Home Health Glenn Ellis Ellis: COVID-19 vaccines: The unanswered questions

Ellis: COVID-19 vaccines: The unanswered questions

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By Glenn Ellis

The long-awaited vaccines are here, but there are still a plethora of unanswered questions and challenges.

Each day, more and more of us are having increasing difficulty trying to sort out the massive amounts of often conflicting information. It is in our own best interest that we continue to do our due diligence and get as best an understanding as we prepare to make decisions.

Let start with the confusion around dosage. Initially, we were all prepared for the arrival with expectations of a two-dose vaccine. The Centers for Disease Control and Prevention (CDC) said, “Depending on the specific vaccine you get, a second shot three-four weeks after your first shot is needed to get the most protection the vaccine has to offer against this serious disease.”

Then, all of sudden news came that the United Kingdom had instituted a game changer: they decided to delay giving people the second dose of the coronavirus vaccine. Instead of the 21-day period, following the first dose that the emergency approval had been granted, Britain’s government decided that the second dose would now be given up to 12 weeks after the first dose. In order to get as many people as possible the first dose, the amount of time folks wait for the second dose is now stretched out three times longer than the results of the clinical trials demonstrated.

In addition to the science questions, there are ethical issues as well. Folks who were at the front of the line getting the first dose, were at the front of the line for a reason; they are at highest risk to be infected by COVID-19. This modified approach, initiated by the British, would deny a “scheduled” dose to those previously deemed most in need of the two doses, based on the data from the clinical trials. Which brings us to question No. 1: Where’s the data that shows us that this is safe, as well as effective?

That leads, inevitably, to discussions in medical and scientific circles about only giving people only a single dose…period; or cutting the dose size in half. There are no data on whether protection lasts longer than three weeks, when the second dose was given. But wait. It gets even more puzzling. Most recently, the big news is the announcement of a forthcoming “one dose” COVID-19 vaccine from pharmaceutical giant, Johnson & Johnson.

Now we have to wonder about the whole “Warp Speed” thing; with all of those resources coming up with a two-dose vaccine, and now here comes a one-dose vaccine. Which brings up question No.  2: Which vaccine should I get, and is one better than the other?

The government spent months going back and forth about who should be vaccinated, first; health care workers and nursing home residents, then broadening out to account for risk factors like age, pre-existing conditions and front-line employment. Then all of that has been thrown out of the window. We are starting to hear about state and federal investigations looking into reports that wealthy Americans are getting vaccinated before they are eligible. This includes the Board of Directors at a nursing home who got the vaccine before the residents, and the New Yorkers who were caught flying to Florida to get a pre-arranged vaccine at a nursing home.

The trend is growing daily across the country with professional sports teams; airlines; and many other industries lobbying for legislation that allows them to jump the line. And finally, the big question: How can one trust a system that allows this?

Yes, there are plenty of folks who are in no hurry to get a vaccine. There are some who are saying that they are outright not getting it. Yes, vaccine hesitancy is real, and it does not benefit any of us for it to guide our national response in times of a public health crisis, such as this pandemic.

Let’s not waste time focusing on convincing people why they need to take the vaccine for the good of society by guilting them, or beating them on the head from the bully pulpit. Simply speaking to the obvious questions that are consistent with the level of transparency necessary for institutional trust is our way forward. Vaccines are clearly our pathway out of this pandemic, whether we want to accept it or not.

Yet, let ‘s not forget that people are human beings with a core common sense and a level of comfort when it comes to things that are “above their pay grade”. Regular folks have to rely on what their “gut” tells them in this type of situation. Those “guts” have to be nourished. We have to do our part to make deeply informed decisions, and public health officials have to just answer the questions.   As my dear friend, Stanley Wallace, a retired educator in Tuskegee, Alabama says, “give them info!”

Glenn Ellis, MPH is a Visiting Scholar at The National Bioethics Center at Tuskegee University and a Harvard Medical School Bioethics Fellow. He is author of Which Doctor? and Information is the Best Medicine. For more good health information visit: www.glennellis.com