Van Dissel’s coat causes many questions from callers to the ‘Doubt Telephone’. The Omikron variant of the virus has put on a “different coat” that makes the immune system less able to recognize it, the director of the Center for Infectious Diseases said during the latest press conference. His comment raised the question in many people: does a booster with the same vaccine as you received months earlier make sense?
The booster certainly makes sense, says a senior medical student from a room at Erasmus MC in Rotterdam to a caller. “A booster increases the amount of antibodies, so that the Omikron variant also has much less chance.” The caller is still not convinced. “You should see it this way,” continues the student, “the booster gives the immune system extra eyes, so that the new coat is better recognized”. Immediately after hanging up, the phone rings again. Eight people are on hold.
Seven medical students calmly and decisively answer medical questions by telephone. They sit behind the desk in white doctor’s coats, headphones on, and work for the Vaccination Doubt Telephone. Anyone who hesitates about a corona vaccination can call.
Robin Peeters, internist at Erasmus MC and chairman of the Dutch Internists Association, set up the telephone line last month together with general practitioners from the region. It turned out to meet a great need – calling between six hundred and eight hundred people per half-day. The university hospitals of Utrecht, Amsterdam, Nijmegen and Maastricht and general practitioners from those cities quickly joined so that you can call five days a week.
Menstrual disorders
“Yeah, if you’ve had AstraZeneca first, you can take a booster shot with Pfizer,” one of the students told a caller. “In fact, research shows that different vaccines increase the amount of antibodies.”
Many telephone calls are now about the booster vaccination because there is a lot of attention for it, says Iris Benschop, medical student and team leader at the Doubt Telephone. She also regularly answers callers herself. “First the booster had to be done after six months, now it is three. How about that? Is that safe? And people with a poorly functioning immune system have received three shots to be well protected. For them, the booster is the fourth vaccination. There are also many questions about that.”
Any news about the coronavirus is immediately reflected in the questions, says Chris Groen, manager of the call center at Erasmus MC. That was the case after Van Dissel’s metaphor. And that was so after the news last week that 17,000 women reported menstrual disorders after being vaccinated. “Menstrual disorders are common anyway,” a student behind him tells a caller. “It can also have another cause. Stress for example. Vaccinations activate the immune system, which interacts with the hormones. But it is not harmful. And it does not affect fertility.”
Also read: Many menstrual disorders after vaccination, but ‘cycle recovers on its own’
Many doubters call about the corona vaccine Novavax, now that it has just been approved. “These are mainly people who don’t want to be vaccinated with mRNA vaccines like Moderna and Pfizer,” says Iris Benschop, “because they think it changes DNA or genes. Although that is not correct, Novavax can still be a solution for these people.” Whoops, there’s someone else on the line about the new vaccine. “Vaccination with Novavax is not yet possible,” is the answer. And after a few minutes of patient listening: “An mRNA vaccine doesn’t change DNA. It activates the antibodies. The vaccine itself is completely gone from the body after a few days.”
Allergic
Most questions are about pregnancy and female fertility. There are also callers with very specific questions about their own health situation. Can I take the vaccine if I have migraines three times a week, or if I’m allergic to certain substances, or if I have an autoimmune disease? Complicated questions, usually about a specific condition of the caller, are discussed directly with the attending internist. The caller can wait for the answer.
Someone just called who is allergic to bee and wasp stings. “Then you can be vaccinated in peace,” is the answer. “The substance to which you are allergic is not in the vaccine. “Also call people with the most diverse food allergies. Vaccination is not a problem for them,” says Iris Benschop. Only people who are allergic to medication should pay attention. They are advised to be vaccinated under the supervision of a specialized doctor. But that allergy is very rare.”
Are there any questions they don’t answer? Yes, says Iris Benschop. “We get quite a few calls about the QR code.” How do they get it right on their phone, for example. But we can’t help with that.”
Calling to be sick
People also call who want ammunition for discussions with unvaccinated people, says Willemijn Kleijn, who just walked in, just like Benschop master’s student of medicine and team leader. “Recently I got a call from a woman who wanted to convince her brother. That brother came up with all kinds of studies found on the internet to which she had no answer. I said to her, ‘We won’t be able to convince your brother through you. Your brother can call himself.’”
Chris Groen: “Or that man who called and said: I don’t believe in the vaccine. Convince me otherwise. Your time begins now.”
Willemijn Kleijn: „I also had a lady on the phone who said: ‘I don’t believe in vaccines. And you?’ I had a good conversation with her. At the end she said, “You haven’t convinced me.” That’s not my goal either, I said. I think it’s already a win if she thinks about it calmly. In the end, everyone makes their own decision.”
Sometimes antivaxers also call. Not because they doubt but to get a little sick. There was even a call on social media to “flatten” the Doubt Phone. The action failed. This morning someone also calls and immediately says threateningly: ‘I am recording this conversation.’ “That’s fine,” the student replies. To his question: ‘Can you guarantee one hundred percent that there will be no unknown side effects of the vaccine in thirty years?’ unfortunately cannot give a definitive answer. “But all studies show that the vaccine is safe,” she can say. “You have to keep the conversation with these people as short as possible,” says Benschop. “Especially because there are so many others on hold.”
Communicating with difficult patients is part of medical training, says Willemijn Kleijn. “So it is also very useful for us.”
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