The vision of the Aviation Covid Collective with regard to COVID-19 vaccination is in no way intended to advise or convince in making a vaccination choice. Our vision seeks to raise our concerns and thereby seek understanding that individuals, for good reason, fail to vaccinate or delay making this choice. Respect for everyone’s free choice and physical integrity should always be leading in the discussions that are held.
How current corona vaccines work
There are currently two types of corona vaccines on the market: mRNA vaccines and DNA vector vaccines. BioNTech/Pfizer (Comirnaty) and Moderna are mRNA vaccines. Janssen and AstraZeneca (Vaxzevria) are DNA vector vaccines.
In the case of the mRNA vaccines, genetic code (mRNA), packaged in fat globules, is injected. These fat globules, also called lipid nanoparticles (LNPs), are taken up by a number of the body’s own cells, after which these cells read the genetic code (mRNA). The code contains an instruction for the body’s own cell to produce spike proteins. The spike protein is one of the proteins that is also present in the SARS-CoV-2 virus.
In the case of DNA vector vaccines, a harmless adenovirus is used as a means of transport to get a piece of DNA into a number of the body’s own cells. This type of vaccine also instructs the body’s own cells to produce spike proteins.  Although the exact mode of action of mRNA and DNA vector vaccines differ, they have a common denominator. Both types of vaccines code for the production of the spike protein of the virus from Wuhan, at the end of 2019.
The immune system will then respond by producing antibodies for this spike protein. The ultimate goal is that when a person is actually infected by the SARS-CoV-2 virus, the body can react more quickly and antibodies can make the virus harmless.
On the one hand, it is an extraordinary achievement to bring vaccines to the market in such a short period of time. On the other hand, however, we are entering uncharted territory because, among other things:
• No vaccines against coronaviruses for use in humans have ever been marketed before;
• Never before have mRNA vaccines been used on this scale for use in humans;
• Never before have vaccines been marketed in which spike proteins are produced by the body itself.
The European Medicines Agency ( EMA ) further states: 
• There is no data on the extent to which vaccinated persons can still carry and spread the coronavirus;
• There is no data to what extent immunocompromised persons (persons with a weakened immune system) are protected by the vaccines;
• There is very limited data on vaccinating pregnant women;
• There is no data to what extent the vaccine affects breastfeeding;
• There is no long term data;
• There are also no data on the duration of protection after vaccination.
The Aviation Covid Collective believes that the above points entail risks, which are currently insufficiently taken into account in the information provision regarding the choice of vaccination.
Amount of side effects
Side Effects Center Lareb registers the reported side effects after vaccination in the Netherlands. It is striking that the numbers of registered side effects after corona vaccination are higher than those of other vaccines that are already on the market. Side effects after vaccination do not automatically mean that they are due to vaccination. It is easy to misinterpret data from databases such as Lareb and VAERS. Good registration is therefore of the utmost importance in order to be able to detect patterns in time, especially since the current vaccines are authorized with provisional approval. Potential side effects are underreported for various reasons, especially mild symptoms such as headaches or nosebleeds.
Recently, researchers have shown in a study that a reduction in brain volume may occur due to Covid-19. Despite the fact that this study is still a pre-print (the study has yet to go through the review process), the results are worrying. What has not been investigated, however, is what has caused this brain damage. Now what is it in the SARS-CoV-2 virus that causes this neurological damage? Headaches are reported to a very high degree after vaccination, without the cause of these headaches being known either. We absolutely do not want to show a connection between the aforementioned research and the headache complaints after vaccination. We do state that additional research is absolutely necessary.
Myocarditis (heart muscle inflammation)
Published by JAMA Cardiology on May 27, 2021 on the relationship between COVID-19 and myocarditis. What is remarkable is that no fewer than 28 of the 37 (more than 75%) diagnosed cases of myocarditis were subclinical, ie of too small a magnitude to be clinically detectable. Myocarditis also occurs after vaccination, although it is still considered rare. What is the exact cause of the occurrence of myocarditis? Why do we see this with both COVID-19 and vaccination? How many cases of myocarditis could be subclinical and undiagnosed after vaccination? What are the consequences for the heart after extra booster shots next autumn? What are the long-term consequences for the heart?
An adverse reaction does not always have to be so serious as to make it impossible to practice a profession in aviation. For example, at the time of writing, more than 1,550 reports have been received at Lareb regarding eye problems, including blurred vision, decreased vision and eye pain. As long as we cannot determine the exact cause of these eye complaints, we can only guess whether these will be temporary, possibly recurring, or permanent complaints.
Medium- to long-term risks
Long-term risks are unknown simply because we cannot fast-forward the time factor. A parallel is often drawn with the years of experience with existing vaccines and that for that reason no (medium) long-term effects are to be expected. This parallel does not hold, however, because we are entering uncharted territory. Both in the field of applied vaccination technology and in the field of vaccines against coronaviruses in general. Time will tell.
Of course we are not specialists in the fields of genetics, immunology and virology. We do, however, closely follow the current discussions and literature with great interest. The fact is that new research, information, developments and insights keep appearing at an unprecedentedly high and barely keeping pace. We are therefore advised and supported by (medical) specialists. As a result, we would like to point out a number of issues (just a selection) about which, based on current scientific literature, there is good cause for concern for the (medium) long term:
Biodistribution of the mRNA vaccine
The assumption was that the vaccines would remain in the deltoid muscle around the injection site. From here, a controlled immune response would be regulated. However, practice shows that part of the vaccine ends up in the bloodstream and thus spreads throughout the body. The vaccine gets into organs such as the spleen, liver, ovaries and brain, where cells take up the mRNA and produce spike proteins. The effects of this with regard to possible organ damage are as yet unclear.
Toxic Spike Proteins
The spike proteins produced by the vaccines are not only presented on the body’s own cells to elicit a controlled immune response. Also, the spike proteins unintentionally enter the bloodstream freely. Various studies show that this spike protein itself can cause inflammatory reactions and COVID-like complaints. As early as 2005, after the SARS-CoV(-1) epidemic, animal experiments showed that only spike proteins caused acute lung damage and thus provided a molecular explanation for why SARS-CoV-1 resulted in serious and often fatal lung failure. All organs contain blood vessels, all blood vessels contain ACE-2 receptors and wherever there are ACE-2 receptors, this spike protein can bind and trigger unintended inflammatory reactions. The consequences of possible inflammatory reactions in the various organs (such as the heart and brain) can very well only become apparent after years.
Antibody dependent enhancement (ADE)
ADE is a serious (and potentially fatal) immune reaction that occurs when antibodies from a previous infection (or vaccination) fail to sufficiently neutralize (disable) a new second viral infection. By partially attaching non-neutralizing antibodies to viruses, viruses can be helped to penetrate (immune) cells and thus give the infection a more serious course. ADE has already been observed in Dengue , Zika , Ebola but also with coronaviruses. We simply don’t know yet whether ADE will perform.
SARS-CoV-2 RNA integration into genome
The enzyme “reverse transcriptase” is able to convert RNA into complementary DNA (cDNA). Subsequently, the enzyme “integrase” can ensure the integration of cDNA into human DNA. In a study published in May 2021, researchers demonstrate through three different approaches that it is possible to integrate SARS-CoV-2 into DNA. They seem to have found the explanation for why people continue to test PCR positive for months after they have experienced an infection, while these people no longer carry an infectious virus. Very recently, only in June 2021, other researchers discovered that the enzyme “polymerase theta” also turned out to be able to convert RNA into DNA. Whether this also happens with mRNA vaccines, and if so to what extent, is not yet clear. The possible consequences of this are therefore unknown.
SARS-CoV-2 infection versus vaccination
Many of the concerns we expressed above with regard to vaccines are also reflected in natural SARS-CoV-2 infections. The question that we therefore ask aloud: is the vaccine an alternative to escape an infection? What if it is precisely the spike proteins that cause the characteristic Covid-like complaints and infections?
An essential difference between vaccinating and actually experiencing the infection is that 98% of people experience little or no complaints with natural infection. This means that little virus replication has taken place in this group of people, which means that their exposure to spike proteins has been very limited.
Vaccination bypasses the immune system and guarantees that 98% of people will also be highly exposed to spike proteins. Not just in the lungs, but throughout the entire body.
Cost-benefit and medical necessity
The current corona vaccines are authorized within the European Union under provisional approval (“ conditional marketing authorization ”). A provisional approval is issued when at least all of the following are present:
• An advantageous cost-benefit balance of the vaccine;
• The vaccine has an unparalleled medical necessity;
• The benefit of the immediate availability of the vaccine to the population outweighs the risk associated with the missing data over the longer term.
In the age of 50 years, after two winter seasons (2019/20 and 2020/21), 141 people in the Netherlands died from Covid-19 out of a total of 17715 deaths. Despite the potential for underreporting of deaths, it is abundantly clear that age and underlying suffering are important factors in experiencing severe Covid-19.
Aviation Covid Collective therefore believes that there is no generic cost-benefit balance and medical necessity for society as a whole. Every individual must be able to make a certain assessment on the basis of complete information and without social pressure. Possibly after extensive consultation with a doctor.
To get an idea of the risk of serious Covid-19 (hospitalization) and death, the University of Oxford has made a calculator.
For example, a healthy 19-year-old man has a 1 in 45,500 chance of hospitalization and a 1 in 1,000,000 chance of dying. This healthy young man of 19 years old will logically arrive at a completely different cost-benefit analysis and a different medical necessity than a man of> 75 years with a BMI of 30 and type 2 diabetes.
For the group of children aged 12 – 17, the balance is even more negative. It is a totally unethical and irresponsible decision to also expose this group to the possible risks in both the short and (medium) long term.
Vaccines don’t stop the spread of the virus
Our trial will not demonstrate prevention of transmission,” said Tal Zaks, chief medical officer at Moderna, “because in order to do that you have to swab people twice a week for very long periods, and that becomes operationally untenable.” 
This has recently been confirmed by both medical microbiologist Heiman Wertheim (Radboud UMC) and clinical virologist Matthijs Welkers (Amsterdam UMC). Both found low Ct values (i.e. high viral load) in doubly vaccinated healthcare personnel, in combination with mild complaints. This combination is especially worrisome because when vaccines suppress symptoms, vaccinated individuals may very well play a large part in spreading the virus. All this without them being aware of it.
“It is mainly the ‘mega-high’ number of virus particles that stands out,” says medical microbiologist Heiman Wertheim (Radboud UMC), who just happened to test positive himself. “We really thought: what is this? If you extend this to the rest of society, you have quite a big problem.”
After all, vaccinees who contract the virus usually have few complaints themselves. “I think you have a significant group of vaccinees who just go through with it,” Wertheim says. “I probably would have done that myself, if I hadn’t happened to test myself. Somewhere you think: I’ve been vaccinated, I’m okay now. But you can still pass on the virus.” 
So you do not vaccinate for someone else. Vaccination is something you do for yourself.
Understanding for each other
We sincerely hope that our concerns regarding the medium to long-term risks will not materialize. Just the extent to which new publications are appearing regarding the SARS-CoV-2 virus or its vaccines reflects how much we simply don’t know yet.
With these large gaps in knowledge, some restraint and caution are in order in our view. We therefore only ask for understanding for anyone who makes the choice not to be vaccinated (yet) in this one, or who wants to postpone a next vaccination.
 European Medicines Agency, Comirnaty, https://www.ema.europa.eu/en/medicines/human/EPAR/comirnaty
 European Medicines Agency, Moderna, https://www.ema.europa.eu/en/medicines/human/EPAR/covid-19-vaccine-moderna
 European Medicines Agency, Vaxzevria (previously AstraZeneca), https://www.ema.europa.eu/en/medicines/human/EPAR/vaxzevria-previously-covid-19-vaccine-astrazeneca
 European Medicines Agency, Janssen, https://www.ema.europa.eu/en/medicines/human/EPAR/covid-19-vaccine-janssen
 Lareb Side Effects Center, Corona Reports, https://www.lareb.nl/coronameldingen
 Shimabukuro, Nguyen, Martin, and DeStefano, Safety monitoring in the Vaccine Adverse Event Reporting System (VAERS), Vaccine (Volume 33, Issue 36, 26 August 2015, Pages 4398-4405), https://doi.org/ 10.1016/j.vaccine.2015.07.035
 Lazarus, Grant Final Report , Electronic Support for Public Health–Vaccine Adverse Event Reporting System (ESP:VAERS), https://digital.ahrq.gov/sites/default/files/docs/publication/r18hs017045-lazarus- final-report-2011.pdf
 Douaud et al., Brain imaging before and after COVID-19 in UK Biobank (preprint), 20 June 2021, https://doi.org/10.1101/2021.06.11.21258690
 Daniels et al., Prevalence of Clinical and Subclinical Myocarditis in Competitive Athletes With Recent SARS-CoV-2 Infection, JAMA Cardiology, 27 May 2021, https://doi.org/10.1001/jamacardio.2021.2065
 Science, Israel reports link between rare cases of heart inflammation and COVID-19 vaccination in young men, June 1, 2021, https://www.sciencemag.org/news/2021/06/israel-reports-link-between-rare- cases-heart-inflammation-and-covid-19-vaccination
 Kuba et al., A crucial role of angiotensin converting enzyme 2 (ACE2) in SARS coronavirus-induced lung injury, Nature Medicine (10 July 2005), https://doi.org/10.1038/nm1267
 Suzuki and Gychka, SARS-CoV-2 Spike Protein Elicits Cell Signaling in Human Host Cells: Implications for Possible Consequences of COVID-19 Vaccines, Vaccines (2021, 9 (1), 36), https://doi.org/10.3390 /vaccines9010036
 Suzuki et al., SARS-CoV-2 spike protein-mediated cell signaling in lung vascular cells, Vascular Pharmacology, Volume 137, April 2021, 106823, https://doi.org/10.1016/j.vph.2020.106823
 Lei et al., SARS-CoV-2 Spike Protein Impairs Endothelial Function via Downregulation of ACE2, Dec 4, 2020 (preprint), https://doi.org/10.1101/2020.12.04.409144
 Katzelnick et al., Antibody-dependent enhancement of severe dengue disease in humans, Science (17 Nov 2017: Vol. 358, Issue 6365, pp. 929-932), https://doi.org/10.1126/science.aan6836
 Bardina et al., Enhancement of Zika virus pathogenesis by preexisting antiflavivirus immunity, Science (14 Apr 2017: Vol. 356, Issue 6334, pp. 175-180), https://doi.org/10.1126/science.aal4365
 Kuzmina at al., Antibody-Dependent Enhancement of Ebola Virus Infection by Human Antibodies Isolated from Survivors, Cell Reports (Volume 24, issue 7, P1802-1815.E5, August 14, 2018), https://doi.org/10.1016 /j.celrep.2018.07.035
 Wan et al., Molecular Mechanism for Antibody-Dependent Enhancement of Coronavirus Entry, Journal of Virology (Volume 94, no 5, 14 February 2020), https://doi.org/10.1128/JVI.02015-19
 Tetro, Is COVID-19 receiving ADE from other coronaviruses?, Microbes and Infection (Volume 22, Issue 2, March 2020, Pages 72-73), https://doi.org/10.1016/j.micinf.2020.02.006
 Zhang et al., Reverse-transcribed SARS-CoV-2 RNA can integrate into the genome of cultured human cells and can be expressed in patient-derived tissues, PNAS (April 19, 2021), https://doi.org/10.1073 /pnas.2105968118
 Chandramouly et al., Polθ reverse transcribes RNA and promotes RNA-template DNA repair, Science Advances (11 Jun 2021: Vol. 7, no. 24, eabf1771), https://doi.org/10.1126/sciadv.abf1771
 Van Dissel, Catshuis briefing 13 December: Presentation RIVM, https://www.rijksoverheid.nl/documents/rapporten/2020/12/14/catshuis-briefing-13-december-presentation-rivm-jaap-van-dissel
 European Medicines Agency, Conditional Marketing Authorization, https://www.ema.europa.eu/en/human-regulatory/marketing-authorisation/conditional-marketing-authorization
 RIVM, Epidemiological situation of SARS-CoV-2 in the Netherlands, 15 June 2021, https://www.rivm.nl/sites/default/files/2021-06/COVID-19_WebSite_rapport_weeks_20210615_1259_final_correction.pdf
 University of Oxford, QCovid Risk Assessment, https://www.qcovid.org/Home/AcademicLicence?licencedUrl=%2FCalculation
 Doshi, Will covid-19 vaccines save lives? Current trials aren’t designed to tell us, British Medical Journal (BMJ, 2020; 371, 21 October 2021) https://doi.org/10.1136/bmj.m4037
 De Volkskrant, Virologists sound the alarm: delta variant also spreads through vaccinated people , 20 July 2021, https://www.volkskrant.nl/nieuws-grond/virlogen-slaan-alarm-deltavariant-verspreidt-zich-ook-via-gevaccineerde~ b800c3e1/