Why Won’t Healthcare Workers (HCWs) Take COVID-19 Vaccines?
(Survey By American Assoc. of Family Physicians (AAFP)
By: G. Yanquoi Lavela, Esq.
The American Association of Family Physicians (AAFP) is a distinguished non-partisan professional organization comprising of eminent physicians who provide day to day patient care. Their website has ongoing weekly journal articles published by the membership that are well sourced and rigorously peer-reviewed. On April 19, 2021, they published an article entitled: “Four reasons for COVID-19 vaccine hesitancy among health care workers...” The class of health care workers (HCWs) studied was very broad, “including doctors and nurses as well as those who deliver indirect care and services (aides, helpers, laboratory technicians, and even medical waste handlers).” Within this broad class of HCWs, the survey found that vaccine acceptance among physicians in Israel was 78%; 61% among Israeli nurses ; and 75% among Israeli population in general. But in two consecutive surveys they found very low vaccine acceptance among nurses in Hong Kong (The Special Administrative Region of the People's Republic of China). That same survey found in late 2020 that only 36% of HCWs in the United States were willing to take the vaccine. But a whopping 56% of US HCWs expressed reluctance to take the vaccines until more data from further research could be made available. With that extremely high vaccine hesitancy rate among American health care workers, the survey found a correspondingly low acceptance of the vaccine tolerance among the general population of Americans. That caused great alarm among policymakers in their hopes to achieve a “herd immunity” through mass vaccination of Americans. Four reasons were given for this strange development among HCWs:
(1) “Safety and efficacy concerns” - the feeling among HCWs that the vaccines were rushed through the research, development and distribution phases too quickly to be safe for use on humans. Part of safety concerns people have about the vaccines are based on reported adverse effects and deaths associated with the COVID-19 vaccines. Some of these reports are mostly fact-checked and confirmed by a research-based Atlanta company that is specialized in collecting data from around the world about adverse vaccine events related to ALL vaccines, and not just COVID-19 vaccines alone. The company's name is “Precision Vaccinations (Pvax). It is an “international publisher of information people can trust to make informed vaccination decisions.” Google them and read the data they have compiled about all vaccines. The Center for Disease Control (CDC) has its own “Vaccine Adverse Event Reporting System (VAERS)”. Precision Vaccinations (Pvax) gets some of its data from the CDC’s own VAERS database. In the case of the COVID-19, Pvax cites CDC’s own report that: “Between December 14, 2020, through July 19, 2021, the Vaccine Adverse Event Reporting System (VAERS) received 12,313 reports of death among people who received a COVID-19 vaccine.” This database is updated daily to include recent vaccine adverse events. Therefore, the safety concerns people have about the COVID-19 vaccinations are not entirely baseless. There is some truth to their concerns.
(2) “Preference for physiological immunity” - these are people among the (HCWs) who prefer “natural immunity”, versus “herd immunity”, that I explained in my last piece on this topic. Natural immunity is an aspect of Darwinian evolutionary biology of “survival of the fittest.” That means, let us all expose ourselves to the pandemic and see who survives it. Many will die and some will live. And those few that live are by natural selection the fittest of the herd. But that requires a general exposure to the pandemic that will force the body to develop its own or “natural immunity” by fighting off the virus using its own antibodies. Once the body wins that battle against the virus and the individual survives a pandemic, and the body builds its own resistance to that particular virus, that immunity becomes a permanent part of the body’s general armory against that virus. There is a vaccine scar on my left arm the size of a dime, which was the smallpox vaccine that I was given as a child in the mid-1950s, as did most of you in my age bracket. Those vaccines were actually replicas of the smallpox virus itself. And the moment you got vaccinated with those replicas of the smallpox, there was an instant and visible swelling of the vaccine spot, which we were told was the body’s natural reaction to the smallpox injection. That was similar to actually being infected by the virus and letting the body fight it off. And the immunity we got was permanent. Nobody that I know from my boyhood days who took the smallpox vaccines ever caught the smallpox again. On the other hand, “herd immunity”, is artificial and “acquired” through vaccination of the greatest number of the population, as I explained in a previous commentary.
3. “Distrust in government and health organizations” - This group of health care workers (HCWs) are people who do not trust governments to be promoting vaccines. Some may be conspiracy theorists for sure. But many of them can point to well-founded historical examples of past government misinformation and deliberate deceptions about other pandemics as the basis for their distrust. By general observation, governments everywhere found and run by politicians are the least trustworthy of all public institutions in human history. The survey notes that “Americans generally have a high level of trust in their physician, and there is evidence that HCWs have greater trust in medical professionals prescribing the vaccine than in public authorities and government.” The main reason vaccines for the COVID-19 virus have been under a continuing cloud of public doubts is that this pandemic has been the most politicized in the history of pandemics in US history. Elections have been won and lost over it. Another study by National Public Radio (NPR) has reported that vaccine hesitancy among Americans is evenly distributed across party lines. Democrats, who now have the presidency, tend to advocate for the vaccines, even if they personally would hesitate to take it; while the largest number of vaccine hesitancy was reported among Republicans, especially those viewed as staunch supporters of the previous president. The last US presidential election was won and lost predicated wholly on the proposition that the incumbent president at that time was a less effective leader in confronting the pandemic, and was accused of deliberate falsehoods to cover up his ineffective handling of this national crisis. The winner and current president was promoted as the better equipped candidate by knowledge and half a century of experience in political statecraft to lead the nation through the crisis. But after his “First 100 Days” in office, signs of the last president's misfortunes are beginning to surface in the government of the new president. Mixed messaging, inconsistent policy pronouncements, suppression of dissenting views about the pandemic, and outright embellishments of the truth as just a few of those signs. One day the public is mandated to wear masks, and another day they are told they need not wear masks at all. One day the vaccinated people are told they are protected against the virus, and another day they are told that the vaccines cannot protect them against future infections. Proprietors of the various social media platforms are seemingly given the unofficial task of policing public opinions about the virus and vaccine efficacy, such that any public opinions too critical of the official versions and against vaccine efficiencies are automatically blocked, or deplatformed. And if that was not enough to dampen public enthusiasm about the vaccines, at a recent FOX NEWS interview with host Bret Beier, the current CDC Director, Dr. Rochelle Walensky, an eminent scientist and physician herself, dropped another zinger. Speaking about this truculent public enemy and intractable Delta Variant of the COVID-19 virus, she said: “We are only a few mutations away from a variant that will be too impossible to defeat with current vaccines.” I could not believe that I had just heard what I heard. This was an astonishing Freudian slip, or what is called in Latin “lapsus linguae” ( a slip of the tongue). If the virus is mutating at a faster rate than our current ability to make vaccines to stop it, what then is the fate humanity? The current US population is 344 million. The national goal for “herd immunity” is artificially set around 80% of the population. At present only 49% or 164 million people of the national population have been vaccinated. That is barely half of the population. To attain the desired goal of herd immunity of 80%, the government has just authorized a vaccine policy compliance incentive of $100 payment to each person who takes the vaccine. In other words, vaccine hesitancy among health care workers (HCWs) has in no small measure contributed to the national failure to attain the overall goal of herd immunity.
4. “Autonomy and personal freedom” - If there is one thing that Americans value most above everything else is their sense of personal freedom and autonomy that is deeply rooted in the constitution of the United States. Any government policies that infringe on personal liberties of the autonomous individual can expect to be vigorously challenged in court. And that is often the case when the government wants to tell the individual what to do with their bodies, or attempts to put something into their bodies without their informed consent or permission. We frequently see cases of this type come before the courts, when it involves abortions and the autonomous rights of women to decide what to do with their bodies. This is true even if it means late term abortions, when fetal viability is no longer a question of debates. By analogy, if courts have upheld the rights of autonomous individuals to keep government out of their bodies in abortion cases, it is very likely that injecting vaccines into the bodies of persons against their consent will meet a similar fate in the courts. Public safety laws often give governments very broad powers to take reasonable measures, including mandatory quarantines of persons infected with communicable diseases, to protect the public. But those involve persons known to be infected. But where a person has not been diagnosed with, or tested positive for COVID-19, mandatory vaccinations of those persons without their consent, based simply on the belief that they might get infected in the future, will most likely be blocked by an injunctive relief from the courts as too speculative, because courts are designed to grant remedies for concrete injuries, not speculative ones. Courts are usually deferential to public policies where there is a “compelling state interest”. But capricious and invidious violations of fundamental rights, like the privacy interests of individuals to be free from forced government vaccinations, are usually subjected to “strict scrutiny” by the courts and often declared unconstitutional. The courts may well accept the government’s argument that it has a compelling state interest in ridding society of the ravaging scourge of a pandemic, and yet conclude that it may not do so in an arbitrary and capricious manner, such as the random vaccinations of individuals without any probable cause to believe that those individuals are positively carrying the virus that may spread to others in society. No one has a right to infect others with a deadly and loathsome disease. But that has to be proven as a fact. We must also understand that vaccination is a medical procedure and, by law, all medical procedures on any person can only be done with the informed consent of the person who is the subject of that procedure. So, in light of this, what happens when an individual refuses to voluntarily take the vaccines? The current administration is weighing different options short of forced vaccination of the population, but has not explicitly ruled out the nuclear option of involuntary vaccination. We must wait and see.
Meanwhile, vaccine hesitant French, Greek and Italian healthcare workers have been told by their respective governments that their continuing reluctance to take the jab might force the authorities to consider mandatory vaccinations as prerequisites to employments. Britain has barely reached the threshold mark of 40% vaccination rates of the general population, let alone healthcare workers. Similarly, CDC Director Dr. Rochelle Walensky hinted in the FOX NEWS interview that the United States might consider mandatory vaccinations. But when pressed by the media she backtracked and said that no such plans are being discussed by the government. But the President has issued a directive as Commander in Chief that all active duty military personnel be vaccinated. Americans are waiting with baited breath to see what the government will do next after military.
Taking the American and European experience with the COVID-19 virus in perspective, as discussed above, it is difficult to gauge the policy initiatives of the Liberian Ministry of Health, or the state of our national preparedness to cope with the challenges of the pandemic. But I worry that Liberia may not be as prepared as other nations, given our history of always playing “catchup” with other nations. I am not sure, for example, about the sufficiency of our vaccine stockpile in the nation’s war chest in the fight against the pandemic. If the policy initiative is to achieve a “herd immunity”, what is the national target in terms of the percentage of the population that needs to be vaccinated to achieve that goal? And do we have the resources to acquire enough vaccines to attain that goal? If not, why not? And I ask this rhetorical question in the knowledge that a recent funeral of the father of one Liberian government official was so lavish that it made international news headlines. And when pressed by local media to explain this grotesque imagery of a conspicuous consumption against the backdrop of the devastating pandemic and abject poverty of the people, that government official cited one of the Ten Commandments that says: “Honor thy father and thy mother...”, as his justification for splurging. What I like about the Bible is that both Saints and Sinners alike can always find justification in it for whatever they do, or failed to do. I know a Commandment that also says: “Thou shall not steal.” So, whose money was being spent at that opulent funeral? Was it money that belonged to the Liberian people? If not, where did that money come from, when the nation cannot afford enough vaccines for the people? These questions cannot remain unanswered forever. Our leaders must be held accountable for waste when people are suffering. If we do not have enough vaccines to cover the entire population, that obviously eliminates the question of whether individuals will be forced, or be given the choice to take the vaccines or not. But that raises even a further question of how the nation will go about distributing the scarcity of vaccines in our stockpiles, and what system of priorities do we have in place that governs who first gets the few vaccines we may have? History has taught us in Liberia that whatever is good and in short supply always goes the top few and the well connected, while the rest of the nation has to make do without it. One practical advice I have for my fellow citizens who might find themselves compromised by lack of adequate vaccines or health care services is to simply follow the old proverb: “prevention is better than cure.” Obedience to this proverb means wearing the masks at all times when you interact with persons outside your immediate families and friends; avoid all public gatherings unless necessary for a specific purpose; observe social distancing when out in public; and wash your hands and face when you come home to prevent transferring any germs you picked up from handshakes to your family.
But my personal and favorite prescription is simple and available to everyone born and raised in Liberia. And it is this: If you have no reason to live in a city, go back to your home village and enjoy the simple things in nature, like the cool and refreshing air of the rain forest; listen to the songbirds chirping up the treetops; watch the colorful monarch butterflies flying lazily against the idle breeze; listen to the quiet whispers of flowing streams in your pathways through the forests; see the tremulous leaves dancing to and fro in the winds just before the storm; and the cascading waterfalls coming down from the hills. You can enjoy all of these beautiful things without wearing a mask or being exposed to the respiratory COVID-19 virus by having someone breathing or coughing in your face. In effect, go back to nature. There are salutary benefits to returning to nature. For one thing, it takes you off the stressful life of being connected to the grid and the congested environment of city living. In his educational work, “Emile (1762)” Jean-Jacques Rousseau admonished parents to send their children up to the country. He believed that nature was the best teacher of all. Send your children up to the countryside, he said, so that they may renew themselves from the “foul air of the crowded cities.” The best 30-day stress-free time of my life was in 2003, when I visited my ancestral roots in Guinea. My late brother and I drove 350 miles deep into the interior. No cellphones. No appointments to keep. We didn't even bother to know time. Our wrist watches were useless to us, except only as adornments. We would rise with sun and go to bed with the sunset. Our nights were filled with traditional entertainments, as elders took turns one after another telling us folktales of distant pasts, when we gathered around the evening fire. Dust clouds from the dancing feet of young girls filled the air, accompanied by their exuberant singing and clapping under the moonlight African skies. We drank freshly harvested palm wines to quench our thirsts. And when I returned to America after that visit, my doctors were amazed at my excellent vital statistics from those 30 days I spent with nature. You can leave COVID-19 in the cities and take a brief respite with nature, if you want to get away from the virus. Trust me. You will not regret it.
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