An Alert To Medical Directors of Nursing Homes And Long-Term Care Facilities: Potential Danger of Indiscriminate COVID-19 Vaccination In The Elderly, Frail, And Infected.
Dear Colleague,
I am writing here to inform you of a serious safety concern, as you embark on vaccination of the elderly, frail at risk residents and patients under your care with all speed.
As you know, COVID-19 illness is caused by a hyper-inflammatory process — triggered by the SARS-CoV-2 virus. In the elderly and infirm with underlying cardiovascular disease, COVID-19 inflammation is far more deadly than in younger or otherwise healthy persons.
We are now accelerating our nation’s vaccination program to achieve herd immunity. Of course, this goal is of critical importance to your patient population, in which the majority are highly susceptible to COVID-19.
But, in the rush to vaccinate all susceptible Americans and adapt, we cannot lose sight of safe and rational medical practice.
As we accelerate our vaccination efforts worldwide, we must all be extremely vigilant of the fact that a substantial number of persons across the US and the world are either concurrently infected with SARS-CoV-2, or have had recent infections.
As you know, concentrated outbreaks of SARS-CoV-2 are particularly real in institutional settings like the one in which you are providing care.
Therefore, it is absolutely incumbent upon you as physicians and medical directors to understand that, from an immunological standpoint, there may be a severe safety risk in the indiscriminate vaccination of concurrently or recently infected, elderly and frail persons, and those with underlying cardiovascular disease.
I recently wrote letters of public warning about this concern to FDA and to Pfizer/Moderna. All these federal and corporate agencies in the US have acknowledged receipt of these warnings.
You may read my two letters HERE and HERE.
My fundamental message is that indiscriminately vaccinating persons with recent or concurrent SARS-CoV-2 infection risks directing an antigen specific inflammatory response to any tissues, in such persons, harboring viral antigens in their tissues. This process could result in exacerbated and deadly inflammation and tissue damage in the infected persons, vaccinated.
It is my serious concern as a physician, immunologist and public health advocate that institutional resident populations and the elderly infirm with cardiovascular disease, are at particularly high risk of inflammatory side-effects — when indiscriminately vaccinated.
I have detailed my concern about the elderly and infirm being indiscriminately vaccinated in the two opinion pieces. You may read these HERE and HERE.
I am also writing to inform you of my serious concern that FDA and CDC may be missing an ominous and tragic index case at a nursing home facility in Auburn, NY named The Commons on St. Anthony. Reporting from that facility, which experienced an unusually high mortality rate within a very short span of time, is suggesting that a large number of residents there were infected at the time their COVID-19 vaccination. The deaths all occurred within a short span of time following vaccinations.
Of course, there are also the COVID-19 catastrophes coming to light at Roberta Place Long Term Care in Barrie,Ontario, Canada and County Wicklow nursing home in Ireland. In both these facilities, like in The Commons of NY, COVID-19 vaccination programs seem to have been initiated in the midst of a COVID-19 outbreak as well — with an unusual rate of death appearing following vaccinations.
Additionally, the tragic case of Dr. J. Barton Williams of Memphis, TN is likely to be another terrible index case of such a post-vaccination disaster. This otherwise healthy 36 year old with a prior asymptomatic COVID-19 infection, developed a severe inflammatory reaction following his vaccination and died from it. In this case, there is almost no question that the vaccination in the setting of this physician’s prior COVID-10 infection were the cause of this death — his own healthcare providers have stated this publicly. If a younger person like Dr. Williams could be susceptible to such a catastrophe, imagine how much more susceptible the elderly and frail will be to such a disaster.
You may read about Dr. J. Barton Williams’ death, HERE.
I believe that the leadership of the FDA and CDC, and public health officials worldwide, are under tremendous political pressure to drive an efficient and speedy vaccine program — and correctly so. But in so doing, it is almost certain that the political machinery of our federal and state public health systems (and the press) are compromising on safety concerns in favor of speed of vaccine delivery.
Therefore, in addition to my formal warnings to FDA, CDC and Pfizer/Moderna, I am making this direct appeal for keeping safety front and center, to you as the “boots on the ground” and guardians of our elderly and infirm in the US. You are the ones whose eyes and clinical judgement are on the ground to protect the elderly and frail— and whose decision making ultimately dictates the course of care and timing of vaccinations.
Please know, I am cognizant that we must be careful about nonchalantly drawing a causal link between vaccination of the infected, and large scale deaths at institutions like The Commons. After all, these can be “true, true and unrelated” events. But, in point of fact, given the mass scale of the rising vaccination tide worldwide, we cannot afford to have left this rational and scientifically predictable possibility unmitigated — we cannot afford to ignore danger signals, real or prognosticated.
I hope that you fully recognize your professional duty and privilege to protect your elderly and infirm patients from the prognosticated risk of harm by indiscriminate COVID-19 vaccination of the concurrently or recently infected — not the least of which is because many of these patients are unable to effectively communicate their existing symptoms of disease, much less provide appropriate informed consent to being vaccinated.
Additionally, you ought to know that current CDC guidelines prohibit vaccination of persons with “known” COVID-19 infections — while the agency has erroneously, I believe, leaving out “suspected or asymptomatic infected persons” from the guideline. Moreover, as you know, it is a standard of care, in general, to delay vaccination of any persons with active infections. So, there is no justification for breaching this CDC guideline and existing standard of medical care during the COVID-19 pandemic — as it pertains to COVID-19 vaccination of the infected. Not for the sake of speed of vaccination alone.
Speed might seem like it would get us to herd immunity faster. But, irrational speed while compromising safety will almost certainly kill the susceptible minority in harm’s way.
I’ve delineated a common sense clinical safety algorithm any clinician or citizen could easily choose to adopt and follow in the US and most western countries — in order to avoid the potential harm that might result from indiscriminate vaccination of the infected.
You may read this clinical algorithm, HERE.
The elderly, infirm and institutionalized are a population of particularly susceptible persons. When an outbreak occurs at an institution, be it clinically visible or asymptomatic, the residents (and staff) at such organizations are likely to be at a high risk of harm from indiscriminate vaccination.
It is my sincere and respectful recommendation that all geriatricians and medical directors at nursing and long-term care facilities take extra precautions in vaccinating the infected — and to ensure that the people in their charge were not recently, and are not concurrently, infected with SARS-CoV-2 at the time of their immunizations with the COVID-19 vaccine.
So, dear colleagues, please #ScreenB4Vaccine — in order to protect those in your professional charge within the nursing and long-term care facility you staff.
In friendship and with respect for all you do,
Hooman Noorchashm MD, PhD.
e-mail: noorchashm@gmail.com
