Are Vaccines the only end to the pandemic?

This is a follow up blog post based on a discussion between @theworldofamran and @thecatalystinme on IG LIVE. You can watch the live back HERE.

The theme of the live: Are vaccines the ONLY end to the pandemic?.

In summary, there is no clear answer to this question! Vaccines are a way of easing the effects of the pandemic, but not the only way out. Until transmission is reduced to very low and controlled levels even WITH a vaccine, social distancing measures and mask wearing will be “the new normal”.

If you are in the UK, you may be aware of the vaccine priority list. The vaccine is being offered widely across vulnerable groups and key workers, if you don’t fall in these priority groups there will be some waiting time before you are offered the vaccine.

So what should you be focusing on instead? In the live session we discuss having a stance on the vaccine prior to being offered and also making sure you read sources yourself. If you have vulnerable people in your life, it is also important you have discussions around vaccines and help them find the correct information. It is your body and it is especially important to make an informed choice. By the time “non-vulnerable/healthy” people are offered the vaccine, the short term effects of the vaccines (at least 1year) would have been studied and at best that is a considerable amount of time to look at the pros and cons to make a well-informed decision.

There has been an overwhelming amount of COVID-19 information. So here is a list of sources to read and follow up on. This post is written based on the most common questions that came up during the live session and other points that we have seen come up a lot. The resources listed here are specific to the UK. It can be applied to other countries, but it is best to follow your local health guidance and measures in place!

Are vaccines the only end to the pandemic?

The answer is no! Pandemic responses are multi-faceted. The COVID-19 vaccine has been developed to prevent severe illness from the disease and as a result reduce the likelihood of death. There have been countries that have successfully controlled the pandemic to get life back to some form of normality. The measures implemented in these countries have been a mix of lockdowns and high compliance of the public, all before vaccines were rolled out. This has been fully discussed in an earlier blog post: the world can handle the covid-19 pandemic.

When looking at vaccine efficacy (effectiveness) news, it is very important to remember the vaccines have been proven to reduce severe disease. A key end to the pandemic is reducing deaths AND transmission. Transmission hasn’t been investigated in the vaccine trials and it is quite hard to understand! Face masks, isolation, handwashing and social distancing are effective measures in reducing transmission and as mentioned before, these guidelines will need to stay in place until transmission levels are low AND controlled.

Basic and simple public health measures will always be in place! With the vaccine there are many unknowns that will be discovered as time goes on. COVID-19 research will require a heavy chunk of research budgets for the foreseeable future! But there are two questions asked that I want to focus on.

Can I catch COVID-19 after taking the vaccine?
Do I need the vaccine if I had COVID-19?

As mentioned earlier, there is little information on how the COVID-19 vaccine affects transmission of the disease. A key feature of the COVID-19 vaccine is to reduce symptoms and for those reasons many people were followed up based on presenting symptoms of COVID-19 and not a positive PCR test while in the trials. What has been found is that COVID-19 patients following an infection have natural immunity for around 5 months. However, what must be remembered is that this does not mean that they are not infectious or unable to transmit the disease. There is a lot of effort and research going into answering this specific question of transmissibility! When that answer does come, this could change what the new normal looks like!

Severe events due to COVID-19 infection have been linked to higher viral loads and in theory, if the vaccines lower severe events by decreasing the viral load - this could have an effect on decreasing transmission. As the transmission rates are loosely dependent on the viral load present in an individual to spread the virus.

Specific Vaccine resources

Vaccine post written on this blog as part of TCIM conversations: A series exploring public perception of science.

Basics of vaccines-What are they and why are they important?

Should I take the Covid-19 vaccine: What is in it, why is it important ( written in July)

Vaccine safety reports ( Pfizer, Oxford and Moderna: the candidates approved for use in the UK) The Links provided lead you directly to official pages with safety documents. I have also included links to summarised Instagram posts of the safety data summarised published in November of the three candidates.

Pfizer

Phase 1 published data safety,
Full protocol ,
Extended Safety data

Oxford Astrazeneca Main Website

Moderna : FDA page on trial data

Extra resources on vaccines

What will the new normal look like?

How can things get back to normal? Will schools, shops and places of worship open like before?
If I decide NOT to get vaccinated? What are the effects on my family and community?

The above questions are all extremely important. To get back to normal, we need to all comply with guidelines as best as possible. The aim should be to get cases to zero and make isolation when infected with COVID-19 a simple process with minimum disruption to everyday life. A huge problem in the UK is compliance to isolation after infection with COVID-19. The BMJ highlights that “ self-isolation in those who are infected or else are contacts of those who test positive for the virus are estimated to be around 18%.”Your first thought may be that people are selfish but as highlighted in this Guardian article, it is a complex situation. Unless you are provided with a safe place to isolate and don't have financial burdens, then it is very difficult to stay isolated for the full period of 14 days. For further reading follow the hashtag #SupportToIsolate on Twitter.

If you decide not to get vaccinated, if put simply, the likelihood of you suffering from severe disease from COVID-19 is increased. At the time of this post being released, the vaccine doesn’t reduce the risk of catching COVID-19 nor transmitting it as stated above. With a recent report by The Guardian reporting 72% of Black people unlikely to take the vaccine, now more than ever we need to continue to think about vaccine hesitancy and the root causes. This plays a huge role in protecting our loved ones that are most at risk from severe disease and even more so with the new variants of COVID-19 which is no longer specifically targeting the old and vulnerable. Sadly, with the increase of loss of life, not only just of the elderly, but also younger and healthier populations, we just don’t know how an individual's body will react to being exposed to the disease. There are also many more reports of ‘long COVID’ and the vaccine potentially reducing the effects of this (although evidence is pending). With the UK Planning to vaccinate everyone by mid July possibly, it is crucial now more than ever to get informed!

Will there be more lockdowns?

We are ALL tired. While you can’t predict the future and everyday with COVID-19 circulating, it is a learning curve and also extremely tiring when thinking about the future. Countries like China that had a strict lockdown, although successful at controlling the outbreak, are now experiencing a new cluster of cases and a localised lockdown.

Pandemic fatigue is a huge issue. On our THIRD lockdown in the UK with unclear guidance, sometimes it is difficult to see the light at the end of the tunnel. Personally I am struggling with this third lockdown as it is hard to see an end, especially when the government hasn't shown many signs of good leadership.

While lockdowns are an effective public health measure to identify and isolate cases, an interesting article published by stanford researchers, highlighted that strict lockdowns do not have the benefit of completely controlling the virus. The article summarises comparisons of countries that had strict lockdowns versus countries with more relaxed approaches to find that where transmission of the virus is not controlled, lockdowns may not be the most effective!

"In other words, it is possible that stay-at-home orders may facilitate transmission if they increase person-to-person contact where transmission is efficient such as closed space"

Following on from that article, it is clear that in order to stay safe, we need to make simple things like hand washing and mask wearing (especially the latter) second nature. By observation, people wear masks more because they ”have” to and less because they want to. I believe I will keep wearing a mask on public transport long after the rules are relaxed. But for the time being, it is important you can answer these questions:

What are the different types of masks available and what protection do they offer?
How to dispose or reuse masks properly?
How to wear masks properly?
When don’t I need to wear a mask?
What is the difference between a mask and a face covering?

All the questions above are answered in the WHO guidance on when and how to wear masks.

We want lockdown to end. So how do you risk assess the situation of meeting people in public once the time comes? You really shouldn't be meeting people right now, but are good to keep in mind when the outside slowly opens. These guides and articles will help you understand the risk and exposure to COVID-19. This will help you make responsible decisions once restrictions ease and the country reopens, so we can get out of this constant cycle of lockdowns and uncertainty.

Should I be worried about the new variants?

At the time of writing this post, there are 3 known COVID-19 variants present in the UK. For someone without a science background, getting into the specifics can be quite confusing and even from someone with a science background, it can be quite overwhelming! For now, the only worry about these variants is that they seem to be more transmittable between people and hence the soaring infection rates. Currently, there is no evidence that the variants are more deadly or the vaccine candidates being rolled out won’t work against them. If the constant updates are stressful, no matter the variant; social distancing, mask wearing and handwashing rules remain the same!

How can I follow correct information?

If you decide to not take the vaccine, it is a personal choice and if you are young and healthy it may not be important to you (YOU THINK?). As we have seen with the increase in COVID variants, anyone can be affected by hospitalisation. You taking the vaccine will reduce your chances of hospitalisation. If you decide not to take it, it is important to not impose your personal views on others and let them make a decision based on their own research and findings. Do not attempt to convince family members based on biased views with little to no medical evidence. With any doubts, there are many immunologists and Drs that have a wealth of resources for you to look through and community discussions with professionals as well!

While the news is a great source of information, it does sometimes offer a lot of confusion as headlines can be politicised. It’s okay to take a break from constant updates.

WHO resource on the covid-19 infodemic

More Resources

People / pages to follow

Kizzmekia Corbett : Immunologist and one of the lead scientists that developed the Moderna Vaccine (Read more)
Science.sam: Science communicator based in Canada
Dr esmeralda Infectious disease doctor in the UK that often answers questions in her stories about vaccines
Dr Samira Hassan: GP in the UK and VP of British Somali Medical Association
Virus.vs.labcoat : Immunologist PhD student in Australia with a wealth of posts on understanding immunity