Opinion

To help end the pandemic, don't pick and choose — take the first vaccine available

It's crucial to think of the vaccines not as something you select based on what your friends got, but as necessary armour to protect yourself and those around you, writes Dr. Noah Ivers.

Think of the vaccines as necessary armour to protect yourself and those around you, writes Dr. Noah Ivers

A staff member at a pharmacy in Toronto prepares a dose of COVID-19 vaccine on March 17. We need to inoculate as many people as possible for the vaccine program to work - and the faster this is done, the faster we can return to normal, writes Dr. Noah Ivers. (Sam Nar/CBC)

This column is an opinion by Dr. Noah Ivers, a family physician and associate professor in the Department of Family Medicine at the University of Toronto. He holds a Canada Research Chair and is a member of the 19 to Zero coalition. For more information about CBC's Opinion section, please see the FAQ.

The onset of spring has brought more than just good weather. Health Canada has added a fourth approved vaccine to our arsenal in the battle against COVID-19, and for the first time in months there is a feeling that we are coming close to the end of a pandemic that has affected us all negatively in too many ways to count.

Vaccination plans are being ramped up across the country, and photos of elderly individuals and front-line workers getting injections to protect them have made many of us misty-eyed. This is why I've been so alarmed of late by friends and relatives who speak of waiting to receive their vaccine of choice.

Until recently, we were desperate for a vaccine. Now people are openly opining about what vaccination they want in the coming months, as if selecting different brands of beer at the local bar.

But the whole point is that we're not able to be at the bar with our friends. We're still social-distancing and worrying about COVID-19 deaths and hospitalizations. And while it's heartening to see lower COVID case numbers, deaths, and hospitalizations than in the peak of waves one and two, the unfortunate reality is that the virus continues to spread, and variants could take us back to the starting line.

That's why it's crucial to think of the vaccines not as something you select based on what your friends got, but as necessary armour to protect yourself and those around you.

For the vaccine program to work, we need as many people vaccinated as possible. And the faster this is done, the faster we can return to normal.

WATCH | Inside the race to get COVID-19 vaccines to Canadians:

Inside the race to get COVID-19 vaccines to Canadians

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CBC’s David Cochrane goes inside the processes of vaccine delivery and distribution as well as the challenges to deliver on the promise of at least one shot for every Canadian who wants it by July 1. 4:08

Often, the justification for wanting to wait weeks to take, say, the Pfizer or Moderna vaccine over AstraZeneca or Johnson & Johnson is attributed to their corresponding efficacy rates. Pfizer and Moderna both have efficacy rates of about 95 per cent. Johnson & Johnson's efficacy rate is 72 per cent and AstraZeneca's is 62 per cent.

What these percentages hide is that the vaccines were tested in different groups at different times. All four vaccines have been shown to be highly effective at preventing severe illness, hospitalization, and death.

A soon-to-be published paper on the effects of vaccinations in Scotland actually showed that four weeks after a single dose of Pfizer or AstraZeneca shots, hospitalizations fell by 85 per cent and 94 per cent, respectively. Those numbers are a staggering success. The Johnson & Johnson vaccine has shown similar promise — 85 per cent effectiveness at preventing severe symptoms of COVID-19.

Preliminary data also support the idea that all the vaccines will help to slow transmission. That means the sooner you get vaccinated, the sooner you can avoid being a link in the chain that leads to somebody's uncle or grandmother dying.

This is the boost we need for that last stretch.

Of course, how effective each of these vaccines is against COVID variants is concerning. We've all heard about AstraZeneca vaccines going unused in South Africa, for example, because they were found not to work well against the B1.351 variant that has been spreading there.

Fortunately, all of the vaccines can combat B1.1.7, the variant first identified in the U.K., which is the one now most rapidly spreading in Canada. We are in a race against these variants, and the faster we vaccinate, the less likely variants will be a problem, as the virus will have less opportunity to jump from host to host, replicating and potentially mutating.

WATCH | Boosting vaccine confidence in COVID-19 hotspots:

Boosting vaccine confidence in COVID-19 hotspots

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As part of efforts to boost confidence in COVID-19 vaccines in Toronto's coronavirus hotspots, grassroots community campaigns and local leaders are helping deliver information and break down barriers. 9:00

In a perfect world with an endless supply of vaccines, we would all take the ones with the highest efficacy rates. But we aren't in a perfect world.

We are in a world in which every day this pandemic rages on, more and more people die. Every day, we see local businesses fold and more families struggling to put food on the table.

The fastest way to get back to normality is to get vaccinated as soon as possible.

And there are risks to waiting. Every day we wait is another day we put ourselves and those around us at risk of getting COVID-19. In Canada so far, nearly one out of 100 people who get the virus end up in the Intensive Care Unit. Half of the COVID-19 cases ending up in the ICU in Canada have been younger than 70 years old.

Right now, some are hesitating to get the AstraZeneca vaccine because there is a potential indication, currently unproven, that possibly one out of about 167,000 people could get a blood clot. The European Medical Association says it is reviewing the data and has seen, "no indication that vaccination has caused these conditions." Thrombosis Canada has said the same.

I'm glad that there is careful surveillance for rare events, but even if this connection is real, it is very, very rare and the threat of COVID – to our health and our livelihoods – is not. Consider that about one out of 50 of those who get a COVID infection end up with blood clots. Other estimates have suggested this could be as many as one in five.

So, I'll tell you what I've been telling friends, family members and patients who ask me if they should wait for one vaccine over another: protect yourself now and take the first vaccine available to you.

If we get vaccinated as quickly as possible, then perhaps we can all get back to selecting our favourite beverages and enjoying them together this summer.


ABOUT THE AUTHOR

Dr. Noah Ivers is a family physician and Associate Professor in the Department of Family Medicine at the University of Toronto. He holds a Canada Research Chair and is a member of the 19 to Zero coalition.

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