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Everything you need to know about the reactions to the COVID-19 vaccines


COVID vaccines have been in use for nearly a year. ‘If there was something that was going to manifest in a delayed fashion it would be manifesting now, and it’s not,’ Dr. Juurlink said

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Dr. David Juurlink is often asked to see people with rare, and sometimes extraordinarily rare, side effects from drugs. “Very often that’s a delayed reaction,” he said: Someone might take an antibiotic for a skin condition and, six weeks later, end up in hospital with damage to a major organ, like a kidney or lung.

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In 35 years of studying drugs and their side effects, Juurlink has seen the “weirdest of the weird.” But, the authorized COVID-19 vaccines? “These are some of the most remarkably safe and effective drugs in medicine today,” said Juurlink, head of the division of clinical pharmacology and toxicology at Sunnybrook Health Sciences Centre in Toronto.

He also believes there is no convincing reason to believe they could have long-term risks, months or years out. “I can’t think of even an obliquely plausible mechanism.”

New drugs brought on the market sometimes have side effects that only “manifest” after widespread use. That has happened with the COVID-19 vaccines — the blood-clotting syndrome linked with the viral vector vaccines AstraZeneca and Johnson & Johnson ; the rare but still higher-than-expected rates of heart inflammation associated with Moderna and Pfizer’s mRNA shots, particularly among young males and primarily after the second dose. The unexpected side effects occurred within weeks or days of vaccination.

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However, “There is simply no reason to suspect that, after a year, or five, or 10 that there is going to be some long-term consequence,” Juurlink said. “I’m not even aware of a vaccine in current use that has long-term side effects.”

“We’re all going to have a date with this virus, whether we like it or not. The question is, how sick do you want to get,” he said. “The only long-term effect of vaccination is protection from disease, from hospitalization and from death.”

A free paper stuffed into some Ottawa mailboxes this week that falsely claimed authorized COVID vaccines haven’t been proven safe or effective and that “safer treatments” exist, highlights ongoing attempts to sway the hesitant, and the online vitriol is heating up as Health Canada considers clearing COVID vaccines for younger children. With the U.S. approval of Pfizer’s pediatric vaccine Tuesday night, millions of American children ages five to 11 could be vaccinated by Christmas.

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“What it all comes down to is our tolerance for risk,” said Dawn Bowdish, Canada Research Chair in aging and immunity and a professor at McMaster University. “And the human brain is sort of programmed to think that doing nothing is safer than doing something. That is not always an accurate assessment of risk.”

“The risk of having COVID is much, much larger, and the risks of health effects that come post-COVID are much larger,” she said.

We’re all going to have a date with this virus, whether we like it or not. The question is, how sick do you want to get

What side effects are people reporting? What’s known so far about COVID-19 vaccine reactions?

A preprint published last week based on side effects reported to a U.S. database that tracks adverse vaccine reactions found that the majority of reports over a six-month period, when more than 298 million doses of mRNA vaccines were given, involved side effects that were “mild and short in duration.” In all, 4,472 reports of death were analyzed; death certificates or autopsy reports were available for 808 of them. Among these, heart disease was the main cause of death, followed by COVID-19. Deaths reported up to 42 days after vaccinations were 15 to 50 times less frequent than the expected background rates of death from all causes, per million people vaccinated.

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According to Health Canada’s latest report on side effects reported following COVID-19 vaccination, of 20,818 individual reports (representing 0.036 per cent of all doses administered) 5,394 were considered serious (0.009 per cent).

In both Canada and the U.S., as well as other countries, more females than males are reporting side effects from COVID shots. In Canada, women account for the majority (74.8 per cent) of adverse event reports, and while Health Canada says it’s not clear whether this is “due in part to health care seeking behaviour” (meaning women are more likely than men to report a side effect to their doctors) or to biological differences — females tend to have more vigorous antibody responses to vaccines, experts say.

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The question is, when do you know enough?

As a result, “women do tend to have more the aches and pains and headaches and missed days from work and feeling unwell,” Bowdish said. Some of it is down to sex hormones and some to other features of female biology scientists don’t fully understand, she said. However, as a woman who feels like “garbage” after her annual flu shot, and who was “incapacitated” for a day after her second dose of Moderna, Bowdish can sympathize.

A research letter published this week found a noticeably higher risk of a brain blood clot known as cerebral venous sinus thrombosis, or CVST, compared to pre-COVID levels in women vaccinated with the one-shot Johnson & Johnson vaccine (which hasn’t yet been distributed in Canada), especially 30- to 49-year-old women. However, the absolute risk was “whisper higher,” based on the raw numbers, Bowdish said.

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With myocarditis, there’s a male bias — it occurs far more often in young males than females, for reasons that aren’t entirely clear.

Canada is continuing to monitor for the heart inflammation risk, and the complication loomed large during a recent FDA advisory committee meeting studying the Pfizer-BioNTech shots for five- to 11-year-olds. Myocarditis historically has been less common in younger children, and the Pfizer vaccine for this age group uses a third of the dose given to teens and adults.

If there was something that was going to manifest in a delayed fashion it would be manifesting now, and it’s not

“It’s always nerve-wracking, I think, when you’re asked to make a decision for millions of children based on studies of only a few thousand children,” said Dr. Paul Offit, of the Vaccine Education Centre at Children’s Hospital of Philadelphia. “The question is, when do you know enough? And I think we certainly know that there are many children between five and 11 years of age who are susceptible to this disease who could very well be sick and are hospitalized or die from it.”

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Like Juurlink, Bowdish has heard the concerns over possible long-term vaccine side effects. A vaccine works by causing an immune response that is “fully and completely developed” by about eight weeks, she said. “There’s never been a case of a vaccine or immune response turning foul after that time point. The vaccine ingredients are long gone; it’s the immune response that remains. And that immune response is only directed towards one thing,” specifically the spike protein that adorns the surface of the SARS-CoV-2 virus.

Drug side effects are mostly front-loaded, Juurlink said. Some drugs have cumulative toxicity, if taken daily for months or years. Vaccines are not daily injections. “They’re not drugs that, by their nature, accumulate in one’s system,” he said.

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COVID vaccines have been in use for nearly a year. “If there was something that was going to manifest in a delayed fashion it would be manifesting now, and it’s not,” Juurlink said.

They’re not drugs that, by their nature, accumulate in one’s system

Anyone who says the vaccines are without side effects is not being honest, he said.

But, “there are two groups of people that invoke long-term side effects of these vaccines as a reason for not getting vaccinated,” he said. Those who, because of ideological or other grounds, have simply made up their minds not to get vaccinated; and people who might be willing to get vaccinated, “but who get their information from wrong sources, like Facebook, Fox News or the cousin who claims to have done his own research,” Juurlink said. “Those same sources often trivialize COVID as nothing more than the cold or mild flu.”

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People are discounting “at their peril” the long-term health consequences of getting COVID, which, for some people, can be severe, he said.

According to Health Canada data, the most frequently reported adverse reactions include tingling and prickling, pain at the injection site, headache, fatigue, and hives, dizziness, numbness, fever and joint pain. As of Oct. 22, there were 97 reports of Guillain-Barre syndrome, 594 of Bell’s palsy (unexplained facial weakness or paralysis) and 1,111 reports involving the heart, among nearly 59 million doses given. There were a total of 208 reports of death following vaccination with a COVID-19 vaccine, though the agency said they are “not necessarily related to the vaccine.” According to Health Canada, 79 deaths are unlikely linked to the shots, 82 couldn’t be assessed due to insufficient information, 41 deaths are still under investigation and six deaths followed a diagnosis of the blood clotting complication after vaccination with AstraZeneca, which is no longer in use in Canada.

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Ottawa has launched a Vaccine Injury Support Program for those who have experienced a “serious and permanent injury” from a Health Canada-authorized vaccine, including COVID-19 vaccines. RCGT Consulting is delivering the program. The Public Health Agency of Canada won’t say how many claims have been submitted so far, or the number of claims resulting in compensation awards. RCGT is responsible for providing “periodic reporting on the program to PHAC,” the agency said in an email, and it’s “anticipated” that the firm will begin providing periodic public reporting later this year.

National Post

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