Commentary

Trying to decide about vaccine?
Know and think about this

How long will the immunity from vaccination last?
Six months? One year?

At dinner last week, a friend announced to the table that she would not get the anti-Covid-19 vaccine because she’s not sure if it’s safe or not. Too soon to tell, she said. Then another countered that she’s willing to try it—”that could be our best ticket to normal life.”

That led to another opinion, then still another, until the dinner turned into what seemed like a college debate sans moderator. I chose not to give my two cents’ worth; jumping into a catfight isn’t my idea of dinner.

What I would have told the impassioned dinner gathering was, let’s not lose our appetite—and friendships—over the vaccine, which is still nowhere in (legitimate) sight in the Philippines, or isn’t yet accessible to the public. What we should remain focused on is how to make the country safe from this viral contagion—if not fully safe, at least we should be able to function as we battle it. This is because even with the vaccine, the whole of 2021 obviously will still be a pandemic year.

A friend puts it graphically, no differently from a fairy tale—“After locking ourselves up for so long, we peep out, step out, and surprise! The big bad wolf is still there, ready to gobble us up.” No Prince Charming in sight.

That is exactly us.

Our country’s frontliners definitely must be the priority in this inoculation. There’s nothing wrong with the medical community, the frontliners especially, and the business sector placing their orders for the vaccines in preparation for sectoral inoculation. But what’s worrisome is how some sectors have surreptitiously, unjustifiably gotten their vaccines. I’ve heard of people making reservations for vaccines in hospitals and health institutions, pretty much like you reserve for next season’s designer bags.

While you can’t take it against these individuals for wanting to live, you must remind them that it still takes a village to fight the pandemic. An individual’s immunity is certainly not enough. The community, indeed the country and the rest of the world, must develop the herd immunity, for this pandemic to be over, as medical and health experts have said over and over.

In light of this, to get a vaccine or not goes beyond a personal choice. We can argue for or against the vaccine all we want, but at the end of the day, what will determine our own safety or at the very least, our survival, is how the global village can get itself inoculated and how swiftly, efficiently, safely and equitably.

Everyone knows that it takes time to determine conclusively a vaccine’s efficacy, certainly more than a few months, but in this pandemic, the world doesn’t have the luxury of time. It is getting what it can get its hands on, while having the basic protocols in place.

So if you’re not a frontliner and you’re just a leisure traveler itching to travel, should you get the jab now and not wait?

‘Since the complete vaccine roll-out will take at least two years… I advise family and friends to wait at least another six months’

Early on, we casually asked on mobile chat the Inquirer Lifestyle health columnist Dr. Rafael Castillo his thoughts about the vaccine:

“Attaining herd immunity requires at least 70% of the population getting vaccinated or infected. But it might come at some cost for some of those who’ll be vaccinated. It will be a leap of faith hoping that there’ll be no long-term side-effects. I think up to this point the LONG-TERM risk-benefit of vaccination is an equipoise, but the short to mid-term benefits are already quite apparent. The knowledge gaps remain: how long will the immunity from vaccination last? Six months? One year? Longer? Safety of the elderly and the frail individuals is still in question. They’re at the highest risk of Covid-19 but they also appear to have the highest risk of suffering from a serious or even fatal vaccination side-effect. So they’re part of the clinical equipoise at this point and should be studied further.”

He added: “It (to attain herd immunity) will still be by vaccination eventually. But the risk of uncertainty with a new type of formulation for the vaccine is unacceptably high for those who’ll avail themselves of it early.

“The safer way for the general population is to wait another 12 months for post-marketing surveillance studies. So I propose it should just be made voluntary for now for the general population. But we should follow the priority or preference schedule followed abroad— i.e. prioritizing medical and other frontliners, other non-frontline healthcare workers, strong non-frail elderly, working adults, etc. Everyone should give informed consent, of course. There should be full transparency on the results of the post-marketing results and outcomes. Pharma companies of vaccines who do not fully disclose should be given least priority in the vaccine rollout.

“Since the complete vaccine roll-out program will take at least two years, realistically three years to implement, I advise family and friends to wait at least another six months, preferably a year until the discomforting knowledge gaps have been reasonably filled. Meanwhile we just have to maintain standard precautions and make sure we fully comply with them and not show compliance fatigue. But we must try to live lives as near normally as possible and maintain a positive and victorious mindset over this pandemic, rather than a resigned attitude of vulnerability. We need the vaccine eventually, but as of now, having survived a highly symptomatic episode of Covid-19, I confidently say that we’ll not only survive this pandemic, but we’ll prevail over it.”

That’s an encapsulating viewpoint from the medical columnist who early on in the pandemic, called the government’s attention to the urgent need to declare emergency measures for the country’s health infrastructure. He was also among the first to warn against the impending burnout of the country’s frontliners because he himself has been on the frontlines. He was also the one, through his column, to warn against the non-reliability of rapid tests.

When it comes to the vaccine, I believe his is a wise counsel.

What we should lose sleep over is not whether or not you and I should get inoculated—that’s already a given, or when—but over how the government, indeed our society, is fighting this pandemic in the short term and in the long term. That remains the overriding issue. It is how efficiently, effectively and equitably the country can do vaccination. It’s been written much too often how ours has been among the mismanaged responses to the pandemic; it shouldn’t get any worse, or could it?

It is tragic—and there could be more tragic consequences—how the vaccine issue has become a political football. It’s mired in political and medical controversies that crop up by the day, from vaccine acquisition and pricing allegedly ridden with graft, to vaccine selection that is again, possibly ridden with graft, and, to which sector should be vaccinated first without falling into the “palakasan” culture.

If we failed to practice transparency early on in the handling of this pandemic, we should at least do it now

For effective management of the pandemic, there must be transparency in governance—if we failed to practice transparency early on in the handling of this pandemic, we should at least do it now. We should expect nothing less from this administration, led by its health officials, as well as the local government units. People can’t say this enough in social media— there should be transparency not only about the vaccine’s efficacy but also about its selection process, procurement, distribution, and assessment or feedback mechanism. It makes you want to throw up each breakfast you read the morning news about the inter-sector brawls, about the alleged overpricing(s) of the vaccines, and the shortcuts done to favor one vaccine over another. Chat groups have produced memes about the alleged graft in the procurement (e.g. List of Covid-19 Vaccines from Country of Origin: UK-AstraZenica, US-Novavax…China-Sinovac, Philippines-Kick-Vac). It’s so funny it hurts.

We should also demand the professional management of the populace’s vaccination, from both the national government and the LGUs—that they finally get their act together, so unlike in the management of the pandemic. It must be managed efficiently and equitably. On it partly rests the significant reopening of the economy and its rebound. It is proactive of big business and the private sector to purchase a sizeable amount of the vaccine for widespread distribution—now the government must do its part by defining the policies and procedures for it.

Any vaccination campaign must be preceded by an information campaign by the government so that the people will know what they’re getting into. This is where its vast social media logistics could be put to good use (troll army).

While the virus has been snuffing out the lives of both the rich and the poor—no class discrimination—the management of the pandemic has tended to be anti-poor. And we’re talking not only about the access to medical and hospital services, but also about the bureaucratic red tape that costs the poor their hard-earned money. For instance, our house help, who had to fly home to her native Samar last month, had to get all kinds of clearances—medical (which costs money), barangay, LGU—to be able to travel. To a daily wage earner, commuting from home to these government offices just to get clearances costs money that otherwise could have been spent on food and other basic needs.

We hope that the poor management of the pandemic is not foretelling of the kind of inoculation process that awaits the population. It certainly doesn’t help that early on, people have developed a fear of immunization after the Dengvaxia immunization was used brazenly as a political tool.

What gives me anxiety isn’t to get the jab or not—but our rickety health care infrastructure

So back to the question—should you get the jab or not? I myself am not tearing at my hair trying to figure this out. What gives me anxiety isn’t to get the jab or not—but all of the above plus, this sounds like a broken record, our rickety health care infrastructure. While we have the most dedicated frontliners and health workers, and possibly the better doctors and medical specialists in the world, our health and medical infrastructure remains that of a Third World. And the pandemic merely brought our plight to the fore.

So vaccine? Looking around at the community, I worry more about Philhealth—yours and mine—and the poor’s access to health facilities, and our own, the middle class’ ability to access hospital and health care in this pandemic without being overcome with fear of contamination. (Dr. Castillo wrote about how in this pandemic, what is worrisome and incalculable is possibly the growing incidence of heart ailments, diabetes and other medical conditions which have not been addressed readily because people are afraid to visit medical clinics, and because teleconsulting isn’t enough.) Medical insurance doesn’t come cheap so that even the middle class must do astute planning and budgeting for it. The employed have their employment medical insurance and benefits. But then, the country has seen an unprecedented rise in unemployment, so just imagine how so many more must fight hunger and illness. And there’s the elderly population—the senior citizens who have been hastened into retirement, if not inactivity, by this pandemic, and now have to worry about their financial security on top of their co-morbidities.

We need to feel secure in our environment, to be assured about its safety. Obviously, this will not happen tomorrow. What we hope, in the short term, is for the government—national and local—to manage the pandemic astutely so that we can resume full productivity, and, in the long term, to build and reinforce an adequate health infrastructure.

In the immediate term, the test-contact trace-treat system must cover a significant portion of the population, the work force and beyond, and for the national government to be in synergy with the LGUs. As of now, they can’t even be on the same page in the use of contact tracing apps; requirements change once you cross a city/province border. And what kind of testing should really be done?

It’s bad enough that the virus kills, why must government corruption finish the kill?

Even if you have yourself jabbed with the vaccine of your choice, you still live in an environment that’s highly vulnerable, compromised and can’t resume its full economic activity because the anti-pandemic measures are not in place fully and efficiently—and because the helmsmen continue to wrangle and rake each other’s muck from day to day. It’s bad enough that the virus kills, why must government corruption finish the kill?

In truth, we’re still hoping to see a comprehensive, encompassing, long-term plan to reinforce and rebuild our health infrastructure. This eventually should give us confidence to resume our lives in the new normal—in the Philippines.

Some friends plan to have themselves inoculated in the middle of this year or as soon as the vaccines are available. We hope that the health department will manage the mad scramble for it.

Beyond the vaccination, however, our pandemic anxiety will be over only when the health and safety protocols (wearing masks, social distancing, etc) become ingrained in our environment, from our workplace to our lifestyle. There is really no turning back to the old normal. Like it or not, our lives must adapt to the pandemic, this and future ones.

I know of some who suffer nightmares or depression as a result of this pandemic. Stress lowers one’s immune system. To fight stress, we need to feel safe and secure living in this environment. That entails more than a jab.

About author

Articles

After devoting more than 30 years to daily newspaper editing (as Lifestyle editor) and a decade to magazine publishing (as editorial director and general manager), she now wants to focus on writing—she hopes.
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