Here in Canada and in many other countries, we likely all know loved ones and colleagues who have gotten that precious and life-saving dose, if not had it ourselves. Having said that, vaccine hesitancy is real. A recent Canadian poll shows that 66% of respondents would be willing to get a vaccine right away if it were available, but hesitancy may vary based on the specific type of vaccine as well as other factors. As well, that figure leaves a significant minority of vaccine hesitant individuals.
Full disclosure: I’m generally somewhat risk-averse when it comes to medications/interventions, and the April 14 Health Canada Advisory on the AstraZeneca vaccine did give me pause. If I’d been offered an mRNA vaccine I wouldn’t have thought twice; but that wasn’t on the menu. Nonetheless, I registered for AZ on multiple pharmacy waiting lists, and when the text message came with an appointment, it got real. I had a decision to make and in all honesty, part of me hesitated – in fact, I kind of panicked. So I did what most of us do: I spoke to trusted friends, colleagues, and loved ones and shared my anxiety and hesitation. The person who tipped the balance was a physician I used to work with
My friend the doctor noted the extremely low risk of admittedly serious adverse effects (which I already knew…but still…what if I was one of those rare cases?!). Then, he noted that in the very unlikely event I was one of the few who experienced VITT, there are treatments available. Somehow I totally missed that part on the Health Canada web page! There it is, clear as day, on its own line:
“In the very rare event that someone experiences unusual blood clots with low platelets, there are treatments available.”
So I had to wonder, how did I miss that crucial and highly reassuring piece of information? For all of us, decision-making is impacted by cognitive biases. There are evolutionary and biological advantages to these biases, but they can also seriously hamper decision-making, especially when we feel like our safety might be at risk. In reading that Health Canada web page, I automatically focused on the content outlining the side effects and risks of the vaccine, as opposed to their rarity and treatability – attentional bias. Even before I started reading, I was primed to hone in on the scary stuff:
“In our personal and professional lives, attentional bias can give us tunnel vision, overemphasizing some factors and blinding us to others. When we narrowly focus on one or two things, we end up overthinking them, and assigning them greater importance in our decision making than we should.”
All to say, I promptly confirmed my appointment and got vaccinated. That night I had shivers and a headache, and felt a bit feverish – and I visualized my immune system marshalling the defenses. The following day – all was well. I was relieved and grateful, and I also felt uncomfortably guilty thinking about the many essential workers, families, and high-risk populations who haven’t yet had the opportunity to get vaccinated. Prioritizing higher-risk communities and populations reflects an ethical approach to vaccinating a whole province/country/world, although not without missteps and stumbling blocks along the way.
We all need a ‘shot in the arm’, and I mean that both literally and figuratively. To everyone waiting anxiously for that appointment or for your eligibility to get that appointment: I am crossing my fingers for you and knowing that it won’t be too much longer. If you’ve already received your vaccine, I am so very grateful to join your number. And to those still on the fence, you’re really who I’m writing this for. These are not always easy decisions, and they are for each person alone to make.
Crossing the milestone of 20,000 COVID19 deaths in Canada is a stark reminder of the tremendous human cost of the virus. Each and every one of those individuals was a parent or grandparent, a sibling, friend, or loved one. The ongoing impacts for COVID19 “long haulers” are also sobering and hard to comprehend in their magnitude and duration. Increasing numbers of younger people in Canada’s ICU beds reinforce the reality that we’re all vulnerable, although by no means equally vulnerable. Life is precious and it’s fleeting, and COVID has already robbed our world of so many.