The V Word (Vaccination)
Such a strange & unprecedented time we live in, where saying the V word can create automatic tension in a conversation; testing family ties & potentially ruining friendships. The opinion & politics around a known public health approach is really hard to watch play out in real time.
Instead of marveling at the absolute miracle of creating a vaccine in record time, we question the very thing that will help us out of being dictated to by an invisible enemy. Armchair experts have come out in droves much like they do every 4 years to comment on where the equestrian rider lost points in the Olympics. Public Health or the Olympics- there is a large difference between opinion & expertise in any area. You wouldn’t walk straight to the cockpit of a plane. You wouldn’t grab the spanner off your mechanic. These experts have spent years (& sometimes lifetimes) honing their skills to be the best in their business. So why do we turn to social media groups & anecdotal hearsay to understand the health predicament we are in?
What is a vaccine & how do they work?
A vaccine is a stimulant to our antibody production which gives our body an ‘introduction’ to what they may need to look out for in the near future. It is usually an inactive form of a disease to provide an immune response so we are better equipped to fight it in the future. Our immune system is amazing but some viruses need a host to thrive. This becomes a battle between us getting on top of the virus & it mutating to hold onto any host (us) it can. As painful as it is to admit, for some situations, our immune system just isn’t good enough. Yes, you can put yourself in a better position to fight it by being active & young but it only helps to a certain point. It’s like breaking your leg & instead of taking yourself to hospital to get it fixed you assume that it will fix itself. Same situation, less graphic!
Let’s understand how far we’ve come with Vaccines-
Australia has one of the most comprehensive immunisation systems in the world. These overall vaccine programs have been one of the most successful medical advancements for reducing both deaths & living with an infectious disease. We are in a time where we are lucky enough to take this for granted. We shouldn’t take vaccination for granted & here’s why:
· Since Rotavirus vaccination was introduction in 2007, the rate of hospitalisation for children under 5 has dropped 70% from the 10,000 per year. This is approximately 7,000 children PER YEAR who have avoided hospitalisation due to vaccination.
· In 2018, the WHO officially declared that Australia had eliminated Rubella. Gone due to a vaccination program.
· Since the launch of a WHO campaign in 1959, Smallpox was officially declared eradicated in May, 1980.
· Australia was declared Polio free in the year 2000. The fact that some people under 30 have never heard of this word is testament to vaccines success.
The flipside of the coin- The importance of quashing misinformation.
In 1998 a paper was published linking the MMR vaccine to autism. Twelve years later, this paper was rejected & retracted from publication but the damage had already been done. Families questioned this decision for their kids & rightly so. In 2014, a meta-analysis confirmed there is no association between MMR vaccine & autism. I can guarantee that this rumour is still floating around within pockets of the community. You can see the ripple effect that 1 paper can cause, let alone opinions & rhetoric through online forums.
If it’s so successful, why so much confusion with the Covid roll out?
· Vaccine approval process & turnaround time- There are three stages of testing for a vaccine before we would see it publically available. Regarding a full approval from the TGA, this takes some years & this is where people may have questions. Understandable but there are two options; trust the process of testing stages & get roll out started OR wait 2-3 years for approval & have a lot more cases & deaths.
· Vaccine coverage- As with any vaccine, there are pros & cons & they don’t always provide 100% coverage. This is confusing but the important points are that we can significantly reduce the spread, likelihood of contracting Covid as well as hospitalisation from it. It’s like a line of defence in football. Likely to stop tries & they sometimes still happen but much less frequently than if no defender stepped onto the field.
· Botched roll out- this is more of a political space & potentially a different discussion. From a public health perspective, we had months to prepare for an inevitable second wave & we have got to a stage where we are racing around reactively instead of proactively.
· Lack of educational campaigns- this has been one of the hardest things to watch fall by the wayside as someone who works in the public health space. Again, we had months to educate our population about what vaccines are & what the Covid vaccine will mean for us, our families & our nation. This is partly to blame for so much confusion, anger& frustration around the vaccine. Also didn’t really help the rhetoric of “aw I’ll wait until others get it first” vibes that we saw at the start of the year. I fully understand that. Why would we want to step forward for something when we have no clue about how good it can be for us & our community & no real context of the risks? Some people & organisations have dropped the ball here & you don’t need too many guesses as to who they are.
So what’s the overall point of a Covid vaccine?
As mentioned by a number of authorities in the past few weeks, the vaccination rate we need for Australian to return to some form of normalcy is around the 70% mark. This is an estimated guess by the leading doctors & researchers based on how contagious Covid19 virus is. We are lucky at this stage that the spread isn’t as contagious as something like Measles which needs a vaccine coverage rate in the community of 95%.
Regarding herd immunity. This is a conversation I’ve tried to put into context in the past few weeks. There is two ways of doing it. One is through a vaccination program where we introduce an immune response to people without having the effects or spread of the virus. The second way is through letting the virus spread naturally through the community until most of us have had it. This is a super dangerous approach & here’s why:
For people who argue that the virus only kills 1% of the population, it may not seem like much but here are those numbers in context.
· Australia has a population of 25.3 million people.
· 1% of 25.3 million is 253,000
· Our current deaths from Covid-19 are 924
· That leaves a whopping 252,076 we would be willing to sacrifice to obtain herd immunity?
Don’t take low numbers as an opportunity to downplay the virus. Look at the public health measures in place which have keep them relatively low. Any death from Covid is devastating. Any health effect that is a result of these shit lockdowns are devastating. No legitimate public health professional would discount this. It’s not a trade-off between a topic like Covid cases & mental health. It’s more complex than that. It’s an understanding of how much strain the whole system is under & without address Covid, the rest of the dominos fall as well.
I have had a lot of exposure to how the machine runs from the back end of contact tracing. There is a lot the community aren’t privy to (& there isn’t a need to heighten awareness or panic). I wish that I could bring people into my work to see the measures put in place to try & fight this virus. For every case number you see, there are countless hours, resources & people power to try & sever community transmission. Sometimes we fail at that but this is a large battle we face & it’s not easy.
What’s the best case scenario off the back of our fight with Covid19?
If the community think we have completely overreacted to the virus, this is a success. Putting in countless hours & leaning on Public Health Policies will all be worth it in our minds even if every Australia thinks we were wrong. When transparency continues to come to light & negative debate starts to subside, I really hope communities understand this was in their best interest from a public health point of view. Could things have been done differently to prop up certain community groups? Yes probably. Could there have been a better system in place for economic aid? Yes, probably. There is a lot happening in the political space of Covid19 but trying to answer complex questions with a simple black & white answer doesn’t solve the problem & this is what we tend to see on a visually appealing social media post.
If this article doesn’t resonate with you, that’s OK. I appreciate people have their own opinions & choices. The reality is that we need ~70% of our choices as Australians to get vaccinated. If in a years’ time, you think “what was all the fuss about. I didn’t get the vaccine & I’m fine.” Firstly count yourself lucky you live in a country where there are decent enough public health practices that you didn’t contract the virus & secondly, thank the 70% of vaccination coverage we were able to achieve. It’s been a slow & stupid roll out but that’s the reason we are a little closer to being in the clear. This article isn’t aimed to be a political. It isn’t aimed to divide people further. It’s an information piece of what vaccines are from a public health perspective & how they relate to our current situation. Public health shouldn’t be political & that’s the point of this article.
In summary
Australian’s in the 1970s were pretty angry & frustrated that they needed to wear a seat belt when driving a car. This is still compulsory but outside of the law, you do have a personal choice whether to wear one. This is the stage we currently see ourselves in for Covid vaccine roll outs. In 10 years’ time, the community will have much more understanding of why we all had to do certain things in 2021. It’s been tough & no-one enjoys the restrictions or being stabbed with a needle (speaking from experience). The word Covid will be spoken many, many times in the future but hopefully with an understanding of vaccines, we speak of it less & less!
References:
Because this isn’t just my own opinion, please feel free to click through the below references for more context.
Top 10 Public Health Successes Over the Last 20 Years
Vaccination greatly reduces disease, disability, death and inequity worldwide
National Immunisation Program Schedule
Vaccine Testing and the Approval Process
One Hundred Years of Vaccination
Current Coverage Data Tables for All Children
How Covid19 Vaccines are Tested & Approved
Vaccine Development Testing & Regulation
A short history of vaccination campaigns in Australia and what we might expect with COVID-19