More than a million people in the United States have been killed by COVID-19 in the past 3 years. The numbers would be much higher, but the vaccines were developed with amazing speed. Time and again, the vaccines have been shown to be safe and effective.
Yet some people persist in claiming the mRNA vaccines are causing an epidemic of stroke.
The data is clear. They do not. If you want to reduce your chances of stroke, get the vaccine.
The new thing that causes stroke over the past few years is COVID-19 itself. If you want to decrease your chances of having a stroke (or another stroke) don't get a severe COVID-19 infection. And the simplest thing you can do to reduce your chances of getting a severe COVID-19 infection is to get the COVID-19 vaccine.
If you do catch COVID-19 despite the vaccine, the data shows it will be much less severe and much less likely to be fatal.
In addition to protecting yourself, you are also helping to protect others who may not be medically eligible to get the vaccine.
The COVID-19 mRNA vaccines are saving lives every day.
In this episode ...
In this episode, I talk with data scientist and epidemiologist Dr. Remle Crowe about the research studies coming out now that show what we already knew from earlier research: the COVID-19 vaccine does not increase your risk stroke.
We talk about several studies, and we talk about how you can do your own research on the credibility of these studies and evaluate how well they reflect the scientific reality of our world.
In this post, you'll also find links to a bunch of these studies that you can read for yourself.
Start by listening to this conversation. If you don't seed the audio player below visit http://Strokecast.com/MSN/vaccine to listen to the whole conversation.
I got my Bivalent COVID-19 booster and my 2022 Flu shot on the same day in October.
Who is Dr. Remle Crowe?
Dr. Remle Crowe is an expert in EMS research and quality improvement. From truck clutches to clinical care, she has shown how research and improvement science work to solve problems across fields. Prior to earning a PhD in Epidemiology, her EMS career began with the Red Cross in Mexico City as a volunteer EMT. She has authored numerous peer-reviewed publications related to prehospital care and the EMS workforce. Now, as a research scientist with ESO, Dr. Crowe routinely uses EMS data to improve community health and safety.
Dr. Crowe previously appeared on the Strokecast in episode 132 to discuss the AHORA pneumonic to help Spanish speakers recognize and respond to a stroke. When it comes to stroke, Time is Brain regardless of which language you speak.
A Sampling of the Studies
When we claim the data indicates that the vaccine doesn't cause an increase in stroke, what data are we talking about? How did "they" analyze it? Who reviewed the studies to ensure they were accurate? Where can you read the details yourself?
As Dr. Crowe explained, there are currently a whole bunch of studies that are coming out. That makes sense; it's roughly 18 months since the vaccines against COVID-19 became widely available. To conduct sound research, you need a large pool of people to look at. You need to take some time to see the results. You need to write up those results. Then you need to submit them for publication. Publications will then need to review before publishing them.
That brings us to where we are today with all these studies now becoming available. Let's take a look at a few of them, and I encourage you to click through to the details and read them yourself. Click the study titles for more.
Surveillance for Adverse Events After COVID-19 mRNA Vaccination
This study published in JAMA (Journal of the American Medical Association) looked at nearly 12 million doses of the mRNA vaccine given to more than 6 million people.
This is what they learned:
"The incidence of events per 1 000 000 person-years during the risk vs comparison intervals for ischemic stroke was 1612 vs 1781 "
In other words, the time period at greatest risk for stroke did not see an increased risk.
They concluded:
"In interim analyses of surveillance of mRNA COVID-19 vaccines, incidence of selected serious outcomes was not significantly higher 1 to 21 days postvaccination compared with 22 to 42 days postvaccination. While CIs were wide for many outcomes, surveillance is ongoing."
COVID-19 Incidence and Death Rates Among Unvaccinated and Fully Vaccinated Adults with and Without Booster Doses During Periods of Delta and Omicron Variant Emergence — 25 U.S. Jurisdictions, April 4–December 25, 2021
We talked about this report from the CDC Morbidity and Mortality Weekly Report during the episode.
This study looked at infections and deaths among vaccinated folks and unvaccinated folks. The rate of infection and death from COVID-19 was much higher among unvaccinated folks than among vaccinated or vaccinated and boosted folks.
The report says:
"Rates of COVID-19 cases were lowest among fully vaccinated persons with a booster dose, compared with fully vaccinated persons without a booster dose, and much lower than rates among unvaccinated persons during October–November (25.0, 87.7, and 347.8 per 100,000 population, respectively) and December 2021 (148.6, 254.8, and 725.6 per 100,000 population, respectively) (Table 2). Similar trends were noted for differences in the mortality rates among these three groups (0.1, 0.6, and 7.8 per 100,000 population, respectively) during October–November."
Even though the vaccine does not guarantee a person will avoid COVID-19, it greatly increases their chances of avoiding infection. And if they do become infected, the vaccine greatly increases their chances of survival.
Acute ischemic stroke and vaccine-induced immune thrombotic thrombocytopenia post COVID-19 vaccination; a systematic review
This study in the Journal of Neurological Sciences looked throughout the published literature and found just 43 incidents of stroke following the vaccine administration.
"AIS has been reported as a rare complication within 4 weeks post COVID-19 vaccination, particularly with viral vector vaccines. Health care providers should be familiar with this rare consequence of COVID-19 vaccination in particular in the context of VITT to make a timely diagnosis and appropriate treatment plan."
The report specifically called out the risk of “viral vector vaccines” (and, again, it’s a shockingly small risk). The most common viral vector COVID-19 vaccines are those from Johnson & Johnson and from Oxford-AstraZeneca.
The mRNA vaccines from Moderna and Pfizer are not viral vector vaccines., indicating that those appear to be even safer.
The recommendation is not to avoid vaccination. It's an extremely rare complication. The recommendation is to watch for signs of stroke, which is something we should be doing all the time anyway.
Association Between Vaccination and Acute Myocardial Infarction and Ischemic Stroke After COVID-19 Infection
This article, published in JAMA looked at what happens after a COVID-19 infection for both vaccinated and unvaccinated folks. If someone does get infected and, does their vaccination status reduce the impacts of infection? Yes, it does.
In fact, folks who got the vaccine and the got COVID were LESS likely to have a stroke or heart attack after their COVID infection.
"This study found that full vaccination against COVID-19 was associated with a reduced risk of AMI [heart attack] and ischemic stroke after COVID-19. The findings support vaccination, especially for those with risk factors for cardiovascular diseases."
Risk of thrombocytopenia and thromboembolism after covid-19 vaccination and SARS-CoV-2 positive testing: self-controlled case series study
This study in the UK looked at patients who had been infected with COVID-19 or who had received the vaccine. More than 30 million people were part of the study. The conclusions were clear:
"Increased risks of haematological and vascular events that led to hospital admission or death were observed for short time intervals after first doses of the ChAdOx1 nCoV-19 and BNT162b2 mRNA vaccines. The risks of most of these events were substantially higher and more prolonged after SARS-CoV-2 infection than after vaccination in the same population."
Even if there is a slight risk from vaccination, the risk from the actual disease is much higher.
COVID-19 vaccine not linked to increased risk of stroke
Not all research becomes available without a subscription. Researchers at Cedars-Sinai have found similar results to other studies though and have come to the same conclusion.
"Newly compiled data evaluated by researchers in the Department of Neurology and the Smidt Heart Institute at Cedars-Sinai shows that COVID-19 vaccines do not raise stroke risk--but that severe COVID-19 infection does. Physician-scientists hope this growing body of evidence, highlighted today in an editorial in the peer-reviewed journal Neurology, will ease the minds of individuals still hesitant to be vaccinated."
Risk of Myocarditis After Sequential Doses of COVID-19 Vaccine and SARS-CoV-2 Infection by Age and Sex
We talked about this study in the conversation with Dr. Crowe. At first glance it is concerning. This is the conclusion:
"Overall, the risk of myocarditis is greater after SARS-CoV-2 infection than after COVID-19 vaccination and remains modest after sequential doses including a booster dose of BNT162b2 mRNA vaccine. However, the risk of myocarditis after vaccination is higher in younger men, particularly after a second dose of the mRNA-1273 vaccine."
That does seem scary for young men, and there are a couple things to keep in mind.
First, the number of events was so small that it's tough to draw firm conclusions. When you get down to such low numbers, that stats can do weird things.
Second, this was based on the adverse event reporting system. That does not prove causality. It just flags something to look at more closely if there are large numbers. Which there are not.
The point of all this research, though, is to learn more and compile more and more evidence. And ultimately to let the body of evidence guide decision making and recommendations.
What we know at this point is that the risk of stroke after a COVID-19 infection is much higher than the risk of stroke following a vaccination.
And the risk of stroke after COVID-19 infection is much lower in folks that have been vaccinated than it is in those who have not been vaccinated.
COVID-19 is not gone. It is still out there in the world infecting people, killing people, and giving people strokes.
Billions of vaccinations later, this is what the data tells us.
The simplest way to reduce your risk of stroke is to get the vaccine and stay boosted.
Do Your Own Research
We talked about a bunch of research in the podcast, and we looked at a bunch of reports above. You don't have to just accept my commentary or Dr. Crowe's. You can read the reports yourself and look at the data and see why the vast majority of medical professionals have concluded the vaccines are safe and effective.
Dr. Crowe offered a number of tips to help you do your research. You'll find them and more in this list.
Tip 1
Search research focused search engines and directories to find studies and resources. Google Scholar and PubMed are great places to start.
Tip 2
Look at the Publication that publishes the research. Is it well known for scientific rigor? Does it have a strong requirement for peer review of articles? Or can someone publish in it by simply paying a fee?
Tip 3
Search for the publication's Impact Factor. The more other publications that cite its work, the higher the number. A publication with a higher impact factor is likely more credible.
Tip 4
When you get to the actual study, look at what type it is. If it was a case study, that's interesting. If it was a randomized, double-blind, placebo-controlled study on a large scale, that's even better. If it was a systemic review evaluating hundreds of other studies, that's stronger still.
Tip 5
Look at how many people were part of the study. A few dozen is interesting. A few million is much more likely to yield credible results.
Tip 6
Look at the results of the study, relative to the size of the study. A few results out of a dozen is one thing. A few results out of millions of subjects is another matter altogether.
Tip 7
Look at the goal of the study. What were the authors hoping to demonstrate? Did they succeed? Why or why not?
Tip 8
Consider confounding. Studies generally deal with a subset of the population -- a limited number of people -- and seek to extrapolate those results and draw conclusions about the broader population. For those conclusions to be valid, though, the group studied needs to be similar to the group the study extrapolates to. The more different the groups are, the less reliable the results.
Tip 9
Finally, does the study demonstrate causality or just coincidence? There’s a reason folks will often say, “Correlation does not equal causation.” For example, the FDA Adverse Event Reporting System (FAERS) Public Dashboard is a collection of negative things that happen to a person after they get a vaccine. It's not a list of events caused by the vaccine. If a person gets hit by a bus after getting the vaccine, that can go in the database. It's an adverse event. That doesn't mean the vaccine caused the bus accident. Read the study carefully to see if the authors claim a causal relationship and if that relationship is supported by the evidence in the study.
AHORA
The last time Dr. Crowe was on the show was to talk about the AHORA messaging to help Spanish speakers recognize and respond to stroke. It's basically the equivalent of the BEFAST messaging we talk about a lot in English.
Here is the stroke warning pneumonic device in Spanish. Download it and share it far and wide.
Reconocer los signos de un accidente cerebrovascular y responder rápidamente. ¡Llame a una ambulancia si observa estas señales!
Let’s look at a translation.
| Letter | Abbreviation for | Spanish Description | In English |
| A | Andar | Tiene dificultad para andar? Tiene problemas con el equilibrio? | Do they have difficulty walking? Do they have problems with balance? |
| H | Hablar | Tiene dificultad para hablar o entender? Usa palabras que no tienen sentido? | Do they have difficulty speaking or understanding language? Do they use words that don't make sense? |
| O | Ojos | Tiene algün cambio de vista? Tiene visiön doble? Tiene dificultad para ver con ambos ojos? | Do they have some change in vision? Do the have double vision? Do they have difficulty seeing with both eyes? |
| R | Rostro | Tiene la mitad del rostro caido? Tiene un repentino dolor de cabeza como nunca se ha sentido? | Do they have one-sided facial droop? Do they suddenly have the worst headache of their life? |
| A | Ambos Brazos | Tiene dificultad para levantar un brazo o una pierna? Tiene debilidad en un brazo o una pierna? | Do they have difficulty lifting an arm or a leg? Do they have weakness in an rm or a leg? |
And, of course, here is the BE FAST messaging for English speakers.
Recognize the signs of a stroke and respond quickly. Call an ambulance if you observe these signs!
Both sets of symptoms look for the same thing. The AHORA messaging includes legs and headaches. The BE FAST messaging specifically calls out calling an ambulance.
Regardless, the more people that can recognize a stroke as it is happening, the better off we will all be.
Pop Culture Moment
During the conversation, Remle mentioned she is a big fan of the movie Sliding Doors. It's an examination of how simple moment can change the course of your life. What path lies ahead if we catch that train or miss it?
Or what happens if we turn right instead of turning left?
In reflecting on the past, it's easy to get fixated on thing were so much better back then, but it's never that simple, is it? Billy Joel reminds us that:
"The good old days weren't always good, and tomorrow ain't as bad as it seems."
Other Shows
Journal Club
Remle mentioned her show, PCRF Journal Club, which is a journal review webinar that meets each month. They go deep into looking at the latest research studies that are coming out. The focus is on research around EMS -- the ambulance and transport industry.
If you'd like to learn more, check out its site here: https://www.cpc.mednet.ucla.edu/pcrf
Successful and Disabled
I was also recently featured on another podcast focused on being successful as a person with disabilities.
I joined host Christ Mitchell on the Successful and Disabled podcast to share my story and discuss how I use mindset to drive my recovery and other goals in life.
Listen to it here. If you don't see the audio player below, visit http://Strokecast.com/MSN/Vaccine to listen to the conversation:
Hack of the Week
Reading a paper book can be challenging with one functional hand. It's even harder if you try to do that while eating a meal. Why? Because books don't always want to stay open on their own. You have to hold them open, which makes it harder to pick up your cheeseburger.
I use my phone to address this problem. I open the book and then lay my phone across the open pages. It's just heavy enough to keep the book from snapping shut so I can enjoy feeding my belly as I also enjoy feeding my mind.
Give it a try.
Links
Where do we go from here?
- Check out the links above to learn more about why getting the vaccine is safer than not getting the vaccine
- Share this episode with someone you know by giving them the link http://Strokecast.com/vaccine
- Do you have a recent win or victory in your recovery? Share it by calling 321-5 STROKE
- Get your vaccine and booster to protect against COVID if your doctor advises it
- Don't get best…get better
Calli and Lt Dan
