What you must know about COVID-19 vaccine

Nigeria expects to get its first COVID-19 vaccine doses in January, 2021. Health Minister, Osagie Ehanire, said that Nigeria has a working group in place to handle vaccines, and is working on the COVID-19 vaccines with the Global Access Program, COVAX, backed by the World Health Organisation.

The country is already talking with vaccine manufacturers as well as teams in Britain and Russia. The United Arab Emirates has also introduced the country to the makers of a Chinese vaccine that UAE officials had tested.

A vaccine is generally made up of a weakened or a dead virus, which, once injected, prompts the body to fight off the invader and build immunity. It saves millions of lives each year. There are currently more than 50 COVID-19 vaccine candidates in trials but recent weeks, two vaccines—Pfizer and Moderna have shown efficacy rates of around 95 per cent in clinical trials.

Both Pfizer and BioNTech and Moderna’s candidate vaccines have been manufactured using mRNA-based technology, a relatively new way to make vaccines. Both are authorised by the U.S. Food and Drug Administration (FDA) for use in people 16 and older, making it the first coronavirus vaccine approved for public use. Also, Moderna’s vaccine has been approved for use.

When the body confronts the real virus, the antibodies and the cells can recognise it and can kill it faster. How long will the protection last? Data from the clinical trials show that Pfizer’s vaccine, which is 95 per cent effective, can offer partial protection as early as 12 days after the first dose.

That protection can last for at least two months; a second dose is then required to achieve the vaccine’s full potential. A second dose to be given 21 days later acts as a booster for the immune response, offering protection starting one week after the second jab.

The Moderna vaccine candidate is reputed to mount protective antibody levels within two weeks of the first dose and last for at least three months. It also requires a second shot and has shown to be 94 per cent effective.

Chairman, Technical Working Group for the Vaccine, Dr Bassey Okposen, said: “If we want to buy as a country, it should be vaccines that have been tested, effective and not very expensive. Some of them are very expensive. The Moderna is about $33 per dose, and one person needs two doses. So, you know what that means when you multiply by the population. It will amount to billions of naira.

“The other protein vector virus vaccines would be of advantage considering that the cold chain storage requires 228 which is what our routine vaccine cold chain storage requirement is, and it makes for easier maintenance aside affordability. Something like AstraZeneca costs about $4 per dose. So, for the two doses, it will be about $8.”

Okposen, who doubles as director, Disease Control and Immunisation at the National Primary Healthcare Development Agency (NPHCDA), added: “But if you are going for mRNA vaccines like Moderna and Pfizer, you are looking for minus 70 Degree Celsius cold chain and the prices are high. But for those very high-risk health workers, we are targeting that supply from GAVI and then, we will acquire some cold chain space to make sure they are properly kept for sustainability. But for the larger volume, we will prefer something like AstraZeneca where the storage temperature is like the one we are using for our routine vaccines.”

However, Incident Manager, Emergency Operation Centre (EOC), Oyo State taskforce for COVID-19, Dr Taiwo Ladipo, said the currently available vaccines do not confer lifelong protection and so the reason individuals will need to take two doses.

According to Dr Ladipo, “COVID-19 is still evolving. It’s been expected that once someone is affected there is meant to be the development of some level of immunity. Unfortunately, we don’t know how long that immunity will be and immune status of individuals defers.”

He stated that some people have been infected more than once, even within the last 10 months since the pandemic started, suggesting that the infection does not confer lifelong immunity.

Dr Ladipo declared that children below 16 years, pregnant women and individuals that are immunosuppressed due to diseases such as HIV, TB and sickle cell disease, are not expected to take the vaccine.

He added “the vaccines are yet to be proven not to cause infertility, its side effects are not fully known and it is said that it will not prevent an individual from spreading the virus, but it will only reduce the symptoms.”

Moreover, Director, Centre for Human and Zoonotic Virology (CHAZVY), College of Medicine, University of Lagos, Professor Sunday Omilabu stated that Nigeria needs to be cautious with the use of COVID-19 vaccines.

“We don’t know what is actually protecting us here, compared with the way they come down in the western world, so that we don’t jeopardise that natural immunity.

“We don’t know much about the vaccine; we don’t know how the vaccine is going to behave after a while, it has not fulfilled all the righteousness of a licensed vaccine,” he warned.

Professor Omilabu said even though its focus is in preventing deaths and other causalities from the infection, a major concern still is that even the virus itself does not confer long time immunity based on what is seen even in Nigeria.

Professor David Olaleye of the Department of Virology, University of Ibadan, however, said vaccines that confer lifelong protection have not been developed for other known coronavirus like SARS, MERS or influenza.

According to him, like these other coronaviruses, developing a vaccine that will confer lifelong protection will be difficult because all viruses keep mutating or change with time as an adaptive mechanism for survival.

Professor Olaleye, however, said that to ensure an effective immunisation, the circulating strains of the virus in a country is considered in determining the appropriateness of the vaccine.

“Take, for instance, the influenza virus that causes flu, the vaccine you produce last year may not be protective against the emergence virus. The implication of this is that with COVID-19, also a virus, we have to look at it in relation to the vaccine.

“We need to really be sure of what we are getting; is it going to be protective against the emergent strains in the next few months? These have implications and that is why we keep on as virologists monitoring these viruses.

“Take HIV, we have not got a reliable vaccine for HIV till today because the virus keeps changing. When you have an isolate today and you are characterising it, before the vaccine is ready, the host has changed,” he said.

Meanwhile, a survey conducted by the Africa Centres for Disease Control and Prevention (Africa CDC), in partnership with the London School of Hygiene & Tropical Medicine (LSHTM) has shown that the majority (79 per cent average) of respondents in Africa would take a COVID-19 vaccine if it were deemed safe and effective.

Conducted between August and December 2020, the survey interviewed more than 15,000 adults, aged 18 years and above, from Nigeria and 14 other African countries, including Burkina Faso, Côte d’Ivoire, Democratic Republic of the Congo, Ethiopia, Gabon, Kenya, Malawi, Morocco, Niger, Senegal, South Africa, Sudan, Tunisia, and Uganda.

Data from the survey shows significant variations in willingness across countries and across the five regions in the continent, from 94 per cent and 93 per cent, respectively, in Ethiopia and Niger to 65 per cent and 59 per cent, respectively, in Senegal and the Democratic Republic of Congo.

The study also indicated that individuals who have had a positive COVID-19 test and are now well believe that they do not need a vaccine because they think they have become immune to the disease and can no longer be infected.

Overall, willingness, or not, to take a COVID-19 vaccine depended mostly on trust in vaccines as well as perceptions of its importance, safety and efficacy, the study revealed.

Safety was of utmost consideration, on average 18 per cent of respondents believed that vaccines generally are not safe and 25 per cent believed that a COVID-19 vaccine would be unsafe.

Respondents who are older, those who know someone who has tested positive for COVID-19, and those who live in rural areas are more inclined to take a COVID-19 vaccine than younger people, those who have not seen COVID-19 affect anyone, and those living in urban areas, according to the study.

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