Urgency and uncertainty: covid-19, face masks, and evidence informed policy
Authors: Graham P Martin, Esmée Hanna, Robert Dingwall
Journal: BMJ (2020)

<h3>Abstract</h3> <h3>Introduction</h3> One of the primary reasons for hesitancy in taking COVID-19 vaccines is the fear of side effects. This study primarily aims to inspect the potential side effects of the COVID-19 vaccines circulated in Bangladesh. <h3>Methods</h3> The study was a cross-sectional anonymous online survey conducted across Bangladesh. Data were collected from December 2 to December 26, 2021. The study included consenting (informed) Bangladeshi individuals aged 12 and above who had received at least one dose of the COVID-19 vaccines. Analyses were carried out through exploratory analysis, Chi-square test, and logistic regression. <h3>Results</h3> A total of 1,180 (males-63.89%, age 50 years or over-65.4%, rural-52.86%) vaccinated people participated in the study. Less than half of the participants (39.48%) reported at least one side effect after receiving their COVID-19 vaccine. Injection-site pain, fever, headache, redness/swelling at the injection site, and lethargy were the most commonly reported adverse effects, all of which were mild and lasted 1-3 days. Side effects were most prevalent (about 80%) among individuals who received Pfizer-BioNTech and Moderna vaccines and were least common among those who received Sinopharm and Sinovac vaccines (21%-28%). When compared to the Sinopharm vaccines, the OxfordAstraZeneca, Pfizer-BioNTech, and Moderna vaccines were 4.51 (95% CI: 2.53-8.04) times, 5.37 (95% CI: 2.57-11.22) times, and 4.28 (95% CI: 2.28-8.05) times likelier to produce side effects. Furthermore, males, those over 50 years old, urban dwellers, smokers, and those with underlying health issues had a considerably increased risk of developing side effects. A lack of confidence in vaccines’ efficacy and a substantial level of hesitancy in allowing children (age five years or over) and older people (70 years or over) to receive COVID-19 vaccines were also observed. <h3>Conclusion</h3> Side effects of COVID-19 vaccines are minimal, demonstrating their safety. Further studies are required to establish the efficacy of the vaccines. <h3>What is already known?</h3> Significant COVID-19 vaccine hesitancy has been observed globally, mainly due to vaccine safety and efficacy concerns. Until now, most of the data on COVID-19 vaccine safety and efficacy have been published in manufacturer-funded trials that adhere to regulatory criteria and are monitored by third parties. A lack of independent studies on vaccine safety may have a detrimental effect on vaccine acceptance, which should be intensified to combat the deadly virus. <h3>What are the new findings?</h3> After receiving the COVID-19 vaccines, less than half of the subjects experienced at least one side effect. The side effects were mild and regular and lasted 1-3 days only. Side effects were most prevalent among individuals who received Pfizer-BioNTech and Moderna vaccines and were least common among those who received Sinopharm and Sinovac vaccines. A lack of confidence in vaccines’ efficacy and a substantial level of hesitancy in allowing children (age five years or over) and older people (70 years or over) to receive COVID-19 vaccines were also observed. <h3>What do the new findings imply?</h3> Side effects of COVID-19 vaccines are minimal and regular, demonstrating their safety. Efforts should be made to disseminate such findings among marginalized people worldwide who showed greater vaccine hesitancy.