Dr Nicole Ramlachan
The world celebrated World Immunization Week (April 24-30), for which the theme this year is #VaccinesWorkforAll focusing on how vaccines–and the people who develop, deliver and receive them–are heroes by working to protect the health of everyone, everywhere.
It is no timelier than right now, as these same heroes are developing and administering vaccines against COVID-19. Historically, vaccines have saved us in the past, ever since the very first known commercial vaccine. As they say, we should know where we have come from to know where we have to go.
Amidst the smallpox pandemic, in 1796 Dr Edward Jenner noticed milkmaids never got the fatal disease but had little scarring from a relatively mild form called cowpox. The smallpox virus was ravaging the world, with the rise in global trade, there were 33 per cent of infected adults and 80 per cent of children dying, and Native American populations decimated due to no known immunity.
Dr Jenner, trained in London, witnessed the horrors of smallpox first-hand. He convinced the parents of an eight-year-old boy to allow him to scratch his skin with pus from the lesions obtained from the hands of a young milkmaid. The boy was then inoculated with matter from a smallpox blister and fully recovered without getting smallpox. Jenner wrote his paper with accompanying experiments on his son and others, in the inquiry. Two hundred years later in 1980, smallpox was eradicated and Jenner is considered to be the father of modern vaccination. Modern vaccines, like those for COVID-19, are derived from much more ethical and less questionable experiments due to the regulatory, legal and “watchdog” health agencies. All available vaccines undergo stringent testing in laboratory/clinical trials and evaluated/continued/paused as needed.
We are in the midst of another pandemic, COVID-19, caused by the SARS CoV-2 coronavirus. We have been through pandemics before. Polio ravaged the world causing paralysis and death (1949-1955), was eliminated by Salk’s attenuated then Sabin’s oral vaccine which saved millions, and are still being given to children worldwide. When pandemics occur and vaccines are unavailable, death comes quickly to many. The Spanish Flu (1918-1919) left 50 million dead and the Black Plague killed 50 per cent of the world’s population, neither of which had an available vaccine. Today, we have lost over three million people in 12 months with cases rising exponentially once again. Vaccination is the only way out of this pandemic.
Distrust of science, lack of political leadership, limited resources, environmental destruction, and refusal to follow public health guidelines have greatly contributed to the spread of pandemic viruses. COVID-19 is the first pandemic revealed on social media platforms. Conspiracy theorists reign supreme, with misinformation usually the first to spread like wildfire, with little truth to extinguishing its fervent blaze, its flames being fanned continuously by sceptical graduates of the University of the Internet, taught by Dr Google.
Who am I?
I am a molecular geneticist, a mother, a daughter, a teacher and a concerned scientist, with no monetary interest in any vaccine or treatment available or being developed against COVID-19. I still, however, feel a strong sense of moral obligation to share my knowledge with the public to alleviate fears, counter untruths, encourage hesitaters and help the community understand what is at stake.
Who is likely to get COVID-19?
In early infections, older, (>50) people with co-morbidities in Asia, then Europe seemed more at risk. As the COVID-19 pandemic was declared in March 2020 by the WHO, it was realised that all demographics were at risk for infection. Children under 18 seemed to generally present as asymptomatic or had a different form of the disease called MISC. The newer variants are more infectious, seemingly to infect children to a greater extent than older people. Of great concern are the variants recently identified in T&T, which seem more likely to cause severe disease and death. We are currently experiencing a surge in cases, with an increase of over 300 in less than three days. We must continue to take precautions, reduce exposure and be vigilant to reduce these surges until herd immunity can be achieved.
Are the risks of the vaccines more harmful than the risk of the COVID-19?
The normal reactions post-vaccination resemble any those of any vaccine you or your three-month old child may receive. Pain at site of injection, localised swelling, fever, chills, aches/pains, headaches etc, are common. Less common are anaphylactic responses, thrombolytic clots and thrombocytopenia. The general population’s risk of cerebral venous sinus thrombosis (CVST)–one of the blood clot types observed in AstraZeneca/Oxford Vaxzevria recipients, is around five in a million. You are at a much greater risk after COVID-19 infection for blood clotting and associated death. After vaccination, the risk of clotting is not any greater than normal, unless you are in a high-risk category which can be evaluated genetically or biochemically. Daily, people accept > 30 times more risk of clotting taking viagra or birth control pills than they would be taking any vaccine, including the COVID-19 vaccines.
Why should you be vaccinated?
Pandemics in history have only ended without great loss in the population, through vaccination. Without vaccinating 80 per cent of the eligible population, we will not achieve the herd immunity we need to end this pandemic, stop new variants and save our elderly, vulnerable and now children and youth from COVID-19. As of this week, more than 225 million doses of vaccines were administered worldwide, with less than 200 associated deaths (which is less than those seen with the MMR vaccines administered to children). Any of the COVID-19 vaccines available are just as safe as and in most cases more effective than the influenza or any childhood vaccines we administer to our elderly and children every day.
Which vaccine is best to take?
The EU, UK, USA, Canada, China, Russian and Indian have all produced very effective vaccines based on different technologies with one single goal: to protect against COVID-19 severe disease and death. Any available COVID-19 vaccine will help protect you by creating an antibody (immune system) response without having to experience severe sickness or risk of death from natural infection. Enough vaccines need to be provided to achieve the 80 per cent herd immunity (natural immunity combined with acquired immunity) required to end the pandemic, reduce the risk of new variants appearing and stopping the spread of the SARS CoV-2 virus to the most vulnerable, unvaccinated immune-compromised elderly or in more recent cases, our youth. The US has just approved previously banned shipments of raw material for the Covishield vaccine, the Indian manufactured version of the Oxford/Astra-Zeneca to be sent to combat India’s surge in coronavirus cases. Johnson & Johnson-Janssen and Astra-Zeneca-Oxford vaccines are being utilised for vaccinations in many countries. Sinopharm, Sinovac, Sputnik, Moderna, Pfizer/ BioNTech, and Oxford/Astra-Zeneca have accounted for the majority of the 225 million doses given. More vaccines are being developed worldwide, will be available locally and are good options.
How will this pandemic end?
Without enough buy-in by our populace or provisions made by the GOTT to achieve high enough rates of immunization against COVID-19, we will be left behind, with our borders artificially shut to “reduce risk” while not only our people, but our economy and small businesses, die. The rest of the world are charging towards achieving herd immunity with Israel, the UK and the US already over 65 per cent vaccinated and even countries in our region like Dominica and Barbados already over 25 per cent, while we are crawling forward with just one per cent. The caseload in T&T stands at over 9,600 cases by RT-PCR with a seven-day increase of ten per cent confirmed by the MOH. The COVID-19 infection will continue to rise, our population will eventually be completely locked out and locked in, with little recourse, if the population does not respond in time or the health authorities do not provide immediate action to vaccinate and achieve the herd immunity needed.
For more information please follow Dr Ramlachan on the UTT COVID-19 Series, Hype or Hope? Investigating the COVID-19 Vaccines. To join the conversation, please use the link below: https://u.tt/research/covid-19