As a doctor, I was skeptical about the Covid vaccine. Then I revised science.

As a doctor, I was skeptical about the Covid vaccine. Then I revised science.

2021-03-05 03:50:30

The Australia Letter is a weekly newsletter from our Australian agency. Sign Up to receive it by email. This week's issue was written by Amaali Lokuge, a physician at Royal Melbourne Hospital.

As the world records more than two and a half million deaths from the coronavirus and the United States celebrates more than 50 million vaccines administered, here in the Royal Melbourne Hospital emergency room, as front-line workers, we have our first vaccination scheduled this week. Australia has not recorded any deaths from the coronavirus for months, and the minor outbreaks we have are declining within days due to aggressive lockdowns and a compliant audience. Given the low prevalence of disease, Australians have the luxury of choosing not to be vaccinated or delaying the vaccine until we are ready.

Until last week I was not sure if I would get the vaccine. Some Media reports emphasize that mRNA vaccines have never been approved for use in humans outside of clinical trials, making it look like a new technology that has not been tested before. The vaccines were developed so quickly that I was not sure that the main side effects had not been overlooked. I was concerned about autoimmunity caused by the expression of the coronavirus spike proteins on my own cells.

Skepticism runs deep in Australia and protests against vaccinations have surfaced in many of our cities. Beyond this vocal minority – who seem to oppose immunization based on theoretical and ideological rather than scientific considerations – it's hard to gauge the popular mood. I feel that Australians feel obliged to get vaccinated, but in private, many of us have reservations.

Within the medical community, the misinformation permeating the anti-vaccination movement makes it difficult to express genuine concerns. That draws soft mockery from my colleagues – to them I sound like I have let go of my medical education.

Every day in the emergency department, patients walk away from necessary care against medical advice, and we watch them leave with a shake of our heads and a sad smile. Like her, isolated with my doubts, I was willing to exercise my right to free will and refuse the vaccine. When my non-medical friends asked me about it, I was torn between telling my concerns and playing the doctor recommending the latest proven therapy.

The few to whom I expressed my concerns looked at me in bewilderment: If a doctor did not trust the vaccine, how should they do it? It felt like betrayal.

The guilt I felt about this forced me to objectively review the literature on mRNA vaccines. Not being an expert in virology or biochemistry, I realized that I was quick to understand unfamiliar words like 'transfection'. and master concepts about gene sequences. Slowly, the information I devoured began to change my beliefs.

I discovered that research has been going on for 30 years on the use of mRNA for vaccinations and cancer therapies. Trial and error refined this modality so that it was almost completely worn out by the time Covid hit. The vaccine mRNA is rapidly degraded in our cells and the coronavirus spike protein is only transiently expressed on the cell surface. In addition, this type of vaccine uses a technique already used by viruses.

It was humble to have to change your mind. When I booked my vaccination period, I realized how lucky I am to have access to all this research, as well as the training to understand it.

I wish more of this information could be filtered to the public so that they too could be informed as much as we are. As medical professionals, we cannot afford to be paternalistic and trust that people will follow advice without all the facts. This is especially true in Australia, where the vast majority of us have never witnessed firsthand the devastation this disease can wreak.

Even though we are now relatively safe, the threat of overwhelming infections is constant. Winter is coming and people are dropping their guard. At the beginning of all of this, I would have been arrogant if I had thought we could escape the horrific mortality that the rest of the world would suffer, but the vaccines offer a glimmer of hope. They may or may not prevent transmission, but they will reduce serious infections, hospitalizations, and deaths.

Like all new converts, I am now a true believer: I would like everyone to be vaccinated. But autonomy is a precious principle of a free society, and I am pleased that ethicists have advised against making the vaccine mandatory. I just hope that with more vigorous discussion and the wider dissemination of scientific knowledge, we can get people like me – who may have valid reservations – to get the vaccine.

I received the first dose of the vaccine on Tuesday. The whole process was so streamlined and fast that I walked away feeling nothing. But when I took a picture of the vaccination card to share with friends and family, I was overwhelmed with a mix of gratitude, relief and regret for the rest of the world where the virus is less well controlled.

My principal wrote in an email to the emergency department last week that the hardest thing he ever had to do was watch us go down to deal with the virus with just our P.P.E. to protect us. And for all of us, the fear that one of our loved ones will succumb to the virus has been a constant shadow.

Knowing that we can alleviate that threat through vaccination seems like a miracle.

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