12th May 2021

Staff report


LAHORE

Are coronavirus vaccines just one big scam?

Many people in Pakistan seem to think so, from healthcare workers who initially resisted the first rollout of the Chinese state-manufactured Sinopharm vaccine to locals that, even in the third wave of the pandemic, refuse to believe that a virus even existed in the first place.

On May 3, National Command and Operations Center (NCOC) Chief and Federal Minister for Planning, Development and Special Initiatives Asad Umar took to Twitter to announce that Pakistan was vaccinated 150,000 people a day – only have of its daily inoculation target. However, by May 4 the number swelled to 165,000 and the following day Pakistan recorded over 200,000 vaccinations in a single day.

However, barely over one percent of the population has been inoculated against the novel coronavirus disease in the past three months since the arrival of the first batch of Sinopharm doses on February 2. With a target of 70 million vaccinated citizens by the end of the year, can the Government convince a population inundated with confusing information and fake news about existing COVID-19 vaccines and increase vaccine registrations?

RUMOURS ABOUND

Among the more popular myths about the pandemic is that existing vaccines are ineffective against variant COVID-19 strains, which now comprise most of the infections being reported across the world.  Dr. Faheem Younus, Chief of the University of Maryland Upper Chesapeake Health’s Division of Infection Diseases, laid rest to concerns by providing that all vaccines currently being administered in different countries across the world work against the original virus as well as its variants.

“The variants will eventually die,” he insisted. He added that all vaccines have so far been quite effective against current variants however the South African variant has proven to be a little more robust for existing vaccines to handle. However, for Pakistan at least there was little cause for worry right now as it had not yet spread here.

“The speed with which the original strain, which we know as the Wuhan virus, was far slower compared to its variants which are 50 percent more transmissible – that number could be higher. But the belief that these variants will keep on coming and they will never go away is fundamentally wrong.”

By steadily increasing the immunity of a community by vaccinating them, the sooner the virus will be in remission. But convincing an already sceptical and suspicious populace that have prior to the outbreak of the novel coronavirus disease have resisted Pakistan’s poliovirus inoculation programme is an uphill task where so much misinformation is abound regarding the properties and effects of existing vaccines.

“Any vaccine is better than no vaccine,” Dr. Younus asserts. “And the faster we increase vaccinations, the faster we can return to a permanent normalcy.”

DOES THE VACCINE INCREASE ANTIBODY COUNT?

“We should not even bother to check antibodies because antibodies are not a reliable marker [for COVID-19 immunity]. If one gets test done when it is not even recommended, it will only serve to raise doubts and create confusion,” stated Dr. Younus. Although he understood that his idea may not be digestible to some, he urged people to have faith in the science that developed, tested and approved vaccines. “We know these vaccines work because they were trialed on thousands of volunteers [before they were rolled out]. It was when our infection tally began dropping that we were certain that the vaccine works.”

He reiterated that getting an antibody test in this regard was a waste of money and causes unnecessary stress.

“People should have a little more trust in a vaccine that went through so much research and extensive trialing. Although people have every right to get antibody tests, but then they are also free to interpret what their test results mean.”

Special Assistant to the Prime Minister on Health Dr. Faisal Sultan considered questions regarding antibody testing the most frequently asked, and agreed with Dr. Younus’ stance that antibody counts after getting vaccinated mean nothing.

“When a vaccine is being tested and trialed, we do not look at antibody development. We look at who became ill and who did not, how many deaths were recorded etcetera,” he said, terming antibody testing as a secondary measure and asserting that there is no pressing need to get such a test done after being vaccinated against the novel coronavirus disease. However, he lamented that Pakistan’s medical community was endorsing antibody testing to the wider public.

“Antibodies comprise just one small part of our incredibly complex immune system. To judge our immune system with a small test is a waste of one’s time and money. There is no scientific justification to have this test done,” he said. “A better way to go about this is to get vaccinated. There is no need for any further tests.”

IS A THIRD SINOPHARM DOSE NECESSARY?

In mid-March, the UAE began administering a third dose of Sinopharm’s COVID-19 vaccine to select citizens after healthcare professionals reported that the standard two doses were not raising the immunity among a few people to acceptable levels.

On April 5, in a media briefing Dr. Faisal Sultan termed the UAE Government’s decision an important ‘fine tuning’ of their inoculation plan, and stated that Pakistan may also adopt a similar strategy but at a later stage.

But will a third dose be administered to any identified groups? Dr. Sultan responded in the negative, saying that there are currently no health guidelines that mandate this.

“Science is always evolving, we will have to analyse and then decide on it,” he said, pointing to clinical trial data for Sinopharm where there was evidence of about 80 percent protection rate among people who received the vaccine as opposed to a placebo. “Antibodies were not tested during these trials. The actual level of protection during actual events, i.e. how many people contracted the disease and how many did not.”

CAN PREGNANT WOMEN GET VACCINATED?

Dr. Younus reiterated the breadth and depth of the research conducting in formulating effective vaccines, and that the thousands of people who had undergone clinical trials for myriad vaccines also included pregnant or lactating women. He also cited an April 21 study published in the New England Journal of Medicine, where no serious side effects or higher rate of complications (such as preterm labour or miscarriages) were reported among pregnant women who were inoculated with a COVID-19 vaccine.

“Whenever a new vaccine is available, extra caution is necessary when it comes to administering it to small children and women. But when there is a pandemic, we need to balance the risks and benefits [of vaccines],” Dr. Faisal Sultan provided. “To my understanding, the risk for pregnant women is pretty much nil.”

He added that the Government of Pakistan has altered its initial guidelines to reflect this, and urged pregnant women to get vaccinated.

IS ASTRAZENECA SAFE FOR PEOPLE AGED BELOW 40?

On May 8, the Ministry of National Health Services announced that the Oxford-AstraZeneca vaccine ADZ1222 will not be administered to females under the age of 40. However, after a review the Government of Pakistan announced that according to new interim guidelines, the aforementioned vaccine would not be delivered to males and females under the age of 40.”

“Every country measures risks differently, however the risk [of developing complications] with AstraZeneca among people aged below 40 is extremely low. It’s one-in-a million,” Dr. Younus debunked rumours that the Federal Government’s move to restrict citizens aged below 40 was because of health risks. Rather, he understood that this decision may have been made for operational purposes.

“In my personal opinion in the next three to six months, if you put a gun to my head, I would say that AstraZeneca will be a workhorse: it will be extensively used the world over and benefit many a country,” he said, expressing relief over media coverage of clotting in a handful of cases. “We will now be able to quickly determine what results in these rare cases and treat them accordingly.”

Dr. Sultan also clarified that the recommendation to restrict AstraZeneca’s vaccine for a certain age group is an interim guideline to ensure a smooth rollout process and to avoid frequent changes to guidelines that may promote confusion among the public.

“According to available data, the incidence of side effects among people under 40 is few and far between,” he said, agreeing with Dr. Younus. “We still have so many people above the age of 40, we think the vaccine can easily be utilised for them.”

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