Some answers to common COVID-19 vaccine questions

It's a profound understatement to say we live in a time of uncertainty and skepticism toward major American institutions. Into that environment, we are introducing new vaccines designed to combat a viral pandemic killing nearly 4,000 of Americans every day.

Is there any wonder, then, that so many myths and rumors circulate about the safety and effectiveness of these vaccines? It's reasonable from human experience to be concerned about having a stranger stick you with a sharp object and inject a foreign substance into your body.

I write to provide some perspective and advice as a pediatric infectious disease specialist at the University of Minnesota Medical School.

First, some history. Raging infectious smallpox outbreaks killed nearly 400,000 people each year in Europe during the 1700s, until physicians noticed that milkmaids who had been infected with cowpox seemed to be immune to the outbreaks.

English physician Edward Jenner's first inoculation in 1796 was crude by today's standards — he took the pus from a milkmaid's cowpox blister and inoculated a young boy who then developed immunity to the smallpox outbreak in his town.

Today, our methods and labs are much more hygienic and careful. The requirements for testing the safety and effectiveness of vaccines involve a range of steps and reviews before final approval by the U.S. Food and Drug Administration. And that leads to the first question:

We've developed a lot of scientific knowledge in the 225 years since Jenner's first vaccine. A wise former mentor of mine, Dr. Paul Offit, once told me, "All the vaccines that are easy to make have been made already. All of the ones left are the hard ones."

The technology behind mRNA vaccines, like the ones developed by Pfizer and Moderna, has been under study as a response to HIV, and required the deadly urgency of a pandemic to bring the research through the approval process. These vaccines have moved through three phases of study and been reviewed by two nonpolitical panels of trustworthy leaders.

As with all vaccinations, we are seeking the greater good, measuring the risks of infection from COVID-19 vs. reaction to the vaccine. And on that scale, the two mRNA vaccines approved so far are definitely superior.

Getting the virus from the vaccine would be like getting a chicken from scrambled eggs. It can't happen. The mRNA has only a tiny amount of code, or snippet of RNA, not enough to make a whole virus.

Some vaccines in the past — the oral polio vaccine for example — were made by weakening the virus to stimulate the immune system. But with the oral polio vaccine, sometimes the virus unweakened. That's not possible with this vaccine because there's no virus in it.

There are no current vaccines that cause autism or cancer — that has been definitively proven — despite what the rumors on social media may say. There's no reason based on the science behind these vaccines that they would do so either, and mechanisms are in place to watch for all reactions.

This is a small sample of the myths raging around COVID-19 vaccines as they roll out nationwide. With 12 additional vaccines in Phase 3 studies, the first two mRNA vaccines will be joined by additional and different types of approved vaccines before too long. And based on experience, that may also increase the numbers of questions or concerns that emerge.

Fortunately, there are reputable resources, such as immunize.org, that are available to help answer those questions.