Covid-19 Vaccine Health Benefits Outweigh Risks: US Expert

By Ashswita Ravindran | 16 December 2020

Dr Rupali Limaye says pharmaceutical companies don’t profit much from vaccines.

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KUALA LUMPUR, Dec 16 — Any Covid-19 vaccine determined to be safe and effective has more benefits than risks, an American social and behavioural scientist said.

During a recent virtual talk, Dr Rupali Limaye from the United States’ Johns Hopkins Bloomberg School of Public Health said that approved Covid-19 vaccines have undergone a rigorous safety process and been determined to be efficacious.

“I would say this about any vaccine, we recommend vaccines because the benefits outweigh the risks,” Dr Limaye said last Saturday at the “Public Health: Tackling the digital spread of Covid-19” virtual talk, hosted by the US embassy in Kuala Lumpur and moderated by CodeBlue editor-in-chief Boo Su-Lyn on December 12.

“It’s a rigorous process, that is a step-by-step process, that goes through stages and phases of clinical trials,” added the faculty member from the Departments of International Health, Epidemiology, and Health, Behavior and Society at the Johns Hopkins Bloomberg School of Public Health.

Scientists have reported lingering effects of coronavirus infection, beyond immediate flu-like symptoms, such as fatigue, shortness of breath, ache in the joints, foggy thinking, a persistent loss of smell, and damage to the heart, kidneys, lungs, and brain. Science magazine reported that it was difficult to identify the chances of a Covid-19 patient developing persistent symptoms, due to varying studies following up with Covid-19 survivors.

In any clinical trial of a vaccine, Dr Limaye said that the concept of the vaccine will firstly have to be approved before moving into animal testing. Following that, the products that are tested will have to show specific markers before going into human testing.

She explained that when the trial moves on to human testing, many individuals will be involved in the trial. Phase 3 trials usually involve tens of thousands of people. Safety signals will be looked at to study the efficacy of the vaccine and adequate cases will also be needed to confirm the efficacy of the vaccines.

“The process is quite rigorous. It’s not something that will happen very very quickly, and it costs a ton of money. I think people look at pharmaceutical companies and they say it’s just a way for pharmaceutical companies to make money, you know,” Dr Limaye said.

“These vaccines are not really bringing in money to pharmaceutical companies.”

Dr Rupali Limaye, faculty member from the Departments of International Health, Epidemiology, and Health, Behavior and Society at the Johns Hopkins Bloomberg School of Public Health

Dr Limaye, who is also the associate director for Behavioral Research at the Institute for Vaccine Safety, said there is public scrutiny of Covid-19 vaccines because of their expedited development process. However, she highlighted that the process of rolling out a Covid-19 vaccine is expedited because of the coronavirus pandemic that has high rates of morbidity and mortality.

“I think a lot of people might then interpret to mean that quarters have been cut and that’s not the case.”

Dr Limaye pointed out that there are independent bodies that have been appointed to look into the clinical trial data of the vaccines to monitor their efficacy, and to ensure the vaccine that will reach the community and overall human population is safe.

For a regular clinical trial for any vaccine, it has to undergo five stages that take years. For instance, in any clinical trial for a vaccine, even the first stage, the preclinical work that is designed to find natural or aesthetic antigens that induce an immune reaction in the body will take one or two years to complete. However, the Covid-19 vaccines by many pharmaceutical companies were developed in under a year.

The Covid-19 vaccine developed by a collaboration between US pharmaceutical giant Pfizer and German biotechnology company BioNTech has already started to be administered to the public in the UK and the US after receiving regulatory approval.

The Malaysian government has procured 12.8 million doses of the Pfizer-BioNTech vaccine to cover 20 per cent of the population, while Singaporean Prime Minister Lee Hsien Loong announced Monday that Singapore would be receiving its first shipment of the Pfizer vaccine by the end of the month.

Dr Limaye also highlighted that one of the concerns people might have when deciding if they want to get a vaccine is the mistaken belief that the vaccine has not been tested on many people.

“It has actually been tested on thousands of people already. So, I think it is important to remind people that it isn’t a few hundred people; we’re talking thousands of people who have gone through these trials.”

Dr Rupali Limaye, faculty member from the Departments of International Health, Epidemiology, and Health, Behavior and Society at the Johns Hopkins Bloomberg School of Public Health

She shared that even with the Covid-19 viral infection itself, there was much misinformation about the spread of the virus as well as treatment of Covid-19 infection. For example, in the US, Dr Limaye said that people thought that they could contract Covid-19 through the 5G network and that bleach could cure Covid-19.

However, she said that this pandemic is a challenging time for a lot of people, whereby they are trying to figure out how to be safe from the virus. Dr Limaye, who teaches classes on health behavior change and persuasive communication, said that people are generally scared because they themselves have seen family members hospitalised or who have died from the coronavirus.

Dr Limaye said people should go to trusted sources to get correct information, especially related to therapeutics or non-pharmaceutical interventions for Covid-19.

“I think it’s something that can be really challenging and I think that social media has done amazing things with regards to breaking down the digital divide and allowing people to have access to information but just as you know, there’s no fact checking so anyone can say anything.”

“It’s also a bit of doing a little bit of digging on your own, to kind of see if the information you are seeing is true or not, and also turning to health care providers and scientists that you may know, whether it’s in your community, whether your friends that are scientists, and asking their opinion to help you decide whether or not something is true or its false.”

Transparent Vaccine Information, Engaging Community Leaders

Volunteers from Semporna Heroes deliver food packs to needy villagers in Sabah. Picture from Twitter @maszlee.

Dr Limaye also stressed the importance of transparency with regards to vaccine information. She pointed out that health care workers who will be getting the Covid-19 vaccine first should share their experience in getting their vaccine.

“It’s really important for US health care workers to talk about their experience right and talk about if they experienced any side effects from the vaccine,” Dr Limaye said.

“That’s what’s really important because health care workers in the US have such a unique perspective because they have been dealing with Covid-19 for months and months.”

BBC reported that the US has started rolling out Covid-19 vaccines after the Food and Drug Administration (FDA) issued emergency-use authorisation for Pfizer’s vaccine, as health workers were given the shot last Monday.

Dr Limaye pointed out that the Covid-19 vaccine will have common side effects, just like any other vaccine like the measles, mumps and rubella (MMR) vaccine, which has side effects of swelling at the injection site, redness, low grade fever and feeling unwell for a couple of days.

“For the Pfizer candidate vaccine, I believe that people did say they felt unwell for a couple of days. I think it’s important to communicate that so that people aren’t scared about it. It’s a normal reaction; people might experience it,” Dr Limaye said.

The most common side effects reported from Pfizer-BioNTech’s candidate vaccine, according to the US FDA’s briefing document, were injection site reaction (84.1 percent), fatigue (62.9 per cent), headache (55.1 per cent), chills (31.9 per cent), and fever (14.2 per cent).

“A lot of the way that we talk about vaccines is like when you think about a child, you think about a car seat, hoping that you don’t have to test the car seat In a crash, but you’re really happy that it’s there, and you think about vaccines in the exact same way,” Dr Limaye said last Saturday.

She also pointed out that governments should get trusted local leaders in the community who can speak about the importance of the Covid-19 vaccine, empathise with people, and answer their real concerns related to the vaccine.

“To me again, it is a new vaccine, we are going to see these questions. It is important for us to be emphatic, build trust to understand why we have trust in this development of the vaccine, why we think that the product that is going to be rolled out is safe and important to you, and more importantly, that it is a best solution for you to protect you and your family.

Dr Rupali Limaye, faculty member from the Departments of International Health, Epidemiology, and Health, Behavior and Society at the Johns Hopkins Bloomberg School of Public Health

“And in the end, individuals will decide and say ‘I don’t have enough information for this, I don’t feel comfortable with this’. I think again being empathetic and saying what other information do you need? How can I help you?” Dr Limaye said.

“Here in the US, we’ve definitely seen that there has been more of a grassroot approach in identifying local community opinion leaders, having them talk about recommended social distancing, mask wearing etc, and I don’t think that will change once the vaccines are rolling out “

Vaccination Priority Groups Should Be Based On Highest Risk

Disinfection activities at the Kajang Women’s Prison on April 20, 2020. Picture from Facebook @jabatanpenjaramalaysia.

Dr Limaye pointed out that governments should identify and first vaccinate those who are at higher risk in getting Covid-19, even if it’s prisoners or migrant workers.

“Just because they are prisoners, doesn’t mean they are not human.”

Dr Rupali Limaye, faculty member from the Departments of International Health, Epidemiology, and Health, Behavior and Society at the Johns Hopkins Bloomberg School of Public Health

“To me, it’s thinking about risk and really trying to prioritise that and say that individuals that are higher risk should be prioritised.”

She said that at the end of the day, it should come down to science to decide who is at higher risk of getting Covid-19 and who has higher exposure to Covid-19 to get the vaccine first.

“So it’s not only protecting them subsequently; indirectly it will protect other segments of the population,” the social and behavioral scientist said.

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