Understanding Vaccines: An Interview with Ryan Hassan, M.D. - Part Two

Below is an excerpt from an interview by Slavic Radio with dad, pediatrician, and Boost Oregon medical educator, Ryan Hassan, M.D.  The interview took place on May 4, 2021. It is reprinted here with permission.



Some people say they are okay with getting the vaccine, but not now. They would rather wait a few months and see the data. They believe that COVID vaccine production started very quickly compared to other vaccines that took much longer to develop and start production. How would you comment on that?

The COVID vaccine was created quickly because we needed it to be created quickly to stop the spread of the pandemic, which has killed over 600,000 people in the US alone. We did this by spending billions of dollars to fund the research, and expediting the approval process to make sure we could get shots into arms as quickly as possible. Studies were also completed faster because it was easy to find people who wanted to volunteer to participate, and, because the pandemic was so poorly controlled, it also didn't take long for enough people to get sick in the study to determine how effective the vaccines were. No steps were skipped. We have now administered almost 300 million doses of vaccine in the US. Anyone who is actually looking at the data can already see that the vaccine is safe and effective, and that getting vaccinated is a much safer option than remaining unvaccinated. There is no data that we will see in a few more months that will change that fact. We identified all common side effects of the vaccine during phase 3 clinical trials, well before they were approved for use. As with any medicine, there is always the chance that rare side effects might exist that we will not be able to detect until millions of people receive the medication. However, by definition those side effects are rare, so the chance of dealing with them is much less than the chance of getting sick, hospitalized, or dying from COVID.

 

Also, our vaccine safety monitoring system is extremely robust. We identified the very rare association of blood clots with the J&J vaccine, which we've seen in about 1 out of every million doses, after only 6 weeks. We identified the association of myocarditis in adolescents receiving the vaccine after just a few weeks (and it looks like that is probably not an actual side effect, but just a coincidental finding).

 

You wouldn't wait to put on your seat belt; every time you go for a drive you are at risk for a car crash, so you need to wear a seat belt during each event of driving. Every day you remain unvaccinated you are at risk for getting and spreading COVID, and the more people who remain unvaccinated the more people the virus will infect and kill, and the greater the chances are of new, more infectious variants developing.

 

Does COVID vaccine contain an attenuated virus, like some other vaccines? Can the COVID vaccines give you COVID-19?

The mRNA vaccines (Pfizer and Moderna) contain only mRNA, which your body uses to create the spike protein that your body creates an immune response to. The J&J vaccine uses a non-replicating viral vector vaccine, which means that they take an adenovirus that does not normally infect humans, and modify it so that it cannot replicate and so that it produces the spike protein from COVID-19. Your body creates an immune response to the protein just as it would if it was infected with COVID-19. You cannot get an infection from these vaccines, and they cannot give you COVID-19 because there is no COVID-19 virus in the vaccine.

 

Recently, it was announced that now children 12 y.o. and older can be vaccinated. What testing of the vaccine was done in children that allowed for this vaccine recommendation? How many children participated?  How many have already been vaccinated?

The Pfizer vaccine was tested in just over 2000 children aged 12-15 years old in phase 3 clinical trials. As we expected, we saw no significant difference in safety or effectiveness in the vaccine, except that it might actually be more effective at protecting younger children from COVID. As of June 3, more than 5.9 million adolescents aged 12-17 have received at least 1 dose of the COVID vaccine.

 

Why has the vaccine only been tested in children no younger than 12 years old? Are there any plans to test it in children under 12 years old?

The vaccine has been tested in subsequently younger age groups. Testing started in adults because adults are at highest risk for COVID and needed the vaccine the most. We wanted to have safety and efficacy data in adults before expanding the studies to younger children. Since we know the vaccine is safe and effective in adults, it is very likely that they are at least as safe and effective in young children as well, and the data so far seems to support that. Right now the vaccine is being tested in children as young as 6 months of age.  



In your most recent experience, when parents with children seek your advice about any health-related issues, do they ask about COVID vaccination for their children?

 

I think most of the patients I've seen who are over age 12 have either already gotten their COVID vaccine or are planning to do so. Mostly my patients are excited to be immune to the virus, start spending time with vaccinated friends without masks, and have fun with loved ones again. I do still have many patients who have asked for my thoughts or suggestions about the vaccine, and my recommendation is always that they absolutely should get it if they have the chance, as it is the safest and most effective way to protect them and their loved ones from COVID. A few of the parents I've seen don't want to get their children vaccinated, and in those cases, I try to understand why they are fearful of the vaccine and explain how the vaccine works and why it is safe and effective, so they can make an informed decision, rather than a fear-based decision. Sometimes these parents change their minds, which is great. However, sometimes they don't, in which case I tell them to keep thinking about it and please let me know if they have other questions I can answer, or would like to talk about the vaccine more at future visits.

 

We hear about new variants of the virus.  When the vaccine was developed, researchers did not know about the variants. Are the vaccines that are currently used effective against the new variants? Or will researchers need to work on improving vaccines continuously?

 

The vaccines have some effectiveness against the new variants. Some variants are more resistant to vaccine immunity than others. Researchers are looking into vaccines that will be more effective against some of the new variants. It's unclear if we will need a new vaccine or not. The longer we take to stop the spread of COVID, though, the more likely it is that we will see more mutant variants. 

 

People are tired of wearing masks, social distancing, and being isolated. How long do you think this situation will last?

Several more months probably. Much longer if we don't get 85% or more of our population vaccinated. 

 

What will you tell our listeners in conclusion?

This is a scary time and it's okay to have questions and concerns about COVID and the COVID vaccine. Vaccinating yourself and the people you care about is the safest and most effective way to protect yourself, your loved ones, and your community from COVID. Vaccinating is an act of love; it is how you can protect not just yourself, but also the people you care about and the people around you from unnecessary illness. If anyone still has questions about the vaccine, I'd encourage them to speak with their doctor to learn more! Remember, not making a choice is choosing not to vaccinate, and putting yourself and your loved ones at risk of COVID.

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Changing the Culture of Immunization

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Understanding Vaccines: An Interview with Ryan Hassan, M.D.