My update on Covid vaccines

Early on, I was more skeptical than he on the initial rosy assessments of the vaccine’s effectiveness and safety. That’s the cynical in me. I have been dismayed at the manner in which our public health officials, administration, and experts have managed the pandemic and this carried over to concerns over the rapidity with which the vaccines were developed and rolled out. Kurt was more pragmatic and embraced vaccination for himself and his patients.

Evidence-based medical practice is all about seeing what works and what doesn’t. It requires a willingness to change and adapt as new information becomes available. I never want to be one of those physicians who is unwilling to rethink his position and adapt as necessary.

Recently, Kurt has been irritable. Thanks to delta, he is burned out with the overflow of patients coming in with Covid. He likened this to drinking from a firehose. Nearly all are unvaccinated and he told me that many, if not most, have hesitated to get vaccinated because of unfounded fears. Some have accepted ridiculous conspiracy theories of vaccines being used to insert microchips into us for some nefarious purpose or of changing our genetic makeup. Others voice fears of the vaccine that, when weighed against their risk of Covid, seem irrational. Nearly all demonstrate a lack of appreciation of their personal risk. Most are elderly and have co-morbidities that increase their risk of serious disease greatly. Kurt has heard many of his sick patients express regret at their decision to refuse vaccination. He admitted that he is frustrated that they now come to him to heal them after ignoring his advice and experiencing the consequences of their choice.

He stated that 94% of the patients currently in the intensive care units are unvaccinated. We can argue the figures because they have been unreliable in much of Covid, but let’s say it is only 50%. Once you hit the ICU, your chance of dying is pretty darn high. He posed a question I had not considered. What if we did not have vaccines when the delta variant hit? Given their established effectiveness in preventing serious disease, he said it would probably have totally overwhelmed the medical system and there would literally be bodies in the street. It would not quite be the black plague, with an infection/fatality ratio (IFR) of 30-60% in medieval times, but it would be bad given the sheer numbers of Covid patients. The overall calculated IFR for Covid varies from 0.5 % to 1.6 %. (1,2) For the 2018-19 season, the IFR for influenza was 0.1%. (3) Yes, Covid is bad.

Kurt is convinced the vaccines are safe in the same manner that we regard anything in medicine as safe. This means to ask, do the benefits outweigh the risks to where the treatment is preferable to the disease? We know that most serious vaccine complications or side effects are recognized in 2-3 months after they are released for widespread use. We are now over 9 months into widespread vaccination with over 200 million doses administered. There have been reports of adverse effects, including deaths that were at least temporally related to vaccination. Was this correlation or causation? The answer is out on this question. Even so, the numbers, given the massive number of vaccines administered, appear reassuring. No vaccine is perfect. The effectiveness of the vaccines in reducing serious illness and death seems to be undeniable, if not quite as high as originally predicted. Their safety seems on par with other vaccines, at least for now. The big question seems to be duration. How long does immunity last? We are now seeing breakthrough infections, but these tend to be mild to moderate and do not land people in the hospital. Even early on in the vaccine process, it was stated that boosters might be necessary, given the high rate of mutation of corona viruses, and SARS-CoV-2 (what I like to call the CCP virus) in particular. It seems the vaccines provide good protection for at least 8 or more months. This is on par with flu vaccines. The link below is to the best video I have seen on the mRNA vaccines (4).

So, what is the final answer? Has my take on the current Covid vaccines changed? If so, how? It is instructive and interesting to review my blog post on the vaccines, which I put up February 15, 2021. Since then, I have had Covid and followed my plan of treatment. I came through it alright but, if I am honest, it was miserable. How miserable? I had the flu in 2018 and wrote an article about the experience. I likened flu to King Kong whereas a cold would be an organ grinder monkey. That article is no longer online but here is a quote:

I wrote this while still recovering from a bout of the flu. I mean the real flu, not a cold. Flu is a cold on steroids. You can die from flu. Once you have had it, you will never want to experience it again. It is enough incentive for me to get my flu shot annually.”*

                                                                        R. Bosshardt, MD October 2018

*I get the flu vaccine annually and have for over 10 years.

Well, Covid, for me, was like the flu. It was awful. It was scary. I am 68, in excellent health, and I considered my risk for serious illness from Covid to be very low, so I did not fear getting it or feel any urgency to getting vaccinated. Now that I have had it and earned my immunity, would I do it this way again? If I am honest, knowing what I know now, I would have probably sought vaccination, just as I do with flu annually. Unfortunately, hindsight is just that, seen only in the rear view mirror and at that time, I had enough reservations, reservations I felt were legitimate, to demur. Nine months later, we know more than we did then, and delta has raised the stakes.

Covid remains a disease of the elderly and those with co-morbidities. Yes, young, healthy people have died, but that happens with flu as well. With the huge numbers of cases being put up with Covid, however, even a less than 1% mortality will yield impressive numbers. To date, the total number of Covid cases in the US has been 40,700,000 and the total number of deaths attributed to Covid has been 656,000. If you do the math, this is a case fatality ratio of 1.6 %, by far in those at high risk. For Comparison, the number for flu is around 1%, but that number is unreliable, and may be higher, because flu is not a reportable disease. Even if you quibble with the numbers, they are impressive. It is undeniable that many of these could be avoided with vaccination. There is also the issue of long haul Covid, which is severe Covid symptoms lasting for months. The incidence of this is estimated to be 15-20 %. For the elderly and those with risk factors for serious illness, Covid can be King Kong on steroids.

One thing that seems to have been forgotten in the deliberations of Covid risk is just how many Americans are not particularly healthy. Our current population is, without question, the unhealthiest population in America since, well, ever. In my professional experience, most people have an overly optimistic opinion of their own health and fitness. The chickens of poor lifestyle choices, over-abundant food, and sedentary lifestyle have come home to roost and Covid has unmasked our vulnerability.    

So, in all of this discussion, what conclusions can be drawn?

  1. While I feel that what I did was right for me, I cannot recommend that to others given my experience and what I know now. I regard my acquired immunity as co-equal with that from vaccines, but I paid a price for it.
  2. Those 65 years old or older and/or those with co-morbidities, such as diabetes, hypertension, asthma, chronic lung disease, or any condition that compromises their natural immunity, should seek vaccination. You have little to lose and much to gain. Forget the conspiracy extremists; you are not being inoculated with a microchip or having your genetic makeup altered. As always, the caveat is: check with your doctor.
  3. If you are young and healthy, and choose not to get vaccinated, make a plan to do something if you get sick. It is insane to just self-quarantine and wait to see if you get seriously sick, then report to the hospital. This is a recipe for tragedy. The best treatment we have for Covid is monoclonal antibody therapy. In Florida, this is available free to all comers and is a simple injection. No physician referral needed. The next best thing, I feel, is to follow the protocol for early Covid as recommended by FLCCC, which is what I did.
  4. I remain admantly opposed to government mandated vaccination. This is still a free country and our personal liberties have been bought at too high a price to throw them out for a pandemic. There are worse things than dying of Covid. This is the idealist in me.

As to the future, Kurt is getting his booster today. I am holding off on vaccination and trusting my acquired immunity for the next 8 months or so. Our conversation was a microcosm of what should be happening in medicine, but isn’t. There should be open, honest scientific discussion and even debate in the medical community to attempt to find the right path through this pandemic. Instead we have the politicization of Covid and vaccines, with cancellation or suppression of views, even from very credible physician groups, that do not agree with the prevailing narrative.

A final note: I have advocated for widespread use of Ivermectin since last year after researching it extensively. The recent recommendations that Ivermectin not be used for Covid by the American Medical Association and the CDC are further proof to me that they have an agenda other then saving lives. The claims against Ivermectin that it is dangerous are false. These pertain only to people on their own taking Ivermectin that is intended for livestock and available as a paste. If you take a paste intended for horses, you will suffer the consequences. I have yet to see a report of harm from Ivermectin for humans that is properly prescribed. It makes no sense not to offer a drug that is safe, cheap, and has a mountain of evidence that it can mitigate Covid in some people and could even be used in cases of breakthrough Covid in those who are fully vaccinated. Those who say it is not effective ignore the experience of reputable critical care specialists and an undeniably proven level of evidence to its effectiveness that made the NIH upgrade their position from not recommending it to neutral on its use. If you wish to know more, go to FLCCC online.

Richard T. Bosshardt, MD, FACS

  1.  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7947934/
  2. https://covid.cdc.gov/covid-data-tracker/#datatracker-home
  3. https://www.cdc.gov/flu/about/burden/2018-2019.html
  4. https://youtu.be/eK0C5tFHze8

Published by rtbosshardt

I am a plastic surgeon, in practice for 30 years, with varied interests. First and foremost is writing. I love to observe people, who are endlessly fascinating. I have interests in health and wellness, our environment, modern culture, history, and general medical matters. I was "born to run" and love long distance running. I have a Christian worldview which infuses everything I do. I hope this blog will be interesting, entertaining, informative, and, perhaps, even a little controversial. If I can get one person to delve more deeply into something I have said, I will have been successful.

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