While most can’t wait to get their shots, the anti-vaxxers and some who are reluctant are not buying the doctors’ evidence-based reassurances.

Vaccine-rejecting groups are not likely to believe pharmaceutical companies and evidence on the safety and efficacy of the Covid-19 vaccines. More may need to be done to address some of their concerns if the health authorities want to get them on their side.

Hearing out the frustrations of those who had suffered adverse events would be a start.

Gauging from reactions in the past, parents who rejected vaccines often said they were concerned about the terrible events their children had suffered.

“The doctors don’t seem to understand. They may say adverse events are rare but this is my child they are talking about,” said a father whose daughter had to be in the Intensive Care Unit (ICU) for two days, 10 days after her second doses of DTP, polio and Hib vaccines.

Although doctors had convinced him that his daughter had e-coli infection which could have caused the swelling in her brain, the father argued that vaccination too could cause the swelling.

At individual level, an adverse event such as a life-threatening allergic reaction (anaphylaxis) or Bell’s Palsy (a condition that causes a temporary weakness or paralysis of the muscles in the face), such as those that had been reported in the Pfizer-BioNTech and Moderna vaccine trials, can be frightening.

Anaphylaxis is an acute, multi-system, allergic reaction to a substance, such as a vaccine, drugs, and food which may result in breathing difficulties, loss of consciousness and a drop in blood pressure.

These concerns are real, and the assurance that the incidence is very low is not convincing for anti-vaxxers and those balking at immunisation.

What’s even more difficult for them to accept is they feel doctors tend to brush off their adverse events as “not related to vaccination” without any further investigation, if the events are not listed as known side effects.

Doctors have, rightly too, argued that the millions who have been jabbed with Covid-19 vaccines currently show that the number of adverse events are lower than those occurring in the population, hence, they are not likely related to vaccination.

Unfortunately, this frustrates the vaccine-rejecting groups, especially mothers who saw their children suffer immediately after childhood vaccination. In very rare instances, some saw their children’s intelligence and speech regressed from that point onwards.

For the layman, there are questions as to whether vaccination can trigger a potential condition or aggravate an existing medical condition. What is the outcome of a vaccine interacting with an existing undiagnosed infection?

Even though adverse events from Covid-19 look rare currently, some of the events may need to be looked into more closely if doctors and the health authorities want to gain confidence from groups that reject the vaccine.

If there are medical tests that can determine the cause of certain adverse events, they should be carried out to rule out the link to vaccination. Surely, this will add vaccination confidence for those groups.

Comparing the level of incidence of adverse events in the vaccinated group to those in the general population may be useful to give a bird’s eye view, but can lower adverse event figures totally rule out a link to vaccination?

The investigation into the elderly deaths in Norway after Covid-19 vaccination is a clear example.

The Norwegian Medicines Agency reported that as at Jan 17, it received reports of 33 deaths after Covid-19 vaccination. All of the deceased were older than 75, the BMJ (Jan 19, 2021) reported.

Initial investigation found that common adverse reactions of mRNA vaccines, such as fever, nausea and diarrhoea, may have contributed to fatal outcomes in some of the frail patients.

In other words, the deaths were indirectly linked to the vaccine.

The vaccine is by and large safe but if a person is too frail or weak, he or she may not survive a normal fever or diarrhoea, whether they are from common vaccination side effects or simple food poisoning.

For this reason, doctors have been advised to assess severely frail and terminally ill patients to see if they can handle the side effects from the shots.

So, if there are side effects from vaccination, why do we still vaccinate?

Health authorities and governments have considered the situation and found that the benefits of vaccination outweigh the low risks. It is needed to stop virus transmission and deaths as well as bring back the economy, schooling and many other activities into our lives.

As at Feb 25, more than 218 million shots have been given across 99 countries, according to Bloomberg vaccine tracker, and adverse events reported had been few in comparison.

However, vaccine-rejecting groups want adverse event following immunisation (AEFI) data to be properly collected and reported and be made public as is done in the US.

A mother who refused vaccination after one of her children landed in ICU for brain inflammation following a Hepatitis B vaccination said that those who suffered from AEFI should also be given medical support and compensation.

What should society do?

Former Sungai Siput MP Dr Michael Jeyakumar, a pulmonologist, puts it well. “Society has made a collective effort to take the risk and vaccinate in order to achieve herd immunity and end Covid-19 transmission.

“If a few people suffered from adverse events after vaccination, society as a whole should give those affected the medical care and support they need,” he said.

We need to recognise that there is no perfect vaccine or medicine and the health authorities will ultimately have to choose the ones that are the most effective and with the least adverse events or side effects.

And the few who suffer adverse events should be taken care of. The government’s intention to draw up a compensation plan is a way forward.

The government needs to do whatever it can to win over the 17% fence sitters.

The health ministry revealed that 67% of 212,006 people surveyed from Dec 2 to 28 last year supported the Covid-19 immunisation programme, but another 17% were unsure while 16% stated that they did not agree with being vaccinated.

Just as we do this collectively by persuading all to take the vaccine to build herd immunity and protect communities, we should not ignore the few casualties along the way. We are in this together.