It’s been quite the week. I managed to write a logic exam, file my taxes, attend a meeting to discuss department climate issues, complete all (read: most) of my homework, assist the student union with a housing justice issue, sort out my summer funding problems, attend a friend’s mock defense, teach two classes, get my grading done, and rewrite an entire chapter of someone else’s dissertation. My physical and mental health have both suffered, to the point that I now feel like a sleepwalking zombie that’s teetering on the edge of a nervous breakdown. And yet somehow, in the midst of all this chaos and lack of sleep, I also managed to draft up a four-page document criticizing the University of California’s (tentative) COVID vaccination policy for the fall. Sigh. I hate COVID every bit as much as the next person does, but I also hate it when the big guys in charge meddle with the science, or simply overlook it altogether, in order to score higher profits while women, children, racial minorities, and disabled folks suffer the consequences of their bad behavior. (Which is exactly why I’m now knee-deep in articles about how termite fumigants lead to neurological damage in children. But more on that later.)
There were many, many objections that could’ve been made to UC’s proposed policy; but with only a 30-day comment period, there was simply no way I could cover all the bases. So I resigned myself to just talking about the uterine hemorrhage issue.
If you’re suddenly like, “huh?” …you are by far not the only one. Since mid-February, or possibly before, hundreds of women have taken to different social media channels to discuss many interrelated endocrine and cardiovascular problems they’ve experienced post-vaccination, the kind of problems that simply…don’t affect men, let’s put it that way. The most alarming issue reported? Sudden-onset uterine bleeding that continues for days, weeks, or even months on end, and that renders the doctors useless. For some reason, no one running the clinical trials thought to look into this issue (of course they didn’t), and other researchers have been left scrambling to collect data and come up with answers. In the meantime (from my point of view, at least), it seems like the wisest thing to do would be to hold off on the universal mandates until the research makes it to the press. But, alas, the University of California seems to have other ideas about this.
So, without further ado, I’ll paste my letter to the university below. Apologies in advance for the technical language and aggressive tone, but it seems like it’s what’s necessary to deal with bureaucracy around here. (Apologies also for the weird formatting; it appears that WordPress isn’t a fan of footnotes. Sigh again.)
To Whom It May Concern:
I am a current PhD student in Logic and Philosophy of Science (LPS) at the University of California, Irvine, with a background in biology and environmental health. I write with certain concerns regarding the proposed COVID-19 immunization policy as it currently stands. Specifically, I have concerns that certain serious side effects, which have not been adequately assessed in clinical trials, disproportionately affect persons assigned female at birth (AFAB) and that, as a result, the proposed immunization policy may constitute a discriminatory barrier to employment and higher education for AFAB persons.
 For the purpose of inclusivity, from this point forward, I will use the phrase “AFAB persons” to describe persons assigned female at birth. This group consists mainly of cisgender women, but also includes transgender men and some persons who identify as non-binary.
Over the past several months, hundreds, if not thousands, of AFAB persons across the country have reported adverse endocrine and cardiovascular symptoms, many of them severe, following vaccination with any of the three COVID-19 vaccines (Pfizer, Moderna, Johnson and Johnson) currently available in the U.S. under emergency use authorization (EUA). Specifically, many AFAB persons have complained of severe uterine bleeding post-vaccination, with some of the reported bleeding episodes lasting weeks or months without respite, leading to further health complications such as vertigo and anemia. It is important to emphasize that these adverse bleeding events (hereafter, ABEs) have been observed to occur in post-menopausal cisgender women and AFAB persons without endometriosis, polycystic ovary syndrome (PCOS), or other pre-existing conditions; are not correlated with the timing of ovulation and do not resemble menstruation in a medical sense; and instead bear a striking resemblance to the ABEs experienced by AFAB persons following exposure to tear gas at the Black Lives Matter protests last summer.  That is to say, many of the reported ABEs are not the “natural” occurrences of a woman’s fertile cycle, but instead constitute environmentally-induced uterine hemorrhages, similar to those observed following acute exposures to certain pesticides and other toxicants.
 In reporting their symptoms, many affected AFAB persons have described their ABEs using terminology (i.e., words like “period” or “spotting”) that is commonly associated with menstruation. Similar language has also been used in media reports. The use of these words by affected persons and journalists does not indicate that the affected persons’ symptoms are related to, or a consequence of, the menstrual cycle; rather, persons without medical expertise are simply describing abnormal symptoms in normal language that they are familiar and comfortable with.
 A recent article covering these adverse health effects experienced by protestors in Portland, OR, is here: https://www.rt.com/usa/522614-study-teargas-health-issues/. Note the terminology issues previously discussed in Footnote 2. The study referenced by the article is Torgrimson-Ojerio et al., 2021. BMC Public Health, Vol. 21, #803; available for free here: https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-021-10859-w#Sec8
Although a plausible biological mechanism exists through which COVID-19 infection, and possibly COVID-19 vaccination, may effect this sort of cardiovascular damage – that is to say, by interfering with the function of the endothelial cells that line the blood vessels – to date, the relationship between ABEs and COVID-19 vaccination has gone largely unmonitored in clinical trials. As a result, the reporting of ABEs experienced by AFAB persons post-vaccination has been largely informal, and has involved affected persons discussing and reporting their symptoms to researchers through a wide variety of public social media channels. Reports of specific ABEs have included complaints that the bleeding began very shortly after the first or second vaccination, or both; that the bleeding was painful, debilitating, or involved the passing of extremely large blood clots; that the bleeding occurred post-menopause, while breastfeeding, or while taking the non-placebo week of an oral contraceptive—all circumstances in which any type of menstruation or uterine bleeding would not normally occur; that the bleeding was prolonged and required further medical attention or intervention; and/or that medical interventions failed to stop or alleviate prolonged bleeding. Because these side effects have been largely overlooked in clinical trials, and because no past studies have analyzed the relationship between COVID-19 vaccination and ABEs, a faculty member in the Department of Anthropology at the University of Illinois at Urbana-Champaign (UIUC) has recently received funding to conduct a study into how COVID-19 vaccination may cause ABEs and contribute to other maladies affecting the female reproductive system. Unfortunately, because (1) Pfizer has already applied for full FDA approval for its COVID-19 vaccine; (2) the six months of clinical trial data submitted by Pfizer to the FDA did not include data concerning the relationship between vaccination and ABEs; and (3) the study currently being conducted at UIUC is still in the data collection stage; it is entirely possible that one or more COVID-19 vaccines will obtain full FDA approval before the relationship between COVID-19 vaccination and ABEs has been appropriately analyzed by the scientific community.
 For an in-depth exploration of the effect of COVID-19 on endothelial cells, see Libby and Lüscher, 2020. European Heart Journal, Vol. 41, Issue 32; available for free here: https://academic.oup.com/eurheartj/article/41/32/3038/5901158.
 An example of such a social media thread: https://twitter.com/kateclancy/status/1364671490772320259?s=21. This thread was started by UIUC faculty member in February who, due to the sheer number of replies detailing similar side effects/symptoms, has now committed to conducting an investigation into the link between COVID-19 vaccination and ABEs (more on this in a moment). Many affected AFAB persons have noted difficulties with officially reporting their symptoms to the Vaccine Adverse Event Reporting System (VAERS), or have complained that VAERS is not publishing their reports in a timely manner.
 As discussed earlier, some affected persons have reported ABEs that lasted weeks or months, even after medical attention was sought.
 Dr. Kathryn Clancy
In response to AFAB persons’ publicly expressed concerns regarding the link between COVID-19 vaccination and ABEs, several mainstream media outlets have recently published articles contending that no such significant link exists. Specifically, published articles on the topic have accused cisgender women and other AFAB persons of (1) insisting that ABEs are a side effect of COVID vaccination, despite the fact that no published studies have demonstrated this; (2) being overly concerned about “fertility issues” in the face of a public health campaign; and (3) attributing to COVID-19 vaccines what could just as easily be attributed to stress or irregularities of the female reproductive system. I will now respond to each of these objections briefly, and demonstrate why they are all without merit.
Objection (1): “No published studies have demonstrated a link between COVID-19 vaccination and adverse bleeding events. Therefore, no link between COVID-19 vaccination and ABEs exists.”
Response: There are currently no published studies showing a link between COVID-19 vaccination and ABEs. However, this is not because ABEs have not occurred post-vaccination, but simply because research into the relationship between COVID-19 vaccination and ABEs is still ongoing. Publications concerning these issues will likely enter the scientific literature within the next few months. In the meantime, many hundreds of informal reports from affected AFAB persons indicate that there is, in all likelihood, a statistically significant relationship between COVID-19 vaccination and risk of ABEs.
Objection (2): “There is no evidence demonstrating that COVID-19 vaccines impact female fertility.”
Response: To date, no link has been demonstrated between COVID-19 vaccination and female infertility. However, it would be a grave error to conflate ABEs with fertility issues. As previously discussed, many reported ABEs have been correlated with the timing of vaccination, and uncorrelated with the timing of ovulation; that is to say, post-vaccination ABEs do not resemble menstruation in a medical sense. Moreover, post-vaccination ABEs have been reported in post-menopausal cisgender women, breastfeeding mothers, and cisgender women of reproductive age taking oral contraceptives—all populations in which ovulation and menstruation generally do not and should not occur. To reduce AFAB persons’ legitimate concerns about ABEs to questions of fertility both (1) perpetuates the harmful belief that a female’s primary role is the production of babies, and that her personal health does not matter so long as her fertility remains intact; and (2) continues the unfortunate tradition, long practiced in Western healthcare, of ignoring cisgender women and other AFAB persons who voice health concerns related to their reproductive organs.
 By ‘uncorrelated with ovulation,’ I mean not occurring approximately 2 weeks after ovulation, when the body’s estrogen levels naturally fall (and when menstruation may occur in some AFAB persons of reproductive age).
 That is to say, “taking (the non-placebo week of) an oral contraceptive.”
 Perhaps the conflation of post-vaccination ABEs with fertility issues is due in part to the frequent, unfortunate conflation of menstruation with ovulation/fertility. As menstruation is neither a necessary nor a sufficient condition for ovulation/fertility, the latter conflation is absurd.
Objection (3): “Uterine bleeding is a normal occurrence of the female menstrual cycle. The female menstrual cycle is often affected by stress and natural irregularities. Therefore, AFAB persons are attributing to COVID-19 vaccination what is likely due to nature, or to stress. Perhaps they are bleeding because they are stressed about having received a COVID-19 vaccination.”
Response: I have already explained at length why post-vaccination ABEs should not be conflated with menstruation, and I do not feel compelled to repeat myself here. While the stress hormone cortisol possesses a very limited degree of endocrine-disrupting potential, there are no known plausible biological mechanisms through which cortisol, or any other stress-related hormone, can induce uterine bleeding. Post-vaccination ABEs have been reported in AFAB persons without a history of chronic stress or menstrual irregularities; and the sheer number of such reports makes it highly unlikely that the temporal correlations between COVID-19 vaccination and the onset of ABEs are merely coincidental.
All of the above leaves cause for concern that the proposed COVID-19 immunization policy, as it currently stands, may constitute undue hardship for—or discrimination against—persons assigned female at birth. In order to gain access to higher education or continued employment, AFAB students, faculty, and staff will be required to assume a risk—that is, the risk associated with prolonged adverse bleeding events—that their male counterparts will not, and cannot, assume. Perhaps some of my readers will disagree with this bleak description of the proposed immunization policy. They may argue that, given the risks associated with COVID-19, it is in the best interest of all members of the UC community to assume the risk of any possible vaccine side effects, even if the burden of risk associated with certain serious side effects falls disproportionately, or solely, on females. To this I can only answer that the relative burden of risk assumed by AFAB members of the UC community would be very great indeed; as prolonged ABEs are but one of numerous endocrine and/or cardiovascular side effects that have been documented disproportionately or solely in AFAB persons after COVID-19 vaccination.  Moreover, under the proposed medical exemption policy, AFAB persons concerned about their personal risk of post-vaccination ABEs—say, because they have an endocrine disorder, a history of abnormal uterine bleeding, or another relevant health condition that does not necessarily qualify as a disability—will be forced to choose between assuming this disproportionate risk, or leaving the university community. To ignore these disproportionate burdens placed on AFAB persons would be to perpetuate the normalization of misogyny and discrimination on the basis of sex in higher education.
 Some of these side effects (e.g., deaths following the formation of certain rare types of blood clots) have received widespread media attention; other, more common side effects (e.g., various forms of endocrine disruption) have received far less attention.
 It may be objected that certain forms of uterine bleeding and other endocrine/cardiovascular symptoms have been observed following COVID-19 infection, and that it therefore makes little sense to worry about whether similar adverse effects could also be observed following COVID-19 vaccination. However, many AFAB persons who reported ABEs post-vaccination also reported that they did not experience the same adverse effects with a prior COVID-19 infection.
To alleviate these problems, I strongly suggest that the university take the following courses of action:
- Amend the proposed policy so that AFAB students with endometriosis, polycystic ovary syndrome (PCOS), a history of abnormal uterine bleeding, or another relevant health condition that puts them at increased risk of post-vaccination ABEs may seek a medical exemption with doctor permission; and ensure that potentially affected students are informed of their right to seek such an exemption.
- Ensure that, should post-vaccination ABEs or other endocrine/cardiovascular side effects occur among members of the UC community following the implementation of the university COVID-19 vaccination policy, such side effects will be well-documented and monitored by the university administration; if privacy concerns prevent affected persons from reporting adverse effects directly to UC/UC Health, then UC should provide all members of the university community with detailed information on how to report adverse events to the Vaccine Adverse Event Reporting System (VAERS). Ideally, a university hotline would be established for this purpose.
- Refrain from retaliating (through suspension, expulsion, firing, or any other means) against AFAB members of the UC community who refuse to seek COVID-19 vaccination due to concerns about ABEs or other possible adverse post-vaccination events for which they are at increased risk, or believe themselves at increased risk, due to their assigned sex at birth.
In closing, I would like to declare that I have no financial or employment-related conflicts of interest; that I prepared this document of my own accord, without prompting, permission, or assistance from other parties; and that, despite the fact that I am myself a person assigned female at birth, none of the information that I have provided in this document affects me personally, as my doctor has told me that I must seek a medical exemption to the university vaccination policy due to a pre-existing disability.
 In other words, this is just something that I did in my spare time, because I care about public health and equal rights.
Emily A. Heydon
Graduate student, Logic & Philosophy of Science
University of California, Irvine