There is a fair amount of coffee shop chat (when they are open, that is) regarding how things will change when a Covid-19 vaccine becomes available.
Some appear to think that it is a final solution that will allow us to return to normal and allow the economic engine to churn at full force.
Unfortunately, any such vaccine is unlikely to be a panacea for our disrupted lives, and many factors need to be looked into.
What is a vaccine?
Vaccines are medicines that are used to prevent certain types of diseases.
Via a vaccine, our immune system is exposed to antigens that are usually derived from parts of a virus or bacteria.
This exposure triggers a reaction that leads to our immune cells creating antibodies.
These antibodies are kept in store, to be unleashed when the actual virus or bacteria attacks our body.
In other words, vaccines train and prepare our immune system for the day when it needs to fight off an actual infection.
Smallpox, which once destroyed countless lives, has been eradicated via vaccination.
Many other diseases such as diphtheria, measles, mumps and rubella, have stopped devastating lives as a result of widespread vaccination programmes.
Vaccines usually take up to ten years to develop.
The speed in which the world has come together to create vaccines against the SARS-CoV-2 virus that causes Covid-19 is unprecedented.
While most experts believe that a vaccine will be ready by the first half of next year, this will very much depend on how effective and safe the vaccine is proven to be.
At the time of writing, there are 11 ongoing phase 3 clinical trials looking into the safety and efficacy of various potential Covid-19 vaccines.
The US Food and Drug Administration (FDA) and the World Health Organization (WHO) have stated that emergency approval will be given for a vaccine if it demonstrates itself to be 50% more effective than a placebo at preventing Covid-19.
A placebo is a substance with no therapeutic effect given as a control to clinical trial participants so that they do not know whether they are getting the treatment being tested or not.
One reason for the use of placebos is to rule out the placebo effect, where trial participants feel better or worse because of the imagined effects of the treatment on them.
What is herd immunity?
The term “herd immunity” refers to the concept where a population is protected from a certain pathogen if a certain threshold of immunity is reached.
If most of the population is immune to the SARS-CoV-2 virus, for example, whether via vaccination or uncontrolled exposure, the overall amount of virus within the population becomes lower and the virus will not be able to spread from person to person.
In an ideal world, everyone should be vaccinated against Covid-19 to achieve this as uncontrolled exposure will result in far too many deaths and disabilities.
However, there are those who may not be able to be vaccinated safely, e.g. immunocompromised patients, pregnant women and very young children.
This is where herd immunity can play a role in protecting these vulnerable people.
Herd immunity is usually reached when 70% to 90% of the population is immune to a disease.
However, the threshold depends on many factors, including how contagious the disease is.
Even if herd immunity is achieved, it will not be uniform across the population, thus allowing smaller outbreaks to continue.
Who should get a vaccine?
As it is unlikely that we will be able to vaccinate everyone during the early period of getting a vaccine, we need to prioritise.
Most countries will focus on those who are at highest risk of contracting the virus.
These include frontliners, the elderly and those with underlying chronic diseases, such as poorly-controlled diabetes and kidney failure.
At this point in time, we do not know if only a single shot of the vaccine is required or multiple doses.
Given the fact that the disease has only been around for less than a year, scientists can only work with the available data.
Having said that, antibodies developed from vaccines against respiratory viruses do sometimes wane over time.
If this results in decreased protection, then repeated or booster injections may become necessary.
There are other factors that need to be taken into consideration as well, such as procurement, financing, registration, approval, storage, distribution and deployment of vaccines.
The logistical matters are essential and will be coordinated by the Special Committee on Ensuring Access to Covid-19 Vaccine Supply, which will be co-led by Science, Technology and Innovation Minister Khairy Jamaluddin and Health Minister Datuk Seri Dr Adham Baba.
What about anti-vaxxers?
The WHO has declared “vaccine hesitancy” as one of the top ten threats to global health.
The reluctance or refusal to vaccinate despite the availability of vaccines may appear to be a small matter, but it is important to remember that vaccines prevent up to three million deaths a year, alongside a decrease in healthcare complications and costs.
Unfortunately, there has been an increasing move over the past few years to cast doubt on vaccines.
This is one of the reasons why measles has seen a 30% increase in cases globally.
There are multiple reasons why people choose not to vaccinate.
A WHO vaccines advisory group identified complacency, inconvenience in accessing vaccines and lack of confidence as key reasons.
Safety is also usually a concern.
An Ipsos poll for the World Economic Forum showed that 85% of Malaysians are willing to get a Covid-19 vaccine when it becomes available.
Approximately half of the remaining 15% had concerns regarding safety issues.
This highlights the importance of clear and transparent communication from the government and healthcare professionals when it comes to vaccine dissemination.
It is essential that ideas, concerns and expectations about vaccines are addressed proactively.
While not everyone can be assured with logic, it is worthwhile being transparent about the available data and information so that individuals can make an informed choice.
What do we do now?
The pandemic we are facing has disrupted our lives in many ways.
Besides the daily healthcare toll, countries across the globe are facing economic crises and a whole generation of youth have had their education affected.
Countries that have performed better are those who have robust public health responses that focus on prevention, as well as identifying, isolating and treating Covid-19 cases quickly.
The evidence is clear: an economic recovery is only possible with appropriate public health measures.
A vaccine will be an advanced scientific tool that will help control this pandemic, but ultimately, the mundane will be more essential in this role; it boils down to us living the new normal of physical distancing, wearing a face mask and washing our hands regularly.
Dr Helmy Haja Mydin is a respiratory physician and chief executive officer of the Social & Economic Research Initiative, a thinktank dedicated to evidence-based policies. For further information, email firstname.lastname@example.org. The information provided is for educational and communication purposes only. The Star does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in this column. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.
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