By Mary O’Brien, M.D.
“Everything should be made as simple as possible, but not simpler.” Albert Einstein said that many years ago. He was referring to physics, but his wisdom could easily apply to any situation, including COVID-19 vaccines.
Increasing numbers of people in business, politics, education and, of course, the media, are trying to force COVID-19 vaccines on everyone. “Vaccination or termination” has become the new threat to employees and students. Most people, regardless of their lofty achievements in other areas, are not well-versed in the fine points of immunology. Sadly, however, some of them are convinced that they know what’s best for everyone.
Nearly everything in medicine carries potential risk and reward. Both possibilities must always be considered. Every prescription we write and every procedure we do has some potential to cause harm. Every patient is unique. Every individual has a combination of genetic factors, past illnesses, medications, and allergies. Also each patient has metabolic, endocrine, hematologic, rheumatologic, neurologic, and cardio-pulmonary conditions that may need to be considered. For example, patients with rheumatoid arthritis, psoriatic arthritis, Crohn’s disease, and other autoimmune disorders produce antibodies that attack their own tissues, hence the need to suppress — with potent drugs such as TNF (tumor necrosis factor) inhibitors — certain parameters of immune function. Giving such a patient a vaccine, which stimulates the immune system to produce antibodies, can be unwise. This is usually most problematic with live virus vaccines such as those for varicella, measles, and mumps, and rubella. The COVID-19 vaccines are messenger RNA-based. They do not contain live virus.
Pregnant women with COVID-19 illness are at increased risk for serious disease and mortality. According to the Food and Drug Administration, data on the COVID-19 vaccines are “insufficient to inform vaccine-associated risk in pregnancy”. Translation: we don’t know enough yet to be dogmatic about these decisions.
All of COVID-19 vaccines available in the United States (Pfizer, BioNTech, Moderna, and Johnson & Johnson) are safe, effective, and appropriate for the vast majority of people. But good medical practice is not about the vast majority of people. Medical decisions are based on the conditions, needs, and details of the individual patient. Politicians, corporate chief executives, school board members, and media types have no business making (or forcing) medical decisions on other people.
Einstein was right. Oversimplifying anything is a bad idea. So is judging others without knowing all the details.