How Legitimate Are Concerns & Trepidation Over New COVID-19 Vaccines?

Compiled by Robert E. Martin

California's health workers are refusing to take the new COVID-19 vaccines - with over half of frontline workers at one hospital unwilling to take it;  and between 20% and 50% of workers at other facilities who feel the same, according to the Los Angeles Times.

At St. Elizabeth Community Hospital in Tehama County, fewer than half of the 700 hospital workers eligible for the vaccine were willing to take the shot when it was first offered. At Providence Holy Cross Medical Center in Mission Hills, one in five frontline nurses and doctors have declined the shot.

Roughly 20% to 40% of L.A. County’s frontline workers who were offered the vaccine did the same, according to county public health officials.

So many frontline workers in Riverside County have refused the vaccine — an estimated 50% — that hospital and public officials met to strategize how best to distribute the unused doses, according to Public Health Director Kim Saruwatari. 

As the Times notes, vaccine doubts among healthcare workers have come as a surprise to researchers, 'who assumed hospital staff would be among those most in tune with the scientific data backing the vaccines.'

But what exactly is that scientific data and how can we be assured of its veracity?

"I’m choosing the risk — the risk of having COVID, or the risk of the unknown of the vaccine," said 31-year-old nurse April Lu of the Providence Holy Cross Medical Center in Los Angeles, who added that she refused to take the vaccine because she wasn't convinced of its safety for pregnant woman. Lu is six months pregnant.

The extent to which healthcare workers are refusing the vaccine is unclear, but reports of lower-than-expected participation rates are emerging around the country, raising concerns for epidemiologists who say the public health implications could be disastrous.

A recent survey by the Kaiser Family Foundation found that 29% of healthcare workers were “vaccine hesitant,” a figure slightly higher than the percentage of the general population, 27%.

“Even the name, Operation Warp Speed, draws some concern for people about the rush to push it through,” said Dr. Medell Briggs-Malonson, an emergency medicine physician at UCLA Health who has received the vaccine. Still, she urged her colleagues to do the same.

Another healthcare worker, office assistant Nicholas Ruiz at Natividad Medical Center in Salinas, California says that while he interacts with nurses who deal with COVID-19 patients, he's not taking the vaccine either.

"I feel like the perception of the public with healthcare workers is incorrect. They might think we’re all informed of all of this. They might think that because we work in this environment," said Ruiz, adding "But I know there’s a lot of people that have the same mentality as the public where they’re still afraid of getting it."

With Pfizer's messenger-RNA (mRNA) vaccine several legitimate concerns have been voiced.

The links below are to articles that describe the mRNA vaccines in greater detail. All these sources are respected journals or media outlets.

Vaccines against viruses work by introducing an inactive virus or viral particle into the bloodstream where this new foreign particle activates our immune system to create antibodies against this specific virus. If the live virus infects us at some later date, our immune systems are already primed to identify and destroy the dangerous virus.

Messenger RNA was only discovered in 1961. DNA is the set of instructions, the "blueprint", and mRNA is a key part of the cellular machinery that copies a strand of the DNA "blueprint" and builds a protein based on the DNA instructions.

Messenger RNA vaccines don't introduce a viral particle to our immune systems -- they deliver cellular instructions (i.e. a "blueprint") for a viral particle which our cells reproduce once the mRNA enters our cells and delivers the "blueprint" for assembling the viral particle.

Here's a recent description of this mechanism from The Atlantic magazine:

"Moderna works on RNA vaccines--injecting not proteins but the molecules of nucleic acid that encode the instructions for building the proteins. Your cells use RNA to instruct their builders to make proteins all the time; the RNA is like the blueprints or schematics that tell the workers on the factory floor what to build."

COVID-19 Vaccines Are Coming, but They're Not What You Think. (March 2020)

And here's another description by a doctor writing in the independent.co.uk:

This is the hard-to-swallow truth about a future coronavirus vaccine (and yes, I'm a doctor)

"Moderna's messenger RNA vaccine, on the other hand, is completely new and revolutionary to say the least. It uses a sequence of genetic RNA material produced in a lab that, when injected into your body, must invade your cells and hijack your cells' protein-making machinery called ribosomes to produce the viral components that subsequently train your immune system to fight the virus.

In this case, Moderna's mRNA-1273 is programmed to make your cells produce the coronavirus' infamous spike protein that gives the virus its crown-like appearance ('corona' is crown in Latin) for which it is named."

Many in the field see the potential for mRNA to deliver superior vaccines because they can generate T-Cell responses as well as the conventional immune responses to viral particles. They are also easier and cheaper to manufacture, and may be stable at room temperature for a week, unlike the Pfizer vaccine which must be refrigerated at extremely cold temperatures.

The Super Cold Covid Vaccine Distribution Problem

But these are the first mRNA vaccines ever seeking approval for human use, and so there are no long-term studies of what might go wrong down the road. This is a major concern because of the following reasons:

One concern is the possibility that mRNA vaccines could trigger a generalized immune response (interferon, etc.) rather than just a specific immune response to a specific virus (antibodies, etc.).

Our immune system is extremely complex and I make no claim to have a complete understanding of it. That said, the immune system has several levels of response. A conventional vaccine triggers the production of a specific antibody that "recognizes" a specific invader. In other cases, the immune system can activate an "all hands on deck" generalized response.

The danger is that the mRNA could trigger an "all hands on deck" response that could then cascade into autoimmune disorders in which the immune system goes haywire and starts attacking the body's own cells rather than limiting its destructive capabilities to foreign viruses, bacteria, etc.

One doctor’s summary encapsulates these concerns.

• Regarding the Pfizer vaccine: it is the first mRNA vaccine ever approved for human use.

If COVID was a 'Steven King' (kills-everyone) virus, sure, go for it--prevent the deaths and take what comes.  But mortality is low, acute treatments are improving, transmission is preventable, and the greatest risk now appears to be longer term morbidity.

• mRNA vaccines by the very nature of their components elicit an interferon response that triggers generalized autoimmunity. This may, in fact, be part of the mechanism of longer term morbidity associated with COVID infection.

• Mass introduction of mRNA strands into the populations may indeed reduce acute COVID morbidity and mortality, but how many autoimmune complications will result? No one knows. It's never been done before -- ever.

• It would take years of carefully controlled and limited trials across all ethnic groups to find out. Is the net good from a vaccine that fewer people die up front but a whole lot more folks suffer long term problems on the back end--especially (as seems likely) boosters will be required.

• Shouldn't there be a discussion before 'immunity passports' are mandated? For that matter, shouldn't we discover how long natural immunity lasts before trying to provoke induced immunity?

First, A Vaccine Approval. Then "Chaos and Confusion." (NY Times)

"It has not yet dawned on hardly anybody the amount of complexity and chaos and confusion that will happen in a few short months," said Dr. Gregory Poland, the director of the Vaccine Research Group at the Mayo Clinic.

"I can see people reading a lot into even minor differences that could just be statistical chance," said Natalie Dean, a biostatistician at the University of Florida."

The FDA has set the bar very low for Covid vaccines: the vaccine only has to be effective for 50% of those taking it to be approved. But as noted above, Big Pharma companies have mastered the art of statistical legerdemain that skew results so they look far more conclusive than they actually are.

If you've actually poured over Phase III drug trial results, you find uncertainties have been papered over with statistical analysis techniques. Many medications are approved that only work less than half of the time in the real world.

Another healthcare professional correspondent recommended the book Tainted Truth: The Manipulation of Fact In America as a source for understanding how study data are manipulated to get the desired results.

The danger here is the poorly-informed, politically polarized general public will assume a Covid vaccine is essentially 100% effective like a measles vaccine, when the real-world efficacy might be considerably less certain. 

Maybe the vaccines will only work for 75% of the recipients. How will anyone be able to tell if they're one of the 25% for whom the vaccine offers only false confidence?

No one knows how long the immunity generated by these vaccines will last. These two uncertainties generate insurmountable doubts, very likely muddying the waters and making it more difficult to ascertain which vaccines actually work and for how long they offer immunity.

Maybe the mRNA vaccines will fulfill their promise the first time out of the gate, with near-perfect efficacy and long-lasting immunity. The problem is it will take a long time and careful, de-politicized, independently confirmed studies to reach any trustworthy conclusions.

In such a highly polarized, politicized environment, is such a scrupulously objective study even possible? In a system that rewards self-serving statistical analysis and "first to market," a system where Big Pharma insiders reap millions of dollars selling their stock on the PR of happy-talk, is it even possible to have truly objective studies of a vaccine's efficacy and long-term effects?

It seems doubtful. And that's a problem that extends far beyond the unknowns of mRNA vaccines.

Here are some links on mRNA vaccines:

•    The Trump Administration Shut a Vaccine Safety Office Last Year. What's the Plan Now?


•    mRNA vaccines -- a new era in vaccinology (Nature, January 2018)


•    Five things you need to know about: mRNA vaccines (EU Research, April 2020)


•    COVID-19 and mRNA Vaccines--First Large Test for a New Approach


•    RNA vaccines: an introduction


•    An mRNA Vaccine against SARS-CoV-2 -- Preliminary Report


•    Immunological considerations for COVID-19 vaccine strategies (Nature)


•    The Vaccine Tightrope