Dear Editor,
I write with respect to a letter dated March 25th in this newspaper where concerns were expressed over mixed messaging on vaccines. I’m not an advocate for any particular vaccine, just the facts, and getting vaccinated with any vaccine available as long as its passes safety scrutiny. I think mixed messaging is oftentimes a result of media muddling the facts or selective presentation of information and so I wish to make the following points:
1. Broad generalizations will lead to confusion as there are different vaccines available so one needs to examine the facts specific to a particular vaccine if there are specific concerns.
2. On vaccine approval
I detailed the standard approval process in a letter to this newspaper on Feb. 4 so in brief there are three phases of clinical trials where results are reviewed prior to approval for use. This is generally the same for most regulatory bodies but decisions can be made after approval and during use as new and more data becomes available, for example, new data arising from trials in a different demographic such as age group. The bottom line is that the learning curve has been steep during the pandemic and decisions can be revised upon the receipt of new evidence. It’s important to keep up with this but it’s more important to make sure the you draw conclusions from a reliable source of information such as published peer-reviewed results and/or results that are independently reviewed or publications which are sourced to these results/reviews.
3. The Oxford-AstraZeneca/Covishield Vaccine
Some European countries suspended the rollout (vaccination now resumed) of the Oxford-AstraZeneca (Ox-AZ) vaccine to investigate blood clots in people who had taken the vaccine citing this as a precautionary measure. This was a decision taken by individual countries although the European Medicines Agency (EU regulatory authority) said that there is ‘no indication’ that the vaccine caused the blood clots and that the vaccine benefits outweighed the risk of side effects. Note, that the UK and India had already vaccinated millions with this vaccine without citing any greater than normal risk of blood clots or adverse events (like allergic reactions) in clinical trials or with ongoing vaccination campaigns. The EMA investigated these concerns and concluded that, “The vaccine is not associated with an increase in the overall risk of blood clots.”
During this time the vaccine was/is not yet approved for use in the US as they awaited results of their own phase 3 (large scale) clinical trials. The results are now available and it supports the EMA’s conclusion. Notwithstanding, although there is no direct evidence to say that the vaccine caused the blood clots, people still worry and it’s very unfortunate that some chaotic European decisions may only add to vaccine hesitancy. For example, France (a country with very high vaccine skepticism) went from allowing the vaccine for under 65s, to everyone, to no one, and now only to people over 55.
Au contraire, Canadian Health authorities kept vaccine rollout during this time and further approved the Ox-AZ vaccine for over 65s. One Canadian province (Québec) decided to use it for vaccination of over 65s against the recommendation of Canada’s National Advisory Committee on Immunization. This is understandable as we just can’t afford to pause vaccination campaigns without strong evidence to support reasons for suspension.
A good rule to follow in deciding on vaccination, as the Ox-AZ is one of the vaccines being rolled out in Guyana and the Caribbean Region, is to get all the facts correct and follow the science. One fact that stands out is that 37 cases of blood clots occurred in 17 million doses of vaccine administered in the EU and UK. Rather than fearing headlines, the obvious questions that people should be asking here are: What are the normal chances of a blood clot without a vaccine? And what are the risks of getting blood clots from the other vaccines in use? The answer to the first question is that its much greater. In fact, the chances of the average woman developing a blood clot from taking contraceptive pills is 1/1000 per a year – far greater than the 37 cases per 17 million does of the Ox-Az vaccine administered. Further, even some pain killers we consume on a regular basis have greater blood clot risks (than taking this vaccine) associated with taking them (check the labels and packaging). The answer to the second question is that the risk of getting a blood clot with the Ox-AZ is similar to that of other vaccines currently in use.
Now there is a debate about the vaccine’s efficacy (79% or 60-76%?) but there is a scientific consensus that any boost is better than none as long as the vaccine is safe. Overall, this is a safe and effective vaccine and importantly, available to most of the world, not just rich countries. It’s the only vaccine whose developer has made a substantial contribution to vaccine equity in the world by waiving intellectual property laws and licensing its technology to other companies. Given that equitable access to vaccines is a major problem, and this is a major vaccine rolled out in the Caribbean region (it makes up 90% of the vaccine distributed by COVAX), we must be careful about labeling it as ‘bad’ and making gross generalizations without all the facts or strong evidence for doing so.
Finally, I am a bit surprised on vaccine hesitancy in Guyana. I grew up in rural Guyana and I can’t recall anyone I know ever not wanting to get vaccinated. General, child vaccination is mandatory and we’ve all had vaccines. Many of our parents and grandparents have that scar on their arms from the polio or BCG vaccines; some of us don’t have them because we didn’t need to take the vaccines as these diseases are controlled or eradicated. Let’s do our part for our own health and future – get vaccinated!
Sincerely,
Jacquelyn Jhingree, PhD
