The World is bracing with the Covid-19 vaccines
Some good signs of positivity of the Covid-19 Vaccines in the offing
African countries are at various stages of introducing COVID-19 vaccines into their countries. They were left out of the “race” as other countries pre-ordered more supplies than they needed. African countries also lacked ultra-cold chain required by some of the vaccines. It is expected that some of the countries will get vaccines for prioritized risk groups by February 2021.
How vaccines work
Vaccines work by generating an immune response in the body. When a vaccine containing an antigen is injected into a body; it induces the body to produce antibodies which will protect the body from an infection by that disease. The antigen in the vaccine does not cause the disease but it generates the immune response. Thus, when the body encounters an infection; it produces antibodies to contain the infection. Many diseases have been controlled in Africa due to use of vaccines. These diseases include measles, polio. Eradication of smallpox was due to global commitment to smallpox vaccination. Vaccines prevent individuals from getting sick however the other advantage is “herd immunity”. When a significant proportion of people are vaccinated, the disease transmission tends to decline.
Vaccines: The Antibody Response
Vaccines are usually given as two doses since two doses of an antigen induces a greater immune response.
There are several types of COVID-19 vaccines, some use the traditional way of inducing antigen response; others use new technology. Over 90 vaccines are in various stages of development.
Types of COVID-19 vaccine
1. Inactivated vaccines
These are like the traditional vaccines. Polio vaccine is an inactivated vaccine which has been successful. The live viruses are rendered inactive by chemical, heat or irradiation. CoronaVac produced in China and Covaxin from Bharat Biotech
2. Viral vector vaccines
There are several new COVID-19 vaccines using this technology. Oxford-AstraZeneca vaccine uses the new method to produce its vaccine.
Viral vector vaccines are similar to live-attenuated vaccines in that they use a harmless virus known as a vector, to carry a gene encoding the antigen of interest (S-Protein). When the vector virus infects a cell, they administer this foreign gene into the cell. The cell then transcribes and translates the gene to produces the antigen (s-protein), which is then displayed on the cell surface to stimulate an immune response. The infected cell may also slowly reproduce the virus which allows more cells to become infected and produce more antigen, thus amplifying the effect. They use a harmless adenovirus as a vector for gene.
3. mRNA vaccine
The mRNA vaccines made by Pfizer/BioNTech and Moderna use mRNA technology to produce their vaccine. The mRNA vaccine consists of an mRNA encoding an antigen which is then covered by lipid nanoparticle. The mRNA is taken up by host cells which is then translated into S protein which then evokes a host immune response.
Vaccine safety
Vaccines undergo stringent tests before they are authorized by the drug regulatory authorities for use in a country. Many African countries do not have the resources for ensuring quality. They will rely on World Health Organization and on assessments from other regulatory authorities from Europe and India.
Which vaccine for Africa
African countries are behind the race for procuring vaccines however recent move by the African Union has ensured that Africa will have some vaccines for the population. COVAX which is a consortium of donors has promised countries that they can use the COVAX facility to buy vaccines at a subsided price. However, there is delay since many countries have applied for the use of the facility. The African countries also have an option of buying directly from manufacturers in India. The Oxford AstraZeneca vaccine is manufactured in India and the manufacturer has offered to supply as soon as the domestic Indian needs are met.
The infrastructure needs such as ultra-cold chain is lacking in most African countries and as such vaccines which require ultra-cold chain may not be used in most African countries. There is great public pressure on governments to procure vaccines and each country will decide its choice of vaccine. It may also happen that each country will have different vaccines in use at the same time. This has happed in the UK where more than one vaccine is being used.
Vaccine myths
The social media is already flooded with messages about the side effects of vaccines. It remains our duty to dispel the “fake” news.
Religious Guidance
The following questions pertaining to the Coronavirus vaccine were sent to his Eminence Sayyid al Sistani (DZ) from The Islamic Education Department at the World Federation.
Question 1: Vaccines against Coronavirus have already been manufactured by Pfizer, AstraZeneca & Moderna, and others are expected, or already on the market. The medical authorities of several countries have approved these vaccines and authorised mass vaccination programmes, despite some side effects. Some muqallideen are apprehensive about the vaccines’ potential side effects, as the testing & approval processes were expedited by the authorities, given the urgency of the pandemic. Some ethnic groups, based on previous negative experiences with mass vaccination programmes, are sceptical about these vaccines, although no serious side-effects have been observed in most cases. In such circumstances, what does His Eminence advise?
Answer 1: In such circumstances, it is appropriate to rely on the advice given by experienced medical experts. As per Shari’ah, it is mandatory to use an approved vaccine in a situation when the probability of suffering from the Coronavirus infection, with its potentially life threatening and/or serious untreatable complications, far outweigh the probable serious side effects of getting vaccinated.
Question 2: Governments have set up prioritisation programmes, so that high-risk groups are vaccinated first. This includes, the elderly, public safety officials and others at significant risk. Is it necessary to observe this prioritisation program, or is it permissible to jump the queue by paying money and get vaccinated earlier?
Answer 2: It is not permissible to violate the prioritization scheme if its mandated by the law of the land.
Question 3: Some developing countries may not have the financial means to procure and make available vaccines for all their citizens. If doctors recommend taking the vaccine, and if private funds do not suffice to procure, distribute and administer the vaccines inside and outside the Jamaat, would His Eminence grant permission to use religious funds for this purpose?
Answer 3: In cases where necessary there is no objection.
Question 4: If a vaccine manufacturer appeals for volunteers to participate in trials for vaccine efficacy and safety, can mu’mineen join the trial if the manufacturer gives assurance of careful monitoring and caution for the safety of the volunteers, though there may be risk of unexpected side-effects, which in some cases could be lethal?
Answer 4: If it has potentially lethal or extremely serious untreatable complications, then it’s not allowed; unless the risk is low and negligible.
Question 5: In order to stabilize the vaccine, manufacturers use several additives. Sometimes this can include porcine gelatine. Is it sufficient to rely on the manufacturers’ non-declaration, or declaration of non-usage of such gelatine? If there is a possibility of chemical transformation during the manufacturing process, is it necessary to investigate? If the amount of gelatine is not negligible, would emergency use to prevent a potentially life-threatening infection, justify its inoculation? *
Answer 5: In all (the above) circumstances there is no legal Shar’i objection.
CHB – YOUR HEALTH IS OUR PRIORITY
Central Health Board
23rd January 2021