Vaccines & variants: your questions answered
Experts explain the difference between Alpha, Delta and Lambda and reveal the latest on Covid jabs in South Africa
THE writing has been on the wall since the start of the pandemic – and just like the experts warned, South Africa now finds itself in the clutches of a cataclysmic third wave of infections.
In Gauteng, hospitals have run out of beds as the virus spreads like wildfire through the province, and our economy continues to take a beating with lockdown level 4 having been extended to stave off the scourge. By all accounts, the third wave is more devastating and overwhelming than the first two. Fortunately, SA’s vaccination programme seems to be ramping up as more and more citizens get the jab. But how exactly will the vaccine protect you from the new variant? And will it work if the virus mutates again? We asked the experts to answer all your burning questions.
THE VARIANTS ALPHA, BETA, DELTA: JUST HOW MANY VARIANTS ARE THERE?
To date several SARS-CoV-2 variants have been documented. But not all variants persist, as some disappear soon after they emerge, according to Professor Hannelie Meyer, head of the South African Vaccination and Immunisation Centre (SAVIC) at Sefako Makgatho Health Sciences University in Tshwane, Gauteng.
That’s why the World Health Organisation (WHO) categorises all documented variants as either “variants of interest” or “variants of concern”.
It’s the variants of concern we need to look at as there’s clear evidence of their significant public-health risk, Meyer says.
There are currently five variants of concern around the globe: Alpha, identified in the UK; Beta, found in SA; Gamma, first detected in Japan; Delta, identified in India; and Lambda, first detected in Peru.
“The latest variant of concern is the Delta because it’s rapidly becoming dominant in many countries across the world – including SA,” Meyer says.
The Alpha variant is predominantly active in the Western Cape, says Professor Barry Schoub, internationally renowned
virologist and head of the ministerial advisory committee (MAC) on Covid-19.
“As far as we know we don’t have Gamma variants in the country,” he adds.
As South Africa struggles to cope with the spread of the Delta variant, the Lambda strain has started rearing its head. This variant started spreading through South America last month, according to a report published by the KwaZulu-Natal Research Innovation and Sequencing Platform.
By 14 June, the WHO declared it a “variant of interest” after Lambda was found in 31 countries, including Chile, Argentina, Ecuador and Australia.
Also referred to as C.37, the Lambda variant accounts for about 81% of the cases reported in South America.
“At this stage it’s not a problem in South Africa,” says Dr Angelique Coetzee, chairperson of the South African Medical Association.
ARE ALL SYMPTOMS THE SAME?
Since the start of the pandemic people have been educated to look for symptoms associated with the virus that has caused more than 63 000 deaths countrywide. These include a dry cough, fever, loss of taste and smell, chest pain or difficulty breathing.
But it’s difficult to clearly outline the symptoms of the Alpha variant, Coetzee says.
“We don’t have that information as it’s not as fast spreading in SA,” she says.
With the Beta variant – which was until recently the dominant variant – symptoms include a sore throat, the loss of taste and smell, high temperature and body aches and pains.
There’s also little information on the symptoms of the Delta variant. It seems as though the early-onset symptoms of infection are similar to those of the common cold, according to Meyer.
“This includes nasal congestion or ‘sniffles’; a scratchy, itchy or sore throat; mild headache and feeling tired,” she says.
These symptoms might be brushed off as a cold while you might have Covid-19.
HOW IS THE DELTA VARIANT SO CONTAGIOUS?
Labelled by the WHO as the “fastest and fittest” variant, the Delta variant is 60% more contagious than the others. “Preliminary data estimates it’s 30 to 60% more transmissible than the Beta variant,” Meyer says.
Being so highly transmissible, it’s
‘THE LATEST VARIANT OF CONCERN IS THE DELTA BECAUSE IT’S RAPIDLY BECOMING DOMINANT IN MANY COUNTRIES, INCLUDING SA’
spreading fast among the unvaccinated population.
Scientists consider two components when they look at the transmissibility of any virus, according to Ravindra Gupta, professor of clinical microbiology at the Cambridge Institute for Therapeutic Immunology and Infectious Diseases in England.
First, they study how the virus can replicate faster and make more infectious variants, but there’s also an “antibody escape component” that looks at how the virus mutates and avoids some of our antibodies.
This is why people who were previously infected with the Beta variant may not be immune to the Delta variant and could be susceptible to reinfection with the Delta variant, Meyer says.
HOW SHOULD YOU TREAT IT?
With the symptoms of the Delta variant mimicking that of a common cold, the danger is that people might ignore it and will therefore not isolate or get tested for Covid-19.
Most patients have a mild infection, particularly those in the young and healthy age group. “We still need evidence from South Africa but early evidence from the UK suggests there’s an increased risk of hospitalisation within 14 days of testing positive for Covid-19 compared to the Alpha variant,” Meyer says.
While there’s no concrete evidence that the Delta variant will make you sicker than the others, Schoub says it’s still important to treat the symptoms and take the necessary precautions as if you have Covid-19.
“If you’ve been in contact with someone who’s positive, and you show any symptoms three to five days later you should get tested,” he advises.
WHEN WILL IT ALL END?
Experts suspect the virus is here to stay because just as they start to get a grip on it, the virus keeps surprising them with new mutations.
“The virus will always be there,” Schoub says. “But I think eventually science will conquer the variants.”
To do this, scientists need to make sure the virus doesn’t cause so much severe disease. “If there are enough people who are immune to the virus either from being infected or from the vaccine then it will stop circulating. Hopefully, it will eventually be a minor disease.”
As experts continue to learn about the virus and its variants, they’ll also learn how better to manage it over time, he adds.
THE VACCINES HOW EFFECTIVE ARE THE VACCINES IN SA AGAINST THE VARIANTS?
The good news is that the Covid-19 vaccines South Africa are rolling out do protect against developing severe disease, hospitalisation and death due to the Delta variant, Meyer says.
While there’s no clinical trial data on the effectiveness of the Johnson & Johnson ( J&J) vaccine against the Delta variant in SA yet, she says laboratory studies suggest the vaccine might be even more effective against Delta than Beta.
The J&J vaccine, which is given as a single shot, provides an estimated 64% protection against moderate to severe disease and 82% protection against critical Covid-19.
“Further good news is that data also suggests the vaccine works effectively up to at least eight months post-vaccination, which means a booster dose isn’t necessary at this stage.”
Based on data from the UK, the Pfizer vaccine, which is given in two doses, has shown high levels of protection after the second dose against hospitalisation caused by the Delta variant.
ARE OTHER VACCINES BEING CONSIDERED?
The South African Health Products Regulatory Authority (Sahpra) has provided an emergency use authorisation for the CoronaVac Covid-19 vaccine, manufactured by Sinovac Life Sciences Co in China.
But there’s little data on the effectiveness of the Sinovac vaccine against the Delta variant, says Professor Kenneth Mak, director of medical services at Singapore’s ministry of health.
Because it takes a long time to register medicines in SA, Sahpra won’t register the vaccine unless it has sufficient data.
There are also conditions attached to the emergency use of the CoronaVac Covid-19 vaccine. “The applicant has to periodically provide vaccine-safety reports and results of ongoing studies before it can be approved for use or in this case emergency use,” Meyer says.
Meanwhile, Professor Rose Burnett from SAVIC says Sahpra is busy with a “rolling review” of the application for the Sputnik V vaccine made in Russia.
This means Sahpra will review the company’s data on a continuous basis until sufficient evidence on efficacy and safety has been provided. “National regulators can only evaluate an application that’s been submitted by a locally licensed applicant,” she says.
As Sahpra hasn’t received any applications for the registration of the vaccines manufactured by Moderna and Novavax, these vaccines can’t be considered for use in SA.
CAN YOU CHOOSE YOUR VACCINE?
You don’t have a choice of vaccines as the government selects which vaccinations are sent to which vaccination sites around the country.
Meyer says the various vaccines are being equally distributed across the provinces. “The government considers various factors in distributing vaccines, including vaccine availability and logistics. For example, if it’s a mobile clinic vaccination site, then having the single dose J&J vaccine is easier to administer,” she says.
“As more vaccines become available, the options available to the public in a specific area are likely to increase.”
The J&J vaccine is being used mainly for teachers, while the Pfizer vaccine is available at all the other sites.
If, for example, you have an allergy or contraindication to the specific vaccine offered at the site you’re attending, you’ll be referred by the vaccinator to another site where the alternative vaccine is available, she says.
“But if you don’t have a specific allergy or contraindication, since all vaccines are more or less the same in terms of efficacy and safety, I recommend you get the vaccine that’s available to you.” S For more information on the EVDS registration and the Covid-19 Public Hotline go to sacoronavirus.co.za. EXTRA SOURCES: NEWS24.COM, NYTIMES.COM, BUSINESSTECH. CO.ZA, TIMESLIVE.COM, DAILYMAVERICK.CO.ZA, JNJ.COM, DAILYMAIL.CO.UK, NGS-SA.ORG, NEWS24.COM, NICD.AC.ZA, KRISP.ORG.ZA,