One has to decide which is the greater risk, COVID or the coronavirus vaccine. It is an incomplete risk management analysis to consider only one. Sometimes, the risk of inaction is greater than that of acting. Long term side effects of vaccines occur. So does death from COVID-19. What are the relative risks of each?
Long-term Side Effects of COVID-19 Vaccine? What We Know.
Feb 04, 2021
Feature Article: Long-term Side Effects of COVID-19 Vaccine? What We Know. | Children's Hospital of Philadelphia
Since COVID-19 mRNA vaccines are new, some people have asked about their effects on those who take them. Short-term side effects (i.e., those that happen in the days after a vaccine has been given) are readily apparent because of clinical trial reports and personal experiences, but people also wonder about possible long-term effects of these vaccines. To answer this question, scientists study the available evidence, and while the rules of science do not allow scientists to say that long-term effects can never happen, the evidence is strong that mRNA vaccines will not cause long-term harm.
The evidence
Vaccine history
The history of vaccines shows that delayed effects following vaccination can occur. But when they do, these effects tend to happen within two months of vaccination:
- Oral polio vaccine — About 1 in 2.4 million recipients of the oral polio vaccine, which is no longer used in the U.S., were paralyzed following vaccination when the vaccine virus reverted to “wild type” poliovirus. This happened when genetic changes to weaken the virus in the lab were lost during viral replication in the vaccine recipient. Paralysis occurred about seven to 30 days (one to four weeks) after vaccination. Because vaccine recipients “shed” the virus in their stools, on occasion, contacts of these people would be paralyzed when they were infected, and the genetic reversion occurred in them. This secondary event could happen up to 60 days (eight to nine weeks) after the first person was vaccinated (because it took time for the virus to spread to the next person).
- Yellow fever vaccine — The yellow fever vaccine is not routinely recommended in the U.S., but it is required for travel to certain countries. Two delayed negative effects have been detected after receipt of this vaccine:
- Nervous system involvement — This effect causes swelling of the brain or spinal cord. It occurred most often when infants younger than 6 months of age received this vaccine, which is why this group is not recommended to get the vaccine. It can also happen, albeit less frequently, in those older than 6 months of age who receive the vaccine. When this happens, the average time between receipt of the vaccine and symptom onset is two weeks, with the range up to three weeks.
- Viscerotropic disease — This condition is characterized by multisystem organ failure. Yellow fever infection can also cause multisystem organ failure. This adverse event happened so infrequently that it was not described until the early 2000s. In this situation, vaccine virus replicates and spreads throughout the body; onset occurs less than one week after vaccination, most often, occurring about three days after receipt of the vaccine.
- Influenza vaccine — Two severe adverse events associated with influenza vaccine are also instructive:
- A 1976 swine influenza vaccine was identified as a rare cause of Guillain-Barré Syndrome (GBS), an ascending paralysis that can involve the muscles of breathing; however, subsequent studies have not found flu vaccines to be a cause of GBS. In contrast, influenza infection is also a cause of GBS. GBS occurs 17 times more frequently after natural infection than vaccination. Almost all cases following vaccination occurred in the eight weeks after receipt of the vaccine.
- In 2009, during the H1N1 pandemic, one influenza vaccine used in Finland was found to cause narcolepsy in about 1 in 55,000 vaccine recipients. Narcolepsy is a sleep disorder characterized by excessive fatigue and periods of sleep throughout the day. Despite various influenza vaccines used during the pandemic, only one caused this issue, which was believed to have resulted from the way that particular vaccine was made. The average onset of symptoms occurred within seven weeks of vaccination.
- MMR vaccine — About 1 of 30,000 recipients of measles, mumps and rubella (MMR) vaccine can experience a temporary decrease in platelets; a condition called thrombocytopenia. Platelets are the cells responsible for clotting of blood. Both measles and mumps infections can cause thrombocytopenia. This condition is most often found between one and three weeks after vaccination, but in a few cases, it occurred up to eight weeks after vaccination.
These experiences demonstrate two important findings. First, when these events occurred, the onset was within eight weeks of receipt of the vaccine. Second, in all of these cases, except narcolepsy following H1N1 vaccine, the side effect of the vaccine was something that could be caused by the infection, meaning that getting infected with the virus also carried a risk of experiencing these outcomes. In the narcolepsy experience, the cause was determined to be related to the adjuvant used in that preparation of vaccine.
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Here's a new wrinkle:
Alabama fan who attended NCAA Tournament dies from COVID-19: reports
A 23-year old died rather quickly of COVID this past week. This bodes poorly for the youth of the world who are used to a virus that mostly spares 23-year olds, and most of those that are afflicted recover or at worse, develop long haul symptoms, but don't see ICU's, vents, or morgues. Maybe they were careful for a few weeks a year ago, but they quickly learned that they need not be. It's on this basis that they say, "I'm going to Florida on spring break anyway."
That may not work now, and ought to affect everybody's risk management assessment, since the risk of infection is likely to increase with new variants that make it into the virus pool. Remember, mutations are random, and can make the virus more virulent and/or lethal, less, or neither. Only the first kind will meet Darwin's criteria for entering and modifying the viral gene pool (fittest at reproduction), and only for the worse. Mutations to the viral binding protein my make the virus harmless if it can no longer bid, or more dangerous if it binds better. As I said, the former mutations are lost, and the latter replace the less "successful" strain.
