The Australia Letter is a weekly newsletter from our office in Australia. Sign up to get it by email. This week’s issue was written by Amaali Lokuge, a doctor at the Royal Melbourne Hospital.
As the world records more than 2.5 million coronavirus deaths and the United States celebrates more than 50 million administered vaccines, here in the emergency department of Royal Melbourne Hospital, as frontline employees, we program for our first immunization this week. Australia has not reported death from coronavirus in months, and the small outbreaks we have disappear in a few days due to aggressive blockages and a complacent audience. Given the low prevalence of the disease, Australians can afford to choose not to get vaccinated or postpone the vaccine until we are ready.
Until last week, I wasn’t sure if I would get the vaccine. Some media reports highlight that mRNA vaccines have never been approved for use in humans outside of clinical trials, making it look like a new technology that has not been tested before. The vaccines were developed at such a rate that I could not be sure that the main side effects were not overlooked. I was concerned about autoimmunity caused by the expression of peak coronavirus proteins in my own cells.
Skepticism is deep in Australia, and anti-vaccine protests have erupted in many of our cities. Outside this vocal minority – which seems to oppose immunization on the basis of theoretical and ideological, rather than scientific, concerns – it is difficult to assess popular humor. I have the impression that Australians feel compelled to be vaccinated, but in particular, many of us have reservations.
Within the medical community, the misinformation that permeates the anti-vaccination movement makes it difficult to express genuine concerns. This attracts the gentle ridicule of my colleagues – to them, I seem to have abandoned my medical education.
Every day in the emergency room, patients evade essential care against medical advice, and we watch them go away with a nod and a rueful smile. Like them, isolated from my doubts, I was ready to exercise my right to free will and refuse the vaccine. When my non-medical friends asked me about it, I was undecided between telling them my concerns and playing with the doctor who recommends the latest proven therapy.
The few to whom I revealed my concerns looked at me in bewilderment: if a doctor did not trust the vaccine, how should he trust it? It looked like a betrayal.
The guilt I felt about it compelled me to objectively review the literature on mRNA vaccines. Not being an expert in virology or biochemistry, I realized that I needed to quickly master unknown words like “transfection” and concepts about gene sequences. Slowly, the information I was devouring started to change my beliefs.
I learned that research on the use of mRNA for cancer vaccinations and therapies has been ongoing for the past 30 years. Trial and error refined this modality so that it was almost fully developed when Covid hit it. The vaccine’s mRNA is rapidly broken down in our cells, and the coronavirus spike protein is only transiently expressed on the cell surface. In addition, this type of vaccine is taking advantage of a technique that viruses already use.
It was humiliating to have to change my mind. When I scheduled my vaccination schedule, I realized how lucky I am to have access to all this research, as well as the training to understand it.
I wish that more of this information could be filtered out to members of the public so that they too could be as informed as we are. As medical professionals, we cannot be patronizing and trust people to follow their advice without all the facts. This is especially true in Australia, where the vast majority of us have never witnessed firsthand the devastation that this disease can cause.
Although we are relatively safe now, the threat of overwhelming infections is constantly present. Winter is approaching and people are letting their guard down. At the beginning of it all, I would have been arrogant if I had imagined that we could escape the horrendous mortality that the rest of the world would suffer, but vaccines offer a glimpse of hope. They may or may not prevent transmission, but they will decrease serious infections, hospitalizations and deaths.
Like all new converts, I am now a true believer: I would like everyone to be vaccinated. But autonomy is a precious principle of a free society, and I am happy that ethics experts have advised against the mandatory vaccine. I just hope that, with a more robust discussion and wider dissemination of scientific knowledge, we can influence people like me – who have what may be valid reserves – to receive the vaccine.
I received the first dose of the vaccine on Tuesday. The whole process was so simplified and fast that I felt nothing. But when I took a picture of the vaccination card to share with friends and family, I was overwhelmed by a mixture of gratitude, relief and grief for the rest of the world, where the virus is less contained.
What you need to know about the vaccine launch
My director wrote in an email to the emergency department last week that the hardest thing he ever had to do was watch us go down the stairs to face the virus with just our PPE to protect us. And for all of us, the fear that some of our loved ones will succumb to the virus has been a constant shadow.
Knowing that we can alleviate this threat through vaccination seems like a miracle.
Here are the stories from this week:
… And to you
Last week, we asked you about the scandal surrounding sexual assault allegations in Parliament and your own experiences with sex education in Australia. Here are some responses from the reader:
Couldn’t Morrison convict until he talks to his wife? What kind of ignorant person is that who fails to recognize that rape is unacceptable?
Dutton with his comment “he said, she said” scared me. In addition, none of them commented on the information that the incident was reported to AFP. I find the whole story and the subsequent information about other aggressions really distressing.
– W. McQuarrie
My sex education in secondary and primary school was totally inadequate. It looked like an advertisement for fear, focusing almost exclusively on contracting STDs, and was rooted in Catholic guilt, promoting abstinence as the only real form of safe sex. When I went to university it was no better. I went to a residential school that used to talk a lot about consent, but without any nuance or any real effort to involve a speaker who could relate to young people. And, when consent issues were actually tested in my college, the administration failed us all over and over again.
– Zoe Stinson
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