Sunday 20 March 2022

Why are Hong Kong seniors so vaccine hesitant?

Elderly get vaccinated at MTR subway station 
At the beginning of this Omicron wave we learnt that only 28% of our elderly Hongkongers were fully vaccinated. In other parts of the world, the elderly were the first and the most vaxxed.  So what’s going on here in Hong Kong? 

I’ve been wondering. And now I think I have some of the answers.

1.  Government advice: early on, as soon as vaccines became available, we elderly were advised as follows by the government: (a) get advice from your GP and (b) if you have a “condition”, wait for that condition to “settle down” before you get the jab. Is it any wonder they waited?

I remember this advice, as I’m in the elder category and have conditions: overweight and high BP. I did consult my doctor who would not give an opinion. I did my own research on the relative risks of side effects of vaccines v death from Covid and went ahead and got vaccinated as soon as I could. 

But it’s not surprising that many elderly — following that government advice — did not do so. Especially when they asked their GPs and their GPs were unwilling to give advice.

ADDED: ironically, as elders were listening to government advice to “wait” before taking the jab, their carers and family were distrustful of government, largely because of mishandling of the 2019 demos and riots.

ADDED (21 March): today Carrie Lam said I would be “difficult” to legislate for mandatory vaccines for the elderly. Without explaining why. And without hesitating one jot to limit the freedoms of all Hongkongers, to protect the few who do not vaccinate. Weird.

2.  Doctors not willing to recommend vaccine to their elderly patients.  Why? Fear of being sued, and more reasons:

Medical practitioners in Hong Kong have been reluctant to recommend Covid-19 vaccines to patients with chronic health conditions for fear of the risk of adverse events. Significant numbers of doctors have also been hesitant about openly discussing or recommending vaccination even for those with no relevant health issues.…

As for why they were unwilling to recommend vaccination, 31 per cent agreed there was “insufficient data to support recommendation”, while 41 per cent suggested “clearer [clinical] guidelines” were needed. Doctors were also concerned about vaccine safety, with 36.2 per cent worrying about the potential for vaccines to have serious side effects in patients with a chronic illness

Above Clip from: Doctors’ concerns about Covid-19 liability must be addressed”. GP’s reluctance to advise vaccines was compounded by the failure of our government to indemnify doctors for advising elderly to get vaccinated. Indemnity that is apparently given in other jurisdictions. 

3. Zero-Covid policy: early on this policy kept the virus at bay and deaths at zero. So there seemed little incentive to the elderly and their families to go get the jab. Until Omicron. Then it was too late.

4. Elderly were expected to travel to a vaccination centre. Government vaccine people should have gone to them, especially those in the nearly 1,000 elderly care homes. Lately, too late, they’ve just started doing that.

One “reason” for elderly vaccine hesitancy is bruited about: that they are “selfish”. I don’t buy that. Our mother is 100 and fully vaxxed. She and her friends at her residence all say “we do what we’re told”.  That was always the case, so let’s not call them “selfish” for just doing what they — and their families — thought they were being told at the time. There is plenty above to explain why it might be that the elderly are so little vaxxed. And why they are dying in large numbers because of those low vaccine numbers. Best now to fix the oversights, the bulk of which are the government’s, and not call the victims “selfish”.