Your Good Health: Benefit of COVID vaccine outweighs risk | #elderly | #seniors | #execrise
Dear Dr. Roach: I’m a teacher scheduled to get the Pfizer vaccine on Friday. My mom keeps sending me stuff about why I shouldn’t get it — fear of what it will do to the immune system in the future. Everything I’ve read confirms it’s safe, but she is freaking me out a little. Could you send me some encouragement as to its safety?
All the data we have so far — and it’s a year of safety data — tells us that this is both a safe and effective vaccine. I, and now my whole family, have received the vaccine after I read the safety and efficacy studies.
There have been times when vaccines have had safety problems; however, when those have occurred, the problems generally were seen within weeks of giving the vaccine. Millions of people have now had the vaccine. The likelihood of an unknown bad effect that will show up later becomes very remote at those numbers. It’s not impossible, so I understand why your mom is concerned. The risk is very small.
You must balance the small potential risk of the vaccine against the risk of getting COVID. Half a million Americans — and millions more people worldwide — have died from COVID, and tens of millions are experiencing long-term side effects.
The risk of a serious side effect from the vaccine is about 1 person per 10,000. So, for yourself, your students and your neighbours, I hope you decide to get it. You are far more likely to have benefit than harm from the vaccine.
Dear Dr. Roach: Could you talk about medication review in older people? In the past year, I have taken three elderly friends to see a geriatric physician when they became weak and unsteady. They were “cured” by having medications removed, reduced or changed. Their primary doctor insisted they needed these drugs, but clearly, they didn’t.
Most primary care physicians are trained as family physicians or internal medicine doctors, and prescribing medications is usually the most powerful treatment we have, if advice on diet, exercise and other lifestyle issues have been ineffective. It is common that medications are given for a problem that might be destined to go away on its own, and doctors are not always as good at ending prescriptions as we are at adding them.
Geriatric physicians have expertise in problems that are unique to older people, and tend to realize better than other doctors the downsides of medications. In fact, the American Geriatrics Society regularly publishes a list of medications that are particularly problematic in older people. Medicines on this list often cause more harm than good. Although there are certainly times to prescribe medicines on this list to an older person, there are usually better alternatives. This list is widely available: One place with helpful advice for patients is at tinyurl.com/beers-med-list.
You needn’t visit a geriatrician or even a new physician to review medications with an eye toward which ones might be stopped. All patients, but especially elderly ones, should have an up-to-date list of their medications, including over-the-counter medicines and supplements, know what each is for and regularly go over the list with their prescriber. You are absolutely right that removing medicines can remove side effects, but patients need to partner with their prescriber before stopping a medicine.
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
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