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COVID-19 Update and Vaccine Information October 10, 2021

Keeping up with the latest on COVID is difficult, so we've updated this link to not only answer questions and dispel myths about the vaccine, but also to give you the latest updates.

The Latest:

The flu vaccine is now available in our office for children 6 months and older. We expect a worse than average flu season this year, so please make an appointment for your child's shot asap.

140,000 U.S. children have lost a primary caregiver due to COVID. If you are a parent, please get vaccinated to reduce the chance your child has to grow up without you.

October 7 Pfizer submitted their formal request for Emergency Use Authorization of the COVID vaccine for patients aged 5-11. The FDA will consider their request at a special meeting October 26. The dose is 1/3 the adult dose.

On September 17 the FDA approved booster shots for those 65 and up who received the Pfizer vaccine and for others 18 and up who are at high risk for severe disease, including with underlying medical conditions, those who live in long-term care facilities, and those who work or live in other high-risk settings. A booster is not yet recommended for those who received the Moderna or J&J vaccines.

On August 23 the FDA fully approved the Pfizer vaccine for persons 16 and up. It is still under the EUA for ages 12-15. They named it Comirnaty, which is supposed to be a combination of community, immunity, covid, and rna. This may be the worst name in history.

September 17 the CDC released a study that found vaccinated people were 10 times less likely to be hospitalized for COVID and 11 times less likely to die than unvaccinated people. Of the 600,000 cases of COVID from April to July, only 8% were in fully vaccinated patients.

The Delta variant now accounts for nearly 99% of COVID infections in the US.

The number of covid patients in our local hospitals has started to drop, but there are still people in their 20's and 30's on the vent.

School has resumed and guidance from the TEA and government has not been very clear. Please stay at home if you are sick or have had a close contact with COVID. We also recommend masks in school for all children 5K and up. For more information on why, please pull up a chair and read this excellent article:

Vaccine information:

Please refer to our previous post, “Should My Child Get the COVID-19 Vaccine?” for more details on how mRNA vaccines work and why we recommend the COVID vaccine.

Here are the common myths and their updates:

Myth 1: It was developed too quickly. Scientists have been developing mRNA vaccines for decades to treat or prevent a variety of illnesses and have been preparing for their use to combat a pandemic. There are several factors that allowed the vaccine to be produced so quickly:

1. Because the basic structure and safety of mRNA vaccines was already known, all the companies needed was the genetic information for COVID-19.

2. The government provided resources to help fund the production and eliminate red tape, thus allowing the companies to overlap steps and gather data faster.

3. Tens of thousands of volunteers quickly stepped up to help perform the studies. It usually takes years to gather enough subjects to test a vaccine.

4. mRNA vaccines are easier and faster to produce than regular vaccines, and the data was so solid that the companies were able to start production even before it was approved so that there would be adequate supply after approval.

We’ve learned that due to the “plug and play” nature of mRNA vaccines it only took Moderna 42 days from getting the mRNA code for the spike protein to producing a vaccine. This demonstrates how established and simple the technology behind these vaccines is.

Myth 2: There hasn’t been enough testing. It usually takes years to get enough volunteers to adequately test a vaccine. In this case, tens of thousands of volunteers signed up for trials, and the virus was so widespread and contagious that it didn’t take long to learn that the vaccine was safe and worked incredibly well. It is about 95% effective at preventing infection, and 99% effective at preventing hospitalization or death. It does not get much better than that. The only thing we do not know is how long the immunity will last, which gets us to Myth 3.

UPDATE – There have now been over nearly 6.5 BILLION doses given worldwide. This vaccine is the largest and most scrutinized medical intervention in the history of the world so there is more data on its safety and effectiveness than any other vaccine in history, all of which suggest the benefits outweigh the risks. A recent study of 1.7 million people who received the vaccine found it to be much safer than natural infection.

Myth 3: It’s not FDA approved so it must not be good. FDA approval requires detailed data on safety, efficacy (how well it works), duration of immunity, and manufacturing processes. Once enough time has gone by to see how long the immunity lasts the vaccines will receive full FDA approval.

UPDATE - Pfizer received full FDA approval August 23, 2021, and Moderna has applied.

Myth 4: There could be long-term side effects that we’re not aware of. If there are side effects of any vaccine, they almost always occur within the first days or weeks after vaccination. We are now almost a year out from the trials, and over 10 months out from full public use. Despite nearly 6.5 billion doses administered world-wide, the only serious side effects have been rare anaphylactic reactions, a rare blood clotting disorder called Thrombosis with Thrombocytopenia syndrome (TTS) that is very infrequently seen with the Johnson and Johnson or AstraZeneka vaccine, and some cases of myocarditis or pericarditis with the mRNA vaccines.

With nearly 6.5 billion doses administered worldwide and intense scrutiny of the vaccine by scientists and the public, these rare side effects have been quickly identified and addressed. Long-term data on mRNA vaccines does not demonstrate any new side effects appearing more than two months after vaccination.

Thrombosis and Thrombocytopenia Syndrome has an incidence of about 2 per million overall, and seems to be more common in women aged 18-49 where the frequency is 7 per million. It typically occurs within 2 weeks of vaccination. Women in that age group many consider getting the Pfizer or Moderna vaccines instead of the J&J, as they have not been found to cause this issue.

Myocarditis or pericarditis has an incidence of about 20 per million, with the greatest incidence in men 30 years of age or younger after their second vaccine, in which case the incidence is about 100 per million. This typically occurs within days of vaccination and in 98% of cases is mild or moderate. Nearly all of the patients studied had complete recovery. Because infection with COVID has a higher likelihood of causing heart problems than the vaccine, the CDC and AAP still recommend vaccination for this age group.

Here's a couple great articles on this subject:

JAMA Cardiology recently did a study on patients 15-18 years of age who were hospitalized with myocarditis after their Pfizer vaccine. Of the 15 cases, 14 occurred after the second dose and 14 were males. All patients were discharged within 5 days, none died, and only one had an abnormal echocardiogram after 13 days. They concluded that despite the risks of myocarditis associated with vaccination, the benefits of vaccination likely outweigh risks in children and adolescents. It is estimated that COVID-19 vaccination in males aged 12 to 29 years can prevent 11 000 COVID-19 cases, 560 hospitalizations, 138 intensive care unit admissions, and 6 deaths compared with 39 to 47 expected myocarditis cases.

Myth 5: The vaccine causes something called Antibody Dependent Enhancement that will cause those who are vaccinated to become more ill than the unvaccinated. Antibody dependent enhancement is when a vaccine causes non-neutralizing antibodies to form which can then actually allow the virus to enter cells more easily, thus causing more severe infection. This has been a theoretical issue with coronavirus vaccines and makes people who emphasize it's dangers sound real smart, but it has not been an issue with the COVID-19 vaccine. If this were an actual problem, vaccinated patients who subsequently became infected would have more severe illness than those who were unvaccinated. What we are seeing is the exact opposite - the low number of people who are vaccinated but still get infected with COVID do not develop severe disease and very, very rarely are ill enough to require hospitalization, while the unvaccinated are filling hospitals and dying. More information can be found here:

Myth 6: Yeah, but I know (someone) who got the COVID vaccine and then (some horrible thing) happened to them, and it was because of the vaccine. Odds are that of the millions of Americans getting the vaccine each day something bad will happen to somebody that day or the next. Most stories you hear are coincidental, so it is only by looking at large populations of people that we can learn if these events are actually caused by the vaccine. The only severe side effects that have been attributed to the vaccine are those discussed in Myth 4. Some people were alarmed when the CDC reported 4,434 deaths after covid vaccination. But each of these were investigated and there was no link found between those deaths and the vaccine. It makes sense when you consider there have been over 363 million doses of the covid vaccine given in the US, and each normal day over 7,800 people die each day in the US of routine causes.

With nearly 6.5 billion doses given worldwide, odds are something bad will happen to someone within a few days of vaccination. Common side effects such as fever, chills, arm pain, and body aches are well known and short lived. Rare side effects such as swollen lymph nodes, Bell’s palsy and tinnitus have been reported after vaccination, but many reports of other problems are coincidental. The benefits of the vaccine far outweigh any risks.

Myth 7: I shouldn’t get the vaccine if I have allergies. Although very rare, there have been people who have had anaphylactic allergic reactions to the COVID vaccine. You should consult your physician if you have a history of an allergic reaction to other vaccines or if you are allergic to any component of the COVID vaccine. The COVID vaccine is safe for people with routine food, seasonal, environmental, and latex allergies.

Myth 8: The vaccines don’t work against new variants of the virus. The spike protein that the mRNA vaccines produce immunity to is common to most strains of the virus, so the vaccine will provide protection against most variants. It is a race, however, because the longer it takes to get everyone vaccinated and get the pandemic under control, the more time the virus has to evolve into a variant that could be more infectious. The South African strain has already demonstrated the ability to infect those who have been vaccinated.

The variants have now been renamed after the Greek alphabet, and each strain seems to be more contagious and dangerous than the last. The Delta variant was first identified in India in December 2020 and was first detected in the US in March 2021. It is felt to be 75% per infectious than the original strain of COVID-19 and has also been found to be twice as likely to cause hospitalization. This variant has doubled in prevalence every 10-14 days and is now causing about over 99% of COVID infections in the US. The good news is that the mRNA vaccines are very effective at preventing infection or hospitalization with this variant. The Pfizer vaccine is 88% effective against symptomatic disease and 96% effective against hospitalization from the Delta variant.

Myth 9: Vaccinated people become ill with and spread/shed the Delta variant more than unvaccinated people do. Again false. It is true that vaccinated people sometimes do become infected with the Delta variant, but on average they don't get near as sick as the unvaccinated. Anyone who is infected can spread the virus, and in the early stages of disease both those who are vaccinated and unvaccinated can spread the virus equally. But because vaccinated people do not get as sick and do not stay sick as long as unvaccinated people, those who are vaccinated cause less spread than the unvaccinated.

Myth 10: Getting vaccinated is pointless because we may need booster shots. We do not yet know how long immunity from the vaccine will last, but this virus may be with us for decades, so odds are we’ll need a booster at some point.

An article published in the journal Nature found that immunity related to antibody-secreting memory plasma cells can produce immunity from the vaccine that lasts for many years, and possibly a lifetime. Studies are ongoing, particularly related to Delta, but so far it appears the initial series of the vaccine is adequate.

UPDATE - September 17 the FDA approved booster shots for those over 65 years old and persons at high risk for severe illness. These are only for persons who received the Pfizer vaccines. Studies are still pending on the other vaccines and in younger people.

Myth 11: I don't need the COVID vaccine if I've already had COVID. People vary in their antibody response to COVID and how long their immunity may last, and there are many documented cases of second infections. Immunity from the vaccine is much greater and more predictable than from infection, and studies show that people with previous infection can increase their antibody levels 25-100 fold if they are subsequently vaccinated.

It is important to know that you can get the COVID vaccine as soon as you have recovered from the infection, which is usually about 2 weeks. The only time you should delay vaccination is if you received monoclonal antibodies or convalescent plasma to treat COVID, in which case you should wait 90 days.

Myth 12: If I've had COVID I have to wait 90 days before getting vaccinated. This is false. The misunderstanding began when the vaccine first came out and was in limited supply. Because people who had covid within the last 90 days were considered immune, the CDC recommended that they wait to be vaccinated so that the few available vaccines could be prioritized to those who were most at risk. Now that the vaccine is readily available you can get it as soon as you recover from COVID, which is usually about 2 weeks. The exception to this rule is that you should wait 90 days after infection if you received monoclonal antibodies or convalescent plasma. You should also consult your physician if you developed MIS-C or MIS-A due to COVID.

Myth 13: You shouldn't get the COVID vaccine if you've recently had other vaccines. False; there is no restriction regarding the timing of normal childhood vaccines and the COVID vaccine. You can get both on the same day or whenever. We are concerned that this could be a bad year for the flu, so get your flu shot asap too. You can get your flu shot and COVID vaccine simultaneously if you wish.

Myth 14: I’m young and healthy so I don’t need the vaccine, and neither do my children. It is true that children and young adults are at less risk of serious infection. But we have had several children as young as weeks of age become ill with COVID, and many young adults with no medical problems are in the ICU or have died right here in Lufkin. Many others have been very ill or have lingering symptoms. 70% of those hospitalized have symptoms 5 months later, and 30% of regular COVID patients have symptoms that linger 9 months after infection.

Even if you don’t get very sick, you could still spread it. It seems the new variants are even more infectious and cause more serious disease in younger people.

Besides all that, getting COVID is a hassle. The isolation and quarantining can cause psychological harm and has certainly hurt our children academically this school year. Students who are vaccinated will have a huge advantage in school this year because they'll be less likely to miss class and other activities.

Currently 94% of people who are hospitalized and dying from COVID are unvaccinated. Being young decreases your risk of severe infection, but the Delta strain is more dangerous in younger people and there are young adults and parents who are dying of COVID every day who felt they "didn't need the vaccine". You could go from low risk of death to (essentially) NO risk by getting vaccinated. Of the 9000 people in Texas who died from COVID between February and July, only 43 were fully vaccinated. Vaccination nearly guarantees you won't die from COVID.

School has started, and there are no mask mandates, contact tracing, or quarantining of contacts in most schools. Not only will those children be getting and spreading COVID, but they will be bringing it home to their parents and loved ones. Young, healthy parents who thought they didn't need the vaccine are dying every day from an infection that could have been prevented. Who will take care of your kids if you're gone? The CDC report August 24 found that the median age of vaccinated patients admitted to the ICU as 64, whereas the median age of unvaccinated ICU patients was 49. The median age of the 24 vaccinated people in the study who died was 78, and 25% of them were immunocompromised. The median age of the 176 unvaccinated people who died was 63.

Myth 15: The vaccine can cause infertility or cause you to have a miscarriage. This myth arose from a false report on social media, saying that the spike protein on this coronavirus was the same as another spike protein that is involved in the growth and attachment of the placenta during pregnancy. The false report said that getting the COVID-19 vaccine would cause a woman’s body to fight this different spike protein and affect her fertility. The two spike proteins are completely different and distinct, and getting the COVID-19 vaccine will not affect the fertility of women. During the Pfizer vaccine tests, 23 women volunteers in the study became pregnant, and the only one who suffered a pregnancy loss had received a placebo, not the actual vaccine. During natural infection the immune system generates the same antibodies to the spike protein that COVID-19 vaccines would. Thus, if COVID-19 affected fertility, there already would be an increase in miscarriage rates in women infected with COVID-19. This has not happened.

UPDATE – This is still untrue, regardless of what Jessica on Facebook posted. Dying from COVID, on the other hand, does make it difficult to reproduce.

Myth 16: The vaccine will affect my genes and cause birth defects. That is not true; the mRNA vaccines do not enter the nucleus where your DNA is.

Myth 17: I shouldn’t get the vaccine if I’m breastfeeding or pregnant. Not only is the vaccine safe during pregnancy, but studies show that 99% of babies will have antibodies to COVID at birth. Antibodies also appear in the breast milk. And getting vaccinated while pregnant protects the mother too because pregnant women who get COVID can go into premature labor and are also at higher risk of becoming more ill and needing ICU care or even ventilator support.

The vaccine has continued to be found to be safe and effective in women who are pregnant or breastfeeding. The NIH is performing a study of 1,000 women who received the vaccine while pregnant or just after having a baby to help fill in any gaps in knowledge.

The CDC and ACOG both recommend the COVID vaccine for those who are pregnant or breastfeeding. We have had many pregnant women in Lufkin who have been extremely ill or even on the ventilator due to COVID.

Myth 18: Bill Gates put a microchip in the vaccine. This myth started after comments made by Bill Gates about a digital certificate of vaccine records, not a microchip in the vaccine itself. The only microchip tracking you is in your phone.

Myth 19: The vaccine can cause magnets to stick to me. The vaccines contain mRNA and other normal vaccine ingredients such as fats, salts, and a small amount of sugar. The COVID vaccines were not developed using fetal tissue, and they do not contain heavy metals, preservatives, implants, microchips, or tracking devices. How do people think of these things?!

UPDATE – This is still ridiculous.

Myth 20: The vaccine has fetal cells in it. Also false. It is true that the J&J vaccine is reproduced in a line of retina cells that were cultivated from a fetus in 1985, but there are no fetal cells or DNA in the vaccine. The mRNA vaccines are produced completely differently and have absolutely no relationship to embryos or fetal cells.

Myth 21: The vaccine is the “mark of the beast” and this is all a sign of the second coming. God gifted humans with minds that can decipher the world around us and use science to improve it. It is my opinion that this and other vaccines are gifts from God that have saved millions of lives! It is our duty as Christians to care for “the least of these”. Getting vaccinated not only protects you, but others as well.

Myth 22: Why should anyone care if I don’t get vaccinated? You make your choice, and I’ll make mine. There are three problems with this attitude. One is that the vaccines aren’t 100% effective, so if you get infected there is a small chance you could spread to it someone who has been vaccinated. Second, children under age 12 and people with certain medical conditions cannot get vaccinated, so they are depending on herd immunity to not get ill. Our children are counting on us. Third, the more people who don’t get vaccinated, the longer the virus will circulate and the greater odds it will mutate, become more infectious, and put us right back where we started from.

Areas of the country with the lowest vaccination rates are currently the ones experiencing the greatest outbreaks. This will only worsen now that school has started back up and when we return to more indoor activities this winter. As the more contagious Delta variant spreads, those who are unvaccinated will spread the virus to others, worsening and prolonging the pandemic. It’s your choice to be part of the solution or contribute to the problem.

Myth 23: Alternate therapies for COVID like Ivermectin are safer and more effective than the vaccine. Although eating a healthy diet, exercising, drinking plenty of water, getting enough sleep, and taking a multivitamin every day can help keep your immune system in top-shape, the vaccine is still the best way to protect yourself. There are no legitimate studies that support alternative treatments. This quote from the article linked to below says it best, "Relying on low-quality or questionable studies in the current global climate presents severe and immediate harms. The enormous impact of COVID-19 and the consequent urgent need to demonstrate the clinical efficacy of new therapeutic options provides fertile ground for even poorly evidenced claims of efficacy to be amplified, both in the scientific literature and on social media. This context can lead to the rapid translation of almost any apparently favorable conclusion from a relatively weak trial or set of trials into widespread clinical practice and public policy." In other words, trust your doctor and not a poorly-done study you find on the internet.

We all just want our lives to get back to normal, and getting the vaccine is the best way to do that.

Vaccine availability: The Pfizer, Moderna, and J&J vaccine are available at local pharmacies. You may also get vaccinated at the Angelina County and Cities Health District by signing up on their website or walking in. The Health District has Pfizer vaccine available for those 12 and up.

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Ghazala Khan, M.D., FAAP

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Ghazala Khan, M.D., FAAP

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