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The COVID-19 vaccines are somewhat notorious for their side effects: fatigue, arm pain, maybe a fever. In some rare cases, more serious complications, such as heart inflammation, occur. So is it riskier to get vaccinated or to take the risk with COVID yourself?

A new to learn The New England Journal of Medicine aims to answer that question and compare the moderate to severe symptoms people experience after receiving the Pfizer vaccine to those experienced by people with COVID infection. (Mild reactions such as fever and pain at the injection site were not taken into account.) They found that:

  • People who got COVID were at a much higher risk of abnormal heartbeat (irregular heartbeat), myocardial infarction (heart attack), deep vein thrombosis (blood clots in places like the legs), pulmonary embolism (blood clots in the lungs, myocarditis (inflammation) of the heart muscle) , Pericarditis (inflammation of tissues near the heart), intracerebral haemorrhage (bleeding in the brain) and thrombocytopenia (low platelet count).
  • People who received the vaccine were at a much higher risk of lymphadenopathy (swollen lymph nodes).

The study was conducted as a medical records analysis in Israel and compared 884,828 vaccinated people with an equal number of unvaccinated controls and 173,106 people with COVID infection and an equal number of controls. (Each person was assigned to a control of the same age, sex, place of residence and state of health.)

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The vaccine affected was Pfizer’s, so this analysis may not apply to other vaccines such as Johnson & Johnson. The Moderna vaccine is very similar to Pfizer’s, so the results would likely be similar if the same study could be done with this vaccine – but without the numbers, we don’t know for sure.

“What is even more compelling about this data is the considerable protective effect vaccines have on adverse events such as acute kidney damage, intracranial bleeding, and anemia, likely because infection was prevented,” writes Grace Lee, Stanford medical professor who wrote one editorial comment on studying.

She also points out that the best way to compare risks is to include the possibility of exposure to COVID; If the disease is rare, the chance that you will get serious side effects from the vaccine is much more likely than from an infection, which could change the risk-benefit balance. But the kind the delta variant is currently raging, COVID is not a rare disease.

She writes: “Given the current status of the global pandemic, however, there is a risk of exposure to SARS-CoV-2 [the virus that causes COVID] seems inevitable. ”