Ahh balls. This week we apparently have to talk about swollen testicles belonging to Nicki Minaj’s cousin’s friend. We don’t know much about this man, but his balls have become a symbol of the struggle to combat vaccine misinformation. See the first story below. We also don’t know much about a California couple who both died of Covid-19 this week leaving behind their newborn daughter and four other young children (though they have been identified as Davy and Daniel Macias and their story has been verified by legitimate news outlets). Davy refused the vaccine because she was pregnant. She was already intubated when doctors delivered the infant. She died a week later. Daniel, whose vaccine status is not known, died two weeks later. What struck me about this story is that Davy was a labor and delivery nurse who should have known that pregnancy increases the risks and danger of Covid-19 to both the pregnant person and the fetus. She should have also known that the vaccine was found to be safe during pregnancy. Her story, along with another about a hospital in New York which has had to stop delivering babies after six of its maternity staffers quit rather than get the vaccine, inspired the reminder below that pregnant women need the vaccine. I know misinformation abounds, but I must admit I’m shocked when I hear about it making the rounds among health care workers themselves.
Nicki’s Cousin’s Friend’s Testicles
The Minaj tweet issues began earlier this week when the rapper explained that she wasn’t going to the Met Gala on Monday night tweeting:
They want you to get vaccinated for the Met. If I get vaccinated it won't for the Met. It'll be once I feel I've done enough research. I'm working on that now. In the meantime my loves, be safe. Wear the mask with 2 strings that grips your head & face. Not that loose one.
Minaj has since said that her baby, not the vaccine requirement, is the reason she didn’t attend the annual fashion event, and that she will likely get vaccinated before she goes out on tour but her original tweet highlights a problem that we’ve seen a lot. The idea that individuals have to do “research” before deciding whether to follow the advice of experts.
That’s now how it f**king works.
The research is done. The data has been presented to people far more qualified than you, me, or Nicki. The experts have made their suggestions. You can choose not to follow the advice of the experts but don’t say it’s because you’re doing own “research.”
A google search does not count as research (but that’s okay because there is no more investigation for you to do). You can’t conduct your own controlled clinical trial (and you don’t have to because they’ve already been done). It’s unlikely that you’re qualified to do a full on scientific literature review (and you don’t have to because they’ve already been done). And, your personal list of vaccine side effects experienced by friends of friends won’t be particularly accurate or generalizable to the population (and you don’t have to make a list because it’s already been done).
That brings us to Minaj’s other tweet about vaccines which highlighted yet another common problem of misinformation—the anecdote. When I was in college there were three urban legends that kept making the rounds (without the help of twitter or even the internet by the way). One was about waking up in a bathtub of ice without a kidney, another involved a cactus that eventually shook and released hundreds of spiders, and then there was the one about the beautifully wrapped present sent home by the spring break hookup that informed the opener they’d been exposed to HIV.
We all heard them—sometimes more than once—but the storyteller always had a personal, albeit tenuous, connection to the victim. “No, man, true story, it really happened to my cousin’s friend’s roommate at Tulane.” (My husband insists that all apocryphal college stories happened at Tulane.)
Anecdotes about vaccine side effects have been freely flowing since the first shots went in arms last year. Some of them may be true and some may be heavily exaggerated as the result of being passed from one person to the other (like an elaborate game of telephone). Others are likely flat out false. One problem is that you can’t disprove them because they happened to someone that someone else knows.
The other problem is that even if they are true, they represent outliers or unique situations and there’s no way to know what other underlying conditions might be causing the “side effects” in questions. Minaj’s tweet specifically said:
My cousin in Trinidad won’t get the vaccine cuz his friend got it & became impotent. His testicles became swollen. His friend was weeks away from getting married, now the girl called off the wedding. So just pray on it & make sure you’re comfortable with ur decision, not bullied
There is no evidence that the Covid-19 vaccine causes either testicular swelling or impotence. There is, however, evidence that Covid-19 infection can lead to impotence as we discussed a few months ago. There are many other explanations for Nicki’s cousin’s friend’s swollen testicles from trauma to cancer. There are many other explanations for Nicki’s cousin’s friend’s impotence from high blood pressure to relationship problems (I mean if she left him weeks before the wedding because he couldn’t get it up, she might not be the nicest person in the world.) We don’t know the full story here and neither does Nicki.
It’s irresponsible for someone with this large of a platform to even suggest that the vaccine is a problem or that people should take into account a random man’s swollen testicle when making their vaccine decision. Public health isn’t bullying people, at this point it’s begging them.
Pregnant Women Should Get Vaccinated
There is growing evidence that Covid-19 infection is particularly dangerous for pregnant women and their developing fetuses. The CDC warns that pregnant people with COVID-19 are at increased risk for preterm birth (which is defined as delivering the baby earlier than 37 weeks) and might be at increased risk for other poor pregnancy outcomes.
New numbers from Mississippi—where vaccination rates are low and the delta variant is running rampant—illustrate just how dire the situation could be. The state announced last week that there had been 72 fetal deaths in unvaccinated pregnant people which the state’s health officer described as “twice the background rate of what would be expected.” This number only includes fetuses that died after 20 weeks of gestation, there may be more Covid-19 related miscarriage earlier in pregnancies that we don’t yet know about. The state is also investing eight recent deaths of pregnant women who were infected with the virus.
Though much is still unknown about Covid-19, we’ve known for years that pregnant people are more susceptible to respiratory viruses and have worse outcomes because of changes to their anatomy, hormones, and immune system. The same is true of Covid-19. One study explained that “the anatomical structure of the respiratory system is changed during pregnancy, and the virus transmitted by droplets and aerosols is more easily inhaled by pregnant women and is difficult to remove.” (I swear pregnant people are like Transformers—the cars that become robots—everything moves around to make room.) The CDC warns that pregnant people who get infected with Covid-19 are more likely to be hospitalized and end up on a ventilator than people who are not pregnant.
The agency is urging people who are pregnant or planning to become pregnant to get vaccinated as studies have shown that the vaccines pose no increased risk of miscarriage.
Moreover, pregnant people can pass antibodies to their developing fetus which can protect their baby after it is born (babies are not yet eligible for the vaccine themselves). In fact, vaccinating pregnant people to protect infants is a strategy that has been used with other viruses. Pregnant people, for example, are given the Tdap vaccine during each pregnancy to protect their infant from whooping cough until the baby is old enough to get its own vaccine at two months.
Unfortunately, vaccination rates among pregnant women are very low with only 24% having received at least one shot as of this month.