[Freddie Sayers from UnHerd talks with NHS doctor Steve James as to the reasons he’s willing to lose his job for refusing to take the Covid vaccine this April, when it becomes mandatory for NHS workers.
Dr Steve James
I’d Sacrifice My Job Over
Jan 13, 2022
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Published on Jan 13, 2022
Dr Steve James: I’d sacrifice my job over vaccine mandates
Jan 13, 2022
Freddie Sayers meets NHS consultant Dr Steve James.
Listen to the podcast version: https://shows.acast.com/lockdowntv-wi…
Accompanying article here: https://unherd.com/thepost/dr-steve-j…
Dr Steve James is a critical care consultant at King’s College Hospital in London. When Health Secretary Sajid Javid visited last Friday, he asked the NHS staff about what they thought of the forthcoming mandates that will make Covid vaccination a condition of deployment for NHS staff. Dr James spoke out, saying why he was against the mandate and why he hadn’t taken the vaccine himself.
It made headlines across the UK media, in particular coming from a Cambridge-educated NHS frontline doctor. Dr James came in to the UnHerd studio to explain his position in more detail to Freddie Sayers.
// Timecodes //
00:00 – 01:40 – Introduction
01:40 – 05:36 – Is the unvaccinated doctor who confronted Sajid Javid an anti-vaxxer?
05:36 – 09:00 – Why did Dr Steve James decide not to take the covid vaccine?
09:00 – 10:03 – Is the doctor’s decision scientific?
10:03 – 16:26 – The vaccine mandate for NHS staff – good or bad?
16:26 – 19:25 – How has the reaction to Steve’s viral exchange been received by his colleagues?
19:25 – 20:27 – Will Steve ever get the jab?
20:27 – 22:14 – Does Steve worry his comments will be misused by ant-vaxx campaigners?
22:14 – 25:29 – Does Omicron render the vaccine pointless?
25:29 – 28:44 – Would taking the vaccine compromise Steve’s integrity as a doctor?
28:44 – 33:43 – What would Dr Steve James’s vaccine policy be?
33:43 – 36:05 – Does the government’s vaccine strategy make sense?
36:05 – 37:27 – Will the vaccine mandate happen? Will Steve lose his job?
37:27 – 37:47 – End
#NHS #vaccinemandates #covid19
Dr Steve James: The minority of people in the UK, adults who haven’t had the vaccine, please let’s give them some credit. They’ve thought about it.
Freddie Sayers: Hello! Happy New Year. And welcome to UnHerd. I’m Freddie Sayers. This week, we’re following up on something that happened in a London hospital a few days ago.
The Health Secretary, Sajid Javid, was visiting and asked the group of NHS staff who were gathered to meet him what they thought of the forthcoming vaccine mandate for NHS staff. It’s due to come in April. And it will mean that medical practitioners who are not vaccinated against Covid will not be able to work in the NHS, period.
One doctor, Steve James, a consultant anaesthetist at King’s College Hospital, gave an answer that the Minister was not expecting.
Let’s have a look at the clip.
Sajid Javid: What do you think of the new rule to require vaccination for all NHS staff?
Dr Steve James: I’m not happy with that.
Sajid Javid: You’re not happy with that?
Dr Steve James: So I’ve had Covid at some point.
Sajid Javid: Yes.
Dr Steve James: I’ve got antibodies.
Sajid Javid: Yeah.
Dr Steve James: I’ve been working on Covid ICU since the beginning. I have not had a vaccination. I did not want to have a vaccination. The vaccines reduces transmission only for eight weeks for Delta. With Omicron, it’s probably less. And for that, I would be dismissed if I don’t have a vaccine? The science isn’t strong enough.
Sajid Javid: That’s your view. And your views? Do you have any view on that?
Freddie Sayers: So that doctor, Dr. Steve James, is here with us in the studio. Hi, Steve!
Dr Steve James: Hi, Freddie.
Freddie Sayers: So the purpose of getting you in, and thanks for coming, is to try and really just understand exactly what your position is.
So are you an anti-vaxxer?
Dr Steve James: No.
Freddie Sayers: What does that mean? That means you recognise the importance of vaccinations in other contexts, or in this context, specifically?
Dr Steve James: You know, to be a doctor and be against a certain group of pharmaceuticals would be a bit strange. It would be like being against surgery, or being against hospitals. Vaccines have done a lot of benefit for a lot of people around the world.
First of all, the term “anti-vaxxer”, is used in a purely derogatory way. Why shouldn’t someone be anti-vaccine if they don’t want to have a vaccine? I don’t have a problem with someone not liking something else, or thinking something else is wrong. I am not a flat earther. But I don’t mind if people want to say the world is flat.
Freddie Sayers: So, in the context of Covid. What is your view about the vaccines then? Because Sajid Javid, the Health Secretary, wrote in a piece in the Mail on Sunday, that just before the clip we’ve just seen, you told him that 70% of people in your ICU were unvaccinated, Covid patients. Is that true? Did you tell him that?
Dr Steve James: Yes, that’s right. That’s true. And the number of patients who are in the ICU is about a 10th of what it was at the peak of the pandemic. The majority of patients who we see now, so about 70% of the patients who come in are unvaccinated. Most of them are also elderly, with risk factors. But of the 30% who are vaccinated and come in, they’ve often got reasons why their bodies didn’t mount a good antibody response.
Freddie Sayers: Right. Because this is quite an important distinction already, isn’t it? Because there are a lot of people out there who feel that the Covid vaccines haven’t actually been very effective. But you’re not part of that group. You think that the vaccines have done something quite important?
Dr Steve James: Undoubtedly! Undoubtedly, the vaccines have made a significant difference. We’ve changed the way we look after patients, because we understand the disease process better. We have got other treatments that are available for patients who’ve got Covid.
But the numbers who come through the door in the first place is so much different. That, I don’t think we can account for by a bit of extra mask wearing. And a few more lockdowns. Because there have been lockdowns and not so the vaccines are the factor of change there.
Freddie Sayers: So is your view, then, that the vaccines are important for people who are vulnerable to serious disease, to be encouraged to take. But if you’re not vulnerable, that’s not important? What’s your position on who should be offered it and who should be encouraged to take it?
Dr Steve James: Well, I’d probably offer it to all adults, if I was in charge. The scale of risk and benefit changes, as you move through the age ranges, and across risk profiles within those age ranges. If you want to give one message, you have a limited ability to decide those things. So as you give that message, you think:
“What will induce people to take up the vaccine and bring the overall best benefit?”
I understand that approach. And we’ve achieved a pretty high level of vaccination in this country. And that’s been of great benefit. But if you don’t give the whole picture to people, or people don’t get the whole picture, because there’s a responsibility on both sides here, then people may feel disenfranchised. They may have felt like that beforehand. And they may not feel they’ve really got a nuanced enough set of information for who they are.
Freddie Sayers: But you’ve made the decision not to take the Covid vaccine. Is that a measurement of risk and reward for you?
Dr Steve James: It’s in the context of my preferences. So I’m happy to take the risk of having Covid. Because I’ve looked at it, I’ve thought about it, I’ve seen who of my friends who have had it, what’s the likely scenarios to play out.
And for myself, I’ve spent a lot of time looking into health, into all the different aspects of health. And I think I can manage a pretty decent job for myself. And so I know my risk profile is really pretty low.
Freddie Sayers: What’s the risk that you’re worried about?
Dr Steve James: Of having Covid?
Freddie Sayers: Of the vaccine.
Dr Steve James: So I don’t worry about the risk of the vaccine, in particular. Because I don’t think about the risk of any medicine I don’t want to take.
Freddie Sayers: But if it’s a risk-reward decision, you must have reached the point where you decided for you, given your particular risk profile, you thought the risks outweigh the reward in some way. And you’re young enough for it not to be a very threatening disease for you. What’s the downside for you of taking it?
Dr Steve James: Firstly, is there a benefit for me and is there a benefit for others? So is there a benefit for me? Well, personally, I now know I’ve had Covid. At some point, I was asymptomatic. I’ve now got antibodies.
Freddie Sayers: But when did you have Covid?
Dr Steve James: I don’t know. So I’ve been testing frequently. There was a period of time obviously at the beginning when I wasn’t testing, I might have had it then. But in all the time I’ve been testing, then I’ve always tested negative. So I just don’t know.
Freddie Sayers: But you have antibodies.
Dr Steve James: I have antibodies.
Freddie Sayers: So if you didn’t have antibodies, would you take the vaccine?
Dr Steve James: Well, I had a few months when I had the opportunity to take the vaccine, didn’t know I had antibodies, and decided not to. And that’s because I think that when the benefit for an individual is likely to be very small, you can give it some time. You can sit and say:
“Well, why not wait a year, or two years, or three years, or five years, to see the impact? Or see to the genuine side effect profile of a medication?”
Freddie Sayers: So you’re worried about side effects then? It’s this question of myocarditis, or whatever the potential side effects are. When it comes down to it, even if it’s a small chance, is that what you judge to be too big a risk compared to the reward that you might get for it?
Dr Steve James: So again, I don’t see a potential reward of anything I’m interested in. From the risk side of things, the risk is very small of a serious event. But I have got a friend whose family member is young, and had myocarditis, a colleague at work who had a pericarditis. We’ve seen three relatively young, healthy people coming to King’s College Hospital post-vaccination, who’ve died. So that’s not zero.
Although the chances are very small. So when you work in a hospital. And you see some of those patients, you’re seeing a very select group. But they’re on your radar.
Freddie Sayers: So do you feel like it’s, because you’ve had some personal experience of those things that you’re more moved by the potential risks, and less persuaded just by the risks as described by the official studies?
Dr Steve James: Yeah, we’re human beings, aren’t we? So when we’ve seen something, we don’t forget it. Because otherwise you’d go back to the same place where the tiger was. And you get eaten, or your kids get eaten the next time around. So you do remember things that are riskier. And you do attribute more weight to that.
Freddie Sayers: Is that scientific?
Dr Steve James: Is that scientific? Is there an advantage to remembering where the risk lay? Like I said, with a tiger, yes. Take yourself back to being a caveman and cavewoman. Our biology is built around survival and procreation. So, if you don’t remember where the danger was, and attribute more weight to that, you’re less likely to survive. Is that scientific? I mean, it’s intelligence.
Freddie Sayers: So let’s talk about this question of mandating vaccinations for NHS staff. That’s what you actually voiced concerns about to the Health Secretary. The plan is from April, anyone who works in the NHS, if they have refused, or have not taken the Covid vaccine, will not be able to work in the NHS anymore, roughly.
Dr Steve James: Pretty much. So it’s called a “condition of deployment”. So it’s not an automatic termination of your contract. They will try to redeploy you somewhere else. There’s not a lot of places where ICU consultants can be redeployed in a hospital. Essentially, I’ve been told that I’d be fired.
Freddie Sayers: So what’s your objection to that?
Dr Steve James: My objection to being fired?
Freddie Sayers: No. [both laughing] Your objection to that. I mean, the argument goes, that the precedent is already there, Hepatitis B, or other vaccines that medical staff are required to get to be deployed. So it’s not a new precedent. What’s the big deal? Why not just go and get it?
Dr Steve James: Okay. So let’s look at the Hepatitis B situation. So before Hepatitis B was made a requirement of employment, we had about 20 years of data on its safety. So that’s very different to Covid.
Secondly, Hepatitis B is required, as a rule by a Trust, rather than by law. So that means that if a Trust were to think this is not in the interest of their staff, to move forwards on this, they could do. Next, Hepatitis B is a serious disease for anyone who gets it.
Covid-19, as I’ve had it, many others have had it, have proved, it’s rarely a severe disease in people who are young and well. And much more likely to be a severe disease in the elderly. So the risk profile there is quite different. It’s given explicitly to protect the members of staff who work in hospital. So they don’t get Hepatitis B. It’s not talked about as being there to protect your patients.
Freddie Sayers: Presuming you’ve taken the Hepatitis B vaccine?
Dr Steve James: Yeah.
Freddie Sayers: Was that something you had to think deeply about, or was that, …?
Dr Steve James: Maybe as we get older, we think more about what we do. When you’re at medical school, I think I had my first boosters when I went to the US to be a medical student, doing an elective there. And it was, if you don’t get it. You’re not going to be doing the next bit. So there’s also a difference.
That’s something I didn’t mention before. Is, if you are required to do something at an entry point, you’ve got a decision to go in a another direction. But if you get asked to do something, when you’re mid career – I think I’m still mid career – then where do you go? So there’s a difference.
Freddie Sayers: So you were talking about this principle of informed consent. Is that the principle that you feel is most egregiously being broken here by requiring people?
Dr Steve James: So if I as a doctor, I’m going to ask you to have your bodily consent, your bodily autonomy respected, it’s a bit odd if I don’t have my own respect, isn’t it? So if I come to you to make a decision about what you have, it’s a fundamental move away from the paternalistic medical model of “now you take this tablet”, or “you’re going to have this operation”.
It’s to respect the patient, as an individual, to go to them, to try to understand how they weigh up risks and benefits. To present those risks and benefits clearly to the patient, and try to help them be sure they understand that, and then make a decision in light of that.
So the same risk-benefit profile will provide different decisions in different patients. And that’s considered appropriate in medical care.
Freddie Sayers: And that’s not what’s happening to you now as a NHS staff member?
Dr Steve James: Precisely! That has been taken away. Someone else has made the decision on the risk-benefit profile, and said:
So, even if I disagree with the risk-benefit profile, even if we’d looked at the numbers, and I said:
“Well, actually, you don’t know quite how long the tail is on potential side effects. We don’t know how long the potential tail is on this. If it’s 20 years of data. Maybe we could be confident that the virus is changing.”
But we don’t understand the virus well enough to really have clarity on those things. So that risk benefit profile is going to be different for different people.
Freddie Sayers: So is that, this principle of informed consent, the thing that really upset you? I mean, you’re standing there in the hospital, the Health Secretary comes to visit, normally it’s a few polite bits of banter, you shake the hand. And then you get back to your job.
What was it that made you stand up and voice your concerns to Sajid Javid? When you think about it, what is the thing that got you going most strongly?
Dr Steve James: What got me going the most was knowing that the voices of colleagues are not being heard. I knew that I just had this opportunity to step forwards and say something that thousands of colleagues would want to make a statement on. So for the last month, or two, colleagues have been winking and nudging each other and having meetings outside the hospital grounds, and making small social media groups to support each other. Because they’re worried like hell about losing their jobs, or being forced to have a vaccine!
And those people don’t know, or haven’t had the opportunity to have their voices heard. So, if there are all these people around. And we’re talking about 10% of the NHS, who are being threatened with the loss of their livelihood, come on! I mean, their voices should be heard!
And the thing is, is that we know that if you say something that is against what’s called “the narrative” — that’s considered to be against the narrative. So if you saying it isn’t, isn’t in alignment with the narrative, it’s considered against the narrative. It’s considered dangerous for society.
Freddie Sayers: You’ve now you’ve now stepped into that role. I asked you just before we started the cameras, what it was like to go back to hospital today, the first day back at work since you were talked about across all the national media. What was the response like, from colleagues?
Dr Steve James: I understand the position of my colleagues. They’ve worked incredibly hard. And they really want to see Coronavirus no longer cause the damage it does to people. So I think the response was a reflection of that. There’s a concern that, …
Freddie Sayers: I take that as a negative response from what you’re saying?
Dr Steve James: Some people. So the majority of people, … But the thing is that people who hold a negative opinion about you are less likely to come forward and let you know, in general. People who feel close to what you’re saying will tend to come to you and tell you those things. It’s a bit hard to know what the overall opinion is.
But I’ve had colleagues come up and ask for a selfie. I’ve had a lot of the juniors express support. The families that I’ve spoken to have said:
“Aren’t you the doctor on the telly?”
And I’ve said, yes. And they’ve all expressed support so far.
Freddie Sayers: Because there’s also been a bit of a backlash, it’s got to he said.
Dr Steve James: Yep.
Freddie Sayers: There has been this movement of other consultants and senior doctors going on social media and saying:
“Well, I’m a consultant anaesthetist at XY hospital. And I strongly believe in the vaccine. I’ve taken it, my kids have taken it!”
How are we supposed to judge? You say it’s 10%. Other people are saying 99% of doctors take the other view. How are we supposed to get a sense of where that support, or not, really lies?
Dr Steve James: Well, I mean, Clive Kay said on the BBC that 10% of his workforce, of 14,000 people, are not vaccinated. That’s not my figure. That’s the Trust’s figure.
Freddie Sayers: So do you think those people will stick it out? If April comes, if this policy remains. Do you think a large majority of that 10% will actually take the decision to forego their job, rather than take this vaccine?
Dr Steve James: So from 120,000, which was the figure published, I believe, by the government at the time they announced it in November, they reckon probably 20, or 30,000 had already been vaccinated, but the trust didn’t have evidence of the vaccination status. So there was a group formed called NHS 100k, based on the idea that there’s 100,000 people out there at present.
Some of those people are not going to have an alternative, and not wish to explore that alternative. And they’re probably get alternative employment. And they are going to have a vaccine, under coercion essentially. That’s not a good thing for those staff.
Freddie Sayers: What about you?
Dr Steve James: If push comes to shove, I’m not going to have the vaccine, no.
Freddie Sayers: So you would lose your job rather than, …
Dr Steve James: Yeah. I’ll lose my job.
Freddie Sayers: Why? You talk about risk-reward. I’m interested there, because clearly the risks of losing your job might change that calculus. But you obviously feel so strongly about it. And this is what I think mystifies a lot of people.
Why some people feel so strongly about this issue, that they’re literally prepared to forego their career to defend it. Explain to us how you could feel so strongly about it?
Dr Steve James: I’m a human being more than I’m a worker. I don’t believe I’ll starve, if I don’t have a job in the NHS.
Freddie Sayers: You’d go private, essentially?
Dr Steve James: No! I won’t be able to go private in the UK.
Freddie Sayers: I see.
Dr Steve James: So not in the UK. So the rules are about NHS England, not about Wales, not about Scotland. The Republic of Ireland have got different rules.
Freddie Sayers: So you would move?
Dr Steve James: Yeah. I’d move!
Freddie Sayers: Wow!
Dr Steve James: Yeah.
Freddie Sayers: What do you say to people who are worried that even though you might have a reasonable position, and it’s carefully thought through, and you’re an educated person. And all the rest of it. There has been a big anti-vax movement.
Dr Steve James: Mm.
Freddie Sayers: Some of which is based on perfectly defensible principle. And some of it has contained scare stories that aren’t true. There was the MMR vaccine controversy a few years ago. Are you worried that you expressing what you are today, can be used by campaigners who are trying to spread fear more generally?
I think it’s a reason why a lot of people might feel that you shouldn’t have said anything, because, even though it might be reasonable, it can be misused.
Dr Steve James: Yeah. But I don’t agree on balance, that’s the biggest danger. I think the bigger danger is the conversation not being had. So I think that it’s reasonable for a period of time when you want to get a vaccine out in a situation, to have a singular message.
But as the benefit for society of increased vaccination goes down, at a certain point, people are asking questions. And the percentage of people, or the minority of people in the UK, adults who haven’t had the vaccine, please let’s give them some credit. They’ve thought about it! They’ve thought about it.
And potentially, it’s a reflection of information from anti-vax campaigners. There’s a small chance of that. But let’s please respect the ability of each individual adult in this country to think for themselves. The vast majority of people can think for themselves.
Freddie Sayers: This new variant, the Omicron variant, is much more transmissible supposedly, and certainly is better at overcoming vaccines than earlier variants. Do you think the so-called pro-social argument, the idea that one should take a vaccine for the benefit of wider society, because it makes the overall level of infection come down. Do you think that is blown out the water by the Omicron variant?
Dr Steve James: If people look around them, they can see breakthrough infection in multiple vaccinated people. Most of us know friends who are multiply vaccinated and got Omicron over Christmas. So we should not look away from what we can see. Doesn’t mean that we should completely run away from vaccines, or Omicron and say:
“Oh, it’s all changing now!”
You’ve still got a look and still got to gather data. But the data on vaccination has suggested for quite a while now, that it’s not really making a big impact.
In August last year, Public Health England stated that being fully vaccinated is going to do little to stop the spread of the virus in infected people. So we’ve known that. That’s the government’s publication.
Freddie Sayers: What if it’s little, but still something? I think people will think that. You’re in this responsible position, you’re coming into contact with vulnerable people all the time. Even if it’s only a marginal effect, maybe you should be required to make that contribution, because who knows, it could have an important effect for someone you come in contact with.
Dr Steve James: Okay. So there’s a couple of things here. One is that when you get a vaccine, your immune system is very strongly challenged initially. But if you look at, for example, your antibody levels, not your entire immune system, but an important aspect of it, then those antibody levels drop off very rapidly. If you’ve got natural immunity, the antibody levels start off lower. But they wane at a much slower pace.
And then you’ve got people who haven’t got antibodies, or haven’t been infected at all. So after three months — I said two months in the interview. But that was wrong, it was three months — the protection from the Oxford vaccine is equivalent to no previous exposure and no vaccination. And the confidence intervals, so where the people who wrote the study are confident, the range is between two and four months.
Freddie Sayers: So that’s the effect on transmission, whether you might catch and pass on the disease, not the effect on how ill you get?
Dr Steve James: Yes. So that’s about transmission. And so if you imagine a sort of curve sloping down towards unvaccinated, then actually, because it’s a curve, you’ve got to be further back than halfway to have half that extra protection. That means you’ve got to be vaccinated probably every four to six weeks, in order to maintain a significant level of difference, even a small, but significant level of difference.
Freddie Sayers: What’s wrong with that? Are you not happy to be vaccinated every four to six weeks? [chuckling].
Dr Steve James: No, I’m not. I’ve also got friends and colleagues who attribute other minor problems to the vaccine. Fatigue, changes. I don’t think we’ve got good, safe historic evidence for taking multiple vaccine doses on a programme like that.
The other thing that’s really important is, what does the patient want from their doctor? Doctors think that patients want doctors with loads of knowledge. And doctors worry about having enough knowledge and being professional enough. And all these kinds of things.
And the list of things that doctors think patients want are quite different from what patients say they want. So patients want a doctor who’s compassionate, who’s going to listen to them, who’s going to speak clearly and honestly to them, and weigh up the risk and balance of things.
So as an individual, you have to decide. What’s. The best way of delivering good care as a doctor. And all of these NHS frontline professionals, they’re professionals. They are professionals at caring, and at doing the best they can for their patients.
So they are making assessments on what’s the best thing for me to do, to be able to overall, give the best care I can for the patient.
So that involves your hygiene when you meet a patient. The time you spend with the patient. It involves whether you wear PPE, whether you take the time to look into the patient’s notes, whether you take the time to do all these other factors, and just be present with the patient. And that’s a much bigger picture than just, …
Freddie Sayers: So why does not having the vaccine make you a better doctor to the patient?
Dr Steve James: No, it doesn’t. But if I’m not true to my own beliefs, I’m not a good example of someone who’s making the risk-benefit analysis for myself and deciding on that. And I think that when you’re with another human being, and you’re — doctors and nurses are in incredibly private spaces with a patient. They are in extremely unusual, often scary situations, they’re worried. And we come very close, and share things with patients that you don’t share often with other people.
And so that ability to be genuine with another human being, it requires you, I believe, to know yourself. And to be present in yourself.
Freddie Sayers: So you feel actually that by taking a vaccine that you didn’t want to take, you would in some way compromise your integrity, or compromise your ability to look patients in the eye and feel like a good doctor.
Dr Steve James: Yeah, if I can’t look myself in the eye, it’s gonna be difficult to look a patient in the eye.
Freddie Sayers: So I’m coming back here to what we should actually do, Steve.
Dr Steve James: Yes, please.
Freddie Sayers: Because we’ve got Omicron. It looks like it’s very transmissive, even amongst vaccinated people. Are you saying that the policy should be, offer it to everybody, encourage it — the vaccine, I mean, — offer it, encourage it for old and vulnerable people, and just leave it at that? What’s the Steve James policy?
Dr Steve James: The problem for society is the people who get sick from Covid-19. That’s what we’re trying to change. So if you look at that population of people who are getting sick from Covid-19, you can look at people who get very sick and die. And you can look at those who get moderately sick, and those who are less sick. And what we need to do, is to be open and clear about who is getting sick.
Freddie Sayers: According to you it’s unvaccinated people, or at least 70% of your ICU patients.
Dr Steve James: Yes! And I have no problem with that. That is the fact, that is the situation. But they are not people who look like you, or have a health profile like yourself, or like myself. So I don’t understand why the message is:
“Everybody take it! And let’s force some people to be an example.”
When actually, the people who are most going to have a problem are the elderly, are the vulnerable, are those who’ve got significant comorbidities.
Freddie Sayers: So when would that line start with you?
Dr Steve James: It’s a combination of factors. So the fit and well 60 year old, is at a much lower risk profile than the obese 40 year old.
Freddie Sayers: But a fit and well 60 year old, would you still not advise them to take the vaccine? I know it’s all an individual case, but the government has to have a policy ultimately. Are you saying that a 60 year old, otherwise healthy person, should take the vaccine, or not?
Dr Steve James: We have data in this country. And we should be presenting to people that data in an accessible form that shows people, let’s say, the risk profile of dying from Covid at different age groups, and for different levels of health status. And then also with that, in each box, basically, you’ve got to be able to say, what’s the risk of dying from the vaccine, in that age group? It cannot be too hard for the government to create a website, where you have a drop-down menu, say “this is my age group”, “these are my risk factors”, this is this. Click! It then says:
“Your chance of dying from Covid is one in 5000.”
I’ll be more than happy to help put it together if they want to do that.:
“Your chance of dying from the vaccine is this, based on the data in this country.”
And then let people say:
“Oh, actually look! For me, it’s very clear!”
For many people, that is going to be more favourable, so the benefit is going to be greater, than the risk. When, you know, you’ve got a pretty individualised set of information, you can then make that choice. Choice!
You’re not being forced to make it. But when you know, that your risk of dying from Covid is one in 100, if you get it, and your risk of having the vaccine and having a problem from that is one in 10 million, or one in, …
It’s not quite so high as that. If you look at the VAERS database in the US, it’s about, as a population, about one in 45,000. Most of those deaths occur in the elderly. So we haven’t got information that delineates that at present, as far as I’m aware. So the risk of dying from the vaccine is going to be very low, also in that age group. People should be able to weigh those things up.
And another thing is that, to people who aren’t vaccinated at present, why not find some way to encourage those people to come to their medical professional, and discuss those things together in the light of their views? You could do that with NHS staff. You could say:
“Every member of staff who’s not vaccinated needs to go and have a meeting with their line manager and have the risks and benefits presented to them. And then they make their decision on that.”
Freddie Sayers: I think probably, I’m speculating now. But I guess even Sajid Javid and government Ministers would probably quite like the plan you suggest, in an ideal world. Some sort of perfectly tailored individual risk profile and everyone can, …
But ultimately, they’ve got to have a policy. This pandemic has caused such a lot of disruption. You’ve witnessed the pressure on your own hospital wards, people are exhausted, 70% of people in ICUs are unvaccinated. So they just say:
“Sorry, your particular risk profile, and the perfect way of doing it is not available. It’s not an option, we need to be a bit more rough!”
Dr Steve James: Yeah.
Freddie Sayers: And that’s the decision they’ve made. Do you understand that?
Dr Steve James: I understand it. But I believe the value in that method has waned. And now we’re at a point where the simplicity of the message is actually starting to frustrate the population.
Freddie Sayers: Do you think there’s a backlash against it, it seems sort of propagandistic?
Dr Steve James: It’s coming. That sort of sentiment is building.
So, if you take NHS workers, the population knows that we were clapped a year and a half ago, and they now know we’re being sacked! We’re going to be sacked! So who wouldn’t ask questions about why that transformation? How does this process protect the NHS? Do you really protect the NHS by losing a large chunk of your staff?
So there are questions that, … And another big question is, what’s the data on natural immunity versus unvaccinated, versus vaccinated? I don’t hear the message.
Freddie Sayers: So you think information around natural immunity, information around potential risks to the vaccine, is not being made properly available?
Dr Steve James: Yes. I do think that. I do think the message of simplicity of:
“Have the booster, have the jabs.”
Is a message that works for a large part of the population. But for the population who are not taking a vaccine, you need a different approach. Because your approach hasn’t worked.
Freddie Sayers: Final question for you, Steve. Do you think it’s going to happen? Because I have a suspicion that come April, this policy might be reconsidered. There’s always a reason when governments plan to do something long in the future, because it gives them a chance to reconsider.
Do you think you speaking out and the effect of Omicron, where it’s so transparently not especially reduced, transmission-wise, by these vaccines. Do you think it’s going to change? Do you think you will actually lose your job?
Dr Steve James: I’m a very hopeful person. I do see the possibility of a change. I do see Omicron giving the possibility for a delay, and a review. I do see the possibility of Trusts to contact the government and say:
“We’re worried about losing our staff.”
And that seems to be a bigger problem than whether they’re vaccinated, or not. Because we’re not really worried about transmission from staff to patients.
Freddie Sayers: So you think you will likely be a practising consultant in critical care, still, at the end of April?
Dr Steve James: No. I don’t think the chances are better than 50%. But I’m gunning for it!
Freddie Sayers: Thank you so much for coming in and explaining yourself and your points of view.
And thank you also to you for watching. This was UnHerd, and we were talking to Steve James from King’s College Hospital. Thanks for watching.
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Version 1: Jan 17, 2022 — Published post. Transcript done.