Dear Zambians, would you take the Covid 19 Vaccine if offered?

By Dr Parkie Mbozi

AFTER months of working around the clock to develop and test vaccines against SARS-CoV-2, the causative agent of COVID-19, the scientists’ hard work has finally paid off. So far three vaccines are under distribution, first – Oxford ChAdOx1-S – in the United Kingdom, and now – Pfizer/BioNTech (mRNA) and Moderna -in the United States. More countries are in a preparatory phase for takeoff and a few African countries have so far paid their vaccine bills, signaling that the vaccine is on its way to Africa, and eventually Zambia.

Here is the reason why vaccines are so crucial to the fight against Covid 19. In just over 12 months since the pandemic broke out, as of 22^nd of December 2020, Covid 19 had infected an estimated 77,716,246 and claimed 1,708,924. About 54,591,959 had recovered from the disease. Although Africa’s contribution to the global cumulative total has been relatively marginal, just below 3.5% of both infections and deaths, there are realistic concerns that the continent cannot cope with a full-blown outbreak.

Experts agree that widespread use of safe and effective vaccines will rapidly contain the COVID-19 pandemic, which is spreading like wild fire especially under the second wave. The Covid 19 virus has already mutated and its variant, reported already in countries such as UK and South Africa, is reportedly 70 times more infectious than the original strain. The global community is resigned to the view that a vaccine is the only panacea to containing the spready of the pandemic.

The question though is, how many of Africans and Zambians are ready to take a Covid 19 vaccine when it finally arrives? I analyse this question given lack of a local study on this subject and in the context of the myths and misconceptions associated with vaccines in general and Covid 19 vaccine in particular. Immunization is a voluntary call. Therefore, how the public perceive of a vaccine, or any medication for that matter, affects it uptake. Below are some of myths and fears that have been widely recorded across the globe and the assurances from the regulatory authorities, in particular the United States Food and Drug Administration (FDA), and scientists.

Myth 1: The vaccine isn’t safe because of how fast it was created

There is widespread concern about whether the requirements to approve the vaccines on an emergency basis have been as stringent as could have been under non-emergency scenario. I have also heard from people around me questioning why there is no vaccine for HIV, which has been around us since 1984. Others have asked whether there were enough trials on the African continent, specifically on black people. Only Egypt and South Africa are reported to have participated in the vaccine trials.

To allay these concerns, the FDA clarifies that the COVID-19 vaccines were adequately evaluated to make sure the benefits outweigh the risks, just as with any other vaccine submitted to them for approval. A statement by the FDA further points that. “Despite its relatively quick creation and emergency approval, both the Moderna and Pfizer COVID-19 vaccines had to meet the FDA’s vaccine criteria which include a clinical trial. Between both vaccines, almost 70,000 people participated in the clinical trials. Before a vaccine is approved for emergency use, non-clinical, clinical, and manufacturing information is reviewed by a data safety monitoring board.”

The FDA assures that it “will continue to monitor those vaccinated for severe side effects, hospitalizations, and death” and also sas “it expects drug manufacturers issued emergency use for COVID-19 vaccines to continue collecting data for future approval.” Satisfied?

Myth 2: COVID-19 vaccines can cause people to have serious side effects like Bell’s Palsy

The fear of side effects has been expressed among a lot of people world-wide. Others have alluded to conspiracy theories, such as that certain races could be targeted for sterilization to reduce the global population. This is a major source of the concern among blacks in the USA, which has prompted some prominent African-Americans to publicly take shots of the Covid 19 vaccine to try and allay these fears.

Reports from clinical trials and the ongoing vaccination in the USA confirm minimal side effects from both Moderna and Pfizer/BioNTech vaccines. However, the manufacturers have argued that the benefits far outweigh the side effects. The most common side effect for the Pfizer vaccine was an injection site reaction, felt in 84.1% of cases. The most common side effect for the Moderna vaccine was injection site pain, felt in 91.6% of trialists.

It is reported that only seven people, out of the more than 60,000 who participated in the vaccine clinical trials, experienced Bell’s Palsy – four in the Pfizer and three in the Moderna clinical trials. Bell’s Palsy is a condition that causes a temporary weakness or paralysis of the muscles in the face, according to the National Institute of Neurological Disorders and Stroke of the USA. The manufacturers say that the symptoms in most patients are temporary and improve within a couple of weeks.

Myth 3: People with underlying health conditions shouldn’t get vaccinated

The myth stems from the misconception that the vaccine could worsen the underling conditions of the affected individuals.

To the contrary, the Centre for Disease Control (CED) of the USA recommends that individuals living in long-term care facilities get the vaccine first to protect them from the virus. This is because individuals with underlying health conditions or comorbidities are susceptible to severe complications from COVID-19. Priority is being given to the vulnerable populations before the rest of the general public. Health care workers and those above 65 years of age fall in this category.

Myth 4: People who have had COVID-19 do not need to get the vaccine

There is debate about how long an individual’s “natural immunity” lasts after getting COVID-19. The FDA and CDC both agree that more research is needed to determine a person’s immunity after a COVID-19 diagnosis but recommend those who have already been sick to get the vaccine anyway.

Myth 5: COVID-19 vaccines contain tracking microchips or “nanotransducers”

This myth morphed into a conspiracy theory after Bill Gates suggested creating a “digital certificate of vaccine records.” Media analysts argue that Gates has been the top subject of COVID-19 misinformation since early in the pandemic, some of which ae steeped in his obsession with computer viruses.

South Africa’s Chief Justice Mogoeng Mogoeng, a devout Christian, for instance, said the following in a prayer at an event in Johannesburg on two weeks ago to honour people who died from Covid-19 in his country, “I lockout every demon of Covid-19, I lock out any vaccine that is not of you, if there be any vaccine that is of the devil meant to infuse 666 in the lives of people, meant to corrupt your DNA,” he said in the prayer.

Despite a backlash, Mogoeng defended his position. “You can’t say we must, as Christians, just fold our arms and say ‘whatever people come with’ is fine. No. We can’t” he said and added that, “If there is a vaccine with 666, I want God to destroy it. If there is any vaccine meant to corrupt the DNA of people, I’m asking God to interrupt it. Any clean vaccine, they must produce it quickly.”

The FDA has assured that the COVID-19 vaccines do not contain tracking microchips or “nano transducers” that control the brain or can download personal information. Gates himself ridiculed this conspiracy theory, “It’s almost hard to deny this stuff because it’s so stupid or strange that even to repeat it gives it credibility.” Whether the doubting ‘Thomases’ are convinced is another matter.

Myth 6: Getting a COVID-19 vaccine will make people sick

The CDC clarified that vaccines work because the body learns to recognize and fight whatever disease it’s being vaccinated against. COVID-19 vaccines help the body identify the virus in order to build the body’s immunity, or help the body fight the virus. The vaccines do not contain a “live” virus. Side effects like fever, muscle, or joint pain are signs the body is building immunity. However, a person can become infected with the virus while still building immunity, according to the CDC.

Myth 7: People won’t have to wear a mask or social distance after getting vaccinated

The CDC is recommending people continue to wear a mask, social distance, and wash their hands frequently, including those who have received the vaccine, until scientists have had a chance to gather more research. The CDC advises that the combination of Covid 19 vaccination and sticking to the health guidelines offer the best protection from COVID-19.

Recent Studies on Uptake of Covid 19 Vaccine

These myths, misconceptions and fears have prompted launching of acceptability and perceptions studies. A recent poll by the Associated Press and the University of Chicago found that in the USA, as few as 50% of people in the United States were committed to receiving the vaccine, with another quarter wavering (not sure). Some of the communities most at risk from the virus were also the most hesitant. Among Black people, for instance, only 40% said they would not get a vaccine while 32% were not sure. Acceptability tended to be higher among older people.

A global study covering 13,426 people in 19 countries with a high COVID-19 burden, with South Africa representing Africa, found acceptance rates ranging from almost 90% (in China) to less than 55% (in Russia). The study also found lowest acceptability among those with lower education and income levels. It also found wide variations in vaccine acceptability across countries and regions of the world. The authors concluded that, “Unless and until the origins of such wide variation in willingness to accept a COVID-19 vaccine is better understood and addressed, differences in vaccine coverage between countries could potentially delay global control of the pandemic and the ensuing societal and economic recovery.”

The authors further concluded and advised that, “In most of the 19 countries surveyed in our study, current levels of willingness to accept a COVID-19 vaccine are insufficient to meet the requirements for community immunity. To build increased trust among the general population, the elements that define and build trust must be understood and interventions crafted accordingly. It is increasingly clear that transparent, evidence-informed policy and clear, accurate communication will be required of all relevant stakeholders. The ongoing pandemic provides the public health community with an important opportunity to build vaccine literacy and confidence to support the uptake of a potential COVID-19 vaccine, as well as to bolster overall immunization programs for all vaccine-preventable diseases.”

Dr Chitalu Chilufya and MoH, please take heed.

The author is a Research Fellow with the Institute of Economic and Social Research, University of Zambia. He is reachable on pmbozi5ATyahooDOTcom. Some of the data used is lifted from Wikipedia and other online sources.