To be or not to be
Jabs, blood clots & a healthy dose of paranoia.
On Wednesday night, between washing the dishes and putting the girls to bed, I flopped down on the sofa, switched on the television, and let whatever was playing at the time wash over me. The first channel that came up was BBC Parliament — don’t ask why, how or pass judgement on me! I did not bother with changing the channel, such was my state of mental numbness; a state I often find myself in at that time of the evening, punctuated as it is with household domestic chores.
A couple of eminent scientists were giving evidence to the Commons Science and Technology Committee about the rare but increasing number of inexplicable instances of blood clots and low platelet counts in those vaccinated with the Oxford Astrazenica (AZ) jab. Layers of lethargy began to peel away slowly. My ears perked up. I sat up and leaned into the discussion with interest. It was a conversation my wife and I had been having for a few weeks and I was curious to see if the scientists and parliamentarians could offer a point of view that would cut through the dilemma we were mulling over.
The UK has bet big on the AZ vaccine (100m doses on order). It is a central pillar of the government’s vaccination programme, which has by all accounts been run very efficiently. Currently, the Pfizer BioNTech and Moderna vaccines at 40m and 17m respectively are the other two approved vaccines and play an equally vital, albeit supplementary role in the National Health Service (NHS) effort to get first jabs in all adults by July. With the scale of the effort and the supply of vaccines being what it is, the vaccinated do not have the option to exercise a preference for type of vaccine. This is perfectly understandable. The science is clear and unequivocal. The vaccines are highly effective in combating the spread of Covid-19 and the benefits at a personal level and to society at large significantly outweigh any residual risks. After all, there are health warnings and risks associated with most medicines and vaccines. Except for age, where there is a higher incidence reported in the younger age groups, there just isn’t enough data to identify trends or characteristics that might make it more likely for one vaccinated person to get a blood clot than another. The numbers are small in comparison, a mere 209 incidents as of April 21, with about a fifth of them resulting in fatalities. Bearing in mind the vaccinated numbers mainly corresponding to those aged 45 and over, the government has opted to give the under-30s and pregnant women the option to get jabbed with a Pfizer or a Moderna instead. They are now considering if this courtesy should be extended to the under 40s. It is a very tricky proposition on many fronts. Logistically, with every cohort that is given the choice of an alternative, the pace of the vaccination programme slows down. Opening the options up to select groups seeds doubt in the psyche of the broader public, especially those that are already predisposed to an anti-vaccination sentiment. Above all, it is a heart-wrenching decision for the Joint Committee on Vaccinations and Immunisations (JCVI) to make, to balance the deaths potentially linked to the vaccine against those linked to the virus.
Uncertainty is the sceptic’s playground. My wife is blessed with a healthy dose of scepticism and paranoia. An argument could be made that there are aspects to our family medical history that renders us somewhat susceptible to the blood clot. The links are tenuous, especially as the science around this is very inconclusive. To be clear, we are not anti-vaxxers. We want the vaccine. We received the text last week and promptly jumped onto the NHS website to book our appointment. Wouldn’t it be great though, we wondered, to be given a choice of vaccine?
Like an experienced barrister presenting evidence for the prosecution, my wife pointed to our neighbours across the pond to one side and the Channel at the other. Look at the States, she argued a few weeks ago, they can choose between Moderna, Pfizer and others. And when there were doubts linked with the Johnson & Johnson vaccine, its use was suspended immediately as a matter of abundant precaution. What about Europe? Some of the Scandinavian countries, she persisted with conviction, have paused the AZ rollout and others have restricted its use to sexagenarians and above. I never imagined ever being in a situation where I’d be called upon to defend Boris and his motley crew, but I found myself patiently making the case for the defence. Why the UK is not in the same position as our ‘friends and partners’ in the States or on the Continent because of our mix of procured vaccines, the risk to life from an expansion of choice, and so on. The risk is miniscule, I said, resting my case. Tell that to those who were unlucky enough to find themselves harbouring a blood clot, came the quick retort.
But I must admit, as I often do: my wife has a point. And when one of the scientists being interviewed on Wednesday extolled the virtues of the AZ vaccine versus not having one at all, rattling off facts and figures like only an Oxbridge academic can, the Chair of the Committee spookily read my mind and spoke it for me. ‘It’s a subtle point, isn’t it?’ he interjected. ‘The comparison is not between having the AZ vaccine versus not having one at all. The true comparison here is of the benefits and risks associated with the AZ vaccine versus the other approved vaccines that could be on offer.’ To this, the illustrious scientists, did not really have a counter argument, and bumbled their way through an explanation centred on logistical challenges.
We called our GP a couple of weeks ago. The seemingly perennially overworked receptionist answered in her usual deadpan and exasperated fashion, ‘The doctor is fully booked and cannot see you for another two weeks.’ When I patiently explained that all we were really after was a quick telephone chat, she explained as if to a five-year-old, that it didn’t matter. Chat or heart-surgery, she was required to schedule a telephone consultation. Biting my lip hard and resisting the urge of throwing the phone across the room like a frisbee, we acceded timidly to an appointment in a fortnight’s time. When the call came, we were handed a lesson in expert stonewalling. We laid out the argument and requested him to kindly write us a referral for the Moderna or Pfizer vaccine. The doctor and we were in the same boat, united in our ignorance of the potential causes of the rare occurrences of the blood clot. We were relying on the outside chance that he might succumb to our request out of the goodness of his heart. The doctor parroted the case for taking a vaccine like a pre-programmed robot and politely, but firmly, declined our request for a referral. We asked pointed questions and prodded and probed for any sign of him relenting. He was solid and unyielding. In less than five minutes, he sent us packing, unsatisfied and frustrated. But looking for the positives in every situation, I recognised that we had just received a masterclass in stubborn resistance. Since then, we have scoured the internet for explanation of causes and consequences, tried clinics, pharmacies, and hospitals, to explore avenues, however slim, to access Pfizer or Moderna, to no avail.
So here we are, presented with a Hobson’s choice. The AZ vaccine — take it or leave it. We are booked in for our jab: my wife next week, me, the week after. We are looking forward to it and putting this pandemic behind us once and for all. As I head to our local civic centre for my appointment, its not that I feel like a ponderous depressive Hamlet in Act 3, Scene 1 contemplating the merits of taking his own life. But as the syringe nears my bare arm, to that doubtful voice in my head, I might just whisper under my breath in response, ‘To be or not to be, that is the question.’
