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How to Deal with Vaccine Hesitancy

The baby is coughing, gagging, gasping for air as I enter the exam room. I see him sitting up and leaning forward, his little ribs showing with every breath, too tired to even cry. He has whooping cough, a once common childhood disease now rarely seen thanks to childhood vaccinations. In the ER we quickly got to work, giving oxygen, X-rays, drawing blood, and starting IV antibiotics, as the parents guiltily looked on knowing that vaccinating their child could have prevented this.

Why is vaccination such an emotional topic? Recently friends have confided in me that they feared visiting their families in the U.S. due to refusals to be vaccinated and the rise of Covid variants.

Arguing with them, pleading with them, threatening not to visit did not seem to make a difference. I admit, having seen my front-line colleagues get sick, suffer long term side effects, and even die from Covid, I have a difficult time reconciling their stance, but I am trying to understand their point of view and clarify some common misconceptions.

The first step is to address their concerns – and to treat the person with respect. Having concerns is legitimate. Be curious. Accusing them of “not caring about me/my family/others” or of being anti-science is not likely to bring about understanding or change anyone’s mind about getting vaccinated.

The official messaging around vaccination has been the idea of collective responsibility – that it benefits everyone to reach at least a 70% vaccination rate to achieve “herd immunity”. While this may resonate with some, the perceived personal risk outweighs this “greater good” mentality for others. It may be more effective to appeal to how the Covid vaccine can help protect their immediate family and themselves personally, as they begin to travel and interact with more people, especially as more infectious and deadly variant strains are on the rise.

In order to make an informed decision, it’s imperative to arm ourselves with the facts.

Here are 8 questions and perceived risks around the Covid vaccine.

1) Can I get Covid from the vaccine?

No. The vaccine does not contain the virus, so it cannot cause an infection. It contains mRNA which codes for proteins that guide our immune cells to attack the virus. This mRNA fragment cannot enter the nucleus or become incorporated into our own DNA.

2) Can the vaccine cause infertility?

No. The vaccine creates antibodies against the protein spike around the coronavirus so that our immune cells can specifically target it. It cannot attack our own reproductive system and there is absolutely no evidence to indicate that it can affect fertility.

3) What if I’ve already had Covid-19?

It is recommended to get the vaccine even if you have had Covid in the past, as it is unclear how long immunity lasts after getting Covid.

4) Will the vaccine turn my PCR test or Antigen test positive?

No. Tests for Covid infections check for viral RNA or proteins in the saliva or nasopharynx. The mRNA and proteins created by the vaccine are rapidly degraded near the injection site, leaving only the antibodies that can mount an immune response if it encounters the virus.

5) Are the vaccines effective against Covid variants?

Yes. The Pfizer, Moderna, and AstraZeneca vaccines are highly effective against variants, including the currently predominant Delta variant, preventing hospitalization by 92-96%.

6) Did they take shortcuts with vaccine development?

No. The mRNA vaccine is not new. Scientists have been developing this technology for the last 14 or so years, with other coronaviruses like SARS and MERS – and they are now working on mRNA vaccines for HIV and even cancer. When Covid-19 came along, the viral RNA was quickly sequenced and so existing technology was rapidly adapted to the current outbreak. The reason why the vaccine became available in record time was because there was a huge outpouring of funding from various governments, no shortage of volunteers (10 times the usual clinical data was collected), and so the vaccine was released with high confidence that it was safe and effective.

7) Why shouldn’t I just “wait and see”?

It’s tempting to think “I’d rather wait and see if there are any problems” or “I should let other people more vulnerable than me to be vaccinated first”. The truth is, we are in a race against time to stop the virus from mutating. The new variant strains are more deadly and infectious, and the current available vaccines are effective against these strains. The more people who are vaccinated and protected against what is circulating now, the less opportunity there is for the virus to keep spreading and changing to outsmart the vaccines.

8) What about the side effects of the vaccine?

Although it’s very rare to have any serious side effects, this is one common reason people fear getting vaccinated. Studies have shown that only one to five in every one million people vaccinated have a serious allergic reaction. Side effects are mainly redness or soreness at the injection site, mild headaches, fatigue, and body aches. Remember, these symptoms are not the effects of the virus (the vaccine is virus-free) but your immune system’s response to the vaccine. Most side effects occur within the first 6 weeks of inoculation, and to date there have been over 3 billion doses of vaccine delivered worldwide, so there's really not much to "wait and see". It is safe to say that the benefits far outweigh risks of these side effects in order for you to be protected and for the virus to finally disappear.

For more information on how the vaccine works, I found this cool little video that explains it well.

Treating this baby with whooping cough is deeply etched in my memory, and I’m sure his parents never meant for this to happen. But getting angry with the parents for what they thought at the time was best for their child would not have solved the issue. Rather than confronting those that are vaccine hesitant with anger and frustration, try to be curious as to why they feel this way and have differing thoughts about vaccination. In the end, it is a personal choice, but one that should be made based on science and facts, not on rumors and fake news.

The more people get vaccinated, the sooner we will reach “herd immunity” where the virus is no longer spreading easily from person to person. Then we can all get back to doing the things we love – team sports, going to the theater, traveling, hugging our grandparents – safely, and without fear.

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