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Posted: Friday 19 February, 2021 at 11:00 AM

A Race Against Variants and Vaccine-Cynicism 

By: Patrick Martin, MD, Commentary

    There are signs of progress against COVID-19.  Globally, the number of recovered cases far exceeds the number of active cases.  The number of vaccine injections is much greater than the number of infections. Worst-affected countries report declining trends in daily cases and deaths.  
     
    However, the longer the pandemic persists, the more likely is the emergence of challenging variants.  Optimal vaccine coverage worldwide is now key to pandemic control. Yet, science-skeptics persist in stoking vaccine anxiety and fear. Every scientific advance is met with a social media firestorm of gloom and doom.  
     
    In the firing line is the Oxford/AstraZeneca vaccine. This product is ideal for low-resource countries because it is easy to refrigerate and affordable - US $4 per dose compared to Pfizer-BioNTech’s $20 and Moderna’s $33. However, people are being led to believe that the vaccine is inferior because of lower efficacy - 62 per cent versus Pfizer-BioNTech’s 95 per cent, and Moderna’s 94 per cent. 
     
    Comparing vaccine efficacies is like comparing apples and oranges. Which is the better fruit? Trials report different efficacies because they are done under different conditions with respect to place, participant demographics, and timing of assessments of outcomes.  
     
    Efficacy refers to how well a medication or vaccine works in a clinical trial. The internationally accepted cut-off for a safe vaccine to obtain regulatory approval is 50 per cent efficacy.  
     
    Simply put, if 100 volunteers were vaccinated in a clinical trial, an efficacy rate of 50 per cent means 50 developed immunity or adequate protection against becoming sick, an ICU statistic or worse. The hope is that the other 50 per cent has some protection, and if infected, they would have milder disease. Efficacy of 50 per cent sounds low but some protection is better than no protection. 

     

    There is currently no research data showing a “best” COVID vaccine. Besides, vaccine alone is not the solution.  Control of the pandemic requires a combination of measures – good hygiene, appropriate masks and physical distancing, robust regional and global coordination, sound public communication, and universal access to safe and effective vaccines.

     

    In the final analysis, what really matters is vaccine effectiveness meaning how a vaccine works in real world populations. There are already published reports of lower rates of severe disease, ICU admissions and death since vaccine roll-out in the USA, UK, Israel, India, etc. This is incontrovertible proof of the high effectiveness of the vaccines produced by Pfizer-BioNTech, Moderna and Oxford/AstraZeneca.  Data from other vaccines is pending.

     

    Since Adult Suffrage in 1952, a legacy of the 1935 Buckley’s Uprising, successive governments have invested meaningfully in public health and partner sectors such as potable water, decent housing, waste management and education. Consequently, there is health progress in St. Kitts and Nevis.  

     

    Life expectancy has increased from 50 years in the colonial era to 76 years in 2016. Gone are the days of 300 to 400 children dying before their first birthday, and buried in cane fields and backyards. Since 2006, infant deaths average 10 to 13 per annum, mostly due to extremely premature newborns; no vaccine-preventable diseases.  

     

    Residents can be confident that every vaccine approved for use in St. Kitts and Nevis is safe and effective. The first Oxford/AstraZeneca tranche being sourced from India is not an issue. India has unrivalled capacity for manufacturing pharmaceuticals of assured quality.  
     
    The global imperative now is a coordinated surge in implementing pharmaceutical and non-pharmaceutical measures. If not, disconcerting variants may continue into 2022 along with health and economic woes.

     

     

     


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