Refusing COVID-19 vaccine is a personal choice with public consequences, says expert at QF

Vaccines are widely considered one of human civilization’s greatest medical achievements – there is no medical intervention that has had more or even as much impact on improving health. Then why is there hesitancy among the public about the COVID-19 vaccine?

“Social media has played a big part in manufacturing this chaos; its shortened format means things are often taken out of context,” said Prof. Laith Abu-Raddad, Professor of Infectious Disease Epidemiology at Qatar Foundation partner university Weill Cornell Medicine-Qatar (WCM-Q).

A recent example is the news about the death of six participants of the Pfizer trial, which has been widely shared over social media. Many read only the headline – a rather misleading one – while the truth remained that among the six dead, four were in the placebo group i.e. injected with a saline solution instead of the vaccine, and only two were in the vaccine group. All of these deaths were due to reasons unrelated to the vaccine.

The biggest fear people seem to have stems from the speed at which the COVID-19 vaccines have been developed. Normal vaccine development time is measured in years, so then how have the COVID-19 vaccines been developed in less than a year?

“The mRNA technology used by the Pfizer and Moderna COVID-19 vaccines had been in development for several years. When SARS-COV-2 arrived, the mechanics of how the vaccine works were well understood. The technology was ready, it was just repurposed for COVID-19,” said Prof. Abu-Raddad.

The actual time it took to design the vaccines was very short – it took only days for the Moderna vaccine to be developed. All the rest of the time has been spent on ensuring the vaccine is safe through rigorous large studies and clinical trials.

Prof. Abu-Raddad said it isn’t wise to compare the development of this vaccine with those in the past. “Simply because the severity of this pandemic is incomparable to anything we have seen in a long time. The resources, both monetary and technological that went into making the development of the vaccine a top priority, are unprecedented.”

Typically, lack of funds and low number of participants mean it can take years to recruit and test enough number of people required to execute large clinical trials. However, because of how wide-spread and serious COVID-19 has been, with its large adverse consequences on society and economy, not only were emergency funds made available, but also patient recruitment was extensive and completed in a matter of few weeks.

“No corners have been cut in the interest of time. The urgent need for the vaccine ensured it happened in an extremely efficient manner.”

Another major concern is long-term side effects. Clinical trials of both vaccines followed participants for two months, but is this enough to rule out long-term side effects?

“Historically, vaccine research tells us that if there are any serious side effects, they appear within the first few weeks. This is because side effects typically relate to the immune reaction to the vaccine which happens only in the first few weeks. As both the vaccine trials ensured that participants were monitored through the stage of immune reaction, i.e the first two months and no side-effects were reported, it is unlikely there will be long-term effects,” said Prof. Abu-Raddad.

“It really is about balancing risks – and factually speaking, the risk of contracting COVID-19 is much higher than the risk of side effects associated with the vaccine.”

Technically, the new mRNA vaccine design in principle should be safer than the earlier designs. Typically, vaccines consist of a weakened virus that kickstarts the immune system, which is not the case with the COVID-19 mRNA vaccines.

“These mRNA vaccines don’t actually contain the virus, they merely contain instructions that allow our cells to make a harmless piece of what is called the spike protein – found on the surface of the virus that causes COVID-19. This protein soon gets recognized by the immune system and it begins producing antibodies to generate an immune response, like what happens in natural infection against COVID-19, except without the involvement of the actual COVID-19 virus.”

When asked if Prof. Abu-Raddad would be taking the vaccine himself, “Absolutely yes – with no hesitation. I have two choices; one is taking a vaccine that has passed clinical trials with no safety concerns and is very likely to protect me. The other choice is staying unvaccinated and voluntarily increasing my risk to get seriously ill, possibly suffer from long-term consequences of the disease, and perhaps even die. The rational choice is to take the vaccine,” he said.

Prof. Abu-Raddad believes the choice to be vaccinated or not is a personal one. However, he adds: “This is beyond just a personal choice for the simple reason that it has direct consequences on public health. People who don’t get vaccinated need to fully realize the negative consequences their decision can have on vulnerable members of their communities. Refusing the vaccine will not allow us to develop herd immunity, causing more potentially preventable deaths.”

Public health experts say that at least 70 percent of any community must get vaccinated with a COVID-19 vaccine to achieve an acceptable level of herd immunity to protect its members.