Hope arrived this week, packed in dry ice — the first precious doses of a vaccine against a pandemic that has become mentally exhausting.
Now, as Canada begins inoculating its high-risk health workers and elderly against a disease that is, once again, battering the country and lives, its official death toll approaching 14,000, more people appear willing to get vaccinated the minute they get the chance.
Still, there is some unease amid the joy.
Pollster Angus Reid Institute this week reported a “notable” jump in the proportion of Canadians who say they will seek to be vaccinated against COVID-19. Just under half of those surveyed (48 per cent) Dec. 8 to 11 said they would immediately get the vaccine as soon as one becomes available to them, up from 40 per cent one month ago. Another 31 per cent were more cautious, indicating that, yes, they would get vaccinated eventually, but that they will wait a bit. Seven per cent were unsure, and 14 per cent said they had no intention of getting inoculated, a figure that has remained mostly static, with those in Alberta (27 per cent ), Saskatchewan (21 per cent) and Manitoba (19 per cent) the most likely to say they want no part of the shots.
The newness of the vaccines and the record speed at which they were developed and approved has created discomfort for some. For the less-than enthusiastic, the most worrisome concern is long-term potential side effects, Angus Reid said. Some fear safety protocols were compromised in the sprint-like speed in which the vaccines were brought to market.
“Some people are going to need a lot of convincing that that was not done,” said Maya Goldenberg, an associate professor of philosophy at the University of Guelph who has an expertise in vaccine hesitancy and public resistance to science. “Some people will of course never believe it.
“Others are so fed up with the toll of the coronavirus that they’re ready to line up,” Goldenberg said, adding that she’s not at all surprised, now that a vaccine has been realized, “that you’re going to see a moment of enthusiasm and an uptake in the people wanting it.”
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Dr. Gordon Guyatt, a renowned McMaster University professor who coined the term evidence-based medicine, believes the risk of serious reactions is very low. While he is “far from a vaccine expert,” Guyatt’s intuition is that, for most people, “the safety against COVID and what it would mean for their lives would warrant taking what very small risk there might be.”
“There is this rule of three,” Guyatt said. “If you vaccinate 30,000 people, divided by three, one in 10,000 is the highest plausible risk of any serious reactions, if no serious reactions have occurred in the first 30,000,” Guyatt said. Pfizer’s study involved 42,000 people, Moderna’s, 30,000.
“My understanding is, with each of the vaccines, they have seen no serious reactions in the clinical trials.”
A wide variety of vaccines, in general, have proved safe. As with any vaccine, the potential for a serious side effect exists, “but these are rare,” Health Canada said.
The limitations are that the people enrolled in vaccine trials tend to be a restricted population. For example, few might have had previous immune problems. Last week, British regulators warned that people with a history of significant allergic reactions should avoid the shots after two health workers, both with a history of serious allergies who keep adrenaline pens with them, reacted to the Pfizer jabs. “There may be subpopulations where they could have idiosyncratic reactions because of who they are,” Guyatt said.
Health Canada is also warning anyone with allergies to any of the ingredients in the Pfizer-BioNTech vaccine not to receive the shot.
“My impression is things are likely to be safe, there are likely to be very few severe reactions, but it is true that this has been rolled out more quickly, and we might be less confident of that than we would be with a vaccine that took four years to develop and test,” Guyatt said.
U.S. regulators required a median of two months safety data; some experts had urged six. Guyatt, an expert in medical-research methods, said it would be unlikely for severe reactions to appear after a two-month time frame.
Still, he said he hopes regulators are watching carefully. Once a product is on the market, the manufacturer — Pfizer and BioNTech — is legally required to submit reports of adverse reactions to Health Canada. Pfizer plans to follow trial participants for at least two years after the second dose of the vaccine is given..
The public wants to know there is a high regard for public safety, Goldenberg said. “It might be happening all the way through, but transparency and accountability and communication are the way you bring the public on board with this,” including how the science and bureaucracy was streamlined and truncated but still with an eye toward maintaining the same safety standards. “Because people are going to have questions about that.”
Fifty per cent of Canadians indicating they now want an immediate COVID shot “is far short of what we would hope for,” said Matthew Miller, a senior infectious diseases researcher and associate professor at McMaster’s Immunology Research Centre. “The good news, though, is the vast majority of people are willing, in principle.”
The Pfizer and Moderna vaccines are messenger RNA vaccines. They contain the genetic code for making the spike protein that the SARS-CoV-2 virus uses to latch onto and invades cells. Once injected, a person’s cells read the code and then produce the protein. The immune system recognizes the protein doesn’t belong, and begins mounting an immune response and making antibodies.
“We know that the vaccine stops people from getting sick. We don’t know yet whether it stops them from being infected overall and/or transmitting yet,” Miller said. “It’s something we can figure out. It will just take a little more time.”
Because vaccines are given to healthy people, the appetite for tolerating any bad events is extraordinarily low, Miller said — “way more stringent than other drugs, which treat you when you’re already sick.”
In a pandemic, however, there are only two ways out: either everybody gets infected, or people get infected and people get vaccinated. Experts estimate that some 65 to 70 per cent of the population needs immunity for SARS-CoV-2 to peter out.
“So long as we do a good job at communicating with those people who are hesitant, then we should be able to achieve a level of immunity that gives us a herd effect,” Miller said.
The online Angus Reid survey involved a randomized sample of 1,603 adult Canadians. A survey sample of this size has a margin of error, plus or minus. 2.5 percentage points, 19 times out of 20.
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