(This is Part 35 of Dr. Pagtakhan’s column Medisina at Politika in Pilipino Express.)

Editor’s Note: In February 2020, CFNet started publishing Dr. Rey Pagtakhan’s Commentary on COVID-19. Now on Part 35 of his running commentary, Dr. Pagtakhan – a retired lung specialist and former Member of Parliament – has kept the Filipino community and other CFNet readers continually informed about 1) the pandemic and its impact, 2) the scientific advances on drugs and vaccines, 3) the effectiveness of public health measures, including mass vaccination, 4) the danger of misinformation and disinformation, and 5) sound public health policy.

Winnipeg, September 16, 2021: Get vaccinated and make common cause with most Canadians, with medical science, and with the common good.

Most Canadians have been fully vaccinated: 67.80% (25,768,558)of the total population and 77.49% (25,726,211)of the 12-and-over population.Canada is coming closer to its revised target of 90% fully vaccinated to avail itself of community immunity, the “point at which enough immunity exists in a certain population to interrupt disease transmission.”

Sobering, however,is the proportion that is still unvaccinated: 32.20% (12,238,164), which includes those under 12 years of age for whom no vaccine is yet approved. The age group 18-29 years has the lowest at 64.39% (3,874,491)among adults.

Could it be due to outright opposition?

I tried to understand why some – admittedly vocal minority – remain opposed to vaccination even at this stage when the fourth wave of the pandemic – fuelled by the contagious Delta variant – continues to hit Canada and inflict havoc. 

In a protest rally in Steinbach, Manitoba 10 months ago, those opposed gave three justifications: 1) they do not believe COVID-19 is a serious disease; 2) neither do they agree vaccination is effective; and 3) they claim mandating vaccination restricts one’s personal liberty and they are standing up for freedom. 

Body of Data from Public Health and Medical Science

Cumulative magnitude of disease and death: As of September 14th, 225,389,505 citizens of the world have fallen ill to COVID-19, of whom over 4 million (4,642,054) had died. The Philippines has had 2,266,066 cases and 35,529 deaths. Canada’s share of the human toll stands at 1,559,432 cases and 27,293 deaths.

Would this magnitude of disease and death not enough evidence of its seriousness? I am puzzled.

While it was understandable before the development of safe and effective vaccines and their approval for emergency use in December 2020, any illness and death from the COVID-19 virus has since become a preventable human tragedy. And, therefore, more painful to accept when unvaccinated citizens become infected and seriously ill or die, or unknowingly spread the disease to others – their loved ones, neighbours and casual contacts in the community. I find it hard to fathom that there are still some who refuse to get their jabs and remain unprotected and as potential spreaders of the deadly virus. Yet, I can sympathize that "for many people, it's very difficult to conceive of themselves as potentially dangerous to other people," as author Eula Biss noted in her 2014 book, On Immunity.

Triumph of medical science:To date, over 5 billion COVID-19 vaccine doses (5,736,218,898) have been administered worldwide. Canada has administered over 50 million doses. These data and the data from the clinical trials have amply established their high effectiveness and remarkable safety.

Canada is fortunate to now have a sufficient supply of COVID-19 vaccines to vaccinate every unvaccinated eligible Canadian. Fortunate, too, that soon – perhaps by the end of this year or the start of next – vaccines would become available to Canadian children under 12 years of age.  The US Centers for Disease Control and Prevention Director Dr. Rochelle Walensky is optimistic it would be available in their country by the end of the year. The beneficial impact to Canada is imminent and palpable.

Breakthrough cases: More recently, concern has been raised about breakthrough cases – so-called because COVID infections“break through the protection vaccines provide.”  Like other protective shields, vaccines are not 100% effective.

But, would we be justified to discredit a vaccine only because its efficacy is only 90+%? If we would do it on that basis, why then would we settle for zero protection by refusing the vaccine outright? I find it utterly difficult to comprehend.  

True, breakthrough infections have occurred. Current estimates of their rate place it at well below 1%. And when these happen, almost all of the patients do not become seriously ill or die. Where the cases ended in critical illness and deaths – few as they are – they were mostly in the 80-year-old group and with other pre-existing medical health issues (obesity, cancer, heart disease, diabetes or some kind of immunosuppressive drug).

Clearly, the message to retain is this: A fully vaccinated person without any underlying health problems alluded to above has a minimal chance of getting infected, developing serious illness, or dying of COVID-19. 

Calculating the actual percentages of vaccinated and unvaccinated people that have been hospitalized or died recently in Ontario, family practitioner Dr. Jennifer Kwan reported on these results:

  1. 99.5 per cent of COVID patients admitted to ICU had not been vaccinated, and
  2. 95.8 per cent of COVID-19 deaths were in unvaccinated people.


Indeed, getting fully vaccinated – while not 100% effective – is the strongest shield against the Delta variant. Who would still continue to stubbornly oppose vaccination?

 The Common Good

The third justification cited by those opposed is their claim to unfettered individual freedom. Let me cite John Stuart Mill (JSM), the English philosopher-civil servant who wrote in his famous Essay on the subject of individual liberty in 1859: “Over himself, over his own body and mind, the individual is sovereign.” If his essay ended this way without further discussion, we could be excused for claiming unfettered individual freedom.

The fact is JSM further wrote: “The only purpose for which power can be rightfully exercised over any member of a civilized community, against his will, is to prevent harm to others.”

Indeed, there are limits to individual freedom when promotion of the common good – public health and public safety – is at stake.

Herein rests the foundation for mandatory vaccination and proof of it as a vital public health policy.A policy that has the support of 76% to 81% of Canadians surveyed by the Leger and the Association for Canadian Studies.

The Canadian Medical Association through its President Dr. Katharine Smart offered a viewpoint: “Federal parties shouldn't be divided on the use of vaccine passports or certificates; it needs to happen from the perspective of science to combat the pandemic. We're in an emergency and we've got everyone kind of walking their own path here, with tools that we know everyone needs, and they need the same tool. So why don't we do it one way properly, that works, and have everyone be consistent?"

Summation

Eula Biss wrote in her book: "My research on vaccination led me to the conclusion that it was my social and moral responsibility to vaccinate my child. It was in the best interest not only of his health but the health of everyone who was going to come into contact with him."

Indeed, getting vaccinated is our ethical and moral responsibility to keep us and others in society safe from the unrelenting COVID-19 havoc and harm. The COVID-19 virus is the common enemy, not each other of us. Getting fully vaccinated is an act of humanity and humility.


Editor's note: Dr. Rey D. Pagtakhan, P.C., O.M., LL.D., Sc.D., M.D. M.Sc. is a retired lung specialist, professor of child health, author of articles and chapters in medical journals and textbooks, and a former health critic, Parliamentary Secretary to the Prime Minister, and cabinet minister, including Secretary of State for Science, Research and Development. He graduated from the University of the Philippines, did postgraduate training and studies at the Children’s Hospitals of Washington University in St. Louis and the University of Manitoba in Winnipeg, and spent a sabbatical year as Visiting Professor at the University of Arizona Medical Center. In June 2003, he spoke on “The Global Threat of Infectious Diseases” at the G-8 Science Ministers/Advisors Carnegie Group Meeting in Berlin.

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