Mask is a must, even with a vaccine

That’s the advice from a top vaccine expert who says ‘normal life’ isn’t going to happen until we reach a level of protection in society whereby should there be an outbreak, it will be self-contained.

THE vaccine is coming! The vaccine is coming! Whoopee!

Like pandemic fatigued people everywhere, I welcomed the news from pharmaceutical companies Pfizer, Moderna and Astra-Zeneca that their Covid-19 vaccines had scored 90% and above effectiveness against the coronavirus.

The Washington Post reported the companies are now applying to US regulators for emergency approval to distribute the vaccines possibly as early as mid-December to high-risk groups in the United States.

It added that if the Pfizer and Moderna vaccines are authorised, there should be enough doses for 20 million people by year’s end.

Meanwhile, our own government has pre-ordered 12.8 million doses from Pfizer and we are expected to receive our first batch of 1.7 million doses in the first quarter of 2021 once it is approved.

While the Pfizer deal is estimated to cover 20% of the population or 6.4 million Malaysians, another 10% would be secured through Malaysia’s participation in the World Health Organisation-backed global Covax Facility.

Covax is a ground-breaking procurement facility initiated by WHO together with the Global Alliance for Vaccines and Immunisation (Gavi) and the Coalition for Epidemic Preparedness Innovations (Cepi) to make approved Covid-19 vaccines available at affordable prices to participating countries, especially low to middle income economies.

Putrajaya also inked an agreement with Beijing that will give Malaysia priority access to Covid-19 vaccines developed by China.

All in, it looks like we have covered all bases to get our share of the vaccines.

So it should be good news and relief for us, right?

I thought so, too, but that was before I listened to what a leading infectious disease expert had to say.

Since the start of the pandemic, we have been told that a vaccine would be the magic bullet to save the world from Covid-19, just as previous vaccines for other deadly diseases like smallpox and polio had done before.

In the meantime, we had to bear with the “new normal” of movement restrictions, mask wearing, physical distancing and frequent hand washing.

Now that the vaccines are fast becoming a reality, we can surely look forward to chucking away our masks, hand sanitisers and kiss and hug freely again.

No, we can’t.

At least that is the key message from Dr Jerome Kim, director-general of the International Vaccine Institute (IVI), a Seoul-based non-profit organisation dedicated to vaccine development and delivery to the developing world.

Named as one of the “50 Most Influential People in Vaccines” in 2014, Dr Kim earned his medical degree from Yale University and was a colonel in the US Army Medical Corps where he did extensive, ground-breaking research on molecular virology and pathogenesis at the US Military HIV Research Program.

In media interviews with Channel News Asia, Asian Boss and others, Dr Kim says there are three steps in developing a vaccine: First, prove it is safe and can prevent infection; second, it must be manufactured; and third, it has to be delivered and administered to the people in vaccination programmes.

As we all know, the speed of developing Covid-19 vaccines to the point they are now undergoing human trials at less than a year has been unprecedented. Previous vaccines took between five and 15 years to reach that stage.

And because of this, the vaccines bring unprecedented unknown factors into play as well. Top concerns, says Dr Kim, are of course safety but also the efficacy and duration of the immunity provided. Again, because of the short time frame in their development, there is very little data on the vaccines to analyse.

A vaccine works by getting the body to produce antibodies to fight the virus. At this point, it is unknown if the early vaccines by Pfizer and Moderna that use the revolutionary messenger RNA (mRNA) technology to trigger an immune response will result in high levels of protective, long-lasting antibodies.

What is also a question mark, as the BBC noted, is: “We do not know if the vaccine stops you spreading the virus or just from developing symptoms. Or if it works equally well in high-risk elderly people.”

Another complication is the capability to make billions of doses.

After that, the doses must be delivered under very strict cold chain arrangements. The Pfizer vaccine needs to be stored under minus 70ºC while Moderna’s requires minus 20°C refrigeration. How does one cart such a fridge into the interior of Sabah?

And because it is still unknown how long the immunity lasts, Dr Kim says no one knows if the vaccines require one or two shots or if a booster is needed and when that should be given.

Prime Minister Tan Sri Muhyiddin Yassin said on Friday that the vaccines would prioritise high-risk groups such as frontliners, senior citizens and those with non-communicable diseases like heart diseases and diabetes.

He noted that a recent study found that 82% of Malaysians were ready to be vaccinated, adding, “I hear that many people out there are waiting for the Covid-19 vaccination to lead a normal life without being easily infected.”

But if we go by what Dr Kim says, “a normal life” isn’t going to happen any time soon.

As he explains in the Asian Boss interview, even if after getting vaccinated, we must continue to wear masks, observe physical distancing and practise hand hygiene until we reach a level of protection in society whereby should there be an outbreak, it will be self-contained.

To him, such measures are the price we must continue to pay to protect ourselves and others and to avoid lockdowns and even harsher restrictions.

To make the world safe from Covid-19, Dr Kim adds that we need time to vaccinate at least 60-70% of its eight billion population to create herd immunity.

He thinks it will be at least the middle of 2021 before there is enough vaccine to start vaccinating people en masse, and only by 20232024 will there be enough supply to vaccinate the entire world.

And vaccinate the world we must because if high income states are selfish and think only to vaccinate their own people, once borders open, the infections could start again.

With so many unknowns and uncertainties about the early vaccines, why bother with them?

Dr Kim opines that vaccines are important because they will speed up the path to being able to do things normally again.

Ideally, we should wait out a few years for vaccines to be developed in a normal cycle, but the world is running out of patience and too many people are dying so we must take our chances with what we have.

As the BBC noted, the vaccines appear safe from the large trials so far, but nothing, including paracetamol, is 100% safe.

So, I guess we will just have to stay calm, get our jabs and keep our masks on.