Vaccine preference: A dangerous waiting game

JARREL DE MATAS

Vladimir: Let us make the most of it, before it is too late!

– Waiting for Godot

ONE OF my favourite works of literature is Samuel Beckett’s play, Waiting for Godot. Apart from the comedic moments, the play contains a cautionary tale about the dangers of waiting and the anxiety that comes along with it. The play’s only two characters, Vladimir and Estragon wait with great expectation for Godot – who (spoiler alert) never appears. As we watch Vladimir and Estragon wait on stage, our own anxiety increases with the prospect of seeing the mysterious Godot. I find a certain degree of similarity between Beckett’s ability to describe his characters’ anxiety with waiting and what I call vaccine preferability: waiting until a "better" vaccine comes along.

For the most part, vaccine confidence in both the AstraZeneca and Sinopharm remains positive. For evidence of this observe the insanely long lines and ridiculous crowding at health centres nationwide last Wednesday. However, there is still a segment of the population who are vaccine-hesitant, not to vaccines in general (although this may also be the case), but to the particular AstraZeneca and Sinopharm vaccines. Any unvaccinated person is at risk of ensuring the survival of the coronavirus. It must have come as a pleasant surprise, therefore, when PM Dr Rowley said last week that 800,000 J&J vaccines have been ordered and expected to arrive in August. While any news of more vaccines, whatever the brand, is a positive sign in the fight against covid19, Dr Rowley’s news could be potentially problematic for the subset of the population who, like Vladimir and Estragon, have been Godot-like waiting for a "better" vaccine.

The key thing to bear in mind about Vladimir and Estragon is that they were woefully misled. By fixating on the promise of Godot, they missed out on what was in front of them. In our case, the stakes are simply too high. We cannot hold out for the misperception of superior vaccines when reliable, available, and WHO-approved vaccines are in front of us. Apart from the "one-shot" appeal of the J&J vaccine, it also carries the promise of being "better" because it is US-authorised.

The science behind proving AstraZeneca and Sinopharm are safe and effective seem to be insufficient evidence for those who still prefer the US-authorised vaccines. Perhaps then, science isn’t enough. Perhaps the doubt surrounding the AstraZeneca and Sinopharm vaccines are symptomatic of our bias towards anything US-made as superior. Perhaps what is needed is a cultural paradigm shift.

Firstly, we need to understand that just because the US-authorised vaccines were approved first does not necessarily make them better. In fact, it has been proven that the earliest vaccines to go to market, Pfizer and Moderna, offer less protection against the covid variants that mutated after those particular vaccines were developed. As it happens, Sinopharm could offer more protection due to being an inactivated vaccine that uses a "dead" version of the whole virus thereby potentially holding up better against mutated variants.

Secondly, we need to consider that it is not the science driving our vaccine preferability. Rather, it our obsession with branding that makes us hold out for a vaccine that has been US-authorised.

Fuelling the brand myth are the differing efficacy rates of each vaccine which have the unintended impact of reducing vaccine confidence in the less-efficacious vaccines. The efficacy rates are misleading for at least two reasons. The first is that different sample sizes were used with variable factors of geographic location, different stages of the pandemic, and using different strains of the novel coronavirus. The second reason why the efficacy rates are misleading is because the purpose of a covid vaccine is not to prevent you from getting the virus, it is to prevent you from getting serious complications due to the virus – something which all the vaccines are able to do. Think of it as an airbag in a car. Airbags, whether in a Ford, Land Rover or Nissan, serve the same function: protecting you from the impact of a collision.

At this moment, with approved vaccines ready to be administered, we all need to have confidence that the best vaccine is the one that is available. A vaccine for one is a vaccine for all.

Unlike Godot, the expected J&J vaccines will arrive. However, we do not have a firm date on its arrival. Therefore, we cannot afford to wait around for the expectation of a superior vaccine when such a thing does not exist. Don’t let the expected J&J vaccines, or Pfizer, or Moderna be your Godot.

Jarrel De Matas is a PhD student of literature at the University of Massachusetts.