Dr. Hooman Noorchashm says FDA, Pfizer and Moderna must consider the danger COVID vaccines pose to the recently convalescent or asymptomatic carriers of SARS-CoV-2 — especially the elderly, frail or anyone with significant cardiovascular risk factors.
In a letter to the U.S. Food and Drug Administration (FDA), Pfizer and the press, Dr. Hooman, M.D., Ph.D., is a physician-scientist and advocate for ethics, patient safety and women’s health. He specializes in cardiothoracic surgery and has taught and practiced medicine for nearly two decades.
Redwood noted that J. Patrick Whelan, M.D., Ph.D., sent similar concerns to the FDA on Dec. 8, 2020.
Whelan raised even more worrisome questions, Redwood said, in that he cited research showing that in addition to the heart, ACE-2 receptors are also present in microvasculature of the brain, liver and kidney.
“Ignoring these valid and scientifically supported warnings from leading physicians may result in hundreds of millions of people suffering potentially deadly injuries or permanent damage following vaccination,” Redwood said. “It will also further erode the dwindling confidence that our country has in our federal regulatory agencies to protect the health of all Americans.”
Redwood called on the FDA and Centers for Disease Control and Prevention to convene emergency meetings to review these concerns and issue new guidelines for vaccine administration that address these concerns.
Below is Noorchashm’s introduction to his letter, as published on Medium, followed by his letter to the FDA and Pfizer.
It is my sincere hope that this public letter might stimulate FDA, Pfizer and Moderna leaders to think critically and quickly about the immunological danger the COVID-19 vaccine might pose to the recently convalescent or asymptomatic carriers of SARS-CoV-2 — most especially to those who are elderly, frail or have significant cardiovascular risk factors.
I want to be clear that my warning here is based on a near definitive scientific Immunological prognostication. It is a “prognostication” in that I have put it forth in the absence of clear “evidence” of it being a material risk.This is because we are dealing with an evolving 11-month old national health emergency with many unknowns, and a vaccine that is only several weeks old — and was approved for massive scale use on the Emergency basis. And, in a setting where it is critical to quickly vaccinate as many citizens as possible to achieve herd immunity against SARS-CoV-2.
I want to be very clear that I am an ardent supporter of President Biden’s plan to vaccinate 150 million Americans in 100 days. And that my letter is not to be abused by political, uninformed or conspiratorial forces attempting to dissuade the American public from being vaccinated. I do believe that it is the patriotic duty of every American who can reasonably and safely be vaccinated, to do so — in order that we save our nation from this pandemic peril that is threatening our very existence.
Here is my email to FDA regulators, Pfizer leaders and the press:
From: Hooman Noorchashm
Date: Tue, Jan 26, 2021
Subject: COVID-19 VACCINE WARNING — Vaccine Directed Immune Response In Asymptomatic Carriers And The Convalescent
To: Janet Woodcock, acting commissioner, FDA and Peter Marks, FDA;
Dear Drs. Woodcock and Marks,
I write here to present a warning and a, nearly certain, prognostication to you as our lead FDA regulators and public health experts.
As you know, the SARS-CoV-2 virus has tropism for the vascular endothelium, among other tissues and organs. This fact was captured in a Lancet paper published in April 2020:
As you also know it appears that the ACE-2 receptor on endothelium is the portal for viral entry into endothelial cells — and it seems that endothelial injury from the virus or from the inflammatory reaction it incites, is the reason why many COVID-19 patients experience thromboembolic complications.
So it is a matter of certainty that viral antigens are present in the endothelial lining of blood vessels in all persons with active or recent SARS-CoV-2 infection — irrespective of whether they are symptomatic or convalescent.
I am writing to warn that it is an almost certain immunological prognostication that if viral antigens are present in the tissues of subjects who undergo vaccination, the antigen specific immune response triggered by the vaccine will target those tissues and cause tissue inflammation and damage.
Most pertinently, when viral antigens are present in the vascular endothelium, and especially in elderly and frail with cardiovascular disease, the antigen specific immune response incited by the vaccine is almost certain to do damage to the vascular endothelium. Such vaccine directed endothelial inflammation is certain to cause blood clot formation with the potential for major thromboembolic complications, at least in a subset of such patients. If a majority of younger more robust patients might tolerate such vascular injury from a vaccine immune response, many elderly and frail patients with cardiovascular disease will not.
Therefore, it is my respectful request that FDA, in collaboration with Pfizer and Moderna, immediately and at the very minimum, institute clear recommendations to clinicians that they delay immunization in any recently convalescent patients, as well as, any known symptomatic or asymptomatic carriers — and to actively screen as many patients with high cardiovascular risk as is reasonably possible, in order to detect the presence of SARS-CoV-2, prior to vaccinating them.
A potential reasonable solution, especially in the nursing home setting, would be to use antibody screening as a surrogate means of excluding/delaying vaccination in persons who might have been exposed to the virus and have viral antigens lingering in their tissues.
The goal of maximally and quickly vaccinating the population is the correct public health goal. It will save many lives and likely our nation — certainly population level vaccination will save far more lives than any given vaccine related complication might compromise. But, in the present national emergency, simply because we know that the majority of citizens in our society will benefit from vaccination cannot justify a regulatory and corporate failure to mitigate against known and rationally prognosticated dangers to the minority subset or persons at risk of harm.
As an immunologist with a good understanding of how antigen specific immune responses could cause organ and tissue specific damage, I am recommending to you, as our lead FDA regulators, not to gloss over the real possibility that vaccinating persons with pre-existing SARS-CoV-2 viral antigens in their tissues could cause that subset of people grave harm — and especially the frail with cardiovascular disease.
Additionally, if the immunological risk I am prognosticating herein is in reality material, over the next months as millions more Americans are immunized, it will become quite visible to the public.
Can you imagine if the public, without having received any real warning from FDA, becomes aware of an increasing number of such vascular/thromboembolic complications? What do you suppose will happen to the level of “vaccine hesitancy” then? And, what kind of accountability do you think the public will demand from our experts and federal regulators — especially if they knew, or should have known, that this immunological danger might exist?
The aim of benefiting the majority of our public and saving the nation from this pandemic by quick and aggressive vaccination is an ethically sound one — but where we know of real or likely risks of harm and mortality, we ought to mitigate the risks to those in potential harms way.
So doing is the only reasonable, ethical, and likely legal option you can pursue as public health regulators — for in America, we no longer sacrifice the lives of minority subsets of people for the benefit of the majority.
Drs. Woodcock and Marks, a professor of mine in medical school used to tell his students “the eyes do not see what the mind does not know”….Thromboembolic complications, 10–20 days following activation of a vaccine induced antigen specific immune response, in elderly frail vasculopaths, will not register as classical “vaccine related complications”….But SARS-CoV-2 is a virus with tropism for the vascular endothelium….So, our Pfizer and Moderna vaccines could easily direct an antigen specific immune attack to that very target organ.
I ask that you carefully and wisely consider my immunological prognostication and warning here — FDA, Pfizer and Moderna ought not miss this risk of harm to what is a daily increasing proportion of the population during this ongoing pandemic. Vaccinating patients with occult SARS-CoV-2 infections or lingering viral antigens, is a clear and present potential danger to the health of these patients.