I like to think I’m a complex person, but here’s one way I’m a basic bitch:
When I heard the AstraZeneca COVID-19 vaccine was up for voluntary registration, I jumped at it. Like an 11.11 flash sale hunter, I camped at my phone waiting for registration time to start. After the opening hour bugs, I finally managed to book my appointment.
This isn’t a thing for Astra. I would have taken any other government-approved vaccine, whether it’s Pfizer, Sinovac, CanSino, or Sputnik. But it wasn’t an easy decision for me. I did my own research, thinking and spoke to a couple of people — most notably my wife.
Ultimately, I decided it’s what’s best for me, and likely what’s best for the community. Sharing my thoughts here in case it’s helpful for your own decision.
Standard disclaimer: I’m not a doctor and don’t have any medical qualifications. I’m just writing this as a citizen who’s deadly concerned about COVID-19.
Here’s why I took the vaccine.
Probability, Stats and Large Numbers of People
To me, it’s clear the benefits of the vaccines outweigh the risks.
“BUT WHAT ABOUT THE BLOOD CLOTS??!!!“
Yes, research says the chances of people my age (30-39) getting blood clots + low platelets after taking the AstraZeneca vaccine is roughly: 16 per million people. Meaning if we give the AZ vaccine to a million 30-something peeps, we can expect1 16 of them to get blood clots sometime after.
Scary, I know. But before we address the risks, let’s discuss the benefits. Back to our hypothetical AZ-vaccinated gang:
Because the group is now vaccinated, even if there’s a medium probability of infection (assumed at 3.8%) — we’d expect only 30 people to need hospitalization from COVID-19. Out of a million. More importantly, we’d expect 0 deaths. Zero.
Compare that to a million unvaccinated people living in the same situation. We’d expect 38,000 to get COVID, 610 to end up in hospital, and 40 in ICU. Sadly, 9 will die.
When you look at it from a broad community perspective — purely from the numbers — it’s clear that mass vaccination is the better option. Our first priority is to optimize for the lowest number of infections, ICU admissions and deaths. As for any rare side effects like blood clots + low platelets, we’ll just have to deal with them.
What If I’m the Unlucky One?
Of course, some would say that’s an unrealistic way of thinking. Who makes decisions from a community perspective?
Rather, vaccination is very personal: “Ok great for the country, but what if I’m the unlucky bastard? I don’t wanna die from COVID, but I don’t wanna die from a blood clot either.”
So let’s reframe this from my personal cost-benefit basis, following the previous assumptions: (Age group: 30-39, probability of infection = 3.8%)
With AZ Vaccine
- Only 0.95% chance of getting COVID (4x better than without the vaccine).
- 0% chance of getting severe COVID.
- 0% chance of dying from COVID.
- Even if I’m infected, potentially reduces chances of me spreading the virus between 38% to 49%.
- Cost: 16-in-a-million (0.000016%) chance of getting blood clots + low platelets.
No AZ Vaccine
- Benefit: Avoids uncertainty around new vaccines. “What if some terrible side effect shows up later?”
- Between 5 to 16-in-a-million (0.000005% to 0.000016%) background chance of brain blood clots2 anyway, even without COVID.
- 3.8% chance of getting COVID, which leads to:
- 0.061% chance of hospitalization.
- 0.004% chance of ending up in ICU.
- 0.0039% chance of getting blood clots.
- 0.0009% chance of dying.
That’s me trying to do a rough apple-to-apple3 comparison, where vaccination wins. (I used this handy website to do my simulations above.)
But if you’ll allow me to relax the “comparison rules” further, we can compare the risk of vaccination versus other everyday things — like going out.
In 2018, Malaysia had a yearly death rate of 236 per million people from road accidents.
I’m 15 times more likely to die from a road accident, than getting a blood clot linked to a COVID vaccine.
But that doesn’t stop me from speeding down the LDP at 95 km/h.
Dealing With Uncomfortable Feelings
Maybe you’ll say driving is different. Maybe the argument is when I’m driving, I’m in control. I can reduce my risk by following the speed limit while reciting verses from Undang-undang Lalulintas Jalan Raya.
Am I fully in control though? Or is that an illusion of control? Sadly, sometimes the best safety measures can’t protect you from a drunk driver. Likewise, you can sanitize your hands 20x a day, but what if you need to meet an important client face-to-face, not knowing he’s just visited a COVID cluster?
My point here isn’t to raise a million “What If?” situations, which doesn’t help anyone. My point is despite the million “What Ifs,” looking at probabilities can help us make the optimal decision.
Yes, probabilistic thinking is not natural. Talking about chances of death openly makes people uncomfortable. And we experience things in a binary way: we’re either sick or we’re not. We’re dead or alive. But life is not a series of black-and-white events. Rather, the world operates in an infinite spectrum of gray.
Choosing between a perfectly good and perfectly bad option is easy. Real life decisions aren’t. Sometimes there are no good options. But you can choose the option which is less bad.
When experts say: “The benefits outweigh the risks,” it doesn’t mean something is completely safe. No, nothing in this world is 100% safe. Even a 99.999984%-safe vaccine means 16 people out of a million will have side effects.
Rather, it’s another way of saying: “Your life is probably gonna be better if you do this.”
It’s Not Only a Personal Decision
At some point, I thought about being an unlucky person who dies after taking the vaccine. Yes, I was scared too. Then I realized, I am gonna die someday — it’s just a matter of when. If I want to be the best decision maker I can be, I have to make peace with that.
Taking the vaccine gives me peace of mind. Sure, I’ll have to monitor for side effects and go to the doctors if anything comes up. I’ll still have to take precautions like social distancing and wearing masks. Just because I’m vaccinated doesn’t mean I get to go to rave parties anymore.
But I know I’ve done my best to prevent catching and spreading COVID. When I get back from work, I won’t be as scared of bringing home a deadly virus to my wife. And when the state borders open someday and I can see my elderly parents again, I’ll be all that more confident to give them a hug.
– – –
225 years ago, a terrible disease called smallpox ravaged the earth. It was an airborne virus too, which killed 30% of the people who got it. A brilliant scientist observed that many milkmaids who hung out with cows were immune to smallpox. In a process that would likely be called illegal today, he got some volunteers to test his new treatment.
It worked — the first-ever vaccine was born. Smallpox was finally eradicated in 1980.
Today, we’re at the mass vaccination stage of the COVID vaccines already. Tens of thousands of people have already gone through clinical trials to prove their safety. Those are the really brave ones. And there’s data from millions of people who’ve already taken the vaccines.
One final argument is: “Why do you have to rush? Let others do it first.” Well if Edward Jenner hadn’t tried experimenting with his crude smallpox vaccine, if thousands of clinical trial volunteers for the COVID vaccines hadn’t been so brave, what kind of world would we live in today? The “Let others do it first” argument only works when enough people are willing to step up. Why not me?
To be clear, I’m not in any position to speak for anyone else. I just hope anyone in doubt considers the facts carefully, and makes an informed decision for themselves.
Personally, I’m tired of feeling like a victim. Of watching helplessly as the situation around me worsens. I want to do my part, and that’s why I got the vaccine. As for whatever happens in the future, let it be.
I choose to live my life in faith and not in fear.
– – –
1. This does not mean 16 people will get blood clots when a million 30-year-olds take the AZ vaccine. Rather, it’s what’s been observed so far. There’s also an important principle in the data world: Correlation does not imply causation. As it stands, there seems to be a link — but there’s also no confirmation that the AZ vaccine causes blood clots.
2. This 5 to 16-in-a-million figure is purely on brain blood clots. For a true apple-to-apple comparison, we’d need statistics on all blood clots + low platelets. Haven’t been able to find this data though.
3. I’m neither a doctor nor a statistician, so I’ll be the first to admit this is not a 100% apple-to-apple comparison. But it’s the best I could come up with.
– – –
Pic from Pexels: RF._.studio
Well written article and more ppl should read this. 👍
Thank you doctor
Hahaha sensitive sensitive topic.
My reason is also ‘why not me?’. Taking control of fear over covid is important for people with proactive outlook.
If we always react in survival mode, we will forget to live.
Thanks Heng. Love the quote!