Covid vaccine The Whole Truth
Does the speedy development of a vaccine make it less safe?
Before Covid-19, the fastest development of a vaccine – for mumps – took four years. Understandably, the speedy development of several Covid-19 vaccines has made some people nervous about receiving one. But the shorter timeframe doesn’t mean dangerous shortcuts have been taken.
While Sars-CoV-2, the coronavirus which causes Covid-19, is relatively new to the world, coronaviruses aren’t. Neither are the efforts to find vaccines for these viruses.
Before Covid-19 appeared, researchers had already done vaccine trials in people on similar coronaviruses: Sars (severe acute respiratory syndrome) and Mers (Middle East respiratory syndrome). But when cases of those viruses tapered off, the research slowed too.
Clinical trials, which test that a treatment is both safe and effective, are divided into three phases, each taking longer and involving more people than the one before. Phase 1 establishes whether the vaccine or treatment is safe to test. Phases 2 and 3 then test how effective the vaccine is, the side effects, and overall safety; in hundreds and then thousands of patients.
Given the traditional process is so time-intensive, it was not fit-for purpose for a new disease.
Scientists and governments knew this before Covid-19 emerged, prompting the 2017 formation of the Coalition for Epidemic Preparedness Innovation: a global alliance for financing and co-ordinating the development of vaccines for emerging diseases.
When Covid-19 appeared, the groundwork to do things differently was already there.
The virus prompted a rapid joint effort using public and private resources, with big pharma and small biotech companies working around the clock, around the world.
Funding came quickly. People were motivated to join studies, the existing science and technology allowed the process to be more streamlined, and reviews of the data from trials were prioritised.
The sheer number of cases means studies have accumulated data faster, pushing them across the line sooner.
Steps which typically take place one at a time, over years, have been carried out simultaneously.
And while mRNA vaccines are new, work on mRNA technology – the backbone of the Pfizer vaccine – has been going on for decades.
Though the timeline was shorter, Covid-19 vaccines were still held to the same safety standards as all vaccines at each step along the way, involving tens of thousands of people in clinical trials.
New Zealand vaccinologist Helen Petousis-Harris has said that if anything, trials have been more stringent and transparent because the world is watching.
Real-world results are also now rolling out, as more than 800 million people worldwide have received at least one dose of vaccine.
Data from Israel, which has vaccinated 60 per cent of its population, is showing the realworld results for the Pfizer vaccine are as good as randomised trials – reducing Covid-19 cases by 94 per cent.
No medicine or vaccine can ever be completely risk-free or 100 per cent effective, but the speed at which Covid-19 vaccines were developed was because scientists had a headstart, unprecedented funding, and global support – not because safety has been compromised.
The virus prompted a rapid joint effort using public and private resources.
New Zealand’s Covid vaccination programme is structured around four ‘‘priority groups’’, chosen by the Ministry of Health.
The definitions of these groups mean those at the front of the queue will include many people with Ma¯ ori and Pasifika backgrounds, starting with Group 1 – MIQ and border workers and their families.
South Auckland, home to Auckland Airport, is the main gateway into the country during this global health crisis. It is also home to the largest Polynesian population in the country and a high number of Ma¯ ori. Many MIQ and border workers are from Ma¯ ori and Pasifika backgrounds.
Group 2, which covers frontline healthcare workers and their families, also includes people over 65, people who are pregnant, and people with chronic health conditions or disabilities living in the Counties Manukau District Health Board area, which includes South Auckland.
The third group includes anyone throughout the country with a chronic condition or other vulnerable health status – again propelling many Ma¯ ori and Pasifika higher up the priority list.
Many of the people included in the higher priority groups are used to being last in line for healthcare.
So why are these groups now at the front of the queue?
Some have already expressed their concerns they are merely ‘‘guinea pigs’’ for everyone else.
But the Government’s vaccination plan is structured to protect those most at risk from contracting the disease, and their families. The higher priority groups (Groups 1-3) have been chosen because they are at higher risk of contracting Covid-19 or are more likely to suffer serious or fatal consequences if they do.
During the 1918 flu pandemic, Ma¯ ori death rates were seven times higher than Pa¯ keha, and during the swine flu (H1N1 influenza) spread in
2009 Ma¯ ori were 2.6 times more likely to be hospitalised or die.
Modelling from Te Pu¯ naha Matatini research centre, and published in the NZ Medical Association Journal, suggests Ma¯ ori are twice as likely to die of Covid-19 compared to non-Ma¯ ori. The rate is even higher for older Ma¯ ori and Pasifika people and those with underlying health problems.
According to the modelling, approximately one in four Ma¯ ori and
45 per cent of Pacific peoples live in crowded housing, and many are multi-generational households, potentially accelerating transmission.
Ma¯ ori and Pacific populations also have a shorter life expectancy and face increased exposure to infectious disease and respiratory conditions.
For these reasons, rather than treating the vaccine with suspicion, some Ma¯ ori and Pasifika health leaders have called for the Government to make all Ma¯ ori and Pasifika people a priority during the vaccine rollout.
Structural health and social inequities mean Ma¯ ori and Pasifika people are more likely to suffer serious illness or die from Covid-19 than Pa¯ keha¯ – and that is why they feature so strongly in the priority groups for vaccination.