The receipt of six thousand doses of the AstraZeneca vaccine and vaccination of frontline workers is an encouraging sign that could signal a turn of the tide in the battle against the Covid-19 virus.
However, this could be deceiving since there are many unanswered questions relating to the vaccines currently on the market and unknowns of the fast spreading variants like the UK and South African strain.
Government and policy makers need to be cautious and not let their guards down and give the virus or its mutations an opportunity to resurge and spread within the population.
The three vaccines, Pfizer, Moderna and AstraZeneca, currently being used to vaccinate persons around the world, have varying degrees of efficacy that is the extent to which they prevent serious disease and illness in a controlled environment.
Both Pfizer and Moderna vaccines are said to have efficacy around ninety to ninety five percent, while AstraZeneca is between sixty two to eighty five percent. On the other hand, vaccine effectiveness refers to how well these vaccines perform in the real world setting.
High efficacy in a controlled laboratory environment does not automatically correlate to the same level of effectiveness in society. Although these vaccines have high efficacy rates, there is insufficient data on vaccine effectiveness. More complete data sets will be forthcoming to make a determination, as the global vaccination campaign picks up pace.
None of these vaccines have sterilising immunity which means that they can’t get the body’s immune system to prevent Covid-19 from replicating in the body and prevent transmission. Therefore, even after someone is vaccinated that person can be infected and spread the virus to others.
At this point, the vaccines in use right now will protect you from getting really ill and dying. Scientist are not sure whether or not you will be protected from getting infected and spreading the virus. This may have prompted the World Health Organisation (WHO), chief scientist Dr. Soumya Swaminathan to call for persons to be cautious after getting inoculated with one of the vaccines for Covid-19.
Dr. Swaminathan told a recent press conference, “there was not enough evidence from vaccine trials to be confident that it is going to prevent people from actively getting infected and passing it on”.
According to her, persons who are fully vaccinated should still quarantine when travelling to countries with lower infection rates.
With that being said, the minister’s suggestion that consideration could be given for a reduction in the length of time for quarantine for vaccinated tourists is irresponsible and laid bare his lack of understanding of the issues surrounding vaccine efficacy, virus mutations and how they can affect vaccines effectiveness.
The minister and his team must keep the existing protocols in place, in particular the requirement for a mandatory second PCR test for all travellers including tourists to the island, until at least eighty percent of the population are vaccinated.
He must also ensure his team, using resources from WHO and other development partners, prepare a National Deployment and Vaccination Plan (NDVP) to enable the country to access the forty five thousand doses allocated to Grenada under the Covax facility.
The six thousand doses given to Grenada by Dominica and Barbados, the result of a gift from India to the two countries, after a bilateral initiative by their leaders, Prime Ministers Roosevelt Skerrit and Mia Mottley, and not as a result of an OECS meeting, is insufficient for a mass immunization campaign.
Timely delivery of the forty five thousand doses will go a long way in helping the island to achieve herd immunity.
The minister and his team should advise the Prime Minister to lobby for agreement on a joint procurement of more AstraZeneca vaccines from India and South Korea, and a future purchase of the Johnson and Johnson and Novavax vaccines that are soon to receive emergency use authorisation, during the upcoming Caricom Heads meeting.
A regional request could be made to South Korea, the second manufacturer of AstraZeneca, for vaccines in a similar manner as was done by Barbados and Dominica to India.
Some countries including Germany purchased millions of doses of vaccines from AstraZeneca, however are hesitant to use it because of its lower efficacy, insufficient information on efficacy within the age group sixty five and older and concerns over its ability to protect against the South African strain.
Caricom should seek to get couple hundred thousand doses from them as well in the spirit of cooperation and solidarity.
Moreover, it is their citizens who have contaminated and spread the virus to our populations, they must now on moral grounds help us protect ourselves. Vaccine nationalism must not be allowed to jeopardize the global fight against the virus.
The Prime Minister, in the upcoming intersessional meeting should get his colleagues to set up a high level Prime Ministerial subcommittee to focus on sourcing vaccines for the region through bilateral initiatives.
This is not time to be beating chest, six thousand doses of AstraZeneca, though we must be thankful to Dominica and Barbados, is a drop in the bucket considering it requires eighty percent of the population to be vaccinated to achieve herd immunity.
Although, the presence of vaccines represents light at the end of the tunnel, the light is fickle and the tunnel is long and riddled with obstacles. These vaccines are new and have only recently received emergency use authorisation, therefore the data on their effectiveness is limited resulting in many unknowns.
All three vaccines currently in use appear to be able to prevent serious illness and deaths, however they fail to protect from mild sickness and asymptomatic cases of Covid-19. Mild symptoms can lead to the phenomenon referred to as, ‘long covid’, which can be chronic and debilitating.
There is little evidence that persons who are vaccinated is less likely to get long Covid.
Also, these vaccines do not have sterilising immunity – the data doesn’t exist to prove they can prevent persons from getting infected and spreading the virus. In light of the many unknowns and misinformation spread on the internet by, ‘anti vaxxers’, it is understandable there will be vaccine hesitancy.
Making pronouncements during press briefings, having health officials publicly confirm they have taken the vaccine would not be enough to overcome vaccine hesitancy. This is a complex problem that requires a concerted effort by a wide range of stakeholders.
The current inoculation exercise or what is being referred to as an immunisation campaign lacks a proper public education component that could effectively address the problem of vaccine hesitancy.
This should be of serious concern to the minister and his team, because if large segments of the population do not get vaccinated, the effectiveness of the immunisation campaign would be compromised.
The situation will create gaps in immunisation that would give the virus an opportunity to spread. With the three mutations of the virus gaining significant foothold in populations around the world, these variants, and others not yet identified, are expected to negatively affect the vaccines.
The vaccines seem to be able to prevent the highly infectious UK variant, B.1.1.7, from causing symptoms in infected persons. However, the South African, B.1.35.1, and Brazilian, P.1.A, strains appear to be more problematic for the vaccines, since they are not able to stop these variants from causing disease.
The Brazilian strain is even more concerning because it tends to avoid immunity created by prior infections and some vaccines. Already, the South African and UK strains are in the region having been found in Jamaica and United States.
The Brazilian strain is now beginning to spread beyond Brazil and has been identified in the United States. With these strains on the loose in many countries around the world, local health authorities can’t afford to let their guards down.
As Sandals hotel, site of the last major outbreak on the island prepare to reopen, public health officials must step up enforcement of entry protocols to avoid another breach that could put the vaccination effort and economic recovery in peril.
The history of the Spanish flu tells us the region was heavily impacted during the third wave of that virus, towards the end of 1918 into 1919. When one looks at the dire situation in Jamaica, St. Lucia, Barbados, St. Vincent and Antigua, it reflects somewhat the same trajectory of the Spanish flu in the region.
Government must take pertinent policy actions to make sure Grenada doesn’t join those countries and experience community spread by either the original or one of the concerning mutated strains just as the global counter offensive against the virus begins.
With all that being said, health officials can’t act as if the tide is about to turn for the better because how fast the new strains spread, how well current vaccines protect us from them, how well new vaccines can be designed to attune to mutations that emerge overtime, will determine the course of the pandemic.
This is definitely not the time to become complacent. Although, the curfew now starts at twelve midnight, Sandals are reopening, frontline workers are being vaccinated; entertainment centres and bars must not be allowed to play amplified music and have patrons dance pressing tightly against each other in tightly confined spaces.
Entry protocols should not be amended to favour the tourist lobby, and the population must not drop their guard on wearing masks, sanitising hands and social distancing when in public.
We must stick to what has allowed the country to keep the infections rate, hospitalisations and deaths extremely low.