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From vaccine hesitancy to hierarchy: will any port do for Covid storm?

“[…] Pfizer is widely perceived to be at the top of the tree, Moderna and Johnson & Johnson just beneath that, followed by Oxford AstraZeneca, Sinopharm and Sputnik. I don’t know the extent to which this is driving decision-making, but I’ve heard several people say that they’re prepared to wait for their preferred vaccine.

“That’s a bad plan. Look at it this way. It’s raining outside. You are confident of getting, in the next week, one of those huge, branded corporate umbrellas; but what you can lay your hands on right now is a smaller, foldable one…”

The following guest column was submitted by media consultant Orin Gordon, who can be found on Twitter @oringordon:

Photo: A nurse administers the Covid-19 vaccine in Trinidad.
(via MoH

With Trinidad and Tobago’s vaccine stock now at a level where anyone who’s willing to get vaccinated can do so more easily than in past months, it’s time to look at the problem posed by a perceived hierarchy of vaccines. 

Hesitancy is still there. Some of it has hardened into outright resistance. But hierarchy is an increasingly significant vaccination challenge.

Let me tell you a story. I’ve a dear friend—let’s call her Susie. She’s like a sister. We don’t pull punches with each other. She would tell me to my face I was being an (insert industrial-strength word). 

If I wanted a frank appraisal of something, I could depend on her to give it to me without sugar. Candour ruled. I love her, platonically. Everyone needs a friend like Susie.

She’s been vaccine-hesitant from the beginning. She’s a fit and healthy 40-something who, as far as I knew, had no medical issues. She doesn’t work for an essential service. She had to wait her turn.

Image: A satirical take on religion and the Covid-19 vaccine.

A door opened during the Sinopharm rollout. One Sunday, the Ministry of Health accommodated walk-in vaccinations near where she lived. On the Saturday, I went to the place to verify. The staff confirmed it, and said that traffic had been light. I rang her excitedly that night, and she said she’d go in the morning. I’d already had my first dose of the Oxford AstraZeneca.

Sunday came, but I held back from asking how it went. I’d heard nothing back, but decided I’d call her on Monday, around mid-morning. No, she hadn’t gone. In an explanation I can’t recall with precision because the reason seemed so fuzzy, she said she’d sent a friend to check, and whatever her friend found was enough to dissuade her from going.

We dropped the subject, and got on with our socially-distanced, be-masked, sanitised and curfewed lives. We continued to chat, mostly by WhatsApp. She sent me a video about state control through vaccination, and I told her, with some irritation, ‘please stop sending me that nonsense’. Stop watching stuff like that, I said, and listen to the medical professionals. 

She didn’t send any more videos, but she did tell me that she was bombarded with the stuff from various WhatsApp groups that she was a part of.

Image: The threat posed by anti-vaxxers.

‘I have to be careful with what I put into my body’, she said one day in the course of a conversation. I’ve seen you wolf down several hot dogs when we’ve been out liming, I snorted. Have you ever seen a video of a sausage factory? Have you ever read the label on a packet of sausages? She was quiet. I felt bad about saying it.

Another opportunity. Minister of Health Terrence Deyalsingh announced the arrival of a new shipment of Oxford AstraZeneca, and the start of appointment vaccination the coming Monday. I brought it up, adding that I respected her choice of pursuing it or not. Her answer surprised me. 

She’d seen it, and would be making an appointment. She mistrusted Sinopharm, but hadn’t wanted to say so. Appointment scheduled.

I think she meant it this time, but the night before her appointment came news that T&T expected Pfizer-BioNTech vaccines soon—first for schoolchildren, then for adults. She didn’t go. I’ll wait on the Pfizer, she said. 

But we don’t really know when the adult doses will be rolled out, I said. I’ll wait, she replied. It could be November! I’ll wait! But the Delta Variant makes vaccination even more urgent, I almost pleaded.

Photo: The Pfizer Covid-19 vaccine.

Last week, something changed. She went to the Divali Nagar site on a walk-in. The crowd was big, and she had to abort the mission. To date she hasn’t been vaccinated, but I sense that she’s turned the corner on that. I’m guessing that it was work-related pressure, but I didn’t ask. 

HR departments everywhere are having tense, uncomfortable conversations with many staffers. One friend who’s unvaccinated described his as a stand-off.

Just when Susie seemed to have got past her hesitancy, she felt the need to navigate around hierarchy. Pfizer is widely perceived to be at the top of the tree, Moderna and Johnson & Johnson just beneath that, followed by Oxford AstraZeneca, Sinopharm and Sputnik. I don’t know the extent to which this is driving decision-making, but I’ve heard several people say that they’re prepared to wait for their preferred vaccine.

That’s a bad plan. Look at it this way. It’s raining outside. You are confident of getting, in the next week, one of those huge, branded corporate umbrellas; but what you can lay your hands on right now is a smaller, foldable one. 

Do you step out into the rain with no umbrella because you haven’t got the big one?

Photo: Nurse Keisha Gomes Prevatt (left) was the first to receive the Covid-19 vaccine.
At her side is Minister of Health Terrence Deyalsingh.
(via TTT online)

The WHO has been clear from Day One that we need to get vaccinated as quickly as possible to stay ahead of the variants. The medical authorities in the US, unexpectedly on the back foot again because of the Delta Variant, say that this is increasingly a ‘pandemic of the unvaccinated’.

Recently, Prime Minister Dr Keith Rowley offered some sobering stats about uptake among workers in critical sectors. Only 50 percent of nurses had been vaccinated, and he was ‘a little taken aback’ by that. The 20 percent rate in prisons was ‘not acceptable’. He recognised the problem, which he described as one of ‘brand and choice’.

Choice is at the foundation of free societies. It’s hard to argue against it. Yet this is a dangerous phase of the pandemic, and we can’t afford to give Delta running room. We’re going to have to vaccinate our way to safety, and bring along people who don’t want to… either not at all, or until later, when their preferred vaccine arrives.

We have no choice, so to speak.

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