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  • Alex Cloherty

Safety, side effects, stars, and sandwiches

In this new world filled with different options for vaccines to protect us against SARS-CoV-2, there is still a lot of public uncertainty about vaccines. Many times medical/biomedical specialists just stop at, "vaccines work, just vaccinate, don't worry about it", but for a curious and engaged public this can be totally insufficient. And I mean, I totally understand the concern about putting something into your body that you don't really understand. That's why I don't eat anything with an ingredient I can't pronounce.

I've written before about how vaccines work on an individual level, how vaccines protect us on a population level, about how rare side effects from vaccines are - both in general and for the AstraZeneca vaccine against SARS-CoV-2 in particular - and about the (extremely low) risks of any long-term side effects from vaccination. But today, I want to talk about how scientists actually find out how safe vaccines are in the first place, and how we track those side effects. Even if it's only a small fraction of the population that has side-effects, it is definitely worth talking about - but in a rational and logical manner, not in a fear-mongering one. Before vaccines are ever administered to a broader public, they are rigorously tested in clinical trials. It's a very stringent process, and getting more so all the time, and it's all designed to ensure that only the safest and most efficacious possible vaccines are licensed. During clinical trials, vaccines typically need to be shown to be both safe, and effective. If they don't work as well, or aren't as safe, as an alternative preventative option, they won't get licensed. This means that, to be licensed at all, a vaccine not only has to be safer than both the disease it protects against, but its effectiveness at preventing disease and its safety has to be so good that, as the Centers for Disease Control and Prevention (CDC) clearly put it, "benefits must outweigh risks". Another important thing to know is that administration of all vaccines is continually tracked in Canada, the USA, the EU, and in pretty much every other industrialized country I looked in to. Since I'm not an expert on the patient side of things, I asked a friend who is a medical doctor how the procedure goes more practically. She confirmed that medical specialists are expected to report any adverse reactions to their national tracking system, with details about the reaction as well as the vaccine (down to the batch number). So indeed, they are diligently tracked and followed up these days. As far as I can tell, the only scientifically-backed fear about vaccines stems primarily from a total catastrophe in the 1950s that I wrote about here. There is no other way to put it, that was a catastrophe. Having said that, modern vaccines are typically constructed in a totally different way, so as to be much safer. In short, they only ever use pieces of a virus or bacterium, never the whole thing, as in that 1950s-era polio vaccine that went terribly wrong - and that is because we learned from this horror. Then, let's talk about that old fear about vaccines and autism. It is just totally nonsense. The one and only medical doctor who published on the topic had his medical license revoked for fraud and negligence. And, his paper that asserted that specifically a new vaccine that had just come out caused autism failed to disclose that he had a financial interest in the continued use of earlier versions of that vaccine. In other words, he was in a position to make a profit off of people not swapping to the new and improved vaccine that he was painting in a bad light. Definitely not the kind of guy I would want to take advice from.

I think it's also important to point out here, that the people working in health science are great people who believe in a better future. There are bad eggs like the "vaccines-cause-autism" guy, but I really don't believe they are in the majority. And usually, they get caught and punished. Working in the biomedical field myself, most of the time I am surrounded by hard-working, meticulous people who believe in helping humanity. And frankly, at least in academia, we don't get paid enough to work as hard as we do without that intrinsic drive. As for the pharmaceutical industry? For the most part, it is the same. Sure, they are profit-driven, but there are also other profit-driven industries that those people could have worked in. The people I know who went to industry chose biomedical research, instead of business or finance for example, to try to make a difference - to help people. When it comes down to it, industry is often just better at streamlining processes and getting products out to people than academia. It's a more polished machine. We do work together, it's just that academics usually just get too excited about the next project to valourize a treatment idea, so they license it to industry and pharmaceutical companies take over from there.

Having said all this, I guess it is clear that medicine has had its highs and lows. What I always come back to, though, is that the risk of vaccinating is far, far smaller than the risk of not vaccinating. Getting back to the food analogy, the contents of vaccines are clearly defined, and meticulously designed to be as safe and protective as possible. Side effects are tracked carefully and reported on. It's analogous to eating at a Michelin star restaurant. Maybe you don't know exactly all of the ingredients, but you can sure as hell trust it'll be good. Not getting vaccinated? That's like opting out of the Michelin star meal to eat the half-eaten sandwich you found in a public restroom. Until next time,

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