The Australia Letter is a weekly newsletter from our Australia bureau. Sign up to get it by email. This week’s issue is written by Amaali Lokuge, a doctor at the Royal Melbourne Hospital.
As the world records more than two and a half million deaths from the coronavirus and the United States celebrates over 50 million administered vaccines, here at the Royal Melbourne Hospital emergency department, as frontline workers, we scheduled ourselves for our first immunization this week. Australia has not recorded a coronavirus death for months now, and the little outbreaks we have peter out within days because of aggressive lockdowns and a compliant public. Given the low prevalence of disease, Australians have the luxury of choosing not to be vaccinated or to delay the vaccine until we are ready.
Until last week, I wasn’t sure I would get the vaccine. Some media reports highlight that mRNA vaccines have never been approved for use in humans outside clinical trials, making it seem like a new technology that has not been tested before. The vaccines were developed at such speed, I couldn’t be sure that major side effects hadn’t been overlooked. I worried about autoimmunity caused by expressing the coronavirus spike proteins on my own cells.
Skepticism runs deep in Australia, and anti-vaccine protests have popped up in many of our cities. Outside this vocal minority — which seems to oppose immunization based on theoretical and ideological rather than scientific concerns — it is difficult to gauge the popular mood. I get the sense that Australians feel obligated to be vaccinated, but privately many of us have reservations.
Within the medical community, the misinformation that pervades the anti-vaccination movement makes it difficult to voice genuine concerns. Doing so attracts gentle ridicule from my colleagues — to them, I sound as though I have let go of my medical education.
Every day in the emergency department, patients walk away from essential care against medical advice, and we watch them go with a shake of our heads and a rueful smile. Just like them, isolated with my doubts, I was ready 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 them my concerns and playacting the doctor who recommends the latest proven therapy.
The few to whom I revealed my worries looked at me in bewilderment: If a doctor didn’t trust the vaccine, how were they supposed to? It felt like a betrayal.
The guilt I felt about this compelled me to objectively review the literature on mRNA vaccines. Not being an expert in virology or biochemistry, I realized I had to quickly master unfamiliar words like “transfection” and concepts about gene sequences. Slowly, the information I was devouring started changing my beliefs.
I learned that research into using mRNA for vaccinations and cancer therapies has been ongoing for the past 30 years. Trial and error have refined this modality so that it was almost fully fledged by the time Covid hit. The mRNA from the vaccine is broken down quickly in our cells, and the coronavirus spike protein is expressed only transiently on the cell surface. Furthermore, this type of vaccine is harnessing a technique that viruses already use.
It was humbling to have to change my mind. As I booked my vaccination time slot, I realized how lucky I am to have access to all this research, as well as the training to understand it.
I wish that more of this information could be filtered out to members of the public so that they, too, could be as informed 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 ravages that this disease can inflict.
Even though we are relatively safe now, the threat of overwhelming infections is constantly present. Winter is approaching, and people are letting their guard down. At the start of all this, I would have been cavalier to have imagined that we could escape the horrendous mortality 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 decrease severe infections, hospitalizations and deaths.
Like all new converts, I am now a true believer: I’d like everyone to be vaccinated. But autonomy is a precious tenet of a free society, and I’m glad the ethicists have advised against mandating the vaccine. I just hope that with more robust discussion and the wider dissemination of scientific knowledge, we may sway people like me — who have what may be valid reservations — to get the vaccine.
I received the first dose of the vaccine on Tuesday. The whole process was so streamlined and quick, I walked away feeling nothing. But as I took a photo 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 contained.
My director wrote in an email to the emergency department last week that the hardest thing he had ever had to do was watch us head downstairs to face the virus with only 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.
To know that we may ameliorate that threat through vaccination seems like a miracle.
Here are this week’s stories:
… And Over to You
Last week, we asked you about the scandal surrounding sexual assault allegations in Parliament and your own experiences with sex education in Australia. Here are some reader responses:
Morrison could not condemn until he spoke to his wife? What sort of ignorant person is he that he cannot recognize that rape is unacceptable?
Dutton with his “he said, she said” comment appalled me. In addition, neither have made any comment on the information that the incident was reported to the AFP. I find the entire story, and the subsequent information about other assaults, really distressing.
— W. McQuarrie
My high school and primary school sex education was totally lacking. It felt like fear mongering, focusing almost solely on STI contraction, and was rooted in Catholic guilt, promoting abstinence as the only real form of safe sex. When I went to university it was no better. I went to a residential college that used to talk a lot about consent, but without any nuance or any real effort to engage a speaker that could relate to young people. And, when issues of consent were actually tested at my college, the administration failed all of us time and time again.
— Zoe Stinson
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