The Australian letter is a weekly newsletter from our Australian bureau. Sign in to get it by email. This week’s issue was written by Amaali Lokuge, a doctor at the Royal Melbourne Hospital.
As the world registers more than two and a half million deaths due to the coronavirus, and the United States celebrates more than 50 million vaccines administered, here in the emergency department of the Royal Melbourne Hospital as frontline workers we have these week scheduled for our first vaccination. Australia has not recorded a death from the coronavirus for months now, and the small outbreaks we break out in a matter of days are due to aggressive blockades and a public that complies with them. Due to the low incidence of diseases, Australians have the luxury of not being vaccinated, or of delaying the vaccine until we are ready.
Until last week, I was not sure I would get the vaccine. Some media reports emphasize that mRNA vaccines have never been approved for use in people outside of clinical trials, making it look like a new technology that has not been tested before. The vaccines were developed so quickly, I could not be sure that the major side effects were not overlooked. I was worried about autoimmunity caused by expressing the coronavirus proteins in my own cells.
Skepticism runs deep in Australia, and in many of our cities protests against vaccines have surfaced. Outside of this outspoken minority – who seem to oppose immunization on the basis of theoretical and ideological rather than scientific problems – it is difficult to determine the popular mood. I have a feeling that Australians feel compelled to be vaccinated, but many of us are private.
Within the medical community, the misinformation posed by the anti-vaccination movement makes it difficult to express true concern. When I do, it makes my colleagues laugh out loud – to them, I sound like I gave up my medical education.
Every day in the emergency department, patients walk away from essential care against medical advice, and we watch them go with a shake of the head and a deceptive smile. Like them, isolated by my doubt, I was ready to exercise my right to free will and refuse the vaccine. When my non-medical friends asked me about it, I struggled to tell my concerns and play the doctor who recommended the latest proven therapy.
The couple to whom I made my concerns known looked at me puzzled: if a doctor does not trust the vaccine, how should they do it? It felt like a betrayal.
The guilt I felt about this forced me to objectively examine the literature on mRNA vaccines. Because I was not an expert in virology or biochemistry, I realized that I needed to master unfamiliar words like ‘transfection’ and concepts about gene sequences quickly. The information I ate up slowly began to change my beliefs.
I learned that over the past 30 years, research has been done on the use of mRNA for vaccinations and cancer therapies. Trial and error refined this modality so that it was almost full-fledged by the time Covid struck. The mRNA of the vaccine is rapidly degraded in our cells, and the coronavirus ear protein is only briefly expressed on the cell surface. Furthermore, this type of vaccine uses a technique that viruses already use.
It was humble to have to change plan. When I discuss my vaccination period, I realize how happy I am to have access to all this research, as well as the training to understand it.
I wish more of this information could be filtered to members of the public so that they too can be as informed as we are. As medical professionals, we can not afford to be paternalistic and trust that people will follow advice without all the facts. This is especially true in Australia, where the vast majority of us have never seen the first time that can cause the disease.
Although we are now relatively safe, the danger of overwhelming infections is constantly present. Winter is approaching, and people are watching. At the beginning of it all, I would have been unpredictable that I could have imagined that we would escape the terrible death that the rest of the world would suffer, but the vaccines offer a glimmer of hope. It may or may not prevent transmission, but it will reduce serious infections, hospitalizations, and deaths.
Like all new converts, I now believe: I want everyone to be vaccinated. But autonomy is a precious principle of a free society, and I am glad that ethicists have advised against forcing the vaccine. I just hope that, with more powerful discussion and the wider dissemination of scientific knowledge, we can get people like me, who have valid reservations, to swing to get the vaccine.
I received the first dose of vaccine on Tuesday. The whole process was so streamlined and fast that I felt nothing. But when I took a photo of the vaccination card to share with friends and family, I was overwhelmed with a mixture of gratitude, relief and regret for the rest of the world where the virus is less prevalent.
What you need to know about rolling out vaccines
My director wrote in an email to the emergency department last week that the hardest thing he still had to do was watch us go downstairs to face the virus, just with our PBT around us to protect. And for all of us, the fear that one of our loved ones will succumb to the virus is a constant shadow.
Knowing that we can improve the threat through vaccination seems like a miracle.
Here are this week’s stories:
… And passed on to You
Last week, we asked you about the scandal surrounding allegations of sexual assault in Parliament and your own experiences with sex education in Australia. Here are some reactions from readers:
Morrison could not condemn before talking to his wife? What kind of ignorant is he who he can not admit that rape is unacceptable?
Dutton terrified me with his ‘he said, she said’ comment. In addition, no one commented on the information that the incident was reported to AFP. I find the whole story and the subsequent information about other assaults really disturbing.
– W. McQuarrie
My sex education in high school and elementary school was completely lacking. It felt like intimidation, focused almost exclusively on STI contraction, and was rooted in Catholic guilt, which promoted abstinence as the only true form of safe sex. When I went to university, it was no better. I went to a residential college that used to talk a lot about permission, but without any nuances or any real effort to engage a speaker related to young people. And when issues of consent were tested in my college, the administration repeatedly failed us.
– Zoe Stinson
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