Vaccine hesitancy is harmful

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Angelo Ryan’s piece on vaccine hesitancy in the Mail & Guardian does not start well. It is judgmental about those who promote vaccines and assumes that those who oppose his position are accusing those who hold such positions of being “ignorant or selfish or simply believe in prayer”.

Once you start out with the presumption that the opposing view traduces you, that is a handy rhetorical device. Any response can be construed as ad hominem. This is hardly an honest form of argument and I am not going to go there but rather stick to the facts.

I fully agree with his distrust of Big Pharma – but each issue has to be taken on its merits. To use a totally hypothetical analogy: imaging a big Swiss multinational has a reputation of killing babies and now comes up with a life-saving therapy. What are you going to do? In my world, I boycott their other products and hold my nose while promoting their therapy.

The problem is not that an otherwise abhorrent business is promoting a life-saving therapy, it’s that abhorrent businesses can exist. If the therapy is life-saving then what are you going to do? Allow a lot of people to die while sticking to your principles? In the long term, we need to break the nexus between Big Pharma and volume production of life-saving drugs, as well as the business model or promoting unnecessary therapies that can end up doing more harm than good.

Arguing that some published science is of poor quality takes us nowhere: what are we going to do? Live in a cave and make fire by rubbing sticks? All scientists have a duty to examine each other‘s work for errors, inconsistencies and irreproducible results. There are failures but on the whole the system is better than the alternative of throwing out all of science and relying on rumour and superstition. Yes, the system should be better: big business should have less influence on regulation – not just drugs; consider for example the Boeing 737 MAX 8 crashes that resulted from flaws in regulatory approval. I am also a big critic of knowledge hoarding: as soon as it started to become apparent which vaccines were most effective against Covid-19, knowledge about how to make them should have been shared.

I don’t believe everything I am told but I also believe in developing the conceptual and analytical skills to check things independently, rather than to throw out everything because the system is flawed.

The war we have now is on Covid-19; it is good to know what the terrain is for future campaigns but if we fight the wrong war now, many lives will be lost unnecessarily.

Pfizer and Johnson & Johnson may have abhorrent legacies but does that invalidate vaccination as a solution to Covid-19?

I have had issues with CDC guidance in the past – they have been slow for example to advocate masking – but on the whole they have access to top-rank science. They may sometimes bow to political pressure. But making this an issue for discouraging vaccination is ludicrous. There is a vast amount of data in the public domain and the overwhelming consensus of this data is that vaccine hesitancy is harmful.

Not only are the vaccinated far less likely to suffer severe symptoms or die, but there is emerging evidence that they are less contagious than the unvaccinated when infected  – even with the delta variant. Delta in early studies has viral loads as high in the vaccinated as in the unvaccinated but the infection clears faser. If we examine real-world data, countries that are further along with vaccination than South Africa like the United Kingdom and the United States have a much lower per capita death rate than we do, measured over the last week. All of these countries are being hit by the delta variant and hence are comparable.

In the last seven days, at time of writing, the UK had a case fatality rate of 0.3%; South Africa’s was 3%. Nearly 60% of the UK population is fully vaccinated; in South Africa, the figure is about 8%.

The delta variant is about as transmissible as chickenpox, which means that pretty much everyone will get it, unless vaccines significantly reduce transmission. This cannot happen unless there is a very high rate of vaccination.

One more issue: the more virus there is out there, the higher the chance of more dangerous variants developing. If you resist being vaccinated, you may not personally develop one of these more dangerous mutations but you risk becoming part of the societal reservoir of infection that the virus needs to develop new variants.

Overall if we look at available facts, vaccine hesitancy is harmful. Not only do you place yourself at higher risk if you are unvaccinated, but you very likely do have an enhanced risk of infecting others. Given that no vaccine is 100% effective, increasing your chances of infecting others – including the more vulnerable – is not a decision to take lightly.

Arguing that “vaccine sceptics … knew which path they were taking” is disingenuous when there is so much disinformation clouding the issue. And when you add the heightened risk that they infect others, the argument loses all traction.