Question: I know you have addressed this issue, but now that my husband and I are fully vaccinated, we are anxious to see our teenage grandchildren. Their mother is a teacher who is afraid to get the vaccine. She says she has a very strong immune system and has been around Covid-positive people and never contracted it. She may be right about the immune system, but she has a form of epilepsy, and I worry about her, as well as our vulnerability, if any. Your thoughts?

Answer: First off, congratulations on being fully vaccinated!  Second, although vaccine hesitancy rates are declining across the country, recent estimates suggest that 25% of Americans remain hesitant (Figure 1). I bring this up for you to know that you and your family are far from alone; many of us are having difficult conversations with our friends and family about vaccination.  One of the main tools we need for all of these conversations is empathy.  If you’d like some tips, I’ve included a few easy-to-read, evidence-informed articles in the bullets below.  

Turning to risk, you should know that according to Johns Hopkins Medicine, epilepsy does not increase a person’s risk of contracting COVID or of experiencing severe disease outcomes.  Additionally, based on information currently available, the COVID-19 vaccines are safe for people with epilepsy.  On that small piece, take heart.  Of course, just because epilepsy isn’t associated with increased risk doesn’t mean that your daughter(in law) is safe from becoming infected, from infecting others, and/or from experiencing severe outcomes.  I hope she will take the vaccine.  Regardless, you can also take heart that you and your husband are well protected.  Available evidence indicates that real-world effectiveness of the vaccines is very high, immunity lasts at least six months and counting (Q&A of 4/2), and the vaccines are protective against the B.1.1.7 (UK) variant of concern as well as the new variant of concern increasing in circulation out of California (see NEJM published correspondence from 7 April).  Breakthrough cases (e.g. infection after vaccination) have occurred, but they are rare (fewer than 3 cases per 10,000 vaccinated individuals based on recent data from Oregon).  

Vaccine communication resources:

• Yesterday, the New England Journal of Medicine published this article, Escaping Catch-22 — Overcoming Covid Vaccine Hesitancy
• Just today, the Washington Post ran this report, Vaccine conversations can be messy. Here’s how to talk about the shots.  
• And our Q&A of 2/2 also offers some relevant advice on how to have these “messy” conversations.  
• I’d also recommend that you have these conversations with your grandchildren.  With Pfizer’s news last week— that preliminary clinical trial results demonstrate vaccine safety and 100% efficacy among adolescents ages 12-15– we can expect that teenagers will soon be eligible for the vaccine (teenagers ages 16+ are already eligible for Pfizer)!    

Figure 1. Time trends of Americans who intend to get vaccinated (from NPR)