Michael Abrahams | How your decision to refuse the COVID-19 vaccine can affect others
“My body, my choice.”
This is the battle cry of women on the frontlines of the fight to legalise abortion. Being pro-choice, I support women in this struggle. I do not believe in coercing or forcing people to subject themselves to something they feel uncomfortable doing.
Similarly, regarding COVID-19, I am uneasy with the concept of mandatory vaccination. I believe the decision to be vaccinated should be a voluntary one guided by informed consent.
People who choose not to be vaccinated are by no means a monolithic group. They range from anti-vaxxers who reject vaccination of any kind, to intelligent people who have rational concerns.
These vaccines are new, and the technology behind them is also relatively recent, therefore we cannot confidently say we know what their long-term effects will be. So, hesitancy based on these concerns is understandable.
On the other hand, there are clear benefits of being vaccinated. The data is now clearly showing that people who are unvaccinated are at a greater risk of becoming severely ill, requiring oxygen, needing hospitalisation and dying from COVID-19.
According to the Centers for Disease Control and Prevention (CDC) in the USA, unvaccinated people are about 29 times more likely to be hospitalised with COVID-19 than those who are fully vaccinated, and are 11 times more likely to die.
A Dutch study found COVID-19 vaccines to be 97 per cent effective in preventing ICU admission, while a study from Ontario, Canada, found that unvaccinated people were 60 times more likely to end up in ICU with COVID-19.
Approximately nine per cent of Jamaicans are fully vaccinated, but at the University Hospital of the West Indies, National Chest Hospital, and Kingston Public Hospital, the percentage of vaccinated patients battling COVID-19 is only about one per cent. There is a significant disparity.
The decision to refuse vaccination, especially now with the Delta variant being the most prominent, may not be in your best interest, and places you at risk. However, although this is a choice you make about your body, your decision can affect others negatively as well.
We know that both the vaccinated and the unvaccinated can catch and spread COVID-19, and that breakthrough infections in vaccinated individuals are not rare. However, vaccinated persons are somewhat less likely to become infected, and if they do become infected, they clear the virus from their bodies quicker than unvaccinated people do.
In other words, unvaccinated COVID-19 patients remain infectious for a longer period of time. So if you are unvaccinated and are among other people, especially others who are not, your likelihood of becoming infected and passing on the virus to them, and causing them to be ill, is greater than if you were vaccinated.
But the ability of the unvaccinated to affect others goes way deeper than just infection. When people contract COVID-19 and get very ill, as the unvaccinated are more likely to become, and are admitted to hospital, the stress on their families is immense. And the toll is not just mental and emotional. The financial burden can be enormous.
When a person is hospitalised, the interventions required to manage them, in an attempt to save their lives, can be costly and include drugs that are expensive.
In Jamaica, the drugs remdesivir and tocilizumab (Actemra) are often prescribed for hospitalised patients. Courses of these drugs cost in excess of J$200,000. The drugs are not usually available in hospitals, so the family members are often given the task of sourcing the drugs and paying for them.
Unfortunately, due to the high cost, these medications are out of reach for many. Also, if these drugs are requested, the patients requiring them are often very ill, and many do not make it out of hospital alive. Then the families are left to deal with the grief of losing someone whose death was likely preventable.
A friend of mine lost two cousins and a grandfather to COVID-19 in the space of a month. They were all unvaccinated. My friend also caught COVID-19, but is fully vaccinated and physically okay now. However, she finds herself repeatedly grieving.
If the deceased was a loner with little or no family, the situation may not be as grim. But in many cases, there are several family members affected, including young children who were dependent on the parent or caregiver who died, and these children face consequences, including poverty, abuse and institutionalisation.
A study published recently in the British Medical Journal (BMJ) found that 1.5 million children have been orphaned by the pandemic. Some of the parents would have died prior to the availability of vaccines, and some may have been vaccinated. But among them would also be those who refused vaccination and whose deaths were likely preventable.
EFFECTS ON SOCIETY
And persons affected are not only family members or people previously known by the deceased. The decision to decline vaccination has an effect on the society. If vaccination reduces the risk of hospitalisation and death, it is not surprising that a disproportionate number of unvaccinated patients would be lying in hospital beds. COVID-19 patients have overwhelmed our health system, and in doing so inconvenienced other patients and increased the likelihood of their conditions worsening, or even killing them.
For example, during the last surge in Jamaica, elective surgeries were suspended. Patients affected included those with cancer. This disruption places them at risk of their cancers becoming more advanced and spreading by the time they eventually get the surgery they need.
I often hear people refer to those who refuse vaccination as being selfish, but I find such a blanket statement to be unfair. There are people I know who are vaccine-hesitant who are kind, empathetic and unselfish.
However, if you are aware that your decision places you at risk of becoming incapacitated, or dying and leaving vulnerable dependents behind, and that by refusing vaccination you belong to a subset of the population that is contributing to the overwhelming of the health sector and the burnout of healthcare workers, you may want to rethink your position.