Everything you need to know about the coronavirus vaccines

Already vaccination programmes are being rolled out across the region, in the UAE, Saudi Arabia, Bahrain, Kuwait and Oman, with various technologies given the go ahead by respective governments.

However, in an age of misinformation, fake news and conspiracy theories, there are real concerns that people will continue to run the risk of catching the deadly virus rather than taking the vaccine.

Here, Arabian Business talks exclusively with Hala Fahs, senior research scientist, NYU Abu Dhabi, about the various coronavirus vaccines.

Around 40% of Americans are wary of receiving a vaccine. Are people right to be mindful of the fact that all medicines have side effects?

Yes, but people forget that, prior to the era of vaccines, about a third of all children died from infectious diseases, like Polio, Diphtheria and whooping cough, and never reached adulthood. Adults were in constant fear of deadly plagues caused by infectious diseases. Scientific research supports the development of efficient and safe vaccines which have done an amazing job. We’ve wiped out deadly diseases and we use vaccines to control things like Measles and Tuberculosis that you could still die from if there were no vaccines.

Some people see vaccines as an artificial foreign substance which stays in our body for our entire life. This is inaccurate. Vaccines work by presenting a weakened germ or a part of it to our body’s natural defences to train our immune system to create antibodies, just as it does when it’s exposed to a disease. However, because vaccines contain only part of a germ or weakened forms of viruses or bacteria, they do not cause the disease.

Modern research has allowed the development of less reactogenic vaccine products. Scientists have shown that vaccines have an excellent safety record, even better than some therapeutic medicines. Misguided safety concerns in some countries have led to a reduced vaccination coverage, causing the re-emergence of diseases like measles.

The Covid-19 vaccine development process consists of three phases of clinical trials to test its safety first (phases I and II) and then its efficacy (phase III). The results undergo a strict audit prior to approval by the regulators in each country. For example, the UAE conducted a phase III trial for the Sinopharm vaccine on more than 30,000 people, with half of them receiving the vaccine and the other half receiving a placebo. The Sinopharm vaccine has been shown to be safe and 86% efficient. It has also been given to many people in China and elsewhere without serious side effects.

Tell us about the different vaccine technologies coming to market

Researchers are currently testing 63 vaccines in clinical trials on humans and 18 have reached the phase III. There are four main types of Covid-19 vaccines that are being tested. Inactivated or attenuated vaccines (eg Sinopharm) which use a form of the virus that has been inactivated or weakened so it doesn’t cause disease, but still generates an immune response. Many existing vaccines are made in this traditional way, such as those against measles and polio, but their production is time-consuming because it requires extensive safety testing.

Genetic vaccines (Pfizer/BioNTech and Moderna) offer a cutting-edge approach that uses part of the virus’s RNA containing the genetic instruction to generate a viral protein that safely prompts an immune response. The production of these genetic vaccines can be very fast.

Viral vector vaccines (CanSino, Oxford/AstraZeneca, Sputnik, Johnson&Johnson) use a harmless virus (for example, an adenovirus) that has been genetically engineered so that it can’t cause disease but will produce coronavirus proteins to safely generate an immune response. These viruses are weakened so they cannot cause disease.

There are also some protein-based vaccines in development, which use fragments of proteins or protein shells that mimic parts of the Covid-19 virus to safely generate an immune response.

The speed of development was incredible. Was it rushed?

No. We live in an an era where technology is advancing at an unprecedented rate and scientists build on recent advancements. Six days after the first sample was isolated from a patient with Severe Acute Respiratory Syndrome, in December 2019, geneticists announced the genetic code of the new virus SARS-CoV-2. They made the sequence available to everyone to develop diagnostic tests and vaccines. One day after the virus identification, diagnostic tests were available due to the advancement in molecular biology. Because it’s a fast spreading respiratory disease, there was a race and a huge pressure to find a vaccine since it would be the game changer. Only 2 months after the virus was identified, the first vaccine clinical trial to check the safety of a vaccine candidate was started. These scientists were already developing those vaccines for other diseases such as Ebola and they quickly re-adapted their research and redirected their activity to tackle the new Covid-19 pandemic.

This wouldn’t have been possible in the past because we didn’t have the genetic, biotechnological tools or the bioinformatics and computational modelling advancements. Science is beating the virus because many scientists around the world have shifted their activity toward the pandemic.

The pandemic is claiming more lives every day, especially among the elderly and people with comorbidities, sand the vaccination is the only way to win this moral battle. The regulators are monitoring the allergic reactions or other adverse reactions that may arise in some people, and this is the case with any new medicine. This process should be transparent, and the data should be peer-reviewed and made available to the public, and the benefit-risk value should undergo continuous evaluation to strengthen the confidence in immunization programs.

But to be clear, the benefit of taking the vaccine should always outweigh the risk. We should keep in mind that there is no vaccine – or medicine generally – that will be 100 percent efficient in 100% of people because of our genetic variation.

Are you worried by the new strains that have been reported?

Each time the virus infects a new individual, it produces billions of new viral copies which may carry mutations or variations in their genetic material. Most of these mutations can be mistakes that lead to less viable viruses. The virus has been mutating ever since it has infected humans, and thousands of viral sequences harbouring different mutations have been published. The new variant identified in the UK has 17 new mutations, and eight of those 17 mutation are in the spike protein. One of them – N501Y – seems to be responsible for an increased number of infections by 70 percent. There is no epidemiologic indication that this variant is more severe, though more clinical studies are needed to determine this assumption. It’s important to remember that viruses would rather evolve not to kill the host, because they cannot replicate on their own and they need live cells to thrive. Viruses would evolve to become less deadly, but more infectious.

Will vaccines work against these new strains?

Several mutations, among them this new variant N501Y have been modelled by scientists studying the spike protein and previously tested in mice. The mice results indicate that antibodies from mice infected with older viral variants would still work against the new strain. Studies are being carried out, and within a week, we will know if this is the case for humans. There are indications that traditional vaccines like the Sinopharm would not be affected by this new variant because they are not specifically designed to target the spike protein. The other vaccines that target the spike protein usually lead to the production of several antibodies against spike regions that are not affected by this variant. However, governments are still concerned because more infections will inevitably lead proportionally to more severe cases, hence you see flight cancellations and border restrictions in several countries to control the spread.

Is Covid-19 likely to become endemic?

Yes, since the beginning we knew that this virus was here to stay. It’s a respiratory virus with a high infection rate which makes it very hard to control, except with social distancing. We will learn to live with it. We don’t yet know if we will have to produce a new vaccine every year like it’s the case for the Flu. Overall, we’re lucky that it’s not severe like its previous relatives, SARS, and MERS.

Tell us about the UAE’s role in Covid research.

Since the start of the pandemic, research universities and centres in the UAE have been involved in various aspects of COVID-19 research such as genome sequencing, testing methods, treatments and vaccine trials. At New York University Abu Dhabi, we have several Labs involved in Covid-19 research – the Centre for Genomics and Systems Biology has developed a highly sensitive testing method that can detect low viral loads accurately to control the virus’ spread.

How has the UAE seemed to fair better than many countries with Covid?

The UAE is among the top countries leading the way in Covid-19 testing. By testing and isolating the patients early, the UAE is achieving great results in terms of controlling the pandemic which is translated by a low death rate of 0.4 percent. This is partly due to the young age of the population. The UAE is leading the global efforts in terms of tracking, isolation, awareness, research, medical support and vaccines availability, which spreads confidence among the UAE residents.