OUTSIDE THE BOX BY ALEX OTTI
If your house is on fire, don’t wait until you have the perfect house. People should get vaccinated with whatever effective vaccine they have access to because this will help protect themselves and their communities by impacting the global viral load.” – Dave O’Connor, University of Wisconsin Medical Foundation Professor of Pathology and Laboratory Medicine, University of Wisconsin-Madison
The advent of the social media has democratised the media space in an unprecedented manner. All one needs to be an active player in the social media is a smart phone and data. Even though it has its negative side, one has enjoyed the social media so much that sometimes when one wants to laugh, there must be something that will make one have a hearty laugh. A few days ago, there was a message circulating in the social media about how the 54 countries in Africa could not make any attempt at developing their own brand of the vaccine but were busy waiting for the rest of the world to develop one for them to shamelessly procure. I will leave out the other part of the message. I forwarded that message to a friend of mine who is a Professor of Pharmacology in one of the Universities in the country and his knee jerk riposte was quite revealing. He pointed out that African researchers were still preoccupied with developing a vaccine against hunger! He therefore requested that they should not be distracted by the global race for the development of the Covid-19 vaccine!
It is a fact that out of the over 200 vaccine candidates going through different stages of tests and trials as at the end of last year, none is of African origin. The reason for this is not difficult to understand. Most of Africa is battling with several existential challenges that are more deadly than the virus. Their scourge are so debilitating that they give the continent little time to pay attention to research and development of Covid-19 vaccines. The fund needed to engage in development of vaccine is such that most African countries find more important and urgent uses for it. For instance, the United States of America is spending a tidy $9b to fund vaccine development and production, mainly for its citizens. The United Kingdom has spent about £12b on the same vaccine as at the end of January this year and is planning to spend more in the years ahead. Japan budgeted a spend of over $6b for the vaccine. From these it is easily discernible that the vaccine play is not for countries that are still battling to feed their populace.
Understandably, the way the whole space is arranged also makes it difficult for those who did not invest to reap any returns from the business. Thus, while such huge amounts are funnelled into the development and production of vaccine, the poor countries would eventually buy the vaccines from countries producing it at exorbitant prices. In the end, the big pharmaceutical companies are left with super profits which eventually go back to the countries that provided the funds for the research and development.
Vaccines are a sure antidote to viral infections, be they common colds or more complex ones like Coronavirus. Because Covid was novel when it was declared a pandemic by the World Health Organisation exactly a year ago, many experts believed that like the Spanish Flu of over a century ago, the development of a vaccine was going to take years. The Spanish Flu of 1918 lasted until1938 when an effective vaccine was developed and accepted by health authorities. It was therefore reasonable to expect that a vaccine would take 5 to 10 years to develop. But they were wrong! The advancement in technology has shortened the delivery period of most human needs. The way vaccines were developed in those days is different from how they are made today. There are four basic approaches for making a vaccine going by existing medical literature. They are the RNA, the Viral Vector, the Whole Virus, and the Protein Subunits. All these approaches either use a harmless version of the virus or a synthetic version to trigger an immune response. So, the whole essence of the vaccine is an immunity play. Rather than being understood as an external body introduced to prevent the virus from infecting the vaccinated, the vaccine, should be understood as an external agent whose job is simply to arouse the body’s immune system to defend the body once it comes in contact with the virus.
Before now, vaccines were produced by injecting passive virus proteins called antigens to stimulate the body’s immune system so that they can identify specific virus and produce antibodies in response. These antibodies are expected to fight, not only the virus in the body, but also develop a reserve army of antigens to fight future virus infections. This is usually a very long process that is also susceptible to some ‘inexactitude’.
The fastest way to make a vaccine is the Ribonucleic Acid approach (RNA) also known as mRNA where m stands for messenger. This system is very easy to understand. We all know that the coronavirus is introduced into the body through the nose or mouth. Once introduced, it attaches itself to the cells in the body and releases its acid into the cell which transports the virus and makes long viral proteins which ultimately compromises the body’s immunity. Having done this, the virus is energised, multiplied and transported to other parts of the body. On account of the fact that the immunity system has been thus weakened, the infected person is susceptible to all types of sicknesses and if he had an underlying health issue before then, he stands a bigger risk of succumbing to any severe sickness and in extreme cases, death. The virus having taken over the body of one person, can be easily transported to other persons through body fluids, like sweat, saliva and other droplets. Therefore the best way to avoid the virus is to keep a reasonable distance from infected persons.
RNA vaccines work in such a way that a small fragment of the virus’s genetic code gets injected into the body and produces part of the Coronavirus which kicks the body into mounting a defence against the deadly virus. You may call it fighting the virus with a virus. This is the technology used by the Pfizer/Biontech and the Moderna Vaccines.
The third big name in Covid-19 vaccine production is the Oxford/AstraZeneca. This vaccine is also based on the RNA system. The only difference is that it uses a harmless virus to carry its own genetic material into the body.
The fourth brand of vaccine is the one made by Johnson & Johnson, which goes by the brand name Janssen. This is made by the same technology as the Oxford/AstraZeneca vaccine. A fifth introduction into the Covid-19 vaccine market is the Novavax Vaccine, code named NVX-CoV2373. This is the only one made using the old technology which harnesses protein from the virus which is used with a chemical to kick the immune system into action once it is injected into the body.
It is instructive that all the vaccines mentioned above are made in Europe or America. China and Russia have also launched and started administering their own vaccines. China developed Sinovax, Cansino and Sinopharm vaccines and have started shipping to countries in Asia and South America. Reports have it that these vaccines are effective. Russia, on its side developed the Sputnik V vaccine made by Gamaloya Research Centre and has been using it to inoculate its people. Sputnik V is said to work the same way as AstraZeneca and is also effective.
All the vaccines considered above, even though are targeting the same virus, have different characteristics, work differently and are stored under different temperatures. While some require extremely low temperatures, others can be stored under room temperature. While some have near perfect efficacy levels, others have relatively low efficacy levels. Many require two doses while some require only a single dose. Of course, they come at different price levels even though most countries administer them to their citizens free of charge. We shall consider a table below where these properties are highlighted for ease of comparison.
Make Efficacy (%) No of Doses Full Dose Price Temp ©
Pfizer/Biontech 95 2 $39 -70
Moderna 94 2 $74 -20
Janssen 66-85 1 $20 -20
Oxford/AstraZ 63-82 2 $6 Room
Novavax 89 1 $16 2-8
Please note that while the Russian Sputnik V is claimed to have 92% efficacy level, China’s Sinovac is said to be 50% efficacious. These numbers are yet to be verified by the WHO. Interestingly, the vaccines are said to be effective in containing the new UK and South African variants of the virus. What has not been confirmed is how long the vaccines can keep the body protected against Covid infection.
The Nigerian government received close to 4m doses of the AstraZeneca vaccine recently and has already started to administer them to the populace, beginning with the President and his Vice. Oxford/AstraZeneca vaccines are from a weakened version of a virus known as “adenovirus” taken from chimpanzees. It is modified to look more like the coronavirus, but it cannot act like the virus. Injecting it into the body teaches the immune system how to fight the real virus. Of all the certified vaccines, AstraZeneca is the easiest to use and seems to have been made for the underdeveloped world, not just because it can be stored at room temperature, but because it is very cost effective. In addition, the second dose can be delayed as the first one can protect the body for a while, quite unlike other two-dose vaccines.
The whole pandemic phenomenon has generated quite some controversy since its advent. Some people argue that it is a scam, while some others insist that it was created in a laboratory in Wuhan, China. Some other theorists contend that it was a capricious campaign launched to reduce world population and eliminate some people of a particular race or income group. There was also the bizarre link of the vaccine with the 5G technology. Clearly, the development of the vaccine has not been left out of the controversy. Some people have argued that a vaccine certificate was in the offing which would entitle holders to enter some certain places to the exclusion of others and to travel by air. When you put all those together, you can better begin to appreciate the scepticism amongst some people with regard to the vaccine.
Criticisms have trailed the choice of AstraZeneca vaccine by the Nigerian government. Some of those critics have limited information about the vaccine. Granted that countries like Austria, Denmark, Norway, Iceland and Thailand which hitherto embraced the vaccine have suspended its rollout, following reports of deaths after the vaccine, blood clot and a few other side effects, it is important to state that there is no medication that does not have risks associated with it. Even the common Panadol pain killer, which some people swallow like food, is associated with the risk of liver compromise. We must therefore always differentiate between safety and risk. By the time we do this, we would realise that while the vaccine could be safe, it remains risky like many other things in life. The risks are the side effects and many of them have been listed. What is important is not whether there are risks but balancing the risks with the benefits. If the benefits far outweigh the risks, medical experts will go with the option. Sometimes the course of treatment would present very heavy risks, but experts would continue to recommend it based on the possible benefits and lack of viable alternatives. For instance, chemotherapy is known to be very violent to patients, but the alternative is to watch the patient get devastated by cancer. Oncologists still recommend chemotherapy to cancer patients despite the risks.
I believe Africa missed the chance of participating in the vaccine race when it neither seriously pushed the opportunities presented by Madagascar nor that of Senegal. No African country was serious with dedicating funding to support research and development efforts aimed at producing an African vaccine quite unlike what other countries did. It is already late in the day as many vaccine candidates are at different stages of the process of adoption. We should at the minimum educate our people about the products of other countries which is what we have attempted to do here. We should also ensure that everyone takes advantage of the opportunity to get the vaccine. It is the only sure route to eliminating Covid-19 for good.