I got so excited about getting my vaccination, I decided to write this article for our local newspaper, rather than the one I was planning for this issue. Getting my jab makes it possible for me to do a long-planned hike in the Northern Territory, and under the new rules, I’ll be able to quarantine at home on the farm if things go pear-shaped while I’m away. We’ll return to the Biodiversity series for the July edition. The image above is from the Larapinta Trail, where I’m, headed for my hike. Image is copyright from David Houlder, used by permission. Nan
One thing health professionals around the world seem to agree on at the moment is that the virus is far from done with us. Ironically, the fact that in Australia we’ve dodged a major outbreak makes us doubly vulnerable—we have herd complacency in place of herd immunity, as only a tiny fraction of Australians have immunity as a result of catching COVID-19.
As Spenser, my favourite fictional private eye, is fond of saying, sometimes it’s better to be lucky than good. Our (mostly) closed borders have mostly protected us, but we’ve also been lucky, and that can change in the blink of an eye. All it takes is the bad luck of a trickier variant or a missed case of community spread. Our herd complacency could easily allow us to underestimate the urgency of getting the whole country (and globe) vaccinated.
With the advent of vaccines that are widely available, vaccination is certainly now the front line in the battle to tame the virus, both in the relatively short term, and in the longer-term war to tame the variants.
The decision to get a vaccination, though, is a highly personal one. Clearly articulated information can help, but at the end of the day, each of us needs to feel comfortable with the choices we make.
There’s a lot of uncertainty in this picture. This should not be surprising, as humanity as a whole is going where it has never gone before. Science can give us guidance, but can’t always provide definitive answers.
While much of the discussion in the news has focused on risk vs reward, I’ve come around to thinking that’s not a particularly useful way to cast the issues. Basically, there are two real worries: COVID -19 itself and side effects of the vaccines. Everything else is a matter of how best to protect the vulnerable people in our communities, prevent widespread surges in the disease and minimise the development of variants of the virus, which can be more virulent, more infectious and more resistant to the vaccines we have so far.
At the personal level, we have spent the past 15 months trying not to get COVID-19, so that particular worry is familiar enough not to seem as scary as it still really is. Now that vaccinations are available, the new worry we have to assess is the safety of the vaccines in the context of our personal health, and in comparison to the consequences of getting a severe case of COVID-19.
The idea that vaccines aren’t safe because they were developed quickly is, in my view, a furphy. The mechanisms for the delivering the vaccine into your immune system have been around for a long time, making it much quicker to adapt to this particular virus. Centres for Disease Control around the world have been bracing for this pandemic for years, so we shouldn’t be surprised that pharmaceutical companies have been able to accelerate vaccine development, in conjunction with an unprecedented level of collaborative research between universities and research labs around the world.
The rated effectiveness of the vaccines varies between types, but all provide significant protection against infection, and really good protection against getting a severe case, once the required number of doses is taken. For instance A/Z gives us about 60% effectiveness against infection after the first injection, and closer to 90% after the second. Pfizer is 69% after the first and 90% after the second. It’s really important to get both injections and to follow the health protocols in your jurisdiction.
Immunity to catching the virus takes several weeks to build, so you really, really want to be vaccinated before you find yourself in the middle of a surge.
In terms of side effects, the usual sore arm and flu-like symptoms have been reported with both vaccines in use in Australia. We don’t have any way to know yet about any longer-term side effects of either vaccine type.
However, a tiny percentage of first-jab A/Z recipients have developed a rare type of blood clot, that cannot be treated with anti-coagulants like heparin, the usual drug for ‘normal’ blood clots. This side effect has been reasonably well reported, and was initially thought predominantly to affect women under the age of about 40, hence the public health decision to reserve Pfizer doses for those under the age of 50 and to use A/Z for people over 50.
Recent analysis and advice from the Australian Technical Advisory Group on Immunisation (ATAGI) finds of the 27 known cases of vaccine-related clot cases 26 are either stable or recovering. One early case resulted in death. The current statistics with regard to risk for different age groups are tricky because it’s a small sample, but ATAGI quotes risks as 1.6 per 100,000 for Australians over 50 years of age, and 2.6 per 100,000 for those under 40.
What do we get in exchange for getting vaccinated? On a personal level, we get increased freedom of action, for instance feeling safe to travel, and knowing you can quarantine at home should it become necessary.
At the community level, we can be confident that we won’t transmit the virus to someone, like an organ donation recipient or a cancer patient, whose immune system is compromised and for whom the vaccine doesn’t work.
In the larger community sense, the best protection from surges in the virus is widespread vaccination of the community, or so-called herd immunity. Avoiding lockdowns and facilitating not just travel but improved economic activity will rely on most of the community getting vaccinated.
At the global level, the primary concern is the development and transmission of variants of the coronavirus. Variants arise as the result of natural mutations in the virus, and given how fast it reproduces, there are lots of opportunities for mutation to happen. Most mutations are irrelevant, but a few are turning out to be distinctly challenging for the virus-tamers, as they can be more virulent, more infectious and more resistant to the vaccines we have available currently.
Even if a variant arises somewhere else in the world, we have experienced firsthand how easily the virus is transported, and the consequences even for countries like ours where the virus is largely under control at the moment.
So, in the long game, the biggest risk to all of us is the advent of nasty variants, and the best way to tame them is to reduce dramatically the number of cases around the world, thereby reducing the opportunities for the virus to mutate.
As a society we have, then, a double-edged motivation—ethical as well as self-interested— to do all we can to assist countries, like India, Indonesia and PNG to get as many people vaccinated as possible.
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For up-to-date information on vaccines, the Royal Australian College of General Practitioners (https://www.racgp.org.au) and the Australian Dept of Health’s News section (https://www.health.gov.au/news) are reliable sources. ABC News’ Coronacast podcast is an excellent daily overview.
In the video below: We haven't grazed this area for a long time, and the lambs have never been here, but they led the small flock of named sheep directly into the she-oak grove like they knew exactly where they were going. Quite amazing, as it's shady and downhill--not their usual choices. I think perhaps the lambs recognise she-oaks from their baby-hood and even in utero nutritional experiences.