BORN in 1949, I was a generally healthy child, apart from experiencing several of the then common communicable diseases of childhood – as an infant I had whooping cough and in primary school hepatitis A, mumps, chicken pox and measles. Each of these diseases can kill or cause serious complications for some of the children who catch them. At that time, none of these illnesses could be prevented by vaccines.

The sickest I have been as an adult was with a severe bout of dengue fever in 2009 – I felt like I could have died but, with good supportive nursing and medical care, obviously I didn’t. While this disease does not yet have a vaccine that has been proven both safe and effective, mosquito management and other public health measures are keeping it under control for now in northern Australia.

In the mid-1950s, our entire primary school in Canberra was lined up for the injected polio vaccine because the whole community was frightened by an epidemic of “infantile paralysis” (poliomyelitis) that was sweeping through many countries. You may have seen the old black and white photos of iron-lung breathing machines.

In 1949, about 4% (one in 25) of children born in Australia died before the age of 10 years. The latest Australian Bureau of Statistics data from 2017–2010 show that less than 0.5% (one in 200) of all children die before the age of 10 years.

A significant proportion of this dramatic improvement is due to the prevention of communicable diseases by vaccination.

So, apart from we older persons, most people alive today have no memory of what it was like to be sick with a potentially life-threatening contagious illness. Few of us understand the experience of watching sick relatives struggle, and perhaps die, from what has now become a preventable disease. But suddenly, death from COVID-19 is on every television screen and we are being dragged back from worrying about the potential side effects of vaccines to the realities of life without them.

Vaccination works for two reasons. First, an effective vaccine for a particular illness reduces the risk of most individuals of catching and/or getting sick from that disease.

The second reason is that vaccinations stop epidemics by halting transmission. If one person develops a disease in a community where most people are immune, either because they have been vaccinated or have already had the disease, it is unable to spread rapidly and widely through the community. Fewer people are infected and other measures such as quarantine are more effective. This is what is known as herd immunity.

Herd immunity protects those people who do not or cannot develop immunity because they have a disease or a treatment that stops their body from responding to the vaccine – they are immunocompromised. Others may be unable to have a vaccine because they have a known true allergy to one of its components. Such people rely on the rest of us being vaccinated to protect them from the spread of disease within our community.

However, if too few of us agree to be vaccinated and our community fails to achieve herd immunity, epidemics can re-emerge. Then all unvaccinated and vulnerable people are unprotected.

In 2019, a measles epidemic killed over 80 children in Samoa after vaccination rates fell (here, here and here). Cases of whooping cough increase in infants too young for vaccination when adults refuse vaccination for their slightly older children. These are the reasons health care workers and governments encourage immunisation.

Indeed, those who choose not to accept vaccination without a valid medical reason can get a free ride as they are protected by the vaccination of others, but only when most of the rest of their community accept vaccination.

Many people have expressed concern about the safety of vaccines for COVID-19. Vaccines against COVID-19 cannot cause COVID-19 because they do not include the information necessary to make a whole virus.

Around the world, many millions of people have been vaccinated against COVID-19 and, even including the very small numbers of cases of serious blood clotting, reports of severe reactions are very rare.

Some people report minor local discomfort at the site of the injection and others have flu-like symptoms for a day or so. It is also very important to realise that when millions of people are being vaccinated every day, some will, by coincidence, become ill from other diseases on that or subsequent days.

Others have expressed the view that they are old or have a life-limiting illness and would prefer to let nature take its course. This is a valid expression of personal values and the right to make choices. At the same time, it is important to remember that because we live in communities, a person with COVID-19 poses a threat to those who care for them, their family who visit, and, in the case of the residents of aged care facilities, other residents.

We must respect the difficulty of decision making in such circumstances which reflects the need to find a balance between our rights and our responsibilities – the rights of the individual to choose which medical interventions they will accept and the responsibility that we all have to act in the interests of the all the individual members of our community, upon which we all depend.

As a doctor, I have always described decision making about the risks of many of the activities of daily life, and particularly whether to accept a particular medical risk, as being based on an understanding of the balance of risks. If, for example, I were talking with a patient who had appendicitis I would discuss the low risks of the surgery and the anaesthetic against the higher risk of them not having their appendix removed. I will accept the known risks of cataract surgery in order to improve my vision and quality of life. I drive to visit family even though there is a risk of being killed on the highway, but “if it’s flooded, forget it”. These are calculations that we make every day.

COVID-19 vaccination has a very low risk and a broad range of benefits.

At 71, I am a “1b” in the prioritisation for a COVID-19 vaccine. Early last week, before the latest advice, I accepted my first dose of the AstraZeneca vaccine. I would have made the same decision this week, and for several reasons:

  • because I feel that I have a moral and civic responsibility to contribute to the wellbeing of the community to which I belong;
  • to protect myself from getting sick and possibly dying, and because I am a carer myself;
  • to reduce the risk that I might transmit COVID-19 to my family, friends and colleagues who work in health care; and
  • because I would like to be able to re-engage in the activities that have been curtailed by COVID-19 and will likely be permitted sooner as a consequence of a successful vaccination campaign. Without vaccination we will, for a long time, remain unable to travel to visit family and friends in other places, and they can’t visit us.

Without a broad uptake of the vaccine, COVID-19 will eventually just have to run its disastrous course across our community, as we have seen in the UK, the US and many other places. With vaccination leading to herd immunity, we can protect many people from dying, restore the social connections that are at the heart of our being, avoid the damage to the health care system that has been seen in many other countries, and start to repair the damage that has been done to so many businesses and the lives of people who work in them.

In the 1950s and 1960s, few parents refused to have their children vaccinated. They had experienced the risks first hand and were hugely relieved when science offered a way to minimise the clear dangers of at least some infectious diseases. We need to remember the lessons of our not so distant past and consider what we are seeing elsewhere in the world.

One of the most significant individual contributions that most of us can make to the lives and security of all the members of our community is to get vaccinated against COVID-19.

Dr Will Cairns OAM is a Consultant Emeritus Palliative Medicine at Townsville University Hospital.



The statements or opinions expressed in this article reflect the views of the authors and do not represent the official policy of the AMA, the MJA or InSight+ unless so stated.


COVID-19 vaccine hesitancy will increase after the AstraZeneca announcement
  • Strongly agree (59%, 152 Votes)
  • Agree (38%, 98 Votes)
  • Neutral (2%, 6 Votes)
  • Disagree (0%, 1 Votes)
  • Strongly disagree (0%, 1 Votes)

Total Voters: 258

Loading ... Loading ...

9 thoughts on “Why I had a COVID-19 vaccine when my turn came


    , 2021 at 7:

    I suspect Sue Leraci’s comment about mortality meant to say: “COVID-19 mortality in Aus has been a little over 3% of cases – about ten times the mortality from INFLUENZA”
    Max , when the benefits of weighing up risks is discussed with patients it “is ” useful to compare evaluation of risk with surgical procedures which patients may be more familiar with.
    You could just as easily compare risks with dying or getting ill from the flu.
    Many people do that and make the judgement to get vaccinated.
    The problem when confronted with a personal decision about the covid vaccine is that it is unlikely that Covid can be prevented from entering Australia forever and will be an ongoing risk unlike the current artificial situation.

  2. Max says:

    Sue Ieraci’s comment about mortality is also nonsensical: “COVID-19 mortality in Aus has been a little over 3% of cases – about ten times the mortality from COVID-19”. One should really proof-read more carefully before committing finger to keyboard to Post Comment.
    Only those who can only deal in absolutes would fail to see that citing 100% as an example is one end of the spectrum of risk. The media which thrives on panic – and sadly many of the ‘informed’ commentators – seem to treat COVID as if the probability of death is just that: i.e. Pr = 1.0.
    A nuanced discussion would admit that if vaccination was risk free, there could be no sensible argument against everyone having the vaccine. Once the prevention itself has a risk, then the benefit has to be correspondingly greater, reaching its logical (yes, logical) maximum in any situation of 100% mortality from the disease. The AZ vaccine risk of a rare but serious clotting disorder does change that equation, much as public health officials would wish it was not the case.
    I agree that there is much more to the discussion about COVID and its potential long-term disability, but unthinking blandishments telling everyone to go off and jolly well get vaccinated are part of the reason why the program has now been derailed, supercilious health officials’ reassurances are seen as dubious, and confidence has been lost.
    If you are under 30, and your risk of death from cerebral venous sinus thrombosis from vaccination is the same as your risk of death from COVID, then any medical practitioner who does not inform you of that equation is, in my view, violating their duty of care to you as an individual patient, whether or not they have the subterfuge of the health of the greater community as their motivation.

  3. Sue Ieraci says:

    “Max” makes a few errors of logic. We know that preventive medicine is different to curative procedures, but both are key components in keeping our community safe. No infectious diseases carry 100% mortality – although perhaps Ebola comes close to that. Even if 50% of people died from an infection, that would be an absolute disaster! We vaccinate to prevent death AND disability, both acute and chronic. In Australia we no longer see complex disability from congenital rubella, deafness from measles or paralysis from polio – thankfully. None of those infections cause anywhere near 100% mortality, but the disability and impact on the community was huge.

    Max’s comment about risk is also nonsensical. COVID-19 mortality in Aus has been a little over 3% of cases – about ten times the mortality from COVID-19. That does not count the disability associated with long ICU stays and so-called Long COVID. One should really become more informed before committing finger to keyboard.

    I am so glad that the wonderful Dr Brentnall did not die in infancy of infectious disease. He has lived such a productive life and touched the lives of many others. Please, Ed, stay safe.

  4. Geoff Chapman says:

    When they have made it difficult for a GP to become a “vaccinator”, after vaccinating patients and generally injecting “substances “in patients for years, does this not also affect the capacity or desire to inoculate.
    And what about Dentists ? Surely they are some of the best injectors of all of us.
    Why not round a few of them up to help, or would they have to do a “Bureaucrats engineered course” in the process of injecting ?
    Sometimes Medical academics worry me, in the rollout of necessary medical procedures, with which they have had little or no practical experience.

  5. JOHN R REHFISCH says:

    I am the same age as Will and still working as an Orthopaedic surgeon. I have been vaccinated and although Max has some valid points, the risk to those in the community who cannot have the vaccine for some reason is a major concern to me. I also want to return to travel and activities that will not be possible if we try to rely on lockdowns to keep the disease at bay.
    No treatment that is effective is without some risk.

  6. Max says:

    Will, with respect, you are equating preventive and curative medicine: they are very different.
    Appendicitis or cataract surgery are curative, not preventive procedures.
    If the COVID fatality rate was 100%, vaccination would make complete sense, but the fatality rate except in the oldest patients is quite low.
    Is it reasonable to risk a rare complication from preventive medicine to prevent a rare outcome from an infectious disease?
    Personally, with the AZ vaccine, I don’t think so.
    For any individual, prevention needs to be as close to risk-free as possible where the worrying outcome being prevented is rare.

  7. Edward Brentnall says:

    I agree absolutely with Dr Cairns. I am now 91, and as a child I had all the common communicable diseases including diphtheria at the age of 5. I can remember how unpleasant it was, and I was told that I did nearly die. If I get Covid I probably shall die, and be a nuisance in the process. I had the AstraZeneca vaccine first dose two days ago, with minimal side effects, and I am very glad to have done so. I still enjoy life and have lots of things that I still want to do.

  8. Lynette Reece says:

    I have been vaccinated, and feel lucky to be so. I have an appointment for my second shot in a couple of weeks. I think the vaccine uptake will be affected by the recent announcement because the media are all about drama and negatives rather than a balanced assessment. We need to ramp up the vaccination process and get everyone done as soon as possible. We need to see if other vaccine rollouts have done things well and learn from them.

  9. Daphne Marion Burrows says:

    As an Registered Nurse as a Community Manager, I still have not been vaccinated with Astra Zeneca vaccine

Leave a Reply

Your email address will not be published. Required fields are marked *