Will You Get Vaccinated for Coronavirus (COVID-19)? Can It Make Tinnitus or Hyperacusis Worse?

[kingsfan]

I'm so terribly sorry to hear you're having such a rough go mate. I've read it could take 3 to 6 months for post COVID-19 vaccine spikes to subside, so don't give up hope that your tinnitus will subside to much more tolerable levels at some point soon!

If I were able to hang out at home in the United States these next few months, I'd probably forego shot 2. But I've got to fly to Indonesia next week where I'll remain until early next year, so I'll probably end up getting the second dose before I go, for better or worse.

I hate that we all seem to be stuck with two bad options here.

3 - 6 months eh? I'm exactly 2 months in and I've only gotten worse, not better.

 

[Wrfortiscue]

3 - 6 months eh? I'm exactly 2 months in and I've only gotten worse, not better.

Did you see at least some improvement? I've been obsessively checking and see that the ones improving are the ones who experienced any type of improvement at any time. Then it usually takes 3-4 months for full recovery from what I've seen. Others are just habituating or not reporting back. I got worse lately when my son screamed in my ear. Ever since my ears have been very sensitive.

It's a terrible roller coaster... I think I have some type of reactive hyperacusis now too.

 

[Alexandor Scott]

3 - 6 months eh? I'm exactly 2 months in and I've only gotten worse, not better.

That is awful. I'm so sorry to hear that. I sincerely hope you make some improvements over the next few months!

 

[Mister Muso]

As my tinnitus is noise-induced, I could be wrong but I reckon the thing most likely to make it worse is more noise, not a vaccine or other chemical/viral causes. So on balance I'm inclined to get my second shot tomorrow of AstraZeneca.

 

[kingsfan]

Did you see at least some improvement? I've been obsessively checking and see that the ones improving are the ones who experienced any type of improvement at any time. Then it usually takes 3-4 months for full recovery from what I've seen. Others are just habituating or not reporting back. I got worse lately when my son screamed in my ear. Ever since my ears have been very sensitive.

It's a terrible roller coaster... I think I have some type of reactive hyperacusis now too.

The sound that I got from the vaccine became louder about a week ago. No improvement. Not sure what I'm doing wrong. I can't live my life in a sound-proof box.

 

[Wrfortiscue]

The sound that I got from the vaccine became louder about a week ago. No improvement. Not sure what I'm doing wrong. I can't live my life in a sound-proof box.

Yeah I don't know what to tell you. I feel like I'm ruined over a damn decision to trust the science crap lol.

 

[Jan64]

There are around 200 reports on the VAERS site for Pfizer and Moderna. Around 30 reports for J&J. That's out of 138 million doses of Pfizer and Moderna and 5 million doses of J&J. If you look closer at the reports, many are short-term tinnitus in conjunction with other symptoms like fever and high blood pressure.

That said, I do think there's a plus to one and done!

So:

Pfizer and Moderna: 200/138*10^6= 0.00000145 = 0.0001% = one ten thousands per cent
Janssen: 30/5*10^6 = 0.00000600 = 0.0006% = six ten thousands per cent

The chance of getting tinnitus as a side effect from Janssen is 4.14 times higher than from Pfizer/Moderna.

But there are other numbers circling the internet:

It says...
Moderna: 114 reports -> chance: 0.22%
Pfizer: 180 reports --> 0.35%
Janssen: 21 reports --> 0.04%
According to these reports Janssen is the best choice being 5 and 9 times less likely to cause tinnitus vs. Moderna and Pfizer, respectively.

Who knows the source of the above table? Was it an early analysis based on old data?

EDIT/UPDATE:

I think I got the answer... I think that the side effect is compared to the number of test subjects.

When you calculate the number of injections out of the number of side effects and the percentage you will get:

Janssen /J&J --> 52,500
Moderna --> 51,818
Pfizer --> 51,429

I can imagine that when you are a test subject, you monitor the side effects more carefully. I think a lot of people do not report to VAERS...

Now the question is: looking at the numbers, what is the best choice, looking solely at the incidence of tinnitus...

Any thoughts?

Thanks!

Jan

 

[Alexandor Scott]

Well, it looks like I'm going for my second dose tomorrow, much to my chagrin. I really, really don't want to do it since my first jab left me with a month-long spike. But I've got a 19 hour flight coming up, and I'll be stuck in a country with a high level of COVID-19 spread for the next 6 months, so not sure what other choice I have. I'm sure my first dose isn't providing much protection since I got it February 1st, and I don't want to risk getting a spike from COVID-19 infection.

This whole thing is so incredibly frustrating. Why why why does tinnitus spiking have to be a symptom of the virus, and a side effect of the thing that's going to stop us from getting the damn virus, too.

 

[Damocles]

Eventually I'll have to get vaccinated, as I have to spend time abroad as part of my studies, and taking the vaccine will likely become compulsory for travel abroad for years to come.

That said, I'm not in any rush. I can wait out this year and next if I choose to, and I very likely will choose to, as I've already had COVID-19 twice and been pretty much okay during and after it. The vaccine on the other hand, I have no idea. So for me it's very much a case of "better the devil you know".

 

[Alexandor Scott]

Eventually I'll have to get vaccinated, as I have to spend time abroad as part of my studies, and taking the vaccine will likely become compulsory for travel abroad for years to come.

That said, I'm not in any rush. I can wait out this year and next if I choose to, and I very likely will choose to, as I've already had COVID-19 twice and been pretty much okay during and after it. The vaccine on the other hand, I have no idea. So for me it's very much a case of "better the devil you know".

This is what's driving me to get my second dose. I could probably put it off, but I'm going to have to do it eventually, so may as well get it over with.

Can't believe you caught COVID-19 twice. That's such bad luck. So glad to hear it didn't cause you any long term issues

 

[Damocles]

Can't believe you caught COVID-19 twice. That's such bad luck. So glad to hear it didn't cause you any long term issues

Cheers dude! I'll be praying for you that your second shot goes fine and doesn't cause you any problems.

If it helps, my Mum had both her vaccinations, and like me, she has tinnitus, and she's absolutely fine!

 

[t_scot randal]

This is what's driving me to get my second dose. I could probably put it off, but I'm going to have to do it eventually, so may as well get it over with.

Can't believe you caught COVID-19 twice. That's such bad luck. So glad to hear it didn't cause you any long term issues

Getting the shot is not a bad decision. You are betting that any tinnitus spike will be temporary (be it 6 weeks or 6 months) and more than offset by the protection you will get from the vaccine and the peace of mind that comes with it. I think for most, this will be the case.

 

[t_scot randal]

Believe it or not, I'd rather take my chances going about my life unvaccinated than risk any negative auditory changes. I believe my tinnitus journey started 19 years ago from taking just a few antidepressants - static. It has gotten worse over time probably due to the normal aging process. I wouldn't cope if any of these experimental 'vaccines' made things worse.

To an extent I agree, but don't discount the negative impact of Long COVID-19 or permanently reduced pulmonary function on quality of life. Both outcomes are very possible if you COVID-19 finds you.

 

[Alexandor Scott]

Cheers dude! I'll be praying for you that your second shot goes fine and doesn't cause you any problems.

If it helps, my Mum had both her vaccinations, and like me, she has tinnitus, and she's absolutely fine!

You're so kind, thank you! I actually ended up backing out. I just couldn't get myself to go through with it. I've convinced myself that since I had a temporary spike from the first one, odds are I'll end up with a worse spike the second time around.

I plan to try again tomorrow. Hoping I can go through with it this time.

 

[Static Sophie 73]

Eventually I'll have to get vaccinated, as I have to spend time abroad as part of my studies, and taking the vaccine will likely become compulsory for travel abroad for years to come.

That said, I'm not in any rush. I can wait out this year and next if I choose to, and I very likely will choose to, as I've already had COVID-19 twice and been pretty much okay during and after it. The vaccine on the other hand, I have no idea. So for me it's very much a case of "better the devil you know".

If you've had COVID-19, you will have a natural immunity - that's what I am reading and that's the best immunity there is. This mRNA stuff is risky - I reckon people will suffer long term with this in their bodies.

 

[Kendra]

If you've had COVID-19, you will have a natural immunity - that's what I am reading and that's the best immunity there is. This mRNA stuff is risky - I reckon people will suffer long term with this in their bodies.

From what I'm aware, the body disposes of the vaccine after it's done its job. It doesn't stay in your system.

 

[Stanlex]

The concentration of COVID-19 among people is so low right now. Really, many antigen testing sites in my country report daily percentage of positive people at levels like 0.2% which is barely nothing. Therefore I think that if I wear mask, use hand sanitizers and keep a distance then the chance of me catching COVID-19 is lower than my tinnitus naturally fading, lol.

Therefore I will not personally take a vaccine and unnecessarily risk getting a spike in tinnitus like many people said it did for them. Also, I can still get a permanent spike from COVID-19 alone (perhaps I even did as I might have overcame asymptomatic COVID-19 in the past), so what I think is the best way for me is trying to keep away from COVID-19 from any form, either natural or vaccine by using mask, etc..

However, due to some politicians in my country who are strongly against the vaccine but also spread bullshit like COVID-19 doesn't exist at all or COVID-19 is here because planes are spreading it in the air etc., I may be forced to take the vaccine in the future or already vaccinated people will think I am the same type of a person and will laugh at me just because I won't take a vaccine. The idea of healthy people understanding someone not getting a vaccine because getting scared of having tinnitus exacerbated is pretty surreal at this point.

 

[linearb]

From what I'm aware, the body disposes of the vaccine after it's done its job. It doesn't stay in your system.

People have a pretty poor understanding, generally, of what happens here.

You get injected with some messanger RNA encapsulated in a lipid. Having a basic understanding of what RNA is and how it's transcribed into DNA is necessary to get past this point:



So, you get the jab, and now a bunch of mostly muscle cells in your arm are full of mRNA that codes for the COVID-19 spike protein. This is quickly taken up by the transcription process, which exists to turn your OWN RNA into your OWN DNA and make copies of your chromosomes -- but the vaccine is more or less hijacking your cells in a manner similar to what a virus does once it gets inside, except SARS-COV-2 creates complete copies of itself, and the vaccines only create copies of the single spike protein the rest of the virus uses to attach to cells.

Your body very quickly identifies these spike proteins as alien, and mounts an immune response. This is why some people feel crappy, and the extent of that crappiness varies with how strongly the immune system responds. It is interesting, but not that mysterious, that the degree of response someone has doesn't actually indicate much about how "well" the vaccine worked: someone who had a strong reaction to Pfizer #2 and someone who just had a sore arm, appear to have the same (insanely high) ~95% protection after 2 weeks.

So, the actual RNA? Yeah, that can't stick around the body for very long, by sheer virtue of the fact that the way the body works is transcribing RNA into proteins, so, that's just gonna happen, and every spike protein created is going to be identified as "alien" and ripped apart (and even if they were not -- single proteins with no ability to reproduce are going to have a pretty limited lifespan in a living human).

Okay, so, the idea that the RNA from the vaccine "sticks around" we can easily put to rest because it's not physically possible. What about the other stuff in the vaccine?

The Pfizer-BioNTech COVID-19 Vaccine includes the following ingredients: mRNA, lipids ((4-hydroxybutyl)azanediyl)bis(hexane-6,1-diyl)bis(2-hexyldecanoate), 2 [(polyethylene glycol)-2000]-N,N-ditetradecylacetamide, 1,2-Distearoyl-sn-glycero-3- phosphocholine, and cholesterol), potassium chloride, monobasic potassium phosphate, sodium chloride, dibasic sodium phosphate dihydrate, and sucrose

First and foremost it's worth noting: there are zero heavy metals on this list, additionally, the total dose size is 0.45 ml and the vast majority of that is lipids that encapsulate mRNA, so the actual doses of everything on this list are tiny.

Sodium chloride, potassium chloride, sucrose, dibasic sodium phosphate dihydrate and monobasic potassium phosphate are all things which exist in USP food grade forms and are, variously, commonly used in prepared foods etc. I have a giant bottle of potassium hydroxide downstairs that I use to pH buffer my cannabis.

The lipids are proprietary magic that Pfizer is likely sitting on patents to, and so this is where we're getting into "human health and safety data over the long term may not exist yet". For instance one of the compounds on that list is also known as ALC-0315 and has this very minimal Wikipedia page:

https://en.wikipedia.org/wiki/ALC-0315

You can read the UK's safety assessment of the lipids here:

https://assets.publishing.service.g...162b2__UKPAR___PFIZER_BIONTECH__15Dec2020.pdf

More or less, I wouldn't necessarily bet on any of these things being as safe to inject as, like, PEG which has been around for 50+ years, but I also wouldn't bet much on them being any more dangerous.

It's certainly possible that something in here is not 100% cleared by human metabolism instantly and deposits in the liver or whatever. So what? Every time you go outside and walk down the street, you're inhaling trace petrol fumes that are bringing cadmium and god knows what else into your body -- we're constantly being exposed to known carcinogens and toxins, and generally the body does a decent enough job cleaning them out that life expectancy went up alongside the mass adoption of gasoline engines.

On the other hand -- it's well known that some people who get actual COVID-19, do have "stuff in their bodies" long term or permanently, this is called LONG COVID-19, it happens to a lot of people, the cause is the body not actually fully fighting the infection off, and many of these people have shown dramatic improvement only after being vaccinated.

Long Covid symptoms ease after vaccination, survey finds

This is mostly academic for me at this point; nothing left to wonder or worry about, I already got my Pfizer #2, and despite having a general aversion to people making silly decisions for unscientific reasons, the odds of any person on this forum being unvaccinated and also close enough to me to put my kids at risk is close to zero.

From a compassion point of view, I do think everyone on this forum should get vaxx'd, simply because the data appears pretty equivocal that "COVID-19 vaccines are generally safe and well tolerated including audiological side effects, whereas COVID itself carries something like a 15% risk of hearing loss and tinnitus". That's not a controversial point at all and anyone who is disputing it in June 2021 is not arguing from a fact based perspective.

 

[linearb]

If you've had COVID-19, you will have a natural immunity - that's what I am reading and that's the best immunity there is. This mRNA stuff is risky - I reckon people will suffer long term with this in their bodies.

Natural immunity may be a lot less than the vaccines, depending on which vaccine you got and which variant of COVID-19 you end up getting exposed to.

We don't have the data to support the idea that natural immunity is "as good as" or "better than" vaccine borne immunity, and it will likely be several years before we have enough data on breakthrough infections in either group.

We do absolutely have the data to say "no, the mRNA stuff isn't risky at this point it's been administered to millions of people over the last year and a half with very very minimal truly scary side effects given the tremendous number of people exposed".

We also absolutely have the data to say "COVID-19 vaccines may pose some tiny risk of temporary or even permanent hearing issues, but based on the reported data the incidence of this is definitely less than 2% and probably even less than that. On the other hand, COVID-19 itself poses a significant risk of temporary or permanent hearing loss and tinnitus, at least 15% but possibly higher because of cases that only present as SSHNL and don't get COVID-19 testing".

So, like, do whatever you want? But if you think the vaccine is riskier to your ears than actual COVID-19 you have been misled because huge data sets point strongly in the opposite direction. If you think the risk from the vaccine is worse simply because you're never going to get COVID-19... well, good luck with that, I don't care too much as long as you're not within 20 miles of me or my kids. Overall vaccine takeup in my state is super high, we're not having the "hesitancy" problems that redder areas are (shocking, right?), so I am gradually feeling safer.

 

[Alexandor Scott]

Getting the shot is not a bad decision. You are betting that any tinnitus spike will be temporary (be it 6 weeks or 6 months) and more than offset by the protection you will get from the vaccine and the peace of mind that comes with it. I think for most, this will be the case.

Yeah, I just wish my brain would cooperate long enough to get the needle in my arm.

Natural immunity may be a lot less than the vaccines, depending on which vaccine you got and which variant of COVID-19 you end up getting exposed to.

We don't have the data to support the idea that natural immunity is "as good as" or "better than" vaccine borne immunity, and it will likely be several years before we have enough data on breakthrough infections in either group.

We do absolutely have the data to say "no, the mRNA stuff isn't risky at this point it's been administered to millions of people over the last year and a half with very very minimal truly scary side effects given the tremendous number of people exposed".

We also absolutely have the data to say "COVID-19 vaccines may pose some tiny risk of temporary or even permanent hearing issues, but based on the reported data the incidence of this is definitely less than 2% and probably even less than that. On the other hand, COVID-19 itself poses a significant risk of temporary or permanent hearing loss and tinnitus, at least 15% but possibly higher because of cases that only present as SSHNL and don't get COVID-19 testing".

So, like, do whatever you want? But if you think the vaccine is riskier to your ears than actual COVID-19 you have been misled because huge data sets point strongly in the opposite direction. If you think the risk from the vaccine is worse simply because you're never going to get COVID-19... well, good luck with that, I don't care too much as long as you're not within 20 miles of me or my kids. Overall vaccine takeup in my state is super high, we're not having the "hesitancy" problems that redder areas are (shocking, right?), so I am gradually feeling safer.

If one has a spike from the first dose, would it not make sense for that person to forego the second dose?

I'm trying to convince myself to get the second dose, but given the spike from the first, the fact that I likely still have a decent amount of protection, and the fact that the COVID-19 cases are declining, I'm having a hard time doing it. I wish someone could just jab me with it while I'm sleeping so I wouldn't have a choice lol.

 

[Exit]

Since I'm in for a life-long quarantine from people and their f... noises... a big fat NO to the vaccine.

 

[Damocles]

If one has a spike from the first dose, would it not make sense for that person to forego the second dose?

Have you looked through the forums to find other people who had spikes after their first dose @Alexandor Scott?

If I were in your position, this is the information I would be going off.

Likelihood is, anyone who had the same vaccine and the same reaction as you to the first dose will be a good estimate of your experience with the second dose.

If you're seeing mostly negative stories, or you just can't find the people like yourself with tinnitus who had the same vaccine, then there's nothing wrong with opting out. Like you said, you still have increased defence now that you've had one dose.

Also, don't rush your decision. I seriously suggest you do your research first and then reschedule your vaccination date if it's going to make you more comfortable when that time comes.

 

[kingsfan]

Have you looked through the forums to find other people who had spikes after their first dose @Alexandor Scott?

If I were in your position, this is the information I would be going off.

Likelihood is, anyone who had the same vaccine and the same reaction as you to the first dose will be a good estimate of your experience with the second dose.

If you're seeing mostly negative stories, or you just can't find the people like yourself with tinnitus who had the same vaccine, then there's nothing wrong with opting out. Like you said, you still have increased defence now that you've had one dose.

Also, don't rush your decision. I seriously suggest you do your research first and then reschedule your vaccination date if it's going to make you more comfortable when that time comes.

I feel like someone has aggregated this very data, but there are quite a few threads and many many posts about the vaccines now that I don't quite know where to look.

The search feature may be of help. If I ever get the second dose, I would happy to report my symptoms, but I don't see that happening any time soon.

 

[Alexandor Scott]

Have you looked through the forums to find other people who had spikes after their first dose @Alexandor Scott?

If I were in your position, this is the information I would be going off.

Likelihood is, anyone who had the same vaccine and the same reaction as you to the first dose will be a good estimate of your experience with the second dose.

If you're seeing mostly negative stories, or you just can't find the people like yourself with tinnitus who had the same vaccine, then there's nothing wrong with opting out. Like you said, you still have increased defence now that you've had one dose.

Also, don't rush your decision. I seriously suggest you do your research first and then reschedule your vaccination date if it's going to make you more comfortable when that time comes.

From what I've seen it appears to be a bit of a mixed bag. I've seen a few people that didn't spike at all from dose 2. A few that had temp spikes from dose 2. And a few that got significantly worse, longer lasting spikes with dose 2 vs dose 1.

I've been researching how effective one dose is, how long protection lasts, and reading about different people's experiences with COVID-19 vs the COVID-19 vaccine, and I think the more I read the more confused I get, and the less clear I am about my decision hahaha.

I've got a little less than 4 days left to decide as once I leave the United States on Tuesday, it will be 6 months before I have access to the vaccine again. So time is of the essence. I'm gonna be pissed at myself if I get a spike either way so not sure why I'm stressing about this so much.

 

[t_scot randal]

Yeah, I just wish my brain would cooperate long enough to get the needle in my arm.

If one has a spike from the first dose, would it not make sense for that person to forego the second dose?

I'm trying to convince myself to get the second dose, but given the spike from the first, the fact that I likely still have a decent amount of protection, and the fact that the COVID-19 cases are declining, I'm having a hard time doing it. I wish someone could just jab me with it while I'm sleeping so I wouldn't have a choice lol.

Tough call on this one. Both decisions are right. I decided to do it, but not sure I would again given my current situation.

 

[linearb]

If one has a spike from the first dose, would it not make sense for that person to forego the second dose?

I don't think the answer to this is a clear cut yes or no, and comes down to what we mean by "spike". My tinnitus was certainly obnoxiously elevated for 5 days following the 2020 flu vaccine; I've had the flu a few times and know it does the same thing for twice the duration.

If someone decides to skip shot 2, scientifically they're in a spot where we don't actually have great data on how protected they are and more importantly how this impacts their ability to transmit; politically they're in a spot where they can't tell people they're fully vaccinated, because they're not. Then it gets into this complex "well, I had shot 1 and I had this reaction I think..." story; I know that would be a reason I personally wouldn't want someone inside my house, but I have kids to worry about.

 

[PeteJ]

From what I've seen it appears to be a bit of a mixed bag. I've seen a few people that didn't spike at all from dose 2. A few that had temp spikes from dose 2. And a few that got significantly worse, longer lasting spikes with dose 2 vs dose 1.

I've been researching how effective one dose is, how long protection lasts, and reading about different people's experiences with COVID-19 vs the COVID-19 vaccine, and I think the more I read the more confused I get, and the less clear I am about my decision hahaha.

I've got a little less than 4 days left to decide as once I leave the United States on Tuesday, it will be 6 months before I have access to the vaccine again. So time is of the essence. I'm gonna be pissed at myself if I get a spike either way so not sure why I'm stressing about this so much.

A lot of research has shown that things are notably worse after dose 2.

 

[t_scot randal]

If you've had COVID-19, you will have a natural immunity - that's what I am reading and that's the best immunity there is. This mRNA stuff is risky - I reckon people will suffer long term with this in their bodies.

mRNA vaccines are here to stay. They need to be cleaned up (dosing, more studies of the lipids etc) but they have been a smashing success overall. Those of us with tinnitus are dealing with after effects of a wicked immune response that likely has little to do with the mRNA technology. AstraZeneca and J&J vaccines also cause it, as do vaccines to other viruses.

 

[t_scot randal]

I don't think the answer to this is a clear cut yes or no, and comes down to what we mean by "spike". My tinnitus was certainly obnoxiously elevated for 5 days following the 2020 flu vaccine; I've had the flu a few times and know it does the same thing for twice the duration.

If someone decides to skip shot 2, scientifically they're in a spot where we don't actually have great data on how protected they are and more importantly how this impacts their ability to transmit; politically they're in a spot where they can't tell people they're fully vaccinated, because they're not. Then it gets into this complex "well, I had shot 1 and I had this reaction I think..." story; I know that would be a reason I personally wouldn't want someone inside my house, but I have kids to worry about.

It's not your kids you need to worry about. They do fine with COVID-19. For those who skip shot 2, you'll need another shot eventually, be it six month or a year from now. Watch and wait to see what plays out and then choose a vax.

 

[linearb]

It's not your kids you need to worry about. They do fine with COVID-19.

The people running the Pediatric Long COVID clinic at the University of Michigan might disagree.

Pediatric Post-COVID Syndrome Clinic:

Over 75,000 children in the state of Michigan have had a confirmed COVID-19 infection. While most children may be asymptomatic or only have mild COVID-19 symptoms, many children may experience persistent symptoms months after initial recovery known as post-COVID syndrome or "Long COVID." Such patients are also described as "long-haulers."

Michigan Medicine Opens Adult and Pediatric COVID-19 Long Haul Clinics:

"We've seen many children who have breathing issues and other lingering symptoms long after an initial infection," says Carey Lumeng, M.D., Ph.D., a Mott pediatric pulmonologist who leads the Mott post-COVID clinic.

If you're going to be so presumptive as to tell me through the internet what is or isn't "fine" for my children, it might behoove you to do some basic research on the subject, thanks!!

For those who skip shot 2, you'll need another shot eventually, be it six month or a year from now. Watch and wait to see what plays out and then choose a vax.

And we don't know what that does to the efficiency, side effects profile, etc. "Watch and wait" seems like a lot of anxiety; I'm done with my COVID-19 vaxx, I am fully vaxxed as of today.

Full disclosure - I did end up reporting "temporarily elevated tinnitus" as a side effect to V-SAFE. This does not alarm me, is not any "new" or "louder than I've ever heard" tinnitus, and seems very much in line with the kind of increased awareness of it that I get during and after a viral illness.

If it hasn't completely resolved in 4-6 weeks I'll start to be slightly concerned, but, I believe it's already on that trajectory and at no point has this caused me to question getting the shots, which is why I sort of hesitate to even mention it -- I was certainly concerned about the possibility of a spike and may just have set up a self-fulfilling prophecy.