In a lab on the National Institute for Communicable Diseases (NICD) campus in Joburg, a team of scientists on night shift, led by internationally acclaimed virologist professor Penny Moore, are working flat out to decipher how well Covid-19 vaccines will protect against the Omicron variant.
They are frontrunners in the global race to make a pseudo-version of Omicron and test it against the blood of vaccinated and previously infected people. This allows them to see how well their antibodies block the latest variant.
Scientists around the world share their sense of urgency. “I’m getting 200 requests a day for Omicron’s genetic sequences,” says Moore, the research chair of Virus-Host Dynamics at Wits University.
This variant has more mutations than the Hydra’s heads, with 26 unique mutations in the spike — the protein on the surface of the virus that is important for both transmission and vaccines. The high number of mutations slows down the process of making a “pseudo-virus” that resembles Omicron.
Omicron, Delta’s successor, is driving the current surge of infections across SA.
Moore has called colleagues in the US and Europe to get key chemicals, known as reagents, shipped in fast, and her team is making versions of the pseudo-virus as quickly as they can. But it will take at least a week before the NICD lab can test the antibodies triggered by the vaccines against the Omicron lookalike.
The lab relies on data from other key labs in the NICD, which generate the sequencing. The NICD, which is part of the Network for Genomic Surveillance in SA (NGS-SA), working together with Lancet Laboratories, was the first to identify Omicron and alert the world about it.
“When we have large enough stocks, we mix the blood of those who have been vaccinated or who have had prior infections and allow their antibodies to bind to the virus,” says Moore. “Then we measure what is left of the virus.”
Another major player in the surveillance network is the University of Cape Town virology department, led by another world-renowned HIV scientist, professor Carolyn Williamson.
Working in partnership with the National Health Laboratory Services, her lab gets Covid diagnostic test samples from public facilities and private labs to analyse for mutations.
“When we are in a trough we get about 100 a week, but at the peak of a wave this can go up to about 300 a day,” Williamson says, noting that test numbers are rising at the moment.
“For most of us doing HIV vaccine research, it was a quick pivot to SARS-CoV-2 research. We had the skills, infrastructure and capacity,” she says.
SUPER SLEUTHS ON OMICRON
“It's too soon to tell.” “We don’t know.”
This is what Covid scientists studying Omicron say when asked if the variant will blunt the protection vaccines offer against the virus, and how sick people could become.
“There is a lot we don’t know, but we do know it is highly mutated away from the original virus,” says Moore.
The virus has mutations in “problem areas”, which are likely to increase its transmissibility and could also undermine immune defences, she says. Potentially a double blow.
But it is too soon to tell and Williamson, whose lab is sequencing and tracking variants for the NGS-SA, says that the variant “may not be as scary as it seems”.
JABS, OR NO JOBS?
Vaccine mandates to access specified public places for employment, education or recreation do not conflict with human rights, says philosophy professor Lucy Allais, from Wits and Johns Hopkins universities.
“Infectious disease is not something confined to one person’s body, but rather concerns the possibility of endangering others. Therefore, the rights concerned cannot be based only on our rights concerning our own bodies, but also concern what we have a right to do to others,” she says.
Across the planet from Europe to Asia, countries are imposing Covid-19 vaccine mandates to limit the spread of the highly infectious virus, and last weekend President Cyril Ramaphosa raised the possibility of vaccine mandates in SA.
Covid-19 vaccines prevent nearly everyone who has been jabbed from getting severely ill or dying of the disease, and they reduce the risk of hospitalisation, transmission and, by reducing viral loads, the development of mutations, like Omicron.
Vaccine mandates push up the number of people getting shots. In SA, only about 35% of adults are fully inoculated.
Dr Stavros Nicolaou, from Business for SA (B4SA), underlines the point that vaccination choices have the power to protect or endanger others. “Individual rights end where public peril begins,” he says.
“Last week SA hosted [Kenya's] President Uhuru Kenyatta. From December 21, Kenyans will have to be vaccinated to access any public facility including buses and trains,” says Nicolaou. “People say we do not have the resources of Europe to restrict access, but this is an African example.”
B4SA and Business Unity SA have come out in support of vaccine mandates for workers.
Employees may be barred from work, or lose their jobs, if they are not vaccinated, and this tension is already playing out in SA. More than 20 cases around vaccination have already been referred to the Commission for Conciliation, Mediation and Arbitration.
Allais says she does not say individuals have the Right to endanger others when a safe and non-invasive procedure can prevent this.
The mandate does not in fact force you to be vaccinated — it merely requires that you are vaccinated if you want to access certain places
— Dr Stavros Nicolaou, from Business for SA
“Your right to bodily integrity does not give you the right to go to a public place, including one you need to go to, in a way that endangers others, when this is preventable in a very safe way.
“Driving a car may be essential for you to access your place of work, but this doesn’t mean that you have a right to drive a car unlicensed. Having to have a licence is a requirement that is legitimately placed on you, for the safety of everyone,” she says.
Mandatory vaccines do not violate people’s bodily integrity, in her opinion. “Crucially, requiring people to be vaccinated to access, for example, a university or a movie theatre, is not the same as holding them down and forcing a vaccination into their arm. The latter would be a violation of bodily integrity.
“The mandate does not in fact force you to be vaccinated — it merely requires that you are vaccinated if you want to access certain places.”
The spectre of a parallel economy developing among the unvaccinated is not an immediate concern for Stavros.
“There is not going to be an economy if we do not get on top of this pandemic,” he says.
Worldwide, vaccine mandates typically affect public servants, including health workers, and employees in workplaces, or access to public spaces.
Indonesia, the tiny nation of Micronesia and Turkmenistan are the only countries so far requiring that every adult be vaccinated or face consequences, including lack of access to government services or potential fines.
In Africa, Egypt and Tunisia have already implemented requirements for public servants and officials to get vaccinated. In Egypt, unvaccinated civil servants must take a weekly test and in Tunisia a card proving vaccination is required to access public and private workplaces.
The US, Canada, countries in South America such as Costa Rica, as well as Russia, Denmark, Italy, Saudi Arabia, Fiji and many more, are among the nations requiring vaccine mandates for public servants and/or to access public facilities.
For decades in SA parents have needed to show proof of specific vaccinations — including for measles, mumps and rubella — to get children into public schools, and this is either recommended or mandated in many countries globally.
So far the Covid death toll in SA is 89,800 and globally the pandemic has cost 5.3-million lives. A nursery rhyme from an earlier scourge, 1665's Great Plague of London, ends: “Atishoo, atishoo, we all fall down.”
But it doesn’t have to end that way. As the experts are at pains to stress, vaccinations have the potential to stop this plague before more people die.
THE SLAVE WHO TAUGHT THE US TO VACCINATE
An enslaved west African man was the first person to introduce the principle of vaccinations to the US.
An epidemic of the dreaded smallpox disease in 1721 killed hundreds of victims in Boston. The first smallpox victims, passengers on a ship from the Caribbean, were locked up in a house with a red flag warning: “God have mercy on this house.”
The slave, known only as Onesimus, told his master, a Puritan minister, that he had undergone a procedure to protect him from smallpox. This consisted of rubbing pus from an infected person into an open wound on the arm.
White colonists were reluctant to undergo a medical procedure developed for black people, believing it was against God’s will to expose his creatures to dangerous diseases.
However, during the 1721 outbreak, a Boston physician decided to perform the procedure on his son and his slaves.
Of the 242 people inoculated, only six died — one in 40, as opposed to one in seven deaths among the rest of the population.
— Source: History.com
HISTORY OF DISTRUST
A 15-country survey by the Africa Centres for Disease Control found 43% of those polled believe Africans are used as guinea pigs in vaccine trials.
In the 1990s pharmaceutical giant Pfizer was sued after 11 children died in a clinical trial during a meningitis epidemic in Nigeria's northern state of Kano. Pfizer was accused of not having proper consent from parents to use an experimental drug on their children. The drug company reached an out-of-court settlement in 2011.
Last year two French doctors were accused of racism after a television debate in which one suggested trials in Africa to see if a tuberculosis vaccine would prove effective against the coronavirus because there were “no masks, no treatments, no resuscitation” on the continent.
Distrust has often been more prevalent in poorer countries during the pandemic, says Dr Saad Omer, a Yale University epidemiologist.
“Almost no investment in vaccine education or promotion has gone into low-income countries,” Omer told the New York Times. “Why do we expect that all we will have to do is drop vaccines at an airport, do the photo op, and people will come running to the airport and grab the vaccine?”
IN OTHER VACCINE NEWS
Clinical trials have begun for a new Ebola vaccine developed by the University of Oxford.
The jab has been designed to tackle the Zaire and Sudan types of Ebola, which together have caused nearly all Ebola outbreaks and deaths worldwide.
Ebola vaccines exist for the Zaire species but Oxford researchers hope the new jab will have a wider reach. There are four species of Ebola virus. Of these, Zaire is the most lethal, causing death in 70%-90% of cases if left untreated.
• Source: BBC
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