There’s no need to pause vaccine rollouts when there’s a safety scare. Give the public the facts and let them decide

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Julian Savulescu, University of Oxford; Dominic Wilkinson, University of Oxford; Jonathan Pugh, University of Oxford, and Margie Danchin, Murdoch Children’s Research InstituteWhen someone gets sick after receiving a vaccine, this might be a complication or coincidence. As the recent rollout out of the AstraZeneca vaccine in Europe shows, it can be very difficult to know how to respond.

For instance, reports of blood clots associated with the AstraZeneca vaccine led to several European countries suspending their vaccination programs recently, only to resume them once these clots were judged to be a coincidence. However, authorities couldn’t rule out increased rates of a rare brain blood clot associated with low levels of blood platelets.

There are also problems with the Pfizer and Moderna vaccines. By early February 2021, among the over 20 million people vaccinated in the United States, there have been 20 reported cases of immune thrombocytopenia, a blood disorder featuring a reduced number of platelets in the blood. Experts suspect this is probably a rare vaccine side-effect but argue vaccination should continue.

So what happens with the next safety scare, for these or other vaccines? We argue it’s best to give people the facts so they have the autonomy to make their own decisions. When governments pause vaccine rollouts while investigating apparent safety issues, this is paternalism, and can do more harm than good.

The ‘precautionary principle’ can backfire

Like any medicine, vaccines have risks associated with their benefits. And no one wants to recommend or use a vaccine with serious side-effects.

So when faced with recent unconfirmed serious side-effects following vaccination, European countries were tempted by the “precautionary principle”, or “better safe than sorry”. They opted to pause and gather more evidence.

Some might argue a precautionary approach could help protect the public’s confidence in vaccination in the long term. However, suspending or withdrawing a vaccine could also undermine confidence. Once a vaccine program is stopped due to safety concerns, it may not recover. This happened with the HPV (human papillomavirus) vaccine in Japan.

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The precautionary approach can also be lethal. In a pandemic, suspending or withdrawing an effective vaccine leads to preventable deaths. The number of preventable deaths depends on three factors.

1. Delay

The first is how many people will be delayed in receiving a vaccine. Fortunately, the AstraZeneca vaccine is not the only approved vaccine in Europe, so its suspension or withdrawal would not wholly prevent vaccination; however, some people’s vaccinations could be delayed.

2. Deaths

The second factor is the risk of people dying if vaccines are delayed. For example, in England (a country that did not suspend the AstraZeneca vaccine), people aged 56-59 are currently being invited to book appointments for vaccination. A study in 2020 suggests roughly 0.3% of unvaccinated 55-59 year-olds infected with coronavirus die. But in countries that have not yet vaccinated older people, the risks of a suspension will be higher. The same study suggests the risk of dying for (unvaccinated) 70-74 year-olds infected with the coronavirus is roughly 1.7%. For those infected over 80, the risk is 8.3%.

3. How widespread is the virus?

A third factor is how common infections are at the time of suspension. When rates of infection are higher, we expect more deaths.

According to the European Centre for Disease Prevention and Control, as low as 8 or as many as 1,518 out of 100,000 people are infected with the virus. The rate varies between countries. Australia could afford to be precautionary because testing figures currently suggest a low incidence of COVID-19 (only 0.2% of COVID-19 tests conducted in the past week have returned positive results). Indeed, its slow vaccine rollout is consistent with a precautionary approach, as evidence is gathered from other countries.

European countries suspended their vaccine rollout, then resumed. But this isn’t the only way to handle safety scares.
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Read more:
Data suggest no increased risk of blood clots from the AstraZeneca vaccine. Australia shouldn’t pause its rollout

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Paternalism or autonomy?

Safety regulation involves value judgements around evidence and weighing risks and benefits. It also involves judgements about who we allow to make decisions about that balance.

Paternalism is the practice of making judgements for other people about what is best for them. And the strongest form of paternalism (“hard paternalism”) fails to respect the autonomy of competent adults, and breaches their right to make decisions about their own lives.

Suspension or withdrawal of vaccines is hard paternalism. Preventing someone from accessing an effective life-saving vaccine to protect them from low risks of rare side-effects is a severe restriction of their autonomy.

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Blood clot fears: how misapplication of the precautionary principle may undermine public trust in vaccines

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There are limits to autonomy. Where an intervention will clearly do more harm than good, it is the government’s responsibility to prevent it. And when there are limited public resources, it is necessary to distribute benefits and burdens fairly.

But what matters ethically is not only vaccine confidence and public health, but whether people can make their own autonomous decisions about the risks they want to take: the risks of COVID-19 or the risks of vaccination.

So how would this work?

Autonomous decision-making here requires:

• disclosure of even small risks if the outcomes are significant
• admission of limits to confidence (for instance, how much we know about the risks and what we don’t know)
• disclosing this information in ways appropriate and comprehensible to all sections of the community
• helping people to think for themselves about the inevitable uncertainties of life.

Safeguarding autonomy here also requires putting safeguards in place to protect those who do not have the capacity to provide valid consent.

When looking at the background rates of blood clots, anaphylaxis or any other rare adverse events, it seems pretty clear vaccines are safe and the associated risks are small.

We must investigate all vaccine safety signals thoroughly. But the process also needs to maintain the public’s confidence in vaccines through effective and transparent communication of risk. Communicating risk in terms people understand is challenging but it is essential to ensure informed decision-making.

For most people, the benefits of being vaccinated will outweigh the risks. But we should treat people as adults and allow them to make up their own minds.

Governments should not be nannies, nor nervous ninnies. Suspending vaccination fails to respect people’s right to make their own choices. It also threatens to cause much more harm overall.

Julian Savulescu, Visiting Professor in Biomedical Ethics, Murdoch Children’s Research Institute; Distinguished Visiting Professor in Law, University of Melbourne; Uehiro Chair in Practical Ethics, University of Oxford; Dominic Wilkinson, Consultant Neonatologist and Professor of Ethics, University of Oxford; Jonathan Pugh, Research Fellow in Applied Moral Philosophy, University of Oxford, and Margie Danchin, Associate Professor, University of Melbourne, Murdoch Children’s Research Institute

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Somali militants chase Christians who’ve fled, beat them

After months of evading his pursuers, they finally caught up with him.

Voice of the Martyrs Canada confirms that on August 21, Islamic militants in Addis Ababa, Ethiopia found Mohamed Ali Garas, a prominent Somali church leader and convert from Islam, and beat him severely, reports MNN.

Five years ago, Garas fled his Somali homeland. VOMC’s Greg Musselman says Garas he sought refuge in Ethiopia because "he was involved in church work there as a pastor. Attempts were made on his life. He’s been threatened, he’s been arrested."

On the night he was attacked, he was walking home when he heard two men calling his name. He turned to see what they wanted, and they attacked, fleeing only when a neighbor arrived on the scene. Although the beating was severe, Garas survived.

The attack itself is unsettling, explains Musselman because "they [extremists] are not just leaving it back home; they’re taking it wherever they find these people that have converted to Christ from an Islamic background."

This incident shows that the persecution is not contained within Somalia’s borders. For al Shabaab, they’re ramping up to an all-out war meant to eradicate Christianity.

Shortly before a deadly suicide bombing attack on August 24, an al Shabaab spokesman was quoted as saying: "The operation is meant to eliminate the invading Christians and their apostate government in Somalia. The fighting will continue and, God willing, the mujahideen will prevail."

Somali Christians living in Ethiopia have come under increased attacks from Somali Muslims in recent months. That’s a trend that is likely to continue. Musselman says, "When you understand a little bit of the group like al Shabaab…you’re not surprised that they will go to any length. They’re thinking is that ‘the only kind of a Somali Christian is a dead one.’"

International Christian Concern notes that a Somali pastor in the Ethiopian capital has described this latest attack as "an apparent attempt to scare the Somali Christian community in Addis Ababa who considers Ethiopia a safe haven from religious persecution."

Musselman notes that prayer is a powerful recourse. "Lord, our brothers and sisters in Somalia are such a small group. They’re trying to be faithful. There are other Somalis that have left the country; they’re trying to be faithful, and they continue to suffer attacks, and it’s difficult for them. But we ask You, Lord, to move on the hearts even of the enemies that are persecuting these believers, that they would have the freedom to share the Gospel of Jesus Christ."

Report from the Christian Telegraph

VIETNAM: ATTACK ON CATHOLIC CHAPEL SHOWS AUTHORITIES’ FEAR OF RELIGION

On same day, Mennonite denomination receives legal recognition; pastors wary.

LOS ANGELES, November 20 (Compass Direct News) – At a chapel on the remaining patch of Thai Ha Redemptorist property in Hanoi that the Vietnamese government had yet to confiscate, at 10 p.m. on Saturday night (Nov. 15) an official came to summon the priests to an “urgent meeting.” According to Vietcatholic.net website and other church sources, it proved to be a ruse to draw them away from the property while government-inspired gangs attacked St. Gerardo Chapel.

As the gangs ravaged the chapel, Father Joseph Dinh told Independent Catholic News, some people at the church began ringing the church bells to signal for help while others sent urgent e-mail and text messages asking Catholics to defend it.

Hundreds of police with stun guns tried to keep the arriving faithful from entering the chapel to stop the destruction. The hundreds of Catholics who arrived eventually overwhelmed officers, going past police to scare off the attackers. Witnesses reportedly said that government, police and security officials had stood by doing nothing to protect the chapel.

They also said that fleeing gang members shouted obscenities threatening to kill the priests and the faithful, as well as the archbishop.

“It is significant that the government attack against the monastery came on the eve of the celebration of the Feast of Vietnamese Martyrs,” a local priest told Vietcatholic.net. “This attack reminds people that since the outset, the seed of faith in Vietnam’s soil was mixed with the abundant blood of Catholic martyrs from all walks of life – from courageous missionaries to local clergy and the Christian faithful.”

The priest concluded by decrying the deterioration of conditions for Vietnamese Catholics.

A government spokesman later denied that the Vietnamese forces or authorities were involved in the attack.

As the government had achieved its objective of taking over the contested land, the well-coordinated attack came as a surprise to many. In September, Vietnam had resorted to force to answer months of growing but peaceful prayer vigils over long-confiscated Catholic properties in Hanoi, reneging on a promise to negotiate a settlement. Unilaterally, the government quickly turned the papal nunciature and the rest of the Thai Ha Redemptorist property into public parks.

The solidarity demonstrated by Catholics throughout the country appeared to have alarmed authorities. They reverted to classic attacks of disinformation and slander against Catholic leaders, and even after they had halted the prayer vigils, taken the contested land and allowed previous gangs to ransack the Redemptorist chapel, authorities demanded the removal of the archbishop of Hanoi, Ngo Quang Kiet, whom they accused of inciting riots against the state.

A Protestant pastor in Hanoi said the government’s recent conflict with Catholics has had a ripple affect on other churches and religions.

“Though it is the Catholics who are being most lambasted in the state media, Protestants are also maligned along with Catholics by government propaganda,” he said. “Secondly, all religious leaders are again subject to closer surveillance.”

 

Mennonite Church Recognized

Ironically, only a few hours earlier on the same day the chapel was attacked, the Vietnam Mennonite Church was allowed to hold its organizing general assembly in Ho Chi Minh City, becoming the fifth smaller church body to receive full legal recognition in 2008.

While registration can mark an improvement in the way the government treats a church, it is not to be confused with full religious freedom, church leaders said, as it is sometimes used as a means of control. The dubious benefits of registration have led many Protestant groups to simply quit seeking it.

Other Protestant groups to receive legal recognition in 2008 were the Grace Baptist Church, the Vietnam Presbyterian Church, the Vietnam Baptist Church, and the Seventh-Day Adventist Church. This brought the total number of fully recognized Protestant denominations to eight. Two of the eight bodies, the Evangelical Church of Vietnam (South) and the Evangelical Church of Vietnam (North), received legal recognition before the new religion legislation initiated in late 2004.

None of the 24 house church organizations of the Vietnam Evangelical Fellowship (VEF), however, has received even the lower-level “national registration to carry out religious activity.” Only one in seven of its congregations even have permission to operate locally.

Of the total 2,148 VEF congregations, 1,498 have applied for local permission to carry out religious activity, but only 334 have received it. Another house church organization has had 80 congregations apply for local permission to operate and has received only refusals or no answer at all. Other groups report a similar experience.

A hint of the government’s attitude toward registered churches, pastors said, was evident in its official news release on the Vietnam Mennonite Church general assembly. The Vietnam News Agency release of Nov. 15 enjoining the church to “serve both God and the nation” and to “unite with other people in the course of national reconstruction” struck some church leaders as an expectation that their congregations will serve political ends.

Christian leaders detected government fear of churches’ international connections in the official claim that, “For more than three decades, the Vietnam Mennonite Church has operated independently from foreign Mennonite churches.”

As is customary, the ceremony included an address by a representative of the Bureau of Religious Affairs. Nguyen Thanh Xuan said he expects the Mennonite Church “to bring into full play good characteristics of Protestantism, uphold the tradition of charity, and join hands with other religious and non-religious people to build a country of stability and prosperity.”

The heavy-handed treatment of Catholics over the disputed property and the offering of legal registration to more Protestant groups does not present the contrast it may first appear, said one long-time observer.

“Catholics outnumber Protestants about five to one and are a much more formidable and unified organization than Vietnam’s fractured Protestants,” he said. “Alarmed at the largest countrywide Catholic solidarity ever demonstrated, nonplussed security authorities ordered a classic, harsh crackdown and incited ‘punishment’ disguised as citizens’ outrage.”

Protestants, he said, are less numerous, more divided and rarely capable of joint action, so they do not pose a serious threat.

“For example, the oft-repeated requests and ultimatums by the Evangelical Church of Vietnam (South) on their 265 confiscated properties are simply ignored,” he said. “And don’t forget that the majority of Protestants are ethnic minorities in remote areas who remain closely watched by the government.”  

Report from Compass Direct News

MICKEY MOUSE IS A SATANIC AGENT

EDITORIAL NOTE: This post includes satire and although the actual base story is true, my comments should be seen as satire and do not accurately portray my viewpoints.

At last, that great agent of Satan, Mickey Mouse, has been revealed for all to see. We have all long expected that such beings as Mickey Mouse, Donald Duck and Elma Fudd are secret agents working for Satan.

How better off would we be if these characters had been eliminated years ago? Surely legislation must be passed to outlaw these characters, with shoot on sight allowances being made for gun owners, especially in the United States. If all gun owners were allowed onto the streets to take out any Mickey Mouses, Donald Ducks, Elma Fudds and all other such characters, how much better would we all be?

Oh to be rid of Ronald McDonald all of our dieting problems would be finished and one of Satan’s great weapons against mankind would come to an end! No more gherkins to haunt us as we eat. No more fear of our burgers being swept off by a hamburgler! No more large Grimace-like creatures to scare children!

All thanks to Sheikh Mohamed al-Munajid the former Saudi diplomat to the United States for telling us that household mice and their animated counterparts must be rubbed out! Mickey Mouse is one of Satan’s soldiers according to the Sheikh.

If only the United Nations could form a committee to oversee the elimination of these demon soldiers!

See more about this at:

http://www.worthynews.com/news/foxnews-com-printer_friendly_story-0,3566,427061,00-html/