The race for a Covid vaccine is on – but the ‘anti-vax’ background noise is only getting louder

I was in a taxi the other day, and conversation turned – as it invariably does – to the Covid pandemic. Muffled by a mask in the backseat, I mentioned how much better things would be when we had access to a vaccine. My driver eyed me in the mirror. “Vaccine?” He said to me. “I’m not having one of those. Nor are my kids.” 

My heart sank. I asked my driver why not. “I don’t know,” he said. “It’s not safe.” I told him that clinical trials were currently being performed by the best minds on the planet. He was not impressed. “Maybe in a few years. But for now, none of my friends are having it, and nor am I.” Pleas about herd immunity, or perhaps even saving the lives of his elderly parents, fell on deaf ears.

Sadly, my driver is not unique in his views. According to a poll of 5,000 people last month by childcare.co.uk, almost half of all parents insisted they would not vaccinate their child if and when a vaccine became available. Eighty-six per cent of these “anti-vaxxers” said the vaccine would be unsafe with “nasty” side-effects: a fifth thought Covid-19 “doesn’t really exist.”

It seems their case was boosted when the leading Oxford/ AstraZenica vaccine trial was halted on Wednesday after a volunteer suffered an “unexplained illness”. A spokesman said this was a “routine action” that would be investigated in an independent review to maintain the integrity of the work. The trial has now resumed.

The anti-vax statistics are pretty troubling, even hypothetically. But the problem is that soon, they may not just be theory. Last Monday, Matt Hancock raised hopes that a Coronavirus vaccine was “likely to come” in the first few months of 2021. He revealed that the UK was making 30 million doses of vaccine: enough to innoculate half the population. “They are starting to manufacture those doses already, ahead of approval, so that should approval come through – and it’s still not certain but it is looking up – then we are ready to roll out,” he said.

The front runner appeared to be a drug known as AZD1222, which was created by Oxford University and owned by drug giant AstraZeneca. There are also others in the ring.

Chris Smith is a consultant medical virologist at the University of Cambridge. He says there are more than 170 projects worldwide, looking into 10 different types of vaccines. “The government has backed multiple horses, but one of the leading contenders is the Oxford vaccine; it’s based on a tried and tested Ebola vaccine construct, which has already proven itself, so that reduces the uncertainty,” says Dr Smith.

The problem is that creating a vaccine is a tricky area. “We are rushing out in a year something that normally takes ten,” says Dr Smith. “So for a vaccine to be a “game-changer”, there have to be an enormous amount of assumptions. Firstly that it’s going to work to produce an immune response. Secondly, that that immune response is sufficient to protect people, And third, that the vaccine is safe, meaning that it does not produce adverse reactions or severe side-effects out of keeping for what you would expect for a vaccine of this type.” You also have to be able to make enough of it, says Dr Smith.

“If it’s the case that a Covid vaccine turns out as effective as, say, the polio vaccine – and it’s a big “if” – then we have a chance to go back to business as usual,” he says. “But so far, no information on the effectiveness of the vaccine at preventing infection in humans has yet been made public.”

While the world strains to find a manufactured solution to “beat” the virus, there is the background noise of the “anti-vaxxers”. These are the people who are against inoculations – and are particularly against vaccinating their own children: who think vaccines cause autism, that politicians are scare-mongering about the disease to drum up profits for drug companies, and that Bill Gates will be using injections to plant microchips into their children. Piers Corbyn (brother of Jeremy) and Novak Djokovic are famous anti-vaxxers.

This movement started with gastroenterologist Andrew Wakefield, the lead author of a 1998 Lancet study purporting to show a link between the MMR (Mumps, Measles and Rubella) jab and developmental disorders. The piece was later retracted after an investigation found a conflict of interest: that Wakefield had been funded by a group of people who were suing vaccine producers. Wakefield was discredited and struck off the medical register in 2010, yet it took nearly two decades for the UK immunisation rates to recover. By the late 2010s, UK families had experienced more than 12,000 cases of measles, hundreds of hospitalisations — many with serious complications — and at least three deaths.

Despite their denunciation, Wakefield”s “findings” gave birth to the “anti-vax” movement. The Centre for Countering Digital Hate calculates that 58 million people follow conspiracy-theory accounts on social media.

The World Health Organisation cares so much about the anti-vaxxers that it has published a 44-page document for medical professionals called “How To Respond to Vocal Vaccine Deniers in Public.” It makes a distinction between “vaccine refusers” and “vaccine deniers”. The former “refuse vaccinations without doubting the wisdom of this decision. But this refusal still permits the refuser to consider other opinions and arguments.”

The vaccine deniers, on the other hand, “are members of a subgroup who have a very negative attitude towards vaccination and are not open to a change of mind, no matter what the evidence says.”

And the problem is that the deniers feed the anxiety of the refusers.

“Regrettably, the echo chamber of social media – where members of these groups find sympathetic like-minded ears – pours oil on the deniers and refuseniks’ fires,” says Dr Smith. “This leads them to believe they must have a point, because hundreds of people, who don’t know any better, ‘like’ the garbage they are spouting. The anti-vaxxers are certainly part of the problem.”

Paul Hunter, professor of medicine at the University of East Anglia, goes further. He calls the anti-vax movement “depressing” and “selfish”. “As a doctor I have known children die who would have survived if they had been vaccinated. The risks of vaccines have been maliciously overestimated.

Let’s consider for a moment that the anti-vaxxers have a case. The American vaccination programme is rather impressively (some would say unnecessarily) called Operation Warp Speed. But there is a limit to how quickly a vaccine can safely be introduced. “Vaccines not only need to be safe,” says Chris Smith. “They have to be proven to be safe, and statistically robust.” America suffered a lesson in 1976 when a rushed-out vaccine in response to a serious flu virus led to the deaths of three patients in a New Jersey nursing home, the day they had been vaccinated. A media frenzy ensued.

Jim Buttery is a Professor of Paediatric Immunology at Monash University in Australia. “In the course of this pandemic, we’ve often heard that fast can’t be safe in the context of a vaccine. We don’t feel that’s the case here.”

The reason these trials are moving so fast, he says, is largely because recruitment is happening so quickly. The phase three trials of the Oxford vaccine will have 40,000-50,000 participants in total. “Beyond this vaccine, we’re seeing open disclosure of processes and transparency around any issues,” says Professor Buttery. “This includes a pledge from the major pharmaceutical companies to keep safety at the forefront when evaluating COVID-19 vaccines.”

And side-effects? “All drugs have side-effects,” says Chris Smith. “Scientists need to work out who gets them, and why. We have to decide what level of risk we are willing to carry.” Says Professor Paul Hunter: “The risks of vaccines have been maliciously overestimated.”

Ultimately, says Chris Smith, it’s about risk. “Covid is not going to go away. So much is unknown about it. But we do know that it’s not an equal opportunities virus. Men are more likely to get severe disease, as are older people, because of their physiology and biochemistry.” The question, then, he says, is how we can best make efforts to protect this section of the population while allowing as much normality as possible in the others.

“We may have to accept uncertainty and take what is offered,” says Dr Smith. “Maybe a vaccine will not be a panacea, but it might turn what would be a lethal infection for some into a non-lethal infection. Grandma might catch it from the youngsters, and she will just have a cold.”

On the anti-vaxxers, Dr Smith has this to say: “if these people will take a gamble with their kids getting a potentially lethal disease like measles, why on earth will they give two hoots about Grandma?”

Read more: I’m a vaccine trial volunteer – here’s my only concern about the risks