COVID-19 vaccines have been successful in saving lives but can also have side effects, including a new condition resembling Long Covid, referred to as Long Vax. The symptoms of Long Vax include persistent headaches, severe fatigue, and abnormal heart rate or blood pressure.

Researchers are investigating connections between certain medical conditions like small fiber neuropathy and postural orthostatic tachycardia syndrome (POTS) and Long Vax. These conditions are also common in people with Long Covid. Some studies have found an increase in POTS symptoms after both vaccination and infection, but the increase is significantly less with vaccination than with COVID infection.

One of the leading hypotheses about the cause of “Long Vax” involves an overreaction of the immune system in people who have previously had cases of COVID. The antibodies produced by the vaccine may attack the previous antibodies created during the first infection. This could also happen if they get infected with COVID again, leading to Long COVID symptoms. More research is needed.

Some research, however, indicates that vaccination prior to infection may be protective against developing Long COVID.

The tweet claims that most childhood vaccine trials use other vaccines as controls, which are immunologically active and not inert placebos. In reality, saline-placebo-controlled trials are conducted for many vaccines to assess both safety and efficacy:

• Rubella vaccine
• Pneumococcal vaccine
• Hib vaccines
• HPV vaccine
• The Salk Polio vaccine
• Measles vaccine
• Tdap vaccine
• COVID vaccine

It is true that sometimes a new vaccine is tested against an existing vaccine, or a placebo may contain an adjuvant, buffers, or stabilizers with a known safety record.

The World Health Organization guides the ethical use of placebos in vaccine trials in certain situations. It is acceptable when no effective vaccine is available and the new vaccine is intended to benefit the population being studied.

However, using placebos is considered unacceptable when there is already an effective and safe vaccine accessible in the public health system of the country where the trial is planned. In such cases, it would be unethical to withhold the existing vaccine from participants if not receiving it would pose a significant risk to their health.

The tweet cites examples like Prevnar-13 and Gardasil, suggesting that their safety profiles were not adequately assessed because the control groups received other vaccines or adjuvants. Prevnar-13 was licensed based on a trial comparing it to Prevnar-7, which was already effective in preventing certain diseases caused by pneumococci.

It would have been unethical to use a saline placebo for Prevnar-13 when a vaccine was already available that provided significant protection against severe bacterial infection. Purposely leaving children at risk, without their knowledge, when an approved vaccine with a known safety record was available would have meant purposely allowing children to get sick and worse.

Furthermore, the CDC’s definition of placebo is consistent with the accepted scientific understanding of placebos in vaccine trials. Inert placebos, such as saline solution, are commonly used, but in some cases, an active control, such as another vaccine, may be used to protect the health of participants.

It may be difficult to convince an ardently anti-vaccine person of the value of non-saline placebos because they enter the conversation already believing that vaccines writ large are dangerous.

Let’s tackle the myth that “the Amish” don’t vaccinate. It’s important to begin by understanding that “the Amish” are not a monolithic group.

The Amish are made up of individuals who make choices that work best for themselves and their families. While it is accurate to say that, on the whole, vaccination rates amongst Amish people tend to be lower than the general population, the vaccination rates are not zero. In one study, it was found that 68% of respondents vaccinated all their children, and only 14% said they did not vaccinate at all.

Beyond Amish communities, it is easy to find unvaccinated autistic people. A number of studies include autistic children that have received no vaccines. There is no difference in autism rates between those that have been vaccinated and those that haven’t.

Whether or not Amish children have autism is a verifiable question. One study sent screeners into an Amish community to assess children and, indeed, found children who met an Autism Spectrum Disorder diagnosis. We may not hear about them because of the privacy inherent in the communities, the lack of resources to support autism, and the unavailability of screening.