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The availability of a Covid-19 vaccine will not be a magic bullet, and any suggestion that it could be dangerously threatens the public’s motivation to continue with non-pharmaceutical interventions.
There is a growing wave of impatience and sometimes even demanding anger, as a result of the delay in having Covid-19 vaccines in the country. “Why is it taking so long to get the vaccine into the country?” Has the government dropped the ball?
To be sure, the issue is becoming increasingly emotional and a hot political weapon. Activist groups such as the C19 People’s Initiative have also jumped into action, alluding to the laudable and effective HIV treatment campaign. However, while the intention is commendable, it must be balanced against the generation of false expectations that could jeopardize crucial precautions for the prevention of Covid infection that are not vaccines and that will still be of vital importance for some time.
Let me say at the beginning that I have spent about four decades of my professional life fighting, supporting and defending vaccines which, along with the provision of clean water, are the most effective modalities to protect against disease and maintain health. However, Covid-19 vaccines are not measles vaccines and the strategies for their control are not the same.
Aside from a handful of anti-vaxers, and perhaps a few more nervous and vaccine-averse folks, we all want this vaccine, and we all want it urgently as soon as possible, none more so than our heroic front-line healthcare workers. The delay is simply due to the grotesque selfishness of high-income countries.
With approximately 13% of the world’s population, they have joined in, even before the results of clinical trials were known to assess efficacy and safety, and bought 51% of the world’s vaccine production, in some cases enough to 3 to 5 times the needs of its entire population. This was done so that at least some of your vaccine purchases would be effective and safe.
However, middle-income countries like South Africa would be roundly condemned if they had considered gambling with their much more limited taxpayers’ money for vaccines that are still undergoing research trials, when it was unknown whether they would be safe and effective.
The decision was then made to secure a guaranteed stretch of vaccine for 10% of the population through COVAX’s joint procurement facility. COVAX would purchase vaccines on behalf of some 189 countries to aim for an equitable distribution of the vaccines available globally.
The news from COVAX is that the expected delivery of this vaccine allocation to South Africa (one of the first countries on the list) would be the second quarter of this year. However, it is important to note that, in addition to this, the government and the business sector are in negotiations with the vaccine manufacturers to ensure the supply of vaccines as soon as possible, and also for the rest of the population. For obvious reasons, these negotiations are, at this stage, sensitive and confidential: no one with a genuine interest in you procuring vaccines quickly now would want to jeopardize these negotiations.
The impatience, anxiety, and dissatisfaction are understandable. The 2020 Covid-19 pandemic has taken a tremendous toll of disease, loss of life and loss of livelihood. There has also been a very significant intrusion into people’s quality of life. Unsurprisingly, people are tired of these nuisances, irritations, and invasions in their daily life. “If we only had a vaccine, all of this would go away”; “If only the government hadn’t been so inept, we wouldn’t have to continue with these restrictions.”
Unfortunately, the reality is that the vaccine will not be a magic bullet, and any suggestion that it is is dangerously threatening the public’s motivation to continue the non-pharmaceutical interventions so critical to controlling the epidemic.
The uptake of vaccines by wealthy nations has not only hurt the low- and middle-income world (the latter is solely dependent on COVAX), but is in fact short-sighted as well. Pandemic infections can only be controlled if they are controlled globally, and that means all countries, rich and poor.
The delay for South Africa is, of course, deeply regrettable and regrettable, especially for our vulnerable and indispensable health workers. However, it offers us a brief respite, allowing us to further evaluate and evaluate the vaccines that are being implemented in the field in the developed world. How are these completely new vaccines doing in the field situation? How they perform in millions of recipients may not always be identical to how they perform in the few thousand volunteers within the structured setting of the clinical trial. (As an example, it has now been reported that a severe allergic reaction, anaphylaxis, has been observed, albeit rarely, but 10 times more commonly with the Pfizer vaccine than with other vaccines, which now requires a specific warning for people prone to the alergies. ).
Additionally, more vaccine manufacturers are now applying for licenses, thus expanding the choice of vaccines for our local conditions, rather than just getting the first licensed vaccines available, as rich countries have done. Our vaccine selection and strategic planning may well be influenced by observations and insights from the field behavior of these vaccines.
In conclusion, and most important of all, the public should be aware that the Covid-19 vaccine will not be a magic bullet. Their arrival on our shores will not miraculously and immediately mean the end of the epidemic.
The UK, one of the first countries in the world to launch vaccines in early December, is currently experiencing a second wave considerably larger than the first wave. It is still experiencing a daily rate of new infections almost three times that of South Africa, as it battles the disease with one of the world’s toughest blockages.
Clearly, we still have a long way to go even after the start of vaccination. For many months after receiving the vaccine, we will still have to rely on public acceptance of precautions against Covid-19 infection.
We cannot afford to create false hopes and false expectations that, sadly, vaccine activism may be in danger of doing. Vaccines will not allow us all to immediately return to our pre-Covid lives. Maintaining the dedication of human behavior to fighting an invisible enemy is challenging, uncomfortable, and even irritating. But it fundamentally depends on the support of all sectors of the community. It is fragile and can be easily broken by the seduction of a magic vaccine. It’s just as easy to look for a scapegoat.
Arguably, there may appear to be a gap in communicating adequate assurances to the public. But let me say that, in fact, there are very broad efforts behind the scenes to acquire safe and effective vaccines as soon as possible, and also to develop a comprehensive vaccine strategy.
Finally, I would like to make an urgent and heartfelt appeal to civil society groups: stop hinting at false hopes and expectations to the public for immediate solutions to the Covid-19 crisis. These only serve to compromise, and even jeopardize, the current critical imperative of maintaining Covid-19 prevention precautions, perhaps less palatable, but critically necessary. The challenges are unique and difficult enough to sustain, and we can only succeed with the support of all the leaders who influence the behavior of the country. DM
Barry Schoub is the chair of the Ministerial Advisory Committee on Covid-19 Vaccines. He is Professor Emeritus of Virology at the University of the Witwatersrand and was previously founding director of the National Institute of Communicable Diseases. This presentation is made in a personal capacity and does not necessarily reflect the views of any organization with which you are affiliated.
