A plea for vaccination

The President of Sri Lanka had said that the only solution with any certainty to the Covid pandemic is vaccination. This is true because prevention is less effective when dealing with a highly infectious and elusive virus capable of mutating into more and more infections and deadly strains like the Covid-19 virus. On the other hand, a vaccine could prevent it more effectively or reduce its effects significantly. A country cannot be locked down for ever whether partially or totally, a way out has to be found and the only way is to vaccinate sufficient numbers to achieve herd immunity. However no vaccine gives 100% immunity but all of them that are being used at present are effective in preventing serious illness necessitating hospitalization and death which is a huge bonus to poor countries. This is not to suggest that preventive measures like face masks, washing hands, social distance and avoiding mass gathering are ineffective and unnecessary, on the contrary they are essential until sufficient numbers are immunized.

Importance and the effectiveness of the Covid vaccines cannot be down played. This is why countries like the US which were ravaged by the virus are going pell mell with their vaccination programmes and closing in on achieving herd immunity. Europe at present has 53 vaccine manufacturing sites and is planning to have more of them. They have delivered 100 million to member countries and plan to produce sufficient doses to immunize 70% of their population by end of July and 3 billion doses by end of the year. They are planning to have a near normal Summer. These countries know the value of vaccines. Herd immunity in relation to major infectious disease has not been achieved by the natural process of the infection but by vaccination. A good example is Measles.

However, there are practical problems with regard to adequate vaccination, such as insufficient availability, cost, logistical issues, people’s acceptance and even politics particularly in a country like Sri Lanka where any issue is maximally politicized by politicians of both sides of the divide. Global politics also could be a factor with world powers expecting hegemonic favours. Sri Lanka received a gift of vaccine from India at the beginning and started a roll out very efficiently but unfortunately it has run into snags as the supply of Indian vaccine is uncertain as India is engulfed in an unprecedented catastrophe due to the ruthless pandemic. It has also received Chinese vaccines but seems to be reluctant to use it until WHO approval is given.

Sri Lanka may also receive the Russian Sputnik vaccine which has been approved by the WHO. It plans to purchase about 13 million doses which would be sufficient to vaccinate about 3% of the population. According to experts like Christellu Liboudo MD at least 80-90% of the population (this figure varies according to the virus) has to be immunized either by previous infection or vaccination to reach herd immunity. This means we will need quite a lot of vaccine doses to come out of the mire. From where could we get them. India has to immunize its own population of one billion before it could think of giving it to others. Prime Minister Modi is unpopular for blundering in the management of the pandemic and will not want to make it worse by depriving the life saving vaccine to their own people. Other vaccine producing countries like the US, UK may not give us the vaccine, they are accused of hoarding the vaccine in excess of their own needs. Could you blame them, though WHO calls for equitable distribution of vaccine the citizens are priority in a struggle for survival.

The only vaccine producing country which has no urgent need for it is China. It has vaccinated 200 million of its people and is planning to vaccinate the rest at the rate of one million a day! It has about five vaccines which are ready for Stage 111 trials. None of them has received WHO approval. Two of these vaccines Sinopharm and Sinovac have entered the last phase to join the COVAX vaccine initiative of the WHO and a final decision is expected before 3rd of May 2021. WHO has pledged Sri Lanka to supply vaccines sufficient for 20% of our population through the COVAX programme. But due to lack of supplies it has not been possible to meet this commitment. However with the approval of the two Chinese vaccines hopefully these would be available in Sri Lanka sooner than later. China is increasing its vaccine producing capacity and would soon develop into be the largest producer.

Chinese vaccines are being used in 65 countries at present despite the fact that they are not approved by the WHO. These include 13 countries in Latin America, 25 in Africa, 22 in Asia and 5 in Europe. And they include countries like Indonesia, Malaysia and Thailand which are more developed than Sri Lanka. In the past week Thailand and Philippines received their 3rd batch of Chinese vaccines.

It is claimed that Chinese vaccines are less effective particularly against variants of the Covid virus. The mutants would escape detection by antibodies but they would be mopped up by T Cell mechanism that has been boosted by the vaccine. This why most of the Chinese vaccines are effective against mutants found in the UK, South Africa and other countries (Global Times, 28.3.2021). In a trial conducted in Brazil 252 new cases were detected out of which 85 had been vaccinated with CoronaVac, a Chinese vaccine, while 167 had a placebo and none in the vaccinated group had to be hospitalized. The vaccine could have a role in preventing severe disease in every country says Paul Offit a vaccine scientist at the Children’s Hospital of Philadelphia in Pennsylvania (Nature, 15.01.2021).

China is Sri Lanka’s friend in need from the time of the Rice Rubber pact that rescued the country in 1952 when no other country would come to its assistance. It was not just a trade agreement but one that was favourable to Sri Lanka and Chinese magnanimity was evident in the agreement. And just last March again China came to the rescue of Sri Lanka at the UNHRC. Could we afford to be neutral and not aligned with a strong friend when we have so many ruthless enemies hovering above as shown at the UNHRC. And could we continue to be reluctant to use Chinese vaccines if we are serious about coming out of this abyss.

N.A.de S. Amaratunga