In spite of vaccination’s preventing horrific disease and death, the road to public acceptance of vaccines has been tough

6/08/2021

Bulawayo Zimbabwe-During public health crises, particularly epidemics, many people experience fear. They worry about their health, their families, and their livelihoods, and sometimes they transfer their worries onto unknowns or new developments, such as vaccines. 

The global scientific community have agreed that the only effective way to defeat the COVID‑19 pandemic is through the mass vaccination of populations around the world. A vaccine is a biological preparation that provides active acquired immunity to a particular infectious disease. A vaccine typically contains an agent that resembles a disease-causing microorganism and is often made from weakened or killed forms of the microbe, its toxins, or one of its surface proteins.

According to Busani Moyo aged 27 a final year medical student at a University in China, “Vaccine is not a cure but boosts and trigger the defence system of the body towards certain disease. People should embrace vaccines because it is God who equips scientists with knowledge and wisdom to be a solution over an epidemic for example Insulin was originally derived from the pancreases of pigs and cows.”

Vaccination hesitancy has been strong but more people are now getting the vaccination against Covid-19, with the government of Zimbabwe promising to import more vaccines from China. In spite of vaccination’s overwhelming success in preventing horrific disease and death, the road to public acceptance of vaccines has been tough.

Vaccine hesitancy can be an attempt to make sense of things that don’t seem to make sense to people in our changing world, which is why it is important to respond to vaccine hesitancy with compassion, rather than judgment. There is no one person or entity to blame — however, it is an indication of the underlying problems in our systems and societies. If all citizens’ needs were met, and everyone felt listened to, vaccine hesitancy and refusal would not pose us such a challenge. As humans, sometimes our brains jump to the conclusion that there must be a causal relationship between two events that happen around the same time even if they are not related. Consider the social media post that spread early in 2021, stating that six people died during the Pfizer-BioNTech COVID-19 vaccine trials. Some readers of the post assumed this meant that the people died as a result of the vaccine. But that has been shown to be incorrect; no causal relationship was established between the deaths and the vaccine. In fact, four of those who died received a saltwater placebo. The other two deaths were determined to be from other causes. They died during the trial, not because of the trial.

In spite of vaccination’s overwhelming success in preventing horrific disease and death, the road to public acceptance of vaccines has been tough. Today, anti-vaccination movements are highly vocal, developing large platforms on social media, organizing demonstrations and protest marches. These groups are trying to derail efforts to fight the COVID-19 pandemic.

Vaccination skepticism is not new! In fact, before Jenner’s discovery, there were people opposed to variolation. When the smallpox vaccine was discovered objectors said it was “unchristian” because it came from animals. Others did not trust medicine and many people objected because they believed vaccination violated their personal freedom.

Great Britain’s Vaccination Act of 1853, made it compulsory for all children to be vaccinated against smallpox during their first 3 months of life. Parents who refused to vaccinate their children were fined. This sparked violent riots and the Anti-Vaccination League was founded in the same year.

There is also evidence of early inoculation (then called variolation) in China, Africa and India but Edward Jenner, a country doctor developed the first successful vaccine in 1796 in England. Smallpox epidemics were very common in the 18th and part of the 19th century. They had a high mortality rate and claimed thousands of lives.  

Jenner, who as a schoolboy, had a nasty experience when he was variolated, wanted to find a safer and more effective way of preventing smallpox. Being a rigorous scientist, he observed that milkmaids who had caught cowpox appeared to be protected from getting smallpox.  

Jenner tested his hypothesis (theory) by inoculating a boy with cowpox pus and then exposing him to a mild dose of contagious variola, the virus that causes the deadly smallpox disease. To his great joy, his method worked and the boy was protected against smallpox. 

His discovery and the eventual global eradication of the disease in the 1970’s is ranked amongst the greatest achievements in human medical history.

The iconic image below, published in 1901, was taken by Allan Warner, a doctor at the Leicester Isolation Hospital.
 It shows the horror of disease and the clear evidence of vaccination at work.
Both boys were exposed to the smallpox virus but only the boy on the right had been vaccinated against the disease when he was an infant. The parents of the boy on the left, influenced by anti-vaccination sentiments, refused the vaccine for their child. At the time the disturbing image was used to encourage people to take the vaccine to prevent the terrible symptoms of smallpox and death.

Vaccination is a key component of the primary health care system and an indisputable human right. It’s also one of the best health investments money can buy. According to the WHO and UNICEF, immunization saves 2 to 3 million lives every year and has prevented lifelong disabilities. It could prevent an additional 1.5 million deaths if global vaccination coverage is kept at the required levels for herd or population immunity.

 The considerable effort to rid the world of one of its worst and most widely spread diseases would take centuries but, in 1980, the World Health Organization (WHO) finally announced its total eradication with the words “Smallpox is dead!” Jenner’s mission was accomplished.

Meanwhile, polio still exists but cases have dropped by over 99% since 1988. The WHO announced on 25 August 2020 that Africa was free from wild poliovirus, leaving just two countries where the virus remains endemic – Afghanistan and Pakistan. An outstanding achievement.

Before any vaccine is approved for use, it needs to go through rigorous scientific testing in three clinical trial phases for safety and efficacy. Most importantly, before recruiting volunteers for the various trial phases researchers need to set out their objectives, what they are aiming to achieve, when they plan or design a trial. These are called endpoints. Clinical trials typically have a primary endpoint. Additional objectives and endpoints are secondary.

Every vaccine under development must first undergo screenings and evaluations to decide which antigen should be used to produce an immune response.  An experimental vaccine is first tested in animals to evaluate its safety whether or not it triggers an immune response. The preclinical phase is done without testing on humans because of the obvious potential risk to life. Animals including rodents and monkeys are used to study human disease because of their similarity to us in terms of genetics, anatomy and physiology. Also, animal models are often preferable for experimental disease research because of their unlimited supply and ease of manipulation. Only if the vaccine is safe in animal models can it be tested in humans in clinical trials. 

Phase1-The vaccine is given to a small number of volunteers to assess its safety, confirm it produces an immune response, and determine the right dosage. Generally, in this phase vaccines are tested in young, healthy adult volunteers.

Phase2-The vaccine is then given to several hundred volunteers to further assess its safety and ability to generate an immune response. Participants in this phase have the same characteristics (such as age, sex) as the people for whom the vaccine is intended.

Phase 3-The vaccine is next given to thousands of volunteers – and compared to a similar group of people who didn’t get the vaccine, but received a placebo – usually saline (saltwater) which is made to look like a vaccine but is not the vaccine.  This phase is to test if the vaccine has efficacy or works against the disease it is designed to protect against (e.g. COVID-19) and to study its safety in a much larger group of people

On average it takes 10 years to develop a vaccine. Covid-19 vaccines have been developed in under two years. This speeded-up process is a reason some people distrust Covid-19 vaccines. The development of COVID-19 vaccines is faster because scientists have worked with coronaviruses for decades. Some Phase 1 and 2 trials have also been run at the same time. Many resources (money and scientific staff) have been put into finding a COVID-19 vaccine to deal with the pandemic emergency. 

The problem is not that the COVID-19 vaccine was developed too quickly! In fact, it’s that other vaccines have been developed too slowly.

 PfizerBioNTech–COVID-19 mRNA vaccines give instructions for our cells to make a harmless piece of the spike protein. Once the instructions (mRNA) are inside the immune cells, the cells use them to make the protein piece. The cell then breaks down the instructions and gets rid of them. Next, the cell displays the protein piece on its surface. Our immune systems recognize that the protein does not belong there and triggers an immune response and makes antibodies. In this way our bodies learn how to protect against future infection. Those who are vaccinated are protected from getting sick with COVID-19 disease

Mordena–COVID-19 mRNA vaccines give instructions for our cells to make a harmless piece of the spike protein. Once the instructions (mRNA) are inside the immune cells, the cells use them to make the protein piece. The cell then breaks down the instructions and gets rid of them. Next, the cell displays the protein piece on its surface. Our immune systems recognize that the protein does not belong there and triggers an immune response and makes antibodies. In this way our bodies learn how to protect against future infection. Those who are vaccinated are protected from getting sick with COVID-19 disease.

Gamaleya-Sputnik V-Viral vector-based vaccines do not contain antigens, instead they use the body’s own cells to produce them. The Gamaleya Institute researchers in Russia do this by weakening the adenovirus (Ad26 and Ad5) that causes the common cold. The adenovirus is then used as a vector – think of a truck – to deliver – the genetic code for COVID-19 spike proteins into human cells to develop an immune response. The first Sputnik V shot uses Ad26 as the vector for the coronavirus surface protein, called spike, while the second uses Ad5. The vaccine mimics what happens when the real coronavirus enters the body. But the vaccine has trained the body to fight the virus without you getting ill. Another example of a viral vector vaccine is the rVSV-ZEBOV vaccine against Ebola.

Johnson& Johnson—Viral vector-based vaccines do not contain antigens, instead they use the body’s own cells to produce them. J&J researchers do this by weakening the adenovirus (Ad26) that causes the common cold. The adenovirus is then used as a vector – think of a truck – to deliver – the genetic code for COVID-19 spike proteins into human cells to develop an immune response. The vaccine mimics what happens when the real coronavirus enters the body. But the vaccine has trained the body to fight the virus without you getting ill. Another example of a viral vector vaccine is the rVSV-ZEBOV vaccine against Ebola.

AstraZenca-Oxford—Viral vector-based vaccines do not contain antigens, instead they use the body’s own cells to produce them. AstraZeneca-Oxford researchers do this by weakening an adenovirus (ChAd) that causes the common cold. The adenovirus is then used as a vector – think of a truck – to deliver – the genetic code for COVID-19 spike proteins into human cells to develop an immune response. The vaccine mimics what happens when the real coronavirus enters the body. But the vaccine has trained the body to fight the virus without you getting ill. Another example of a viral vector vaccine is the rVSV-ZEBOV vaccine against Ebola.

Novavax–This vaccine uses a lab-made version of the SARS-CoV-2 spike protein. Novavax has inserted into the vaccine ingredient called an adjuvant, which gives the immune system an extra boost to spring into action. Novavax’s subunit vaccine traditional approach is a tried-and-true method for generating effective vaccines. Modern flu vaccines, Human Papillomavirus Vaccines (HPV), and Hepatitis B vaccines all use a similar approach. The vaccine mimics what happens when the real coronavirus enters the body. But the vaccine has trained the body to fight the virus without you getting ill.

Sinopharm-These traditional vaccines are different in that they use the whole virus and not pieces of the virus (spike protein.) Instead, researchers make this vaccine by inactivating, or killing, the whole virus. The inactivated virus can still produce an immune response and as with other vaccines it does not cause the vaccinated person to become sick. This vaccine uses a tiny amount of an adjuvant which boosts the immune systems response to the vaccine. The inactivated polio vaccine is an example of this type of vaccine.

References Internews: Lets Talk Vaccines, WHO:Vaccines

Enos Denhere is an accomplished Journalist, advocate on social Justice and Entrepreneur.  He is the brain behind ‘Rebuild Africa’ advocacy. You can sponsor us so we can keep on writing for you and able to take the vision to greater heights. Email enosdenhere@gmail.com Call/WhatsApp +263773894975

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