As Hospital Prices Soar, a Stitch Tops $500 (Published 2013)
I Got Vaccinated – But My Family Can't, And The Guilt Is Killing Me
Editor's Note: Melissa Mahtani is a senior producer and reporter for CNN's live news team. The views expressed in this commentary are her own. Read more opinion articles on CNN.
CNN —
Vaccine guilt is a real thing – and although it may not make sense rationally, emotions aren't rational. Last Saturday, I got the Moderna vaccine against Covid-19. I had been eligible to get it under New York City guidelines due to underlying conditions. However, I wasn't planning on it.
I do have underlying conditions, but I've been able to manage them and I'm very aware that there are others out there – teachers, health care workers, those over 60 – who need it more than I do. As more and more of those types of people did get vaccinated, I was still planning on waiting until everyone could get the shot and was hopeful that my family in Zambia would also be able to get their doses at that time.
What spurred me to get the shot was the loss of one of our closest family friends last month, who I consider my uncle. Originally from Yorkshire, England, he had lived in Zambia – like many other expats in the former British colony – for most of his life. When he got coronavirus, even being around 80 years old couldn't secure him a spot in an overcrowded hospital, so he was turned away. That led to him having a stroke and eventually being admitted to an intensive care unit (ICU) where he lived out his final days, on a ventilator.
Had he been in England, or any other rich nation, he likely would have received treatment immediately, or got the vaccine, and would possibly still be alive today. The tragedy was made worse by the fact that his family and friends couldn't say goodbye in person due to him having Covid – like countless others around the world who have been robbed of real goodbyes to their loved ones.
Losing him was hard. The reality that this could be my parents, and I wouldn't be able to see them or say goodbye if they got the virus, was worse. Thousands of miles away, would the last time I had seen them be the absolute last? That haunting thought made me realize that I needed to take the vaccine that was offered to me here, so I could be one step closer to being able to see my parents if disaster struck. But still, I felt racked with guilt over being eligible to take it when they, who need it more than I do due to their age and more severe underlying conditions, could not.
My husband made the appointment for me to get my first dose and I immediately cried, feeling like I was being selfish. On the way to the appointment, I was distraught at the fact that we live in such an unfair world, where someone like me gets to take it and thousands of others don't – and may not have access to it for a very long time. Don't get me wrong, am I grateful I got a vaccine? Of course, I am. Everyone needs to get vaccinated. I just wish everyone could.
While my family was so happy for me – the news even led them to open a special bottle of wine to celebrate – I was crying my eyes out with guilt, and overcome with a sense that I had somehow been chosen to live and they hadn't. I know it doesn't make any sense, but even though I was one step closer to being able to see them, I felt and still feel like I will somehow never see them again. Rationally I know that's not true, but I can't shake the feeling. I would give anything to be able to give up my dose for them to get it. I feel so sad and guilty that I got to take a vaccine and they don't. The worst part is not knowing when they will.
According to Our World in Data there are currently 67 nations around the world with no access – none – to vaccines. Do their citizens not count? Doesn't every human life count? What makes my life more valuable than theirs? Why isn't every pharmaceutical company rushing to get every single life on planet earth vaccinated for a disease that has shown us it can infect anyone, regardless of citizenship, age, race or status in society? Shouldn't the treatment for the virus be equally as broad? No one in the world can be safe when others are still at risk of contracting and spreading the virus. Didn't the global pandemic teach us that?
The pace of the vaccines' rollout largely depends on pharmaceutical giants. Backed by the governments that funded them, these companies are thus far reluctant to share their patents – which, critics argue, effectively amounts to choosing profit over human life.
Instead, they have contributed to a global vaccine-sharing program called COVAX, aimed at reducing vaccine inequality. COVAX uses donations from governments and multilateral institutions to buy vaccines for poorer nations that can't afford contracts with major drug companies. It's a great start but getting enough supplies has been difficult, in part because wealthier countries ordered more than they need.
Sharing patents could help. As Tedros Adhanom Ghebreyesus, director-general of the World Health Organization, recently said, AstraZeneca is "the only company that has committed to not profiting from its COVID-19 vaccine during the pandemic" noting the significant contribution the company has made to vaccine equity, "by licensing its technology to several other companies." This includes companies in Korea and India that are producing more than 90 per cent of COVAX-distributed vaccines.
I'm not suggesting that patent sharing would be a magic wand or that every country has the capacity or facilities to make vaccines. But in the face of a global pandemic, we should all do everything possible to end it.
Yet earlier this month, richer World Trade Organization (WTO) members blocked an effort from more than 80 developing nations to waive patent rights to increase production of Covid-19 vaccines for poor countries. They argue that upholding intellectual property rights encourages innovation. Thomas Cueni, the director-general of the International Federation of Pharmaceutical Manufacturers, told the AP that lifting protections on patents is "a very bad signal to the future. You signal that if you have a pandemic, your patents are not worth anything."
Not sharing vaccine data or doing more to share vaccines, hurts rich countries as much as poor ones. As Dr. Tedros also pointed out: "A me-first approach might serve short-term political interests, but it is self-defeating and will lead to a protracted recovery with trade and travel continuing to suffer … as long as the virus is spreading anywhere, it has more opportunities to mutate and potentially undermine the efficacy of vaccines everywhere. We could end up back at square one."
As we in the US receive our vaccines, we cannot forget what led to this birthright. America, for example, is a land of immigrants. That means the people born here owe their freedom and privilege to others who risked their lives to come here, much like the thousands at the southern border are doing now. Where are the pro-life voices in crises like this? They fervently make the case against abortion, but I haven't heard them raise their voice as loudly for their fellow citizens in other countries dying. Do those lives not matter?
Ironically a global pandemic that should have made us realize we're all the same, with the same concerns and fears and susceptibility to disease, has perhaps made us more selfish, putting fears for ourselves and our loved ones ahead of our concern for strangers across the world. The love and concern I feel for my family in Zambia is just as valuable as the love and concern an American feels for their American family or a European for theirs.
Every single person needs to get vaccinated for all of us to collectively be safe. Until that happens, we must remain thoughtful and compassionate, and recognize our own privilege to have the resources to protect ourselves from this virus. Covid-19 has shown us that it doesn't discriminate, and neither should the antidote.
COVID-19 Vaccines
As the coronavirus continues to cause illness and death around the world, vaccines are seen as one of the best ways to stop it.
The virus that causes COVID-19 only surfaced in late 2019. Normally, developing a vaccine for a new virus takes years, but scientists were able to get a boost from research on similar coronaviruses that cause severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS).
Experts say this coronavirus could eventually turn out to be seasonal, like colds and the flu. A vaccine is vital to helping control it.
Health care workers and the elderly were the first to receive the vaccine. But after the success of mass production and distribution, the vaccines were made available to a broader population.
The CDC recommends everyone ages 6 months and older get vaccinated against COVID-19. Everyone ages 6 months and older should get a booster with the 2024–2025 COVID-19 vaccine.
The CDC says the vaccines are safe for pregnant people, and there's no indication they pose any danger to a fetus. There have been reports of adverse allergic reactions to some of the vaccines, but these are extremely rare.
The CDC advises that anyone who had a severe allergic reaction after getting Pfizer-BioNTech or Moderna vaccines should not get another dose of either. Anyone who had a severe allergic reaction after receiving the Johnson & Johnson or the Novavax vaccines should not get a dose of that particular one.
There are four types of vaccines approved in the United States:
Pfizer-BioNTech. This vaccine uses messenger RNA (mRNA). This is what carries instructions for making the "spike" protein that lets the virus enter human cells. The mRNA vaccine tells your immune cells to make just the protein and act as if they've already been infected with the coronavirus, giving you some immunity against it.
This vaccine is approved for children and adults. The children's dose is not as strong as the adult version. Children from 6 months to 4 years old get a three-dose primary series, and everyone age 5 and older gets a two-dose primary series.
The CDC recommends the updated (bivalent) COVID-19 booster for everyone 6 months of age or older. The Pfizer-BioNTech updated (bivalent) booster can be given at least 2 months after the 2nd dose of the primary series or last booster. People ages 6 months and up can get either a Pfizer-BioNTech or Moderna booster.
Moderna. This is an mRNA vaccine given in two doses, 4 to 8 weeks apart to people ages 6 months and older. The updated (bivalent) Moderna booster can be given to anyone ages 6 months or older at least 2 months after 2nd primary series dose or last booster.
Johnson & Johnson vaccine. The J&J vaccine uses DNA that's designed to trigger an immune response to the virus.
Johnson & Johnson's COVID vaccine has a weakened version of the adenovirus, one of the viruses that causes the common cold. It's been combined with genes from the new coronavirus's spike protein to trigger your immune system to fight it.
Top health experts recommend you choose a COVID vaccine made with mRNA (like the ones from Pfizer and Moderna) rather than the J&J vaccine, which is made differently. Their recommendation is endorsed by the CDC and comes from the Advisory Committee on Immunization Practices, which reviewed the latest evidence on the effectiveness, safety, and rare side effects of available vaccines.
That said, if you can't get an mRNA vaccine or you don't want to, you should get the J&J vaccine. Receiving any COVID-19 vaccine is better than being unvaccinated, experts say.
If you got the J&J vaccine, the CDC recommends that you receive one updated (bivalent) booster as long as it has been at least 2 months since your last COVID-19 vaccine dose, whether that was:your final primary series dose, or an original (monovalent) booster. Even if you got more than one original (monovalent) booster, you should get an updated (bivalent) booster.
Novavax. The FDA has approved the Novavax COVID-19 vaccine for people 12 years and older.
This vaccine offers another option for those who haven't gotten the Pfizer, Moderna, or J&J vaccine. The Novavax shot is like other vaccines that have been used in the U.S. For more than 30 years. It uses protein subunits, just like the hepatitis B, influenza, and whooping cough vaccines.
The CDC suggests Novavax if you prefer to get a vaccine that's built on different technology than previous COVID-19 vaccines.
It includes a two-dose series. You'll get your second shot 3 weeks after your first. The Novavax vaccine is different from the other three available COVID-19 vaccines. It contains:
Clinical trials show that the Novavax vaccine helped prevent some COVID-19 infections and lowered the likelihood of severe illness from the virus in 90% of cases.
Novavax boosters are available after 6 months for people 12 years and older.
When you come in contact with viruses or bacteria, your body's immune system makes antibodies to fight them off.
A vaccine forces your immune system to make antibodies against a specific disease, usually with a dead or weakened form of the germs. Then, if you come in contact with them again, your immune system knows what to do. The vaccine gives you immunity, so you don't get sick or so your illness is much milder than it otherwise would have been.
The vaccine should slow the spread of COVID-19 around the world. Fewer people should get sick, and more lives can be saved.
The Pfizer, Moderna, and Novavax vaccines have been shown to be at least 90% effective for adults. Johnson & Johnson's COVID vaccine is more than 66% effective. But these numbers were from before new COVID-19 variants became common.
While these vaccines may not completely prevent you from getting infected with a COVID variant, they'll likely protect you from getting severely ill.
Yes. The CDC says you no longer have to wait 14 days between vaccinations. Experts say that after getting the COVID-19 vaccine, your immune response – the process in which your body builds antibodies to protect you against the virus – is basically the same whether you take it alone or with the flu vaccine. Flu season in the U.S. Typically lasts from October to May.
Possible common side effects like pain, redness, and swelling where you got the shot may last a day or so. These won't change much if you get the flu vaccine, too. Call 911 if you have a severe allergic reaction.
The development of a vaccine against COVID-19 has taken place in an unparalleled pace. Usually such a process takes years, but the scope of the pandemic triggered round-the-clock work by thousands of researchers working on over 100 forms of the vaccine.
Before any vaccine can be used widely, it must go through development and testing to make sure that it's effective against the virus or bacteria and that it doesn't cause other problems. The stages of development generally follow this timeline:
If you're interested in volunteering for a COVID-19 vaccine trial, here are some sources of more information:
Government-sponsored sites:
Sites that link volunteers with trials nationwide include:
Individual hospitals, universities, research centers, and others may also provide opportunities to enroll in a COVID-19 vaccine clinical trial. Some are:
You can also call or visit the website of your local hospital or research institution to find out if it is taking part in any trials.
Dear Doctor: I Got The Older COVID Vaccine 2 Months Ago. How Long Do I Wait Before Getting The Newer One?
DEAR DR. ROACH: I received a COVID vaccine seven weeks ago. It's the one that has been given since 2023, so it was not an updated vaccine. But the Food and Drug Administration just approved and released the updated vaccine for 2024. Can I get the most recent and updated vaccine, or must I wait? -- V.C.
ANSWER: A new vaccine was approved by the FDA in August, and it's available now, specifically for the new omicron variant, KP.2. This new vaccine closely targets the circulating viruses. You can get the vaccine if you have not had (any) COVID vaccines in the past two months, so you just need to wait another week.
There is a lot of COVID circulating right now in many areas of the country, and getting a vaccine right away may be a good choice for people, especially if they haven't been vaccinated in a long time or if they are at a high risk due to age or medical conditions. Some people might consider waiting a couple of months for the expected winter surge. I am advising most of my patients to get the new vaccine now, but your particular situation may be different. So, talk to your doctor about the optimal timing.
DEAR DR. ROACH: It was less than five years ago that I had a TURP (transurethral resection of the prostate) surgery for slow urination. It is not at a critical point yet, but it feels like my urine flow is slowing down again. How often do men who've had a TURP surgery require a second operation?
A normal prostate is the size of a walnut. As men age, it enlarges. Does it ever stop growing at a certain point? How large can it actually get? Can it get to the size of an orange or larger? -- Anon.
ANSWER: You are right that in young men, the prostate is typically the size of a walnut. In many men, the prostate enlarges, but there are different anatomical areas within the prostate, called zones. The urethra, which carries the urine from the bladder out through the penis, goes right through the transitional zone of the prostate, and it's this zone that most often causes symptoms in older men.
Surgery is done less often now for enlarged prostates than 20 years ago, because medication is much more effective. Most men don't need surgery, but surgery is certainly still done. In addition, there are other options, such as photoselective vaporization, microwave treatment, cold and laser treatments, and prostate artery embolization. The decision of which to offer is in the hands of the urologist, but I can give some guidance on how often a repeat surgery is necessary.
After five years, about 7% of men who had the surgery you had required a second operation. Most other treatments were similar, but some weren't as long-lasting. Prostatic artery embolization required retreatment 24% of the time at five years, while microwave treatment required retreatment 31% of the time.
Unfortunately, the prostate tends to keep growing. You really don't want to beat the "world record" of 4 liters, which is about the size of a small watermelon. (The person who had it didn't have any symptoms, so treatments weren't done.)
Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.Cornell.Edu or send mail to 628 Virginia Dr., Orlando, FL 32803.
(c) 2022 North America Syndicate Inc.
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