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70-80% of population need jabs to control community spread
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Health Minister denies community spread, maintains only clusters
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One dose vaccination could limit antibody production
Prof. Tissa Vitharana[/caption]
Do you think the current programme on administering vaccines has to be further developed?
The WHO was giving Oxford-AstraZeneca vaccines for 20% of the Sri Lankan population. During the period the WHO decided on this, the majority of Covid-19 cases were sub-chemical – that means they were asymptomatic; close to 80% of the patients were asymptomatic. The severity of the disease was high and that was mostly affecting elderly people and those with other debilitating health conditions or whose immune system was weak.
We are not a rich country and there is a shortage of vaccines in the world. There is a very high demand for vaccines and the rich countries are going to steal a march on this. The amounts of money we have to exceed the 20% grant from the WHO is very limited. Now, if we are trying to prevent transmission with vaccines, we have to immunise at least 70-80% of the population. Otherwise, the transmission in the community will continue.
What I advised was that there is this vulnerable group – the elderly and those with other diseases – which we have to select first and give the vaccines. Then we are minimising deaths and also the number of severe illness cases.
The disease, which was originally in clusters, is no longer in that stage; it is now widespread in the community. It is now a community spreading disease which affects each and every body. Viruses are not worried about political affiliation, skin colour, religion, language, or race; viruses only seek live cells to multiply. We have to use masks, especially when we are leaving the house, then ensure that we are maintaining social distancing. I say two metres rather than one metre, especially if a person doesn’t have a mask. Hand hygiene is also important and washing hands with soap and water kills the virus. These three simple rules have to be followed.
The WHO says the first dose of Oxford-AstraZeneca is valid for six months. What is your opinion?
Yes, I agree with that. With the present situation of the virus transmission, the duration of the protection is limited and we have to boost the protection annually. When I directed the Medical Research Institute (MRI), we used to collect samples from different influenza cases from different age groups and genders around the year.
We used to send them to the World Influenza Centre in London and they examined those samples and informed us if the vaccine that was available was providing protection against any new strains that have appeared. If it wasn’t, then they add the particular strain in the production of the next batch of vaccines. In future, we might also have to follow a similar procedure if we identify new strains, but still, we don’t know because this is a new disease.
What considerations need to be made and what principles need to be added for the national immunisation programme?
Principles have to be determined as we move along. At the moment, there are different variants of the virus. There is the UK variant, Indian variant, South African variant, and so on. So, we don’t know. In the calcification of viruses, the bigger group is called zero type. Within the zero types, we have these variants. So far, the world regards Covid-19, whether it is in the UK or India, as one zero type, but there are different variants.
As an example, when I was in the Polio Eradication Committee, we found three zero types of the disease and in that case, we had to develop three separate vaccines for each zero type. They were not three variants of one zero type, so it was a different situation.
For Covid-19, we don’t know yet whether these variants will remain within one zero type or whether it will develop to different zero types depending on the genetic changes. This is a new disease which is evolving. At the moment, there are different types of vaccines. The Serum Institute in India and others who are developing the Oxford-AstraZeneca vaccine use a different technique where they introduce the antibodies from the Covid-19 virus and give them as a vaccine. This is a tested method which has worked. The Pfizer vaccine (methodology) is used for the first time and we don’t know what the repercussions will be. In my view, we have to develop suitable policies depending on our funding capability and the availability of the vaccines. First, we have to protect vulnerable groups.
Are there any reports being released on the possibility of Covid-19 vaccines causing death within two years?
That is fake news. French virologist and Nobel Prize winner Luc Montagnier (who shared his controversial opinion about Covid-19 vaccination) is a person who led the group that discovered the HIV virus. He is a capable virologist and he deserved a Nobel Prize for that discovery, but we have to first properly understand the disease, the factors of transmission, and the severity of the disease. All these aspects have to be properly studied before coming to a conclusion. So, we have to plan our strategies accordingly.
In that sense, are there any new Covid-19 prevention strategies planned currently by the Sri Lankan Government?
I had different strategies. I was not consulted at any time. The only place that I was involved in the consultation process was in the Parliament Advisory Committee and I was a member of the Health Advisory Committee. At the committee, I had explained the things I had mentioned in the interview and these are the things we have to do. Then, the Health Minister said she doesn’t agree with me and that the virus is still in the cluster stage. She also said we don’t need to change our strategy and we are going to continue with the same strategy. So, after that, I didn’t say anything about the strategy.
Russia says the first dose of Sputnik V provides sufficient protection. In that sense, can Sri Lanka avoid administering a second dose? What is your opinion?
It will give some protection, but for how long? We still can’t say that. It is a whole process. The entire process is the ability to produce antibodies but if we are giving one dose, the number of antibodies that’ll be produced can be limited, and it doesn’t last very long; it keeps on dropping with time.
We have to give a booster to develop antibodies for a much longer period and for that we need the second dose.
We have to wait for a certain period and check how the immunity is developed by the vaccine, even after getting the two doses. For Oxford-AstraZeneca, we have to provide boosters annually. There is a high demand for vaccines and many people are trying to take shortcuts. So, we have to be careful.