One of my school teachers used to tell a cautionary tale about a pedestrian who was killed when caught on a road at the bottom of a hill. He’d stepped between the lights of two oncoming bicycles. We were twelve or thirteen years old and not everyone in the class understood the silly joke.
Not everyone seems to understand the cautionary approaches to Covid-19 vaccinations.
For example, one current question is whether one dose is better than none when two doses may not be available?
Tim Harford explained it like this recently in his Financial Time column:
‘Cars are better with two headlights, and bicycles are better with two wheels. But while a bicycle with one wheel is useless, a car with only one headlight might be good enough in a pinch. The judgment here is that a single dose is more like a car with a single headlight than a bike with a single wheel.’
Another concern is that the vaccine itself may be harmful in ways we can’t anticipate.
The idea that the vaccination is unsafe is itself unsafe when judged from a public health perspective. Whooping cough has been on the rise in the US for over a decade and it’s pretty clear that unvaccinated children are the reason.
The Lancet has a lot to answer for after it published the appalling bad science in the 1997 study by Andrew Wakefield. Wakefield lost his medical license, the paper was retracted from The Lancet and yet his erroneous findings are still regularly quoted by those scared of vaccines. And by the way, autism is increasingly reported as a condition that starts in utero, long before birth.
The critical thing for any immunisation program is ‘herd immunity’, a term that was widely abused in 2020. As long as a large majority are immunised, the rest will be protected. Ideally, ‘the rest’ will be babies, pregnant women, elderly, and those with weakened immune systems who cannot be given vaccines.
There’s an ethical question that arises if the vaccine hasn’t been tested enough.
The suppression of polio in the US and Ebola in West Africa are famous success stories of vaccination without the full regimen of randomised, placebo-controlled clinical trials.
Of course, our communities and nations must balance these and many more issues regarding the Covid-19 vaccination programs.
I’ve not had much confidence in much of what our governments have done for us during this pandemic. But I know that the least worst public health scenario involves as many of us as possible taking the vaccine. It’s up to the public health officials to ensure that we have free access what we need on a timely basis.
And because nothing is perfect, once vaccinated, I will continue my incessant hand-washing, my mask-wearing and I suspect I will have to stay socially distant for years to come. That’s because our scientists remain focussed on the eradication of the virus. This is a good thing. But soon we’ll need to switch sciences and learn how to modify people’s behaviour. After all, if the vaccination is 80% effective and 80% of people get it, then no more than 64% of the people you meet are likely to be immunised. So they better behave.