Why I am not yet vaccinated… and when I plan to get vaccinated.

---

July 31, 2021 – Sunday

With practically every media outlet and news story focusing on the urgency of getting a larger percentage of people vaccinated, I felt that sharing my own story might be helpful for some; I am writing specifically to share with folks that within the worrisome overall statistic of slowing/plateauing vaccination rates across the country, there are hopefully still some unvaccinated folks like myself who, for a variety of valid-but-temporary medical concerns, have held off on receiving the vaccine…and who anticipate getting vaccinated…

I am married and have four children [two of my children are now adults, who have moved out of our home]. Of the six of us, five are fully-vaccinated. I am the only one in the family who has not yet been vaccinated — which means that, at this point, my family is 83.33% vaccinated. I made the difficult choice to hold off for specific medical reasons, which I will explain below.

I also want to reiterate what I have said elsewhere: I am not ideologically “pro–vaccination“, nor “anti–vaccination” — I am pro-medical freedom (freedom of choice in all things medical). [Read more about this here.]

My older two children have received some of their scheduled vaccines (my eldest got the full schedule for a person his age and my second son had the full (delayed) schedule through age three — but, due to medical reasons (not the least of which was the health impacts of my children’s Lead-poisoning in 2005), we decided – with the support of their pediatrician – to hold off on the full schedule of childhood vaccinations after that point.

For my two youngest children, the Pfizer mRNA CoViD-19 vaccine was their first ever vaccine of any type [they were 12-years-old, and 16-years-old when they were vaccinated in May/June].

We weighed the risks vs. the benefits for each of our children individually – for their specific medical conditions – and chose to go ahead with the Pfizer vaccine, based on the research and evidence available at the time. You can read more about that decision on this post.

---

Continue reading below the image!

Why I have not yet gotten vaccinated – specifically

As my readers may know – I broke my leg in the wee hours of the morning (in a cabin in Maine – in a forest – surrounded by snow!) on January 6th of this year. I broke all of the bones in the bottom of my leg – above my ankle, a trimalleolar fracture.

• January 8th: I had surgery to put my leg back together (with 11 bolts / screws + one very long metal plate).
• On January 27th – upon arriving home in Portland by train (because doctors had determined it was unsafe for me to fly given the potential for blood clots from my injury and surgery) – I was in pain and went straight from the train station to the hospital (before even going home to see my kids!). When I met with my doctors at OHSU my medical team decided to look for clots in my leg at that visit (Deep Vein Thrombosis: deep-vein clots which are a known risk related to that sort of traumatic injury and extensive surgical procedure) – and unfortunately, they did find deep vein blood clots (via ultrasound).
• From that point (and throughout most of February and March) I was on blood thinners (ostensibly as a more effective way to address the blood clots than aspirin would have been) with disastrous consequences / “side effects” (extreme anti-coagulant induced menstrual hemorrhaging.)
• Around this time (late-March?) I was also diagnosed with a concussion from my initial fall in January (that had gone unrecognized until that point because treatment had been focused on my broken leg, broken finger/damaged hand and damaged shoulder.)
• End-of-March/early-April of 2021 – my doctors had me stop the use of the blood thinners because of the extreme bleeding and then (a few days later) did a follow-up ultrasound (more extensive than the first one in January) to see if my blood clots had resolved. They had not (in point of fact), instead they detected additional more significant blood clots in my leg at that time.
• And then – arthritis! In addition to fairly constant physical therapy sessions (two or more times a week most weeks) over the past 8 months I have had more x-rays and MRIs and ultrasounds than I can remember at this point. As a result of all of these medical scans done because of my injury I was unexpectedly diagnosed with Calcific Tendinitis (there are calcium deposits floating in my soft tissue in my shoulder) and other issues that are likely arthritic in nature (I had all of the blood work for this done recently and 4 of the blood tests came back “abnormal”.) I am actually “happy” about this diagnosis because it gives me some answers about the extreme chronic pain I have been experiencing for more than two years now. I have an “urgent” appointment coming up to see someone in rheumatology to get more answers – and because our healthcare system in the United States is so broken, the soonest they can see me for this urgent appointment is September 16th!
• While I might update this post with more details later I want to take a moment to say that this “laundry list” [broken leg, broken hand, damaged shoulder, blood clots, concussion, hemorrhagic bleeding, arthritis, chronic pain) does not even cover all of the health issues I have been facing since I broke my leg in January. There are more areas of concern (including being prescribed steroids for a skin reaction I was having, steroids that caused my skin to thin and my tissue to tear and bleed – causing yet more extreme pain [couple that with an inability to take pain killers due to allergies/reactions!]… resulting in a second surgery in the near future most likely too!)… but that’s enough to give you a good picture of the mess my body is in right now!
• Fundamentally many of the issues I have been dealing with are rooted in the lack of continuity in medical care in the United States. Primary Care Providers (PCPs) are overwhelmed by their case loads (this is a thing during “normal” times I expect, but is amplified due to the impacts of CoViD-19 on the already over-taxed / poorly organized healthcare system) and no-one is looking at the whole patient anymore (with specialists taking action and prescribing medications without being present to unexpected consequences that might fall within a different area of medical expertise… so many specialists! [=too many cooks in the kitchen!])
• One final “fun fact”… since arriving home on January 27th I have had no fewer than 58 doctor appointments related to my injury and complications- most of which were in person at the hospital. That’s nearly 10 each month… one every three days! [Although on some days were three in a single day!] I think this works out to more doctor visits than what I had in my entire 51 years of life prior to this time!

---

Back to the CoViD-19 vaccine… and my blood clots

• When I heard multiple news stories about the findings of a statistical [albeit very small] increased risk of post-vaccination complications among a cohort that exactly fit my medical description (female; over 50;  obese) – and specifically, the concern for “blood clots” – I started looking into (reading and asking my orthopedic surgical team and other medical providers about) this.
• My first thought was, “‘blood clots’ = ‘blood clots'”. Meaning, if there was a possible “blood clotting” reaction (and specifically among people like myself) then I might want to get to know exactly what that is and see what specific data they have on it (given I already have been diagnosed with blood clots)!
• Through my research I then learned that there are two different types of blood clots for the purpose of this discussion — and the deep-vein clots I have wouldn’t have any bearing on the type of micro–clotting that was raising some concern as a statistically rare reaction to the vaccine [nor was it considered to be linked at all to the common and much more extensive and dangerous micro-clotting observed among many CoViD-19-infected patients].
• Throughout all of this (with so many medical complications going on and things being newly diagnosed seemingly at every step along the way) I was waiting to get vaccinated as it would be too much for me to handle an adverse vaccine reaction with all I was already going through (especially given some sort of adverse reaction was likely with all of my medical issues and general overall health.)
• Then – in June – I mentioned my crazy medical odyssey to a hematologist [a woman who was on hand at the hospital while my sons were receiving their Covid-19 vaccinations], and in that casual “unofficial’/”off-the-record” conversation, she said that in her professional opinion, while she was not concerned about potential new clotting as a possible reaction to receiving the vaccine, the concern she did agree with is that any potentially intense reaction to the vaccine (including fever) might actually “mobilize the existing blood clots“ in my leg, which she felt would constitute “a significant health risk” for me. 
• Given that I have been so extensively systemically traumatized / compromised, and have been experiencing so much pain with my various medical complications, she shared my concern that I might likely not do well in the event of any possible intense vaccine reactions, and [“unofficially / off-the-record”] supported my decision to hold off until my medical situation is at least a bit more settled/resolved.
• I later reconfirmed this concern with a member of my pre-surgical evaluation/preparation team (for one of my upcoming surgeries) and they also agreed with the hematologist’s assessment.

What’s next – surgery on Friday!

This week I am preparing to again have “urgent” surgery on my leg – this time to remove the 11 bolts (and one long plate) that were installed to hold all the fragments of my leg together (but that are now causing additional pain and limiting my recovery.) This surgery is scheduled for Friday, August 6th; 8-months-to-the-day since I broke my leg!

While it is generally customary to wait 12-18 months from the installation of the hardware for good measure, my surgeon is confident in the decision to move the date up in my case, given x-rays confirming sufficient bone remodeling, coupled with my body’s severe intolerance (acute localized pain, and a hard limit to my range of motion) from the continued impingement of a few of the more problematic extremely long screws – and the added potential for actual skin perforation by the longest one of those, the head of which  is creepily protruding quite prominently from my leg!

When I am planning on getting vaccinated.

Given I am planning on traveling by plane for work on September 28th, I would like to be fully-vaccinated prior my trip (especially given the heightened risk posed by the many-times-more-transmissible Delta variant!)

Working backward… I would need to have my second vaccine dose no later than September 14th (to have the two week-post vaccine period for full immunity, and also to cope with the impact of any potential reactions), and therefore my first vaccine dose no later than August 25th [=21 days prior to the second dose].

I have been told that, in my case, after my surgery on August 6th I will not be able to put any weight on that leg for two weeks (i.e. will be in a wheelchair again for 14 days after having the hardware removed) – but I should be starting to walk again by August 20th – and my surgical wound should be pretty well healed by September 1st – so, all around, the timing seems good for a vaccine first dose to happen by August 25th!

During the coming month of August, since I will be at home healing anyway  – I should be isolated enough (as we have been since the beginning of the pandemic) that I don’t expect to have any potential CoViD-19 exposure sources.

Why I wrote this all up…

I wrote this out in detail for friends and readers who may have anxiety around concerns for why particular friends or family members have not gotten vaccinated — maybe ask them? (They might have some “good” – and more important – merely temporary reasons).

In the end this is a medical choice and – with this specific disease and the impact the pandemic has had on my family personally (and especially the impact it has had on my youngest children) – I hope that enough people do choose to get vaccinated so that we reach some level of herd immunity and our kids can play with friends and go back to school in-person again without worry.

Tamara Rubin
#LeadSafeMama