#BTColumn – Shall we take it or leave it?

Disclaimer: The views and opinions expressed by this author are their own and do not represent the official position of the Barbados TODAY Inc.

by Dr. C.V. Alert

While Barbadians sit comfortably knowing that over 63 500 individuals have gotten the first dose of the two-dose Oxford AstraZeneca anti-COVID-19 vaccine, far more than most of our Caribbean neighbors, one cannot escape some skepticism, especially coming out of Europe, about the safety of this vaccine. Indeed, some countries, even while suffering hundreds (and sometimes thousands) of deaths daily due to COVID-19, have suspended vaccination campaigns with this brand of the anti-COVID-19 vaccine.

Fact No. 1: at the time of writing (4/5/2021) COVID-19 (and its variants) have affected over 123 million persons globally, and has killed almost 2.9 million of them, about 2.35 per cent of those known to be affected.

The disease is especially severe, and in many cases fatal, in those affected by the non-communicable diseases, the same group of individuals who were dying here prematurely even before COVID-19.

It seems unfortunate that COVID-19 is just speeding up the rate of deaths in this population. The various brands of anti-COVID-19 vaccines all seem to share the property of reducing an individual’s chances of developing severe disease, of needing hospitalisations (good to know when our hospital is already overfilled), and Intensive Care admission.

Fact No. 2: While we are yet to learn, through ongoing surveillance, the full spectrum of side effects that may develop after receiving the Oxford AstraZeneca vaccines, the medical profession still think we will have a better chance of treating any side effect that may show up than ‘bringing back people from the dead’. This is one scenario in which we can’t “Build Back Better”.

In the UK, where the Oxford AstraZeneca has been distributed since early December 2020, and up until mid-March 2021, there were four deaths from rare blood clots, the only possible important side effect noted up to this time.

This was out of the 15.8 million persons who got at least one dose of the Oxford AstraZeneca vaccine. In that same period, 2.5 million persons there caught Covid-19, and 63 082 died.

By these numbers alone, the benefits of this vaccine outweigh the risks.

The focus in the press on the concerns about the Oxford AstraZeneca vaccine, while understandable, threatens to undermine efforts to get as many people vaccinated as soon as possible.

Fact no. 3: There is no guarantee that any of the other vaccines will be available to Barbadians anytime soon.  The efficacy of the Oxford AstraZeneca vaccine is 76 per cent after the first dose against symptomatic infection; it increases after the second dose 8-12 weeks later.

This is lower than the 90 per cent reported for the Pfizer BioNtech and Moderna vaccines, but there are significant financial and logistic reasons why those vaccines are not available to ‘third world’ countries like ours. We must “cut one’s coat according to one’s cloth”.

If the numbers of persons who refuse to take the vaccine, as they are legally allowed to do, remain substantial, then the virus would have a large number of persons to potentially affect. Of course, that is a personal life of death decision.

But we know that COVID-19, when left unchecked in a population, gives rise to a number of mutations. These mutations have scientific names, like VOC 2020/01, 501Y.V2; ‘geographic’ names, like the Brazilian variant, the South African variant, the UK variant, the California variant, and others. These various mutations seem to have different degrees of infectivity and transmission.

But if the virus is allowed to ‘stick around and mutate’, it may evolve into a form that the vaccines available now do not protect against.

In some states in the US, we are seeing a sudden surge in the number of cases of serious disease in younger unvaccinated people, who previously seemed relatively immune to COVID-19.  This has raised the possibility that they are now seeing “COVID-21”, a mutation of COVID-19.

It is unclear, at this point, how effective our current vaccines would be against these current or subsequent variants. This may mean that some of us who have gotten our Astra Zeneca vaccines may still be affected by a mutation of COVID-19 in the future.

At the moment, the demand for vaccines outstrips the supply, and this situation may persist for some time. If it does, then we will still have large numbers of people who have not been vaccinated, and serve as a reservoir for the virus. In this scenario, COVID is here to stay.

We may one day get to the point where the supply of vaccine outstrips the demand, and many people may choose to decline the vaccine, as is their fundamental human right.  This is the group that needs special targeting by a variety of health officials, if we hope to achieve herd immunity, and return our way of life to pre-pandemic activities.

Thus a population vaccination programme, in addition to current preventative protocols – Wash your hands, Wear your mask, Watch your (social) distance – is a necessity both to keep people alive, and to reduce the number of infections in circulation.

“United we stand, divided we fall” should be our motto going forward. As a community, taking the vaccine is probably the best option.

Dr. C.V. Alert, MB BS, DM. is a family physician.