Covid-19 Vaccination in Bangladesh: We must report responsibly on vaccine side-effects

The Covid-19 vaccine that has reached Bangladesh was developed by Oxford University scientists. It has already been approved for use in the UK and the EU. Five peer-reviewed scientific papers have been published in top scientific journals, establishing that the vaccine is safe and effective. However, there is no dearth of misinformation and disinformation swirling around the vaccine in Bangladesh. This, in part, may have contributed to the low rate of registration, leading the government to lower the age bar for vaccine registration to 40. It is quite unfortunate because low uptake of a safe and effective vaccine against Covid-19 will almost inevitably cost lives.

As the vaccine, locally known as Covishield, is being rolled out on a broader scale, the spread of misinformation might increase even more and further dissuade people from taking the vaccine. I can anticipate two areas where the risk will increase if the media does not play a responsible role. Let me explain them below.

Side-effects:

It is absolutely normal to experience some temporary side-effects after receiving the vaccine. These are signs that the immune system is kicking into action and getting ready to protect you from Covid-19. You can expect to have pain and swelling in the arm, feel feverish, tired, unwell, etc. for a few days after you get vaccinated. This is not accidental—this is by design. We want the immune system to react to the vaccine so that it can fight off the virus if you later catch it. The side-effects are signs of immune response and mean that your body is building protection.

Understanding this is vital. Otherwise, we may see reports with headlines like "X number of people experienced side-effects after getting the vaccine", which will scare people unnecessarily. We have seen such reports after mass vaccination started in India. It must be communicated to everyone that side-effects are normal, common, expected, and will go away in a few days. Of equal importance is to communicate that these are miniscule compared to the devastating complications of Covid-19, which the vaccine will protect us from. Who in their right mind would prefer long-term lung damage instead of arm pain for two days?

Such information needs to be put forward so that people can weigh the potential benefits and risks. Only using the term "side-effects" can leave a lot of scope for interpretation. Some may imagine it to mean death, while in reality it might have been fever for a few days with complete recovery.

Deaths:

The vaccine protects people from Covid-19, not from other illnesses. A number of people die every day for many illnesses other than Covid-19. We don't expect this to be any different after people get the vaccine. As more and more people get vaccinated, we will see deaths in those who have received the vaccine by chance alone. But if we are not careful, these deaths might be wrongly attributed as being caused by the vaccine. Newspaper reports highlighting deaths after Covid-19 vaccination may stoke fear irrationally among the general people, and the damage might be too huge to be undone.

Similar events have happened before, causing irreparable damage. Back in 1998, around 50,000 children received MMR vaccination every month in Britain and the prevalence of autism was 1 in 2000 in English children, which meant roughly 25 children would be diagnosed with autism every month soon after receiving the MMR vaccine, merely by coincidence. The same year, a now-retracted article described 8 children who started showing autistic symptoms after MMR vaccination, suggesting a causal link. This started the endless scare story of MMR vaccine causing autism, which persists to this day, despite being disproved by a large number of scientific studies. This is just one example of how difficult it is to change perceptions once they are established, however wrongly, in this post-truth world.

It is important to note that we must continue our surveillance as the vaccine is being deployed on a national scale. If there is a suspicion that the Covid-19 vaccine might have caused illness or death, the incident must be carefully investigated. There are established criteria on how to assess adverse events related to vaccines, and the Directorate General of Drug Administration (DGDA) should take the leading role in examining these claims. Indeed, DGDA has published a detailed protocol on how they plan to monitor and investigate illnesses and death after vaccination and assess whether these were caused by the vaccine.

To sum up, I think we all realise that it is all the more important for the media to report responsibly on this issue. For example, when the media is reporting a death after vaccination, it must mention whether a causal link has been established. It is not good enough to bury the lack of causality deep inside the report. In my opinion, this vital piece of information should be reflected in the headline.

Our journalist friends have played a key role in the fight against misinformation during the pandemic and I am sure they will continue to do so.

Tasnim Jara is a doctor in the UK's National Health Service and co-founder of Shohay, a health-tech start-up working to provide reliable health information in Bangla.