Panic before use

Numbers and fears on the covid-19 vaccines

🇮🇹 This article is also available in the original Italian version

Prepare for landing. I clasp my hands to the seat, take a breath, close my eyes and as soon as I feel the wheels of the plane land on the ground, I let out a sigh of relief, as if it had all been a dream. With me, others sigh or applaud, while only a few habitual flyers remain indifferent - although I have seen some flight attendants experience the same irrational feeling.

It is well known that the plane is the safest mode of transport. You know it rationally, but you don’t feel that way. The fear that rises from the bowels to the throat and obscures our thoughts is due to a lack of control: I'm afraid because I am not the one flying the plane. I do not trust the pilot. We experience similar feelings in the case of the COVID-19 vaccine. The same distrust exists, not of the poor pilot, but of the government, and of the authorities who decide on our behalf.

Trusting your feelings can sometimes be good, but we must also exercise our ability to read statistics. It can be useful not only to us, but to all those around us. It might not be possible to avoid fear, but we’ll be able to manage it better.

Many of us are afraid of getting vaccinated: those who contract their muscles, those who turn their heads, those who close their eyes, those who list the medicines to be taken later, those who try not to think about it. Here, I will present some data that could become a new nursery rhyme to chase away your thoughts if you want, but that should also serve to inform and give confidence.

The data comes from national and international institutions that decide how we should treat, not only COVID-19, but also cancers, cardiovascular diseases, and infections. So, if you go to the emergency room for pain in your chest and left arm, these are data that you already trust.

Firstly, those who are afraid of dying from this vaccine, which records 0.5 deaths per million vaccinated, will certainly have even greater fear of traveling 10 km by motorbike, 340km by car, or 27km on foot (at a death rate of 1 per million). And as soon as we leave the house, we should all keep an eye on the sky to avoid the frequent, life-threatening lightning strikes, since the risk of being struck over the course of 80 years of life is 1 in ten thousand. It’s true that we don’t run the show: there’ll always be a fear, and we might be unlucky, but maybe these data can help us.

What next? Does this vaccine work? Let us, first of all, remember that the vaccine does not prevent infection, despite slowing down its spread, but it prevents serious complications from the disease caused by COVID-19. An important report by the Italian Ministry of Health that records data on the 27.5 million Italians vaccinated as of 13th June shows that after the second dose the risk of hospitalization declined to 0.03 per 10,000 people, and mortality declined to 0.01 per 10,000. Data from the American CDC (Center for Disease Control and Prevention) suggests that the lucky ones are certainly the "fearless" vaccinated: vaccinated people have a 17 times lower risk of being hospitalized due to COVID-19 than the unvaccinated. 

The pandemic remains a complex situation full of uncertainties, but we can certainly say that the effectiveness of the vaccines used in Europe is very high.

Even once we accept the vaccine, unanswered questions remain, and the answers are too often mediated by competing interests. Here is some food for thought.

A pandemic does not only affect the Western world: vaccinating countries that cannot afford the luxury of buying vaccine doses is not only an ethical responsibility but also a practical necessity. Vaccinating as many people as possible throughout the world decreases the risk of developing dangerous new variants. The WHO has established the need to vaccinate more of the global population before we think about dispensing third (or ‘booster’) doses. The third dose is essential for immunocompromised individuals to build up sufficient antibodies, but it remains unclear when a third dose should be administered to individuals who are not immunocompromised. The European Medicines Agency (EMA) has allowed carte blanche, or the right to decide individually on this matter, to Member States. Yet long term interests have not prevented the richest states in the world from starting to vaccinate their entire population for a third time, even before studies have determined when the protection that is offered by two doses expires. The disagreements between Joe Biden and experts within the American Federal Drug Authority (FDA) demonstrate that this uncertainty creates a difficult tension between science, and political and economic interests.

The expiration date of protection from two doses should be checked with precision by the scientific community before we anticipate the need to renew protection with boosters, in order to avoid wasting a large number of vaccine doses and inadvertently making pharmaceutical companies even richer. Let us remember that Albert Sabin gave the polio vaccine to the world without making any money. It is possible that certain population groups (for instance those aged between 18 and 25) might not need a third dose in the near future. Saving those doses while the world at large is still experiencing a pandemic would not only save money, but also allow us to direct these doses to the people who really need them.

In Italy, the third booster dose is already expected, despite the fact that there are still three million people who are unvaccinated. This is an ethical problem that calls into question the principles of equality and freedom. We remind you that the unvaccinated are those who are most at risk, but they are also those who, without the slightest physical or mental effort, enjoy the benefit of others having been vaccinated. Widespread vaccinations have caused hospitalizations and deaths to dramatically decline, made Italy a safer country, and avoided everyone having to find each other dystopically on their balconies once again.

The vaccine works, but only if the majority of the world population is vaccinated. It cannot be a luxury nor an excuse. The vaccine, in fact, does not stop the spread of infections, so states will still have to strive to trace contacts, sequence variants, and to make schools and means of transport safer. Even individuals will have to make some effort for a while longer: even those who are vaccinated are in danger of contagion when they are indoors without masks.

In conclusion, the cracks and contradictions are many, but saving lives should come before any economic, political or social concerns. Questioning a tool that allows us to save lives is useless, but questioning the system is essential.

And for the conspiracy theorists: if the whole pandemic were a way to control humanity through the vaccine, then whoever conceived this project - convincing politicians, doctors, technicians and citizens from all over the world - deserves my respect. Not easy!