29 January 2021

Boulevard of Broken Dreams

When I wished everyone a COVID vaccine for Christmas, I did not realise this could become a contentious issue. I received my first dose of the PfizerBioNTech COVID vaccine on 23 December, the same day that I completed my training to be a vaccinator. Since then, all of my immediate colleagues have received their first dose. My hospital has by now delivered over fifteen thousand first doses to employees and the wider health and social care community. We have begun to assist with the roll-out of community vaccination clinics. My motivation for being part of the volunteer vaccinator workforce  - alongside numerous others  - is complex. On a simple level, I am just excited to play an active role in our recovery from the pandemic. The pleasure of doing a straightforward clinic where everyone is happy to attend and keen to receive the treatment on offer is not to be underestimated after a career in cancer. The vaccines clinics have been sociable, fun and demonstrated incredible teamwork and I have appreciated seeing the practical arrangements for myself.

To their extreme credit, many of my haematology consultant colleagues have volunteered as helpers for the ITU nurses who are now managing multiple, ventilated patients in unfamiliar, temporary settings. I will admit that worries about my own ability to function across a 13-hour night shift in a clinical area where I lack expertise means that I have not yet undertaken a shift. However, my petty concerns about my own well-being mingled with such huge guilt, that I set my mind to volunteer for ITU as soon as I had received my second dose of vaccine. Since then, all of our second vaccine doses have been cancelled and not, to date, been re-booked. How to live with the complicated and extremely lonely feeling of wanting to be as safe as possible oneself whilst doing risky work and yet understanding the overall national imperative to afford at least some protection to the greatest number of people? There is no right answer to these complex moral questions. COVID has left many of us feeling “I walk this empty street, On the Boulevard of Broken Dreams”1.

The BSH stepped in to advocate for full, 2-dose vaccination of our clinically extremely vulnerable patients and for us, their healthcare workers, who are sometimes the only people they interact with face to face. Blood Cancer UK has recently advocated for household contacts of such persons to also receive vaccine priority. We have shared our letter to the JCVI with you all. We have received many messages in support of this advocacy, although understandably, our stance has not pleased every single member. The UK’s vaccine strategy of getting single doses into as many arms as possible may well prove to be a great decision for public health if it works. However, there is, as yet, no real evidence that it will work and we are not certain how that evidence is going to be gathered and evaluated. I think it is important that we always voice concerns and raise valid questions, especially those which generate testable hypotheses. This sort of dialogue must never be seen as undermining public confidence or needlessly criticising our poor government who are seemingly doing everything they can. I know that you, as front-line healthcare workers, are definitely doing everything you can and the BSH must be here to make representations and ask the right questions in support of your efforts.


  1. Green Day, "Boulevard of Broken Dreams", American Idiot, Reprise Records, 2004