More than 150 million Americans have been fully vaccinated against COVID-19. But even as that number approaches fifty percent of the U.S. population, misinformation and misconceptions about the vaccine and the science behind it are making it difficult to drive that number to even safer levels.
Addressing the issue, the Stony Brook University Labor Council hosted a COVID-19 vaccine panel on June 23 that featured a diverse group of Stony Brook experts, moderated by Stacey Finkelstein, associate professor of marketing in the College of Business, and vice president for academics, UUP West Campus.
“The underpinnings of vaccine hesitancy are numerous and deal with questions ranging from science to psychological biases,” Finkelstein said. “Anti-vax attitudes are not the same as being hesitant, and even those who are pro-vaccine may experience hesitancy… People who are hesitant have questions, and we’re hoping to answer some of them here today.”
Kenneth Kaushansky, senior vice president of health sciences at Stony Brook University, took on questions surrounding the current COVID variants, including the Delta variant, which he described as “totally expected.”
“We know that the natural history of virtually every viral infection is that it will mutate with time,” he said. “By ‘variant’ we mean that the nucleic acid structure changes. Most of those changes are irrelevant, but occasionally the virus creates a mutation that makes it more transmissible or enables it to escape immune system surveillance.”
Kaushansky said the variant is now in almost every state in the United States and that mutations have changed the infectivity, but not in any way that affects the ability of natural or vaccine-induced immunity to deal with it.
“This variant is supposed to be a bit more infectious than the other viruses, but it’s completely covered by neutralizing antibody responses that are directed by any of the vaccines that are generated,” said Erich Mackow, professor, Department of Microbiology and Immunology, Renaissance School of Medicine at Stony Brook. He said a very small number of breakthrough cases — around 1 in 10,000 — are yielding mild COVID positivity but not serious disease. “These vaccines seem to be almost 100-percent effective against serious disease, hospitalization and death, which is a very important point.”
Bettina Fries, chief of the Division of Infectious Diseases at Renaissance School of Medicine, pointed out that those who have received a full course of vaccines and who are infected now are not being hospitalized or dying.
“We’re seeing younger people coming in, and yes, they don’t get as sick as the older folks, but they do get sick, and in some cases, very sick,” she said. “That is the reason the CDC (Centers for Disease Control and Prevention) is pushing for everybody to get vaccinated.”
Immunologist Catherine Feintuch addressed confusion surrounding Food and Drug Administration (FDA) approval and the difference between full FDA authorization and emergency-use authorization.
“Look at it as comparing a courthouse wedding to a country club wedding,” she explained. “At the end of the day the two people are still married, but the bells and whistles are different. With the emergency-use authorization, you have all the critical safety and efficacy information submitted. The only piece that’s missing is the six-month follow-up data. Moderna and Pfizer have already submitted for full authorization approval. We’re in unprecedented times, but no steps were skipped and the safety and efficacy data we have is very, very good.”
The panel also reviewed concern for potential long-term effects as a contributor to the vaccine decision-making process.
“When we talk about vaccines, what we are actually doing is giving somebody a substance against which their body makes an antibody response,” said Fries. “This antibody response sort of becomes a cell memory response that will remember this antibody response. If years from now you need to fight coronavirus again, your body will still be able to mount this antibody response.”
Fries said that vaccine-hesitant people may fear an unwanted immune response that accidentally recognizes not only the virus, but something else that you have in your body, which is called an autoimmune response.
“We would have seen that already, and we didn’t,” she said. “After two months your antibody response is at its max. If you don’t see it by then, there’s no reason to believe that you’ll see it 10 years from now. There have been patients that had thromboembolic events (blood clots) that we are looking into. But there’s no biological evidence that supports something developing 10 years from now, and the concern of the vaccine somehow getting integrated into your genome is also not biologically supported.”
Mackow said that “the other side of the coin is that instead of worrying about the side effects of the vaccine, what we should be worrying about is the long-term effects that we don’t know about from having gotten COVID and whether damage from the infection will predispose us to later pulmonary or cardiac disease. Those are going to be much more worrisome going forward.”
Feintuch offered a sobering observation regarding future exposure.
“Everyone’s going to be exposed to coronavirus at some point,” she said. “It’s here to stay for the foreseeable future, and unless you plan to isolate and mask yourself for years, you will be exposed. So, you really can’t compare the vaccine versus nothing; the appropriate comparison is getting the vaccine versus getting coronavirus.”
Fries advised those who were pregnant that the only way they can protect their baby is by being vaccinated before the baby is born. “From a protective point of view, you protect your baby best if you give them as many antibodies as possible before they are born,” she said.
“Many people are misinformed and just don’t know it,” she said. “They truly believe in their information as much as we believe in the information that we’ve gathered here.”
She also advised double-checking your own information when it seems to conflict with someone else’s.
“Try not to treat the conversation as a corrective lecture,” she warned. “Many times you hear, ‘Oh, I just read it on Facebook’ or ‘I just saw it on Twitter.’ People don’t realize those are just platforms and not sources of the information. They are not going to be responsible for every single piece of information that’s circulating on them.”
Kaushansky offered some final guidance and advised not to wait get vaccinated.
“You can take precautions and be as careful as possible, but if you go out there’s a chance you might get infected,” he said. “Why wait? People who work in the health sciences didn’t wait. There’s not a lot to fear here.”
Fries said that in every worldwide pandemic, the breakthrough came with vaccines.
“Go ask the older folks who saw kids die of measles growing up. Polio was a nightmare two generations ago. Plague killed a third of Europe in the 1300s and recurred until the 19th century. With all of these, progress came from hygiene and vaccination. Almost every physician at Stony Brook Medicine got vaccinated. Why? Because we saw those patients die, we saw terrible and devastating loss. 40,000 kids lost a parent during this pandemic.”
“As a psychologist, I know that fear and risk are very personal judgments, and it’s really important to listen and heed the experiences of those who have been on the frontlines treating patients,” said Finkelstein. “Sometimes we process things emotionally, but we really need to think about the very real consequences to not being vaccinated.”
— Robert Emproto