By Okot Nyormoi, Editor

Children's vaccinationIn 2019, I wrote an article titled, “TO BE OR NOT TO BE VACCINATED”. Little did I know that one year later, the question would loom even greater than it was at that time. When coronavirus struck with a vengeance in late 2019 and early 2020, the world began to scramble for vaccines. There were no effective drugs for treating the symptoms. When it became apparent that vaccines would become available by late November and early December 2020, the question took center stage.

Vaccines have been around for years and it is no secret that they have saved millions of humans from death, debilitation, and disfigurement. Thanks to vaccinations, young people today may not even know about diseases such as tetanus, polio, smallpox, measles, and yellow fever.

If vaccines have been around for years and are safe and effective, why are we still wrestling with the question “to be or not to be vaccinated?” Though, it seems to be a simple straightforward question, one must go through multiple layers like peeling onions to arrive at some reasonable answers.

First, there were people who alleged that coronavirus was a hoax. Even when they eventually accepted that it was real, they thought it was not serious and that it would soon disappear. They even accused big pharmaceutical companies of hyping up the seriousness of the virus to sell their drugs.

When the virus did not go away and was declared a pandemic, the question was then how to deal with it. Some people believed that it was a punishment from God. Therefore, only a supernatural solution, prayer, was needed. God would take care of it. Others even went to the extent of asserting that they don’t mind dying from the virus because it would be God’s will. Such line of thinking, of course, forgets that God is supposed to help those who help themselves.

The next layer was the group of people who approached the problem from a materialist point of view. The first of this group are those who believe that they have effective indigenous herbal medicines for treating COVID-19. Prominent among them were the President of Madagascar, the late President of Tanzania, and a whole slew of others. They include concoctions made of lemon, ginger, Artemisia, pineapple, etc. The World Health Organization (WHO) was even willing to promote them if they have supporting evidence based on rigorous scientific tests. So far, no evidence to confirm the claims, which does not necessarily rule out future discoveries.

Rounding up the rear is the science-based approach. Many drugs: Remdesivir, hydroxychloroquine, dexamethasone, and others including a ridiculous proposal like the one of shooting ultraviolet light into people, were touted to cure COVID-19 infection. While some of them do help in managing the symptoms, none turned out to be miracle cures they were claimed to be.

The absence of effective treatment drugs for COVID-19 drove people to focus efforts on vaccine development. Though the task seemed unsurmountable, the possibility of success provided a tantalizing hope of salvation from the pandemic. However, the thought of vaccines soon triggered all sorts of reactions.   

The first in line were the anti-vaxxers organizations which oppose vaccines. Their objections are a mixed bag of valid and invalid reasons, but they all fall into three categories of concerns: process of production ranging from conceptualization up to the finish product; quality; safety of the vaccine itself as well as side effects; and efficacy of vaccine. Regardless of whether they are valid or not, the anti-vaxxer’s claims can have a profound effect on vaccinations. They create vaccine hesitancy which can become permanent perceptions of vaccines in general or of specific vaccines.

Some of the objections are simply based on ignorance or disinformation intended to mislead people. For example, it is nonsensical to reject the COVID-19 vaccine just because we don’t yet have vaccines against other diseases such as malaria, HIV, and other complicated diseases.

It is false to claim that there are no vaccines against cancer because there are, preventive as well as cancer treatment vaccines. They include vaccines against human papillomavirus (HPV) to prevent HPV-associated cancers: anal, cervical, head and neck, penile, throat, vulvar, and vaginal cancers; hepatitis B virus to prevent liver cancer. Three cancer treatment vaccines are: Sipuleucel-T (Provenge) for treating prostate cancer, T-VEC for treating advanced melanoma (skin cancer) and Bacillus Calmette-Guérin (BCG), a TB vaccine re-purposed for treating early-stage bladder cancer.

COVID-19 VaccineThe suggestion that we should reject COVID-19 vaccines because we still don’t yet have vaccines for malaria, HIV or other diseases is also preposterous. Such reasoning simply shows a lack of appreciation for the fact that not all diseases are the same. Some are caused by infectious agents such as viruses, bacteria, fungi, or parasites whereas others are caused by non-infectious agents such as chemicals, radiation, and random changes (mutation) in the hereditary material.

Diseases such as malaria, trypanosomiasis and AIDS are caused by pathogens with complicated modes of existence, which present different degrees of difficulties in understanding them in the first place let alone developing vaccines against them. It may not be possible to develop vaccines for them and vaccination may not even be appropriate for preventing or treating them.

While it is true that it used to take 10-15 years to develop a vaccine, technology has evolved which enables scientists to develop new and faster ways of making vaccines. Instead of using the old, long, and tedious methods of attenuating virus (producing harmless virus strains) and risking the use of inactivated or attenuated virus vaccines, the new technologies are more efficient and rely on using only targeted portions of viruses. They use only surface virus proteins, or genetic codes (DNA or RNA) for producing the surface proteins used for inducing immunity. They are also carefully constructed to ensure that they do not integrate into and alter the human hereditary materials.

Besides, due to the emergency of the pandemic, the usually long process of vaccine production had to be telescoped. Animal and human clinical studies had to be conducted simultaneously instead of sequentially. The ethical question is whether it is better to let millions of people die in 10-15 years while waiting for the vaccines to be produced or to risk losing some lives to save millions of others by using the shortest process possible without compromising the quality, safety, and efficacy of the vaccines. The latter is what the world community decided to do with COVID-19, and it worked.

The speed of the production of COVID-19 vaccine is analogous to the speed of crossing the African continent, which took Stanley three years (1884-1887) to complete, whereas today we can fly across the continent in hours. Would anybody prefer walking to flying across Africa today? Heck no!

The concern about the uncertainty inherent in the novelty of the mRNA and DNA vaccines which have never been used in humans before is legitimate and normal. The fear of sickness or death is even fueled by all sorts of conspiracy theories, especially when they seem to be confirmed by the number of deaths which have occurred among some people who were vaccinated with the AstraZeneca vaccine. Such deaths reportedly caused by blood clots have recently caused many countries to temporarily halt vaccinations as a precaution while proceeding with investigations to determine whether the clots are caused by the vaccine.

So far, the number of deaths reported among millions of vaccinated people is statistically small and is consistent with normal occurrence. More importantly, since no evidence was found to show that COVID-19 vaccination caused the clot in the people who died following vaccination, the AstraZenica vaccine was declared safe again. 

Other COVID-19 vaccination objections are based on philosophy (lifestyle) that prohibits the intake of animal substances into the human body. Some people may also reject the vaccine on moral grounds while alleging that the vaccines are made in tissues or cells of aborted human fetuses. These objections are based on false assumptions because none of the COVID-19 vaccines are made of animal products or in aborted human fetuses.

Alleged violation of civil rights is another reason for rejecting vaccination. However, such a rejection may endanger the lives of other people, thus rendering them socially irresponsible. Ironically, the same people have no problem abiding by other mandates required for the good of the public. 

Some people are afraid that the vaccines are being used as a trojan horse by developed countries (imperialists or racists) to commit genocide against black people. Such a concern is based on some past experiences such as the Tuskegee syphilis experiment in which the USA government unethically used black American men to study syphilis. While this is a relevant historical fact, we must not forget that time has also changed.

Human experimentation is now rigorously monitored. Dr. Kizzmekia Corbett, one of the scientists who is at the forefront of developing the Moderna vaccine is a black American woman. The man who was the Surgeon General when the vaccine development started is a black American doctor. Members of the Biden’s administration committee on COVID-19 are of diverse ethnicities. In the USA and Europe people of all nationalities were included in clinical studies and are being vaccinated. The head of WHO is an African from Ethiopia. Are all these people conspiring to commit genocide in Africa and against black people all over the world? Certainly not.

Is the vaccine 100% safe? No, it is not. No medical treatment is guaranteed to be 100% free of side effects for everybody. There are always a few individuals who react adversely. Unfortunately, one cannot always tell unless one receives the treatment. Thus, we take medicine on faith that the experts are truthful about the medicines they authorized for human use.

In COVID-19’s case, only 1-2% of the infected people develop serious symptoms and may die. Therefore, some people argue that we should not bother with vaccinations since only a small percentage of people will be seriously affected. Regrettably, one cannot tell whether one belongs to the 98-99% of those who will be asymptomatic or have only mild symptoms or the 1-2% who will have serious consequences until one is infected. The 1-2% is a lot of lives that will be lost and among the survivors, some will be “long haulers”, those with serious long term chronic residual symptoms.

One must also keep in mind that the longer the virus lingers around, the greater the risk that it will mutate to a more infectious and or more virulent form. That will mean that more than 1-2% of infected people will die including those who are currently part of the 98%. Therefore, it is terribly ill advised to gamble with having the disease which is preventable with vaccination.

When my turn came to answer the question whether “to be or not to be vaccinated”, it was a no brainer. The hardest part was scheduling an appointment for the vaccination. As for vaccination schedules, that depends on the resident country, but generally people with high risks due to the nature of their work, age, pre-existing conditions, determine the priority of who gets the vaccine first.

Nyormoi is Ok 7 weeks after vaccinationWhen the day came, I had to fill out forms including screening for pre-existing conditions such as allergies. Expectedly, there was some waiting in line. After each shot, I had to sit down and wait for 15 minutes before leaving just in case of anaphylactic reactions or other adverse reactions. There were medical personnel on hand to handle any adverse reactions.

Which vaccine and when one gets it depends on availability and locality. Nevertheless, all the approved vaccines meet WHO’s minimum standard required for quality, safety and efficacy.

Luckily for me, there were no adverse reactions other than some mild soreness in my jabbed arm which lasted for about three days and was gone. Meanwhile, for a couple of weeks, I had to fill out questionnaires online to monitor my health conditions. This was eventually reduced to fewer questions and only once a week till the end of six weeks. Expectedly, other people experienced mild swelling at the site of injection, headache, chills, or fever.

Unless it is mandatory, it is up to the individual to answer the question, “To be or not to be vaccinated against COVID-19”. Although, one is free to decline the vaccine, one must consider the potential damage it could cause to the individual, loved ones, friends, and the public. Based on the evidence and the opinions of thousands of experts who developed the vaccines, it would be foolhardy to risk acquiring a preventable infection with regrettable consequences.