As the Delta variant of COVID-19 continues to spread within communities, Australians are being encouraged to get vaccinated to protect themselves and others from the coronavirus. Prime Minister Scott Morrison has said 70% of the adult population needs to be fully vaccinated before the country can get a step closer to normality – think low-level restrictions, international arrival cap changes and reduced quarantine arrangements.
But social media conspiracy theories and mass anti-lockdown protests have left many Aussies confused about vaccine eligibility, side effects and the effectiveness of the shots. In Australia, the AstraZeneca vaccine is more readily available than the Pfizer jab, but many people are still unsure which vaccine to get and what side effects are possible.
So, to help set the record straight, we've spoken to some qualified Australian health experts — infectious diseases expert and epidemiologist, Professor Raina MacIntyre, and Melbourne-based GP, Dr Preeya Alexander (@TheWholesomeDoctor on Instagram). Here, they debunk those 5G myths, address concerns about blood clots, fertility and if your breasts will get bigger after the vaccine, as well as some other big questions.
Will the Pfizer vaccine cause my breasts to become larger?
Professor MacIntyre: No. COVID vaccines can, however, cause inflammation in facial fillers and breast implants. Reports of breast implant reactions usually involve pain and swelling.
Dr Alexander: I’ve seen a lot of women talking about this! Most likely what is occurring is that women are getting some lymph node enlargement after the vaccines, and it is being perceived as larger breasts.
When you get any vaccine, the intention is to give a body a taste of a particular disease so that it can prepare for battle and get the armoury ready. The body sees a glimpse of the illness and starts making the right weapons in case it encounters the illness in the real world. This process can cause the lymph nodes (where the fighter cells tend to live) to enlarge – it’s a temporary thing and whilst you may feel like you have larger breasts for a day or two – it isn’t permanent – sorry!
Can I get the COVID-19 vaccine if I'm pregnant?
Professor MacInytre: COVID Vaccines have been given to millions of pregnant women worldwide and are safe and effective for mother and baby. In fact, COVID affects pregnant women more severely, so it is important pregnant women are protected against COVID.
Dr Alexander: Yes! In fact, the recommendation in Australia is for all pregnant women to be offered the Pfizer vaccine to protect both mum and baby in pregnancy.
With millions and millions of COVID-19 cases globally, we now have much more insight into which groups of people are at higher risk of complications from COVID-19 infection. It has become apparent that pregnant women are a vulnerable group and at higher risk of COVID-19 complications. Many countries, including Australia, have updated their recommendations to ensure pregnant women are included in the priority group when it comes to vaccination.
Lots of changes happen to the body in pregnancy – the way oxygen is consumed by the body changes and the lung volume also changes as the baby grows and pushes up into the chest cavity – and it’s a combination of these changes that make the mother more vulnerable.
I think all women who are concerned, or who want some solid reassurance, should read the joint statement from the Australian Technical Advisory Group on Immunisation (ATAGI) and the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) which clearly outlines why pregnant women should consider vaccination and the details around why we know it is safe.
Does the COVID-19 vaccine cause infertility?
Professor MacIntyre: No, there is no known mechanism by which any vaccines can cause infertility. This myth has been used against other vaccines too, in the past, such as polio. In Nigeria, a conspiracy theory that polio vaccines make women infertile resulted in a drop in vaccination and Nigeria becoming a hot spot for polio in the recent past.
Dr Alexander: This myth was sadly born when some researchers wrote a letter suggesting that the spike protein on the SARS COV 2 virus (the virus that causes COVID-19) were similar to proteins seen on placental cells. They suggested that anything targeting the spike protein (like some of the vaccines) could also target the placenta as well. This has since been debunked.
The proteins on the SARS COV 2 virus and placental cells were not actually similar at all; they were very different. And in the clinical trials for the vaccines, there were the same number of pregnancies in the vaccination group and the control group suggesting that the vaccines did not have a positive or a negative impact on fertility.
Can I get the COVID-19 vaccine if I have endometriosis?
Dr Alexander: Yes, you absolutely can. I think everyone should have a chat with their GP if they have any concerns about their underlying medical conditions and vaccination – so we can reassure you with all the information.
Does the AstraZeneca vaccine cause blood clots?
Professor MacIntyre: The vaccine can very rarely cause clots — the risk is higher for younger people, and lower for older people. In people under 60, it is about three in 100,000. In people over 60, it is between 1.4 to 1.9 per 100,000.
Dr Alexander: There is a rare immune-mediated clotting disorder associated with the AstraZeneca (AZ) vaccine and it is known as TTS which stands for thrombosis with thrombocytopaenia syndrome (to put it simply it is a clotting disorder with low platelets).
This side effect is rare and the risk of this depends on your age group. TTS can be mild, moderate or severe in nature and in the worst-case scenario can cause death; the rate of death due to TTS post-AZ vaccination is one in one million in Australia.
So yes, this is a real side effect but the risk is low and what we are trying to do across Australia in GP counselling sessions is counsel people about the risk, benefit ratio and help them understand, visualise and process risk so they can make a decision about vaccination with AZ (if they are not currently eligible for Pfizer).
If I get the vaccine, will I test positive for COVID-19?
Professor MacIntyre: The vaccine will lead to you making antibodies to the virus, so you would have a positive antibody test, but not a positive test for the virus (the PCR test, which is used to diagnose COVID).
Dr Alexander: The COVID vaccines are not live vaccines, and they cannot “give you” COVID-19. They will not make you test positive on a PCR test (the swabs we do to diagnose COVID-19 most of the time).
Do I have to receive two doses and do they have to be the same type of COVID-19 vaccine for it to be effective?
Professor MacIntyre: There is emerging evidence that mixed dose schedules may work well and even result in stronger responses, but it is not yet approved in Australia.
Dr Alexander: The current recommendation is to stick with the same vaccine for both doses, unless there is a medical reason to change the type of vaccine used for the second dose due to an adverse reaction. You do get some protection against COVID-19 and hospitalisation and death due to COVID-19 with one dose, but two doses make the level of protection much better!
After two doses of the vaccine, you have a reduced risk of being hospitalised due to COVID19 and a reduced risk of dying from it. You also protect those around you, because if you are vaccinated you are less likely to get COVID-19 and thus less likely to pass it onto those around you.
Why do young people need to get vaccinated against COVID-19?
Professor MacIntyre: The Delta variant is like a brand new pandemic — it is more infectious and more deadly, and spreads to almost 100% of people in households. It is important to protect your loved ones. Young people are more likely to spread the virus, so be cautious, wear masks, be aware that shared air is the biggest risk – infections mostly arise from breathing in contaminated air. Simple measures like opening a window or switching your car air conditioning to “outside air” will reduce the risk.
Dr Alexander: I think we just need to look at some of the recent tragic events in NSW with deaths of young people. The same things have been seen in other countries, but it all feels much closer to home now. I think there are many who still believe that COVID-19 does not affect younger people and we know that is not true — particularly when it comes to the delta variant. Particularly with the Delta variant, we are seeing that we are all potentially at risk regardless of our age.
Who should I be listening to when it comes to deciding which vaccine is most suitable for me?
Professor MacIntyre: Listen to the official health advice from your State government and Federal government.
Dr Alexander: Qualified health professionals and not people who claim to have done their research by relying on papers released by deregistered health practitioners and trawling Facebook forums. This is the time to listen to reliable, qualified voices who present accurate science and evidence-based information in a calm, logical manner. I cannot say this enough — health misinformation never has a place — but particularly not in a global pandemic; it’s incredibly dangerous and it’s undermining a public health initiative at a critical time.
Your GP is the best-placed person to chat to regarding which vaccine is for you and when. This is what we are doing across the country — on top of our normal general practice commitments.
While a sore arm and fatigue are the most commonly reported side effects, what are the more severe side effects and how common are they?
Professor MacIntyre: Severe side effects are rare. We have already talked about the thrombosis and thrombocytopenia reaction following AstraZeneca. The Pfizer and Moderna vaccines may very rarely cause myocarditis or pericarditis (inflammation of the heart), usually in young males (teens or twenties). In most cases, this is mild and gets better.
Dr Alexander: There is the potential for side effects after both vaccines currently available in Australia (but I would remind people that there are side effects with nearly anything including the Ibuprofen you might take for a headache).
It’s really important for people to know that when you get vaccinated — at either a hub or GP clinic — you will get an information sheet related to the vaccine you have been given which lists the common and more rare side effects, so you are in the know. We encourage all side effects to be reported as data continues to be collected in real-time (you will get details on how to report when you get vaccinated).
Common side effects include pain at the site of injection and some fatigue. There are less common but more severe side effects with both vaccines that will be covered in the handout you receive. With AZ vaccination, there is a low risk of TTS I mentioned earlier so, we tell you about symptoms to watch out for including a severe persistent headache that doesn’t resolve with normal pain relief.
With Pfizer, there is a potential for rare cardiac side effects called myocarditis and pericarditis and again we inform you of the symptoms to watch out for like chest pain. It is so important to reiterate that you will be armed with knowledge (excuse the pun!) when you are vaccinated so you know what to look out for.
Once I'm vaccinated, do I still need to get tested if I experience COVID-19 symptoms?
Professor MacIntyre: Yes, the Delta variant can cause infection in vaccinated people, and you can spread it to others. Vaccination will protect you against severe disease, but vaccination alone will not be enough, as we are seeing now in the US.
Dr Alexander: Yes, yes, yes! There is a misconception that if you are fully vaccinated (2 doses) you cannot get COVID-19, that you are 100% protected. At no stage have qualified health professionals and scientists claimed that these vaccines are 100% effective against COVID-19.
These vaccines are brilliant at reducing your risk of getting COVID-19 (and of being hospitalised with complications from COVID-19 or dying from it), but they are not 100% effective! Just like a seatbelt is not 100% effective at preventing you from dying in a car crash and a helmet is not 100% effective at preventing you from getting a brain injury if you fall off your bike. These vaccines are about risk reduction, and they do a great job of that — but you can still get COVID-19 so if you have symptoms, you must get tested.
Are these theories true? Does the COVID-19 alter DNA, contain nanoparticles that are used to connect people to 5G networks, and contain a microchip that's tracking us?
Professor MacIntyre: This is untrue. The vaccines cannot alter your DNA. The mRNA vaccines like Pfizer and Moderna use nanoparticles to coat the vaccine. There is no scientific basis for this being able to connect people to the 5G network. There are no microchips in the vaccines, and I doubt that invisible microchips have yet been invented.
Dr Alexander: They are simply not true and sometimes I cannot believe we have to inject time and energy into debunking these myths when there are way more important things to be talking about!
Imagine how hard it would be to fit a microchip into such a teeny tiny needle — it just isn’t possible! Come on!
The vaccines cannot alter DNA — the vaccine contents do not enter the nucleus of the cell where the DNA is safely locked away!
What other myths are incorrect?
Dr Alexander: There are many who are trying to claim breakthrough infections (COVID-19 infections in those who are fully vaccinated) are proof that the vaccines do not work or that this entire pandemic is a hoax. Breakthrough infections are normal — they should not surprise anyone.
There are 2 important points here. If you have a small proportion of the population vaccinated, then less vaccinated people will contract a highly contagious virus circulating in the community because there are fewer of them. If loads of the population are vaccinated, then there are more vaccinated people who are at risk of getting infected with a highly contagious virus circulating widely. These vaccinated individuals, however, have a level of protection against severe disease, hospitalisation, and death due to COVID19.
As I said before — no one qualified ever said these vaccines were 100% effective — so again, breakthrough infections should not be a surprise. The vaccines reduce risk but they do not stop the infection altogether. There should be no surprises here.
Interviews have been edited for length and clarity.
Refinery29 Australia reminds readers to seek their own medical advice and stay up to date with official health advice from the government.