Those All Singing and All Dancing vaccines again: just think what we will be able to get up to when we have all been vaccinated!

…by Dr Priscilla Robinson,(retired Epidemiologist and member of SGH Board)
A couple of weeks ago I went along to the Medical Centre, and had the first of my free Covid vaccinations (hooray!). Did it hurt? Only a teeny bit. Did I have any after-effects? Yes; but although I felt very ordinary for a day or so I was rather pleased because it means my immune system, over which I don’t have much control – other than to eat healthily, sleep well, and exercise as much as I can – has made a good response to the vaccine. And COVID-19 is definitely high on the list of illnesses I don’t want to get! `A month before that I had my annual ‘flu shot at the drive-through clinic, and a couple of weeks before that a booster pneumonia vaccine, all without side effects. Then I breathed a huge celebratory sigh of relief that these are health problems I don’t have to worry about for a while, and sent a massive if silent dose of thanks to all of the scientists and medical staff who make this possible.

Worldwide, there have now been more than one BILLION doses of COVID vaccine given, and about 10% of the world has now had one dose. Two approved vaccines are now being used in Australia, AstraZeneca (AZ) and Pfizer. We are lucky that Australia is using very effective vaccines: AZ and Pfizer turn out to be as good as each other, with a very similar overall safely record. They protect equally against the disease, and if people do get the COVID illness even one dose of vaccine reduces the risk of having the worst effects, especially being sick enough to need to go into ICU. How do we know this? Well, apart from all that Phase 4 monitoring, an interesting study from the UK which followed nearly 700,000 people for some time before being vaccinated showed that side-effects were more common after the first AZ dose, and second Pfizer dose – and younger people reported more than older folks, and women more than men. This is an important study, because by following people for months before being vaccinated it is possible to filter out the effects of generally circulating coughs and colds and other infections including COVID (remember, this study was done in the UK, where they have quite a lot of it). Many people, I know, are still very worried about the unusual CVST blood clots, which is understandable because the media only ever seem to report a little bit of the story (the scariest bit). Yes, a small number people out of those three billion have had very specific CVST blood clots associated with the vaccine (not the same as the usual blood clots our doctors see every day – these are no more common with the vaccine than without). These clots happen in one in 50,000-250,000 people who have the vaccine. How I wish the press would report that out of every 50,000 (or more) people who had the vaccine, 49,999 DEFINITELY DID NOT HAVE BLOOD CLOTS!! This is actually lower that the rate of these clots in normal times (See https://www.hopkinsmedicine.org/health/conditions-and-diseases/cerebral-venous-sinus-thrombosis for more information.) Compare that with the COVID fatality rate – just over 2% – so out of 100,000 cases of COVID19 we know that about 2,000 will die, including from CVST clots, and many more will end up with long-term problems.

The story of the scientific miracle that has been the production of these vaccines in such a short time is to be celebrated, and the scale of the risk of CVST blood clots from vaccines compared with disease put into real perspective. But I suppose that would not sell many papers …In Australia, nearly four million vaccine doses have now been given, and although exact figures are not available these have mainly been AstraZenica. Of course, some side effects have been recorded. The Therapeutic Goods Administration (TGA) which looks after the safety of medicines in Australia has a running report on COVID vaccine side-effects which you can read about – it is not secret – at the TGA website: (https://www.tga.gov.au/periodic/covid-19-vaccine-weekly-safety-report-20-05-2021). We cannot keep COVID out of Australia for ever, and we all know that from time to time we have an outbreak from hotel quarantine and so on, as we have right now in Melbourne. We are back to social distancing, hand hygiene and masks, things we have been a bit relaxed about recently. So back to elbow bumps, using the hand gel when soap and water is not to hand, and please, please wear that mask over your nose as well as your mouth – or you might as well not bother!

We have been rather lucky in Australia compared with many countries, so for most of us it does make the risk of getting COVID seem remote. But, unless we are all prepared to stay at home and not allow anyone to travel for any reason at all, for ever, we have to find better ways to protect our community than just relying on it not arriving here. Much better to have a day feeling a bit off than having life-as-usual derailed by a major infection. Just one year ago people were describing COVID as being a bit like ‘flu. Well, whilst real ‘flu is certainly not at all pleasant and comes with a range of its own problems. As time has gone on, we see that for people who get sick COVID is clearly worse than flu with many very nasty after-effects, many of which have only become obvious as time has passed, such as ‘long covid’. These vaccines are clearly safe and much, much safer than getting COVID.

None of us is fully protected until we are all protected. So, the message is that nobody should wait for a specific vaccine because it might never be available, they are as effective as each other, and have much the same rate of side effects. The sooner we are all vaccinated the sooner we can do all of those things we have been unable to do for so many months – and I for one am really looking forward to that. Please, do it! Book now.