Here’s what every LGBTQ2S+ person should know about COVID-19 vaccine myths

Earlier this month, the New York Times published an alarming article titled “L.G.B.T.Q. People Face Increased Risks From Covid, but Many Don’t Want the Vaccine.” The piece, written by Christina Caron, relays the results of a study published in March that reported a high rate of vaccine hesitancy among queer and trans folks (notably, the participants of the study mostly identified as gay men). Black respondents to the study reported even higher rates of vaccine hesitancy, which the study credits to a generally higher level of medical distrust within Black communities.

The study comes as several reports suggest that LGBTQ2S+ folks are at an increased risk of testing positive for COVID-19 and suffering negative economic consequences related to the pandemic. The Williams Institute found that BIPOC queer folks were twice as likely to test positive for COVID-19 than white people, and 30 percent more likely to test positive when compared to non-LGBTQ2S+ people of colour. The Centers for Disease Control and Prevention (CDC) credits this disparity to “long-standing systemic health and social inequities,” including wealth gaps, reduced access to quality housing and discrimination. 

Despite these results, the reality is that vaccination is a necessary step in curbing the spread of COVID-19. Getting  virus transmission under control is particularly important for groups like LGBTQ2S+ people who disproportionately experience its deleterious effects. Here, Xtra debunks some common health misinformation, and answers a few of the questions you might have about the COVID-19 vaccine.

Do the Oxford-AstraZeneca and Johnson & Johnson vaccines actually cause blood clots?

In April, the European Union’s drug regulator reported a “possible link” between AstraZeneca and blood clots. However, the risk of blood clots is rare and no definitive link has yet been determined.

According to the European Medicines Agency, for example, there is a risk of approximately six and a half events per million doses of AstraZeneca. Vaccine-induced prothrombotic immune thrombocytopenia (VIPIT) and cerebral venous sinus thrombosis (CVST) have also been linked to the Johnson & Johnson vaccine, although they are once again considered extremely rare. Based on data from the Food and Drug Administration, there have been about six cases in 6.8 million doses with the Johnson & Johnson vaccines. 

Doctors have suggested that the blood clots could be caused by VIPIT, a rare adverse effect which has mostly been reported by women who have taken the AstraZeneca vaccine. Most alarming is the possible link between the vaccine and CVST, which causes blood clots in the brain and can be potentially fatal. Other vaccines, including the Moderna and Pfizer jabs—both of which have been widely circulated—have not been associated with an increased rate of blood clots.

Although experts widely agree that the benefits of the vaccine greatly outweigh the risks, the United Kingdom has recommended that alternatives to the AstraZeneca vaccine be offered to adults under the age of 30—this after the country’s drug regulator also correlated AstraZeneca’s vaccine with blood clots on an extremely rare basis. Spain, Italy and Belgium have followed suit. In Canada, the administration of AstraZeneca has been paused for people under the age of 55 (although administration of the Oxford vaccine has been expanded to include people over the age of 45 in Quebec, and over the age of 40 in Ontario, B.C., Alberta and Manitoba). It’s up to  individual provinces and territories to make official decisions on who can get which vaccines—federal bodies like Health Canada can only make non-binding recommendations. 

In the United States, top infectious disease specialist Dr. Anthony Fauci said the country has no need for the AstraZeneca vaccine because the government has secured enough of the other vaccines to inoculate all citizens who want one. He added that this was not a “negative indictment” of the AstraZeneca vaccine.

Should folks on estrogen be avoiding AstraZeneca? 

Medications that contain estrogen—including birth control—list an increased risk of blood clotting as a side effect. There have been no studies about whether medications which contain estrogen, including feminizing hormone therapy and birth control, can work in conjunction with AstraZeneca to cause blood clots, but experts say it’s unlikely.

The U.S. National Blood Clot Alliance reported that one in 1,000 women reported blood clots while on birth control. And, according to Patient-Centered Outcomes Research Institute, transgender women taking estrogen reported higher rates of blood clots and strokes than non-transgender folks. That rate increased the longer the trans women studied reported being on estrogen.

Dr. Andreas Greinacher, who led the German team that discovered the link between the AstraZeneca vaccine and blood clots, said contraceptives like birth control have a “very minor influence” on whether the vaccine could cause blood clots. 

Most of the people reporting blood clots following doses of the AstraZeneca vaccine are women. However, the chair of the U.K.’s Commission on Human Medicines said that the incidence rate of the rare blood clots showed “no difference” between men and women. At this time, there have also been no documented warnings asking folks taking estrogen not to take AstraZeneca.

All my Instagram followers are saying that testosterone is an immunosuppressant. Is that true?

Although there is some evidence that testosterone could be an immunosuppressant, there is no confirmed link between testosterone and a weakened immune system. This has been researched quite extensively, but the results of studies often contradict others. 

One 2016 study found that people with higher testosterone levels generally have stronger immune responses, while a 2013 Stanford study found that people with higher testosterone levels had a weakened response to an influenza vaccine compared to those with lower testosterone levels. Another study by Frontiers in Immunology states that “generally testosterone has an immunosuppressive effect while estrogen has an immunoenhancing effect on the immune system.” And yet another study published in Nature called the link between testosterone and lesser immune response “weak.”

Do HIV-positive folks qualify for earlier vaccines? 

HIV-positive people were included in clinical trials for all of the vaccines, and no adverse effects from the vaccine or the placebo were reported among these people. There is no evidence that antiretrovirals, a daily medication that HIV-positive people can take to suppress HIV, have any effect on the protections provided by the COVID-19 vaccine.

Since HIV can weaken the immune system, HIV-positive folks are generally considered to be at a higher risk of suffering long-term negative effects from a COVID-19 diagnosis. As a result, HIV-positive people have been fast-tracked to receive the vaccine in several regions. In Ontario, HIV-positive individuals are in a priority group that is currently open, distributing vaccines to “at-risk populations” from April to June 2021. However, this varies across Canada: In Quebec, for example, HIV-positive individuals under the age of 60 are not considered to be a “vulnerable” group at this time. 

In the United Kingdom, HIV-positive individuals can receive the vaccine as part of that country’s current vaccine rollout. And in the United States, the CDC has recommended that individuals who “might be at increased risk for severe illness,” including HIV-positive people, receive the vaccine early in the rollout. 

Since the rollout is so varied across different regions, it is best to consult your municipal and provincial or territorial governments to find out if you are eligible for a vaccine.

Is it just me, or are these recommendations changing every day? Who am I supposed to trust?!

Don’t feel bad if you find yourself getting confused. Advice from public health officials is ever-evolving and differs from region to region and from vaccine to vaccine. In places like Ontario and Alberta, the COVID-19 restrictions currently in place don’t align with the science-based advice of those provinces governments’ own experts.

It can be difficult to balance trying to abide by official advice that changes and contradicts itself on a seemingly daily basis (while also dealing with the mental and physical toll of the pandemic) and try to chase vaccines that seem more elusive than they should be. 

But it’s important to stay on top of the latest COVID-19 news to ensure you’re up-to-date with what’s safe to do, what your local restrictions are and how you can get vaccinated. 

An independent Twitter account called Vaccine Hunters Canada has been regularly tweeting out available vaccines from across the country, specifying which age groups are eligible and where people can either register for or travel to in order to receive them. This account has been widely praised for aggregating vaccine information in one easy-to-find place, a service which many regional and provincial governments in Canada have notably failed to successfully provide. Vaccine Hunters Canada can also be found on Facebook and Discord. Leading health organizations like the CDC and the World Health Organization have made it abundantly and repeatedly clear that vaccines are the safest and most effective way to protect yourself and others from contracting COVID-19 or suffering severe effects as a result of contracting the virus. They’ve also shown that the side effects related to the vaccines, including blood clots, are extremely rare and treatable.

It’s also important to remain up-to-date on how COVID-19 is affecting your region. Check in with your municipal and provincial or territorial guidelines via their official websites, and keep up with your local news outlets regularly.