COVID vaccination....a phantasm
Millions of people have contracted the virus, and it has contributed to nearly 2 million deaths
The coronavirus disease 2019 (COVID-19) has turned into a global human tragedy and economic devastation. Governments have implemented lockdown measures, blocked international travel, and enforced other public containment measures to mitigate the virus morbidity and mortality. But yes the fact is that as of today, no drug has the power to fight the infection and bring normalcy to the utter chaos. This leaves us with only one choice namely an effective and safe vaccine that shall be manufactured as soon as possible and available to all countries and populations affected by the pandemic at an affordable price.
Different vaccines are now available in various countries. In the United States, vaccines need approval from the Food and Drug Administration (FDA).
Other vaccines that have approval for use in various countries include:
- The Oxford AstraZeneca vaccine, in the United Kingdom
- Coronavac, developed by Sinovac, in China
- The Sputnik V vaccine, in Russia
- Covaxin, developed by Bharat Biotech, in India
There has been an unprecedented fast track path taken in Research & Development by the World community for developing an effective and safe vaccine. Platform technology has been exploited to develop candidate vaccines in a matter of days to weeks, and as of now, 108 such vaccines are available. Six of these vaccines have entered clinical trials. As clinical trials are “rate-limiting” and “time-consuming”, many innovative methods are in practice for a fast track. These include parallel phase I-II trials and obtaining efficacy data from phase IIb trials. Human “challenge experiments” to confirm efficacy in humans is under serious consideration. The availability of the COVID-19 vaccine has become a race against time in the middle of death and devastation. There is an atmosphere of tremendous hype around the COVID-19 vaccine, and developers are using every moment to make claims, which remain unverified. However, concerns are raised about a rush to deploy a COVID-19 vaccine. Applying “Quick fix” and “short cuts” can lead to errors with disastrous consequences.
Need for coronavirus vaccine
There has been an intensive search for an effective drug against the virus or the resultant disease and has not led to any breakthrough agents. Few drugs namely hydroxychloroquine and remdesivir have been advocated as desperate measures to fight COVID-19 based on a few preliminary, contradictory, and inconclusive studies. What we need is a drug that is at least 95% effective to stop the pandemic. These and other drugs may save lives but are nowhere near that power to bring normalcy in the utter chaos caused by the pandemic. This leaves us with only one choice namely an effective and safe vaccine that shall be manufactured as soon as possible and available to all countries and populations affected by the pandemic at an affordable price. A vaccine has the power to generate herd immunity in the communities, which will reduce the incidence of disease, block transmission, and reduce the social and economic burden of the disease. Very high immunization coverage can effectively fight the pandemic, prevent secondary waves of infection, and control the seasonal endemic infection outbursts. Eventually, the disease can be eradicated as has happened in many other diseases that have had even with higher potential than COVID-19 to cause pandemics namely smallpox, poliomyelitis, etc.
Are the vaccines safe?
More than 200 COVID-19 vaccines are in development worldwide, with governments securing deals to access advance doses. But access is only one issue. Willingness to accept a COVID-19 vaccine when it becomes available has varied considerably across countries over the course of the pandemic.
In The Lancet Infectious Diseases, it presented a data collected in Australia in April, 2020, which suggested 86% of people surveyed (3741 of 4362) would be willing to vaccinate against COVID-19 if a vaccine became available. Furthermore, the COCONEL group showed in March, 2020, that 74% of French citizens would vaccinate. Between April and July, 2020, willingness to vaccinate has ranged from 58% in the USA to 64% in the UK and 74% in New Zealand. The New Zealand data showed that the most commonly reported reasons to get vaccinated were to protect family and self, with safety being the chief concern about the vaccine. It is important to investigate both motivations and concerns about a future COVID-19 vaccine to help shape communication strategies.
In the latest two surveys from an Australian longitudinal study,1 participants in June and July, 2020, were asked to respond on a seven-point Likert scale to the statement “If a COVID-19 vaccine becomes available, I will get it” (strongly agree, agree, somewhat agree [yes], neither agree nor disagree (indifferent), and somewhat disagree, disagree, strongly disagree [no]). In June, 2020, 87% (1195 of 1371) of the sample said they would get the COVID-19 vaccine if it became available; in July, 2020, this percentage was 90% (1144 of 1274), a slight increase of 1·91% (95% CI 0·08–3·73; p=0·030, McNemar's test of paired proportions, n=997).
These findings are important because they highlight some of the determinants of willingness to accept a COVID-19 vaccine if one becomes available. Concerns are not surprising since vaccine development can take 10–15 years. The vaccine development process must be transparent to increase public trust in safety and effectiveness, even for those who are already willing to vaccinate. Involving vaccine communication experts and the public in developing messaging and long-term vaccine strategy is crucial, and governments worldwide should begin preparing these strategies imminently. A prioritization framework proposed by health economists might aid with the development of these strategies.
We should not forget about the success of previous novel vaccines and ensure that we build on lessons learned in their implementation, including capitalizing on early public enthusiasm shown during a pandemic. We need to understand and address citizen's concerns that can prevent optimal uptake, build motivations into messaging, and priorities public trust by informing and involving the community in the process. Supporting health-care professionals in their role as educators will ensure people have adequate and accessible information from a trusted source, to optimize vaccine uptake and ultimately reduce community transmission of COVID-19.