Old and vaccinated

 On the 5th of January 2021, my wife and I were vaccinated against COVID-19. We were surprised to be invited because both of us are in Priority Group 4 (people between 70 and 75 years of age), and we therefore assumed that we would have to wait until all the people in England who are in Priority Groups 1 to 3 had received their vaccine. But that was not how it was organised. Instead, supplies of Pfizer vaccine seem to have been distributed to a limited number of locations, which vaccinated as many people as possible in the first four priority groups who were registered with the surrounding medical practices. The vaccine centre for our corner of Worcestershire is in the GP surgery at the nearby village of Ombersley. The process of vaccination was efficient. We waited for about two or three minutes, and then entered one of the treatment rooms in the clinic. We were met by a friendly team of two people who asked us to confirm our identity and whether we had any allergies. We were then given the injection, which was painless. We were told to wait for 15 minutes in the Practice waiting-room. The whole process took 20 minutes, with a new patient vaccinated every five minutes. There were several teams operating in parallel, so that several hundred people were vaccinated in Ombersley each day.

We have not yet had our second vaccination, and are by no means free of any risk of infection, but the odds of us getting COVID-19 are now much reduced. This seems such a obvious gain for minimum fuss that it is bewildering to learn that a substantial minority of people are hostile to vaccination. The most recent survey in the UK found that 76% would take the vaccine if advised by their GP or other health professional, while 8% were ‘very unlikely’ to do so. The rest were ‘unsure’. Those most unsure are those most at risk of contracting the illness, namely people from black and minority ethnic groups. But the ‘very unlikely’ group includes some who are hostile and alienated, believe that COVID-19 is a hoax (even to their last breath) or who do not see why they should suffer the inconvenience of wearing a mask merely to protect other people.  

Surveys in the UK have found that older people are more willing than the young to accept vaccination. This may be because the old are less exposed to the Internet, which has become the greatest engine in our society for spreading conspiratorial beliefs. But I think a more important factor is that older people were raised in a time when infectious diseases were a part of everyday life. In my primary school years, I contracted measles, German measles (rubella), mumps and whooping cough. I remember as a child one day looking down at my chest and seeing with dismay the spread of the rash indicating rubella. There was no MMR vaccination then, and so pregnant women were at risk of contracting this illness and giving birth to children who were blind, deaf and with severe learning disability. For the rest of us, however, infectious diseases were commonplace and an expected part of childhood. It was widely believed that it was better to contract these illnesses as a child than in later life.

Quite different were tuberculosis and polio, both of which were widely feared during my childhood. There were still over 50,000 cases of TB notified in England and Wales each year in the 1940s. One of my uncles contracted the disease when serving in the Army in the Second World War. People with TB were often treated in isolation hospitals, many of which were located in the countryside. These were distinctive buildings, designed to enable patients to be separated into single rooms, linked by an open verandah. One of these buildings survives at Sunningdale, near where I live in Worcestershire, although the hospital has been converted into a small housing estate. The incidence of TB began to decline in the 1950s, with the widespread introduction of the BCG vaccine, but also because of better living conditions for the great bulk of the population.  

Polio, unlike TB, was not a disease associated with poverty and seemed to strike adults and especially children at random. A child in my primary school (it was rumoured) had died from the illness. We were all aware of the many children crippled with withered limbs as a result of Polio. What made things worse was that the number of new cases of polio increased in England throughout the 1950s, arriving mainly in summer. This was reversed by the introduction of the Salk vaccine after 1955, named after Jonas Salk, who refused to patent his invention or profit from it, so that it could be distributed to as many people as possible.

COVID-19 resembles TB more than polio, in the sense that its cure will be a result of both scientific development and living circumstances. Also, like TB, COVID-19 will not disappear. It may cease to infect large numbers of people, but it will still be there and may require periodic re-vaccination. TB is still with us, and 4655 people were infected by the disease in England in 2018, with the highest rates among the poor and the homeless. Over 300 people a year die of TB. So we still need the vaccines against polio and TB, as well as the MMR and now the new COVID-19 vaccines to protect us.