On Shots, and the Throwing Away Thereof

Hi. So, as many of you probably know, I come from a very large family. With such a large group, there is a correspondingly large diversity of sociopolitical opinions, approaches, positions, beliefs—I dunno what you want to call it, I am SO TIRED. Long story short, it became pretty clear to me pretty quickly that a significant percentage of my loved ones might not be fully on board with the whole treating-COVID-as-a-real-and-serious-thing… thing. So in a fit of optimism and a need to feel like I was doing SOMEthing about *gestures wildly*, I sent the following e-mail to all 43 people on my sister’s family reunion mailing list. I tried to write it as simply, clearly, and non-confrontationally as I could, and I know it could be better but I feel like I got pretty close to where I wanted to get. That being the case, I thought I’d share it here in case someone else might find it useful. Feel free to crib from it if you feel driven to write a similar e-mail. And stay safe out there.

Hello family!

Sorry for piggy-backing on the [reunion] email but I have something I want to share with everyone, because you’re my family and I love you. It’s this:

Covid is extremely serious. But vaccines are extremely helpful. Please get your shots. 

Look, I know there’s a lot of weird baggage around this issue. And before I go any further I want to clarify that the absurdly long message that follows is not, like, copy-pasted from somewhere else. This is all me — your brother, your brother-in-law, your cousin, your nephew, your uncle — and what I’ve learned by reading things by people whose job it is to know about this stuff. I am not one of those people! I don’t claim to know everything about these issues! (I will include sources so you can see where I’m getting my info from, though.) But among people who do actually know about this stuff, these things are very, very clear:

1. Covid is extremely serious. Early on in…all this…some folks tried to downplay the severity of the disease, saying it’s no worse than the flu (or worse, that it was a total hoax) and that the seriousness of the pandemic was being exaggerated for reasons I’m still not totally clear on. By now I hope we can all see that this approach was pretty misguided. As of this writing 4.7 million people have died of it

I know none of us finds it easy to wrap our heads around numbers that big, so to add some context: That’s a bit more than the population of all of Northeast Ohio. Imagine literally everyone in your hometown just…gone — empty houses, shops, schools, for miles in every direction. 

Of course, the flu is serious too! In the roughly 1.5 years since Covid hit, we could have averaged as many as 750,000 deaths from the flu. Still really bad! But Covid is six times worse. And that’s not taking into consideration “long Covid,” where some folks lucky enough to survive the initial onset of the disease continue to experience some of the symptoms for months afterward (and maybe even longer; it’s not fully understood yet). (Also, side note: I say “could have averaged” because this past flu season had dramatically fewer flu cases than average — like around one fiftieth —for reasons I’ll get to in a bit.)

So, yeah. Covid: It’s real bad! Which makes us really, really lucky that…

2. Vaccines are extremely effective. We currently have three Covid vaccines approved for use in the U.S.: Pfizer, Moderna, and Johnson & Johnson. The first two (those are the ones that require two doses) are currently shown to be at least 80 percent effective at preventing infection by Covid — even the more infectious “Delta variant” — and at least 85 percent effective at preventing getting sick from that infection. The single-dose J&J doesn’t seem quite as effective, but it still more than halves your chance of getting infected or getting sick. (All stats as of August 9, from here.) 

(For more about effectiveness, here’s a good primer from the WHO, but basically “80 percent effective” means that the infection will only sneak through the vaccine’s defenses in about one out of every five people — when considering the group of all vaccinated people. So that apparent effectiveness can vary pretty significantly depending on specific situations; like, places where people are in closer contact might see more people getting sick because they’re more likely to be exposed to more people who are already sick.) 

But the really great thing is that even if you get it after being vaccinated, you’re way less likely to get seriously ill from it than unvaccinated people. The effectiveness there gets into the high 90th percentile. (And the effectiveness against death from Covid is very close to 100 percent!) We hear about “breakthrough infections” a lot right now, and I personally know four vaccinated people who have tested positive. Of those four, though, one had no symptoms, two had what felt like bad colds, and one had to spend a day or two in bed. Compare that to a week of misery (at minimum) that Covid brings to unvaccinated people. If you ask me, that’s a pretty fair tradeoff, especially since…

3. Vaccines are extremely safe. I know this is a sticking point for some people. Here’s what we know: Aside from the kind of side effects you might get after a flu shot — slight fever, muscle aches, fatigue, etc. — there have been two issues that have shown any significant link to vaccines. First, a treatable blood-clotting issue called TTS showed up after some folks (mostly women) got the J&J vaccine, at the rate of no more than seven in a million. Three people who did not get the condition treated have died (page 26) — out of 8.73 million doses. The other thing is myocarditis that has shown up in a small number of (mostly minor-aged) recipients of the Pfizer or Moderna vaccines. That’s a potentially bad issue if it lasts, but these cases seem to clear up quickly

So why might we have heard stories about other illnesses or deaths from the vaccines? That’s probably because of how the CDC collects data. They have a database called the Vaccine Adverse Event Reporting System, or VAERS, where anyone can submit details about conditions that arise after getting vaccinated. There’s two really important details in that previous sentence: 1. Anyone can contribute, and it’s not curated by the CDC. That is, it’s intended to be for collecting information, not for spreading information; the claims are evaluated and investigated, and when the scientists and statisticians see a legitimate connection, that then gets shared with the public. (That’s how we learned about TTS and myocarditis.) And 2. The system asks for any symptoms or events that happen after being vaccinated — but “after” doesn’t mean “caused by.” To use a kind of extreme example, if someone got hit by a car walking out of their vaccine appointment, this could technically be submitted to VAERS as a death following vaccination. 

So there’s some statistics for you. I think it’s also useful, though, to consider a more personal side of vaccinations. Like, every living president (and their wives) have been vaccinated; every governor has been vaccinated; at least 80 percent of Congress has been vaccinated… These are people for whom death or debilitating illness would be a very big problem for a very large number of people. But they, their families, their staffs or administrations — they’ve all agreed it’s safe enough. (Source here.) I feel like that says something.

All that said, though…

4. Vaccines can’t do everything. This has been another source of contention, so let’s talk about what vaccines can’t do. So, we know that vaccines are very effective at preventing infection. What we don’t know at this point is whether it’s possible to carry and transmit covid virus without being technically infected. What we do know is that Covid is a sneaky little bugger that doesn’t like to let you know you have it for a few days. That’s one of the big reasons we’ve been in this pandemic for so long: You can have Covid for several days — and be infectious! — without showing a single symptom. And since no vaccine is perfect, that means that it’s entirely possible to be vaccinated, get a Covid infection, and spread it around to everyone closest to you without having a clue. 

So how do we combat that? Well, first of all, it helps a lot if anyone who can be vaccinated, is vaccinated. Think of it like this (though I don’t think this math is perfect): If you have a 20-percent chance of getting infected while vaccinated, your vaccinated loved ones have a 20-percent-of-20-percent-chance of getting infected by you — that’s 4 percent. And their vaccinated loved ones who you don’t see have a 20-percent-of-20-percent-of-20-percent chance of getting infected by you. Thats less than one percent! 

But because nothing is perfect, and we can have Covid without knowing it, it’s also really important to wear a mask and keep your distance when around unvaccinated people. I’ve seen a meme saying something like “If vaccines work, why do we have to wear masks? If masks work, why do we need vaccines?” The truth is, prevention methods complement each other. One virologist I follow calls it the “Swiss cheese method”: Each slice of Swiss cheese has holes, but if you layer a few slices from different blocks on top of each other, the holes are unlikely to line up. The vaccines are a slice of Swiss with very few, very small holes. Even something as “holey” as a bandanna can block a lot of them. 

And if you worry that these methods don’t do anything, remember from like fifty-seven paragraphs ago when I mentioned the flu being practically nonexistent this past season? That’s because we were masking regularly, keeping our distance, and washing our hands. We have proof that taking these simple steps is effective!

To put it another way…

5. Your choices matter. We’re currently dealing with this more serious Delta variant of Covid because the virus has had time and opportunity to reproduce a lot, which means it’s had time and opportunity for mutations to appear that have made the current vaccines slightly less effective. A bad enough mutation could put us right back where we were early last year. The more chance the virus has to spread, the worse off we’re all likely to be.

But that means the flip side is true, too: Everything you do to make things harder for this virus helps everyone. Like, in the world. Getting vaccinated protects you, yes, but it protects your community too — and it also, even if just a tiny bit, helps protect literally everyone else on earth, by taking one potential host out of the pool, giving the virus one fewer opportunity to reproduce and potentially mutate. You’re especially helping those of us with kids who aren’t old enough to be vaccinated yet (and those with loved ones who are unable to be vaccinated for medical reasons). 

I would be so grateful if you could help Eleanor in this way. 

So that’s what I wanted to say. If you’ve read this far, I really appreciate it. I appreciate you taking my thoughts under consideration. If you find this helpful, please feel free to share it. If you have questions, I’d be happy to do my best to answer. (That’s why I’m sending this via BCC, so we don’t have a reply-all tsunami.) Please, whatever you do, stay safe. This pandemic will be over eventually. I’d really like to see you on the other side of it.

With love and optimism,