To vaccinate or not to vaccinate: Egypt’s medical community debates the decision

Dina Ezzat , Monday 22 Feb 2021

Some doctors say the coronavirus vaccine will protect them and their patients. Others believe it is better to adopt a precautionary lifestyle until its efficiency and side effects are clear

Professor Ahmed Rashad.

On 10 February, Ahmed Rashed, a professor of gynaecology at Ain Shams University got the first shot of the COVID-19 Sinopharm. He waited for a while and then drove to his sports club in Heliopolis to have his morning coffee.

“It was so easy. I went in. I got the shot. I went to the club and I sat there having my coffee without being super worried about anyone who would come near me. Of course, I still and will continue to observe wearing my mask and to keep the social distance, but for sure I am much more relaxed now that I got my first shot,” he said.

Rashed is anticipating his second shot on 3 March. He is confident that things would “work in line with the schedule. Everything has worked well right from the beginning. I am confident things will continue to work well,” he said.

Like other professors at the Faculty of Medicine at Ain Shams University, Rashed learned about the availability of Sinopharm from the notification of the administrative office of the faculty. He went to register his name and in a few days he got a notification to get the first shot.

Rashed “did not at all mind” that Sinopharm was the only available vaccine for him. As far as he is concerned, there is “hardly any difference between Sinopharm and any of the other vaccines” that received an emergency licence under the plan to confront the pandemic that has hit more than 100 million people around the world, killed over half a million and left many others with long-term complications, some of which have proven to be deadly.

The two fashions used to formulate all these vaccines are not problematic. “Any vaccine comes with a side effect, but without vaccines how could the world have dealt with polio, measles, and such other illnesses? I am not really worried about the side effects,” he said.

Rashed spoke to Ahram Online a week after he got the first shot of Sinopharm. He said he did not develop any symptoms.

Egypt is planning to use three vaccines in its inoculation campaign: the Chinese Sinopharm, the British-Swedish Oxford-AstraZeneca and the Russian Sputnik V.

The health ministry said citizens can start registering for vaccination next week.

Mostafa Hemeida, a professor of plastic surgery, also at Ain Shams University, said that he suffered “a mild throat irritation” after getting the first shot of Sinopharm. “It did not persist at all. I went home and took it easy and I took an [off the shelf common cold medicine] in the evening. The following morning I woke up feeling fine.

“This is exactly the reaction that my son had when he got the first shot of the same vaccine in Dubai where he lives. I was not worried at all,” he said.

Hemeida said he never really paid much attention to the debate over Sinopharm even though he learned that some doctors including those who work in the COVID-19 isolation hospitals and those who work at fever hospitals had already declined to take it upon concern over the lack of transparency over its testing on humans.

“Egypt is not the only country to have used Sinopharm and it has been used in other countries along with other vaccines. I am grateful that I got it; if this is the best the government could afford then it’s good,” he said.

“It is basically one and the same thing; the differences are perhaps insignificant; it might be similar to the difference between one painkiller and another; in essence the debate about the better vaccine is a trade war between companies that will be making billions of money out of this vaccine,” he argued.

Hemeida said that when the time for the vaccination comes next year, as it would be probably the case still, he might still opt for Sinforam given he had tried it.

“We will see what will happen next year; I don’t think we are getting rid of the coronavirus in one year,” he argued.

This same concern over a long battle with COVID-19 “before the nightmare might be over” prompted Maher Fawzy, a professor of anesthesiology at Cairo University, to go for Sinopharm once it was made available by his faculty of medicine.

With his line of work that puts him at a very high risk every single day, with a very lethal second wave of COVID-19, and with no close end in sight for the pandemic that hit the world in the last week of 2019, Fawzy felt he had no choice but to go for Sinopharm.

The most crucial reasons behind Fawzy’s decision to go for Sinopharm is the “totally devastating experience” he had had when he was infected with COVID-19 in the early weeks of 2020 and the fact that “this particular vaccine is manufactured by the traditional way of using a weakened virus.”

Fawzy is one of 155 over 60-year-old medical professors who are waiting to receive the second shot. He said he had no doubt that the other close to 3,000 professors, of the same age group, and the rest of the staff of the medical school of Cairo University, who make around 7000, would be able to get the shot if they chose to.

“It is not a joke; if they started by giving us the first shot then for sure we will get the second shot. In a couple of weeks there would be more shots made available – for those who need the second shot and those who got the first shot,” Fawzy said.

During the last week of January, the Ministry of Health started providing Sinopharm for all members of the medical teams working at isolation hospitals who wished to get the vaccine.

Some went ahead and many hesitated.

Ten days down the road, the vaccine was made available for over 60-year-old professors of medicine in many medical schools across the country. Again, some went ahead and some hesitated.

Next week, the ministry, according to official statements, is set to start making the vaccine available to all medical workers, of all ages and practices, again on strictly volunteering basis, and for free.

Amal Hanafy, a professor of anesthesiology at Abul-Rish Hospital, is not planning to be vaccinated. “Certainly not this year, and actually maybe not at all,” she said.

Having suffered the “nightmare of an aggressive infection of COVID-19” in the early months of 2020, Hanafy is hopeful she has developed “ a level of immunity” that she is working on developing by a certain line of immunity enhancement supplies and some medications that she believes reduce the risk of infection and/or reduce the symptoms in cases of infection.

Having developed an immunity due to regular vaccination with the flu shot without being aware of an auto-immunity issue that she suffers from, Hanafy feels that her case is not the right one to get a vaccine that was passed for emergency use.

“I have no information how this vaccine would act on my body. I don’t feel comfortable taking the risk,” she said.

Her colleague at Abul-Rish, Mohamed Abdel-Raouf, also aprofessor of anesthesiology, is “not at all comfortable” to be among the first group of people to go for a vaccine that was developed and passed in a few months.

Unlike some of the doctors who take issue with Sinopharm particularly, Abdel-Raouf said that he actually is not convinced “of any of the vaccines – irrespective of the manufacturing company or the mode of manufacturing.

“I have a lot more questions than I have answers and I read a lot of contradictory reports. I am not in a place to make an informed decision, so I would rather wait,” he said.
Abdel-Raouf is not sure when he might change his mind or whether he would at all change his mind. He would only say that he needs time to learn more and be more confident.

“If I have to choose between the risk of inducing my body with a vaccine that I don’t know enough about and between the risk of catching COVID-19 then I will go for the second, because I am taking as many precautionary measures as possible to avoid the infection, but with the vaccine there is no going back once I get it,” he said.

This said, Abdel-Raouf is not planning to advise any patient or colleague against the vaccine. “I just share my views on my position but I do not have a strong case against the vaccine to advice patients against it,” he said.

For doctors like Rashed, Hemeida and Fawzy, their lives and practice of medicine would be a lot easier with the vaccine. They argue that they are not just protecting themselves but also their patients.

For those like Hanafy and Abdel-Raouf, it is best to stick to a restrictive lifestyle at least for a while to come when the efficiency and side effects of the vaccines have been made clear and when more vaccination options are made available.

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