To vaccinate, or not to vaccinate?

After the Prime Minister’s address on the plans to roll out the COVID-19 vaccine, I was left struggling to explain to my Amchi (mom’s elder sister) what little I could remember from my high school biology class ten years ago, about viruses and vaccines, in Sharchop! You can imagine the impromptu translations: ‘virus’ becomes bu (i.e insect), ‘vaccine’ become men (i.e. medicine), ‘immune system’ becomes sungchop (i.e. guardian)… I gave up when I reached ‘clinical trials’, ‘blinded studies’ and oh, don’t get me started on ‘genetics’ and ‘ribonucleic acids’.

Nevertheless, I cherish my Amchi because for me, she represents that generation of our elders who have had a vastly different life experience and so, if I usually struggle to communicate something important to her, I know for sure that other Amchis, Azhas, Anis, Abis, Jojos and Uncles must also be in the same boat as her. However, as the generation who did get some education on modern medicines and science, I also feel that it is our responsibility to not give up on them and seek to bridge that gap. Here’s my attempt at doing so at some of the doubts and reservations that she had:

Photo: Adam Singer/Flickr
1. “I heard that people had died after getting the vaccine in other countries!”

Such sensational statements are understandably commonplace due to the dizzying blurring of lines between fact and fiction nowadays, with people’s personal ‘opinions’ getting labelled as ‘news’ and spreading like forest fires on WeChat and WhatsApp messaging platforms. People like my Amchi are at a particular risk since they are unable to access news through reading and have to rely on voice messages from ‘their friend’s niece who works at the hospital’.

Your first question should always be, “Where did you hear this from?” Imagine that in your personal life, you hear a rumor about another person whom you don’t know well; If you are a smart person who isn’t gullible, your next questions is usually, “Who said that?” Why do we ask this question? Because it matters who it came out of. Was it the person who is always snooping in other people’s personal lives and thrives on the attention that s/he gets from breaking this ‘sensational’ news to others? Such a person usually starts with, “Wai! you will never guess what I heard today” or “This is only between you and I”. News sources aren’t much different! If the title tries to play on your non-reasoning, emotional side, then you should be careful of what you hear next. NOT ALL NEWS SOURCES ARE CREATED EQUAL!

Photo: Ministry of Health, RGoB / Facebook

Long story short, it has NOT been true so far that people had died after getting the vaccine. There were rare cases of allergic reactions that have been observed in the US. How rare? 21 people out of 11 million so far. Now, if you still remain unconvinced, roughly 32 million Americans are allergic to certain foods and every year 200,000 Americans require emergency medical care due to allergic reaction from food. From FOOD! something that all of us HAVE to eat! Everyday! Three times! So, allergic reaction can be caused even by the thing that sustains us. It is not particular to vaccines. However, there is an emerging news story about 29 deaths in Norway of 80+ year olds with ‘serious basic disorders‘ after receiving the Pfizer vaccine. However in total, 42,000 people had received the vaccine and it also helps to contextualize that 400 elderly people die on average in a week in Norway’s nursing homes.

2. “I heard that the production of the vaccine was rushed and its quality is duplicate” (only Bhutanese would get this joke)

Once again first ask, “Which vaccine?” Different vaccines produced under different countries have different regulations. For Bhutan, there are three candidates: Pfizer, Moderna (both produced in the US) and Oxford/AstraZeneca (produced in the UK). The good news is that both countries have rigorous processes in place to adhere to the main guiding principle when we are talking vaccines: DO NO HARM. How rigorous is the process? Here’s an easy-to-understand infographic made by the Center for Disease Control (CDC)

Both countries require non-clinical trials (testing on animals first), then clinical trials where the vaccines are tested on thousands of human volunteers: 20,000 for Oxford/AstraZeneca and 43,000 for Pfizer. Pfizer trials included volunteers from various age groups, ethnicity, gender and races. The trails are ‘blinded‘, which means generally no one (not even the drug companies manufacturing the vaccines) knows who receives the vaccine (treatment group) and who doesn’t (control group), except an independent group of scientists. Then there are other independent bodies that monitor the safety and yet other independent bodies that monitor the ethics of the trials. Most importantly, after administering the vaccine (15.6 million as of 20/01/21 in the US; 2.2 million as of 15/01/21 in the UK), the medical bodies monitor the people very closely to make sure there are no dangerous side effects.

3. “But vaccines in the past usually took 2-5 years to produce. How did we get one within a year?”

That was my question as well! So, I did a bit of fact-finding and here’s what I found from Johns Hopkins (which I had been using since beginning of the year for COVID-19 updates globally):

  1. China shared genetic information on SARS-CoV-2 coronavirus which allowed researchers to get an early head start at the beginning of 2020.
  2. Government and donors gave money for the research so that they could find a cure as soon as possible
  3. Social media played a huge role in recruiting huge number of volunteers within a short period of time for the clinical trials
  4. After getting the vaccine, since coronavirus was so widespread and contagious, people who got the vaccine came in contact and it took shorter time for scientists to measure if the vaccines worked
  5. Finally, and I left the most difficult for the last, the vaccine production technique used, called messenger RNA or mRNA (remember the biology chapter on genetics?) allowed for faster approach.
A Bit on mRNA Technique

So traditionally, vaccines are essentially dead or weakened virus that is injected into the body intentionally so that we give our body an ‘easier’ challenge (as opposed to a fully live virus) to fight it by producing antibodies. This process takes years!

Photo: Sanofi Pasteur / Flickr

Enter the mRNA! This technique artificially manufactures just the needle-like spikes of the SARS-CoV-2 virus, not the whole virus. Why just the spikes? Because that is what helps attach itself to our cells in the body and make us sick. So, the COVID vaccine (made using mRNA technique) essentially are an ‘instruction manual’, which when injected, tells the cells to begin ‘photocopying’ itself. After these spiky ‘photocopies’ are released out of the cells, our immune system recognizes the foreign entities and begins producing antibodies to fight them.

Later, when we are actually exposed to the real virus with its spikes, our immune system ‘remembers’ the spikes and begins re-producing the antibodies that fight the virus and stops it from ‘photocopying’ itself in our body.

“Well people who contracted COVID-19 haven’t died in Bhutan and most have recovered so, I think I’ll risk it and not vaccinate”

That has been true so far, thanks to our Choechong Sungma, His Majesty’s unceasing efforts and our Prime Minister as well as Health Minister both of whom come from medical background. Most of the contacts have been youths coming in from abroad who are physically advantaged, coupled with our free and effective quarantine practices (in most countries it’s only two weeks, not three) that has put us on the much safer side of this pandemic.

Photo: homebasedillustrator / Instagram

However, the most dangerous element of this virus is it’s invisibility and the speed with which it infects. This has already been evident from this second nationwide lockdown as we discovered how far it had spread in such a short amount of time! The whole nation was saddened with news of our first COVID-19 death in the country, a 34-year old with pre-existing conditions. Now, imagine the horror if this virus takes hold of all our physically frail and old grandparents and our sick fellow citizens, which it could very well do if we are complacent or misinformed.

Vaccinating might not feel like ‘serving the nation’ since no one is exerting himself or herself to a particularly hard or demanding work. Actually, the fact that we are getting the vaccine is in itself a miracle; the head of WHO warned nations globally that the unequal distribution is ‘at serious risk’. In Bhutan we are getting it for free. We simply go, sit on a chair, request the nurse to be gentle with the needle and thank them,

but we must realize what happens at the societal level where our individual eyes do not see.

So far, the approach has been to minimize or eliminate human contact through social distancing, which has come at a serious social, cultural, psychological, spiritual and economic cost. This simple act of vaccination will essentially reduce the number of bodies that the virus can take up shelter in and multiply. If the virus has no place to live and multiply, then it certainly has no place to spread. Simply put,

If you vaccinate, you will protect yourself AND others;
If you don’t vaccinate, you may recover BUT you will harm others


3 thoughts on “To vaccinate, or not to vaccinate?

  1. Simple and well written blog on why it’s important to vaccinate and how it works. Better than any media platform in our country. MoH could use this article to educate and demystify vaccine rumours, not to undermine their technical skills and knowledge but only because you explain it in a simple manner for majority to understand it.


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