The COVID 19 vaccine: Fear it not!

  • Simon Paul Attard Montalto

Abstract

As a paediatrician I see children and speak to parents, who frequently recount how the pandemic has adversely affected their lives and livelihood, with many describing ‘hard times’ in relation to their family, job, travel, income, disposable wealth, etc., etc. Invariably, the question “How will it all end?†crops up and directs the discussion toward vaccination. Despite having just described the ‘hit’ that they have sustained, medically or economically or both, and even before any discussion on the rationale and benefits of a vaccine, I am repeatedly surprised by many parents’ immediate comment that “They fear and will not take the vaccine†and, equally concerning, that they “. . . will be reluctant to give the vaccine to their childâ€. This position is by no means exceptional, and stems from an inherent fear of something new that is relatively untried, and is compounded by misunderstanding from or confusion within the general and social media (less so in the regulated and mainstream channels), as well as unsubstantiated claims from anti-vaxxers.

Interestingly, many parents who raise concerns regarding the COVID vaccines, have very few problems with the anti-meningococcal vaccines, even though the diseases covered are significantly less common than COVID infection, kill far fewer patients over a given period and,1,2 in some cases (e.g. Men B vaccines), these vaccines carry a much greater adverse event profile.3 The word ‘meningitis’ appears to generate an all-encompassing fear that justifies everything whilst, inexplicably, ‘COVID’ does not!

So, should we fear the COVID vaccines? Certainly, for those vaccines developed by large international companies who have been involved in this work for decades, and have published their data for general and expert scrutiny, the answer is no. Efficacy rates of between 70-90% and very low risks of reported adverse events and allergic reactions (for the AstraZeneca and Pfizer vaccines, for example),4-5 makes these amongst the most promising and safe when compared with numerous vaccines already established and in routine use for other diseases. The fact that the development of these vaccines was fast-tracked, reflects the seriousness and adverse impact on a global level of COVID-19, and does not mean that short-cuts have been taken. Again, for those vaccines where detailed published data is available, established or advanced vaccine technology has been applied, clinically and scientifically sound methodology adhered to, and pre-licencing rigorous checks and scrutiny enforced as with any new medication, including vaccines.5 Indeed, together with a postgraduate PhD student, we have been personally involved in a multi-centre meningococcal C vaccine coordinated by the Oxford Vaccine Research Group over a number of years,6 and can reassure readers that the standards set were unequivocally ‘world-leading’. There is absolutely no reason why this modus operandi would be altered in any way for the development of a COVID vaccine.

Let us be clear: Fact 1: The COVID 19 pandemic has created a pan-global health crisis with severe impact on individuals, society, business and national economies. Fact 2: Social distancing measures mitigate and control spread of the virus but do not eliminate the pandemic, and Fact 3: In 2020, only a vaccine that is safe AND effective AND is widely distributed to the vast majority of a given population, can suppress the pandemic. The conclusion, therefore, has to be mass population vaccination, with at least 75% (but possibly nearer 90%) of the population vaccinated to achieve effective herd immunity.7,8 All those in a position to influence public sentiment, have a duty to promote COVID vaccination at every given opportunity. Only with a supportive and concerted effort will any reasonable doubt relating to COVID vaccines be addressed, fears dispelled and the public encouraged to take this on, ‘en masse’ (or staggered, as supplies permit).

*Note that the current vaccines have been trialled on adult subjects and, initially, will be licenced for adults. Trials on children are on-going but a COVID19 vaccine(s) for children are not expected till late 2021.

References

  1. Burman C, Serra L, Nuttens C, Presa J, Balmer P, York L. Meningococcal disease in adolescents and young adults: a review of the rationale for prevention through vaccination. Hum Vaccin Immunother 2019; 15(2): 459-469.
  2. Meningococcal B vaccination: real world experience and future perspectives. Patholog Glob Health 2106; 110(4-5): 148-156.
  3. Merstzer D, Oberle D, Keller-Stanislawski B. Adverse events following immunization with a meningococcal serogroup B vaccine: report from post-marketing surveillance, Germany, 2013 to 2016. Euro Surveill 2018; 23(17); 17-00468.
  4. Foligatti PM, Ewer KJ, Aley PK, Angus B, Becker S, Belij-Rammerstorfer S, et al. Safety and immunogenicity of the ChAdOx1nCOV-19 vaccine against SARS-CoV-2: a preliminary report of a phase 1/2, single blind, randomized controlled trial. Lancet 2020; 396(10249): 467-478.
  5. Mirzaei R, Mohammadzadeh R, Mahdavi F, Badrzadeh F, Kazemi S, Elrahimi M, et al. Overview of the current primary approaches for the development of an effective severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine. Int Immunopharmacol 2020; 88: 106928.
  6. D Pace, A Khatami, S Attard-Montalto, M Voysey, A Finn, S N Faust, P T Heath, R Borrow, M Snape, A J Pollard. Use of a booster dose of capsular group C meningococcal glycoconjugate vaccine to demonstrate immunologic memory in children primed with one or two vaccine doses in infancy. Vaccine 2016; 34(50): 8350-57.
  7. Anderson PM, May RM. Vaccination and herd immunity to infectious diseases. Nature 1985; 318: 323-329.
  8. Randolp HE, Barreiro LB. Herd immunity: Understanding COVID-19. Immunity 2020; 52(5): 737-741.

Figure

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Issue
Vol. 32 No. 3 (2020)
Section
Editorial
Published
22-12-2020

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