Michael FITZPATRICK
‘Icame in here really excited to get the vaccine, and now you seem to be trying to put me off…” This comment, overheard in our Hackney Covid vaccine clinic earlier this year, came back to me this week in the kerfuffle over extending vaccinations to 16 and 17-year-olds. With all the talk about “vaccine hesitancy”, I fear that the insecurity and defensiveness of the medical profession may be being transmitted to our patients.
In fairness, my medical colleague was merely following the requirements of the official guidelines to advise patients in detail of the risks of rare adverse consequences of vaccination.
But when patients not well versed in classical languages are subjected to earnest inquiries about prior experiences of anaphylaxis, thrombosis or thrombocytopenia, or episodes of “capillary leak syndrome”, a condition so rare that only a few hundred cases have been recorded in the half century since it was identified, you wonder whether common sense has been surrendered to an obsessive commitment to regulations and a concern to rule out any future prospect of legal liability.
The programme to vaccinate teenagers ahead of the return to school next month has prompted demands that our vaccinators produce further evidence of advanced qualifications in risk aversion. These include high-level police checks and familiarity with child protection and specialised paediatric resuscitation procedures.
We are also required to attend teaching on issues of “capacity and consent”, and “face to face” Send (Special Education Needs and Disabilities) training. If doctors regard young people with such a combination of fear and trepidation, it is not surprising that they are not in a strong position to reassure them about vaccination.
In all the years we have been vaccinating children and adults in our surgeries, we have never felt obliged to read out the small print from the vaccine data sheets, listing every possible adverse effect.
Yet we are now expected to warn teenagers of the risks of heart inflammation that rarely occur with some Covid vaccines. These conditions cause mild and transient symptoms, such as shortness of breath, palpitations and chest pains that are far more likely to be induced by anxieties provoked by such warnings.
The health authorities seem determined to turn the simple process of consent into a legal contract. But if somebody walks through a door labelled “Covid vaccination centre”, sits down and rolls up their sleeve, I think that a reasonable person would interpret this as consent to vaccination, without subjecting them to interrogation and instruction.
Even the simple matter of the 15-minute period of observation required after the Pfizer vaccine because of rare allergic reactions has become a focus of anxieties about the need for additional measures to safeguard teenagers from predatory adults.
A free lunch
At the same time as they are being subjected to grim warnings about rare side effects of vaccination, young people are being patronised by being offered diverse incentives to get the jab. These include food and travel discounts, clothing gift cards and gym passes. I suspect that these measures will not encourage the hesitant, while irritating many who readily appreciate the case for vaccination and are happy to attend the clinic.
I find that most teenagers have a good grasp of the balance of the (relatively small) benefit of vaccination in protecting themselves from illness and the (largely notional) risks of adverse effects. Their main motivation, as one boy told me, is that “this is something I can do to protect my family and community”.
An appeal to the good sense and altruism of our country’s teenagers seems more likely to improve vaccination uptake than attempting to bribe them with pizzas and free taxi rides.
‘When vaccinating children before, we were never expected to read out every possible side effect’