COVID-19 vaccines: side effects, 
efficacy and length of protection. 1

Perhaps we can start with vaccines against COVID-19. They have arrived, yet many people are hesitant to be vaccinated. What kind of questions about COVID-19, and about vaccination in particular, do you hear most often from your patients? Perhaps you could discuss the most relevant questions about Coronavirus vaccines that you are being asked. Well, let me start with the three main questions which come from patients. That is: Is the coronavirus vaccine effective? Are there side effects of COVID-19 vaccines? And a very important question. How long is a vaccine against coronavirus effective? And these three questions are not easy to answer. The reason for this is the development of SARS Coronavirus 2 vaccines had been the quickest development ever. So starting in spring and being in phase three clinical studies in autumn. This is a tremendous development in this circumstance if you believe that normally vaccine development lasts for five or more years. With this in mind, the first clinical trials had been started in autumn. And the results of coronavirus vaccine clinical trials that we have now we’re responsible for the emergency approval by the FDA and in the United Kingdom, and the provisional approval by the European Union. The data, which are short term, so four to eight weeks after vaccination, vaccine efficiency had been measured, and side effects have been measured. This means we are quite sure that short term, these new vaccines, and mainly the mRNA-based vaccines from BioNTech, Pfizer, and Moderna, are effectively producing antibodies, neutralizing antibodies against the SARS-CoV-2 virus. And we are also sure in the short term that the side effects are not threatening. So there are local side effects, redness around the injection site, and some else, but not severe side effects. However, what we do not know is how long immunogenicity will last. So we have no long term data about effectiveness. And on the other hand, some side effects we know from other vaccines are long-term side effects. And I only want to bring the narcolepsy story for the influenza vaccine during the swine flu pandemic into my mind. And these long-term side effects of vaccines are missing in the data in the coronavirus vaccine trials at the moment. So I think the COVID-19 vaccine is an effective and safe vaccine available now (mRNA-based vaccine BioNTech and Moderna). But it’s a kind of ongoing, live investigation. So we have just a sample of information about side effects and effectiveness data for the next months and years. It’s very important to state that people have to weigh the risks between vaccine and coronavirus disease. They need vaccination. The risk of Coronavirus is real for many people. It brings a very significant disease, especially for older adults. But at the same time, the long term safety data on vaccines is being accumulated. But from everything that we know at this point, I think over several million people in the states, up to 4 million people have been vaccinated. The safety data looks pretty good. I’m sure it’s a safe vaccine. As I said, you can never exclude long term side effects. But I’m sure it will not be so important. And you have to have in mind, the risk to die from COVID-19 is remarkable. It’s worldwide, something between 0.5 to 3%. And for the elderly, for patients above 65 years of age, at-risk patients with comorbidities like diabetes, obesity, like arterial hypertension, can go up to 20%. And if you balance this, the risk of side effects from the coronavirus vaccine much less than the risk of the disease itself. And obviously, people who are younger, but who might be in contact with more elderly relatives or friends or friends or relatives of their friends. So it’s a chain reaction. So perhaps it’s important to underscore that this vaccination is very relevant. It’s not only for people who are elderly who have an increased risk, a high risk of dying, but also for the younger people, who are healthier, and who might tolerate the disease itself on their own is pretty easy. It’s still important from a public health perspective and their family’s perspective. I agree. It’s a psychological issue. So if you are young and your risk for dying is very low, nevertheless, you could infect a relative or someone else who is elderly and who is comorbid. And I think if you have to think you are responsible for someone’s death because you are not vaccinated, and you are SARS-CoV-2 infected, that that’s not a good feeling. And if we can avoid this, we should do so.