Last week, we discussed how history seems to be repeating itself with a one-size-fits-all strategy of mass vaccination for COVID-19, just as the scientists and health officials attempted to do during the Spanish flu of 1918, but desisted from it when they observed that it was not working to control the pandemic.

Lucia Sto. Tomas of Makati City says that we don’t have to go that far in time; just look what happened in the Dengvaxia catastrophe of 2016, when we prematurely rolled out the mass vaccination program to all schoolchildren, only to realize six months later—after having given close to a million doses—that it’s not safe to give to children younger than 9 years old without history of infection.

We must remember that it took Sanofi 20 years to develop the vaccine, and went through all the phases of clinical trials required by the regulatory authorities; yet there were some nuances that all their bright scientists and clinicians still missed. And to that was attributed the deaths of hundreds of schoolchildren given the vaccine.

Warp-speed vaccine

We’re not discounting the competence of all our well-meaning scientists and virologists who, at warp speed, came up with a new-technology vaccine in less than a year and secured regulatory approval to use it as emergency intervention for an infection, when the average Filipino’s chances of surviving in the next 12 months is 99.97 percent.

The risk of dying for the average Filipino is around 0.035 percent. In 20- to 40-year-old healthy young adults, the risk of dying is 0.003 percent, or three in 100,000 or one in 33,333. Compare that to the risk of developing potentially life-threatening myocarditis or swelling of heart muscles due to mRNA vaccination in a 16- to 24-year-old, which, based on studies coming out of Israel and the United States, can be as high as one in 10,000.

I have been criticized and advised even by colleagues who are experts in infectious disease to back off in my commentaries on COVID-19 because it is not my expertise (I am an internist and cardiologist). I politely refuse to accept that, because COVID-19 is a multiorgan disease, and among the frequently affected organs and structures are the heart muscles and the lining of the blood vessels. If you put together the lining of the arteries, called endothelium, it can cover two or more tennis courts; that’s why it’s a favorite anchoring place of the virus, particularly its spike protein, which the virus uses to latch onto a cell.

And now, experts are recommending the vaccines for even low-risk individuals despite the alarming risk of blood clots and myocarditis. Both the disease and the vaccine can potentially damage the heart and blood vessels, so it’s well within the cardiologist’s turf, and we’re not overstepping our competence when we discuss these things.

Reckless treatment

An infectious disease colleague argued that most cases of myocarditis due to the mRNA vaccines recovered, though some of them had critical moments in the intensive care unit. I hastily corrected him that these young adults with myocarditis do not really recover completely. They may improve for some time, but at least a third of them will die of refractory heart failure in the next three to five years. Those who survive will literally be cardiac invalids for the most part of their lives.

These are young adults, adolescents and teenagers who still have a whole life ahead of them. We may be recklessly subjecting them to a treatment that can save at best only one in 100,000 given the vaccination, but may potentially ruin or compromise around 10 of them. It’s my turn to tell these expert colleagues to shut up if they don’t know what they’re talking about.

We have rolled with the punches, but it’s comforting to hear words of appreciation from readers of our column. Just when we were doubting if we were doing the right thing of giving people the information they might need, God moved two distinguished lawyers to send us a message on the same day, to assure us that what we’re writing here makes sense.

Ruel M. Lasala, former deputy director for Intelligence and Investigation of the National Bureau of Investigation and former deputy director-general for operations of the Philippine Drugs Enforcement Agency (PDEA), sent this message:

“Your articles have been very enlightening. We share your deepest concerns for our fellowmen. Me and my wife (Norma Lopez-Lasala, former national treasurer of the Philippines), also got COVID and got well without hospitalization and without infecting anyone as we quarantined at home. We are not opting to be vaccinated and we believe in your stand. We hope that the government will be enlightened by the many articles you already wrote about COVID-19. God bless.”

Natural immunity

Lasala was referring to our column last week, which explained that those who were previously infected with the COVID-19 virus have developed a robust natural immunity which is superior to vaccine-generated immunity. Tampering with natural immunity may have unfavorable side effects, which we don’t know yet.

By virtue of his decades of experience in investigative work at the NBI and PDEA, people like Lasala can never be easily convinced with shallow, brain-tickling data. You need hard evidence. We’re sure he didn’t take everything we wrote here hook, line and sinker. He must have validated it and weighed all the data.

Kenneth Radaza, another brilliant litigation lawyer, and his wife, Cat, also wrote: “Thank you for the advice you give through your column. We align with your advice … We understand now fully about natural immunity. Thank you so much for looking after us (your readers). We commend you for your articles, and hopefully people and the authorities appreciate them as much as we do.”

Thank you so much for these kind words. But, as always, we reiterate that whatever we discuss in this column is just for educational and guidance purposes. It’s not to be taken as a prescription for everyone. We just want to empower you, dear readers, with information that can help you make intelligent decisions. It would be a good idea to discuss it with your respective family physicians.

Side effects

It’s good that many people have access to the internet, where most of this information on the side effects of drugs including vaccination could be read. But many are just relying on what doctors and health officials tell them, which may not be complete.

For example, many women of child-bearing age don’t know that the vaccination can increase their risk of miscarriage, should they get pregnant. Possibly, although there is no data yet, it may also increase risk of congenital anomalies in the baby should one get pregnant a few weeks or months after vaccination.

If one gets the jab when one is already in the first trimester of pregnancy, the risk of abortion, as shown by a study, is more than 90 percent. Our recommendation is to avoid getting pregnant at least six months after getting the second dose of vaccination.

We hope our Food and Drug Administration (FDA) would require the inclusion of this risk in the vaccine package warning, as well as the risk of developing myocarditis, pericarditis and thromboembolism (blood clots), similar to the graphic warnings in tobacco packs.

The vaccine manufacturers will likely soon apply for an emergency use authorization (EUA) of the vaccines in pregnant women. We may seriously doubt the competence of FDA director general Eric Domingo if he approves this. We already had misgivings when he approved the mRNA vaccination of adolescents despite the much higher risk of myocarditis and pericarditis in this age group compared to older adults.

Reviewed basis

We strongly recommend that the FDA reviews its basis for giving an EUA for all these still inadequately tested vaccines. When they started the vaccination rollout, no one knew that deadly blood clots, heart swelling, heart attacks and neurologic disorders could develop. It’s only after millions of doses that we discover there are these serious side effects, although rarely seen. There are probably a lot more that will only be known several months after.

We believe the EUA for the elderly and the immunocompromised or vulnerable sectors with comorbidities are justifiable; that’s why we keep emphasizing that all efforts at vaccinating these vulnerable sectors must be exerted, even if the local governments have to arrange for house-to-house voluntary vaccination. These people have the highest risk of dying should they get COVID-19.

But vaccination in the other age groups should only be approved after full clinical trials, including postadministration surveillance have been completed. We pray that the FDA and our health officials soon get out of their seeming trance and keenly assess all available data.

Again, let not the Dengvaxia blunder haunt us again in the future when an eager-beaver but misinformed mass vaccination in schoolchildren was initiated, when it should have been limited to a specific age group. It may be excusable to commit a mistake, but repeating it—particularly if human lives hang in the balance—is unforgivable.

The science of medicine is always an enigma. That’s why perhaps it’s represented by the caduceus symbol of a short staff with two entwined serpents. Physicians are expected to give healing potions, but when given to the wrong patients, for the wrong indication or at the wrong time, it can be like snake venom that can kill rather than heal patients. INQ