The Australia Letter is a weekly newsletter from our Australian office. Sign up to receive it by email. This week’s issue was written by Amaali Lokuge, a doctor at the Royal Melbourne Hospital.

With the world recording more than two and a half million deaths from the coronavirus and the US celebrating over 50 million vaccines administered, here in the emergency room at Royal Melbourne Hospital we have been scheduled as frontline workers for our first vaccination this week. Australia hasn’t had a coronavirus death in months and the small outbreaks we have are gone within days due to aggressive lockdowns and a compliant public. Given the low prevalence of disease, Australians have the luxury of not getting vaccinated or delaying the vaccine until we are ready.

Until last week I wasn’t sure I would get the vaccine. Some media reports highlight that mRNA vaccines have never been approved for human use outside of clinical trials, giving the appearance of a new technology that has not been tested before. The vaccines were being developed at such a rate that I couldn’t be sure that the main side effects had not been overlooked. I was concerned about the autoimmunity caused by expressing the coronavirus spike proteins on my own cells.

There is a lot of skepticism in Australia and protests against vaccines have surfaced in many of our cities. Outside of this vocal minority, who appear to be resisting immunization based on theoretical and ideological rather than scientific concerns, it is difficult to gauge public sentiment. I have a feeling that Australians feel obliged to be vaccinated, but privately many of us have reservations.

Within the medical community, the misinformation permeating the anti-vaccination movement makes it difficult to raise real concerns. This attracts mild ridiculousness from my co-workers – to them I sound like I’ve given up my medical training.

Every day, patients in the emergency room walk away from primary care against medical advice, and we watch them with a shake of the head and a rueful smile. Just like them, isolated from my doubts, I was ready to exercise my right of free will and refuse the vaccine. When my non-medical friends asked me about it, I was torn between telling my concerns and playing the doctor’s suggestion for the latest proven therapy.

The few to whom I shared my worries looked at me puzzled: If a doctor didn’t trust the vaccine, how would they? It felt like betrayal.

Feelings of guilt forced me to objectively review the literature on mRNA vaccines. Not being an expert in virology or biochemistry, I realized that I needed to be quick to master unfamiliar words like “transfection” and concepts about gene sequences. Slowly the information I devoured changed my beliefs.

I learned that research into the use of mRNA for vaccination and cancer therapies has been going on for 30 years. Trial and error have refined this modality to the point where it was almost fully developed at the time of the Covid meeting. The mRNA from the vaccine is rapidly broken down in our cells, and the coronavirus spike protein is only transiently expressed on the cell surface. In addition, this type of vaccine uses a technique that viruses are already using.

It was humbling to have to change my mind. When I booked my vaccination window, I realized how lucky I am to have access to all of this research and the training to understand it.

I would like more of this information to be filtered out to the public so that they are as informed as we are. As medical professionals, we cannot afford to be paternalistic and trust that people will take advice without all the facts. This is especially true in Australia, where the vast majority of us have never seen firsthand the havoc this disease can cause.

Updated

March 4, 2021, 11:13 p.m. ET

Although we are relatively safe now, there is a constant risk of overwhelming infections. Winter is approaching and the people are letting go of their watch. At the beginning of it all, I would have been carefree if I had imagined we could escape the terrible mortality the rest of the world was suffering from, but the vaccines offer a glimmer of hope. They may or may not prevent transmission, but they will reduce serious infections, hospitalizations, and deaths.

Like all new converts, I am a true believer now: I want everyone to be vaccinated. But autonomy is a precious principle of a free society, and I am glad the ethicists advised against using the vaccine. I just hope that with more intense discussion and wider dissemination of science, we can get people like me – who may have valid reservations – to get the vaccine.

I received the first dose of the vaccine on Tuesday. The whole process was so rational and quick that I went away and felt nothing. But when I took a picture of the vaccination card to share with friends and family, I was overwhelmed by a mixture of gratitude, relief, and regret for the rest of the world where the virus is less well contained.

What you need to know about the vaccine rollout

My director wrote in an email to the emergency room last week that the hardest thing he ever had to do was watch us downstairs just to face the virus with just our PPE to keep us safe. And for all of us, the fear that one of our loved ones might succumb to the virus has been a constant shadow.

Knowing that we can alleviate this threat through vaccination seems like a miracle.

Here are this week’s stories:

Last week we asked you about the sexual assault allegations scandal in Parliament and your own experiences with sex education in Australia. Here are some of the readers’ responses:

Morrison couldn’t judge until he spoke to his wife? What kind of ignorant person is he who cannot see that rape is unacceptable?

Dutton with his comment “he said she said” horrified me. In addition, neither of them commented on the information that the incident was reported to the AFP. I find the whole story and information below about other attacks really worrying.

– W. McQuarrie

My sex education in high school and elementary school was completely absent. It felt like scare tactics, focused almost entirely on the STI contraction, and rooted in Catholic guilt that encouraged abstinence as the only real form of safe sex. When I went to university it wasn’t any better. I attended a residential university where there was a lot of talk about consent, but with no nuance or real effort to hire a speaker who might relate to young people. And when consent questions were actually checked at my college, the administration failed again and again on all of us.

– Zoe Stinson

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