What you need to know about vaccination for Covid-19 – An interview with Dr. Sabastine Eugene Arthur, A Virologist

The world entered into the twenty-first century breathing with optimism. Conflicts have been on a low key; famine has almost been overcome to the point that starvation is more a political challenge than a natural challenge, and technology has seen important advances. In all this, the irruption of the coronavirus disease 2019 (COVID-19) came as a shock to the world. This is not the same as saying that the world never expected an outbreak of a potential virus, as it is about the world being stunned by the ravaging effect of the pandemic.

As the coronavirus pandemic upends the world, despondency burdens humans, precisely because, since the outbreak of influenza in 1918, the world had not seen a virus that has been such deadly. Most economies have taken a nosedive, while politically, nations are becoming more nationalistic – burdening the need for internationalism to deal with a common “invisible” enemy. Socially, the imposition of social distancing protocols, including the wearing of face, destabilises the sociality of human beings.

The impact of the pandemic exposes the vulnerability of human beings. It has unveiled the illusions that humans have conquered the world. In response to this frustration, conspiracies and counter-conspiracies have characterised the fight against the COVID-19. But it is worth noting that these conspiracies are important in helping human beings to make sense of a world that appears to be spiralling out of its axis.

The conspiracies deepen as the COVID-19-related death toll continues to rise. As of the time of writing, 2,477,315 have died from the COVID-19 globally, while many others are battling with their health in hospitals. Given the rapacious spread of the virus and its accompanying frustrations, the world launched into a frantic search for a vaccine. Fortunately, by December 2020, the world was successful in rolling out a vaccine that proved efficient in enhancing human immunity to fight the virus.

While the breakthrough in the vaccination infuses hope into the world – restoring “normal life”, concerns – some genuine, others informed by conspiracies – have been building around vaccination. These concerns and conspiracies have become major obstacles to getting as many people as possible to be vaccinated. And considering the political liberal state that fosters individual rights, democratic states are in a dilemma, as they struggle to negotiate the complex terrain of individual rights and state responsibility. Question: can the state use coercive power to promote vaccination?

It is against the conspiracies and concerns around vaccination that I engaged Dr. Sabastine Eugene Arthur. Dr. Arthur is a virologist who received his training from the University of Arkansas in the United States and the University of Cambridge in the United Kingdom. He has been instrumental in educating the Ghanaian public about the coronavirus since Ghana recorded its first case in March 2020. The following is a transcription of our interview:

Me: To which extent should we fear the COVID-19?

Sabastine: Historically, the world has recorded pandemics, but none wiped away the human race. This is not to dismiss the devastating impact of the pandemic on different spheres of life. Most people will recover, after they have been infected. One major challenge, however, is that health facilities would be overwhelmed, as more and more people are infected.  The lockdown and social distancing protocols affect people differently. While the privileged class in society may arguably benefit from such safety protocols, the same cannot be said about the socially marginalised. The poor are usually the most affected by pandemics, since most of them are involved in the informal sector of the economy where livelihood is based on daily earning – and not salaries. What we should rather do is to follow social distancing and other safety protocols. In all this, we should not fear to the point of losing our senses. Our fear should rather motivate us to follow all the safety protocols.

Me: How has the pandemic mirrored the healthcare system in Ghana?

Sabastine: I think it reveals the disproportionate ratio between doctors/healthcare workers and patients. While we did not see our health facilities becoming totally overwhelmed like in the case of other European countries like Italy and Spain, the pandemic points to the need to revamp the health sector – training more healthcare workers, investing in infrastructure and providing state of the art medical equipment. I have heard some individuals comparing Ghana with some developed countries. I think we need to understand that the pandemic has impacted different nations differently. If Ghana had recorded the high numbers that some countries in the West did, definitely our health system would have been burdened than what we are currently observing.

Me: We are told that it takes quite some time for vaccines to be developed, how come scientists succeeded in getting their act together to get us a vaccine in a record time? This is because the speed at which these vaccines were developed has generated lots of conspiracies.

Sabastine: Before I start, with vaccines, let me name them as “fake viruses”. This is because the are made and introduce into our bodies to make the body think they are the original viruses. There are two reasons for the rapidity in generating vaccines. First, because the world has had a history of pandemics, scientists have always been on the alert for potential viral epidemic or pandemic and developing appropriate technologies. So, the technology that aided the production of the vaccines were well developed and only needed some improvisation and reengineering to produce a vaccine. Second, scientists in China, where the virus epidemiologically is believed to have originated, were quick to share the genetic makeup/information about the virus with the rest of the world. So, the scientific community got the mRNA sequence of the virus early enough to have started the search for a vaccine.

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Me: So, how does the mRNA help in the production of the vaccine?

Sabastine: When scientists got the information encoded in the messenger ribonucleic acid (mRNA) of the virus, they studied it thoroughly to understand how the various parts of the virus is made from the mRNA, most importantly, the spike protein which is used by the virus to first interact with and enter the human cells. It is this protein that is mimicked by the protein made by the cells using the information encoded in the mRNA contained in the vaccine. I must emphasise that the human cell does not use the mRNA molecule itself, but rather the information the mRNA carries. The mRNA degrades after the cell has used the information it carries. This helps the human cells to mount an immune response against the real virus upon a subsequent infection. We need to understand this as it sheds light on the debate around the supposed capacity of vaccines to change human DNA.

Me: Is it true that the COVID-19 is given as part of vaccination?

Sabastine: At no point is a “live” and potent virus given to human beings. In instances where a virus is introduced to the human body, the virus is rendered ineffective – it loses its infectious effect. It is, I think, the Oxford-AstraZeneca vaccine that used some part of the SARS-CoV-2 genetic material carried in a cold-causing adenovirus vector which was isolated from chimpanzees. The adenovirus is engineered so that even though it can enter the cells it is not able to replicate or cause any disease in humans. At all point, the virus is rendered non-infectious. Usually, what happens is that when the mRNA of the virus is produced and introduced to the human cell, the human cell is primed to produce a protein (anti-bodies) that wards off the mRNA of the SARS-CoV-2. So, when one receives the vaccines, one already has an in-built protection/immunity that fights the virus. So, as a simple illustration, the production of the vaccines follows the logic of producing guns to fight guns. If you are going to fight a group of people who use guns – instead of stones to fight – you look for information about the guns your belligerent party is using and produce something similar that is equally powerful to neutralise the effect of the enemy’s gun.

Me: Does the vaccine have a curative effect? In other words, does it cure a COVID-19 patient?

Sabastine: The vaccine does not have curative efficiency. In other words, it does not cure a COVID-19 patient. It only prevents one from getting the virus. The goal of the vaccine is to make sure when one is infected, one does not yield to the illness and health complications that accompany the infection. 

Me: Which is more effective in dealing with the COVID-19: Drugs or vaccine?

Sabastine: Both are absolutely important in dealing with the current pandemic. But, as I said earlier, because there were existing efficient technology and early knowledge about the mRNA of the virus, it was comparatively easier to produce a vaccine than a drug. Producing a drug to cure the virus may have its own processes that pharmacists and chemists can better explain. But since we do not yet have a known curative drug to deal with the virus, we will have to do with the vaccine. So, in sum, I will say that both the curative (drug) and preventive (vaccine) are important in dealing with the pandemic, but since we already have a vaccine, we should apply it, even as we work concurrently to develop efficient drugs.

Me: Does the vaccine cause miscarriage and/or infertility in women?

Sabastine: It is said that miscarriage is partly caused by some spike-like proteins during pregnancy. So, the argument is that the spike protein of the mRNA may cause miscarriage. Research has shown that several pregnant women were involved in the clinical trials for the vaccine and none of them not had a miscarriage. Also, it is established that the SARS-COV-2 spike protein or the spike protein mimic made from the vaccine is unlike the pregnancy-related type. The understanding within the scientific community is that women who suffer miscarriage after receiving the virus may be predisposed to causative underlying health conditions, hence, pregnant women are advised to speak to the doctors before receiving a vaccine.

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Me: Does the vaccine alter human DNA?

Sabastine: The mRNA does not get into the nucleus – the residence of cellular DNA. The human cell only uses the information on the mRNA to make proteins. Immediately after that, the mRNA gets degraded. It has a very short lifespan. It does not get into the DNA. It is because of the brevity of the life of the mRNA that some have suggested may pose a challenge in rural areas in the tropical zones. Because mRNA needs to be stored in at colder temperatures. This is where the Oxford-AstraZeneca vaccines have an upper hand because they do not contain mRNA, instead, the information to make the spike protein is stored in a DNA. Even with that, It does not interfere with the cellular DNA to alter it.

Me: How different is this COVID-19 from HIV since the latter appears more devastating – in terms of mortality? And why don’t we have a vaccine for HIV? This is because anti-vaccinationists have questioned this as part of the conspiracies against the COVID-19 vaccination?

Sabastine: Simply put, HIV has intelligent ways of hiding from the immune system of humans through it ridiculously rate of mutation generation. Several strains of the HIV virus exist and unfortunately, no single vaccine has been able to fight against them all. We must also understand that one of the key cells in the immune system, CD-4 T is the target for HIV. These and other reasons make HIV vaccine development a challenge and renders the virus more problematic to public health. Regardless research is still underway to develop a more potent vaccine against HIV.

Me: How long is one protected from the COVID-19 after receiving the vaccine?

Sabastine: We don’t have enough data to show the length at which one is protected after receiving the vaccine. But what we know from the clinical trial is that at least two months were used to measure the efficacy of the vaccine in terms of duration. But we are yet to gather enough evidence on your question.

Me: Does the vaccine cause COVID-19?

Sabastine: No. Nothing in the vaccine causes COVID-19. COVID-19 is caused only when one gets into contact with SARS-CoV-2.

Me: Does the vaccine have a psychotic effect? In other words, does it lead to madness or insanity?

Sabastine: There is no evidence of people developing psychosis or madness as a result of the vaccine.

Me: What are the possible side effects of the vaccine?

Sabastine: The side effects are headache, sore arm – from the injection, tiredness etc. But not coughing. These side effects resolve in about 48 years. The reason for these effects may include the body’s reaction to the adjuvant in the vaccine which helps to trigger the immune system. Also the vaccine gets into the body and stimulates different pathways including inflammation. People with a strong immune system develop antibodies and quickly which then triggers immediate side effect. I had this type of experience when I had my first dose of vaccine, but it was resolved in 48 hours. I must also say that while these symptoms may be common, different people may experience slightly different symptoms with varying degrees of intensity. It is always advise that people disclose  

Me: Can’t the body develop natural antibodies?

Sabastine: Yes, the body can develop natural antibodies after one is exposed to the virus. But we are not sure about the extent that can be efficient for COVID-19. But natural antibodies also means that persons who have been infected may be re-infected but may not feel sick. It must also be mentioned that with a strong immune system, a person who has not been vaccinated may not fall sick, even if he or she is infected. It is important to state that a person who is re-infected may not fall sick or show symptoms. But we do not know how long natural antibodies stay to keep protecting a person after the first or second infection.

Me: If we have natural antibodies, why do we need vaccination?

Sabastine: We do not know how much the body’s natural antibodies can stand the test of time and frequent reinfection. There are critical issues about people’s (compromised) health and lifestyle that may undermine one’s immune system. But the quest for natural antibodies means we should have a healthy lifestyle, boost our immune system, and eating well. If it were possible for all human beings to do this, we may be able to fight the virus naturally.

Me: Must we still wear facemask after receiving a vaccine?

Sabastine: Yes, we should still wear facemask because we can still contract the virus. The only difference is that, because we are vaccinated, we will not fall sick. But the danger is that we may tend to infect someone who, if he or she has not been vaccinated, can fall sick and develop COVID-19-related complications. This means we have to wear the facemask until the majority of people have been vaccinated.

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Me: So, it means, I can be infected, even after vaccination?

Sabastine: Yes, especially at the very early stages of vaccination when the immune system is being stimulated. Note that no vaccine is 100% at protecting anyone. In fact, there are chances that some very few people will still catch the virus and fall sick, however, the chances of developing severe illness are super low. We still need time to make a very firm claim on the protection that can be acquired from vaccinations. Receiving the vaccine is definitely better than not receiving it at all.

Me: How often should one be vaccinated after the first-two shots?

Sabastine: For this current virus unlike the flu, we do not know anything about that. This is different from the flu virus which studies have shown that mutants evolve virtually annually, so vaccines are altered to take care of all mutations and people are advised to take the shot each year. But for the COVID-19 we do not know about any seasonal vaccination yet.

Me: Is vaccination a way of making people think in a homogenous submissive manner?

Sabastine: Anti-vaccinationists are only pre-conditioning people’s minds to rebel. But as I said, while there are side effects, no study has shown that the vaccine per se causes human beings to be mentally controlled by others or cowed into submission. I must, however, say that if one has an underlying health condition that may be triggered by the vaccine, one needs to talk to one’s doctor first. Or, if you are uncertain about your health status, please talk to your doctor before proceeding to receive the vaccine.

Me: We now know that the COVID-19 virus has been mutating, at least we know of the South African and UK ones. How efficient and adaptable are the vaccines to these variants?

Sabastine: These new variants emerged after the vaccines had been produced. Preliminary data are showing that most of the vaccines out there are effective in fighting the new variants. But we are still gathering more data on that.  

Me: Why can’t the west share the formulation of the production of the vaccine with other nations in Africa to stem the tide against myths and conspiracies and more so paranoia that the west is there to destroy Africa with vaccines?

Sabastine: This is a difficult question, but even if we are to get the formulation, do we have the facilities to produce the vaccine? There are ethical issues when it comes to data sharing and patents and I am sure these will impact your question. I am sure we may have the potential though. And for those who think these vaccines are made to kill human beings, are we sure that there are no other subtle ways of killing human beings? Have people thought about other biological weapons? No COVID-19 vaccine has been developed with the intention of killing anyone.

Me: What about herbal medicine, which many thinks may have the cure for the COVID-19, since our ancestors are said to have survived on them?

Sabastine: Well, this isn’t a bad idea. I have heard about some of these herbal medicines under review and testing. So, let us see what comes out of that. The other thing is that herbalists should be encouraged to also engage in a robust search for a cure, while the Ghana Food and Drugs Authority should support the process.

Me: What should we do to dispel conspiracies among people, especially as Ghana gets ready to receive vaccines?

Sabastine: I think the media needs to be appropriated. Just as the president rightly uses the media – until fairly recently – to give a bi-weekly update on the pandemic, the same could be done with educating Ghanaians on the importance of vaccines. People should be given basic education on the virus and how important vaccines are in restoring normalcy in our world.

As Ghana is set to receive its first consignment of vaccines, the state and other stakeholders must intensify the education on vaccination. Religious leaders need to be creative in theologising to collaborate with the state. This is important since religion is pervasive and important in the daily routines in Ghana. Until then, we strongly encourage as many Ghanaians as possible to receive the vaccination. Our lives are hidden in God who has given human beings the creative capacity to do science. Science is a product of an intelligent God creating intelligent human beings. To end with, there are no chips or tracking devices in the vaccine and the vaccine, just like the virus has no relationship with 5G technology, has no relationship with 666 or mark of the beast as touted by some people.

Dr Sabastine Eugene Arthur, University of North Carolina at Chapel Hill, School of Medicine.

Charles Prempeh ([email protected]), African University College of Communications, Accra