By Ayisha Karim (pharmacist)

Would you get the COVID-19 Vaccine?

What a year it has been! According to a circulating image all over social media, the first confirmed positive case of COVID-19 was in November 2019. Coming up to the New Year, it is crazy to think we have almost completed a year of living this new way of life - masks at the go, lockdown closures, one-way shopping directions, 2-metres-apart-queuing-procedures, and more. No doubt, it has changed all our lives, from losing loved ones to affecting our own health physically and mentally.

Vaccines, what a topic they have been recently! With the term “anti-vaxxers” being created over the years, it has definitely been an interesting topic to say the least. Of course, everyone with capacity has the right to accept or refuse treatment/vaccines. Aside from COVID-19, there are many vaccines out there that people do not want to have administered.

My personal experience

When I was pregnant, (pre-COVID times), I remember being offered a whooping cough vaccine from my GP. One of my friends advised me not to take the vaccine as she said it could do harm to the baby. I, of course, was worried but decided to take the vaccine as I felt rather lucky to be offered something that could help protect me and my baby, and working in healthcare, I knew this was important for me to take. It’s funny, I usually would recommend anyone to go and get their vaccines, but when it came to me being the patient and having been informed by others of the risk of harm, for a split-second, I did think about it. However, I came to the conclusion that it was best for me.

It could have been bad - I could have had complications with my labour and with the baby. I was very thankful that I was safe and healthy.

I then got a text, out of hours, from my manager (this had never happened to me before). I knew there was something urgent to it. She asked me to call her when I got the chance. She informed me that I needed to contact occupational health as I was over 34 weeks pregnant and that the department I worked in had reports of 2 members of staff who had contracted Whooping Cough. At this stage I was worried, but I was also relieved because I had chosen to take the vaccine. I had to contact occupational health and inform them of me taking the vaccine. They reassured me that I will be fine as I had opted for the vaccine. It could have been bad- I could have had complications with my labour and with the baby. I was very thankful that I was safe and healthy.

Risks to Health- Benefits vs Risks- the Facts

According to the NHS, vaccinations prevent 3 million deaths worldwide every year. Since vaccines were introduced to the UK, small-pox, polio and tetanus that used to kill or disable millions of people, are now erased or rare to find. If people stop having vaccines, it is possible that diseases can rapidly spread again.

I do understand the reason why many people are scared of the risk that vaccines could have on our babies and in our own bodies. We should be aware of the risks involved and the side-effects that it can cause. However, we should ensure that we get this information from the correct sources and not just any social media/random website. Like any medicine, there are risks involved and a small percentage of people may have a reaction that others won’t.

If I were to tell you to take a medicine which has reports of patients having side-effects such as “blood dyscrasias, thrombocytopenia, neutropenia, pancytopenia, leukopenia, and agranulocytosis”, would you take it? You may be surprised to know that these are in-fact, rare, reported cases of patients taking Paracetamol…YES, Paracetamol! (This is rare, so do not feel you need to stop taking paracetamol. The reason I am talking about this, is to show you that every medicine will have a percentage of people who do not react well to it, with side-effects that do sound concerning. There will be a set amount of people allergic to paracetamol. Patients under a certain weight are advised to have a different dose to the normal dose of paracetamol, too. There are people who get nausea, vomiting and even headaches with paracetamol as well (yes- ironic, or what?). My point is, we need to be aware of side-effects, yes, and of risks, but we also need to consider what the benefits are, and how likely it is that you could get an unwanted side-effect?

I for one, feel lucky to receive an immunisation schedule under the age of 16 to help keep us safe and alive. We don’t hear of children contracting polio anymore, which in history would have been a huge risk factor toward death rates. Due to vaccination, we are here right now. Granted, there are risks to anything we take, and we should be aware of this.

Controversy of the MMR Vaccine

With headlines spreading about the MMR Vaccine and its link to autism, many parents decided not to get their children vaccinated. This has been researched and there is no link to the vaccine and autism. As a result, measles and mumps are now starting to spread again in England. According to the NHS, in 2016, there were around 530 cases of measles and 573 cases of mumps. In 2018, this has almost doubled, with, 970 cases of measles and 1061 cases of mumps. The spread of this is serious because measles can lead to life-threatening complications such as meningitis, and mumps can lead to hearing loss. It’s important to note, that if 95% of children receive the MMR Vaccine, it is possible to get rid of measles. However, if less than 90% of people are vaccinated, measles, mumps and rubella can spread again.

Having seen some of my colleagues struggle with COVID-19, some of who have died as a result of it, I personally, want to take the vaccine.

This is the world without ONE vaccine to COVID-19

Social distancing seems the only way to manage life without the vaccine. I know that it is scary that perhaps the vaccine has been “rushed” and that we do not know the long term implications as we do with other vaccines. The Medicines Health and Regulatory Agency (MHRA) have now approved the vaccines. I believe that the scientists behind this are experts at what they do, and if there is a vaccine available, I would personally want to take it. This is partly because I work with patients who have COVID-19 and other members of staff in health. But also, I feel that living in a world of social isolation is dangerous too. The risk of mental health issues has increased with lock-downs and social distancing. With the potential roll-out of the COVID-19 Vaccine for NHS Staff in the near-future, I am excited to receive it. I annually receive my flu vaccine as I am dealing with patients daily. Having seen some of my colleagues struggle with COVID-19, some of who have died as a result of it, I personally, want to take the vaccine.

Ingredients in Vaccines- Are they Halal?

This is a question I am hearing a lot from patients recently. I am not in a position to Islamically give a ruling as I am not a scholar. I am a pharmacist, and I therefore do have an idea of the ingredients used in vaccines. Not every vaccine has the same ingredients. Not every vaccine has gelatine. Some, however, do. So I thought it would be useful to address some of these questions on this article.

Why do Some Vaccines Have Gelatine?

Gelatine is used as a stabilising agent in some vaccines. Not all vaccines have it. Gelatine can help to protect vaccines from the effects of heat or freeze-drying (which are used in the processes of making vaccines), and helps to maintain the shelf life of the vaccine so it does not go out-of-date too quickly. Once manufacturers choose a stabiliser, such as gelatine, if there are any changes to this, it would affect safety and effectiveness of the vaccine and could add several years to the process.

Which Vaccines contain pork gelatine, and are there any alternatives?

The only vaccines that contain porcine gelatine in the UK routine vaccination schedule are as follows:

· Fluenz-Tetra - the nasal spray flu vaccine for children. There is no nasal spray alternative for healthy children, but there are injectable flu vaccines that don’t have pork gelatine. These are however, less effective than Fluenz Tetra in children. This is only recommended for children and adults who are at high risk of the complications of flu.

· MMR Vax Pro - a vaccine that protects against measles, mumps and rubella. You can get an alternative without gelatine that is as safe and effective- this is called Priorix

· Zostavax - a vaccine that protects older adults against shingles. This is the only available vaccine currently in the UK.

Will the COVID-19 vaccine have pork gelatine in it?

We are not sure yet, as the ingredients are not shared- but once they are available, you can find this out. There are LOADs of vaccines out there, only a few have porcine gelatine.

Are Vaccines permissible?

According to the majority of scholars, vaccines are permissible. The majority of scholars state that there is a clear benefit of vaccines that outweigh the risks, but that we should be aware of the risks involved. Rulings about how ingredients can change under a chemical process, e.g. the process of how alcohol turns into vinegar, is also used by certain schools of thought, to explain why medicines can be used even if there are ingredients that you and I may think are wrong. Always do your research on what your school of thought says, and then decide what you think is correct.

What about you?

Having asked many patients about vaccines, and colleagues, I know that many people do not want to try the COVID-19 Vaccine. With everything in the media and concerns, I can see why people are reluctant. No one can be forced to directly take a vaccine (it may be a requirement indirectly if we want to travel), but I do urge everyone out there to not rely on what the news says, or what their friends say. Whatever you decide, take a look at sensible resources about the vaccine- websites like the NHS website, recommendations from Public Health England, National Institute of Health and Care Excellence (NICE) and more. Think about how many people you come across in a day. It could help save your life or someone else’s.

I want to end this article on this beautiful verse from the Quran:

Surah Al Maidah- 5:32

“And whoever saves a life, it will be as if they saved all of humanity”…

Who knows…maybe you taking that vaccine could prevent someone you walk past getting an infectious disease such as COVID-19. Maybe you could contribute to someone being alive without realising- imagine that reward from Allah swt, The All Compassionate, The All Merciful and Kind. The One who rewards even an atom of good.

In conclusion, this decision is something that only you can decide for yourself. Whether you are for it or against it, whatever you decide, please ensure you get your facts and research from proper resources to make an informed decision. If you have any concerns about the ingredients in your medicines and vaccines, speak to your local pharmacist and your GP. You may be able to get an alternative prescribed.

For more information about where to look for advice here are some links that may be helpful for you:

https://www.nhs.uk/

https://www.nice.org.uk/

https://www.gov.uk/government/organisations/public-health-england

https://111.wales.nhs.uk/pdfs/WGGe.pdf