In 2003, I joined some colleagues for a professional retreat at the Coeur D’Alene Resort. It was wintertime and the drive from Pullman was fraught with drifting snow and icy roads. During one of the meeting breaks, a casual conversation drifted to favorite meals and one of my valued colleagues shared his recent decision to stop eating beef. There are many reasons for such decisions, but I was surprised to hear that concern over mad cow disease (BSE) was the primary motivation. As was demonstrated in the U.K. during the 1990’s, consuming cattle with BSE is a risk factor for prion disease in people.
In 2003, BSE was on our minds because of a recent case in Washington state, but the primary concern was about risk to commerce rather than human health. We already knew that BSE was extremely rare, and this has borne out with only six confirmed cases of BSE in U.S. cattle since 2003. These included one import from Canada and five in older animals that likely arose from spontaneous mutations. None entered the food supply. No cases of cattle-to-human spread of prions has ever been documented in the U.S. Consequently, the opportunity for acquiring disease from U.S. cattle is vanishingly small. Meanwhile, between 2003 and 2018 nearly 600,000 Americans died in motor vehicle crashes.
My colleague had risked life and limb to get to our retreat in northern Idaho, but he found this to be perfectly acceptable while considering the risk of acquiring a prion disease from modern beef production systems to be excessive. This story comes to mind as people consider the relative risks from vaccination versus infection. For a pandemic, risk not only includes the individual, but it includes our family, friends, communities and economy.
For those who are hesitant, consider the remarkably short history of vaccine problems in the U.S. In 1955, live polio virus was present in some vaccine batches; in 1998-99, a new rotavirus vaccine caused severe complications in infants; in 1976 the swine flu vaccine was associated with a serious auto-immune disorder. There have been contaminated batches of vaccines (polio 1955-63, rotovirus 2010, and human papillomavirus, 2013), but none of these were linked to injuries or deaths. There have been other scares that proved unfounded in 1998, 2005, 2007 and 2009. In 1998, Andrew Wakefield raised the idea that childhood vaccines might be linked to autism (based on eight self-referred cases), but this hypothesis has been thoroughly debunked by multiple breathtakingly large epidemiological studies. In short, with literally millions of annual vaccinations in the U.S., we’ve had remarkably few problems and most of these have come from manufacturing issues, each of which led to improved standards.
So where does this leave us with COVID-19 vaccinations? For those who delve in conspiracy theories and deny the existence and severity of the pandemic or who simply harbor a deep and abiding distrust of medicine, there’s a very high probability that they will skip the vaccine and remain a significant risk to those who can’t have vaccines including people suffering from cancer and auto-immune diseases.
Many very reasonable people are concerned about the speed with which COVID-19 vaccines are being developed under the reasonable assumption that speed might translate into insufficient safety testing and opportunities for mistakes, and concerns that the FDA faces enormous pressure to license vaccines that would not normally pass safety assessments. These days it might feel wrong to trust the system, but keep in mind that the FDA also relies heavily on independent review to help guard against poor decisions.
Furthermore, the Pfizer vaccine that rolls out this week (and the Moderna vaccine that will follow soon) is the simplest possible vaccine design and thus it is not surprising that testing with over 44,000 volunteers has identified no serious side effects. Consequently, the risks of vaccination are unmeasurably low compared to the very real risks from the disease. That makes vaccination a no brainer (I will enthusiastically roll up my sleeve at the first opportunity). I hope that most Americans will make the same decision and help rid us of this pestilence.
Doug Call is a microbiologist and father of three.He first discovered the Palouse 37 years ago.