To Vaccinate or Not?

With a lot being talked about vaccines and their availability not a seeming problem in our scenario, the question still remains, should I?

The World Health Organization defines vaccine hesitancy as a “delay in acceptance or refusal of vaccines despite availability of vaccination services”. Vaccine hesitancy is not new to India as well. Fears like religious contamination, safety, efficacy, and conspiracy theories have time and again posed a challenge to the system. Considering  the current circumstances as we are amidst a pandemic and vaccines have rolled out, the hesitancy towards the vaccine remains a matter of concern. This piece is intended to address some common queries about vaccine safety and benefits.

Safety of vaccines

Q1. How do we know vaccines are safe?

The safety of each vaccine is carefully checked before it is licensed and it is monitored on an ongoing basis after licensing. If a serious side effect is found, the vaccine is pulled out from the market. The risk of diseases is greater than any risk posed by vaccines.

Q 2. How do we know vaccines do not cause long-term health problems?

Based on more than 50 years of experience with vaccines, it is not likely that vaccines cause unexpected long-term problems. Studies have found no relationship between vaccination and development of chronic diseases.

Q3. Can I get a disease from the vaccine itself?

Inactivated or killed organisms, which make up most vaccines, cannot give you the disease from the vaccine itself. Live vaccines contain viruses that are weakened, so occasionally you might get a mild case of disease (for example, mild flu in case of COVID19 vaccine). This is not harmful and actually means that the vaccine is working.

Q4. Why is aluminum in some vaccines?

Aluminum is used to boost the immune system. It is commonly ingested from food, drinking water, and medicine. In fact, the amount of aluminum found in a vaccine is similar to the amount present in breast milk and infant formula.

Q5. Doesn’t the MMR vaccine cause autism?

We all want answers to the cause of autism. But study after study has shown that vaccines do not cause autism. One study showed that the rates of autism were the same in groups of children who received the vaccine compared with those who did not receive the vaccine.

Q6. Isn’t vaccination unnatural?

No, vaccines invite the immune system to produce its own protection, just like a natural infection would. The difference is your child does not have to get sick first to develop these protective antibodies.

Q7. Isn’t natural immunity better than vaccination?

Although natural immunity might give better immunity than vaccines do, the risks are much higher. With natural infections, complications can develop, the disease often is grave. On the other hand, if you are exposed to a disease after being vaccinated, you would already be armed and able to fight it off.

Q8. Can’t so many vaccines overwhelm my child’s immune system?

A child’s immune system has to deal with thousands of germs on a daily basis starting at birth. Scientists estimate that babies can handle up to 10,000 shots at one time. By stimulating the immune system to do what it is naturally meant to do, vaccines make your child’s immune system better at fighting off these diseases.

About Covid-19

Q9. Why did one year suffice for Covid-19 vaccines to be developed?

  • Because the causative agent was rapidly characterized, and was found to be relatively stable
  • Because knowledge on coronavirus immunity was already present
  • Because previous, highly advanced research rendered possible the use of innovative vaccinal platforms
  • Because an unprecedented scientific and financial deployment has occurred
  • Because clinical trials were conducted in record time

Q10. Why were the clinical trials of some vaccines suspended?

Whenever doubt arises on an eventual adverse effect of a given vaccine, trials are suspended. So it was that on 6 September 2020, trials of the adenovirus-based AZD1222 vaccine developed by AstraZeneca and the University of Oxford were suspended following the appearance of myelitis in one of the participants from the United Kingdom. Only after (a) an independent committee of neurologists had concluded that the myelitis was idiopathic and (b) equally independent regulatory agencies had given their approval were the trials allowed to resume.

Q11. Is there any danger in vaccinating someone who has previously had Covid-19 or been asymptomatically infected by SARS-CoV-2?

In phase 3 trials for the Pfizer-BioNTech, Moderna and AstraZeneca vaccines, it was that over a thousand volunteers who were shown to have had previous SARS-CoV-2 infection received at least one vaccine dose during the trials. Within the limits of this volunteer population, there was no signal of poor tolerance or occurrence of severe COVID19.

Q12. Once a certain threshold of vaccine coverage has been attained, will circulation of the disease be limited?

During the initial phases of the vaccination campaign, the objective will be to protect persons at risk of complications and, a fortiori, to avoid deaths and hospitalizations. Prior to the emergence of “variants” of the virus, it appeared that herd immunity could be reached once 60% of the population would be immunized. The emergence of more transmissible variants is liable to increase the proportion of immunized persons necessary to effectively achieve “group effect”, which would indirectly protect individuals who could not be vaccinated, and possibly bring the epidemic to a halt.

The article sources answers from “The official Journal of the college of family physicians of Canada” and “Infectious Diseases Now”.

Samiullah Bhat is a Final Year Medical Student.