There are currently three COVID-19 vaccines awaiting approval by the U.S. Food and Drug Administration. FDA approval will trigger millions of vaccine doses to be distributed across the U.S. and administered to the first “tier” of recipients, likely consisting of health care workers and congregant living residents.
What was only a thought experiment this summer — “would I be willing to get a COVID vaccine developed in the time frame of less than a year?” — has become a question I answered in reality last week as my health department began planning its tier one vaccine supply request, of which I am a part since I am a public health nurse there. I have had my own concerns related to the vaccine, which I have reconciled for myself; my hope is that sharing my thought process may help you as well.
First, I admit that I do not fully understand the mRNA vaccine — but there are plenty of things about science and medicine that I don’t fully understand, yet accept as fact. Since I am not an immunologist or vaccine expert, I have to trust that the community of professionals has been as honest and thorough in their assessments of these vaccines as they have been with all other vaccines before them. The electrical wiring in my house is best tended to by an electrician; I try to be an informed electricity consumer, but I mostly leave it up to the professionals. I choose the same approach here.
Second: I, too, have concerns about long-term vaccine safety. Truly, only time can tell about any long-lasting effects of the vaccine, but we must first survive the pandemic in order to be affected by long-lasting effects — survival that is made more likely by receiving the vaccine. More than a quarter-million people have died in the U.S. from COVID-19, and the University of Washington Institute for Health Metrics and Evaluation projects that number to nearly double over the next four months. The more time we spend on research and development and getting comfortable with the idea of the vaccine, the more people who will get sick and possibly die.
These vaccines have been developed quickly as a result of safety trials, efficacy trials, manufacturing and distribution planning happening concurrently rather than sequentially as they have in the past. No part of the process has been skipped — instead, it is all being done at the same time and must all be completed satisfactorily before any vaccine is approved by the FDA and offered to the general public. This saved time is a gift, and I accept it gladly.
Third, some of my colleagues are concerned about being treated as “guinea pigs.” I am happy to report that my friends and colleagues who participated in the clinical trials took that role on for us and have reported only minor complaints of the flu-like symptoms common following vaccine receipt. No amount of tweaking will make any vaccine 100% safe for every person, but the side effects appear minor and definitely not as big or bad as the virus’ effects on our bodies and communities.
I know that my opinion as a white woman may be of little comfort to communities of color that historically have been exploited in medical research. I am buoyed by the fact that the trials have enrolled a proportion of Latinx individuals exceeding their proportion of the U.S. population and that Moderna fell just 3% short of Black Americans’ proportion of the U.S. population. I am also heartened by the Black Coalition Against COVID-19’s encouragement of Black Americans to get the COVID vaccine, which was signed by the presidents of four HBCU Colleges of Medicine, the National Medical Association and the National Black Nurses Association.
I, and many of my friends, family and colleagues have lingering concerns, including the need for transparent data regarding safety, children and pregnant persons, as well as more experts expressing faith in the vaccine’s safety and efficacy, and difference between these trials and historical trials. Personally, my biggest fear is that the vaccine will not be as effective under real-life circumstances as it has been in the controlled setting of a clinical trial — but if that is the worst-case scenario, then I am OK with giving it a shot.
Jenna Mermer is a public health nurse with the Howard County Health Department in Maryland.
