Is it safe to have the Covid-19 jab?
People fear Covid-19. But many South Africans are also scared of the vaccines that have been proved to offer protection against the virus.
An infodemic of false information, particularly on social media, has targeted those who are "vaccine hesitant". Here are answers to 10 of the common fears.
#1: Covid-19 vaccines have been developed too fast and are too new to be safe
Covid-19 vaccines have been developed at record speed but have not skipped any of the safety trials or rigorous checks required to make a safe vaccine for humans.
The rapid results came partly as a result of the billions of dollars invested in accelerating Covid-19 vaccine development and the single-minded focus of the world's foremost vaccine scientists who collaborated in a way never seen before.
The typical phase 1 (safety), 2 (safety and efficacy) and 3 (expanded efficacy) trials were conducted to the same standards as always; in some trials phase 1 and 2 were combined and ran concurrently.
Professor Lynn Morris of Wits University, an HIV vaccine specialist who volunteered as a guinea pig to receive one of the Covid vaccines during the trial phase, says safety aspects were not fast-tracked and were done to the same high standards as all vaccine trials.
"An important aspect of why vaccines were developed so fast is also because of the disease itself," she says. "Covid-19 is an acute infection (people get symptoms very soon after infection) and so one can measure the effect of a vaccine quickly, especially if it is done in areas where infection rates are highest."
Countries such as the UK and US only issued early or limited approval or "emergency use authorisation" to vaccines after preliminary evidence from phase 3 trials showed they were safe and effective. Russia and China authorised their vaccines before getting phase 3 results.
"SA has a long history of providing safe vaccines," says professor Carolyn Williamson, head of medical virology at the University of Cape Town. "A new vaccine, like the Covid-19 vaccine, will be reviewed by our own regulatory body, the South African Health Products Regulatory Authority, who will only authorise its use if the vaccine is shown to be safe and effective.
"Covid-19 can be a deadly infection and vaccines can protect you. In turn, through vaccination you can interrupt the chain of transmission and thus protect those around you. It is our best chance of controlling this pandemic that is devastating our country."
The vaccines are based on science that has already been tested for decades. For example the novel mRNA design used in the Pfizer and Moderna vaccines has previously been studied for viruses such as Zika and flu.
The Oxford-AstraZeneca vaccine uses the chimpanzee adenovirus - which causes common colds in chimps but is harmless to humans - which was developed years ago for use against a number of viral diseases. The adenovirus is a vehicle to transport a new cargo (in this case the spike protein on the surface of the coronavirus) into the body to prime its immune defences.
#2: A genetic vaccine with mRNA will alter our DNA
mRNA (messenger ribonucleic acid) is a single-stranded molecule that carries instructions, in the form of genetic code, for making proteins.
The mRNA vaccines will have no effect on our DNA because mRNA does not enter the cell nucleus where our DNA (genetic material) is found, and mRNA naturally degrades in our bodies.
In this vaccine, the mRNA molecule is enclosed in an oily drop which binds onto a cell, allowing the mRNA to enter it. Once inside the cell, mRNA gives instructions for making the coronavirus spike protein. These proteins prime the immune system to make antibodies against future infection.
#3: Vaccines will give you dangerous side effects, or the disease
Covid-19 vaccines cannot give you the disease; they do not contain the active virus.
But vaccines, like medicines, can have side effects. The results of the Covid-19 vaccine trials and rollouts to date have found most side effects to be mild, with rare exceptions.
Bloomberg reported this week that more than that more than 54 million doses had been given across the world, including 17-million in the US, 15-million in China and nearly 6.7-million in the EU.
The severe reactions so far have been to the Pfizer-BioNTech vaccine, among people with a history of allergic reactions, all of whom recovered.
Norwegian health authorities ruled out a direct link between this vaccine and elderly deaths there.
The US Centers for Disease Control and Prevention reported last week that 11.1 people out of 1-million vaccinated in the US with the Pfizer shot suffered severe allergic reactions.
The average global death rate for Covid-19 is now about 250 people per million, more than 20 times higher than this risk.
In vaccine trials, the "adverse events" reported by participants include anything related to their health, and most often have nothing to do with the shot they have been given.
Professor Linda-Gail Bekker, deputy director of the Desmond Tutu HIV Centre at UCT's Institute of Infectious Disease and Molecular Medicine, says trial participants may develop a worsening of a condition they already have, for example hypertension, or they could develop an "intercurrent" illness - one that is not necessarily related to the trial - which is then reported as an adverse event.
"The investigators have the task of teasing out whether this is related to the administration of the vaccine and in most cases it is not. They do this by looking at timing, symptoms and previous medical history," says Bekker, who is the national co-principal investigator of the Johnson & Johnson Covid-19 vaccine trial taking place in SA.
#4: Vaccines put children at risk
A discredited study falsely linking the MMR (measles, mumps, rubella) vaccine to autism in children in 1998 was fully retracted and the author, former doctor Andrew Wakefield, was struck off the medical register. His claims have been disproven by other studies.
A rigorous analysis of childhood data in Denmark found the rate of autism between children who were vaccinated and those who were not vaccinated is not statistically different.
#5: The public cannot believe scientists or governments, who change their facts and guidelines on coronavirus and Covid-19
Coronavirus is a new virus and, as scientific and medical knowledge expands, what is known about it must be updated and sometimes corrected.
In March 2020, for example, not enough was known about the ways the coronavirus spreads, and the public in the US were not advised to wear masks (to avoid shortages among health professionals). Now, wearing a mask is seen as one of the best tools to stop new infections.
At the start of the pandemic Covid-19 was treated as a respiratory disease, but now it is also known to cause vascular, neurological and gastrointestinal complications, which may occur with no respiratory symptoms.
#6 Vaccines are against our religion
Most major religions have no objections to vaccines and immunisation programmes. But last month chief justice Mogoeng Mogoeng spoke of possible spiritual harm from vaccines.
"Any vaccine that is of the devil, meant to infuse 666 in the lives of people, meant to corrupt their DNA, any such vaccine, Lord God Almighty, let it be destroyed by fire," said Mogoeng. He has defended himself, saying he has a right to express his beliefs.
Mogoeng falsely implied vaccines could be dangerous, said the African Alliance, a digital health advocacy group, which laid a complaint with the Judicial Service Commission about the judge's remarks last week.
#7: The West wants to sterilise Africa's population using Covid-19 vaccines
Most people would agree that this is an outlandish conspiracy theory but it has arisen before with deadly results. In northern Nigeria in 2003, polio immunisation ground to a halt after Muslim and political leaders rejected the vaccine as being part of a sterilisation plot.
Historically, Africans and minority populations have every reason to be suspicious of Big Pharma and researchers from the developed world, after being unethically treated in studies.
In 2011, Pfizer paid out four families in Nigeria whose children had died of meningitis in a drug trial involving the experimental antibiotic Trovan, following claims that it did not first get full parental consent.
One of the worst examples in history is the "Tuskegee Study of Untreated Syphilis in the Negro Male" from 1932 to 1972 in the US. Long after treatment for syphilis had become available, African American participants were not told they had the disease, not offered treatment and were left to die or suffer debilitating harm.
This legacy of suspicion lingers on with vaccines. More than a third of black adults surveyed in a poll in the US said they "probably or definitely would not" get a Covid-19 vaccine, while 71% of the broader public said they would, the Kaiser Family Foundation reported last month.
#8: 5G Wi-Fi & microchips fake news
Let's be clear: the Covid-19 vaccine does not contain a microchip that Bill Gates will use to track people, and 5G Wi-Fi is not linked to the spread of the virus. In KwaZulu-Natal three cellphone towers were burnt down, apparently on the basis of such fears.
But conspiracy theories spread like wildfire on social media, as platforms like Twitter show.
The information void at the beginning of the pandemic - combined with all the additional time people had for surfing the internet during global lockdowns - fanned the flames. So did uninformed micro-influencers and idle celebs, whose concerns have been systematically stoked by anti-vax campaigners.
Only about 2%-3% of the population are estimated to be staunchly opposed to vaccines, but the anti-vaxxers have targeted the big middle ground of the "vaccine hesitant".
#9: I am not at risk and mandatory vaccines are a violation of individual rights
In SA, Covid-19 vaccinations are not mandatory, but to achieve "herd immunity" to stop the pandemic, at least two-thirds of the population need to be vaccinated against it.
The more privileged and protected members of society are less likely to feel at risk from Covid-19, compared with those in vulnerable populations.
For example, the Africa CDC reported last month that a survey in 15 African countries, including SA, showed that younger people in urban areas who did not know anyone affected by the virus were less likely to accept a vaccine than older people who lived in rural areas and knew someone with Covid-19,
On average 79% of the 15,000 adults said they would be willing to be vaccinated, the survey, run from August to December, found. Those who were reluctant usually cited fears over vaccine safety.
#10: #VaccineSouthAfrica was trending at No 1 on Twitter last week; fake news and conspiracy theories were mixed in with facts
A survey of 3,000 South Africans by tech company M4Jam found that concerns about the vaccine related to possible side effects (68%); lack of trust in the government to ensure the safety and effectiveness of the vaccine (50%); and that the vaccines are too new (39%). More than half said they would prefer to "wait and see" if a vaccine worked for others before getting it themselves, a higher degree of unwillingness than the 36% expressed in the Africa CDC survey.
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