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To Vaccinate Or Not? Facts Vs “Alternate Realities”

It is human nature to be inquisitive. In fact, our survival as a species depends on it. We have been the dominant species when it comes to food chain for
24 Sep 2021 14:59
To Vaccinate Or Not? Facts Vs “Alternate Realities”
A COVID-19 vaccine. Photo: Leon Lord

It is human nature to be inquisitive. In fact, our survival as a species depends on it. We have been the dominant species when it comes to food chain for a whopping 300, 000 years and, provided we do not implode and destroy our life sustaining mother earth, we will feasibly continue with the status quo for many years more.

Our time on earth pales in comparison to the existence of earth itself, which is estimated to be around 4.5 billion years, give, or take 50 million years! Suffice to say, even for the most sophisticated philosophical thinkers amongst us, these timelines are overwhelming.

In the fraction of the time, we have existed as humans in the greater context of the existence of our planet Earth itself, we have done remarkably well as a species to not only make it to the top of the food-chain but become custodians for all the other species that we co-exist with today.

Our innate ability for self and species preservation has ensured this survival with our ability to evolve and adapt being the key. Certainly, other species that didn’t adapt to change are now extinct. We should therefore be eternally grateful as a species, to our creator for the tools of adaptability ingrained into us.

Abraham Maslow, American Psychologist of Russian origins, in 1943 beautifully summarized Human motivation. He created a classification system which reflected the universal needs of society as its base and then proceeding to more acquired emotions and this is known as Maslow’s hierarchy of needs.

 

Basic needs

Our basic needs such as our physiological needs for food, water and shelter must be satisfied first before our need for safety and security starts to take precedence. Once the safety needs are satisfied, we then have a need for love and social belonging. Once we feel loved and have a sense of belonging, we can then develop a need for self-esteem. Upon satisfaction of our self-esteem needs, we can then aspire to the higher needs of actualization where we can realize our full potential. Understanding Maslow’s hierarchy of needs is the key in our understanding of individual, group and community behaviors and motivation.

The basic needs must first be sufficiently met before we can then aspire to the higher needs of actualization and realize our true potential. To put it in another perspective, individuals or groups who are struggling to meet their basic needs will only be thinking about self-preservation.

Only when these basic needs are met on a consistent basis, will an individual or group then be able to think beyond the self and for the good of the population.

Humanity has faced and overcome many challenges and we will certainly encounter many more challenges which we will have to overcome. Thanks to science and innovation, the overwhelming majority are now able to satisfy their basic needs in a clockwork fashion and now, more than ever, we have the greatest number of humans fully realizing their potential and innately changing the world.

One challenge we are facing right now is COVID-19. Because of the infectious nature of this disease and the inter-connected nature of the world, it is a problem for our entire humanity and the solution will not be for groups of people but for humanity. Here again, we must rely on science and medicine to help us get through this challenge.

 

Response to the virus

In response to the virus, Doctors and Scientists all over the world have been able to collaborate in unprecedented levels and in a record time to produce one of the most important ammunitions in the form of effective vaccines that will play a significant role in helping us overcome this challenge. Our human nature dictates that anything new must be questioned because our survival may depend on it. So, I will try and briefly explain how a vaccine comes into existence.

Most vaccines have been in use for decades, with millions of people receiving them safely every year. As with all medicines, every vaccine must go through extensive and rigorous testing to ensure it is safe before it can be given to people. The first stage in vaccine development is known as the preclinical phase and here the vaccine under development must first undergo screenings and evaluations to determine which antigen should be used to invoke an immune response.

 

Preclinical phase

This preclinical phase is done without testing on humans. An experimental vaccine is first tested in animals to evaluate its safety and potential to prevent disease. If the vaccine triggers an immune response, it is then tested in human clinical trials in three phases.

  • Phase 1 is where the vaccine is given to a small number of volunteers to assess its safety, confirm it generates an immune response, and determine the right dosage. In this phase vaccines are tested in young, healthy adult volunteers.
  • In Phase 2, the vaccine is then given to several hundred volunteers to further assess its safety and ability to generate an immune response. Participants in this phase have the same characteristics (such as age, sex) as the people for whom the vaccine is intended. There are usually multiple trials in this phase to evaluate various age groups and different formulations of the vaccine. A group that did not get the vaccine is usually included in phase as a comparator group to determine whether the changes in the vaccinated group are attributed to the vaccine or have happened by chance.
  • in phase 3, the vaccine is given to thousands of volunteers – and compared to a similar group of people who didn’t get the vaccine but received a comparator product – to determine if the vaccine is effective against the disease it is designed to protect against and to study its safety in a much larger group of people. Most of the time phase three trials are conducted across multiple countries and multiple sites within a country to assure the findings of the vaccine performance apply to many different populations.

During phase two and phase three trials, the volunteers and the scientists conducting the study are shielded from knowing which volunteers had received the vaccine being tested or the comparator product.

This is called “blinding” and is necessary to assure that neither the volunteers nor the scientists are influenced in their assessment of safety or effectiveness by knowing who got which product. After the trial is over and all the results are finalized, the volunteers and the trial scientists are informed who received the vaccine and who received the comparator.

When the results of all these clinical trials are available, a series of steps is required, including reviews of efficacy and safety for regulatory and public health policy approvals. Officials in each country closely review the study data and decide whether to authorize the vaccine for use. A vaccine must be proven to be safe and effective across a broad population before it will be approved and introduced into a national immunization programmed.

The bar for vaccine safety and efficacy is extremely high, recognizing that vaccines are given to people who are otherwise healthy and specifically free from the illness. Even after approval for use is given, further monitoring takes place in an ongoing way after the vaccine is introduced.

There are systems to monitor the safety and effectiveness of all vaccines. This enables scientists to keep track of vaccine impact and safety even as they are used in many people, over a long-time frame.  These data are used to adjust the policies for vaccine use to optimize their impact, and they also allow the vaccine to be safely tracked throughout its use.

The COVID-19 vaccines currently being administered to our beloved nation have undergone all the scrutiny described above and have been approved for emergency use by health watchdogs such as the World Health Organization and European Medicines Agency.

Their effectiveness continues to be monitored in the real-world situation and that data enables the medical fraternity to keep abreast of any adverse reactions.

There are collaborative weekly updates released by the Royal Children’s Hospital and The University of Melbourne from cumulative data regarding the vaccines from across the world which is helping us get a true picture of the real-world effectiveness of the COVID-19 vaccines. It is encouraging to see that the AstraZeneca vaccine currently used in Fiji is highly effective against the delta variant wreaking havoc in Fiji. If you are fully vaccinated, not only is it 92 per cent effective in preventing severe disease, hospitalizations, or death, but also up to 70 per cent effective in you acquiring COVID at all.

This is really encouraging as we can be hopeful that getting the critical mass of people vaccinated will then protect the vulnerable amongst us who cannot be vaccinated. The more people who are eligible vaccinate, the higher the protection rate of the vulnerable amongst us who cannot be vaccinated.

Since the advent of vaccines, there has been vaccine hesitancy. This phenomenon will always exist.

With the advent of social media, people around the world are now more interconnected than ever. As with anything new, a more sinister dark side often becomes apparent later. For social media, these are “alternative truths” whereby conspiracy theories run rife. 2018 MIT Sloan research about social media and fake news, found that false information was 70 per cent more likely to be shared than information and reach the first 1500 people 6 times faster! This means that social media platforms are fertile grounds for influencing an individual to make an unwise decision.

 

Challenge for health Professionals

The challenge for health Professionals today is not only producing solutions for health problems but to also convince the very people for whom the medical solutions are created, to believe that it is for their good.

The value of extensive public education tapping into the principles of Maslow’s hierarchy of needs cannot be overstated. Multi sectoral collaboration and constant advocacy to our people to make the right choices for their health is of vital importance if we are to win this war against COVID.

 

 



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