In this ever changing world of Covid 19 one aspect that remains constant with the ability to disperse rapidly is misinformation about Covid 19 and none more so than regarding vaccines.
From the incorrect perception that all vaccines are dangerous to unwarranted alternative facts about Covid vaccinations and microchips, the public has been subject to a deluge of data that has at times been difficult to interpret or understand.
Social media campaigns against vaccination or propagation of myths have not helped.
Some of these myths can relate to genuine concerns about beef or pork which is a legitimate concern to religious groups. It is clear that none of these can be found in any current vaccines in use in the UK and this is confirmed in patient information leaflet for each vaccine and the vaccine rollout is endorsed by all religious groups were this might be a concern.
A common myth is that mRNA vaccine will change our DNA. Conventional vaccines contain inactivated versions of whatever pathogen causes the disease, or proteins on its surface, to cause an immune response in the body which means it can fight the real infection later.
RNA vaccines instead contain what’s called messenger RNA (mRNA), which codes for a protein specific to the pathogen’s surface. The body uses this mRNA to build its own copies of these proteins, which the immune system responds to by producing antibodies providing protection if the person catches the real disease later. The introduction of mRNA into human cells does not change the DNA of the human cells.
Many discussions on online forums and social media have circulated since mRNA vaccines were considered as a solution to the COVID-19 pandemic. In particular was the potential impact on fertility related to this type of vaccine.
The reason given for this is that the vaccine works by initiating an immune response to a spike protein on the Covid-19 virus’ surface, and that this immune response could also attack similar proteins that make up the placenta, and therefore reduce fertility in women.
A small part of this spike protein resembles a part of another protein vital for the formation of the placenta, called syncytin-1. To date there has been no evidence that mRNA vaccines have any impact on syncytin-1, fertility or the placenta.
The UK Royal College of Obstetricians and Gynaecologists (RCOG) have issued a statement: ”We want to reassure women that there is no evidence to suggest that Covid-19 vaccines will affect fertility. Claims of any effect of Covid-19 vaccination on fertility are speculative and not supported by any data.”
The Royal College (RCOG) also recently updated their advice regarding COVID-19 vaccines since the JCVI (Joint Committee on Vaccination and Immunisation) updated their advice on 16 April 2021 and are now advising that all pregnant women should be offered the COVID-19 vaccine at the same time as the rest of the population, based on their age and clinical risk group.
The advice being that they should be offered an mRNA vaccine only (Pfizer or Moderna).
Previously their advice was that pregnant women, at high risk of exposure to the virus or with high-risk medical conditions, should consider having a COVID-19 vaccine in pregnancy.
The change in guidance is largely based on real world evidence from the US which has shown around 90,000 pregnant women have been vaccinated—mainly with the Pfizer and Moderna vaccines—without any safety concerns being raised.
Until very recently blood clots associated with the AstraZeneca vaccine (and recently Johnson and Johnson) has been and remains topical and important.
It is difficult to call the ongoing review of vaccines controversial but from a medical and scientific perspective this is normal, although we are not living in normal times in terms of vaccines being developed over the course of 9-12 months which is an incredible scientific achievement.
Overall, the UK MHRA (The Medicines and Healthcare products Regulatory Agency) and European Medicines Agency both confirm that the AstraZeneca vaccine is safe and effective and issued statements that harmful blood clotting is likely a rare, but significant, side effect of the Oxford/AstraZeneca Covid-19 vaccine.
Based on current available evidence, specific risk factors have not been confirmed, but the effect is considered significant enough for the UK JCVI to recommend that under 30s do not receive this vaccine and be offered an alternative.
As a medical doctor there is clearly a lot more I could say about all of these topics, as they are broad from a scientific and societal perspective and change on a daily basis. However, I would say that the data suggests that vaccines are working best in the UK or Israel case numbers and mortality are reducing with reduced hospitalisations which are all reassuring.
So when you do get your call up for vaccination I would strongly recommend discussing any concerns with your medical practitioner or vaccinator on the day.
The journey to managing a sense of normality in the shadow of Covid 19 is not complete, however we should draw some confidence that vaccines have largely been shown to be safe and effective.
We must not forget that aside from clean drinking water, vaccines as a whole are probably the single most important global health intervention in the past 100 years and are proving to be so again and I believe will do so in future.
Dr Reval Sukkhu, Senior Physician, HCA Primary Care
