COVID-19 vaccine availability: what are the side effects?

A NEW ANXIETY

It was with great hope for a better 2021 that we ended last year having heard the news of effective vaccines for COVID-19. We will never forget the year of lockdowns, thousands of lives lost, and fears of overburdening the NHS. Sadly, we had to go into another lockdown in England for the start of the new year, as COVID-19 infection rates continued to rise. It became a race between vaccinations and rates of infection during the third lockdown. A plan to first vaccinate the most vulnerable and exposed was drawn up, with the availability of vaccines being the main rate-limiting factor.

Interestingly, there are different attitudes to the vaccine, especially among Black, Asian and minority ethnic (BAME) groups, which have affected uptake. Conspiracy theories about the new vaccines were being spread on WhatsApp and social media sites, raising questions about possible unknown side-effects and ulterior motives.

As a GP, I have the privilege of prompt access to a COVID-19 vaccination and vaccine training as a vaccinator, and nothing I have read or seen so far has given me unusual cause for concern about the vaccine, but I am interested in a possible ‘side effect’ of the release of this vaccine that we may not have discussed so far.

Although people are being advised to continue to maintain social distancing, stay home, and wear masks even after vaccination, many have become even more anxious about when they will get the COVID-19 vaccine. It reminds me of the panic-buying before the first lockdown when there was a shortage of toilet rolls and flour! When we were all staying home and taking precautions to avoid a virus we had no cure or vaccine for, people felt we were all in the same boat and worried for each other.

Now it seems that some new anxiety and even anger is creeping in, as certain groups feel let down because they have not been prioritised to receive the vaccine, even as key workers. Even though no vaccine is 100% effective, the feeling that others are getting a vaccine advantage over them in a pandemic is making some people even more fearful than last year. I have had patients sounding very upset during phone consultations that they haven’t yet been called to receive the vaccine in spite of their risky jobs or medical conditions, which they are supposed to be shielding for anyway. Well-meaning people sharing photos of their COVID-19 vaccination cards on social media possibly add to this anxiety because others (who desperately want it) feel even more vulnerable and disadvantaged knowing that others have had the vaccine already.

INTERNAL CONFLICT

There is still a lot to learn about these new vaccines and some people (including professionals) have not yet made up their minds about whether to personally have the recommended COVID-19 vaccine. I can imagine that being bombarded with photos and news of who has or has not had the vaccine has not been helpful for their own mental health either. There will be days when people read about coronavirus death rates and want to have the vaccine to reduce their risk of infection, not waste their privilege of being offered one, and live longer for their families; and there will be other days when they feel that taking the vaccine will just be ‘following the crowd’ against their own personal convictions and understanding of the available data. There will also be people offered the vaccines who have a needle phobia or other conditions, making it a more complicated decision for them. Such internal conflict can be stressful, especially when also dealing with patients ill with COVID-19, the practicalities of lockdown living, winter pressures at work, and supporting others with more serious problems. There is also the anxiety and guilt some people experience around having the vaccine while worrying about others in their families or social circles whom they feel deserve to have it sooner.

AFTER VACCINATION

School teachers, pharmacists, and supermarket workers won’t be getting the vaccine for another few weeks or months while working in lockdown. Even the Royal College of General Practitioners has questioned why BAME groups have not been prioritised for the vaccines after the discovery of higher death rates from coronavirus among these groups last year. Resources are limited and have to be managed accordingly, but professionals also worry that patient groups who have not been properly adhering to COVID-19 social distancing rules before now might become even more nonchalant if/when they do get vaccinated.

Will they still wear their masks and shield as advised when they get their vaccines? We still do not have concrete answers for when immunity kicks in, how long it will last for, and whether the ability to transmit the virus is reduced, but we hope that as more people get vaccinated we will soon be able to have less social restrictions as a country. These are just some questions and concerns that we may not have had without a COVID-19 vaccine, but these anxieties have been affecting the mental health and stress levels of patients and professionals this year already.

I was pleased to be able to end my book, 2020 Year of Plenty, on a good note with the news of effective vaccines, but the real impact of this pandemic is yet to be fully seen. For now, we can choose to be grateful that there are effective vaccines we can receive should we choose to, and that this too shall pass.

I have not stated so far whether I have had the vaccine myself as I don’t want to add to the pressure some are feeling to get it now. I think we should make up our own minds about the vaccine personally after reading the available information, avoid scaremongering, and be sensitive when talking about this to others. Remember that wearing masks, social distancing, and hand hygiene will continue either way and for the foreseeable future, so having the vaccine is not a reason to be complacent. Focusing on the bigger picture and obeying the rules for the most vulnerable in our communities will help us beat this pandemic sooner, and have a happier 2021.