A FRIEND recalls a recent exchange with an employee of a utility company who came to read a meter at his home. Asked by the friend if he was vaccinated, the utility worker replied: “No, I don’t believe in that stuff.”

What does he not believe in? Is it the SARS-COV 2 virus and its variants? Is it vaccines? Or other realities of the pandemic? There are many around the world and at home who will never understand basic science or the nature of a pandemic.

There are quite a number of people who prefer to get sick rather than vaccinated. A colleague recounts a young lady who said that those promoting vaccines should stop pushing something so dangerous.

This very same young lady in her mid-20s, who suffers from obesity, got sick from COVID. She lost her boyfriend and an aunt to the disease. Yet she refuses to get vaccinated because of the misinformation with which she has been inundated and her lack of understanding of general science.

Scores of people in the 21st century are pre-scientific and pre-Enlightenment. This is one of the reasons that vaccine mandates will be necessary to address the reoccurring and crippling waves of the pandemic.

Governments will have to continue to be aggressive with mandates and other measures to get more citizens vaccinated and the pandemic under greater control. Childhood vaccination mandates work because there is little room for personal discretion or waffling by parents who want their children enrolled in schools.

In Europe, Greece has now joined Austria in requiring vaccines for citizens, who now face financial consequences for refusing vaccines. Both countries are experiencing stalled vaccination programmes and a surge of infections.

This past Tuesday, the Hellenic nation required that those over 60 must be vaccinated by mid-January or face monthly fines. Greece is the first EU country targeting an age group.

About 83 percent of older Greeks are vaccinated. But the remaining percentage, amounting to approximately half a million people, remain at greater risk because of their age.

Speaking to his cabinet in a televised meeting, Greek Prime Minister Kyriakos said of the new requirement: “It’s not a punishment. I would say it is the price for health. It is also an act of justice for the vaccinated. It’s not right that they are deprived of health care services because others stubbornly refuse to do the obvious.”

Individuals who have suffered a car accident or a heart attack or stroke or are in need of critical health services, all of whom are fully vaccinated, should not be deprived of life-saving measures and beds because of unvaccinated individuals who refuse free vaccines. The responsible should not die because of the selfishness of the irresponsible.

Sadly, there is no amount of reason, rationality or facts that will persuade those incapable of grasping basic concepts like what is a virus or a vaccine. Then there are others, conspiratorially minded, who will go to their graves railing against vaccines.

Vaccine mandates, booster shots, mask wearing, social distancing and other measures are vital for reducing the incidence of death and dying around the world. There is an urgent need for vaccine equity, which may help to reduce the number of new variants.

But even as access to vaccines improves, a number of developing countries are struggling with other issues such as vaccine hesitancy, as well as logistical and communications challenge in getting citizens vaccinated.

South Africa, which enjoys a very sophisticated virology monitoring programme, has so many Johnson & Johnson vaccines in-country, that it has delayed receipt of additional J&J vaccines in order to avoid spoilage.

Vaccine hesitancy, including among the immunocompromised, such as individuals with HIV, is playing a role in the emergence of new variants. Vaccine equity and reducing hesitancy are both critical fronts in the pandemic.

Here at home, we have a good supply of vaccines. But the hesitancy and fear remain, even after the painful and punishing Delta wave.

There are certain dynamics of the virus. When a country removes various restrictions the virus circulates more, as it is currently in The Bahamas, where there is no curfew, few restrictions and a laissez-faire mentality by some in the political directorate, along with many people giddy and complacent during a holiday season in which many will let down their guard.

Those who believe the worst of the pandemic is over might look to Europe for what is possible next year. Though the alarm bells are being rung, the Christmas bells and other noise are drowning out the warnings.

Magical thinking and wish-fulfilment have their own rationale for those whose eyes see what they want and whose ears ignore what is inconvenient. Despite what we have experienced over the past two years, we have not experienced the worst of the pandemic as have other countries.

Trinidad and Tobago has gone through hell, with repeated high numbers of cases, hospitalizations and deaths. Despite our hard mouths and bravado, Bahamians are in many ways very fragile people.

If we go into a deep shock and trauma like other countries, and things become dire, it is uncertain how Bahamians will respond. By example, Princess Margaret Hospital bent, but did not collapse during previous waves. Even when they were running low, we maintained oxygen supplies

Suppose we run out of oxygen? Suppose PMH has to shut its doors to incoming patients? Suppose bodies have to be left in homes for days because they cannot be recovered for some time?

Suppose hospitals, in the triage process, have to decide who is likely to live or die because of infection from COVID? This is all possible. It has already been the reality in many countries.

There now seems to be a reluctance, perhaps because of a fear of political costs, to communicate more aggressively about vaccinations and the pandemic in general. With the coming waves there is likely to be a similar fear in imposing restrictions. A major test is coming for the current administration, which seems ill-prepared.

The government is already being tested. Health and Wellness Minister Michael Darville has announced 20,000 Johnson and Johnson vaccines will likely expire at the end of the month.

This is a terrible sign, especially for a developing country such as ours that was trying desperately to source vaccines. Has there been any decision on exchanging these vaccines with another jurisdiction so that they do not go to waste?

Another test: what are the plans for booster shots? Noting the advice of the US Centres for Disease Control (CDC), the Bahamas Government has said it will roll-out booster shots for the immunocompromised.

That is good, but it is not the most current advice. The CDC has announced that: “Everyone ages 18 and older should get a booster shot.”

The CDC advises: “Although COVID-19 vaccination remains effective in preventing severe disease, recent data suggest vaccination becomes less effective over time, especially in people aged 65 and older, and at preventing infection or milder illness with symptoms.”

When might booster shots for the general public begin? How many Bahamians and eligible residents are due for booster shots? For those who received the AstraZeneca COVID-19 vaccine, what are the best booster shots? A number of studies suggest the Pfizer shot. How many Pfizer shots are there in-country?

Why can’t we begin giving Pfizer shot boosters as soon as possible? Those who have been responsible in getting their previous vaccines should not be disadvantaged by the recalcitrance of the anti-vaxxers, the hesitant and the conspiracy theorists.

What are the best booster shots for the COVID-19 vaccines produced by other manufacturers? The Government has an obligation to communicate thoroughly and effectively on its plans for booster shots, especially given that another wave could come early next year.

Dr Darville notes that his ministry has a goal of 200,000 fully vaccinated people by the end of the year. We will see if this target is met.

During the lull we are in, this is a vital opportunity to plan for and put in place the measures we need to address the ongoing pandemic, which still has a long way to go.

We will be in a “forever” pandemic unless we fully vaccinate approximately 90-plus percent of our population, along with administering booster shots! Yet, we remain unprepared and in many quarters, unaware.