Excerpt: With multiple vaccines now being discovered, the issues of distribution and accessibility are at the forefront of global leaders, but in Nigeria, the issue is acceptability.
As the world welcomes the news of the various discoveries of vaccines that can tackle the coronavirus pandemic against the time frame which some medical specialists predicted, it serves as a relief to the world in which the possible vaccines are now in their third phase of clinical trials. While some vaccines await for the governments' approval for it to be made available for public use, there are still questions on how the vaccines will be distributed and if vaccination will be mandatory or optional. However, medical experts agreed that for a vaccine to be effective it must work globally. Africans are not new to vaccination or vaccine trials, history has documented the various vaccines used and tested in Africa. But the most pertinent question is how Africans will respond to the vaccination process against COVID-19. (article continues below)
Yahia boulahia
A vaccine is any substance that is introduced a strong stimulated antibodies into the body in order to provide immunity against infections or diseases without making the individual seriously ill. This biological preparation was first created and introduced by a British physician Edward Jenner in 1796 to fight the smallpox virus, the vaccinia (cowpox virus) was used to confer smallpox. Before Jenner's vaccinia, Asian physicians are known to have used the principle of “yi tu kung tu" loosely translated to mean "fighting poison with poison". Also, the story of the English doctor Thomas Dimsdale in 1768 was claimed to have used what is called variolation (transferring a smallpox pustules from a sick patient into a healthy one) on Catherine the Great, the Russian empress. This act at that time was a pinnacle of medical achievement and it was 28 years later that Jenner’s vaccinia (using another variolation; cowpox) was developed on this intentional infectious idea to strengthen immunity against diseases. [1] According to WHO, a vaccine reduce the risks of getting a disease by working with the body's natural defense to build protection. When you get a vaccine, your immune system responds. [2]
The development of vaccines as claimed by medical historians did not start with Dimsdale or Jenner, some claim it started in China. It is claimed that it was the Chinese merchants that introduced variolation to India and Africa, while this idea was introduced to Americans in 1721 by a slave man named Onesimus who taught his cotton slave master the technique of variolation. [3] However, Jenner’s vaccinia is still regarded as the first clinical formulated vaccine.
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Moderna and Pfizer
Moderna and Pfizer vaccines are made from messenger RNA also known as mRNA. Traditionally, vaccines are known to contain weakened viruses signature proteins, unlike having the viral protein injected. The Moderna and Pfizer vaccine introduces a genetic material (mRNA) which is injected into the upper arm of the patient in which the muscle cells the mRNA into the viral protein directly in the body. Pfizer's vaccines (BNT162b2 is 90% effective) needs to be stored at -940 F (Fahrenheit) and will degrade within five days at 37 - 420 F which is the normal refrigeration temperature of slightly above freezing, Moderna claims its vaccine is almost 94.5% effective and can be maintained at home or medical freezer temperature (37-420) for up to six months which is good for long shipping and storage term.
The need for an Africa vaccine started when African Union (AU) approved the need for Africa to develop a framework to actively participate in the development and access to COVID-19 vaccines. The South African Ox1CoV-19 vaccine run by the University of the Witwatersrand in Johannesburg made South Africa the first country in Africa to begin the clinical trial of COVID-19 vaccine. Also Kenya launched its own clinical testing of AstraZeneca vaccine which is run by KEMRI (Wellcome Trust Research program). South Africa and Kenya vaccines are working with Oxford University’s Jenner Institute ChAdOx1 nCoV-19 vaccine. This is made possible under the Nagoya Protocol on Access and Benefit-Sharing (2010) which was ratified by 120 countries.
The AstraZeneca vaccine (created by the Oxford University) is the latest vaccine that is greeted in the medical world. The AstraZeneca vaccines are likely to be the vaccines that can be distributed without any logistic nightmare which can be stored long term at 2o to 8o Degree fahrenheit.
Africans and Vaccination
Africans are not new to the idea of vaccination, according to Dr. Albert Onobhayedo, [4] a medical historian. He said that Africans are known to have developed some form of inoculation to fight disease in the past, before the introduction of colonial rule, traditional African societies used their herbal knowledge to create a “traditional inoculators” to fight diseases without any orthodox medicine. During the colonial era, Africans hospitality nature made the colonists introduce various ideas and concepts and which Africans accepted with open hands, orthodox medicine was introduced to Africans by the colonists.
Bright Azebokhe Jerry
In the pre-colonial era, the mode of vaccination is different, Onobhayedo said that “as long as you introduce a substance into your system is a form of vaccination and Africans in the past are known to introduce herbal substance into their body through an incision in a form of tribal mark”5. In Nigeria, Albert said that the various tribal marks were not only used to show someone’s tribal affiliation or a form of beautification, but serves as an inoculation against measles and evil spirits. Among the Yoruba people of Nigeria, the use of ileke (waist beads) is used to wade off menstrual pain. Also, other Africa inoculations are derived from traditional herbs, like the Madagascar inoculation was made from Artemisia plant (a popular plant used for treating malaria), although was not accepted by the WHO, Africans welcome it.
In Colonial Africa, vaccinations were made compulsory due to their colonial control over their various territories. In colonial Nigeria the Yellow fever vaccine was made only for the white who were not immune to the sickness, the vaccine was later made available for Nigerians.
How will Africans Respond to COVID-19 Vaccines?
With the possible introduction of these various vaccines at the development stage (some awaiting approval) and the issues of distribution and acceptance, how will the Africans welcome this breakthrough if the vaccines gain approval? I believe that the factor of colonial mentality and conspiracy theories are what will surely influence Africans acceptability towards the COVID-19 vaccines.
Colonial Experience
Koprowski's Polio vaccine incident breeds suspicion on any western vaccine on Africans. Dr. Hilary Koprowski, a polish virologist and immunologist, created the Oral Polio Vaccine (OPV) which led to the AIDS hypothesis that it was the OPV that led to the creation of AIDS virus. The hypothesis claims that the OPV was derived from chimpanzee tissue that contained Simian Immunodeficiency virus (SIV) (which causes infections in about 45 species of primates). Although the hypothesis has been refuted with evidence that shows the HIV-1 virus was already in humans before the OPV trials were conducted in Belgian territories (now Democratic Republic of Congo, Rwanda and Burundi) between 1975 and 1960. The damage of the OPV hypothesis has already created a level of distrust on vaccines in Africa. Some Africans still believe that the OPV is the cause of AIDS in Africa and this might affect any vaccination attempts of COVID-19 in Africa.
French doctor remark
The remark of two French scientists (Camille Locht and Jean-Paul Mira) on a French TV program suggested that Africa should be used as a “testing lab” for the trial of the BCG vaccine against COVID-19. Dr. Mira said that “if I can be proactive, shouldn’t we be doing this study in Africa, where there are no mask, no treatment, and no resuscitation?” This comment was faced with backlash from Africans who tagged it as a colonialist view of Africans as guinea pigs and the reaction of the Director-General of WHO, who happens to be an African from Ethiopia Dr. Tedros Adhanom Ghebreyesus, said that WHO condemned this with the strongest term possible.”6 This remark caused an uproar in the continent. Africans took to their social media platform to condemn the statement by the French doctors, that Africa is not a lab to test their vaccines. The French doctor's comments have resituated the skepticism that Africans hold against the creation of a possible vaccine.
Comfort Ante
Infodemic: Conspiracy Theory
The conspiracy theory that greeted the world was that the COVID-19 is an artificial virus that was created in China, which spread either accidentally or intentionally to other parts of the world. Another conspiracy is that it’s a bioweapon created to start biological warfare. The conspiracy of biological warfare was made popular with Dean Koonts's The Eyes of Darkness which was published in 1981. Also the introduction of 5G was attributed to COVID-19 and that any vaccine created is to reduce the population or a new world order. The conspiracy theory states that the vaccine will be harmful to Africans. This form of fake news in circulation is what the WHO termed as Infodemic.
Infodemic is one factor that will truly influence Africans' responses to a vaccine against COVID-19. The level of fake news about the virus has made Africans wary of any vaccine.
How will Nigerians Respond to COVID-19 Vaccine
Nigeria's response to COVID-19 vaccine will be affected by two factors in different regions of the country.the Northern region will be influenced by the Pfizer incident while the Southern region will be largely influenced by conspiracy theory.
According to Bernard et al [5] in their study describing the conspiracy in Nigeria, Nigerians believed that the coronavirus was more of a divine intervention to kill all corrupt politicians. This was believable when a top Nigerian government staff; Abba Kyari (Chief of Staff to the President) was reported to have died of complications from COVID-19. Bernard et al. state that "In Nigeria, the conspiracy theory is that the virus has come to eliminate the corrupt political leaders of the country. It is also feared that the pandemic will be used as an excuse to impose mass vaccination, whose real purpose is to implement the Orwellian mechanism of social control. In addition, other conspiracy theories suggest that the lockdown is an excuse to force people into their homes, while authoritarian measures are being implemented. A common goal is to show the collusion of political and economic powers for evil intent"7. This is still the views of the majority of the Nigerians especially in the rural areas.
Comfort Ante
Nigeria is a society where everything is politicized and the people see the COVID-19 as another political move by politicians to enrich themselves. Many Nigerians are still in doubt of the existence of the COVID-19 virus, they believe it is just a game of politics, this was backed with the government's initial lockdown policy in which all political activities were still held while schools, markets, worship centers were closed. Nigerians went to social media to engage in a viral video that was first released via a social media platform, by a lady who was seen dancing continuously to the chorus "Do you know somebody who knows somebody, who has corona?" Which reinstate the calls that COVID-19 in Nigeria is a hoax. An average Nigerian believes that COVID-19 is a hoax, and if the virus truly exist it cannot affect Africans nor Nigeria due to the hot weather condition (in which medical data has proven otherwise).
On the 8th of April, Pastor Chris Oyakhilome of Christ Embassy (LoveWorld Incorporated) delivered a sermon that was watched by approximately 13,000 people In his YouTube video, Pastor Chris claimed that the introduction of 5G is the cause of COVID-19, he went further to say that this pandemic will lead to the introduction of a vaccine which is a ruse to implement a hidden agenda of a "new world order" led by the anti-Christ. Many of his ardent followers believe him and this created some level of support to the Anti-vaccinations groups in the country. Although the 5G story has been proven otherwise, the idea of a vaccine to create a new world order is still resounding on the minds of Nigerians.
The Pfizer drug trial of 1996 in Kano, Northern Nigeria is another factor that might influence Nigerians, especially in the north to be wary of the Pfizer vaccine. This Pfizer incident occur when a clinical trial was conducted by Pfizer during the meningitis epidemic, in which the US-based pharmaceutical company was testing its new antibiotic called trovafloxacin (Trovan) which was given to 100 children and another 100 were given the standard anti-meningitis treatment of ceftriaxone. Eleven children who were given the new antibiotic, died, and dozens were left disabled. The investigation later found out that the clinical trial was illegal and the human trial letter of approval was falsified. [8] Pfizer was found guilty and was given a heavy fine. Although Nigerians are known to have a short memory, the incident will affect Nigerians (especially the north) acceptability of the Pfizer vaccine.
Way Forward?
All these factors are going to play a major part in COVID-19 vaccination in Africa and Nigeria in particular. African governments need to embark on the need for the vaccination when it becomes available, infodemic needs to be addressed with a massive campaign for the need for vaccination. The PR message should be propagated by religious leaders, to educate their members of the need for vaccination against COVID-19.
The COVID-19 vaccination should be made mandatory (but not enforceable) like the Yellow fever vaccine to all Africans as a requirement for government officials, students and the elderly. It is important to make it free and easy to access especially for those in the rural area. It is paramount for us to end this dreadful virus and for any vaccine to work it must have global acceptance and outreach.
Editors Pick:
Bright Azebokhe Jerry
Endnotes:
[1] Cody Cassidy “Who Discovered the First Vaccine? Retrieved from http://www.wired.com/story/who-discovered-first-vaccine/amp
[2] World Health Organization. Coronavirus. Accessed on 10/11/2020.
[3] Read Yu Thien-chhih’s Collected Commentaries on Smallpox; Cody Cassidy “Who Discovered the First Vaccine? Retrieved from http://www.wired.com/story/who-discovered-first-vaccine/amp
[4] Interview with Dr. Albert Onobhayedo, Medical Historian at the University of Benin, Nigeria, 23/11/2020
[5] Ibid
[6] Anne Mawathe, “Coronavirus: Why Africans should take part in Vaccine Trials retrieved from http://www.bbc.com/news/amp/world-africa-52678741
[7] Favour Obianujunwam Bernard et al. COVID-19: the trends of conspiracy theories vs facts. Pan African Medical Journal. 2020;35(2):147. 10.11604/pamj.supp.2020.35.147.25536
[8] BBC, "Pfizer: Nigeria drug trial victims compensation" retrieved from http://www.bbc.com/news/world-africa-14493277
