health

'I'm an infectious diseases expert. Now is not the time to wait for a vaccine.'

A couple of months ago, I started having conversations with friends about getting their COVID-19 vaccine.

Most had already been, were keen to be vaccinated, or had made appointments. 

However, a few were quite hesitant and had delayed their jab.  

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At the time of these discussions, there were few cases in Australia. But as the last two months of outbreaks across the country have shown, it can all change so quickly. 

Lockdowns and other restrictions are short-term solutions. 

There is a path out of this chaos and uncertainty. We have safe and effective vaccines. They are the closest thing we have to a silver bullet. It simply requires most of the population to get vaccinated.  

COVID-19 vaccine hesitancy is a major obstacle to this goal of ‘herd immunity’. 

Some people have the opinion that the available vaccines were developed too quickly. 

Others seem to think that the risk of death or serious long-term illness from COVID-19 is more palatable than the risk of a rare vaccine side effect. 

Some mistakenly think there is no risk of getting COVID at all. Let’s explore the facts:

COVID-19 vaccines are based on decades of groundwork

What might seem like an overnight discovery to the rest of the world is actually the product of years of painstaking, highly technical and innovative work.

COVID-19 vaccines are based on decades of research in the context of other infections. 

For example, Sarah Gilbert, the Oxford scientist behind the AstraZeneca vaccine, cut her teeth in the 1990s developing malaria vaccines and conducting clinical trials in the UK and Africa. 

Until COVID-19 came along, Gilbert’s team were developing vaccines for other diseases including Ebola and MERS (also caused by a coronavirus). 

When the genome of the COVID-19 virus (SARS-CoV-2) was released, Gilbert’s team were able to quickly design the new vaccine, literally over the weekend. 

There is no time to delay when a pandemic is unfolding.

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COVID-19 vaccines are safe and effective

A common misconception is that corners were cut with the COVID-19 vaccine. 

While it was a race to find a safe and effective vaccine, all approved vaccines have undergone the same rigorous safety testing and regulatory processes of any medicine approved for human use. 

Compared to other vaccines, COVID-19 vaccines had what could be considered a dream run, with no funding obstacles or red tape delays. 

The global urgency meant the billions of dollars of funding and partisan political support removed all barriers that typically slow down vaccine development. 

Early results were promising, so production and regulatory procedures began simultaneously as data was still being collected, and different phases were run concurrently. 

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High infection rates gave the required numbers of cases within months and most importantly, results showed stunningly high (up to 95 per cent) efficacy against hospitalisation and death. 

These trials included tens of thousands of people in multiple countries - the largest trials to have ever been run. 

As vaccines roll out around the world, at least for the AstraZeneca and Pfizer versions available in Australia, ongoing monitoring shows that efficacy is even higher than in some of the trials, and side effects remain rare and temporary. 

These vaccines have been rolled out not because they are the only vaccines developed, they have been rolled out because they are the vaccines that have consistently proven to be safe and effective.

Side effects need to be balanced with the benefits

Most vaccine side effects are minor and short-lived. 

Concerns tend to focus on the rare blood clotting condition thrombosis with thrombocytopenia syndrome (TTS), which has been observed after the first dose of AstraZeneca in around 1 in 50,000 women under the age of 50 (and lower in older age groups). 

However, blood clots can occur at any time at a rate of up 1 in 10,000 women aged 15-44 each year, while the contraceptive pill increases that risk up to tenfold to 1 in 1000

AstraZeneca has been approved by the TGA, (the Therapeutic Goods Administration) for use in people over 18 years of age. 

When ATAGI (the Australian Technical Advisory Group on Immunisation) recommended to restrict AstraZeneca to over 60s, it was weighing a miniscule risk of TTS against the risk of becoming unwell with COVID-19, which was negligible in Australia at that time. 

This recommendation undoubtedly increased vaccine hesitancy, even against vaccines other than AstraZeneca, and in older age groups in which the blood clot risk was even lower. 

Media reporting further reduced confidence in AstraZeneca, the same vaccine that is approved for use in 181 countries and applauded overseas for its overwhelming successes. 

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How do vaccines work?

Vaccines trick the immune system into thinking you’ve got an infection to induce an immune response. 

You will not get COVID-19 from a vaccine. You may have some flu-like symptoms but that’s just your immune system developing the responses needed to protect you from COVID-19. 

Vaccination results in a substantial reduction in risk of infection, but you can still get infected. 

If you do get infected, almost all vaccinated people are protected from severe symptoms, hospitalisation and death.

There is also increasing evidence that vaccination prevents transmission to household contacts. 

So, if vaccinated, you are not only protecting yourself against getting sick from COVID-19 you are potentially protecting your loved ones. 

If enough people in the community are vaccinated, these effects combine and eventually we expect less spread in the community and a reduction in infections overall. This is ‘herd immunity’, a kind of economy of scale.

The risk-benefit equation is changing

Recent outbreaks are forcing the Australian population to re-evaluate their risk appetite, with many overcoming their vaccine hesitancy and wanting to do their bit to bring the pandemic to an end. 

It is recommended to obtain advice from a GP in order to weigh up the risks and benefits for yourself.  

The onus is on each of us to take the time to educate ourselves and make an informed decision, we owe it to ourselves, we owe it to our loved ones, we owe it to our fellow Australians, and we owe it to humanity to find a pathway through this pandemic with as little further death and illness as possible.  

Roll up your sleeves!

Worldwide, more than 2.8 billion people are now fully vaccinated against COVID-19. 

Severe disease and death due to COVID-19 in other countries where vaccination rates are high, are now predominantly in the unvaccinated. 

Data is also showing long-term symptoms (long COVID) even from mild cases, and unlike severe COVID, long COVID doesn’t seem to discriminate between young and old. 

If you are in the ‘wait and see’ camp, now is not the time to wait.

You will need to be vaccinated eventually, especially if you want to travel, and maybe even to go to a restaurant, the theatre or a concert. 

It may take a while to get an appointment, and when you finally decide you will go, you may be in a much longer line. 

So, if you are eligible, take up the chance now, book your appointment and roll up your sleeves!

Professor Alyssa Barry is Professor of Systems Epidemiology of Infection at Deakin University and Honorary Principal Research Fellow at the Burnet Institute in Melbourne where she leads research on infectious diseases including malaria, Buruli ulcer and COVID-19.

Feature Image: Getty.