The vulnerable count on healthcare workers to protect them, not spread misinformation

In addition to battling a pandemic of Sars-Cov-2 since 2020, we have also been battling an "infodemic" of misinformation. Since the beginning of the Sars-Cov-2 pandemic and the rise of misinformation and self-appointed experts on social media platforms and other places, there has been an increasing need for more healthcare professionals and scientists to combat misinformation and communicate evidence-based advice. Unfortunately, most healthcare professionals are not scientifically trained and, as a result, some have either knowingly or unknowingly spread misinformation, further perpetuating this issue. Last week, a video clip of an unvaccinated doctor challenging the UK health secretary over the government’s plans to mandate Covid-19 vaccines for NHS staff went viral. In the video, the doctor made a series of incorrect statements about the vaccines as a basis for his argument. First, he claimed that he did not need to be vaccinated because he had antibodies from previously contracting Covid-19 infection, and was therefore immune. This is incorrect, as previous infection confers varying degrees of antibody response. Only antibodies formed against the Sars-Cov2 spike protein are able to neutralise the virus. Studies suggest that 20 to 30 per cent of individuals don’t produce neutralising antibodies after infection, and of those who do, varying degrees of durability have been reported. Vaccinated individuals make neutralising antibodies (antibodies to the spike protein) and do so more consistently among all demographics. Furthermore, while a number of commercially available antibody tests can be purchased, these remain unvalidated and vary hugely in reliability. The advice is that they should not be used for clinical decision-making. The emergence of the Omicron variant, which has a high reinfection rate among those who have had previous infection with Sars-Cov2 but who remain unvaccinated, has strengthened the argument for vaccine-induced immunity. There is good evidence that double vaccination and a booster dose induce good protection against infection that is maintained at least 10 weeks later. In the video clip, the doctor goes on to suggest that vaccines don’t reduce transmission for more than a few weeks. This, again, is incorrect. Recently published data suggests that, even if antibodies were to wane over time, vaccinated individuals with breakthrough infections are able to suppress the viral load more quickly than those who remain unvaccinated. Vaccinated and boosted individuals, therefore, are much less likely to become unwell but are also less likely to transmit the virus to others overall. Boosters further reduce transmission of Sars-Cov2. After booster vaccines, the breadth and capability of our immune system improves in targeting and neutralising even mutated versions of the virus. This doctor made these comments while standing in a busy intensive care unit (ITU), where 80 per cent of Covid-19 patients, if its figures reflect ITU admissions in London in December 2021, would have been unvaccinated. As NHS staff, we often treat the most vulnerable patients. These are individuals who will not necessarily mount the same immune response and protection despite being vaccinated, due to their compromised immune systems. They count on us as healthcare staff to not put them at risk. We can do this by being vaccinated and implementing other measures such as wearing masks and regular testing. People have the right to choose to get vaccinated or not, but nobody has the right to put others at risk, least of all healthcare staff who are entrusted with the health of the most vulnerable in our society. The doctor who challenged Sajid Javid is not an immunologist and most likely lacks understanding of the evidence on vaccination. However, anti-vaxxers have branded him a hero and the damage is done. As we continue to battle this "infodemic", it’s vital that we work to arm everyone – especially healthcare staff – with accurate information and improve science literacy among all to help them understand the difference between opinion and robust scientific data. Only then can we facilitate informed decision making. Dr Bnar Talabani is a kidney and transplant hospital doctor and immunology scientist at Cardiff University, and a Team Halo Guide. A doctor who made headlines last week when questioning the planned Covid-19 vaccine mandate for all healthcare workers has said that the UK Government should produce scientific proof for doing so or “stop threatening NHS staff with the sack”. Dr Steve James, a consultant anaesthetist, caused a backlash from many colleagues and members of the public when he told Sajid Javid why he disagreed with the policy during the Health Secretary’s visit to the intensive care ward of King’s College Hospital in London. In an exchange caught on camera, Dr James explained that he had acquired immunity through infection and that the resulting antibodies meant he was no more likely to spread Covid-19 than someone who had been vaccinated. One fellow anaesthetist, Dr Rich Breeze, branded the comments as “deluded, irresponsible and dangerous”, while other medics criticised them as a fillip for the anti-vaccine movement. But Dr James maintains that he follows the available scientific research and can find no clear evidence to support compulsory vaccination. The idea, he says, that vaccines “provide an impenetrable shield against infection is not backed up by the science”. Writing in the latest issue of The Spectator magazine, he makes clear that his principal objection is to a mandate that forces staff to decide between retaining bodily autonomy or retaining their jobs. “There are about 85,000 unvaccinated NHS workers,” Dr James says in the 1,000-word comment piece. “All those I have spoken to say they will not have the vaccine. Will the NHS really benefit from losing all these dedicated members of staff? If the government does intend to fire us, it is incumbent on ministers to explain the scientific basis for doing so. “Any law that could end the careers of so many doctors, nurses and other health professionals demands evidence and scientific proof. If ministers cannot produce such proof (and Javid had no answer when I spoke to him) then they should stop threatening NHS staff with the sack.”