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Little adverse reaction but great social benefit to COVID vaccine

Doctors treating Central Virginia’s COVID-19 patients say vaccines against the virus are proving safe and recommend people take the vaccine as soon as it’s offered.

The University of Virginia physicians say they understand that people, especially in communities of color, may distrust the medical community but they say the vaccine is the best bet to help minority communities being hit hardest by virus.

“We knew we’d be the first group to get it and we were looking forward to getting it as soon as possible,” said Dr. Cameron Webb, a geriatric specialist who works with COVID patients and serves as the UVa hospital’s director of health policy and equity.

“We did the research and we looked at the safety statements and reviewed the literature,” Webb said. “I felt like we know more about this vaccine than any other I’ve had in my life.”

Webb and his wife, UVa hospital emergency room physician Dr. Leigh-Ann Webb, got their shots together on Thursday, Dec. 17.

“On Friday I had some muscle discomfort in the arm but I typically get sore with the flu vaccines as well. By the time I woke up [last] Saturday, the soreness was gone. I had a couple of minor joint pains, but they didn’t last long,” Webb said. “My wife actually had a fever [last] Friday, right about 101.8. For her, that’s a typical vaccine reaction. She woke up [last] Saturday morning and felt back to normal.”

“I basically had zero side effects. It was a pretty boring procedure for me,” said Dr. Ebony Jade Hilton, an anesthesiologist and critical care physician who works with COVID patients at UVa Medical Center. “I don’t usually have much of a reaction to vaccines.”

The doctors, and others who have taken the vaccine, will need to get a second shot in three to four weeks. Dr. Taison Bell, a critical care physician and director of the medical intensive care unit at the medical center said the second shot may have a stronger reaction.

“I have friends who were in on the trials and said the booster creates more immunological response, like fevers or aches,” said Bell, who will get his booster shot on Jan. 5. “It’s not anything to be worried about. [A reaction] is a sign that things are working the way they should and that your body is creating antibodies.”

“Fevers and aches are classical vaccine reactions. It means your body’s immune system is gearing up and you’re gaining immunity,” said Webb. “It’s not a reverse reaction, it means that your body is learning to recognize and build immunity.”

Reports of strong allergic reactions to the vaccine have been reported in Great Britain and the U.S., but the doctors say those reactions occur to about one person in every one million.

“As more vaccine is distributed, will see if the numbers are higher, but they appear to be similar to other vaccines. Of course, if you’re that one person, it’s devastating. If people are on multiple allergy medications – and I know people who take five or 10 medications – it’s important to talk with their doctor,” Hilton said.

“Overall, the safety profile of this vaccine is similar to others. We know people, typically, refer to a normal immune reaction as a side effect, but if you develop a fever or body aches, that’s an immune reaction that means your body is working. It’s natural,” she said.

The doctors recommend anyone with doubts about taking the vaccine research it. They also suggest using multiple sources of information.

“We’re encouraging folks to do their research and suddenly people are running up against terms that they have never heard, like lipid nanoparticles,” Webb said. “People are trying to get up to speed and when you’re looking for information you sometimes find good sources and other sources that aren’t so good.”

Hilton said it is important for people in minority communities to get the vaccine when it becomes available.

“This is affecting us more. We are dying at younger ages than white people. We’re dying at rates that are equal to white people who are 10 years older than us,” she said. “This happens a lot to minorities. We have higher death rates, infant mortality, breast cancer and other rates. We have less access to health care. There’s an old saying that your zip code is more important than your genetic code when it comes to medicine. Where you live is often more important than your genes.”

Hilton noted that pollution, air quality and water quality often are worse in predominately Black and Latino communities. She noted that six years after lead and other chemicals were found in dangerous levels in the Flint, Michigan water system, the predominately Black population is still being warned by the federal government to not cook or brush their teeth with the water.

“Different people have different responses to the medical community. For undocumented people, they worry that ‘if I get it, will I walk out the door and have an ICE agent waiting for me? For African Americans, it’s a historical mistrust based on historical events,” Hilton said.

“We need to address that. We need to say that ‘we have shown you time and time again, for many generations, that you should not trust us. We are making changes to earn that trust.’ And then we have to do it,” she said.

For minorities, it’s even more important to research the virus to help overcome historic mistrust of the medical community, the doctors said.

Hilton noted that mistrust goes back nearly 200 years. Many studies were conducted on enslaved worker in the 1800s, including those conducted in the 1840s on enslaved women by Dr. James Marion Sims, once heralded as “the father of modern gynecology.”

A 1830s advertisement published by the South Carolina Medical College, now the Medical University of South Carolina, proclaimed that the college could obtain patients from the enslaved community “in sufficient number for every purpose, and proper dissections carried on without offending any individuals in the community.”

Medical tests, experiments and forced sterilizations continued into the 1900s, often as part of eugenics studies. Blacks, as well as prisoners, served as test subjects, usually without being told of the studies or being asked for permission.

The most well-known of those experiments was Tuskegee University’s 40-year clinical study of syphilis conducted on 399 poor Black men who were not told they had the sexually transmitted disease or that they were not being given treatment.

U.S. Public Health Service researchers instead studied the disease’s progression, including its transmission to family members, and did not to treat the subjects even after penicillin became the primary cure in 1947.

The study continued from 1932 to 1972 when news coverage of the study forced its closure. An estimated 128 participants died either from the disease or complications. An estimated 40 spouses were infected with the disease and 19 children were born with congenital syphilis.

The Public Health Service conducted a similar experiment in Guatemala from 1946 to 1948.

“It comes down to a mistrust of government and the medical community and that’s something we in the medical community need to address. Our best hope is to prevent COVID with a vaccine because there is no cure,” Hilton said. “For that, we need people to feel comfortable in getting the vaccine.”

“It’s normal to have questions and concerns about something that is going to be injected into your body,” Webb said. “In many instances, we ridicule people who are worried, but it’s normal to be hesitant. The question is how do we address those concerns?”

Webb said he was ready to take the vaccine because of his experience treating patients with the disease and his research.

“I was an early adopter because of what I’ve seen clinically and I’ve been following the development of the virus and the vaccine for 10 months. Other people aren’t in that situation. We need people to understand how it was developed,” he said.

The vaccine was created quickly using methods developed through the creation of other vaccines and an all-out international push to find a vaccine. It uses a tiny portion of the virus, called a lipid nanoparticle, to stimulate the body into creating antibodies.

“If you think of a car, when you take the vaccine you get a steering wheel. Your body looks at that steering wheel and says ‘that doesn’t belong here’ and develops antibodies to clean it out,” Hilton said. “The next time it sees a steering wheel, it will automatically get rid of it.”

Although the vaccine will bolster immune systems and is believed to be about 95% effective, that doesn’t mean that someone cannot become an asymptomatic virus spreader. The doctors agreed that, even after the vaccine, people should continue social distancing and wear face coverings.

“We can’t say that it prevents people from getting infected. We can’t say that it will be impossible to spread it, if they do get infected,” Webb said. “What we can say is that the chances are significantly less and, with the increased immunity, the impacts will be significantly less.”

“The vaccine is the hope we have to end this pandemic,” Bell said. “We have a conversation we need to get out there. There are people who want information and they need health care providers to be held accountable.”

“I feel like I’m on my way to getting last bit of protection and it’s good knowing that by January, when I get that second dose, I’ll be vaccinated against COVID,” Webb said. “I’ll continue to take the precautions we’ve been taking, with masks and social distancing, but I’ll have that background level of security knowing that my body will have an extra bit of defense.”


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