When it comes to parents making a decision about whether to vaccinate their children against coronavirus, it is a matter of taking responsibility for what goes right or wrong if they do or don’t, according to Dr. Talya Miron-Shatz.
Miron-Shatz is an expert in medical decision making and the author of Your Life Depends On It: What You Can Do to Make Better Choices about Your Health. She is a member of the Business Faculty at Ono Academic College.
The Health Ministry is slated to rule on whether to greenlight the Pfizer coronavirus vaccine for children aged 5 to 11 this week, after it was approved and is being administered in the United States.
But so far, it is unclear just how many Israeli parents will ultimately inoculate their children. One of the main reasons for parental indecision is a legitimate concern about causing their children harm.
However, Miron-Shatz explained that in reality, there is little difference between parents actively vaccinating their children and possibly exposing them to potential vaccine side effects and not getting them vaccinated and exposing them to the virus, with which they can ultimately be infected and from which they could even develop severe symptoms.
Miron-Shatz recounts a study about a man who, hypothetically, inherits an investment portfolio from an estranged uncle. When the investment manager calls and asks him if he would like to reconsider where the money is invested, he opts to keep the status quo – even though he knows nothing about the uncle’s investment capabilities.
That’s because, according to Miron-Shatz, the man believes that if he changes the investment strategy and his portfolio’s worth goes down, he’ll be responsible. However, if he leaves the money where it is, even if the portfolio’s performance isn’t brilliant, he would not feel responsible, because he was just being passive.
It is a classic case in behavioral economics but “irrational,” Miron-Shatz said. “The decision to stick with the status quo is also a decision.
“It is very human to think we are more accountable for action than for inaction, although in both cases we are making a choice – either to do something or not to do something,” she said.
And this is the reason it might be difficult to convince parents to vaccinate their children aged 5-11, even if the Health Ministry ultimately rules in favor of the shots.
Parents will feel responsible if they vaccinate their children and something goes wrong but can more easily convince themselves it is not their fault if their children contract coronavirus or suffer from any of its aftereffects.
But that does not mean they would not be responsible, Miron-Shatz said.
“Their children’s well-being is in their hands,” she said. “There are parents who are saying they don’t want to vaccinate, because they don’t know enough about the vaccine. That’s legitimate and it is fair to ask what the risks and benefits are. But there are too many parents ignoring why we have this vaccination in the first place.”
PFIZER DID not develop its coronavirus vaccine on a whim. Rather, the pharmaceutical company and others searched for a solution to a global pandemic that has thus far claimed the lives of more than five million people and has made around 250 million others sick, including children.
Studies presented by local and international health experts have shown that the risk of developing some side effects like myocarditis are higher from the virus than vaccination.
Health officials and parents have to decide about the likelihood that children will be harmed from the vaccine. But to pretend that the other side of the equation does not exist – that there is no risk to children from COVID-19 – is “irresponsible and not part of a good decision-making process,” Miron-Shatz said. “You cannot just look at the risk of something and not the benefits.”
She added that above and beyond severe cases of the disease or post-COVID syndromes, there is also the situation that children have been experiencing socially and emotionally as a result of the pandemic: no school, isolation, depression and more.
“Saying that you are saving your children from the evil side effects of vaccination is really turning a blind eye to the disease and the physical and mental price the disease brings with it,” she said.
But it could be difficult to convince parents of this.
An initial survey by Meuhedet Health Services found that only around half of Israeli parents would be willing to vaccinate.
And judging by Health Ministry numbers, parents are less likely to inoculate their younger children. As of November 6, only 57% of 12- to 15-year-olds had received at least one shot of the Pfizer vaccine, compared to 87% of adolescents aged 16 to 19.
DURING THE live-streamed vaccination debate last week, Head of Public Health Services Prof. Sharon Alroy-Preis said that before the vaccines, the percentage of verified infected children aligned with their percentage among the population. But since then, children aged 5-11 jumped from being 10% of daily cases to around 35%.
However, until it’s your child who gets severely ill, it is hard to believe that anything bad can happen.
Take the situation of Aden Jamal Fayumi, 16, from Jaljulya, who died last month from post-COVID syndrome. He was unvaccinated. In interviews, his father said that the family did not even know he had been infected with the virus.
“It is incorrect to think that we will act if something goes wrong and there is nothing to do before that,” Miron-Shatz said.
She admitted that it is sometimes hard to grasp what is not tangible. She and her colleague are currently working on other research showing that governmental restrictions were a strong signal to citizens of the severity of the coronavirus pandemic – even more so than the number of new cases or people who died.
“The numbers are sad, but what do they really mean?” she asked. But “if the government thinks I should not leave the house, I understand that the situation is bad.”
Last week, the Health Ministry aired the debate of the COVID-19 Vaccination Advisory Board and offered the public an opportunity to ask questions during the discussion. But only a little over 100 people asked to speak and no more than a couple of hundred logged on at any given time throughout the hours-long session.
The low numbers have led Health Ministry officials to question whether the efforts made to live-stream the debate were worth it and whether they would do it again. But Miron-Shatz said it undoubtedly was a good idea.
“I think these discussions are complicated,” she said. “Ethical, medical, psychological and biological experts – it gives people a headache.
“But people like [the fact] that there was transparency, even if they did not watch the debate,” she said. “It means that no one is hiding anything.”
If the vaccines are approved in Israel, it will make it easier to convince parents to inoculate their children, she said.
THERE ARE experts who are against vaccinating children, such as Prof. Rivka Carmi, the former head of Ben-Gurion University, who spoke out at the live debate and said that despite data shared by Pfizer and the Health Ministry, in her estimation the risk of side effects from the vaccine is greater than the benefits.
“COVID is a mild disease for children in most cases,” Carmi said.
Miron-Shatz said that Carmi is among those people who are “legitimately opposed to vaccination,” meaning that the professor is making an active decision based on how she interprets the data.
The coronavirus crisis in Israel is the best it has been in many months. On Saturday night, the Health Ministry reported fewer than 200 people in serious condition and only 514 new cases.
“The coronavirus presents us with a challenge – to act even if it seems unnecessary, to vaccinate children even when they are not sick,” Miron-Shatz said.
“Let’s overcome the human tendency to pretend that we are not responsible for avoiding action,” she added. “Because when something goes wrong, it may be too late.”