As more than 50% of UK adults have had their second dose of the covid-19 vaccination, Mary Higgins reflects on the role of vaccinators
There have been numerous pieces published in The BMJ‘s opinion pages over the last few months, covering the vaccines themselves, logistics of vaccination, the experiences of being vaccinated (my own euphoric experience included) and issues of vaccine inequality. I thought it would be a good reflective experience to write about what it is like personally to be a vaccinator. If in a hundred years’ time a student of history is scoping the written history of the pandemic through the virtual pages of The BMJ, should this not be included also?
I took part in vaccinator training because of the wish to help out, to play a small but significant part in helping life to return to some sort of normality, to allow lockdown to lift to some degree, to feel as if I had played my part. First step: the training. Vaccinating clinical staff within the Republic of Ireland have to complete mandatory training using a system called “HSeLanD” where we had to update our knowledge of hand hygiene, infection prevention and control, anaphylaxis education, data protection and covid-19. As a doctor it wasn’t required for me to complete the nurse and midwife module on the covid-19 vaccine, but as with most things in nursing and midwifery education this proved to be useful, practical, and thorough, so I ticked that off the list also.
Virtual paperwork completed, I volunteered to work in our hospital vaccination centre, covering breaks for midwifery and nursing colleagues who are long acting peer vaccinators. Once the inevitable teasing about whether I would be able to give an intramuscular injection was over (apart, obviously, from my friends, where it was relentless) it was time to work. Our centre was based in the Education building, where potential candidates for vaccination queued to register (with administrative staff), to get the vaccine (by midwives and nurses) that were drawn up nearby (by pharmacists, anaesthesiologists and pharmacy technicians) and then have a socially distant rest in a nearby lecture theatre (supervised by the obstetricians). OK, I admit it, this was supposed to be my job, but a) I wanted to be in the action and b) I couldn’t face the inevitable slide by medical staff out of the room before their 15 minutes were over – “but I have a clinic” (sit down!) “I got a call to..” (role model good behaviour!) “just going to the bathroom…” (are you an adult?).
What was it like to vaccinate? The first thing I noticed was the change on people’s faces when I called them into the room. They had been waiting patiently in a socially distant queue where they could pretend that it was something ordinary, but at the time that the “next please” was them, you could see their face change with anticipation. Most people had their sleeves rolled up before they even sat in the chair, so eager were they to get the vaccine. Some didn’t listen to the eligibility questions answering “yes” to “Have you had a vaccine in the last 14 days?” or had forgotten how much time had passed since their first dose because, well, its 2021 and time is meaningless. Others mixed up normal side effects (sore arms) with anaphylactic reactions that would have made them ineligible for a second dose. I often had to repeat questions because people weren’t listening and sat there just looking at the vaccine with awe.
Some people were pregnant and stated that with defiance as if they expected me to say “sorry, no” at the last minute. Some were presenting for the first time for the vaccine and sat with tears in their eyes, talking about family members that they hadn’t seen in months, or travelling to home countries or counties not seen in the previous year. Some talked about requiring treatments or procedures in the near future where the vaccine would give them greater protection. Some were young healthcare workers, some were old, many of us were frontline and had faced the pandemic together as a team and were now getting vaccinated as a team.
Giving the vaccine itself is an experience. As the (very fine) needle goes in, for many people there was an involuntary muscular contraction with injection of the vaccine, with nearly everyone staring out the window and into the future. Once finished, each looks down at the empty needle and then up into my eyes. Wearing masks, it seems that our emotions show more in our eyes as we make contact, with their non-verbal communication saying “well, that’s a relief”. Then off they go into the lecture theatre, to rest, reflect, and hope for the next seven to fourteen days (vaccine type dependent) that they won’t have a significant exposure. And I went on to call the next person.
Mary Higgins is an obstetrician working in Dublin.
Competing interests: None declared.