OF SUBSTANCE AND SPIRIT
(Last of two parts)
Last week’s column discussed the vaccine’s effectiveness and safety, given its rather short vetting period. This limited testing time also makes it premature to immediately call for their free-flowing supply. It is incumbent for country leaders to temper expectations and call for caution and circumspection. Long-term side effects have not been fully established. Moreover, over-dependence on any released vaccine may have great risks.
Lives are at stake.
Perhaps knowing the risks, last December 6—in jest or in seriousness—Senator Bong Go challenged Health Secretary Francisco Duque and vaccine czar Carlito Galvez “to take the first shots to encourage Filipinos to avail of the coronavirus vaccines once they become ready for rollout next year.” Not one, but two doses.
To be fair to both Duque and Galvez, the Food and Drug Administration (FDA) should first vet any vaccine presented for distribution and use. Once completed, Duque and Galvez should, by all means, inspire confidence among our suspicious citizenry. It is their duty. In the meantime, we can afford to wait—and watch—before we ourselves are vaccinated.
There is every reason for us to go gently into vaccination.
In the US experience, both Pfizer/BioNTech and Moderna/National Institutes for Health claim that their vaccines score higher-than-the minimum benchmarks for effectiveness. But experts had to also test their safety.
On this, President Trump’s vaccine czar indicated that only 10-15 percent of the volunteer recipients exhibited “significantly noticeable” side effects but for onlya day or two.
Moderna’s Phase 3 vaccine trials yielded 10 percent of participants experiencing fatigue; 9 percent reported muscle aches; and 5 percent complained of joint pain and headaches. In the case of Pfizer, there was fatigue among 3 percent of participants and headaches in 2 percent.
It is good for both the authorities and medical suppliers to be transparent to leave no space for surprises. Side effects may be expected. Side effects are not unique to COVID-19 vaccines. Even the common flu shot is accompanied by fatigue and fever. Vaccines against shingles can produce shivering, muscle pains and even upset stomach. Medicine for hypertension could weaken the kidneys and the liver.
Winning and keeping public trust is critical for people to get vaccinated. Since two doses are required to be effective, unanticipated side effects might discourage people from getting the full dosage. Half-administered doses might make them more vulnerable to future infections. This emasculates the vaccine, rendering the claimed 90 percent effectiveness meaningless.
Apart from other unknown side effects, other factors prevent people from considering vaccination.
Last week, Dr Edsel Maurice Salvana, director of Molecular Biology and Biotechnology at the National Institutes of Health at the UP Manila and professor and research coordinator at the Philippine General Hospital, decried the proliferation of anti-science conspiracy theories. They posit that COVID-19 is a hoax and the vaccines dangerous even after “more than one and a half million people have died from COVID-19.”
These conspiracy theories could prevent lives from being saved and hinder economic bounce back.
Early last month, the Centers for Disease Control and Prevention showed several types of vaccines. Of these, the major type developed by pharmaceutical companies is the mRNA or genetic vaccine. This vaccine is fast and relatively inexpensive to develop. Millions of doses could be produced quickly. They have also proved to be highly effective.
There are only two setbacks. One, they have no track record for obvious reasons. And two, they require super-cold storage which makes global distribution problematic.
But there is a more fundamental objection. The mRNA vaccines, or messengerRNA, contain material from the COVID-19 virus that gives the cell instructions on how to make a harmless protein unique to the virus. After the cells copies the protein, they destruct the genetic material from the vaccine. Human bodies recognize that the protein has no business being there and builds B and T lymphocytes to fight it. The B lymphocytes are defensive white cells that produce antibodies against the virus. The T lymphocytes are also defensive white blood cells that attack infected body cells. Both lymphocytes establish immunity. But people fear this vaccine could generate irreversible genetic modifications.
To this, Dr. Silvana and other experts argue that humans do not have the so-called “reverse transcriptase enzyme” that turns RNA into DNA. He also clarified that there is no aborted fetus material in some of the vaccines. There are no so-called HEK 293 cells allegedly produced from an aborted fetus in the 1960s. Finally, Dr Silvana clarified that steps were not skipped in vaccine development. Rather, the quicker pace was possible through the use of technology and repurposed SARS and MERS vaccines which were already in advanced stages of development.
One concern is that the Philippines would be left behind. A few days ago, Indonesia announced it received its first shipment of COVID-19 vaccines from China. It is now preparing for mass inoculation. Indonesia has been testing the vaccine since August, 2020. Indonesia is not alone in testing the Sinovac vaccine. Brazil and Turkey are also doing their homework.
Beyond these initial deliveries, Indonesia will be receiving a shipment of raw materials to produce 15 million doses in December, and another shipment for 30 million doses in January, 2021.
Another concern is the quality of specific vaccine we might be getting. Washington Post recently reported that “Sinovac Biotech had been found to have a record of bribing Chinese drug regulators to secure vaccine approvals, which had raised serious questions about its product’s safety.” This is the same company that shipped vaccines to Indonesia, and is being considered as a possible vaccine supplier of 50 million doses for the Philippines. At $30 per dose, the country will be spending $1.5 billion or P75 billion.
The other side of the vax is therefore the question of safety. While we yearn for life and activities to go back to normal, learning to live with it—by religiously physically distancing, avoiding crowded areas, wearing face masks and shields, not touching our faces and meticulously washing our hands often, remains a reasonable option before safe mass vaccination comes of age.
The other side of the vax is indeed learning how to dance and live with the virus in the new normal.