San Antonio Express-News (Sunday)
Benefits far outweigh risks of COVID-19 vaccine
In a previous column, I deferred making a recommendation about a COVID-19 vaccine until more data were available.
After thoroughly reviewing the data, I recommend getting the vaccine when it becomes available to you. I plan to get it as soon as it is offered, as the benefits far outweigh the risks, in my opinion.
More than 20,000 study participants received the vaccine; another 20,000+ received a placebo. Subjects ages from 12 to 91 were studied. The FDA reported data up to four months after subjects received their first vaccination. Eight cases of confirmed COVID-19 occurred in the group that got the vaccine, compared with 162 in the group that received placebo, meaning the vaccine is 95% effective.
The age of the subject had little effect, with a 96 percent effectiveness in those ages 16-55, and 94 percent in those 55 and older. The vaccine started to become effective at 14 days. People with a history of COVID-19 infection benefited from the vaccine just as much as those without, suggesting no natural immunity was present.
Vaccine reactions were common and expected. The most common unsolicited patients reports included redness or swelling at the injection site (11 percent), fatigue (6 percent), headache (5 percent), muscle pain (5 percent) and fever (5 percent). Serious adverse events were rare, less than 0.5 percent. This puts the vaccine at somewhat more likely to cause a mild side effect than a typical flu vaccine, but less likely than the shingles vaccine.
Some people have worried that the vaccine has been rushed. Indeed, this is the fastest a vaccine has ever been approved, but knowledge on vaccine development has dramatically improved in the past few years. What is most important is the large number of people who volunteered to be in the studies. Some people are also worried that because the vaccine is an mRNA virus, it could change a person’s DNA. That isn’t possible.
There are some important unknowns. The most important is that we do not know how long immunity to the vaccine will last. It may be that people will need booster shots. Further, there are immense challenges to getting a large enough proportion of the population vaccinated so that ongoing transmission will be disrupted. The virus is so entrenched in the population now that it will be a massive undertaking. Public health officials are devising the most efficient ways of getting the population protected by the vaccine.
If we think of COVID-19 as the enemy, the vaccine is an important
weapon in the war. However, a single weapon doesn’t win the war. There simply won’t be enough vaccine available as fast as we would like, so it remains as important as ever to take all the steps we can to prevent further infections. That especially means social distancing, hand hygiene and mask-wearing. Most important of all is to avoid large gatherings, especially
indoors.
It has been a long time that we have not been able to do many of the things we want the way we want to. Unfortunately, the vaccine is only a step in the process in getting back to “normal.” The inconvenience is temporary, and there is an end in sight. However, getting infected now, before the vaccine is widespread, can lead to longterm
consequences and death. Thousands of people in the U.S. are dying every day of COVID-19. Hospitals are overwhelmed all over the country (and the world). We need to be as diligent as possible. Please be careful until, and even after, you get the vaccine.
Q: I would like to know how to treat arthritis. I have been using Voltaren per my doctor’s orders, but it does not seem to be helping much. I have also been taking ibuprofen, but I am afraid of stomach bleeding. The arthritis is in my wrists and thumb. I can hardly open a doorknob or lift any small objects. Does turmeric help?
I would appreciate any advice you can give me. It is hard to do any cooking or housework using my hands. They ache and throb all day.
M.V. A: There are several types of arthritis of the hand, and it sounds as though your doctor has made the diagnosis of osteoarthritis, which is the most common type. Rheumatoid arthritis and psoriatic arthritis are inflammatory varieties that require different therapies. Blood testing and X-rays help separate the types of arthritis from one another if your history and physical exam indicate the need.
If you have osteoarthritis, oral anti-inflammatory medicines like Voltaren or ibuprofen (but NEVER both — taking two NSAIDs orally adds only toxicity, not effectiveness) are common and often effective treatments. Voltaren is also available as a gel, and it’s OK to use both Voltaren gel and a different oral NSAID such as ibuprofen. The gel is poorly absorbed into the body and is very unlikely to have systemic side effects.
However, remember that exercise improves pain and function. One set of exercises specifically for hand arthritis from the Mayo Clinic can be found at tinyurl.com/mayohand.
You asked about turmeric. There are studies showing benefit for turmeric and it has little toxicity, so I think it is worth a try. Similarly, Boswellia supplements have shown benefit in some people with osteoarthritis.
Q: I am a senior citizen with a history of glaucoma. My right eye has clouded up over time, but I still have vision in it. Is there any way I can cut down or eliminate the cloudiness? My doctor says there is not. Second opinion, please!
D.S. A: Glaucoma is a disease of the retina. There are several types of glaucoma, and I am only going to consider openangle glaucoma in adults.
The major risk factor for open-angle glaucoma is elevated pressure inside the eye, although glaucoma can happen even with normal intraocular pressures. Glaucoma is more common in older people, Black people, those with diabetes or high blood pressure and those with a family history.
Without treatment, glaucoma will lead to vision loss, initially in the peripheral vision, and may eventually lead to total blindness. Glaucoma is the second leading cause of blindness in the world (after cataracts).
Treatment for open-angle glaucoma is to reduce the pressure, usually through medication applied to the eye via drops.
In general, vision loss from glaucoma is irreversible. That’s why it is so important to diagnose and treat glaucoma early, ideally before much damage is done to the retina. Treatment is aimed at preventing or at least reducing further damage. A regular eye exam can identify people with elevated intraocular pressure. Those people can then be closely monitored, or even treated, to prevent or delay damage to the retina.
Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med .cornell.edu or send mail to 628 Virginia Dr., Orlando, FL 32803.