Features
COVID vaccines and curse of disinformation and misinformation
by Dr B. J. C. Perera
In an article in The Island newspaper, titled “COVID-19 VACCINES FOR CHILDREN: THE LATEST MEDICAL INFORMATION” published on 10th January, 2022, I have mentioned in passing some of the bits and pieces of disinformation and misinformation regarding some of the side-effects that are claimed to occur after the COVID vaccines. In this article I intend to deal with more of the scientific information that debunks some of the disinformation and misinformation propagated to discourage people from taking the COVID-19 vaccines by many sources, as well as by the confirmed antivaxxers.
There were some apprehensions expressed in some quarters about mixing up of different vaccines for the booster dose as several different vaccines have already been used in Sri Lanka for the first and second doses. When the identical vaccine to the one used for the first and second dose is given as a booster dose, it is known as a homologous booster while a different vaccine that is used for the booster dose is referred to as a heterologous booster.
In a research paper published in the reputed New England Journal of Medicine quite recently, both homologous and heterologous booster vaccines had an acceptable safety profile and were immunogenic in adults who had completed a primary two-dose COVID-19 vaccine regimen at least 12 weeks earlier. The increase in the pre-booster levels of both binding and neutralising antibody titres following the boosters were similar or even greater after heterologous boosting than after homologous boosting. In fact, the reactogenicity was similar to that described in previous research evaluations of mRNA-1273 [Moderna], Ad26.COV2.S [Johnson & Johnson–Janssen], and BNT162b2 [Pfizer-BioNTech] vaccines and did not differ between heterologous and homologous boosters. These results totally justify the blanket usage of the Pfizer COVID-19 vaccine as a booster dose in Sri Lanka.
There is a generally circulated argument that a booster dose is not necessary and may even cause some harm. This is a complete fallacy. We know for sure that the immunity tends to wane off, starting from about four months after the second dose of the initial primary regimen. The booster dose is given to increase, augment and improve the immune status against COVID-19. In a very recent article published in the Journal of the American Medical Association (JAMA), in a single centre in Israel healthcare workers who were previously vaccinated with a two-dose series of the Pfizer-BioNTech BNT162b2 vaccine, administration of a booster dose, compared with not receiving one, was associated with a significantly lower rate of infection by COVID-19. The results of the study tend to suggest that receipt of three doses of mRNA vaccines, relative to being unvaccinated and even to the receipt of just two doses, was associated with protection against both Omicron and Delta variants. However, the results showed less protection for Omicron than for Delta. One significant finding in this study is the fact that after the booster dose, there was protection against the recipients actually contracting the disease as well. Most definitely, this is excellent news.
As of now, there seems to be considerable reticence and reluctance on the part of younger members of our populace, especially the young male adults, to take the booster dose of the vaccine. Apparently, this is due mainly to various messages being given for public consumption through nebulous channels of communication including the social media, regarding the booster vaccine causing problems with reproductive health. For any human being, reproductive health is something quite precious and any suggestion of interference with reproductive abilities is likely to have an abiding effect on the inner self of most people. One such rumour is that the booster dose could produce infertility or sub-fertility in the recipients and the other is that the booster interferes with sexual prowess of individuals, especially males. We can now say, on good evidence, that there is no scientific basis for either of these contentions.
Vaccination against COVID-19 did not affect fertility outcomes in patients undergoing in-vitro fertilisation (IVF), according to a study published in the journal Obstetrics and Gynecology. Researchers from Icahn School of Medicine at Mount Sinai, New York, USA, compared rates of fertilisation, pregnancy, and early miscarriage in patients of IVF (“test tube baby”) procedures in those who were vaccinated against those who were not vaccinated. IVF patients who had received two doses of a COVID-19 mRNA vaccine had the very same outcomes as non-vaccinated patients. This is a large study to review fertility and IVF cycle outcomes in patients who were vaccinated. The study found no significant differences in response to ovarian stimulation, egg quality, embryo development, or pregnancy outcomes between the vaccinated, compared to unvaccinated patients. The researchers concluded that the findings that vaccination had no impact on these outcomes should be reassuring to those who are trying to conceive or are in early pregnancy. IVF procedures are carried out in an artificial scenario and if vaccination has no effect in such situations, there is no real reason to believe that it will be any different when fertilisation and pregnancy results from the natural process of reproduction.
COVID vaccines and curse of …
Many young people, especially males, believe that it is sex and sexual prowess that makes the world go round. If there is anything like a COVID vaccine that is even remotely connected to a disturbance of reproductive aspects of manhood, they will run even several miles to get as far away as possible from a COVID Vaccination Centre. As medical professionals we can understand the psyche of these young people quite well. However, we need to look with a jaundiced eye at the anti-vaxxers who have capitalised on these totally unfounded fears of young people.
Does the COVID vaccine of any type interfere with sexual prowess, fertility and ability to reproduce? Let us look at the evidence. None of the manufacturers of COVID-19 vaccines have listed any issues related to sexual health, erectile dysfunction, impotence or infertility in their reports. The clinical trial data from the Moderna, Pfizer-BioNTech, and Johnson & Johnson vaccines show that the shots may cause pain or swelling where you received the vaccine. Other side effects can also include nausea, vomiting, headache, chills, fever etc. But there is no evidence suggesting that COVID-19 vaccines can cause any damage to the reproductive systems in both males and females.
Additionally, the Vaccine Adverse Event Reporting System (VAERS) has not released any information that links COVID-19 vaccinations to sexual problems. The VAERS system is a national tool that monitors adverse reactions to all vaccines in the United States of America. Raw data is available to the general public and a summary is reported by the Centers for Disease Control (CDC) in Atlanta, Georgia, USA. Currently, the CDC is monitoring several possible complications of COVID-19 vaccines and will continue to look at all aspects of these problems.
Can the COVID-19 vaccine affect sperm count or male fertility? At this time, there is no evidence suggesting that COVID-19 vaccines can impact the sperm count. Two small studies looked at sperm counts following COVID-19 vaccination. One study from the University of Miami examined sperm counts before and after COVID-19 vaccination. The study looked at both the Pfizer and Moderna vaccines and found no differences in sperm production. Another study, that has not yet been published, showed the same results. The CDC also states that COVID-19 vaccination is safe and does not affect fertility in males, or even females for that matter.
Yet for all this, there is growing evidence that COVID-19 infection and some types of disturbances of sexual prowess are related. This is a crucially important aspect of this controversy. COVID-19 DISEASE is now well known to cause sexual dysfunction in males as a manifestation of the ‘Long COVID Syndrome’. As to the possible effects of the disease itself on females, we do not have sufficient evidence at the present time. The bottom line for males is that if you get the disease itself, you are more at risk of being subjected to all these sexual disturbances. For the millions of young Sri Lankan men who remain unvaccinated, you may want to again consider the consequences if and when this highly aggressive virus finds you.
One reason for vaccine hesitancy is the perception among many that COVID-19 shots might affect male fertility. Global research does not support this contention. There is no evidence that the vaccine harms a man’s reproductive system. But ignoring the vaccine and contracting COVID-19 very well could do just that.
The clarion call of the hour for the people of our country is to take the vaccine, regular doses as well as the booster. In addition, the time-tested manoeuvres such as avoiding crowds, keeping the requested distance from people, wearing a face mask properly and washing of hands regularly, should be continued as our contribution to the community preventive efforts. In the light of all these scientific connotations, there is no doubt at all regarding the absolute necessity to take the booster doses of the available vaccines. If we are to defeat this blight of a virus, it is essential that at least 70 per cent or preferably 80 to 90 per cent of the population is adequately vaccinated. We have good evidence that after two doses of the primary vaccination regime, the immunity against all forms of the virus causing COVID-19 tends to wane off, starting from around four months after the second dose. The booster doses have been very clearly shown to uplift and enhance the immune status of the recipients quite rapidly.
The take-home message from all this validated information is the advice to just disregard all the negative publicity conjured up by the anti-vaxxers, especially in the social media, and just take into account only proven scientific evidence.