Friday, December 9, 2022

‘Can I Ask People’s Vaccination Status Before I Invite Them To Christmas Dinner?’ A Vaccine Expert Answers The Many Tricky Questions We’ve All Got This Christmas

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As we approach Christmas and the summer holidays, our vaccination numbers are looking robust and strong and Aotearoa is well on its way to being one of the most vaccinated countries in the world – which is something to be proud of. But in most family or friendship circles, there is a mix of who is vaccinated and who isn’t – and that can be tricky to manage when it comes to social gatherings around this festive time. We asked Dr Nikki Turner, a GP and the Director of the Immunisation Advisory Centre, about how to keep everyone safe while also keeping our communities together.

‘Can I ask people’s vaccination status before I invite them to a gathering?’
Yes – traditionally we’ve done this before with newborn babies and whooping cough; where you’ve got a newborn baby in the house, you want to look after them as best you can and so you ask people about their whooping cough status.

People have always accepted that for the protection of newborn babies so we’ve already got the model of doing that. This is us looking at our community, our whānau, so I think it’s totally appropriate from a perspective of ‘how can I protect my family?’

I also think we’ve got to take an evidence-based approach to it. What we’re really clear about, internationally, is that the people who are getting severely ill and dying are, firstly, the unvaccinated. That’s really clear. And secondly, older people who respond to the vaccine but not as strongly as others and, in particular, the frail elderly. And then it’s people with medical problems and pregnant people.

You don’t have to be so worried about children because most healthy children are unlikely to get Covid badly. But if you’ve got elderly people, if you’ve got children with significant medical problems or pregnant people, then we want to look after them – and it takes more than just them being vaccinated, because you can’t totally rely on just the vaccine alone.

‘I know that one of my loved ones is unvaccinated and yet they still want to come to Christmas dinner. How can we keep everyone safe?’
Social distancing and ventilation work, so sit outside – it’s New Zealand, you should be okay to have an outside barbecue, so long as you keep social distancing and good ventilation. That will make a difference. And if your family are up for it, mask wearing as well.

If you’ve got a dialogue going, say ‘Okay, well I’m going to respect the fact that you don’t feel you wish to be vaccinated; how can we make this environment or gathering safe for everyone?’ You leave the door open to people all the time. Do not shut the door.

We have to accept – and we will have to continue to accept – that some people in our communities do not trust the scientific advice or the government advice, for whatever reason. Let’s accept that and have some compassion towards that.

‘There is real division in my family or friend group between being vaccinated and not being vaccinated and it’s causing big arguments. What do I do?’
I would say, is there a middle road available where we don’t need to be completely polarised? We don’t have to totally polarised our families here, so let’s think carefully about the most important bits – and not just panic. Children, on the whole, are low risk.  It’s really important to look after our elderly, even if they’re vaccinated, so how do we protect them? It’s really important to look after people with medical problems, so how do we protect them? The rest of us, if we’re vaccinated and we do get Covid, the risks are much lower.

There are people out there who have distrust, from way back, and they’re not going to be shifted in how they feel, so in that case the question is how can we still include that person in our community? Because I don’t want to see an angry, polarised community and I don’t want to see our community divided. How can we safely make Christmas happen for everybody, while recognising that some people need to be protected but without marginalising others.

We have to accept – and we will have to continue to accept – that some people in our communities do not trust the scientific advice or the government advice, for whatever reason. Let’s accept that and have some compassion towards that. On the other side, we should be able to reasonably expect to protect those who are most vulnerable in the community. We have to balance these positions.

We are not going to be able to reach across barriers if we destroy friendships.

‘I have a close friend who in unvaccinated but still wants to hang out. I want to keep the friendship but I also want to keep myself safe. What should I do?’
I would say it’s very important to, say, suggest going for a walk together so you can stay safe but stay engaged, where you keep socially distanced; you’ve got that ventilation from being outside and you yourself are fully vaccinated and you both wear masks. You keep your friendship and you keep your friendship going because we are not going to be able to reach across barriers if we destroy friendships.

We need to understand that people’s fears and different beliefs come from all sorts of directions. And it’s hard to understand why somebody comes to such a completely different conclusion from our own – but that’s what society is all about. We have to try and be compassionate to people who do not accept our world view and yet they are part of our communities.

‘I’m incredibly frustrated by people who are unvaccinated – I want to be understanding, but mainly I’m just angry.’
I think you’ve got to take the bigger picture and say ‘New Zealand is a community, what do we want to look like as a community?’ We don’t want to look like an angry, divided community. We will always have people who disagree with the government advice and the medical advice. How can we keep New Zealand as safe as possible while recognising that there will always be people who do not have the same view as us? And it’s hard – it’s really hard. So that anger doesn’t go away, but you can put it in its right corner.  

In General Practice, I see a lot of people where difficult things have happened to them in the past and we don’t always know why. They’ve had bad health events or terrible experiences with health services or government services and those are what mould us – if you have had a bad experience with health services in the past or something’s happened to your body that nobody understands. And then that fear turns to mistrust, and then to a very different world view.

We have to have compassion for someone – even if we think they’re wrong – because they may well have had things in their background, that don’t make sense, that have helped them frame the world the way they see it. So, if you’re carrying that frustration or anger, you have to try to have as much compassion as possible in order to see the bigger picture of what makes us who we are.

How can we keep New Zealand as safe as possible while recognising that there will always be people who do not have the same view as us?

‘I’m leaving Auckland to see my family for Christmas – how can I keep them and everyone else safe?’
Be aware that in any community, there are many who we would call vulnerable people. When we travel to see family, we know who in our family group is particularly vulnerable but we need to always be aware that all around you are strangers who might be recovering from cancer, be on strong medication, or who may have medical problems that aren’t obvious. So be aware of the importance of helping to protect them, of getting vaccinated, of social distancing and wearing a mask, because you just don’t know who around you are the most vulnerable. Let’s all do our best this Christmas.

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