This is the second article in a four-part series about the coronavirus. Read the first article.

"For want of a nail" is an ancient proverb and the most familiar form is that of Benjamin Franklin’s: “For the want of a nail the shoe was lost, for the want of a shoe the horse was lost, for the want of a horse the rider was lost, for the want of a rider the battle was lost, for the want of a battle the kingdom was lost, and all for the want of a horseshoe-nail.”

This proverb drives home the concept that seemingly unimportant acts or omissions can have grave, unforeseen, far reaching and potentially devastating and even deadly consequences.

Health and medical experts universally agree that vaccines are one of the major achievements in the 20th century. Vaccinations have changed the world, banishing a plethora of deadly diseases that cause significant mortality and curtailment of life with significant health complications in many others who survive.

The classic example is polio, which may kill or leave survivors with various degrees of permanent paralysis. This particular scourge only re-emerges in countries where conspiracy theories abound, such as in Africa which was on the verge of being declared polio-free until politicians and imams fanned the conspiracy theory that the polio vaccine was part of a Western plot to sterilise Muslims. This occurred in northern Nigeria until 2015 when Nigeria’s president, Muhammadu Buhari set a personal example. He gave the vaccine to one of his grandchildren on television, before rallying politicians and tribal leaders to join the polio vaccination campaign. His efforts and those of hundreds of thousands of volunteers paid off - Nigeria is now polio-free.

Coronaviruses are usually relatively innocuous and several strains visit us every winter and leave behind them a variety of colds and coughs. These viruses comprise only a part of the common cold family of viruses and this explains why it is so difficult to cure the common cold – so may viruses of different families and so much mutation that vaccines would not remain effective for long.

This is why the annual influenza vaccine differs from year to year – experts attempt to create a vaccine that will cover the viral strains are likely to circulate every winter. Dozens of initiatives are frantically racing to come up with a novel coronavirus vaccine, one that prevents or attenuates infection with the current pandemic COVID-19 virus.

Counterintuitively, opposition to vaccinations has been discussed with increasing frequency in the news and on social media and concerned parents are opting to forgo vaccinations for their children for many different and inaccurate reasons.

This has unfortunately resulted in a surge of infectious diseases that had been previously or nearly eradicated. Such recurrences risk not only the ordinary public but greatly threaten the immunocomprised: from birth, after chemotherapy, after recovery from a serious illness, pregnant women, the elderly, and so on. These groups can be very strident and vociferous and are collectively labelled as the anti-vaccination (anti-vax) movement.

A woman holds a placard reading "Mandatory vaccination = Nazi law" during an anti-vaccination demonstration in Romania in March. Photo: AFPA woman holds a placard reading "Mandatory vaccination = Nazi law" during an anti-vaccination demonstration in Romania in March. Photo: AFP

For this reason, the officials of the Centers for Disease Control and Prevention have facetiously announced that vaccine/s for COVID-19 should be (hopefully) available next year, in 2021, in time to be rejected by the anti-vaxxers: "we will work tirelessly to ensure all anti-vaxxers have the opportunity to decline, refuse, and reject this potentially life-saving vaccine as early as possible." The CDC also noted that conspiracy theories about the not-yet-developed vaccine containing mercury were already spreading on Twitter.

The inescapable conclusion is that despite the ongoing debacle to health and economy by COVID-19, for want of a vaccine, resistance to vaccines will (incredibly and unfathomably) continue. I can only quote one of my favourite (albeit minor) philosophers Friedrich Schiller (1759-1805): "Against stupidity, the gods themselves contend in vain."

Victor Grech is a consultant paediatrician (Cardiology) at Mater Dei Hospital. 

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