Don’t let FHM slow down a mass vaccination

DEBATE. Science and proven experience are two important pillars in the world of medicine and the meaning is that we must base our decisions on what is scientifically proven or, alternatively, on what we know through long experience that it works. But how to act when those who influence the decision-making process do not have this focus? The answer is that in such circumstances the responsibility falls heavily on those who have to make the decisions: politicians.

An example: the evidence that mouth guards protect against SARS-CoV-2 is overwhelming today. But the Public Health Agency has said no and wants to wait, even though the list of references on its own website provides strong support for the conclusion that mouth protection protects.

Similarly, scientific data showing that children can spread infection, that much of the spread of infection occurs before symptoms appear, has been largely ignored, and that a distance of two meters is not always enough to avoid getting infected.

Our hope is the vaccine

During the spring, between 5 and 10 times more people died in our country compared to the relative population of our Nordic neighbors. Now we have a sharp increase in the spread of the infection again, with many times more cases than in the other Nordic countries.

We are now approaching the next phase in the fight against pandemics: vaccines. Two vaccines, from Pfizer and Moderna, are sure to be approved by the European Medicines Agency EMA and the Swedish Medicines Agency and will therefore be available in the coming weeks, while other candidate vaccines knock on the door. Now it is announced that the UK and Germany plan to start vaccinating from the first half of December and that the UK aims to vaccinate all adults in April.

But again, representatives of the authorities are acting late. State epidemiologist Anders Tegnell has said: “Based on what we know about the various vaccines, where in their processes they are, our assessment is that a vaccination start before January is not conceivable.”

Of course, there are logistical problems in the distribution of the vaccine to the 21 regions, while special freezing solutions are required. But no one has been put to bed, there has been a lot of time to plan.

A delay means a lot of deaths

And at the same time, this negative opinion about how quickly Sweden should be able to organize mass vaccinations is spreading. The Skåne Region infection control doctor has issued the message that “not everything will be in place in January, we can say for sure” and in Skaraborg they plan to start vaccinating in January and seriously only in February. At the same time, Sweden’s crisis coordinator says that we will not get rid of this virus in 2021. And Johan Carlson adds: “At best, we can eliminate everything in 2022.”

Let’s not have to experience the equivalent of testing clutter again

If we theoretically start from the death figures we have today, about 40 reported per day, about 1,200 people would have time to die a month late in the entire process. And if it takes until 2022 before fighting the virus, the loss of life will be considerably higher.

Why this delay?

Why then is this delay? The explanation can be found in the statement of the Director General of the Public Health Agency, Johan Carlson: “For each week that passes, the safer the vaccine becomes. If you have a side effect problem, there is an opportunity to withdraw it. ”

Both Johan Carlson and Anders Tegnell were key decision makers regarding the 2009 swine flu vaccination program, the program that led more than 350 children and youth to suffer from narcolepsy. Therefore, a possible explanation may be that they want to delay the Swedish process until more data on side effects is obtained from other countries.

This means that one values ​​Swedish life differently from the lives of citizens of other countries and, paradoxically, can result in many Swedish lives being wasted.

The benefits outweigh the side effects

Tens of thousands of people have already received the vaccines and so far the risk of serious side effects has been shown to be small; however, the benefits of the vaccines will outweigh the problems with the side effects of the vaccines.

Let’s not have to re-experience the equivalent of testing clutter, where there was uncertainty among authorities and regions about who was responsible and where it took months to get the volumes needed to do the infection control work. And behind the figures of the press conferences hides a great individual suffering for those who are going to die, for their relatives and for those who suffer from long-term covid.

Good that the government has taken over

In recent weeks, we have seen a trend break, where the government on its own initiative has taken new initiatives regarding the fight against infection and has not awaited the recommendations of the Swedish Public Health Agency. The hope is that the government will continue on this path. There is great competition in our country, both within the universities and other central governments and within our 21 regions. Take advantage of this ability, it will benefit us all.

By Fredrik Elgh

Chief Physician and Professor of Virology, Umeå University

Stefan einhorn

Chief Physician and Professor of Molecular Oncology, Karolinska Institutet

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