Covid-19 vaccination challenges

Should we shame and pressure people to take the [“experimental”?] Covid vaccine?

Part 109/2021 (Contribution)

BRADES, Montserrat, February 28, 2021 – On Wednesday, February 23, Montserrat’s Chief Medical Officer Dr. Greenaway-Duberry unexpectedly appeared in our media. She announced that based on new findings, it is now recommended that the second dose of the Oxford/AstraZeneca vaccine for Covid-19 should be taken eight weeks after the first dose, as that gives a superior result to the previously recommended four-week point. This puts several questions on the table, starting with: just how experimental is the cluster of emerging Covid-19 Vaccines?

A key clue is found in a February 12, 2021, Gina Hawkins report on Military dot com, “Navy Will Make COVID-19 Vaccination Mandatory ‘As Soon as We Can:’ 3-Star Admiral” which cites Vice Admiral Andrew Lewis, U.S. Second Fleet Commander and US Defense Department Officials:

“ ‘We cannot make it mandatory yet,’ [Admiral] Lewis said. ‘I can tell you we’re probably going to make it mandatory as soon as we can, just like we do with the flu vaccine’ . . . . Defense Department officials have previously said that the COVID-19 vaccine would remain voluntary while it’s under emergency-use authorization by the Food and Drug Administration. That designation is expected to last up to two years while the FDA assesses the vaccination’s efficacy and side effects.”[1]

Taking account of testing already undertaken in recent months, this tells us that it may take up to two or three years “[to] assess . . . efficacy and side effects.” That easily explains why our CMO has had to make a change in the recommended waiting time to take our booster shots: globally, we are still studying and learning about the vaccine, the “science” has not settled down yet.

In a related Defence dot gov  report, “Military, Medical Leaders Discuss COVID-19 Issues With Service Members,” Terri Moon Cronk cites[2] US Army General and then Chairman of the Joint Chiefs of Staff, Mark A. Milley, who:

“. . . noted that the National Institutes of Health and the Food and Drug Administration have declared the vaccines as “safe and highly effective” but he acknowledged that getting the vaccine is a personal decision. “We . . .  encourage you to consult your primary care physician to address any concerns . . .  so you can be well-equipped to make the right decision for you and your family,” Milley said. “Protect yourself, protect your families and protect our communities. Together, we can all lead the way for the nation in the fight against COVID-19.”

We see here a clear recognition that while there is good evidence of vaccine effectiveness, we are responding to a global, fast-moving pandemic and are strictly speaking still in a somewhat exploratory phase of testing and evaluating the vaccines. The challenge being faced by officials here and overseas is that the epidemic is outracing the usual pace of new drug development, testing and certification so it is necessary to act on good enough but not complete evidence, in hopes of saving lives, net.

But what about the AstraZeneca vaccine in use here?

A copy of the official “Product Information as approved by the CHMP on 29 January 2021, pending endorsement by the European Commission,” tells us:

“COVID-19 Vaccine AstraZeneca is indicated for active immunisation to prevent COVID-19 caused by SARS-CoV-2, in individuals 18 years of age and older.  The use of this vaccine should be in accordance with official recommendations . . . . The safety and efficacy of COVID-19 Vaccine AstraZeneca in children and adolescents (less than 18 years of age) have not yet been established. No data are available . . . .Appropriate medical treatment and supervision should always be readily available in case of an anaphylactic event [i.e. strong allergic reaction] following the administration of the vaccine. Close observation for at least 15 minutes is recommended following vaccination. A second dose of the vaccine should not be given to those who have experienced anaphylaxis to the first dose of COVID-19 Vaccine AstraZeneca . . . . The duration of protection afforded by the vaccine is unknown as it is still being determined by ongoing clinical trials . . . . Currently available clinical trial data do not allow an estimate of vaccine efficacy in subjects over 55 years of age.” 

In short, the AstraZeneca vaccine is also still being evaluated through “ongoing clinical trials.” It is credibly effective but clearly, points of concern remain. Therefore, we should recognise that while it is generally advisable to take it, any significant medical treatment should be taken under the advice of a doctor familiar with one’s medical history and current circumstance. That is simple, basic medical ethics and professional standards. (That’s part of why when we first go to a doctor she or he will normally take our general medical history, blood pressure etc. and will set up a patient file.)

Similarly, it is common sense that people prone to strong allergic reactions or who have significant medical challenges should be extra careful to get advice from their doctor.

Finally, what about “herd immunity”?

It is commonly reported that the AstraZeneca vaccine is about 70% effective.[3]  Where, we can see from a Healthline dot com article by Noreen Iftikhar, MD, “What Is Herd Immunity and Could It Help Prevent COVID-19?”[4] that:

“For some diseases, herd immunity can go into effect when 40 percent of the people in a population become immune to the disease, such as through vaccination. But in most cases, 80 to 95 percent of the population must be immune to the disease to stop its spread.  For example, 19 out of every 20 people must have the measles vaccination for herd immunity to go into effect and stop the disease. This means that if a child gets measles, everyone else in this population around them will most likely have been vaccinated, already have formed antibodies, and be immune to the disease to prevent it from spreading further.”

“Herd immunity” happens when on average an infected person is so unlikely to pass the disease on to someone without antibodies that it begins to “die out.”  That can come from enough people catching then recovering from a disease, or from vaccination. Now, we know that Covid-19 is fairly contagious so the 80% estimate some have suggested is reasonable. But if 100% of our population is vaccinated with a vaccine estimated to be 70% effective, then by simple Arithmetic we cannot make the 80 – 95% of population threshold; herd immunity may not be achievable using AstraZeneca, not only from “doing our sums” but especially as we can see that it is not recommended for children under 18

Where, too, the other vaccines that are said to be 90+% effective in immunising (Moderna, Pfizer), are based on novel technologies never before used with people. That means they are far more experimental than AstraZeneca.

Obviously, there is room for different opinions and for different people to make up their minds on the balance of medical risks they face given issues such as allergic reactions.


[1]           See: https://www.military.com/daily-news/2021/02/12/navy-will-make-covid-19-vaccination-mandatory-soon-we-can-3-star-admiral.html

[2]           See https://www.defense.gov/Explore/News/Article/Article/2493366/military-medical-leaders-discuss-covid-19-issues-with-service-members/

[3]           For example, see https://inews.co.uk/news/uk/covid-vaccine-how-effective-astrazeneca-pfizer-moderna-vaccination-efficacy-compared-what-meaning-845136

[4]           See https://www.healthline.com/health/herd-immunity

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Should we shame and pressure people to take the [“experimental”?] Covid vaccine?

Part 109/2021 (Contribution)

BRADES, Montserrat, February 28, 2021 – On Wednesday, February 23, Montserrat’s Chief Medical Officer Dr. Greenaway-Duberry unexpectedly appeared in our media. She announced that based on new findings, it is now recommended that the second dose of the Oxford/AstraZeneca vaccine for Covid-19 should be taken eight weeks after the first dose, as that gives a superior result to the previously recommended four-week point. This puts several questions on the table, starting with: just how experimental is the cluster of emerging Covid-19 Vaccines?

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A key clue is found in a February 12, 2021, Gina Hawkins report on Military dot com, “Navy Will Make COVID-19 Vaccination Mandatory ‘As Soon as We Can:’ 3-Star Admiral” which cites Vice Admiral Andrew Lewis, U.S. Second Fleet Commander and US Defense Department Officials:

“ ‘We cannot make it mandatory yet,’ [Admiral] Lewis said. ‘I can tell you we’re probably going to make it mandatory as soon as we can, just like we do with the flu vaccine’ . . . . Defense Department officials have previously said that the COVID-19 vaccine would remain voluntary while it’s under emergency-use authorization by the Food and Drug Administration. That designation is expected to last up to two years while the FDA assesses the vaccination’s efficacy and side effects.”[1]

Taking account of testing already undertaken in recent months, this tells us that it may take up to two or three years “[to] assess . . . efficacy and side effects.” That easily explains why our CMO has had to make a change in the recommended waiting time to take our booster shots: globally, we are still studying and learning about the vaccine, the “science” has not settled down yet.

In a related Defence dot gov  report, “Military, Medical Leaders Discuss COVID-19 Issues With Service Members,” Terri Moon Cronk cites[2] US Army General and then Chairman of the Joint Chiefs of Staff, Mark A. Milley, who:

“. . . noted that the National Institutes of Health and the Food and Drug Administration have declared the vaccines as “safe and highly effective” but he acknowledged that getting the vaccine is a personal decision. “We . . .  encourage you to consult your primary care physician to address any concerns . . .  so you can be well-equipped to make the right decision for you and your family,” Milley said. “Protect yourself, protect your families and protect our communities. Together, we can all lead the way for the nation in the fight against COVID-19.”

We see here a clear recognition that while there is good evidence of vaccine effectiveness, we are responding to a global, fast-moving pandemic and are strictly speaking still in a somewhat exploratory phase of testing and evaluating the vaccines. The challenge being faced by officials here and overseas is that the epidemic is outracing the usual pace of new drug development, testing and certification so it is necessary to act on good enough but not complete evidence, in hopes of saving lives, net.

But what about the AstraZeneca vaccine in use here?

A copy of the official “Product Information as approved by the CHMP on 29 January 2021, pending endorsement by the European Commission,” tells us:

“COVID-19 Vaccine AstraZeneca is indicated for active immunisation to prevent COVID-19 caused by SARS-CoV-2, in individuals 18 years of age and older.  The use of this vaccine should be in accordance with official recommendations . . . . The safety and efficacy of COVID-19 Vaccine AstraZeneca in children and adolescents (less than 18 years of age) have not yet been established. No data are available . . . .Appropriate medical treatment and supervision should always be readily available in case of an anaphylactic event [i.e. strong allergic reaction] following the administration of the vaccine. Close observation for at least 15 minutes is recommended following vaccination. A second dose of the vaccine should not be given to those who have experienced anaphylaxis to the first dose of COVID-19 Vaccine AstraZeneca . . . . The duration of protection afforded by the vaccine is unknown as it is still being determined by ongoing clinical trials . . . . Currently available clinical trial data do not allow an estimate of vaccine efficacy in subjects over 55 years of age.” 

In short, the AstraZeneca vaccine is also still being evaluated through “ongoing clinical trials.” It is credibly effective but clearly, points of concern remain. Therefore, we should recognise that while it is generally advisable to take it, any significant medical treatment should be taken under the advice of a doctor familiar with one’s medical history and current circumstance. That is simple, basic medical ethics and professional standards. (That’s part of why when we first go to a doctor she or he will normally take our general medical history, blood pressure etc. and will set up a patient file.)

Similarly, it is common sense that people prone to strong allergic reactions or who have significant medical challenges should be extra careful to get advice from their doctor.

Finally, what about “herd immunity”?

It is commonly reported that the AstraZeneca vaccine is about 70% effective.[3]  Where, we can see from a Healthline dot com article by Noreen Iftikhar, MD, “What Is Herd Immunity and Could It Help Prevent COVID-19?”[4] that:

“For some diseases, herd immunity can go into effect when 40 percent of the people in a population become immune to the disease, such as through vaccination. But in most cases, 80 to 95 percent of the population must be immune to the disease to stop its spread.  For example, 19 out of every 20 people must have the measles vaccination for herd immunity to go into effect and stop the disease. This means that if a child gets measles, everyone else in this population around them will most likely have been vaccinated, already have formed antibodies, and be immune to the disease to prevent it from spreading further.”

“Herd immunity” happens when on average an infected person is so unlikely to pass the disease on to someone without antibodies that it begins to “die out.”  That can come from enough people catching then recovering from a disease, or from vaccination. Now, we know that Covid-19 is fairly contagious so the 80% estimate some have suggested is reasonable. But if 100% of our population is vaccinated with a vaccine estimated to be 70% effective, then by simple Arithmetic we cannot make the 80 – 95% of population threshold; herd immunity may not be achievable using AstraZeneca, not only from “doing our sums” but especially as we can see that it is not recommended for children under 18

Where, too, the other vaccines that are said to be 90+% effective in immunising (Moderna, Pfizer), are based on novel technologies never before used with people. That means they are far more experimental than AstraZeneca.

Obviously, there is room for different opinions and for different people to make up their minds on the balance of medical risks they face given issues such as allergic reactions.


[1]           See: https://www.military.com/daily-news/2021/02/12/navy-will-make-covid-19-vaccination-mandatory-soon-we-can-3-star-admiral.html

[2]           See https://www.defense.gov/Explore/News/Article/Article/2493366/military-medical-leaders-discuss-covid-19-issues-with-service-members/

[3]           For example, see https://inews.co.uk/news/uk/covid-vaccine-how-effective-astrazeneca-pfizer-moderna-vaccination-efficacy-compared-what-meaning-845136

[4]           See https://www.healthline.com/health/herd-immunity