Vaccination with vector type vaccines – is it worth the risk?

COVID-19 has the potential to re-frame the whole debate about individual and societal risk, risk balancing, benefit-cost analysis, individual rights, societal responsibilities of individuals and responsibilities of Governments within the overall context that there are limits to what can be achieved in particular instances, and in totality across society. There has been considerable discussion and debate globally about the real and perceived risks of having a vaccination against COVID-19. This might be interpreted as having contributed to the uncertainty in the vaccine debate and contributed to doubt and even erosion of trust in some of the population. Some of this has been due to an understandable demand for immediate answers, before the necessary and detailed data were available and verified. The recent publication of unexpected negative side effects from the Astra Zeneca version of the vector-type vaccine, “vaccine induced prothrombotic immune thrombocytopenia” (VIPIT), has been the latest complicating development, which has caused further concerns, uncertainties and confusion. The risk figures that Governments use are derived from whole population data and processed to give a smeared out average “societal” risk. But to the individuals having to make the choice, these figures may, or may not, be relevant. The corresponding societal estimate of an individual’s chance of being stuck by lightning is the well-known 1 in a million. But individuals know intuitively that for someone who never goes out in bad weather, this is way too high. Conversely someone who goes out to fly a kite in a thunderstorm has an almost certain chance of being fried. In this paper we discuss the current arguments put forward, which accept the 1 in a 100,000 as acceptable collateral damage for societal exposure. It then contrasts them against the numbers that could be derived, if it is approached from the point of view of a particular individual’s risk benefit calculations. Subsequently we discuss how communication and information by policy makers and media may influence the decisions of individuals to have or not have themselves vaccinated. While the current debate about vaccinations provides data and the central focus of this paper, the issue is a general matter, it is symptomatic of a much wider risk question which the vaccine debate has brought into focus; and not just for other vaccines and medical interventions.