To Vaccinate or Not to Vaccinate

Photo: Makati ICRD

By Greg B. Macabenta

To vac or not to vac, that is the question
Whether ‘tis nobler in the mind to suffer
The slings and arrows of coronavirus
Or to give arms to vaccination
And with the serum, end it.

With apologies to William Shakespeare for my paraphrasing Hamlet, this should be a no-brainer for desperate folks in the face of the COVID-19 pandemic. But it has, in fact, stumped millions of Americans and Filipinos.

Many in the US, mostly supporters of ex-President Donald Trump, are either confused or are choosing not to be vaccinated. It’s not as if they have no access to vaccines. Inspite of his bluster, Trump mandated Operation Warp Speed that spurred the development of the COVID-19 vaccines by Pfizer, Moderna and Johnson & Johnson.

But Trump also sent confusing signals about how to deal with the virus – with or without a face mask, and the wisdom or folly of social distancing  – thus leaving his supporters doubting science and discarding common sense.

Since President Joe Biden assumed office, the vaccination program of the government has taken off. In fact the White House recently advanced the timetable for vaccinating everyone in the country. If all goes well, the US hopes to celebrate this coming July 4th as Freedom from the Pandemic Day.

In the Philippines, only a few have been vaccinated out of a population of over 100 million. This is due to a combination of unfortunate factors: politics, bureaucratic incompetence, fear of the unknown, the varying degrees of efficacy of the available vaccines, and not enough of the vaccines in stock.

The last factor is bad enough, but even if the vaccines were in the government’s hands, making them available to the public is like an obstacle course – a test of patience and grim determination or the ability to pull strings.

Postings on social media tell of exasperating hours online or on the phone trying to arrange a vaccination appointment until one gives up and decides to take a chance by lining up - again for hours - at the vaccination venue and praying for a compassionate needle pusher to dispense a shot.

But then one would need a second shot, and the prospect of going through the same process can make one appreciate what the Via Dolorosa entailed.

But that assumes that one is willing to be injected with the vaccine in stock. That will likely be Sinovac or Sinopharm, both made in China. In this regard, the question of efficacy can lead the prospective injectee to paraphrase Hamlet: To vaccinate or not to vaccinate?

While Pfizer and Moderna have rated upwards of 90 per cent in terms of efficacy, and even Johnson & Johnson has been tested highly effective, the ones made in China have had widely varying results in tests conducted in several countries – from around 70 per cent  to just above 50 per cent efficacy.

This has resulted in doubts about - and even outright resistance - to the Chinese vaccines.  For this reason, many in the Philippines – in spite of being desperate to become immune from COVID-19 – prefer to sit it out until Pfizer and Moderna become readily available.  Even the J&J vaccine is preferred inspite of six recent cases of blood clotting suspected to be due to its use –out of millions of safe injections (the US Center for Disease Control has called for a pause in J&J vaccinations while the problem is looked into).
As one social media pundit put it, “If Sinovac only has a 50 per cent efficacy, then I also have a 50 per cent chance of catching the virus. In that case, I would rather wait for Pfizer or Moderna or even J&J.”

The logic is flawed in a number of ways. If we were to compare a vaccine to a bullet proof vest, it should be obvious that having a vest on is better than wearing none and being fully exposed to bullets. But no bullet proof vest can guarantee 100 per cent safety.

In this regard, health authorities have given the following advice: The best vaccine is that which is available.

There is a Tagalog saying for this: “Aanhin pa ang damo kung patay na ang kabayo?” (What good is the hay if the horse is dead?)

Vaccines - in fact, any kind of medication - usually vary in effectiveness, depending on different factors, among them, the recipients’ physical condition. This is why medical clinics routinely ask patients if they have any kind of allergic reaction to certain medications.

My wife and I are both 81 years of age. We had our two boosts of Moderna without experiencing any after-effects. On the other hand, our children felt varying degrees of discomfort after their vaccinations. A grandnephew, who is an athlete and a police  officer, felt weak and dizzy a few days after vaccination. But in all cases, the adverse reactions were temporary.

The good news is that COVID-19 vaccines are being developed by other countries, albeit with varying degrees of effectiveness. Two other vaccines are reportedly being tested by Cansino Biologics and Anhui Zhifei Longcom, both in China.  Oxford University has developed the Oxford-AstraZeneca, and Russia, not to be left behind, has developed the Sputnik vaccine. India, a prolific drug manufacturer, has introduced Covishield and Covaxin.

The bad news is that in several countries, particularly in Europe and Latin America, the virus has not only remained untamed, more virulent variants have also emerged. These variants, which are more transmissible, have already begun to infect thousands across  the US. Hopefully, the accelerated vaccination program will outpace the surge.

China has donated thousands of  doses of Sinovac to the Philippine government, in addition to the quantity that the latter has purchased. There has also been a substantial order of Pfizer and Moderna vaccines from the US, but it appears that their delivery can only be made by mid-2021 owing to the huge requirements of the US, which have to be given  priority.

Philippine Ambassador to Washington Babes Romualdez and the Filipino-American community are lobbying the US government for the early release of the Pfizer and Moderna vaccines, and are also requesting for a donation of vaccines, the same way the US did to Mexico.

We understand that UNICEF, through its COVAX facility, has also allocated several thousand doses of vaccines for the Philippines. But there are still not enough vaccines to meet the needs of the country.

What has made the situation worse is the usual bureaucratic inefficiency (which even the US has also suffered), as well as the increasingly desperate situation created by the high incidence of infections (said to hit up to 10,000 a day),  and the increasing mortality rate. Two friends of mine from the San Francisco Bay Area, Cip Ayalin and Gerry Palabyab, were among the recent fatalities. Cip was on vacation in Metro Manila while Gerry was with his family in Leyte.

Frankly, the response of the Duterte government has been wanting in many respects, overlayering being only one of them. Perhaps believing that the more top officials he assigned to address the pandemic, the more efficiently the crisis could be met, Duterte assigned a virtual all-star cast to handle different aspects of the pandemic - with media referring to them as “czars.”

This may have blurred primary accountability for results. This, in effect, made a super-czar of the President himself.  We have all heard the saying, “Too many cooks spoil the broth.”

The usually cynical Filipino public and the media have suggested that this could be one reason why the Philippines is said to lag behind other Southeast Asian countries in solving the crisis.

But whatever the reasons, they cannot be solved by taunting and kibitzing. The Philippines does not have a monopoly of inefficiency in facing this global pandemic, the most deadly in over a hundred years.

One group, perhaps with an eye on the 2022 presidential election, has even called on Duterte to resign for his “mishandling”  of the crisis.

None of that can make an already bad situation better.

Frankly, this isn’t the time for partisan politics or for grandstanding and useless kibitzing.

We should all follow the classic typing lesson: Now is the time for all good men to come to the aid of their country.