Ask the Doctor: Visions of Vaccines Dance In Our Heads

Dr. Bickel, featured almost weekly on WNZF’s Free For All Friday program since last March to update the community on the coronavirus pandemic and answer questions, will be doing so on a rolling basis here. The questions don’t have to be limited to the pandemic.

You are invited to submit your questions using the form below, or by email, or in the comment section below. The entire list of questions will be archived, indexed and linked to their answers on a separate page, here.

As Dr. Bickel describes it, “the “Ask the Doctor” column will be a semi-regular feature of FlaglerLive, the frequency of which will depend on the volume of questions we receive. The updated timestamp in red at the top of the page, will indicate when new question s have been answered.

Please feel free to ask any medical question you want, and I will do my best to answer it. In preparing my answer to your question, I may consult with some of my medical specialist colleagues or review the medical literature in order to come up with the best possible answer.

“Please limit your questions to general medical advice—I can’t give you specific medical advice since I don’t know your individual medical history. The emphasis of this column will be to provide information based on current scientific evidence while keeping speculation and politics to a minimum. If I don’t know something or the medical literature really doesn’t have much to say on a particular topic, I will tell you that.

“The fields of medicine and science in general are always advancing and we don’t have all the answers, but I will try to come up with something helpful for every question I receive, even our knowledge in an area is limited. At first a lot of the questions may be about Covid-19, but they don’t have to be, and any area of medicine is fair game for this column.”

The inaugural installment of the “Ask the Doctor” column is based on common questions that seem to be on many people’s mind at the moment.

By Stephen R. Bickel, M.D.

This new year is going to be much better than last. Why? Because we now have a powerful weapon to fight the virus that devastated the whole world last year: vaccines. The coronavirus will join polio, smallpox, tetanus and measles on the list of medical enemies that we conquered or controlled. We will regain our health, economy and social relationships. But I know you have questions.

Should I get the vaccine? You are very smart to ask. No vaccine is without risks. And these vaccines are new. Their development and approval has gone at “warp speed.” Our knowledge of this new virus has evolved rapidly over the past months and information has seemed contradictory. All of this is true. But I have received the vaccine and I will tell you why. I don’t want to get sick or die. And I don’t want you, my neighbors, to die, or suffer in the short or long term. You will need to weigh the benefits and risks to decide if you would like the vaccine. I will try to answer questions you may have in making that decision.

Are the vaccines safe? They are very safe. Minor side effects of arm soreness, fatigue, or headache, generally lasting less than a day, are pretty common, especially after the second dose. Serious side effects are very rare. Severe allergic reactions occur in about one in 100,000 people, tend to occur within 15 minutes of administration, and can be treated with an Epi-Pen. Pfizer and Moderna vaccines went through phases 1,2, and 3 (the same evaluations that tetanus, polio and all vaccines go through) and passed them with flying colors. The difference is that these new vaccines were given an Emergency Use Authorization (EAU) by the U.S. Food and Drug Administration (FDA) before the usual year-long period of watching for infrequent, delayed side-effects. So we do not yet know if there are late complications but careful surveillance is being done and there is no scientific reason to suspect problems. With the remarkable, internet-assisted flow of information these days, problems may be detected and communicated much sooner than in the past. And so far (over 28 million vaccines given worldwide), so good.

Isn’t vaccination unnatural? Is it dangerous to our genes? I would say vaccines are among the most natural of medical interventions. Much more natural than, say, surgery or antibiotics. We simply turn on the body’s natural ability to fight off a virus. Human bodies have been doing this forever. We benefit from many years of high-level medical research, much of it inspired by the SARS epidemic back in 2003, which has taught us how to safely turn on our natural immune response. The two current vaccines are made with messenger RNA which goes into our cells and without even entering the cells’ nucleus tells our body how to stop the coronavirus before it makes us sick. This is our body’s natural response; we just get the body to do it before we are sick. Sweet! And, really, quite natural.

What benefit do I personally get from the vaccine? That’s a good question. It’s different for different people depending on age, race, underlying health and likelihood of exposure. But the benefit could be dramatic. It could save your life. Vaccinated people are over 90 percent protected from getting sick from Covid and even more protected from getting a bad enough case to be hospitalized. And the chance of dying if you are vaccinated but unlucky enough to get Covid, is essentially ZERO.

What benefit does the community get from people like me getting vaccinated? And what’s the deal with “herd immunity” anyway? Again, those are good, important questions. First of all, I don’t like the term “herd Immunity.” I prefer the term “Community Immunity” and I define it this way – the more members of a community who are immune (either because they survived or were vaccinated), the less the disease spreads. And that “community” could be as big as the country, or as local as Flagler County.




What should we do now? Not to brag, but we in Flagler County have done a heck of a job fighting Covid. We have benefitted from an engaged media (radio, online and print), committed local and county leaders, and a public willing to support measures to contain the spread. The result is that Flagler County has among the lowest case and death rates (per capita) in the state. Now, with the availability of a safe and incredibly effective vaccine (and within the bounds and challenges of the state and federal distribution system), our Health Department is rolling out a rational, ambitious vaccination campaign that could bring us local, community immunity. Wow.

So here is what I suggest. 1) Continue to be vigilant about spread. We are in the home stretch. Double down on masks, distancing, avoiding indoor gatherings. With vaccines and community immunity so close, this would be a silly, and tragic, time to get Covid. 2) Decide if you would like a vaccine. If you have questions, ask your doctor, or contact me through FlaglerLive. 3) If you would like a vaccine text FlaglerCovid to 888777. If you do this properly you will receive a text that begins “FLAGLERCOVID: Thank you for signing up . . .” You will then receive updates on how, when and where you can get a vaccination.

Here’s to a better, healthier New Year.

Please be safe.

Dr. Stephen Bickel, M.D.

Dr. Bickel, currently the medical director of the Flagler and Volusia County Health Departments, treats HIV and Hepatitis C patients at both departments, treats internal medicine patients at the Volusia Volunteers in Medicine free clinic, and is the medical consultant to the Community Care program at 9 Advent Health campuses in Florida.Dr. Bickel has a BA from Brown University, an MD from Rush Medical College, as well as MBA and MPH degrees from UCLA. He did residency training in internal medicine at Rush, public health/preventive medicine residency training at UCLA, as well as an endocrinology research fellowship at the University of Chicago. He is board certified in internal medicine and preventive medicine, as well as being a credentialed HIV specialist and a certified hypertension clinician.

He is very interested in how the social determinants of health impact our community and how we can address health disparities by improving our safety net. He has been on the Board of Directors of Flagler Cares since its inception.

Disclaimer: The content in FlaglerLive’s “Ask the Doctor” column is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. If you think you may have a medical emergency, call your doctor, go to the emergency department, or call 911 immediately. Reliance on any medical information provided by FlaglerLive.com or medical professionals presenting content for publication is solely at your own risk.