Are allergic reactions to mRNA vaccines rare or common? Let’s compare to other vaccines and COVID-19 deaths/long-haulers

Allergic reactions to the mRNA vaccines are rare – very rare, in fact. A person is MUCH more likely to die from COVID-19 or be a long-hauler than have an adverse reaction to the vaccines. The reactions are reported in individual cases in news media outlets as stories though – so, it can probably seem like they are more common than they are and make some people nervous about getting a vaccine. Let me help:

✅ PICTURE 1 – A study in JAMA (top-tier, peer-reviewed medical journal) looked at people who received their mRNA vaccines (Pfizer or Moderna) in December – this included 1.9 million people. They then looked at the VAERS reporting system to evaluate the occurrence of allergic reactions among these people. (We will talk about the VAERS in more detail below). What did they find?
◾Of the 1.9 million, 21 had severe allergic reactions; That equates to 11 cases per million doses.
◾Of the 21 severe allergic reactions:-17 had a previous allergic reaction history-17 were treated in the ED and discharged home-ALL 21 had allergic reactions within 3 hours after the vaccine (most were within the first 30 minutes).-All were discharged home; no deaths


Let’s compare the allergic reactions to other common vaccines. Remember that we are comparing the mRNA vaccine (which has no dairy, eggs, nuts). Let’s compare per 1,000,000 doses (that’s the rate of daily vaccines happening now for COVID-19).

◾Pfizer COVID-19 mRNA vaccine – 11 cases (0.0011%)

◾Moderna COVID-19 mRNA vaccine – 2.5 cases (0.000025%)

◾Flu (influenza) vaccine – 1-2 cases (0.00001%)

◾DTaP – 1 case (0.0001%)◾MMR – 53 cases (0.0053%)

◾Bee stings – 4000 (0.4%)


Now, let’s compare COVID-19 deaths

◾Case fatality rate – ~18,000 per 1 million (1.8%)-The case fatality rate varies across age groups and increases with age. This brings me to Picture 4 – it’s not just about dying from COVID-19


Let’s compare COVID-19 long haulers

◾350,000 per 1 million had long-haul symptoms 14-21 days after testing (35%)

◾200,000 per 1 million healthy young adults 18-34 were considered long-haulers (20%)

◾Of the long-haulers, the median age was 44 and most were women. Yuk.

-For more on long COVID-19, go here:

✅ TAKE HOME MESSAGE: Allergic reactions are very rare with the vaccines – magnitudes smaller than the risk of getting COVID-19, dying from COVID-19, or having long-hauler COVID-19 which can last for months and be pretty debilitating (and can affect every organ in the body, including the brain and heart). I hope this helps put you at ease about the safety of the vaccines. The rare allergic reactions we are seeing as vaccines continue to roll-out are what was seen in the vaccine trials (in other words, they are not expected or severe).

***I want to make a quick note about the VAERS reporting system. This is a system that has been around for a long time to report ANY symptoms after ANY vaccine. Individuals, individual’s families, and clinicians can report to the system in a passive manner (meaning anyone can report anything that looks suspicious). If severe adverse reactions or deaths are self-reported in VAERS, the CDC investigates. Remember the CDC members have families too which will receive vaccines and they want them to be safe. So, the VAERS is meant to be a safe-guard for all of us. The big thing to keep in mind is that the reporting is self-reported which may or may not be related to the vaccines. Remember our discussions on causation versus correlation? That cannot be determined through VAERS, which is why the CDC investigates the reports. So, when you hear reports about deaths in VAERS after the vaccines (I see those memes/headlines too), that does not necessaily mean those deaths are CAUSED by the vaccines. There’s so much circulating about this issue in the US and Norway and I will write a post specifically this week related to the VAERS. But for now, just know that correlation does not equal causation and the VAERS is a passive, self-reporting safe-guard system.


***Go here to see my full Vaccine Series if you have other questions:


Picture 1: Allergic reactions to mRNA vaccine data

Picture 2: Case fatality rates

Picture 3: Allergic reactions to common vaccines

Picture 4: Long COVID

Are cases going down?

We have seen a decrease in national cases over the past two weeks. But, we need to be very cautious in interpreting what that means. The decrease we are seeing are RELATIVE to the cases from the past two weeks – which were high. We still have a ways to go to get back to the daily cases we saw in October or November (which were still too high) and what we saw in the summer. Let me explain:


◾ Our US cases have decreased by 21%. Although that reduction is going in the right direction, we need to keep in mind the ABSOLUTE numbers of cases are still very, very high.

◾ For example, yesterday the US reported 190,630 cases – that is WELL above the 46,000 daily cases on October 1st and 100,000 daily cases on November 3rd. A 21% reduction is good – but that is comparing a reduction from 2 weeks ago when cases were well into the 250,000-daily mark.

◾ Deaths are still increasing, sadly. We are expected to hit 500,000 deaths in February.

◾ Hospitalizations are down slightly – remember that decrease is RELATIVE to the last two weeks – which were abundantly high. So many hospitals continue to be strained.


As a whole, much of the country is well beyond the goal metric of 10 cases per 100,000 people in the past week. You still see quite a bit of dark orange, red, and deep maroon. This, coupled with high positivity rates above 10% in the country, still shows widespread, uncontrolled transmission.


This picture shows were new cases are high and staying high.

TAKE HOME MESSAGE: Are new cases decreasing? Yes-ish. But, frankly they are way too high to celebrate. The new cases and cases per capita are still within the uncontrolled spread range – this means that they can start climbly again very quickly. Remain vigilant, web-peeps. Wash your hands, wear your masks, distance, distance, distance, get the vaccine when you can.


Pictures 1-3:

Relative risk versus Absolute risk reduction

Have you seen the viral post starting with “Plot twist: Numbers don’t lie?” The post then states we should be using absolute risk instead of relative risk…and, that the absolute numbers show the vaccines don’t work. And, there’s a lot of fancy math that is hard to follow. Confused? Me too.

✅ Short answer: There’s no plot twist. The numbers are not lying.

✅ Long answer – Here’s the details: ◾ The post going around states the vaccine efficacy data (the 94 and 95% numbers we have all heard about) for Pfizer and Moderna are the wrong numbers to look at – instead, the post says we should be calculating the absolute risk reduction.

◾ The post uses the wrong formula to calculate the 95% number.

◾ Then the post does more fancy gymnastics to calculate the absolute number – and ends up with 1.16%. (BTW, this number is calculated wrong in the post too).

◾ The post claims that we should be using the absolute risk reduction number which is only 1.16%.

◾ The post then concludes “How is almost every drug and vaccine study reported? Relative risk”. That ending is supposed to be a mic’ drop to say scientists are using the wrong number to show the vaccine works.

◾ Therefore, the post concludes the true vaccine effect is actually the low 1.16% number, not the 95% number. Ugh.

✅ Whoa. Uhm, get ready for some learning, web-peeps. Welcome to epidemiology 101.

✅ First some definitions.

1) Relative risk is the comparison between the placebo group RELATIVE to the vaccine group. It’s kindof like a ratio through division.

2) Absolute risk is the absolute difference between the groups. Like an addition or subtraction problem.

BOTH measures are calculated in epidemiology. BOTH measures are important and tell a certain part of the epidemiology-story. BOTH measures have value in certain studies and you have to use them appropriately when drawing conclusions in science. This depends on your study design, sampling methods, and endpoints – all fun epidemiology stuff.
For vaccine trials, both measures are important. BUT the most meaningful number is the relative efficacy numbers, not the absolute risk reduction.

✅ TAKE HOME MESSAGE: The vaccine efficacy is legit at 94-95%. No one is lying about that by not using or reporting the absolute risk reduction. The correct numbers were reported. There’s no plot twist.


***I’m sorry if this post feels vague if you haven’t seen the viral bad-data post. I’m trying to not share that stuff even as a screenshot to do my part in reducing bad information.

Vaccine data so far: A summary!

Dr. Fauci and his team at NIAID (National Institute of Allergy and Infectious Disease) published an excellent summary of what we know so far (and what we are still learning) with all the COVID-19 vaccines in the pipeline – with an excellent summary table. To those of us data-nerds, this table looks like a giant beautiful excel spreadsheet. (If you are a highschool or college student and you LURV excel spreadsheets, you will also LURV epidemiology – come join our MPH program!) =) To those of us who want the pandemic to end quickly, this table looks like gold. Let’s go through the main highlights:

✅ PICTURE 1 – This shows the current EUA approved vaccines for Pfizer (left) and Moderna (right). These likely look familiar to you by now – they show the efficacy of these vaccines and also indicate when dose #2 occurs.

✅ PICTURE 2 – This Table (Table 1) shows the current CDC distribution priority lists.

✅ PICTURE 3 – This Table (Table 2) is the big beautiful vaccine summary of the current 7 vaccines in the pipeline. ◾ The EUA-approved vaccines (Pfizer and Moderna) are at the top, followed by the next-in-line for EUA approval (J&J). ◾ The table also contains information on the dosing schedule (1 or 2 shots), study sample in the Phase 3 trials (30,000-45,000 people), efficacy against normal and severe disease, side effects, and storage. ◾ The paper goes into more detail in each of these trials and findings.

✅ PICTURE 4 – An excerpt from the paper talking about the mRNA vaccines. We’ve talked about that here already – but, we need to keep remembering this was not new technology made is 10 months. A TON of ground work has been laid on mRNA technology development and that foundation was used to jump-start the process for the mRNA vaccines. No rushed science here!

✅ PICTURE 5 – An excerpt discussing the biggest unknown (and debated) question: Do the vaccines prevent infection and transmission OR symptomatic disease? In other words, do you still need to wear a mask after vaccination?

◾ Based on Picture 1 (showing the efficacy) the current vaccines do a fantastic job (better than 90% of all other vaccines on the market right now) at preventing symptomatic COVID-19 (INCLUDING severe disease and less severe disease that is associated with long COVID-19).

◾ It’s important to restate what I just said: You do not want long COVID-19 or severe disease. We probably all know someone suffering with that right now with months-long fatigue, breathing problems, lung damage, heart problems, and more fatigue. The median age of long COVID-19 is 44 years and 90% are women – uhm, hello to that group of women! I see you.

◾ Ok, back to the picture. In the Moderna trial, 14 participants who received the vaccine shed the virus compared to 38 participants who received the placebo. This SUGGESTS reduction in viral shedding and transmission and more studies are currently being done to get a definitive answer.

✅ – especially during a pandemic. Learning as you go while doing what you can with what you have. What we have is lots of data with rigorously designed trials, independent reviews, two EUA with great efficacy, and some grit. Part of the scientific process (shout out to Mrs. Dodd, Mr. Acosta, Ms. Streiber, my favorite science teachers who sponsored my science fair projects and gave me a college textbook to read on DNA in 10th grade) is hypothesis building, testing, critically evaluating, concluding, recommending, and doing it all over again. The social media age has made this harder to communicate due to misconceptions about the scientific process or conclusions or study designs or…So, I want to encourage patience and trust in the process. I’m not saying to not be critical or ask questions. I’m saying to do your research carefully with experts and trusted voices. That’s one reason why I am highlighting this study – the authors have earned the right over decades of solid scientific work to speak into the pandemic. They are trusted.

✅ Now, today I’m headed over to my excel spreadsheets for my own data today. Today, my team (100% all-female-team, shout-out to the Drs.) and I are analyzing data on children in need of surgical care in Somaliland, the 4th poorest country in the world. Let’s hear it for the data and scientific process! It’s a pathway to hope and help to most in need – for both vaccines and our regular work.

-Friendly neighbor epidemiologist


“Why can’t I get a vaccine?”

This week I tried helping a family friend schedule a vaccine appointment time. I’ve also been trying to figure out how to get my parent’s vaccine appointments set up in another state. Appointment slots go REALLY fast in some areas. In my town, they were gone within 3-4 minutes because of the limited supply. If you are not fast with a computer, I don’t know how you can get an appointment. If you don’t have a computer, it’s hard to get an appointment through the phone system. This is not our city’s public health’s department fault either. Many health authorities are doing the best they can with limited supplies, limited information, and sporadic/delayed shipments. I’m hearing that there’s not as many reserve vaccines in Operation Warp Speed as we originally thought. And, on and on and on. So, I just wanted to empathize with everyone today. I’m as surprised as you are to hear about the logistical hardships of the vaccine roll-out and not knowing if reserve supplies are running out. I knew it would be hard, but not this messy. Here are my thoughts on this:

✅ 1. The logistical challenges of keeping a cold chain on the vaccines (especially the Pfizer one that needs to be stored as really low temps) is very complicated. Only certain facilities are equipped with the freezers needed which, in turn, can impact who can access the vaccines.

✅ 2. States are doing things very differently – indicating a severe lack of a coordinated national plan (and, we need a national plan to get this done). Some states (like Florida) let people come get a vaccine from any state which impacts the Florida residents who are high-risk and need one. Other states have not received shipments that were promised. And, the list goes on. So, it’s a bit of a mess.

✅ 3. Biden outlined his vaccine plan to ramp up production and distribution of vaccines during his first 100 days. I do think he will do a great job with his team to get this done. The distribution planning has to be done on a national scale to make this work. However, he is inheriting a mess so it might take a while to work out the kinks and figure out what went wrong.

✅ 4. Where are the vaccines? Why are they being distributed but not administered? Why are people who are not in the first few risk groups getting them? Are there inequities on who gets the vaccines (the answer is probably yes)? So many questions that I don’t know. I thought I knew the plan and have talked about that with you all. I don’t really understand what’s happening either though.

✅ 5. A success story is West Virginia! Let’s hear it for WV! In the first few weeks of vaccine roll-out, they had administered 90% of distributed doses. That’s a huge number! They used existing independent pharmacy networks (as opposed to OWS partnerships with CVS and Walgreens) with existing relationships, partnerships, and vaccine pipelines (like flu shots) to administer the COVID-19 doses. They focused on long-term facilities, rural areas, and other vulnerable populations. You can read more in the story below in the sources.

✅ 6. I’ve attached a few pictures to show the % of doses that have been administered in a few states: WV, Texas, and California. To see your state, go here:

✅ 7. The last two pictures show where we need to be to reach herd immunity and how many doses per day we should be administering in the US. We are a bit away from our goal of 1.5 million doses per day. I am hopeful this will change in the coming weeks to get us closer and closer to herd immunity.

I want to end by saying I’m sorry some of you cannot find a vaccine. I know it’s not my fault. =) But, I empathize with you on this. And, you’ve probably called everywhere you could think of and tried to register in an online system that crashes from so many trying to get a time slot. Some of you are high risk or have family members that are high risk. So, there’s an emotional toll of trying to get a family member a time slot to no avail. I feel ya, friend. I usually say “hang in there” and will say that on this post too. But, I also want to say I’m surprised, frustrated, and trying to be patient with you too. Hang in there, web-peeps!

-Friendly neighbor epidemiologist



WV –

𝐈𝐧 𝐡𝐨𝐧𝐨𝐫 𝐨𝐟 𝐃𝐫. 𝐌𝐚𝐫𝐭𝐢𝐧 𝐋𝐮𝐭𝐡𝐞𝐫 𝐊𝐢𝐧𝐠 𝐉𝐫 – Where do we go from here?

You do not have to go far to see the complex web between systemic racism, unconscious bias, privilege, justice, white supremacy, white nationalism, poverty and COVID-19. I’ve written on this before here – But, I want to highlight one of the most powerful statements from Dr. King. These are excerpts from his 1967 presidential address to the Southern Christian Leadership Conference titled, “Where do we go from here?”. It’s a question many, many of us are asking after 2020, particularly those in churches that have traditionally not asked hard questions, lamented, and moved forward correctly. (Have you read “The Color of Compromise”? If not, I would highly recommend it.) Where do we go from here? Let’s listen to Dr. King today. At the end of the post, I also link to a modern-day prophet in my own community, Malcolm Foley, with some poignant reflections on today and tomorrow and the next.

✅ “𝐖𝐡𝐚𝐭 𝐢𝐬 𝐧𝐞𝐞𝐝𝐞𝐝 𝐢𝐬 𝐚 𝐫𝐞𝐚𝐥𝐢𝐳𝐚𝐭𝐢𝐨𝐧 𝐭𝐡𝐚𝐭 𝐩𝐨𝐰𝐞𝐫 𝐰𝐢𝐭𝐡𝐨𝐮𝐭 𝐥𝐨𝐯𝐞 𝐢𝐬 𝐫𝐞𝐜𝐤𝐥𝐞𝐬𝐬 𝐚𝐧𝐝 𝐚𝐛𝐮𝐬𝐢𝐯𝐞, 𝐚𝐧𝐝 𝐥𝐨𝐯𝐞 𝐰𝐢𝐭𝐡𝐨𝐮𝐭 𝐩𝐨𝐰𝐞𝐫 𝐢𝐬 𝐬𝐞𝐧𝐭𝐢𝐦𝐞𝐧𝐭𝐚𝐥 𝐚𝐧𝐝 𝐚𝐧𝐞𝐦𝐢𝐜. 𝐏𝐨𝐰𝐞𝐫 𝐚𝐭 𝐢𝐭𝐬 𝐛𝐞𝐬𝐭 𝐢𝐬 𝐥𝐨𝐯𝐞 𝐢𝐦𝐩𝐥𝐞𝐦𝐞𝐧𝐭𝐢𝐧𝐠 𝐭𝐡𝐞 𝐝𝐞𝐦𝐚𝐧𝐝𝐬 𝐨𝐟 𝐣𝐮𝐬𝐭𝐢𝐜𝐞 𝐚𝐧𝐝 𝐣𝐮𝐬𝐭𝐢𝐜𝐞 𝐚𝐭 𝐢𝐭𝐬 𝐛𝐞𝐬𝐭 𝐢𝐬 𝐩𝐨𝐰𝐞𝐫 𝐜𝐨𝐫𝐫𝐞𝐜𝐭𝐢𝐧𝐠 𝐞𝐯𝐞𝐫𝐲𝐭𝐡𝐢𝐧𝐠 𝐭𝐡𝐚𝐭 𝐬𝐭𝐚𝐧𝐝𝐬 𝐚𝐠𝐚𝐢𝐧𝐬𝐭 𝐥𝐨𝐯𝐞.” And so, I conclude by saying today that we have a task, and let us go out with a divine dissatisfaction. (Yes)

✅ So, where do we go from here? Another great resource is a write-up from a very respected voice in my own community, Malcolm Foley. He continues to remind us to not simply lament, but to be agitators and extremists of justice. He also reminds us that some of us need to be agitated for comprehensive love and justice. For those of us who are white, we have to listen, listen, and listen some more with extreme humility, not defense stances if you hear the word “privilege” and get mad. This is more than lamenting. Let’s be agitated in the right way.

◾He said in a recent post, “This is a moment where we need to offer the right peace rather than say, peace, peace where there is no peace. Many need to be agitated by extremists for comprehensive love and comprehensive justice. If there’s one thing I’ve learned from my forefathers and mothers (and Jesus), it’s that there can be no unity without justice.”

◾Let us be dissatisfied until America will no longer have a high blood pressure of creeds and an anemia of deeds. (All right)

◾Let us be dissatisfied (Yes) until the tragic walls that separate the outer city of wealth and comfort from the inner city of poverty and despair shall be crushed by the battering rams of the forces of justice. (Yes sir)

◾Let us be dissatisfied (Yes) until those who live on the outskirts of hope are brought into the metropolis of daily security. ◾Let us be dissatisfied (Yes) until slums are cast into the junk heaps of history (Yes), and every family will live in a decent, sanitary home.

◾Let us be dissatisfied (Yes) until the dark yesterdays of segregated schools will be transformed into bright tomorrows of quality integrated education.

◾Let us be dissatisfied until integration is not seen as a problem but as an opportunity to participate in the beauty of diversity.

◾Let us be dissatisfied (All right) until men and women, however black they may be, will be judged on the basis of the content of their character, not on the basis of the color of their skin. (Yeah) Let us be dissatisfied. [applause]

◾Let us be dissatisfied (Well) until every state capitol (Yes) will be housed by a governor who will do justly, who will love mercy, and who will walk humbly with his God.

◾Let us be dissatisfied [applause] until from every city hall, justice will roll down like waters, and righteousness like a mighty stream. (Yes)

◾Let us be dissatisfied (Yes) until that day when the lion and the lamb shall lie down together (Yes), and every man will sit under his own vine and fig tree, and none shall be afraid.

◾Let us be dissatisfied (Yes), and men will recognize that out of one blood (Yes) God made all men to dwell upon the face of the earth. (Speak sir)

Here’s his full write-up which should be a required reading:

“𝐋𝐞𝐭 𝐮𝐬 𝐛𝐞 𝐝𝐢𝐬𝐬𝐚𝐭𝐢𝐬𝐟𝐢𝐞𝐝 𝐰𝐢𝐭𝐡 𝐭𝐡𝐞 𝐬𝐮𝐟𝐟𝐞𝐫𝐢𝐧𝐠 𝐨𝐟 𝐨𝐮𝐫 𝐧𝐞𝐢𝐠𝐡𝐛𝐨𝐫𝐬. 𝐈𝐟 𝐰𝐞 𝐚𝐫𝐞 𝐭𝐨 𝐛𝐞 𝐟𝐨𝐮𝐧𝐝 𝐨𝐧 𝐚 𝐬𝐢𝐝𝐞, 𝐥𝐞𝐭 𝐮𝐬 𝐛𝐞 𝐟𝐨𝐮𝐧𝐝 𝐨𝐧 𝐭𝐡𝐞 𝐬𝐢𝐝𝐞 𝐨𝐟 𝐭𝐡𝐨𝐬𝐞 𝐫𝐞𝐩𝐞𝐧𝐭𝐢𝐧𝐠 𝐚𝐧𝐝 𝐰𝐚𝐥𝐤𝐢𝐧𝐠 𝐚𝐥𝐨𝐧𝐠𝐬𝐢𝐝𝐞 𝐭𝐡𝐨𝐬𝐞 𝐰𝐡𝐨 𝐡𝐚𝐯𝐞 𝐛𝐞𝐞𝐧 𝐭𝐫𝐨𝐝𝐝𝐞𝐧 𝐝𝐨𝐰𝐧. 𝐋𝐞𝐭 𝐮𝐬 𝐛𝐞 𝐚𝐠𝐢𝐭𝐚𝐭𝐨𝐫𝐬 𝐚𝐧𝐝 𝐞𝐱𝐭𝐫𝐞𝐦𝐢𝐬𝐭𝐬 𝐨𝐟 𝐥𝐨𝐯𝐞. 𝐋𝐞𝐭 𝐮𝐬 𝐛𝐞 𝐚𝐠𝐢𝐭𝐚𝐭𝐨𝐫𝐬 𝐚𝐧𝐝 𝐞𝐱𝐭𝐫𝐞𝐦𝐢𝐬𝐭𝐬 𝐨𝐟 𝐣𝐮𝐬𝐭𝐢𝐜𝐞. 𝐋𝐞𝐭 𝐮𝐬 𝐛𝐞 𝐚𝐠𝐢𝐭𝐚𝐭𝐨𝐫𝐬 𝐚𝐧𝐝 𝐞𝐱𝐭𝐫𝐞𝐦𝐢𝐬𝐭𝐬 𝐨𝐟 𝐭𝐡𝐞 𝐆𝐨𝐬𝐩𝐞𝐥, 𝐭𝐡𝐞 𝐨𝐧𝐥𝐲 𝐦𝐞𝐚𝐧𝐬 𝐛𝐲 𝐰𝐡𝐢𝐜𝐡 𝐚𝐧𝐲 𝐨𝐟 𝐮𝐬 𝐚𝐫𝐞 𝐬𝐚𝐯𝐞𝐝.”


SOURCE: Here’s the full speech. We have a tradition in our family to watch the MLK JR “I have a dream” speech. I am going to add this speech to our tradition too.

Picture: Dr. Martin Luther King, Jr. speaking before crowd of 25,000 on March 25, 1965 in Montgomery, Alabama. Stephen F. Somerstein—Getty Images