Covid-19: three questions everyone should ask about vaccines

Dr Muiris Houston: It is reasonable to be hesitant and ask questions about the vaccine

New York City ICU nurse Sandra Lindsay has become one of the first Americans to get the newly approved Covid-19 vaccine made by Pfizer and its partner BioNtech. Video: Reuters

We have Covid-19 vaccines on the way and a plan for their administration, starting in January. It’s now time to ask yourself, will I accept vaccination against Covid-19 when it’s offered to me?

The issue goes well beyond “anti-vaxxers”. Media coverage has been quick to conflate people who are “vaccine hesitant” with conspiracy theorists – drawing comparisons between those wary of the newly developed vaccines and the corrosive mythmakers who reject sound science. In fact, it’s quite ok to express some reservations about the new vaccine, if that’s how you feel.

We don't actually know how many people will want to receive a covid-19 vaccine here. In the UK, a survey found that 64 per cent of respondents felt they were very or moderately likely to get a Covid-19 vaccine when one is approved, while 14 per cent felt they were moderately or very unlikely to be vaccinated. The Pew Research Centre in the US reported an almost 20 per cent fall, between May and September, in the proportion of adults who were definitely willing to have a Covid-19 vaccine. There is almost as much distrust in France as there is in America, while Spain and Germany have fairly positive attitudes, with about two-thirds of the population in favour of the vaccine.

What's needed is for us to create the space for open conversations about why some people might pause in the face of a new vaccine

Meanwhile a recent Ipsos/Global News poll suggested that 71 per cent of Canadians feel nervous about a vaccine being created and approved so quickly. A similar percentage said they are concerned about long-term side-effects. However other Canadian polls found between 11 and 15 per cent of respondents said they would not get vaccinated at all, in line with other western countries.


According to a recent editorial in the medical journal Drugs and Therapeutics Bulletin (DTB), willingness to receive a vaccine is affected by factors such as complacency, convenience and confidence. “Issues that influence vaccine uptake include concerns over adverse effects, negative messages on social and mainstream media, access to vaccination services, and the actions of health professionals, peers and communities”, it says.

We know what definitely won’t work is dismissively expecting people to just take the new vaccines. Science lectures from ivory towers by distant professors will do more harm than good. What’s needed is for us to create the space for open conversations about why some people might pause in the face of a new vaccine.

Only then can we tease out the many nuanced reasons people hesitate. Those of us in favour of Covid vaccination need to think carefully about why we trust and why others might not. We need to listen to peoples’ thoughts, feelings and social interactions in a non-judgmental way and be part of relaxed conversations about the pros and cons of getting a new vaccine.

Healthcare professionals must be honest about what we know and what we don't know about the harms and benefits of the Covid-19 vaccines. We need to describe what harms have been reported with Covid-19 vaccines, with what frequency they occurred and openly discuss what happened to those who had adverse reactions, such as the two British healthcare workers, who had an anaphylactoid reaction to the Pfizer vaccine.

The following are reasonable questions to ask about Covid-19 vaccines: does a vaccine help reduce asymptomatic transmission and the duration of infectivity; do vaccines prevent mild disease or reduce admissions to intensive care; and do they reduce the risk of death from infection?

Not everyone will want this level of detail; for some the “mum test” will suffice – would I encourage my older mother to take the vaccine when it is offered?

I reckon the Government has, at best, a month to ensure that healthcare professionals have a suite of communications with which to engage with people who have questions about Covid-19 vaccine.

And for those of you with questions, please ask – and ask again.