COVID-19 Vaccine: To Get or Not to Get?

As mentioned in a previous post, the race of the vaccines is ON and more competitive than ever at this point. Well, there seems to finally be some progress in the race. Operation Warp Speed is a federally funded program working hard to produce and deliver hundreds of millions of safe, effective, and affordable vaccines by January 2021. They have been active in the vaccine race since March, and have already been developing plans for delivery of the vaccine upon approval. Just several days ago, the U. S. department of Human Health Services announced partnerships with large chain pharmacies and networks that represent regional chains to cover up to 60% of all pharmacies in the United States, which will greatly increase access to the vaccine once available. This is great news, right? Well, not exactly. The public opinion on the vaccine seems to be pretty indecisive, surprisingly. I know all I’ve heard for awhile was “I can’t wait for them to just have a vaccine already so things will go back to normal,” but now that that is becoming more of reality, people are starting to express distrust for the vaccine. Even physicians and nurses are expressing distrust for the new vaccine. There are many reasons one may be distrustful of a vaccine, but today I will be discussing one individual in particular whom I believe is responsible for much of the public’s distrust.

Andrew Wakefield is a former British physician, according to his Wikipedia page, who has been struck off the medical register in 1998 due to his claims of a link between vaccines and the MMR vaccine. He has since become known for anti-vaccination activism. In 1998, Wakefield published a report from a study that hypothesized a link between vaccination and developmental disorders (this study has since been retracted). In his study, Wakefield investigated 12 cases of children referred by a pediatric gastroenterology unit who had a history of normal development followed by a loss of acquired skills to try and determine the cause of the regression. At a first glance (and as a student who has been involved in research), this study was quite poorly conducted and interpreted. The sample size was considerably small, and given the retrospective nature of the study, Wakefield essentially concluded that the the MMR vaccine may have been the causative agent from word of the parents of the affected children. This was also a case series study, which results from these studies are generally only generalizable to very specific populations. This study had no control subjects and relied on descriptions of histories in order to pinpoint a cause. Dr. Zane Thomas also outlines several discrediting factors of Wakefield’s study in an article published by the Cambridge Center for Behavioral Studies. One of the first flaws pointed out in this article is the lack of randomization of the study, which impacts the validity of the study. It is even thought that Wakefield picked his participants from a program called Justice Awareness and Basic Support (JABS), which is a program offering support for “vaccine-damaged children.” Another concern discussed is the fact that the children exhibiting bowel problems may have been doing so prior to vaccination, discrediting any causal relationship. The last major point that was discussed in Thomas’s article, in my opinion, is that of the obvious research bias exhibited by Wakefield. It is mentioned that Wakefield and colleagues’ objective of the study was to seek evidence of a causative connection between the MMR vaccine and certain conditions in children. This makes it seem as if they knew what resulted they wanted to obtain, and would tailor their study to provide these results, indicating some serious researcher bias.

Another article I would like to discuss is a study published by the New England Journal of Medicine that also examines the relationship of the MMR vaccine and developmental issues. This group of researchers conducted a retrospective cohort study of ALL children born in Denmark between 1991 and 1998. The researchers received the subjects’ MMR vaccination status from the Danish National Board of Health and information on the subjects’ autism statuses was obtained from the Danish Psychiatric Central Register. They also were able to obtain information on confounders through several other reputable sources. This study ended up enrolling 537,303 subjects, with 82.0% having received the vaccine. After adjustment for confounding variables, the researchers assessed the risk of developing a developmental disorder from the MMR vaccine to be .92%. This study was able to use unvaccinated children as a control and ultimately was able to conclude that the risk of acquiring autism was similar in both vaccinated and unvaccinated children. They also were able to observe that there were not “clustering” of cases of autism at any time after immunization. This study seems to be very unbiased, in their objective was to examine the relationship between the MMR (not to prove a relationship), used a representative sample and controls, and used scientifically ethical research methods and data analysis. This study did a wonderful job at discrediting the initial Wakefield study.

Back to the topic at hand, I believe it is safe to conclude that Wakefield is largely responsible for the distrust of not only the COVID-19 vaccine, but for vaccines in general. Personally, I do think that more people are weary of the vaccine due to it being generated in such a short amount of time and not knowing about long term side effects more than they are worried about autism spectrum disorders. Either way, something I still don’t understand is why everyone was pushing so hard for a vaccine that only 50% of healthcare personnel would admit to being comfortable with getting. In my own experience, I have heard my peers talking about herd immunity and how they plan to rely on others to get vaccinated so that they will not have to, but if everyone has this same train of thought, no one will get vaccinated. This is a very scary time for our country and I am honestly very disappointed in much of our country’s response to both the virus and our attempt at flattening the curve. What I believe I am most disappointed in, however, is how our country managed to take a virus and turn it into a political issue. I promise this virus does not care if you are left or right, so stop behaving as if it is the case. This is science, not a political platform.

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