Questions About COVID-19 Vaccine Risk

Updated: Aug 1

Antibodies bound to virus.
Image By Kateryna Kon

Data shows that the COVID-19 vaccines are safe for the majority of people. The vaccines also induce a strong immune response, especially the mRNA based vaccines. In terms of best efficacy (efficacy meaning induction of an immune response), it looks like a wash between Pfizer and Moderna, while the J&J vaccine produces a weaker antibody response. The current data on COVID-19 related hospitalizations, ICU admissions and deaths show that the vaccines are protective against severe infections, since most people who now end up in the hospital are unvaccinated (1, 2).

Safety concerns are real and there is a subset of people who have adverse events (AEs) to the vaccines. However, besides age and gender, there has not been a widely published report on the demographics, pre-existing immune signatures or genetics in those who have vaccine related AEs. It is likely that people who react poorly are predisposed to a vaccine related complication. Meaning, AEs aren't just random.

Those people could be reacting to the nanoparticles, the mRNA vector or to the viral spike proteins produced by your body after vaccination. Or they could just have immune system that runs a bit hot, and it doesn't take much outside stimulation to go haywire.

The number of adverse cardiac events in young people, especially males, is high. The vaccine seems to be causing heart issues in some men under 29 years old (22-27 myocarditis events per million doses). We need to know more about who is having these adverse events and why.

There are legitimate concerns about complications and considering the high COVID-19 survival rate in the under 29 year old age cohort, it is reasonable to question the risk vs benefit of vaccination. This is especially true when not much is known about the vaccinated people who have cardiac events. You should discuss your own vaccination risk-benefit with your physician.

The AE issue is complicated by the lack of quality data. People often cite the VAERS database, but that database is messy and subjective. Anti-vaxxers and pro-vaxxers alike will tell you that, albeit for different reasons. Insurance claims, hospital medical records and genetics are probably the best data sources to determine the who, what, why and when of vaccine related adverse events.

However, the low rate of adverse events means that individual health systems or insurance companies may not have enough member data to discern specifically who has AEs. If that is the case, then multiple clean data sources need to be aggregated to reach a better understanding.

Unfortunately, analysis like that hasn't been done or hasn’t been widely shared. The analysis is not easily performed without access to those clean data sources. So we need people from inside those institutions to fill us in. It would be a great public service.

There are now emerging reports about breakthrough infections in vaccinated individuals. This is not surprising considering the relatively high mutation rate of RNA viruses, like SARS-CoV-2. Antibody neutralization is on a continuum, so as the virus mutates, your antibody repertoire loses some, but not all effectiveness. This means that even in breakthrough infections vaccinated people have a little protection, which most likely translates into reduced severity.

It is possible that SARS-CoV-2 variants will continue to emerge until everyone has been infected, even vaccinated people. The difference will be whether you have some protection due to past vaccination, or if your immune system has no pre-existing recognition of SARS-CoV-2. Depending on your personal risk associated with comorbidities, a vaccination may make a big difference for your outcome.

The good news is that people who recovered from a COVID-19 infection are protected against reinfection and likely protected against emerging variants. This is because infection induces an immune response against multiple viral targets, which makes immune evasion more difficult for the virus. You can read Cure-Hub's report on that here.

And because I believe in transparency and providing people with the clearest picture possible, my vaccine situation is that I am 35 years old, have no pre-existing conditions, am in good health and I received the Pfizer vaccine in March. Prior to vaccination I never had a COVID-19 infection. My main motivation for getting vaccinated was the fact that I sometimes collect blood samples in person and have collected directly from infectious individuals.

Note: Do not consider this medical advice. If you have questions, then you should run anything written here by your own physician.

You can see the CDC’s statistics on adverse events, hospitalizations and deaths here.

If you want to get a COVID-19 neutralizing antibody test and participate in Cure-Hub's nationwide antibody study, then click the sign up button below. The study has no external funding and is paid for by the participants or individual donors. The cost is $64 for a test + $35 if you need a sample collection kit shipped to your door. Click the donate button if you would like to support Cure-Hub without participating in the antibody study.

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