Professor Barry Schoub, a world-renowned virologist, details the Covid-19 vaccine process and the innovations being made in the field as well as the involvement of Africa in these trials.
Q. Given how each phase within a clinical trial has been expedited to find a Covid-19 vaccine, do you think it will have the same effectiveness or efficacy as other vaccines used to combat infectious diseases similar in nature?
A. I think up to the Pfizer release, scientists, virologists, vaccinologists thought it would be a vaccine with a 60% efficacy. So these results are in the same ballpark as the influenza vaccine because it’s got a similar kind of disease process. It is only an interim analysis of course, but it certainly has very good connotations attached to it. It is also a possibility that the corona vaccines will have a higher protection rate than the influenza vaccine for example. However, it will not have the same efficacy rate as more successful vaccines such as the measles vaccine which has an efficacy of about 95% and therefore we do need to have some reservation.
Q. There are a number of vaccine types currently in trials. Pfizer and BioNTech are developing a genetic vaccine while Johnson & Johnson are trialing a viral vector vaccine model they have used for finding an Ebola vaccine previously. Do you think the type of vaccine influences the efficacy rate?
A. These vaccines are all new, this has never been done on humans, so there is no definitive way to say. We’ve never had an RNA or DNA vaccine going into human beings and we’ve never had a virus vector going into human beings. Previous use of a viral vector for HIV vaccine trials didn’t go well because of pre-existing immunity to the adenovirus being used as the vessel. All of this is new territory and really in a way, unpredictable.
Q. What do you think of the innovations then made with these vaccines?
A. It’s very exciting and just the speed with which these vaccines have come out as well. This disease has only been with us from the beginning of the year, so it’s amazing as vaccines usually take years to develop.
Q. These trials are also being tested throughout the world, and given that South Africa is the only site in Africa with any of these trials happening, do you think there should be more testing sites in Africa?
A. I don’t think all of Africa needs involvement in trials per se… It would just be where there is prevalence of disease, for example, endemic diseases such as HIV and TB in southern Africa and more tropical diseases so these are scenarios that do need to be looked at.
Q. Do you think these trials have accounted for all necessary factors that could play a role in how successful the vaccines could be?
A. In European and American trials, there are still key populations missing in the evaluation of these vaccinations like the elderly or people with co-morbidities, so all of these factors do need to be evaluated. All the vaccines currently in Phase III lack the optimal populations, so they all have a set age parameter and these vaccines still need testing in high-risk populations.
Q. Do you see any potential barriers that could decrease the uptake of the vaccine?
A. Well… there’s always suspicion, and polls here and abroad have shown hesitance and reluctance. First of all, things have been done at such fast speeds so there are concerns about safety and also the novelty of these vaccines and that they haven’t been used on humans before. So these factors can lead to suspicion.
Q. Do you think there any possible solutions to this?
A. They need to be reassured that these do undergo very rigorous safety testing and this will prove to be an educational exercise.
Q. What are your thoughts on the eventual accessibility of the vaccine within Africa?
A. In the beginning, we could possibly get a relatively small proportion of vaccines for the population, so the initial batches will have to go to priority groups. This includes frontline workers as an example, people in elderly homes and other high-risk populations.
Q. Do you think initiatives such as CEPI could also see Africa receiving the vaccine sooner than anticipated?
A. Initiatives such as CEPI and COVAX are pooled procurement mechanisms, so these aim to provide both middle and low income countries with their initial supply of the vaccine when it becomes available. So the vaccination process will need to happen in two steps; first step would be to protect vulnerable groups and then only later try to achieve herd immunity.
In an African Union (AU) meeting in November to discuss Africa’s strategy for financing Covid-19 vaccines, AU Chairperson and South African President Cyril Ramaphosa noted that about $12 billion was required, and this was expected to come from three sources: the COVAX Donor Initiative, The World Bank, direct donors, and the African Import-Export Bank, which has committed to raising up to $5 billion.
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