Covid-19 Vaccines

With the ongoing 4th wave of Covid, as well as increasingly common mandatory vaccination mandates in the industry, Dr. Gautama and I have been fielding an increasing number of enquiries from airline pilots concerning these vaccines. We are struggling to keep up with all of them. The purpose of this information page is to address some of the more common questions.

Background

The pandemic has been, to cite an overused cliché – unprecedented. Equally unprecedented has been the emergence of a new, internet-fuelled phenomenon of “alternative facts”. As Daniel Moynihan famously said, everyone is entitled to their own opinion – they are not entitled to their own facts. The facts about Covid – and the various vaccines, are relatively easy to search out, provided one consults reliable internet sources1,3. Once one descends the rabbit hole into conspiracy theory, fringe websites and social media propaganda – and enters an alternate reality twilight zone, there is nothing we can do for you. If that is where you choose to go, you will have a belief system impenetrable to logic or data – one does not alter belief systems using data. In fact, the statements of trained physicians and medical scientists are cited by conspiracists as proof that we have been hoodwinked by the new world order, or whatever conspiracy you embrace – and our opinion is not accepted as having value. Mercifully, very few pilots seem to hold such beliefs - you all seem to be a pretty logical, grounded bunch! In fact, we have been impressed by the thoughtfulness of the majority of questions. So here are the main issues we have been hearing:

Would you recommend getting the vaccine?

Yes. If you are unvaccinated, and in the middle of an active wave of the pandemic – (and there will be multiple more waves – just as there were in other pandemics), you are at significant risk to contract the virus, and spread it. The CDC study2 released last week gives interesting data: Unvaccinated people are about 29 times more likely to be hospitalized with Covid-19 than those who are fully vaccinated. It also found that unvaccinated people were nearly five times more likely to be infected with Covid than vaccinated people. So even though it is possible to contract – and spread – Covid even if you have been vaccinated – you’re much more likely to do it if you are unvaccinated. You are also at increased risk of getting sicker. By the way if you are interested in a good, well written explanation of vaccinated people getting covid – check out this article in Atlantic: https://www.theatlantic.com/science/archive/2021/09/sterilizing-immunity-myth-covid-19-vaccines/620023/

“The false dichotomy”

We love discussing relative risk with airline pilots – as they are used to choosing between two (or more) courses of action, NONE of which are risk free. The false dichotomy currently plaguing discussions of vaccination is that it comes down to a choice of doing something (vaccination) which has small, measurable risks1, or NOT doing it – which eliminates these risks. That is false. The real choice is between vaccination, and the risks entailed with (likely) coming down with Covid. Covid is a very risky thing to chance. 15% of those contracting the disease in the general population will experience significant medical issues. (With delta variant, these are appearing in younger individuals, who do not have the typical secondary risk factors). Among these, just to choose some examples for education purposes, are:

Severe pneumonia requiring at least oxygen, and in about 1/3, ventilation.
5% get serious multiorgan failure or other systemic issues requiring ICU care.
The incidence of clinically significant clotting in Covid varies widely depending on whether you are in hospital, in ICU and whether you have other risk factors, however, consider: Blood clots with COVID-19 have most often been seen in people who’ve been hospitalized with the disease.
A study of 184 people in the ICU for severe COVID-19 found that 31 percent of these individuals experienced complications related to blood clots.
It’s still unknown how common blood clots are in individuals who have a mild case of COVID-19.
COVID-19 complications from blood clots can happen across all ages. A small study looked at 14 people with COVID-19 who had experienced a stroke due to a blood clot. The study found that 42 percent of participants were under age 55 and had no existing risk factors for stroke.
There are other risks to consider if you get Covid – here is an interesting, if light-weight BBC article on the effect of vaccination on “long Covid”. https://www.bbc.com/news/health-58410354

Have you seen any pilot get career ending complications from the vaccine? I don’t want to put my career at risk.

No we haven’t. Nor have any of the Regional Aviation Medical Officers we asked. On the other hand, as has already been stressed, 15% of those who get Covid will experience significant to catastrophic health events – most requiring hospitalization. Any one of these (stroke, lung fibrosis following adult respiratory distress syndrome, multiple organ failure, sepsis, death) have a high likelihood of ending a pilot’s career. Especially death.

Does Transport have a policy on vaccination.? Do I need to be grounded following vaccination?

No, they don’t. No you don’t – except under CARS 404.06 – if you feel under the weather following vaccination. Mild aches/pains, mild fever, feeling a bit “fluey”, have all been reported. 404.06 says if you don’t feel well enough to be on top of your game – don’t fly.

Who should NOT get the vaccine?

If you have had a violent reaction (allergist confirmed anaphylactic shock) to a first dose of one of the Covid vaccines, you will need specialist consultation with an immunologist or allergist, to determine next steps to mitigate. Anyone who experienced the extremely rare side effect of myocarditis or pericarditis in response to the first dose of mRNA vaccine ( this is extremely rare and the risk of myocarditis from COVID infection is almost 4 times that of the vaccine) .

Okay – full disclosure doc. Have you been vaccinated?

Yes – with bells on. Both doses. Between Dr. Gautama and myself we have over 60 years of combined medical training/practice experience. We are one of the few groups who actually have the scientific and practice background to properly evaluate the data – and the risks involved. We got it, and all our family members got it. We have had no problems subsequently.

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