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The COVID-19 vaccine is on a lot of people’s minds. With the aid of new technology, an entire world at work with resources on a scale almost inconceivable (including $10B from the US Government), with the world’s greatest minds working on it day and night and lots of cutting of bureaucratic red tape, the first two vaccines are in use in record time.
Many are unsure what they should do – vaccinate or not? I have a simple answer for most of you. Chill. Seriously, there’s no need for most people to make this decision now because so few of you can get it now. For our health care workers and nursing home residents who can get the vaccine now (or very soon) the answer is simple due to their very high risk. The two very similar vaccines have been given in two doses to about 35,000 people in trials. Another 35,000 received placebo (saltwater). Vaccination reduces cases of symptomatic COVID-19 by an amazing 95%. Side-effects were minimal. Nobody died from the vaccine. There were a small number of allergic reactions, as is normal with vaccines. However, it seems to be less frequent with this new type of vaccine due to the simple “recipe”. There are no preservatives or adjuvants. Based on follow up of the smaller earlier trials, we know the vaccine leads to antibody levels that are still high after 4-5 months, similar to people who had severe COVID-19. People who had COVID-19 with mild symptoms often lose half their antibodies in 2-3 months, and people who had COVID-19 without symptoms often have no antibodies after 2-3 months. The inconsistent antibody durability in people who had the virus is one reason why the vaccine is recommended even for people who already had COVID-19. In summary, vaccination had few side-effects, strong production of durable antibodies and exceptionally high success. For high-risk groups, it is a simple decision to get the vaccine.
At each stage of the rollout, progressively lower risk individuals will have the opportunity to get vaccinated. Importantly, at each stage of the rollout we will also have the experience of the prior stage. The vaccines are being used in other countries as well. In a month or so, tens of millions of people will have been vaccinated and we will know if there any extremely rare side-effects.
In Israel, the vaccine is being made available for everyone early on, so the decision is relevant now, and leading Rabbonim from different community segments have ruled:
Rav Chaim Kanievsky – the vaccine is obligatory due to hishtadlus. I have often wondered why hishtadlus hasn’t been talked about more in regard to COVID-19. https://www.theyeshivaworld.com/news/featured/1930228/watch-it-hagaon-harav-chaim-kanievsky-people-are-required-to-take-vaccine-dont-be-afraid.html
Rav Chaim Kanievsky was also part of a joint statement with Rav Gershon Edelstein (who was just vaccinated) and Rav Shalom Cohen that stated anyone who can get vaccinated, should. https://www.i24news.tv/en/news/coronavirus/1608120799-israel-top-ultra-orthodox-rabbis-issue-recommendation-to-get-covid-19-vaccine
Rav Yitzchak Yosef – vaccination is an obligation. https://www.theyeshivaworld.com/news/headlines-breaking-stories/1930079/hagaon-harav-yitzchak-yosef-every-person-must-be-vaccinated.html
Rav Asher Weiss – says you should definitely get vaccinated but stops short of saying it is an obligation. The full shiur is just over an hour and had me spellbound every second. The shiur is very clear and easy to follow! The link is set to the part where he specifically addresses the COVID-19 vaccine (about 20 minutes before the end), but I highly recommend going back to the beginning if you can spare the hour. https://youtu.be/CvdRqMiPfL4?t=2591 And a written summary can be found here: http://web.colby.edu/coronaguidance/files/2020/12/Rav-Asher-Weiss-Covid-19-Vaccine.pdf
OU Poskim: vaccination is an obligation (Rav Mordechai Willig, Rav Herschel Schachter; Rav Dovid Cohen). https://together.ou.org/page/guidance
Keep in mind that some of these rulings may take into account not just your own personal risk, but also the saving of other lives from reduced transmission. Rav Weiss’s shiur discusses this.
Lastly, we should take note of Hashem’s hidden blessings. The original SARS virus (2002-2003) and MERS virus (since 2012) have killed several thousand people, which is tragic for the affected families. However, research on those related coronaviruses was instrumental in the speedy development of COVID-19 vaccines, which will save hundreds of thousands, if not millions of lives worldwide.
P.S. – This webpage does a nice job responding to common myths about the COVID-19 vaccines: https://www.uab.edu/news/youcanuse/item/11771-debunking-the-myths-about-the-covid-19-vaccine
P.P.S. There is a lot of press about the new strains of the virus. Viruses mutate all the time, but they usually aren’t that different. They are being tested, but the expectation is that the vaccines will work against these new strains just as they work against the other strains.
Mendel Singer, PhD MPH
Associate Professor and Vice Chair for Education
Dept. of Population and Quantitative Health Sciences
School of Medicine
Case Western Reserve University
TrumpJew says
’10 billion from the US Government.’…I.E. thank you Donald Trump.
concerend doctor says
well written
anticipating a statement from our board of rabbis to go along with vaccines.
Baltimore’s vaad has already issued an endorsement!
would even be better if they put out a video of some of them taking the vaccine
medically, ,the risk of illness and even death to the population is much higher than any possible risk of the vaccine
.
Halachically, vadaii against sofek, , vadaii always wins
TL says
Well said! 100% agree.
(One caveat: if you have severe allergies consult your personal physician first. )
DF says
Well said, Dr. Singer.
We appreciate your knowledge and clarity.
I’ve been telling my patients the same thing, albeit not as eloquently.
“Chill!” Love it.
Daniel Fleksher M.D.
Ira B Taub MD, FAAP, FACC says
I appreciate the time taken by Dr. Singer to offer our community advice that is grounded in actual scientific expertise in the subject matter. I look forward to IY”H receiving my vaccine when my turn comes.
William Kushner says
Thank you Dr Mendel Singer for taking the time to give a true scientific and halachic perspective on the vaccine. Unfortunately our community has suffered from a lack of science based information regarding the virus and vaccines…your contribution is greatly appreciated…
Eli Fink says
Well written Mendel.
One point you make I’m not so sure is accurate.
Long-term immunity is not based on laboratory-detectable levels of circulating antibodies, but rather on memory cells.
The system demonstrates Hashem’s brilliance. While the virus is circulating in the community, the body maintains circulating antibodies so it can take down subsequent invasions rapidly. In later months, (under normal circumstances — without lockdowns and such) when the threat is less likely, the antibody-producing cells go into a more dormant state.
This does not mean that the person is no longer immune. It just means our laboratory tests cannot detect it. We medical professionals have a habit of equating laboratory tests with the full reality. (If I can’t detect it with tests, it doesn’t exist).
If a person has survived a real Covid-19 infection, that is the best vaccine there is. There is no longer any sound reason to take the risk of these experimental vaccines whose long term adverse effects are completely unknown.
With admiration and respect,
Eli
Mendel Singer PhD MPH says
I don’t understand your point about the antibodies circulating in our bodies – they aren’t affected by the level in the community. When there is one wave, then, yes it works out nicely – your protection often lasts until the virus stops going around. But if there are future waves further down the line, as time lapses immunity wanes. Another wave of virus can lead to new infection. This is what happens with the common cold coronaviruses. You get it and you’re protected for a while, but a year later you’re at risk again. We expect the same to be true for this new coronavirus, with the length of immunity unknown.
Yes, memory B and T cells are part of fighting off a future exposure to the virus. For this virus, these memory cells also diminish over time. What level of antibodies or memory cells will protect against a re-infection entirely or minimize the symptoms of a future re-infection is unknown. But studies show that for this virus, these all diminish over time, with people who had no symptoms or very mild symptoms losing antibodies and memory cells much faster than those who had stronger symptoms. So far, people who got one of the new vaccines have had strong, sustained antibody levels on par with people who had severe COVID. The length of protection following infection or vaccine is still to be determined.
All the best, Eli!
Mendel Singer, PhD MPH
Eli Fink says
There is another concern for those who already experienced the real virus. We have no data on the effects of these vaccines on people already exposed to the virus. These viruses were placed in the world by Hashem in a way that we would encounter them through our mucous membranes. This is the way our immune system is meant to encounter these antigens. There is a strong risk that some immune systems will overreact explosively if they finds the foreign antigens already deep within the body from an injection. This can potentially be a fatal reaction.
Eli Fink says
Typo next to last sentence — if they find
Mendel Singer, PhD MPH says
Your claims of a “strong risk” and potentially a “fatal reaction” is completely at odds with science and medical history. When a person is unsure if they have had a vaccination or a booster, we don’t test for antibodies – we just give them the vaccine because there is no danger. This goes on all the time in practice! And due to poor record keeping by parents and changing doctors, it is common for young children to get an extra dose of a routine vaccine – and it hasn’t been a problem (other than the poor kid having to get an extra shot and the cost).
The science is very simple. Getting the vaccine is like being exposed to the virus in terms of the body’s reaction. If you already have immunity, you can take care of the weakened or dead virus in the vaccine just like you can take care of the actual live virus. For the new mRNA vaccine, the body is instructed to make spike proteins. That’s all the vaccine does – it is given one instruction and the vaccine disintegrates fast. So if the body makes spike proteins and it already has antibodies from prior infection, it can just kill it! It won’t need to rev up the immune system much. There is no scientific basis or logic to believe that the body will react dangerously strong to seeing just the spike protein (thanks to the vaccine), when it reacts perfectly normal to seeing the actual virus again – spike protein and all! So, if you think getting COVID protects you against the virus (at least for a while), then getting the vaccine also won’t be a problem.
Thanks Eli for your continued concern. I know that our disagreements are purely l’sheim shomayim!
Mendel
Eli Fink says
Mendel,
Thanks for clarifying these points.
These are good answers.
The long-term risks of the vaccines in everyone do remain completely unknown.
Yes, we are really all on the same side and we need to remember that.
Personally, having thrived through my own Covid-19 infection, I will trust my G-d given immune system to do the same or even better the next time I encounter the virus.
Keep fighting the good fight!
Much hatzlocha,
Eli
Mendel Singer, PhD MPH says
I’m so glad you did well with your COVID episode! You are right – G-d gave most people a remarkable immune system. Mine happens to be somewhat dysfunctional – though still remarkable!
Personally, I see vaccines as gifts from G-d, and the same for medicines. The True Healer works through many mechanisms. I am grateful for all of them. And as much as I am driven by data and evidence (and the limits of that data/evidence), I also realize the true healing comes from Hashem and when we take medicines or vaccines, we do so out of hishtadlus. Ultimately, it is in G-d hands.
Wishing you and your wonderful family the best! If they have the middos of their parents (and I hear they do), they must be wonderful!
mendel
William Kushner says
It seems as if you are arguing that people shouldn’t take the vaccine…and you are using the “viruses are natural strengthen the immune system” argument….however as we see from the numbers…covid kills between one to two percent of …since that is astronomically high compared to the usual flu etc…I don’t understand how any rational person could argue against the vaccine…. One doesn’t need a medical degree to see that 3000 people are dying every day in this country….even if the vaccine is imperfect…or unproven….although since millions of people have already received it and there have only been something like 10 bad reactions out of millions and millions of recipients….it’s far far safer than getting COVID…..as a physician you are certainly aware of the dangerous nature of the disease…it’s also a question of lifnei ever…since someone could listen to these things not get vaccinated and die of covid as a result
c says
Thank you for a very straight-forward and informative article. It is quite distressing to hear of the myriad rumors and misinformed notions that are being spread and accepted as fact especially in our community… let’s get back to normal living! This vaccine will help us get there, with Hashem’s help of course.
Concerned doctor says
I received my Jewish press this week with a picture of The chief rabbi of Israel on the cover,getting his vaccine
the article also quotied the numerous great Poskim Who have come out for taking the vaccine see dr Singers first article
Mishpacha magazine also did an in-article with an immunology expert on the vaccine and guess who they used as their expert-none other than doctor Lederman Who has written about the vaccine in the local Jewish news
dr Singer appropriately called out Dr Fink for using hyperbolic phrases like strong risk and fatal reaction reaction without any scientific backing
Dr Fink is obviously a good person and a religious Jew
He needs to do the public a service and standdown down in the face of numerous gedolim Who are more authoritative than he is in the world of Halacha And scientists who are experts in the field of immunology, virology and infectious disease
One should not claim a authority in HMG no he/she is not board-certified in
I
May I suggest the public attending an online webinar about the vaccine sponsored bye Puah
It is on Tuesday, January 5 at 8 pm and you can go to
http://Www.puahfertility.org/vaccine for details