The Psychological Impact of the COVID-19 Vaccines

The incredible COVID-19 vaccination effort is underway around the world, something we had dreamed about but were hardly sure of a year ago when the frightening shutdowns began across the globe including the United States. A combination of factors (most importantly, some preparatory work started during the “dry runs” of the smaller but worrisome SARS and MERS outbreaks) allowed this one shining success to flourish during a year of horrific tragedy and missteps, with over half a million now dead in our country to the horrible novel coronavirus.

More than a few people have noted feeling very emotional after receiving their first shot of the COVID-19 vaccine; even stereotypically stoic grown men have admitted to crying afterwards. Receiving the shot is more than just a lifesaving intervention; it is a symbol of so many things, a turning point during one of the hardest years in our modern history.

Essentially for a year we have been living under the gun of a potentially deadly virus: an omnipresent, invisible threat whose insidious nature renders conventional feelings of control and self-defense immobilized. Although humankind has lived with plagues since the beginning of our existence, we had been lulled for the past century into a false state of invulnerability, thanks to some of the advances of modern medicine. We’d conquered smallpox, polio, even chickenpox in recent decades. We’d assumed that our everyday levels of hygiene were sufficient to handle the waves of colds and flu that bothered us but mainly targeted those who were already frail and immunocompromised (who we admittedly ignored with our practices). Our global economy and world travel became superheated in the last decade, high on technology and e-commerce.

But all along, despite clear warning signs with ebola and other outbreaks, we chose, as is typical, the here and now. We defunded pandemic public health programs, left research on life support with bare minimum budgets. It is a testament to the brave dedication and brilliance of those vaccine researchers and their supporters that they were able to accomplish so much so quickly, with so little.

So when COVID-19 rushed over us like a tidal wave of horror, we were caught in the grips of an unprecedented emergency. Hospitals were flooded with mysterious contagious illnesses that terrified those who were dedicated to help them, and many made the ultimate sacrifice themselves as we were caught flat-footed with minimal protective supplies. Nurses were wearing trashbags early on in desperation. Our own top health agencies completely misjudged the initial information on how COVID-19 spread, assuming it was based on heavier droplets … and not as it turned out a fine, dangerously contagious mist from everyone’s own breath. Based on the weakest levels of evidence, people began to conjecture whether everyday ibuprofen was risky and whether an old malaria drug was a miracle cure.

But slowly, the correct information began to emerge from scientists. The way to remain reasonably safe was to isolate at home, do outdoor activities whenever possible, and wear masks for indoor errands or necessary work. The enemy became misinformation and denial. Many people childishly refused the simple kindness of masking, insisted on large indoor superspreader gatherings, etc. The death rates peaked again when fall came, even higher than the first wave.

Some of us still hunkered down, obeying the rules, waiting with bated breath on the news that the vaccine trials were going well. When the initial stunning results were released, it was a revelation. We had hoped for 50% efficacy and got in the 90s. And the safety was also there.

The newness of the vaccine technology understandably gave people pause, including myself, but once I read the specifics of how and why it worked, and what the side effects meant in that context, the mRNA vaccine story made sense to me. Even remarkably so. I knew I would sign up as soon as I could.

I received news that I could receive it sooner than expected, due to my being a physician. It was a privilege and honor I would not take lightly. I hesitated briefly, wondering if I even deserved the vaccine. But a wave of anger almost came over me, thinking of the months of living in terror and isolation, of the carefree life I once had being gone. The night before my first shot, I had one of the most vivid dreams I’d ever had. I was wandering around a new brightly lit shopping center and mall in my own neighborhood, which had just opened. I walked around an indoor hotel lobby arcade filled with tall palm trees and well-dressed employees. People chatted and drank cocktails at a busy restaurant. Perhaps it was a bit silly that glitzy commerce was all I dreamt about … but that was normalcy to me. Shallow perhaps, but I missed it anyway. I missed the carefree foolishness of it all.

The vaccine site was well-run, although I was a bit terrified of being indoors for an hour in a crowded room. At the end of a long weaving line reminiscent of a Disney World ride, I got the shot. I let out a yelp of joy.

That evening and the next couple days I had a very sore arm, but I figured that was the vaccine working, with my muscle cells creating the spike protein “dupe” from the mRNA code, and my antibodies responding to and fighting the “dupe.” Like magic, one day the pain vanished as the mRNA dissipated. I heard worrisome stories about the second shot making people feel even worse, but I was ready. I had one day of feeling half-asleep, half-awake at night and a day of feeling like I had a mild case of the flu, achy and tired. I watched the Super Bowl with my mildly fried-feeling brain. By the next morning, again, I was magically better. And mentally I felt so much lighter. The invisible terror everywhere I went was no longer a beast; it was a lamb. I knew I still needed to be careful and would wear a mask to continue protecting others … but the fear wasn’t the same. It was an amazing relief.

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We cannot underestimate the psychological impact of this past year, the literally living in a state of low-grade, even high-grade, terror for much of it. Many of us will basically be recovering from a form of PTSD. Aside from the fear of the virus itself, there has also been the in-fighting, the disagreements, the disgust at people’s callous disregard for each other’s safety and the ethical (and unethical) choices and social sacrifices being made all the time … all of it has taken its toll on us. Thankfully, the vaccine gives us antibodies, but it also gives us a chance to recover from the emotional stress and burden of this ongoing pressure and threat. It gives us some degree of freedom and control again over the lives and world we have been mourning, a chance to move forward.

Many are still desperately waiting for this chance; the vaccine rollout has been clunky and ragged, even downright unfair at times, but ultimately it is improving. A third one-shot vaccine has just now been added to the mix. The sites are streamlining their procedures and learning quickly, and the people involved are all dedicated and hardworking. I am confident that in the next few months, everyone in our country who wants a vaccine will receive one and also feel this relief.

I will always be grateful to everyone who made the vaccine’s rapid creation and approval possible, and to everyone who helped with its distribution. We have seen some parts of humanity that were ugly and heartbreaking in the past year, but we have also still seen the best of us as well. There is still enough good in us to hopefully save some of us moving forward into this uncertain future … but an unspeakable number are now gone. We owe it to them to continue to examine what went so very wrong, and work towards a better society, a better world.