true as several doctors have reported severely ill patients insisting to them that Covid-19 is a hoax, right up until the point they go onto a ventilator.