I am always reluctant to use belligerent military metaphors when it comes to matters of health. But they have abounded in our ‘fight’ against COVID-19. The UK government ‘enlisted’ the public in its battle against the virus and we have ‘mobilised’ troops (sometimes literally) to rollout the COVID vaccines. These are wars against something but, sadly, there is a war within—a civil war—around the issue of vaccinations, whether vaccines should be used at all, whether they are specifically necessary for COVID-19 and how far and with how much pressure they should be administered.
There are, to my certain knowledge, nurses who adhere to all the above views and, of course, nurses who promote and administer the vaccines some of whom will be vaccine evangelists, completely convinced of the necessity for vaccination and expressing no doubts about their efficacy or, for some people, their lethality. Should individual nurses take a position on these issues and should nursing as a profession have a collective position? I imagine most people will take the view that at both levels, nurses and nursing, there should be a positive stance on vaccines generally and specifically the COVID vaccines. After all, we know that vaccines save lives and have helped in controlling and even eradicating some lethal diseases. The question might be: ‘what’s not to like about vaccines?’
While I would tend to agree with the above question, it has become increasingly clear that the issues around vaccines and especially the COVID vaccines are not that simple. In fact, if someone said to me: ‘it’s quite simple’ whatever view they were going to express, I would reckon that they had not dug very deep or thought for very long about the issues. After all, there has been considerable ‘mission creep’ internationally regarding COVID vaccines.
For example, in the UK it was made abundantly clear that vaccines were only intended for high-risk groups of older and medically compromised people. There were explicit denials that the vaccines were intended for use with younger and less at-risk groups and certainly no intentions that they should be administered to children. In less than 6 months, we are already rolling out COVID vaccines to the whole adult population with considerable pressure, ultimately, to include children. Although at the time of writing this is still in doubt. These vaccines remain experimental in the sense that they have not been fully tested in the conventional ways and data on safety continue to be gathered with, in some cases, alarming findings. Given the way that the mRNA vaccines work then how happy are we that something which—however temporarily—hijacks the final step of the central dogma of genetics (the translation of RNA into protein) is going to be injected into children? This is especially salient now that there is evidence that the central dogma of genetics can be reversed in human cells such that RNA sequences can become incorporated by reverse transcription into DNA.
People who have been willing to accept the use of vaccines in adults and to accept the vaccine themselves, are expressing concerns about the use of COVID vaccines with children. But it is remarkably difficult to express any objections related to COVID vaccines without being accused of being an ‘anti-vaxxer’; now one of the worst insults that can be aimed at someone.
That there are anti-vaxxers within the nursing profession there is no doubt; I could name a few. How should our professional bodies deal with these people? It may be assumed that they are unlikely to work in clinical areas where it is necessary to administer vaccines in the same way that pro-life nurses would not work in areas where they are required to participate in abortions. But is that enough? Should anti-vaccination nurses be tolerated in the profession if they are known as such and promote anti-vaccination information? That is a question to which I only have an opinion; I do not have an answer. I tend to believe that nurses who are against vaccines should not be struck off but, in the UK, we already have at least one example of a nurse who has been.
A nurse may well be, generally, pro-vaccination but, nevertheless, have concerns about the COVID vaccines and may also be reluctant to have the vaccine. The first issue is whether nurses who voice concerns about the COVID vaccines, either regarding their necessity or their possible harm, should be tolerated in the profession. Holding and expressing the view that the COVID vaccines are possibly unnecessary is a reasonable position, in my view. COVID-19 is a mild disease in most people who become infected, and most people recover. The small proportion of people who die are those who would, for example, most likely die of influenza. These people could be protected, as has been argued consistently, either by non-pharmacological means or a targeted vaccine campaign. It is perfectly legitimate to ask why the whole population needs to be vaccinated at enormous expense and at the known risk of exposure—no matter how small—to harm and death.
The common argument—one which I have used myself regarding the COVID vaccines—is that there are no medical treatments without risk. Also, if people are aware of the risk, they can weigh up the consequences and make up their own minds. But when I went for my COVID vaccines I was told about the risk of side-effects, the risk of death was not mentioned and certainly not contextualised numerically. When I have had other invasive procedures, I have been told the precise risk of harm and death. But those procedures were designed to save my life and, most likely, had I not had them I would by now be dead. The risk of death from COVID vaccination is in the realm of 1 in 100,000 and even then, direct attribution is hard to establish. But the fact that it is so small does not mean that you may not be that one person. And for a disease that poses minimal risk to most people, how would a professional nurse or a trained vaccinator feel if they knew that they had injected someone who had subsequently died?
Finally, there is the very difficult issue of compulsory vaccination for health workers. Only under very limited circumstances are vaccines compulsory for a few medical workers in the UK. The introduction of compulsory vaccinations, initially for care home workers, has some face validity. These are people working with the most vulnerable group to COVID-19. But what are the consequences if there is poor uptake of COVID vaccines amongst workers in this sector? Already individuals have been made an example of by dismissal thus adding someone else to the numbers of unemployed. If large numbers refuse the vaccine, then widespread dismissal is not feasible; the sector already has a staffing problem. Moreover, influenza vaccination is not compulsory for care home workers or others in health care. What is the logic of having compulsory vaccination for COVID-19? I do not doubt the good intentions of some who propose compulsory COVID vaccination for care home workers. But I am sure that these are people largely not working in care homes whose salaries as academics, public health officials and politicians vastly outweigh the average care home worker and whose jobs are secure whether they are vaccinated or not.
Beyond the issues of vaccines per se and the possibility of compulsory vaccinations for care workers lies the especially thorny issue of compulsory vaccination for the whole population. And be under no illusions, there are those who have been proponents of compulsory vaccination long before COVID-19 was a threat. For example, Cynthia Leifer Professor of Immunology at Cornell University in the USA is on record as saying: ‘We cannot allow freedom of choice to endanger the lives of whole populations, so governments need to step up efforts to enforce vaccinations.’ I assume that Leifer is not one of the people who would be administering the compulsory vaccines; that will be left to nurses in practice. In which case, I have a question for any Registered Nurse: ‘could you administer a compulsory vaccination against someone’s will?’ Think about it.
*the author is a Registered Nurse
Opinions from the Unity News Network (UNN) editorial team & various contributors. | UNN always clearly distinguishes between news and opinion pieces and as an open minded outlet we publish views from a variety of people and organisation that do not necessarily reflect the views of UNN or its writers. Articles published under UNN Opinions are always opinion pieces and if published on behalf of a contributor will contain that authors name at the start of the piece.
