COVID19 Goals life

2021 & Vaccine Musings

December 3, 2020

Note: I did not really expect the reactions in the comments, but people are certainly entitled to them. I am a human first and foremost on this blog, and in life. I do not and never have provided medical advice on this blog. I am sorry it is disappointing to anyone that I have thoughts that are not always 100% in line with what they would like them to be. I chose to be honest in this post — as I always show up here — and shared my thoughts, and not any conclusions. Finally, I would like to point out that I DO plan on most likely getting the vaccine if offered, as I noted below. I think that those who have trepidations are more likely to be convinced to GET the vaccine after reading that I had to think about it a bit before doing it than if I just said nothing.

I did it, everyone! I came up with some 2021 goals. I still haven’t put it into my planner, but we are recording our annual Goals podcast for BOBW, so I had a deadline.

And I am pretty happy with them, but there may be tweaks before they end up in my planner for posterity!

Themes are:

Making time for relationships & rest

Continuing some of the habits I’ve been working on all year

Organizing/decluttering the house (my physical space is not a disaster, but it’s definitely not as tidy as my planner is!) (Not for 2021, but I think I’m going to become a trained Kon-Mari consultant some day. Retirement job?)

Nothing earthshattering, but I’m excited to do everything I wrote about. I truly hope 2021 will be a transitional year, where things go from decidedly abnormal to something-resembling-normal again. We will see.

In other news

Our hospital is getting a distribution of the Pfizer vaccine, possibly before the end of the year. We are being asked to think about whether we want to get it. I am the farthest thing from an anti-vaxxer (kids get everything recommended, including flu shots) but I admit I am a little nervous that we don’t have any postmarketing data and that it’s the first mRNA vaccine up for widespread use.

Guess it’s too late to buy stock now

If I were in a high risk group or living with elderly or medically complex in some way, I’d take it in a heartbeat because then I think the risks would be clearly outweighed by benefits. Interestingly, our residents — most of whom are early 30s or younger — seem very excited to receive it (but perhaps that is because they have more front-line contact with COVID patients).

My guess is that upon carefully weighing risks and benefits (and considering the opinions of others that I respect) — I probably will choose to get it if offered. (If there is enough that I am offered — obviously it will go to people who interact with COVID-19 patients frequently first, then providers who are medically at-risk/older, then everyone else.)

(If I get it, Josh would likely get it as well as he’d be in the same or a higher risk tier than me.)

I’ll let you all know!

56 Comments

  • Reply Irene December 3, 2020 at 9:58 am

    If there is any chance you would not take the vaccine when offered, I hope you are taking the responsibility to access all publicly available information including watching the full panel meeting of experts talking about their rationale for why they believe it is safe. To be honest the idea that you would consider not getting vaccinated because you personally are somewhat low risk has to be influenced by the fact that your family is doing relatively ok despite the pandemic. Those of us whose kids have special needs that are not currently being met NEED everyone possible to be vaccinated as soon as it is safe to achieve herd immunity so that essential services can resume.

    I understand that vaccination like any medical procedure, no matter how small, is incredibly personal. However, since you are a physician writing in a public space please think carefully before normalizing these kinds of vague hand waving type fears before the pertinent information has even been publicly discussed.

    • Reply A. December 3, 2020 at 11:59 am

      I agree. I am extremely troubled by the idea that someone in the health care community would not be vaccinated or refuse it, regardless of their position in the hierarchy of the health care system. Maybe you’re not sure enough in your reflexion to share your thoughts yet, so maybe rewrite the post or delete it until you have read/talk/studied etc. the sensible case?

    • Reply Smith December 3, 2020 at 12:49 pm

      I find your concerns completely valid. I am concerned that none of the data or even the ingredients of the vaccine have been made public. I believe in medical choice, and that people should make decisions based on how it impacts themselves. I have a son who suffered encephalitis (brain swelling) from the DTAP vaccine at 2 months old. He is on a medical exemption from vaccines. I’m amazed at how people above are so quick to judge and use terms like “anti-vaccine” or “anti-science” without thinking twice about people who may make different choices because they have a family member who suffered a vaccine injury. No medical treatment is 100 percent safe, nothing. Where there is risk there should be choice and there would be no way I would sacrifice my son’s health so “essential services can resume.”

      • Reply Brooke December 4, 2020 at 5:54 pm

        @Smith, do you mean the Tdap?

        • Reply Sarah Hart-Unger December 4, 2020 at 6:18 pm

          Tdap is usually given to adults, DTaP is usually given to babies.

  • Reply Tara December 3, 2020 at 10:16 am

    We are in a similar boat here. My husband is also a physician and he was also asked recently by the hospital if he would want the vaccine upon arrival. We have two young kids, one that is under 6 months. We’ve been very conservative about not going out, minimal grocery runs etc.

    I have similar thoughts to you. It’s the first widespread mRNA vaccine and as with any drug/vaccine, including the flu shot each year, we like to wait about 3 months in case there are any Lot issues/manufacturing recalls. I work in drug development so very much agree that I’d like to see some post-marketing safety data first. With that being said, if anyone receives it, he will likely be the first in the family since he does see patients. But even then he will probably wait 6 months from release for this one.

  • Reply Student December 3, 2020 at 10:46 am

    ^^agree with Irene.
    I’m also surprised at your surprise that my cohort (med students and residents) are so eager to be vaccinated. 1. Public health, 2. My six weeks in the MICU witnessed SO MANY hospitalizations and deaths from COVID, including young and relatively healthy people. So again, public health, and frankly, fear of getting this myself, and utter terror of my parents getting ill. 3. I live many miles from my parents and haven’t been home for 15 months because I’m terrified of spreading something to them or someone on my flight home. 4. At some point, I’d also like to see my friends at a restaurant and maybe be able to babysit the kiddos. 5. I also would like to travel overseas again, and had a big trip to visit extended family planned for after the Match, but that’s obviously not going to happen anymore. 6. I will hopefully Match in March, and therefore, can no longer claim “LOL JUST A STUDENT CANT SEE COVID PATIENTS”. The closer I get to the Match, the more nervous I am of being a resident in COVID times. I’m guessing your residents also feel that way.

    I’m get what you’re saying, I truly do, BUT, as someone with a PhD in immunology, I winced just a tiny bit imagining how my non science/medicine friends and family (who do read here!) may interpret what you wrote.

  • Reply RKK December 3, 2020 at 10:58 am

    Completely understand that this is a personal space, where you share your personal thoughts – and I love coming to read them! But I have to echo the two comments above. As a physician writing in a public space in a country where there are already so many myths and misgivings about vaccines, I was surprised to read your post today too. I appreciate your personal feelings on it, but if you, as a doctor, are contemplating publicly about getting the vaccine, what signal is that sending to others who may be on the fence? And isn’t it about the greater good of helping those who are more at risk, than your personal level of risk? It’s your judgment of course, but I have to admit I was a little shocked to read this from you today.

  • Reply Laura December 3, 2020 at 11:03 am

    I am not a medical professional but am in the age range you described of being eager to get it (late 20s) and I too am eager to get it whenever it is my turn. I also live in Florida and I have been taking this extremely seriously. Haven’t seen any friends/extended family, haven’t gone out to eat indoors or out, haven’t been anywhere besides the store, etc. since March. I am young and healthy and not a frontline worker so I know I’m on the bottom of the list to get the vaccine but as soon as it is ready for my group, I will take it. The benefits far outweigh any risk I could think of. I think of it the same way I think of wearing a mask, I am doing it for everyone else around me (esp. w/ Florida’s elderly population). I hope most people feel the same way I do and will get the vaccine as soon as they are offered it.

  • Reply Fellow pediatrician December 3, 2020 at 11:10 am

    Pretty shocked about your vaccine musings. I think it is irresponsible, as a physician and a program director, to post this on your public blog. I’ve actually never commented on a blog before in my life, but I feel that is necessary to comment here.
    I’ve just been so disappointed by humanity’s inability to rally and be responsible for the greater good. I will be getting the vaccine and will be as public about it as possible (even though I do not have a blog and have minimal social media presence). While no one should be forced or bullied into getting this vaccine, our responsibility as medical providers, leaders, educators and scientists is paramount here.

  • Reply Leslie December 3, 2020 at 11:11 am

    My perspective is as a non-medical person. I actually find it extremely helpful to hear a doctor express a little nervousness about a vaccine that’s so new and relatively untested, but still say it’s probably worthwhile to get it anyway (because I’d have a hard time taking seriously someone with NO concerns.) And unless I’m totally misreading, I’m pretty sure you, Sarah, are saying that you might not be ABLE to get the vaccine right away as a lower risk person, not that you wouldn’t BOTHER with it because you are lower risk?… I’m not sure what’s shocking about any of these statements!

  • Reply Omdg December 3, 2020 at 11:12 am

    I would get vaccinated in a heartbeat at the first available chance. I deal with respiratory secretions all day long and could have to take care of covid patients (in addition to taking care of them in the OR), so this is a no brainer for me. Every doctor I’ve talked to at work feels the same way. I hope my husband is able to get vaccinated this year too so we can live our lives more normally.

  • Reply KGC December 3, 2020 at 11:22 am

    Emily Oster’s email newsletter today was about the vaccine and I liked the way she framed things. I work for a large academic hospital, which has apparently already committed to vaccinating every employee (who wants it, I guess?) by April, starting with front-line workers in December or as soon as approval is granted. I am non-patient facing at the moment so I suspect I will be relatively far down the list, but plan to get it when it is available. I think that hesitation about any new vaccine or medication or treatment is completely normal – and in science/medicine, it’s perhaps even encouraged? – but it’s how the hesitation is dealt with that is important..and maybe that’s what other commenters are concerned about? It seems to me that you have already noted that you will review the data and very likely come to the conclusion that the benefits of the vaccine are worth it; that seems like a reasonable way to approach this and probably the way that most scientists would/will. An unreasonable way would be to say ‘this is new and it makes me nervous and therefore I’m not taking it’ because that would have no evidence. Given that you are not an unreasonable person, I don’t think this is a concern.

  • Reply Heather December 3, 2020 at 11:33 am

    I’m a teacher and our school board has already written a letter to our state health secretary asking that teachers be considered for the vaccines after front line workers. I will get the vaccine if offered, but you better believe I will be very nervous as there is always a chance (albeit small) to have reactions or side effects etc.

    In my non medical opinion, I disagree with some of the other comments that are critical of your viewpoint. I think you’re just like the rest of us in expressing your fears about a new vaccine. I think that’s perfectly acceptable and I appreciate your honesty in stating it. And as a non-medical worker, I am not dissuaded from receiving the vaccine because of your trepidations.

  • Reply Claire December 3, 2020 at 11:54 am

    I was shocked by this post and really disappointed. First, I have seen nothing, and you raise nothing concrete that indicates there is any risk to a healthy adult from the vaccine that outweighs the benefit (not getting COVID). Second, there is no mention of the community benefit of you getting vaccinated, including for your family, your patients, and the community you live in. You treat patients (diabetics) in a high risk group!! This kind of musing about vaccines like it is a personal choice that can be taken or left instead of a serious community responsibility absent a specific health condition that can’t tolerate vaccines is responsible for low vaccination rates in this country. That that attitude is coming from a doctor is very disappointing.

  • Reply Gillian December 3, 2020 at 12:00 pm

    As a physician I feel a responsibility to be vaccinated when the opportunity is offered to me. It isn’t really about me or my family, but about protecting all of those I come in contact with during my work day who may not be vaccinated for any number of reasons. Every person who is vaccinated is a person who is unlikely to get and spread CV. I am in an outpatient clinic and don’t see “sick” patients so I suspect I will be waiting awhile, but I will get the vaccine when it is made available to me. I have spent a lot of time thinking about this and I share my thoughts about the vaccine when asked by patients.

  • Reply Pankti December 3, 2020 at 12:37 pm

    I don’t really agree with the comments above; I don’t think in any way, shape, or form you were advocating for anyone NOT to get the vaccine, but just sharing your nervousness about something so new. I feel like many of people that I interact with are in the same boat – are they nervous about it, yes? Will they still get vaccinated – yes.

    What I did want to comment on – I feel for SO long, the solution to this years’ madness has been a vaccine that honestly felt so far fetched into the future that I couldn’t even see the light. But hearing how your hospital is going to get this magical cure that will end this crazy year, is so … liberating.

  • Reply Keren December 3, 2020 at 12:54 pm

    I’m definitely not eager to get the vaccine and wouldn’t like to be among the first ones who get it. It’s a perfectly understandable gut reaction, and I don’t think that eagerness to try a new vaccine is a reasonable reaction.
    And like Sarah I may decide to get it after there’s more data and after considering the risks of getting it vs. the risk of catching CVOID. But being eager to get a vaccine that is basically almost still in testing phase is not the same as deciding to get it after carefully considering it and after having more data.
    For all those who don’t understand this reaction, would you have volunteered in a heart beat to be on the clinical trials and be the first one to get the vaccine?

  • Reply Young December 3, 2020 at 1:14 pm

    I see nothing inflammatory about your post. I work in healthcare, too, and my feelings are pretty much aligned with what you’ve expressed here.

    • Reply L December 3, 2020 at 6:17 pm

      Me too. I’m sorry you’re getting so much criticism Sarah.

      • Reply KGC December 3, 2020 at 8:48 pm

        Agreed.

        • Reply Lindsay December 4, 2020 at 8:35 am

          Couldn’t agree more – we don’t have any actual data yet, everything we know is from press releases. As our infectious disease team is reminding everyone right now, it is absolutely valid and 100% acceptable to want to wait and read the data before making a definitive decision.

          If we push everyone to get it without thought, then we could risk alienating many, including some who need it most.

      • Reply Connie C December 4, 2020 at 9:06 am

        Agreed X 100000000

    • Reply Amy December 4, 2020 at 6:46 am

      Same, I think you’re saying out loud what a lot of people — medical professionals or not — are thinking. Being honest about your thoughts here is an important thing to do. I personally loathe being patronized and gaslit by people who act like any decision is risk-free or a no-brainer. It’s okay to point out things like, this is a really new intervention, what are the facts? Otherwise it’s really just an emotional decision for a lot of people. I appreciate your honesty. (As someone who can’t get the vaccine.)

  • Reply KC December 3, 2020 at 2:48 pm

    I work in public health and my husband is a physician. Our kids get all their vaccines on schedule, and we have never given a second thought about them. We all get our annual flu shots and boosters as needed without reservation. With that context, I completely understand where you are coming from, and I feel similarly, likely because I don’t work directly in the front lines dealing with COVID-19 or seeing their devastating impacts in my own eyes . I thank you for being honest. The beauty of living in our democracy is that we are allowed to question things, but questioning doesn’t always mean opposition. It’s healthy to be inquisitive!

    • Reply Amy December 4, 2020 at 6:47 am

      Omg this: questioning does not mean opposition. It’s important to ask questions! It’s not morally wrong!!

  • Reply Alex December 3, 2020 at 2:55 pm

    I understand this is your personal blog, and you have a right to express your hesitations, but I was surprised and sad to read this. I think it is partly a tone issue- a breezy maybe I will, maybe I won’t for such a serious issue. And your surprise at the residents who are eager to get it- why would you be surprised at anyone eager to get this vaccine? This has made life a misery for so many, even if not for you. To hear that when when you will be offered an opportunity to get a vaccine sooner than many others who are desperate for one was tough.

  • Reply Allison December 3, 2020 at 3:03 pm

    So, a couple things – I found this helpful on what risks could conceivably be missed in trials of this type: https://www.deplatformdisease.com/blog/long-term-effects-of-covid-19-vaccines-should-you-be-worried

    It’s also possible to overstate the novelty of mRNA vaccines. Non-vaccine RNA therapies have been on the market since 2013. The cancer therapies involve using much higher doses, which I find reassuring.

    Finally, mRNA-based vaccines themselves have been in phase 1 and 2 trials since 2013: https://twitter.com/florian_krammer/status/1332077763809996801

    All these years of work are the reason the vaccines could be accelerated during this crisis and have come to market now. And I think it’s important to communicate that context while musing about whether or not to get vaccinated. I get that it’s tough to come back to a comment thread this long, and that we’ve all had a tough year, but I hope you’ll sit with this for a bit.

    • Reply Sarah Hart-Unger December 3, 2020 at 3:16 pm

      That first post with references was helpful. Thank you! I appreciate that you shared evidence rather than just expressing anger that I dared to express my personal thoughts (which included to do more reading by experts like the one you posted).

  • Reply Melissa W December 3, 2020 at 3:09 pm

    Huge thank you to the 43,538 brave patients who have participated in the PFE vaccine trials alone…we certainly won’t have to make any decisions in the absence of data.

  • Reply Erin December 3, 2020 at 3:57 pm

    I would encourage anyone who feels hesitant to look into some of the many doctors, immunologists, and researchers who are using their social media platforms for scientific communication about the facts of the COVID-19 vaccines. @kinggutterbaby on instagram is a great example of someone who is on the research side of things and using her direct knowledge to inform people! She links to a lot of other great resources like @dr.martaperez (OB/Gyn), @jessicamalatyrivera (epidemiologist), and @doctor.darien (emergency physician). Where available, they all link to statements from medical organizations, preprints, and the like. (I’m not an MD but PhD in the social sciences, so I value references!)

    Personally, my view is that vaccine hesitancy and anti-vaccination conspiracy theories are so prevalent and dangerous (especially on social media) that we really have to get comfortable calling them out.

    • Reply Nikki December 3, 2020 at 4:24 pm

      Yes, I second these IG accounts – they have truly guided me through the pandemic. Incredibly educational – both the info they share as well as link too.

    • Reply Erin December 4, 2020 at 9:08 am

      Just wanted to clarify that I don’t think you are an anti-vaxxer, Sarah! I just think the false equivalency about “data” and “do your own research” has been used strategically by those folks and it’s infuriating to see as a person who does actual scientific research for a living. There are so many good sources of accessible information about the Covid-19 vaccines out there (as I mentioned above) that in, my opinion, hesitancy based on concern about a lack of available research can be assuaged to a large degree by checking out those resources.

      • Reply Brooke December 4, 2020 at 6:15 pm

        @Erin, great point and I agree

  • Reply Natalie December 3, 2020 at 4:28 pm

    I’m an epidemiologist and internal medicine specialist, mom to two small kids (ages 2 and 9), and since August I have been taking part in a COVID vaccine trial (phase 2, or safety study). To me, this was something I could do to help in the midst of a crisis, and I’m so glad that I did.

    Being a part of a vaccine trial to help end a pandemic has been one of the best decisions I’ve ever made. Prior to enrolling, I did my homework and took the time to understand how the vaccine was expected to work and what the potential (known) side effects are. Yes, we have no idea if there are long term safety concerns with any of these vaccines– but many of them are structurally similar to other vaccines out there (not the mRNA vaccines but the adenovirus vectors like the AstraZeneca vaccine). And we know that there is significant morbidity/mortality associated with contracting COVID.

    Ordinary people like myself have signed up to be safety guinea pigs for the greater population. Please consider getting vaccinated!

    • Reply Amy December 4, 2020 at 6:48 am

      That is really cool. Thank you for all you’ve done!

  • Reply Holly December 3, 2020 at 5:26 pm

    Sarah, love your blog and also deeply respect that this a personal blog where you post personal experiences – NOT a blog for medical advice. And doctors should be allowed to be people too. But I find the tone of the original post (somewhat flippant, lacking in references) and then the follow up statement (defensive) fairly questionable. I don’t question your right to have differing opinions as a medical professional, and I do understand why you want to carefully consider the risks. But the choice to share those publicly just seems…unnecessary? I don’t see how you think it will help BUILD confidence/convince people, as you state in your updated disclaimer, among normal/non-medical people to see a medical professional questioning it publicly, even if she does decide to take it.

    I also echo other commenters who note that you do not mention the whole point of vaccines in your original post – building community immunity as a whole and protecting others you come in contact with, both at work and in daily life. The glib way that you seem to treat this vaccine as a personal choice, not a public health responsibility, is concerning – which I would feel even if you weren’t a physician.

  • Reply Cara December 3, 2020 at 6:08 pm

    I enjoy your blog and appreciate that you are open in what you share. However in this case I have to agree with many others here. I feel like this post has a tone issue and that is because it screams privilege, without any acknowledgement or responsibility around that. While this is a private blog and you are entitled to your opinions you also very frequently reference the fact that you and your husband are doctors. I also work in health care and feel that with that comes a certain responsibility to promote public health messaging as people do view us as having authority on these topics, even when we aren’t at work. While your comments about post marketing data are very true the situation the US has found itself in doesn’t afford you that kind of luxury. Some countries can wait but the situation in the US is now so dire that option is not there. A large part of the reason for that is a distrust of public health messaging and science. Unfortunately with your comments you have stepped into being part of that exact problem.

  • Reply Sarah Sbarra December 3, 2020 at 6:52 pm

    I am a NP working in primary care seeing Covid patients in the office, so obviously my calculations on to take or not take the vaccine is not the same as yours. I know you are a podcast fan so a few weeks ago I listened to a podcast that was very helpful in making my decision about if I want to be first line for a vaccine.. It is called Deep Background with Noah Feldman and they interviewed a physician on the FDA vaccine advisory panel.. the episode was called What We Know about Covid19 Vaccines.

    I have personally decided to get it as soon as offered.. I am seeing it as protecting my parents who are at a higher risk as well as my many patients who are at high risk.. often seeing up to 25+ a day of them! The podcast made a point that the risk of the vaccine (which studies have so far demonstrated no serious side effects) must be compared with the risk of the disease.. which is quite high. I have been sharing with my patients that I will be taking it and hoping to encourage them to feel safer to do so.

    • Reply Sarah Hart-Unger December 3, 2020 at 7:40 pm

      Thank you – downloading the ep!

  • Reply Jennifer December 3, 2020 at 7:01 pm

    As a practicing ED physician, I really appreciate the humanity and authenticity of your blog. Considering and discussing questions and concerns is part of thoughtful decision making. I’m disappointed by some of the dogmatic comments here, and hope you are not disheartened!

  • Reply Erin December 3, 2020 at 7:37 pm

    I appreciate reading your honest thoughts! I’m surprised by the comments here. My feelings about being vaccinated are very similar to yours. I’m glad you have left the post up. I honestly would not be excited to get the vaccine first. I really think most people would be at least a little nervous.

  • Reply Milly December 3, 2020 at 9:44 pm

    These comments are astounding. I didn’t read any “privilege” in this post. I read thoughts of someone who I respect… but I’m certainly not gonna base my decision on a random blog of a person I don’t know in real life. I don’t mean that in anyway to disrespect you or your blog, but all these comments were a bit much. Certainly lots of people coming out of the woodwork to complain I’d say. I appreciate hearing your thoughts and hope you continue to share these kinds of post. The world is a strange place.

    • Reply Amanda December 4, 2020 at 12:46 am

      This. Exactly. I appreciate hearing your thoughts and do not believe you need to over-curate them and feel very sad that you received so much criticism. I love your blog and your perspectives and certainly am capable of the critical thinking required to know that this was just your current musings on the topic and not some scientific recommendation from my treating physician. Carry on! I look forward to your blog every/most days!

  • Reply cate December 3, 2020 at 10:26 pm

    husband and I are both physicians (peds and EM) and he feels very similarly to you, that he is a bit nervous to get it given the new technology. But, he is somewhat high risk (overweight) and now that it’s becoming likely we’ll be able to get it soon, he is planning to get it when offered.

  • Reply Dana December 3, 2020 at 10:27 pm

    I don’t think your thoughts are crazy at all. Some of us are reluctant to be early adopters of anything and would rather wait to see how things go for the early adopters. In a world where there is a limited supply of vaccine, choosing to wait only allows others to receive the vaccine sooner. Turning it down completely would be surprising, but judging yourself low risk and waiting a while seems reasonable to me.

  • Reply Anastasia December 3, 2020 at 10:31 pm

    I’ve been a blog reader for a long time and a podcast listener since the beginning. I, too, am disappointed in the flippant tone of the vaccine “musings.” It’s just too important a topic to publicly post half-baked thoughts. And the reason it comes off as privileged is because literally millions of people around the globe would LOVE to be offered the vaccine so early. So it did read as very tone deaf especially without any sources linked in terms of the risks alluded to, etc. Again, just too important a topic to not be fully flushed out even on a personal blog (it’s public and you are a trusted voice as an MD). Just really tone deaf and I agree that the follow up comes off as very defensive and just left me feeling icky that you couldn’t see at least somewhat where the comments are coming from. Of course we know you are human, that doesn’t mean you are exempt from valid critique. Just really disappointing and sad.

  • Reply L December 4, 2020 at 2:00 pm

    Sarah, I never comment, but I trained the same time you did at Duke (different specialty) and have followed your blog for quite awhile now. I want you to know as a fellow physician who does treat covid patients I find NOTHING disappointing or sad about your post. Don’t let internet strangers convince you that because you’re a physician you have a responsibility to leave your human ness aside. This is such a dangerous mindset that is RAMPANT in medicine and contributing to a crisis of burnout that non medical people simply do not understand (and is a very very serious danger to everyone). This is incredibly personal! I am a human first, then I am a mom and wife. Then I am a physician. In that order. And the fact I have my priorities set that way actually makes me a BETTER DOCTOR. So be human, ask questions. As an aside, from a liability perspective you may need a disclaimer somewhere about anything you write not being medical advice. Some people have clearly not gotten that picture using their brain cells and might need you to actually spell that out for them. Now THAT is sad. Don’t stop being you, your blog and podcasts are awesome.

  • Reply Angie December 4, 2020 at 5:08 pm

    We are going to take it. We really want the Pfizer one because they have been working on it starting in Jan and we are a bit nervous about it but we also want to stop living like this. I get that it’s scary. I have a doctor friend that is part of the Moderna trial and after talking to her I feel more comfortable with any vaccine. Yes I wish it was a longer study but that’s what we’re dealing with. My mom works at a hospital and they are starting the Pfizer vaccine very shortly as well. It’s such a personal decision and people need to feel comfortable with it or maybe wait a few months and see what happens? That’s what a few of my elderly neighbors are doing. I just want to be able to send my kids back to school next school year and overall my household is healthy so we are willing to go for it. Plus my husband travels for work and hasn’t done so in 9 months. Thanks for sharing your concerns. It’s such a tough decision.

  • Reply Cynthia December 4, 2020 at 7:35 pm

    You have every right to express your opinions including any hesitancy regarding the COVID vaccine, physician or not. It’s part of your refreshing honesty that I have appreciated reading your blog for the last… decade? And just for completeness, I too am a physician (anesthesiologist). I will get the vaccine and also hope for the best that there will not be any sequelae.

  • Reply Katie December 5, 2020 at 12:28 am

    Sarah, jumping out of the woodwork as another physician to say, I hear you. Given how many ‘medical reversals’ have happened just in my short career, I think many reasonable physicians take a cautious stance about new therapies. Now, cautious, of course, doesn’t mean anti-progress, anti-science or anti-vaxx, but given how polarized literally everything is these days, some people are going to take it personally.

    Also, the health care field has been hung out to dry by this country in 2020. I think we have a right to be a little bit skeptical that TPTB have any interest at all in our wellbeing, and thus, there can be some spill-over skepticism onto the vaccine as well.

    Personally, given the larger number of patients enrolled in trials, I think if getting the vaccine was riskier in the near term than getting COVID, that signal would be picked up by now. And that’s really all the calculation I have to do, at the end of the day:
    unknown risks of vaccine are << risks of COVID (even for this healthy adult).

  • Reply Sarah December 5, 2020 at 7:05 am

    A little late to the game and that’s fine – this is not a response to the original post but a detail that seems to have been overlooked regarding community protection with this first round of vaccinations. That isn’t what these vaccines are intended to do and isn’t the criteria they have been scored on in the stage 3 trials. The Pfizer ceo has been pretty open in the media that he “isn’t certain” their vaccine stops transmission and that they didn’t evaluate or attempt to test for that at all. Moderna used similar scoring criteria and test protocols.

    This first round is literally to prevent people developing severe disease. Which is a significant accomplishment.

    But if your primary purpose in getting a vaccine is to “get back to normal” and “protect your community”, that may be a bit naive at this point. If you want to visit your parents, you are probably better off to get them the vaccine and wait until there is enough general availability for yourself.

    • Reply Natalie December 5, 2020 at 2:23 pm

      @Sarah– no, the primary efficacy endpoint literally WAS the prevention of COVID infection. More details on the study endpoints and the study groups can be found at clinicaltrials.gov: https://clinicaltrials.gov/ct2/show/NCT04368728

      • Reply Sarah Hart-Unger December 5, 2020 at 2:36 pm

        just clarifying the Sarah above was not me (SHU)

  • Reply Emily December 5, 2020 at 9:52 pm

    I’m a PA in a hospital-based surgical specialty and feel the EXACT same as you. In medicine, we see rare bad outcomes from routine things and I think well within the realm of reasonable to want a little more safety information/data, which is really all you said.

    I’m early pregnant and due in July and I don’t think I’ll get it until I deliver. Of course there is a risk of severe disease, but since it wasn’t tested in pregnant women at all, it makes me nervous! I’m absolutely willing to consider more data when available and especially as the risk goes up closer to my 3rd trimester.

  • Reply Fellow Doc December 19, 2020 at 11:33 am

    Sarah, I appreciate your honest thoughts about this. I think you have always been very clear about this blog being a personal outlet and not a source of professional medical advice, even though you are a physician. I think you are entitled to that, and I disagree with the comments that call your post “flippant” or “irresponsible”. It is so easy for people to forget that physicians are people too and to alway expect them to place other people’s needs before their own, and I don’t think that is appropriate.

    As for your hesitation to get the vaccine, I feel like I can relate to that. I am a physician with direct patient contact predominantly in an outpatient setting. I do not directly take care of COVID19 patients, and all of my patients are presumed to be COVID-negative. I will soon be offered the vaccine, and I really want to get it, but I am in a subgroup that has been left out of the initial vaccine trials, and to this day there is very limited information about vaccine safety in people with my “pre-exiting condition”. My personal physician recommended that I wait to see more data before getting the vaccine, but I am torn. If I were working on the front lines, I would get vaccinated in a heartbeat, because the known risks of not getting vaccinated would clearly outweigh any hypothetical risks of the vaccine. But since my risk of exposure is lower, the balance is not as clear. While there is overwhelming evidence for this vaccine’s safety and efficacy in healthy individuals, the decision to get vaccinated yourself is very personal and not always straightforward. So I find it helpful to read about other people’s thoughts and personal struggles with this question. And frankly, I find it disheartening to read all of the judgmental comments from people who assume that they know everything about you, many of whom are healthcare workers. Why do we find it so hard to show compassion for each other, not just for our patients?

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