By Helene Bednarsh
Please don’t misunderstand: I am not an antivaxxer. Rather, as a public health professional for 47 years, I am an avid proponent of immunization for vaccine-preventable disease for one’s own good and the good of the community. But I personally have an Achille’s heel that could potentially make the current vaccinations too risky. I have allergies, an epipen and a history of anaphylaxis. Lions and tigers and bears, oh my.
Growing up in Michigan I thought hay fever was endemic, not dangerous--just a nuisance. I’ve lived in many different states and one thing each had in common was that I would find some new allergen that attacked my body—again, a nuisance. I should have bought stock in antihistamines then.
But it was when I moved to South Dakota in 1977 that I discovered my allergy to bee stings. At that time, I was working in the Aberdeen Area Indian Health Service and traveling between four states and a dozen reservations by car or by plane. One morning, I was simply walking my dog and was stung by a ground bee. I thought nothing of it until my leg swelled ankle on up.
My doctor said it was an extreme reaction, as if I couldn’t tell, and that the next sting could lead to anaphylaxis. As I was soon to learn, anaphylaxis is a potentially life-threatening allergic reaction that can occur within seconds or minutes of exposure to peanuts or bee stings, or something else you're allergic to. So he gave me a syringe and a vial of epinephrine and had me practice doing injections of saline into an orange. Having given injections before, that was no problem. I left with the epi, syringe and a note allowing me to carry them.
As careful as I was, I found that even in the presence of others, I would be the one stung. I was so happy when the Ana-Kit came out – a preloaded syringe in a case by prescription. Years later, the epipen injection device to deliver epinephrine went on the market. Wow! Easy and convenient, and I never left home without it.
I have been hesitant to speak or write about this since I do not want to contribute to anti-vaccination conspiracy theories or discourage anyone who is eligible to be immunized. I am an outlier of sorts--if I get a bee or wasp sting or am in the presence of a cat, I am one of the rare ones who may suffer anaphylaxis. In that case, I must immediately inject two doses of epinephrine to counteract it, and then head to a hospital. But this is me and I know how to manage it and live with it. I’ve lost track of how many times I’ve injected myself but probably 20 or so. Let’s just say I don’t leave home without it.
So naturally reports about people who’ve suffered anaphylaxis after a Covid vaccine have given me pause. First there were headlines about two nurses in the U.K. then about a healthcare worker in Alaska, a doctor in Boston and a physician in Miami, then more news of other of allergic reactions from around the world. Some of the people who experienced anaphylaxis had allergies or other underlying medical conditions, others did not. All but one person was successfully treated. (That person developed an extremely rare autoimmune disease.)
Despite that, I have not ruled out being immunized. Instead, I am taking an evidence-based approach. I contacted my primary care physician and he said yes, you should get a vaccine, but bring knitting or reading materials because we will keep you here for a long time to observe you and monitor any reactions.
On the other hand, I have not contacted my allergist here in Massachusetts, since he told me, after my second anaphylactic reaction to the cat allergy injection he gave me, that he liked me but never wanted to see me again. On that occasion, I was so excited that an allergy shot to protect against cat dander was available and went in for testing and to schedule the allergy shots. After the first dose, three minutes in, I found myself being hauled into an exam room and injected with epinephrine. They wouldn’t even tell me what my heart rate was, but three hours later they let me leave. A month later they thought it safe enough to administer a child-size dose, same reaction and that was the handshake and goodbye. I get it.
However, I am the kind of person who delves into things much too much. I read the CDC Advisory Committee on Immunization practices report, searched the FDA website for adverse reporting, and tortured myself by joining a CDC COCA call (Clinician Outreach and Communication Activity) on allergic reactions, contraindications, and precautions. Too much information, alas. I even emailed the link of the recording to my PCP who affirmed that I needed to step away.
So, armed with entertainment, my own epipens and theirs, I’ll get my vaccine when I can because, in the end, the most important protection we can have is immunity. In Eula Biss’ 2014 book, On Immunity, she aimed to bring “substance and common sense” to the vaccination debate, as “an inoculation against ignorance and fearmongering.’ And this week, CNN advised viewers not to fear the vaccine, but to fear the virus itself. I agree.
Helene Bednarsh retired this year as the Director of the Ryan White Dental Program, Boston Public Health Commission but continues to consult to the program.. She is Vice President of HIVDENT and is the Dental Director for the New England AIDS Education and Training Center. She has published numerous articles. When she’s not advocating for something, she’s knitting.