Modern life is full of vile words and phrases. Dr No is not taking about the more traditional terms of abuse aimed at race and sex, but of the new elitist terms of abuse aimed at proles, thickos and others who for whatever reason have failed to embrace the Establishment narrative. Take vaccine hesitancy, the catchall phrase for all who decline, as they are perfectly entitled to do, to have a vaccine. A picture is cast of a timid individual, perhaps like a child reluctant to enter a swimming pool, who will nonetheless get there in the end, after a little encouragement from the grown ups. The term is innately paternalistic, condescending and belittling, and made all the more sinister by the fact that the cure is invariably some form of political re-education, indoctrination or behavioural nudging. How curious then that one of the groups most likely to show vaccine hesitancy is the one group we might reasonably expect to be the most grown up about health care, health care workers themselves.

Study after study, in more than one country, has shown that between a quarter and a half of doctors and nurses are vaccine hesitant — or to put it another way, have reasonable and significant doubts about the vaccine. Indeed, Dr No may as well nail his colours to the mast, and say that he too has declined an invitation to be vaccinated. The seductive vaccine cavalry narrative that has cast a spell on politicians and the mainstream media has failed to work its magic on Dr No, as well as so many others in health care. Why has the magic cavalry narrative failed?

It is because there are other equally credible narratives. It is as well to emphasize that they are narratives, nothing more, nothing less. But narratives, which are all that we have at present, because the science is far from settled, are stories that make sense of a complex world, and that gives them great power. When each and every one of us is offered the vaccine, we use our understanding of the vaccine narrative to make our decision on whether to accept or decline. Those who claim to have a complete understanding of covid vaccine science merely have access to bigger and better crystal balls than the rest of us, and that takes them on a different narrative trip. No one knows what is round the corner, because we are in a novel to the power three situation: a novel mass rollout, during the pandemic, of a novel vaccine technology,  against a novel coronavirus.  

What are the other narratives? The first, and most obvious, one is that the novel vaccine technology that has only been in routine clinical use for a little over three months. No amount of person years of exposure (number of persons exposed multiplied by the duration of exposure, so 12 million people exposed for one month gives us one million person years) can alter the fact that no one individual’s personal exposure has yet reached one year, and for the vast majority it remains three months or less. This narrative tells us one very important thing: the vaccine is still experimental. We have no way of knowing about medium or long term side effects. For many, this is sufficient to have reasonable and significant doubts about the vaccine, until such time as we do have data on longer periods of exposure.       

The second narrative comes from flu vaccination, and the story is that flu vaccine isn’t very effective. Unlike vaccines against the diseases of childhood, which generally are impressively effective, vaccines against seasonal respiratory infections caused by viruses capable of antigenic drift are a cavalry on rocking horses forever trying to play catch up. CDC’s annual estimates of flu vaccine effectiveness (the estimated real world protection achieved in those who have been vaccinated, estimated because the hard science is hard to do) over the last 15 or so years have ranged from 10 to 60%, with an average effectiveness among those vaccinated over the period of 40%. If only three quarters of the population are vaccinated, those percentages for the whole population (vaccinate and non-vaccinated) drop to 7.5%, 45% and 30%.

Covid–19, like flu, is a seasonal respiratory infection caused by a virus routinely produces new strains, and effectiveness percentages at those sorts of levels are nowhere near the levels needed to achieve herd immunity. In this narrative, Hancock and the rest of the Establishment have simply backed the wrong horse. Dr No rather suspects this is where Whitty’s recent in-and-out of-lockdowns-forever narrative stems from. Unlike the other goons, he has realised the vaccine may never be capable of adequately controlling covid–19 at a population/herd immunity level, and that can only mean one thing, on and off lockdowns forever. For the rest of us, that narrative might instead mean there is simply no point in mass quasi-compulsory vaccination, because, for very plausible, but as yet unproven reasons, it can never achieve its stated aim.

The third narrative is the first narrative taken a step further, by asking what could possibly go wrong? After all, vaccines are one of the great success stories of modern medicine. But, according to this narrative, because the vaccine is so new, there is an awful lot more we don’t know, over and above the relatively simple to answer question of individual side-effects. What if the vaccine causes worse disease in some recipients, through the process of antibody-dependent enhancement (ADE), or perhaps more accurately, vaccine-associated disease enhancement (VADE)? These reactions, which suffer from a confusing plurality of definitions and abbreviations, generally involve one of two mechanisms. In the first, sub-optimal antibodies paradoxically facilitate infection by the virus, leading to more severe infection. In the second, the body’s immune system over-reacts, and it is this over-reaction that causes more severe disease. A balanced and reasonably accessible, and indeed not unduly pessimistic, account of ADE can be found here, with a more technical account available here.

What else could possibly go wrong? Most vaccines are given prophylactically, before exposure to the risk of infection, so immunity has time to develop. Unusually, mass covid vaccination is being rolled out while the virus is in active circulation, meaning that people can, and will, get infected — as our erstwhile Health Secretary Jeremy Hunt has so helpfully shown us — while their immune system is in the throes of developing immunity, and they only have partial immunity. This, as a German virologist has emphatically pointed out (click on the bit.ly link to get a fuller treatment), is the ideal breeding ground for new vaccine resistant strains of the virus. Just as indiscriminate (mass) and inadequate (not fully effective) antibiotic use inevitably gives rise, through simple natural selection, to antibiotic resistant bacteria, so too could mass vaccination while the virus is in active circulation  programme create the ideal conditions for new vaccine resistant strains of the virus to emerge.

None of this is proven, but it is plausible enough to exist as a narrative, without any taint of conspiracy theory. Indeed, the idea that vaccination against a circulating pathogen has the potential to aggravate disease dynamics, just as careless and indiscriminate antibiotic use all but guarantees antibiotic resistance, considerably predates covid–19, and cannot be dismissed as the mere fancies of covid deluded minds. Instead, they raise valid questions that we do not yet know the answers to, and so deserve thorough , if necessarily sceptical, investigation.

Dr No is not an anti-vaxxer, but he is profoundly anti-not doing the science, and even more anti-saying we know when we don’t. Where, pragmatically, does all this leave Dr No, were he an active clinician, able to vaccinate his patients? He would neither advocate vaccine acceptance nor refusal: that is not his job, given all the uncertainties. Instead, he would make sure his patients had all the facts necessary for fully informed consent, and then proceed on the basis of his patient’s decision. He would afford exactly the same respect to the brave soul who accepted a still experimental vaccine as to the one who, having considered the matter in the round, decided to brave the world without having the vaccine.      

Comments

  1. James Robinson Reply

    So much we don’t know.

    However, we do know that several countries worldwide, including most recently, Ireland, have banned the AstraZeneca vaccine (for now at least).

    Reports of blood clots and other adverse reactions don’t bare well. But where’s the moderate, cautious narrative, citing these examples / cases to justify holding back?

    With the death of investigative journalism, we have little evidential reporting to consider. The whole echo chamber, loaded with the virtue signaling of ‘you must take the jab’ prevails.

    Herd immunity? More like: herd conformity!

  2. Misa Reply

    The widespread use of flu vaccination in the UK does seem initially to have been followed by a significant reduction in deaths due to influenza, but this information is not typically presented, and the large numbers of deaths from ‘Pneumonia and Influenza’ (mainly pneumonia) rather obscure what happens with the much smaller numbers of influenza deaths.

    Over the five years (1996-2000) prior to the widespread deployment of the flu vaccine, in England and Wales, an average of 354 deaths were each year recorded with an underlying cause of influenza.

    From 2001 to 2008, the eight years following widespread vaccination (of over-65s), in no year were more than 67 deaths attributed to the underlying cause of influenza, and the average across these eight years was 38.75.

    I suppose there are two ways of looking at this:
    1) Vaccination programme produces stunning 90% reduction in deaths due to influenza!
    2) Vaccination programme produces no obvious reduction in overall mortality.

    Whatever your view of these numbers, what happens next seems more interesting…the numbers bounced back to more-or-less pre-vaccine levels.

    From 2009 to 2017, the avarage number of deaths due to influenza was 263, then during 2018 there were 1598, and in 2019 there were 1223 – numbers rarely seen the 1970s.

    What do you make of this, Dr No?

    • dr-no Reply

      Misa – interesting. There was some discussion here a short while ago on flu vaccination rates and the effects or otherwise on mortality, with somewhat unsubstantial conclusions, partly because 2000 may not have been a watershed year for vaccinations (rates were already fairly high in at risk groups).

      The observation that “the numbers bounced back to more-or-less pre-vaccine [or whatever intervention you fancy] levels” is not unknown in public health interventions, most likely due to a combination of waning Hawthorne effects and individual risk compensation.

      Dr No couldn’t find your exact figures for flu deaths but he did find these very similar number of deaths from flu (ICD10 J09-J11) figures using this ONS ‘interactive webservice’:

      2013 159
      2014 118
      2015 282
      2016 427
      2017 458
      2018 1,596
      2019 1,213

      and the years 2015-2019 are available here. ONS’s annual summary 21st century mortality data (note – huge 34MB download) has even lower figures. These figures are sharply at odds with other estimates which have annual flu deaths in the tens of thousands.

      Frankly, the stats are all over the place. Some of the difference might be down to (a) deaths from/with (b) strictness of diagnostic criteria (eg lab confirmed or not) and (c) actual counts of deaths certs (ONS) vs inferred eg fuzzing up excess mortality estimates. But to get orders of magnitude differences – truly, that is the work of a master statistician.

      • Misa Reply

        Thanks for that, Dr No. I’d not seen the discussion of pre-2000 vaccination.

        I’m aware that the change to ICD-10 in 2001, and an accompanying change in selection rule 3, brought a dramatic (~40%) reduction in the number of deaths recorded with an underlying cause of pneumonia. This was not a reduction in doctors placing ‘pneumonia’ on the MCCD, but a change in whether this would be accepted as underlying cause for national statistics. It’s my impression that influenza was not, however, similarly affected, and it appears that influenza is typically recorded as underlying cause where present.

        I’m not sure why my numbers have strayed from those you found. I was working from the ONS 21st Century Mortality data, ICD-10 J09-J11, along with 20th century data from here

        Figures from the USA make an interesting comparison as, I believe, flu shots were more widely used much earlier, and there was no sudden nationwide programme (accepting that I perhaps overstated the extent of that in the UK). Figures from the CDC Wonder site show that deaths with underlying cause of influenza averaged 1335 per year from 1979-2008 before increasing much as is seen in the UK. For comparison with the UK Nomis figures you provided:

        2013 3,697
        2014 4,605
        2015 5,251
        2016 2,905
        2017 6,515
        2018 11,164
        2019 5,902

        There was a bump with 2009 swine flu, both in the US and UK, but why we should then see such an increase within the past decade, I just don’t know.

        As to why we often hear about tens of thousands of UK flu deaths when ‘official’ numbers are so low, I’m not sure either. Clearly there are more deaths during winter than summer, and it may be that peaks in winter excess deaths do match up with circulating flu viruses, but I’m left with the impression that much work has been done to sell flu shot. If winter excess deaths must be attributed to flu, surely this means that ‘flu’ must include many more viruses than those of the influenza family.

        On the subject of selling flu shots, you may be interested by this guidance on How to respond to vocal vaccine deniers in public.

        And I see Simon Elmer has located some information on Vaccine Adverse Reactions. (via twitter @9thfloor)

        • dr-no Reply

          Misa – our (ONS) sources appear to be similar, and any differences in numbers are probably due to the many varied and creative ways in which ONS both present and obfuscate their data. One of Dr No’s constant gripes is the regular minor changes made to rows (inclusion/exclusion, or subtle changes to what the row represents) which have anything but minor consequences for looking at trends over time. The alternative PHE flu reports are models of impenetrable complexity, and apparent contradictions: hospital flu deaths typically in the (low) hundreds, and then, by some magical numerology (FluMOMO, an ‘extension’, whatever that means, to the bizarre EuroMOMO algorithm), tables presenting [emphasis added] “Number of deaths associated with influenza observed through the FluMOMO algorithm” typically in their tens of thousands. Frankly, this is meaningless garbage. What does ‘associated’ mean? How do you ‘observe’ deaths in an algorithm? Algorithms don’t observe, they predict.

          The marked (order of magnitude) difference between ONS MCCD (‘death certificate’) and the alleged excess mortality based numbers of flu deaths remains an enigma, unless, as you suggest, and Dr No is strongly inclined to agree, PHE and even ONS are inclined to plug flu as a leading cause of excess winter mortality, as a wheeze to push up flu jab numbers. Let’s have a look at some killer flu news reports from recent years, and see what is actually said.

          From a typical BBC report (from Feb 2015) (emphasis added):

          “Experts [ie PHE] say flu could be the driving force…”

          “There is evidence [from PHE], however, that flu may be a crucial driver of this year’s elevated deaths…”

          A Daily Mail headline (from Feb 2018):

          “Killer flu outbreak is to blame for a 42% spike in deaths in January after 64,000 people died – the highest number since records began”

          which is followed by:

          “The killer flu outbreak is to blame for a 42 per cent spike in deaths across England and Wales, statisticians (ie ONS) claim.”

          The Telegraph (Feb 2015):

          Under the headline “Winter death toll ‘to exceed 40,000′”, we have:

          “The (ONS) statistics suggest that by March 31…numbers will have surpassed 2008-2009’s flu-hit toll of 36,450 toll, making it the worst since 1999-2000’s landmark peak of 48,440 deaths.”

          The Sun does it better, of course. Under the Oct 2020 headline “GET FLUED UP How many people die of flu every year?” by Terri-Ann Williams, Digital Health & Fitness Reporter (hullo?), it has:

          “AROUND 17,000 people die of the flu every year in England, data from Public Health England (PHE) shows.”

          And further down it has:

          “A spokesperson from PHE said the number of deaths from flu cases varies every year. ‘The average number of estimated deaths in England for the last five seasons (2015/16 to 2019/20) was over 11,000 deaths annually.'”

          And so on. Excess winter deaths certainly happen, partly but not exclusively due to the colder weather, but there are many causes apart from flu, including cardiovascular and other respiratory diseases. Nonetheless, it seems that the habit of fuzzing up the numbers of deaths attributed to killer respiratory viruses, seen so clearly since the arrival of covid-19, has in fact been an honourably established public health harum’n’scarum tactic for years, if not decades.

  3. John B Reply

    All drugs carry risks and adverse reactions to adjuvants in vaccines is well known and documented. So leaving aside the novelty of the CoVid vaccines, there are known risks from it as with all vaccines.

    We know that the risk from CoVid for anyone in reasonable health under the age of 65 is very low, approaching zero in the under 45 age group, so the risk assessment must be is the known risk from CoVid vaccine plus as yet unknown/suspected risk greater or less than the risk from the disease?

    Doesn’t it seem likely for most people the risk from the vaccine is higher? Added to that, many in the population by now have had contact with the virus and have developed immunity, so vaccination for them is all risk with no reward.

    Given that mass vaccination can only stop an epidemic if it takes place prior to it starting, not after it has become endemic, that CoVid vaccines introduce risk to a large population group probably higher than that from the virus, and that it certainly will not eradicate the virus, I cannot see a favourable cost benefit analysis for vaccination. Worse, it takes resources away from other beneficial medical diagnosis and treatments for non-related diseases, and distracts from early treatment of CoVid cases with the range of products used successfully in many Countries.

    It is strange medical practice to make a positive diagnosis, then tell the patient they cannot be treated and to go home and isolate themselves until they get so ill they have to dual 999, or die or hope a vaccine comes along in time.

    • Tom Welsh Reply

      “I cannot see a favourable cost benefit analysis for vaccination”.

      I quite agree, John B. But you will perhaps agree that one can see a very favourable cost benefit analysis for vaccine manufacturers and purveyors. And a very much desired extra grip on the citizen body for government.

      And as hardly anyone in the vaccine industry or government gives a flying rodent’s backside about the health of the general population…

  4. Tish Farrell Reply

    Many thanks for this, Dr. No. What amazes me is how many people unquestioningly believe the vaccine is some kind of panacea; that we should be dashing out to get it – when logic says – how can it be after so little time in development, to say nothing of the long failure with SARS1 vax and its considerable issues. We truly have had the witchdoctoring-modellers’ curse laid upon us.

    I know I’ve said this before, but in the face of mass vaccination (with intimations of coercion – direct or indirect) surely the narrative that should have been explored is: how many people have had the virus. About a year ago Dr John Wright in the Daily Mail was reflecting on the Bradford Choir and the viral outbreak among them and how it spread (the landlady of the pub the choir frequented became very ill). This occurred in late December 2019. One of their number had recently returned from Wuhan.

    It now appears the virus was abroad by at least October 2019. It also turns out the business and academic relations between the UK, the world and Wuhan were considerable. Surely, then, common sense (rather than modelling) should at least suggest that a significant number of people must have been infected/ been in contact with/have immunity from infection prior to the 2020 March lockdown. Yet no one thinks it important to find out before doling out in-trial vaccines.

    Of course Mr Microsoft says (in a youtube vid) that he expects 20% return on his vax investments.

    • Tom Welsh Reply

      “What amazes me is how many people unquestioningly believe the vaccine is some kind of panacea…”

      I think, Tish, that what we are seeing is the result of a culture that increasingly deprecates rigorous – or even clear – thinking, and much prefers the warm comfort of woolly emotion.

      They have allowed themselves to be terrified by grossly exaggerated depictions of the risk deliberately put about by government and the media. Yet they also believe that there must be a safe, easy and cheap solution. Mummy will make it better.

      • Tish Farrell Reply

        Well that’s the other thing, Tom, that people cannot bring themselves to even consider that much of what they have been told is either complete nonsense or full of unknown unknowns, and I’m including educated souls in this, people who astonish me by their adamant compliance and fervour of belief. And then there are those who are so excited to have so many new means to pillory those who do not conform. I have neighbours who think runners and cyclists should be gagged – in the middle of rural Shropshire for godssake. If ever anyone wanted to consider what hell is, I think we have now colluded in its inglorious fabrication. How we ever dismantle it is also another story.

        • Tom Welsh Reply

          Although critics apparently disagree about the correct interpretation, Tish, I think we have arrived at Sartre’s declaration (from “Huis Clos”): “L’enfer, c’est les autres”. (“Hell is other people”).

  5. Tom Welsh Reply

    “Of course Mr Microsoft says (in a youtube vid) that he expects 20% return on his vax investments”.

    Very low by the standards of mass market software. But what the hell – you take a few billion whenever you can, even if costs you a bit.

  6. Frank Reply

    Apart from ADE, the thing that interests me is exactly how localised, or alternatively how widespread throughout the body, and in which organs, are the cells which are targeted by the mRNA and therefore express the spike protein, and which will presumably be targeted by the immune cells and be destroyed by them. Also, how long-lived are these nanoparticles and their associated mRNA? Dr Sucharit Bhakdi has expressed concern about autoimmune attacks being mounted against the targeted cells and the risk of irreversible autoimmune effects. There is a detailed discussion about how the lipid nanoparticles carrying the mRNA are circulated and where they are likely to end up in this discussion on the Pipeline blog:

    https://blogs.sciencemag.org/pipeline/archives/2021/01/11/rna-vaccines-and-their-lipids

    From the discussion there, it appears that no one really knows the answers, yet I would have thought that this is of fundamental importance.

    I’d also like to know if this is an inherent risk with the viral vector vaccines like the Oxford one, as well as the mRNA ones. I haven’t really seen this addressed, presumably because most of the discussion takes place in the US where they only use the Pfizer and Moderna jabs and not the AstraZeneca one.

  7. dearieme Reply

    It’s quite simple for me. I am old, fat, ill. So to take the vaccine seems a reasonable gamble.

    My advice to the youngsters in the family is that it’s probably wise not to take the vaccine, and that if they must they should defer it as long as possible in hopes that more will be known.

    In the large, it’s not an anti-viral vaccine at all. It’s an anti-lockdown vaccine.

  8. Isabelle Reply

    I found this blog so interesting. Thank you, Dr No.

    I’ve read so much about the AZ vaccine and I still don’t understand how it works, in detail. I do have a degree in health science but that hasn’t helped me.

    I wish that someone who understands this would produce an animated info-graphic showing where the vaccine comes from, how it’s made, and what happens when it’s injected.

    Anyway, it’s doing my head in. Every night I stay up late reading science / medical blogs and watching “covid” videos. There’s so much jargon.

    This blog is great. But I’ve got to start showing some restraint around Covid data. Perhaps I’ll go back to kitten videos.

    • carolyn_f Reply

      Isabelle, I found this link from another blog – the info about Oxford/AstraZenica vaccine is certainly presented graphically. I hope it helps. I read the piece and again thought “so much we don’t yet know”.
      I found a similar NYork Times piece about how the Pfizer vaccine works but I have to register to read it. So, perhaps read one, clear the browser cahe, then read the other…?

      • Isabelle Reply

        Carolyn, thank you for that link. I have read the article and on the one hand it seems clear, but then also raises questions.

        I’m going to accept now that I can’t understand the science in any meaningful way. But I’ve read enough to know that I don’t want any these vaccines injected into my arm. The long-term consequences seem to be unpredictable. If they prove negative I expect the results to be hidden, minimised, unpublicised.

        I hope vaccine -coercion never becomes legalised. If I could sail I’d buy a boat and look for a safe haven.

        • dr-no Reply

          Isabelle – Dr No can sail (and has done so since he was a lad), and he has a boat, so in one sense he is all set up and ready to go. But the depressing thing is: where? Last summer he managed a very modest Solent to Dartmouth and back cruise. Anchoring was fine, but all the harbours were on a covid control freakery trip. Weymouth was particularly bad. You had to book your berth in advance (that’s not how sailing works…) and they would only allow one boat per berth (normally there might be up to five) so they reduced their capacity by 80%. The prize for lunacy though went to Dartmouth, where they closed the showers for harbour commissioner visitors moorings. One hand of the state says we must wash our hands regularly, the other says the ultimate handwash is banned. Dr No took it in his stride, having grown up in an era when cruising sailors took a bath once a month, whether they needed it or not.

          • Isabelle

            Dr No – Covid control freakery seems to have permeated every nook and cranny of UK life. I follow the blogs of several expat Brits who have bought land abroad, Portugal mainly, and are exploring permaculture and small-scale self-sufficiency.

            They seem to be relatively unaffected by the Covid virus, living in remote areas, without Tv or news. They aren’t “survivalists” in the American sense, just people trying to live off the land and doing their own thing.

            If you are a sea captain I wonder if Galicia might provide a sense of freedom.

  9. dr-no Reply

    Here’s another narrative, all true, except possibly for any joining up of the dots made by you, dear reader.

    Pfizer, one of the biggest, and often the biggest drug company in the world by revenue, sees covid-19 as the mother of all golden geese, capable of laying astonishing quantities of golden eggs. It rapidly sets to work with its specialist biotech partner Biontech to develop a novel mRNA vaccine against SARS-CoV-2.

    It partially succeeds. The mRNA is clever, and clinical trials appear to show it is efficacious (which is not necessarily the same as effective, former is after tests in ideal conditions, latter is after tests in the real world) but it is also flawed, in that it is remarkably unstable. Stability can only be achieved by keeping the made up vaccine at extremely low temperatures.

    Pfizer submit data to the various drug regulatory bodies around the world, in pursuit of regulatory approval. Unknown criminals targeted one of these regulatory bodies, the European Medicines Agency (EMA), and after a successful cyber-attack, looted over 40 megabytes of classified regulatory data including sensitive emails which they then distributed, both on the dark web and to journalists and academics.

    The leaked emails confirm that mRNA fragility is a real problem in the real world. In particular, the mRNA integrity (how much of the mRNA remain in tact in the vaccine) in some commercial batches of the vaccine was markedly lower than in clinical (presumably clinical trial) batches, falling from around 78% to 55%. No one really knows what happens to the fried mRNA debris, or whether it has any short, medium or long term clinical implications.

    Then, out of the blue, these concerns evaporated, and the Pfizer vaccine got the green light. None of the regulatory bodies and drug companies approached by the BMJ were able to explain the basis for the volte face, choosing instead to hide behind ‘commercial sensitivity’. On the key question of what amounted to an acceptable level of bedside mRNA integrity, all remained silent.

    Make of this narrative what you will.

  10. Anna Reply

    Thank you for an informative and educational post Dr No.

    Initially I was pro-caution re the vaccine, fearing all had been rushed and the Pfizer requested/required indemnity cover increased my reservations, all reservations’ being feelings of too soon, too soon. I informed my family I would wait and see…

    When offered the vaccine three weeks ago and nil accounts of adverse reactions. I, like a lamb, went for slaughter – but I did not think like that then. Nil accounts of adverse reactions had somehow calmed me, reassured me…

    I have read Vanden Bossche’s, McLean’s and Plos Biology’s articles and now wonder what I have allowed myself to take part in – well, it’s a trial isn’t it?

    “The usual duration of a vaccine efficacy trial is 2 or 3 years. Given the importance of long-term efficacy, long-term follow-up of cohorts involved in vaccine trials is clearly essential.” (McLean).

    And of course, across the three articles there is so much more to worry about…

    We are playing with fire with unknown outcomes…and personally, I feel I have allowed it.

    Why didn’t I follow my initial gut-feeling?

    • dr-no Reply

      Anna – thanks. Can Dr No suggest that your narrative got changed, ‘got changed’ because you didn’t necessarily change it, instead the external no reports of adverse reactions became part of your internal narrative, and so it made sense to have the vaccine?

      Can you remember how whoever consented you for the jab explained the risks?

      • Anna :o] Reply

        You are probably correct Dr No.

        As to your question:

        I was contacted via telephone by my GP surgery and invited to attend for vaccine on a particular day at 12:21 precisely.

        Upon attendance, I found it a very streamlined, efficient and friendly process of which I was pleasantly surprised.

        At my turn, the doctor introduced herself and informed that the AZ vaccine had been expected, but that Pfizer had been delivered, and I was to receive that. She then detailed all the known side effects and what I should do if any occurred. She then enquired if I would accept the vaccine – which I did. It was 12:22, which left me quite impressed.

        Had she not asked me if I would accept vaccination, would I have gone ahead or even mentioned her omission? To the former probably yes and the latter, probably not… I don’t think I would have even noticed it.

        It was such a seamless process that I was bought and sold – and that now worries me.

        • dr-no Reply

          Thanks Anna. The timings are very helpful as well. Hmmm, Dr No rather expects that might be a lot of people’s experience. Known side-effects is certainly part of informed consent, but given a new vaccine using a new technology with less than three months history of routine clinical use, isn’t explicitly including that information also part of informed consent? Or is the person being vaccinated expected to know that anyway? If we use the Montgomery rather than the Bolam test, that is informed consent needs to cover anything the person being consented would be likely to attach significance to, then Dr No rather suspects it fails that test.

          Dr No very much hopes the vaccine will in due course be shown to be safe and effective, but, the thing is, we aren’t there yet.

          • Anna

            Re Montgomery – you are of course correct. “…but given a new vaccine using a new technology with less than three months history of routine clinical use, isn’t explicitly including that information also part of informed consent?” A patient has the right to know.

            Perhaps it is possible that after reading that particular (Montgomery) post – at its time of posting – it was the genesis of my growing concerns re the haste that we all must/should be (altruistically?) jabbed; all too soon, too soon.

            Having a nursing background you would think it so that I would be aware that:
            “The usual duration of a vaccine efficacy trial is 2 or 3 years. Given the importance of long-term efficacy, long-term follow-up of cohorts involved in vaccine trials is clearly essential.” (McLean). …but I didn’t, although realising three months is certainly too short a period a trial period…

            In this respect (of following orders), I have sadly become a sheep…

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