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MARCH 2021 Download this Article
Vaccine sceptics have been there ever since the vaccine is in use. But the positive results over the years have changed the perception for good.
It does not mean, though, this positive perception is for all vaccines. For the medical science community, this assumption will be a mistake.
For new ones, like the COVID19, the scepticism strongly persists. It is not just because of the vaccine that people are wary of, but because of the pharmaceutical industry's overall distrust and the governments imposing vaccination.
In the U.K., vaccine hesitancy is 1 out of 3, and it is high in young adults and ethnic groups.
Social:
For all to survive, the entire country and the practically whole world needs to be healthy. But that has not been the case all this while.
In all countries, except for a few, good health care has been a privilege of few. With this pandemic, health inequalities have come to the forefront.
The U.S. is a case in point here. The black community had been struggling with health care due to complex insurance and expensive medical system.
The same fracture between the have and have nots is playing havoc. In the other part of the world, health care was shallow during ordinary times, and services were slim.
Suddenly, governments and healthcare services cannot wake up from the welfare slumber and start imposing vaccination programmes during the pandemic.
The trust relationship between the health care policy and people does not exist. Therefore, a prompt response should not be expected for vaccination.
There was a racist element too. W.H.O confirmed the news that. "The vaccines are to be tested on Africans when they're developed".
It was a claim made by a senior participant. In the same meeting that the most likely testing centre was in Nigeria.
In previous vaccines, animal products like pig gelatine went against the religious sentiments of the Muslim community.
For the COVID vaccine, though pig gelatine was not used, governments failed to inform this fact. It was too late in the chaos of misinformation that it was clarified.
Similarly, based on the history of the vaccine using mercury as an ingredient, there was apprehension. Even today, there is no aggressive campaign to clarify these misgivings.
Many health care workers and doctors themselves were hesitant until the vaccine was made compulsory by various governments.
There was hesitancy amongst them is a matter of deep inquiry but certainly not a bold indicator of confidence in the immunisation system.
In the U.K., 63% of the health care workers who died of COVID19 were from the BAME group. (BAME is short for Black, Asian, Muslim and Ethnic Communities).
Subsequently, the vaccine messaging should have been focused on this vulnerable group. On the contrary, 90.6% of covid-19 vaccine recipients are white, while others are hesitant.
Logistical Inadequacies:
There is an acute shortfall of vaccines in India. While the number of cases is rising exponentially, the vast population to be immunised, the country has run out of essential supplies.
If this was not enough, India was the largest producer of vaccines for all the global brands. A quota of manufactured stock was being exported, which has been halted now.
So, other countries are suffering from the shortfall too.
Earlier, the European Union and the United Kingdom engaged in a vaccine quota war.
In the height of a pandemic, the spat between leaders of the developed world was only lowering the immunisation programme's credibility, if nothing else.
In the U.S., a manufacturer for Johnson & Johnson mixed its doses with that of Astra Zeneca. Hence, the supplies had to be stopped.
Tainted history of vaccine:
Activists have been raising concerns about the vaccine at a different point in time. Over the years, their voices have made a difference.
Even though the companies have not openly accepted their shortcoming, but have drastically changed their methods and ingredients.
In the U.K., Dr Gordon Stewart published multiple reports drawing a connection between neurological disorders to D.T.P. vaccines.
There were concerns raised about the use of mercury in vaccines which was the alleged source of autism. Although safety reviews conducted in 2001 rejected the causal relationship, though mercury (thiomersal) was subsequently discontinued.
It may not be wrong on the public to suspect such an unresearched component being used in the COVID vaccine. It will be too late before being detected as a cause for their lifelong ailments.
Earlier in the year, in India, the indigenous vaccine was released without phase3 trial approval. The news about untested vaccines created public outrage. The Indian prime minister had to take 1st dose of that particular vaccine on camera to assure its safety.
While Britain and Europe were ahead in approving Astra Zeneca vaccines, the US FDA was still reviewing. It pointed out that data used to determine the efficacy was faulty.
The efficacy declared by the company initially was disputed by the F.D.A., which was corrected subsequently.
These incidents lead up to mistrust in the process and undoubtedly give rise to suspicions on the pharmaceutical companies' commercial motives.
In March of 2021, the French president raised doubt about the Astra Zeneca vaccine's effectiveness for over 65s. He called it "almost ineffective".
There was a rebuttal from the manufacturer, and the president stepped back with his statement. By then, the damage was already done.
Countries like Denmark, Norway, Germany, France (initially) suspended using the Astra Zeneca vaccine. There were incidences of blood clotting and fatalities.
Though the incidences, statistically minimal in number, has been contested, further trials are going on.
Based on the blood clotting incidences' statistical data and not based on medical research, the qualifying age for Astra Zeneca was changed. Vaccination age for over 50s only was approved.
Incidences of blood clotting after the Johnson & Johnson vaccine, like the one with Astra Zeneca, has led to the suspension in the U.S., South Africa and Europe.
COVID Vaccines and medical science
The rumours were rife that vaccine would change the R.N.A. and D.N.A. of the recipients. The scientific community contests this.
The origin of this suspicion arises from the fact that few brands have used a new method of gene-editing for higher efficacy—the new process used gene editing and genome sequencing for the creation of mRNA vaccine.
Widespread doubt in the pharmaceutical industry for shortening the development cycle came to light during an interview with MERCK CEO.
According to him, the research and development cycle time for Ebola and Mumps vaccine, compared to the COVID vaccine, was four to five times longer.
As an interpretation of the statement, it is suspected that a shorter cycle meant cutting corners in the testing cycle resulting in safety and efficacy issues.
Here are few vaccines listed with their development cycle:
Ebola – 4 years
Diphtheria – (about 10 years) - developed in 1921 but widely used in the 1930s.
Tetanus Toxoid - (about 14 years) – developed in 1924, an absorbed version of the vaccine was developed in 1938, which was widely used in the 1940s during World War. The efficacy is 100%.
Pertussis (Whooping Cough) - (about 10 years) – developed in the 1930s but widely used in the 1940s. It took 6 years to develop the vaccine.
From the pre-vaccine era to 1976, nearly 30 years, the cases have dropped from 2,00,000 to 1,000 a year.
Since the 1980s, the cases have increased to epidemic levels of 50,000 in 2012, reducing to 15,662 in 2019. There were several deaths as reported by C.D.C. The whole-cell vaccine is 70 - 85% effective.
Rabies (about 23 years) – first introduced in 1885 and improved version for mass immunisation in 1908.
Hepatitis B (about 17 years) – developed in 1969, approved in 1981, and recombinant version came in 1986.
H.I.V. (No Vaccine since 1984) – Still under development and trial.
COVID (less than 12 months) – Millions of doses used under emergency approval with the continued minor and major side-effects.
The efficacy record has not been perfect for all the vaccines. While it is nearly 100% for rabies, for others, it is lower.
The majority of people are risk-averse when an uncertain future beholds them.
In the report about trials, women and ethnic groups were underrepresented. Therefore, the official efficacy as declared by the manufacturers of the vaccine stands skewed.
Blacks (about 10% of participants) and Hispanics (about 20% of participants) people, older age groups (about 25%), and people with conditions such as obesity, diabetes, heart and respiratory conditions were included in the trials.
Similarly, in the U.S. study, participants for the one-shot COVID-19 vaccine were 15% Hispanic/Latino, 13% Black/African American, 6% Asian and 1% Native American.
The variations of the type of trial groups were limited.
The population consists of various ethnic groups, races, comorbidity, minor health conditions, allergies, age groups, pregnant women, childbearing age, children, young adults and others.
The trial's variation was not shared by the vaccine manufacturers or by the governments to reassure the safety.
The vaccines are not tested on pregnant women. The onus of vaccination had been shifted to the doctors who are themselves unaware.
In all probabilities, they would make an uninformed choice. The responsibility got diverted from the manufacturers to the medical professionals, which would risk their job.
Yellow Card Scheme in U.K. indicating A.D.R. cases is growing every day for people to see. The symptoms reported range from minor ones to death.
These numbers on the yellow card in no way are boosting the confidence. Those many getting vaccinated are either ignorant of these yellow card adverse reactions or have decided to weigh in the low probability of adverse effect.
There were shifting guidelines concerning women of childbearing age, which added to the confusion.
Failure of Logical Reasoning:
There is no protective assurance from vaccine manufacturers for safety against the disease. Masks and social distancing still must be maintained as the risk of contagion persists.
So it defeats the logical reasoning. Why take the vaccine, whose long-term side effects are barely known while the risk of infections continues to stay?
People have got alternatives to getting a cure from COVID. Countries like Vietnam, Ghana and other African countries have been dealing with COVID without a vaccine. Their mortality rate is much lower than the European countries.
The adverse reaction time suggested to patients have been claimed as few hours to few days. Simultaneously, the history of vaccine indicates that vaccines and other medications have shown contraindication after a period beyond few days.
There seems to be an information gap here, as the development itself was shorter than a year. Therefore side-effects that would arise after a few months or years remains unknown.
Communication Failure
There was an ocean of unofficial and informal information floating around social media. There remain, in some quarters, distrust about the genuineness of the disease itself.
Some believe COVID is due to electromagnetic waves from 5G mobile telecommunication towers, while others claim that COVID is like any other flu which will go away on its own.
Despite so many deaths, the Brazilian president still denies the seriousness of coronavirus.
Many other countries, outside of Europe and North America, have a low number of cases, and the vaccination program does not exist.
So, for the conspiracy theorist, the vaccination is a commercial proposition for the developed countries.
Justification for VACCINE
The statistic is the most effective tool used by the government to promote immunisation programme. It is said that there is no alternative to the vaccine, and the benefits outweigh the risks of side effects.
Moreover, the adverse effects are manageable, temporary and usually will subside in a couple of days. The statistics are on the side of those who are already vaccinated.
Also, it is claimed that vaccine immunity will protect people from hospitalisation or death if an infection does happen in the future.
Course Correction:
Pharmaceutical companies must work hard on improving trust with their consumers. It is a testing time and reflects what the population perceives.
It is a matter of introspection for the policymakers too. What makes people vaccine-hesitant, even when their life is at stake? It is the million-life worth a question.
Immediately, governments must start to communicate clearly about medical issues. The messaging needs to come from trusted sources like the local nurses, family doctors etc.
Anyone with suspected conflict of interest will discount the argument of vaccination.
If a vaccine is the only resolution to the COVID crisis, the scientific community needs to communicate to dispel myths and misinformation.
A one-size-fits-all communication package is not beneficial because different groups and sections of society have varied information gaps. The fact that vaccine-hesitant are large in number, nudging will work.
Covid-19 has harshly exposed the health inequalities. Engaging with vaccine-hesitant subgroups is vital, and efforts must be made to increase knowledge levels, reduce perceived risks, and enable informed decision-making.
Globalisation has taught us all one important lesson.
The health care system across countries must be fixed immediately for all to survive; none must be left behind.
Disclaimer: Mention of names, community, religion and brands is only for purpose of information and explanation. The writer or publisher in no way, wants to cause any harm, whatsoever, to anyone. If one feels so, it is purely unintentional.
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