Every doctor’s COVID-19 jab is one step closer to your vaccination

The myalgia I awoke to this morning isn’t unfamiliar to me. It’s the common achy feeling we all experience at the onset of a touch of flu. The mild malaise I’m also feeling, after a shorter night’s sleep, is a physiological effect I try to avoid, but it’s the result of a habit that seems to creep into most of our busy lives.

Perhaps more particular, last night was the close constant attention I paid to my glucose levels as a Type 1 diabetic. Thankfully, all remained normal. Barring my mild symptoms, I’m feeling fantastic this morning, 24 hours after receiving the Johnson & Johnson COVID-19 vaccine.

My mind drifts back to almost a year ago, when I contracted a simple rhinovirus (the common cold). In spite of experiencing similar symptoms, I would certainly not have described myself as feeling “fantastic” at the time. These same symptoms used to conjure up uneasiness that my family had to bear as part of the role in life I have chosen. That’s what happens when you live with some comorbidities and work in a busy practice that had started to screen its patients vigilantly for the new “Wuhan flu”.

I welcome the vaccine’s side effects as do my colleagues as we enrol this week as the guinea pigs of the Johnson & Johnson trial. This is the only vaccine to date that has shown significant efficacy in preventing severe COVID-19 or death as a result of the 501.V2 variant, the most common strain of COVID-19 in South Africa today.

It’s a single-dose vaccine, with 500 000 doses secured to inoculate healthcare workers over the next four weeks. This is a trial still at stage 3b, which means that it’s not yet registered anywhere in the world for commercial use, in spite of its rolling application in the United States, the United Kingdom, and South Africa.

The vaccine is being rolled out as an emergency measure while it awaits FDA (Food and Drug Administration) approval potentially at the end of this month. Should the vaccine prove to be effective amongst South Africa’s healthcare workers, it will give SAHPRA (the South African Health Products Regulatory Authority) the green light for commercial rollout to our citizens.

My social media feed has been preoccupied with posts by colleagues receiving their vaccines. I, too, have added my own story to this noise. In reality, it’s far from noise. The supportive response we have all received from the public has been overwhelming.

A dear pulmonology colleague and I engaged in conversation yesterday as to whether doctors should be “flaunting their receipt of a vaccine” on social media or rather just quietly receiving the jab under the radar.

After some meaningful thought, we both agreed on the former. The palpable excitement by the public to doctors’ Facebook posts is fuelled by some valuable perspectives which I would like to share with you. These are the reasons that our community members should feel joy that our healthcare workers are finally being vaccinated this week.

The healthcare worker’s safety perspective: during surges of COVID-19 infection, patients have described the thought of not being able to see their doctors, nurses, and paramedics with ease as a terrifying dynamic. Statistics have shown that healthcare workers are three to four times more likely to develop COVID-19 than the general public. As many as 54 685 healthcare workers in the public sector alone have been infected with COVID-19 over the past year, with 779 losing their lives.

Unfortunately, every community doctor knows another doctor who has either contracted a serious COVID-19 infection or even lost their life to this plague. The vaccine offers you the promise that your doctors will be protected and able to help you when you may need them whether for COVID-19 or another reason.

The experimental perspective: the AstraZeneca vaccine taught us that in the dynamic, evolving space of COVID-19, variants affect efficacy tremendously. This phenomenon is so significant, that an already procured vaccine at one million units had to be returned. It’s still unknown whether the Johnson & Johnson vaccine will indeed be effective in large numbers on the ground, beyond the limited sample size of the original study in South Africa.

It’s best to run a live trial on largely healthy healthcare workers. I have my predictions that even with the Johnson & Johnson vaccine, modifications will need to be made to the product in the near future. Dr Glenda Gray advised me that a two-dose regimen is also being explored. Other expert vaccinologists have reported that it’s relatively simple to modify vaccines. As a member of the public, you will hopefully have access to the next round of vaccines – the improved version two.

The snowball perspective: this is the mindset that has excited me most since the rollout of vaccines a week ago. Every country with a functional vaccine campaign started off by vaccinating its healthcare workers. They constitute less than 5% of the population. Once healthcare workers start being vaccinated, the rollout soon spreads to essential workers and the elderly and vulnerable. Thereafter, vaccines are offered to younger healthy adults.

There is nothing more my wife and I would like to see than our own parents being vaccinated. I can say the same for my elderly patients. Understanding the procurement plan in South Africa, I’m confident that once the initial snowball of vaccinated healthcare workers has been formed, it’s inevitable that it will grow quickly and our deserving, beloved, vulnerable citizens will be vaccinated soon. Every doctor you see vaccinated means you are one step closer to being vaccinated yourself.

COVID-19 has changed our lives. It continues to place tremendous strain on our community socially, emotionally, financially, and physically. It has been proven that our second-nature, non-pharmacological measures of mask wearing, sanitising, and social distancing are powerful weapons in our armament. These measures dropped COVID-19 cases from a peak of 21 980 a day on 8 January 2021 to 998 today. However, we are finally exploring options of real pharmacological immunity. I’m utterly grateful to be contributing towards the body of knowledge of this development, and I have confidence that as the lightning development of vaccines continues to play out in South Africa, we will slowly get back to normal life.

Dr Daniel Israel is a family practitioner in Johannesburg.