Concerns over global clampdown on the unvaccinated, waning jab immunity

• Vaccinated groups at highest risk of COVID-19 hospitalisation, death identified using new QCovid tool
• Faking of vaccine cards spreads as U.S. Customs seizes more than 6,000 as Nigeria, others on alert

In recent times, there have been concerns over a worldwide clampdown on the unvaccinated, waning COVID-19 vaccine immunity after six months of the administration and there are reports that developed nations like United Kingdom (U.K.) and United States (U.S.) have said that people that were vaccinated in Africa would be considered as unvaccinated.

The scenario has raised questions: What are the implications and possibilities in Nigeria? What about the considerations that there are not enough vaccines?

A consultant virologist and chairman, Expert Review Committee on COVID-19, Prof. Oyewale Tomori, told The Guardian: “Those Nigerians wishing to travel outside the country must get vaccinated, with vaccines approved by the country of their destination. For those receiving ‘unapproved’ vaccines, the hope is that the country of their destination will eventually approve the vaccine they took. As for us, in Nigeria, before the government starts clamping down on people and restricting their movement, the government must first ensure the availability of and access to the vaccine. Certainly, you cannot receive what you do not have.”

Tomori, who was the pioneer Vice-Chancellor of Redeemer’s University, Ede, Osun State, said the issue of waning immunity is not new. “This is normal. This is why we get boosters- immunity against yellow fever is a good example. For COVID-19 it is an evolving issue, and there is no definitive conclusion because the vaccine has been around for less than two years,” he said.

On reports that COVID-19 vaccine immunity lasts for six months, Tomori said: “It may probably last longer. We only have interpretation based on available time-limited information.”

He said the UK and their respective national regulatory authorities are within their rights to endorse only the vaccines approved by the US. “The vaccines they are using have been approved by their national regulatory authorities. The ones we are using are not. Therefore either we stay at home and avoid travelling to those countries or get ready to abide by the rules and guidelines for unvaccinated people. In the alternative, we get the manufacturers of the vaccine we use to get the approval of the UK and US regulatory authorities,” Tomori said.

A public health physician and member of Lagos State COVID-19 containment team, Prof. Akin Osibogun, told The Guardian: “I will advise that all countries follow the science and once the vaccine production protocol in any country meets global best practices, those who receive such vaccines should not be discriminated against. The World Health Organisation (WHO) and other responsible global agencies should monitor for enforcement of standards. Vaccine politics should be reduced as much as possible.”

Osibogun, who is the immediate past Chief Medical Director of Lagos University Teaching Hospital (LUTH) Idi-Araba, said vaccination offers the possibility of rapidly building up the herd immunity of populations and thereby bring this pandemic to a halt earlier than if it were to occur in response to the natural infection.

Osibogun, who is also the chairman of, Lagos State Primary Health Care Board, said: “If vaccines are available and massively administered, we may also be able to reduce the likelihood of further mutation of the virus. As many developed countries have vaccinated more than 50 per cent of their population, there is increasing hope that access to vaccines by developing countries will also improve.

“Nigeria for example is expecting some 52 million doses of a vaccine in the first quarter of the year 2022. With regards to the duration of the immunity conferred by the vaccines, data are still emerging. However, following exposure to the vaccine, it is likely that as part of the cellular immunogenic response, memory cells will be produced by the body which will be present, even if in small quantities, if the person comes in contact with the virus in future. It means that the symptoms may not be as severe as in a person who has never been vaccinated.”

Meanwhile, researchers from the University of Oxford have today reported on findings on the vaccinated people who are at greatest risk from severe COVID-19 leading to hospitalisation or death from 14 days post the second dose vaccination, when substantial immunity should be expected.

In a paper published in the British Medical Journal, they write that by updating the QCovid tool developed in 2020, which directly influenced UK policy in February 2021, adding 1.5 million people in February 2021 to the list of those advised to shield, they are able to identify groups more at risk of hospitalisation or death from COVID-19.

They used national linked datasets from general practice, national immunisation and Severe Acute Respiratory Syndrome Coronavirus type 2 (SARS-CoV-2) testing, death registry and hospital episode data, in order to analyse a sample of over 6.9 million vaccinated adults, of whom 5.2 million had both vaccines doses, which was representative of the UK population as a whole. This sample included 2,031 COVID-19 deaths and 1,929 COVID-19 related hospital admissions, of which 81 deaths and 71 admissions occurred 14 or more days after the second vaccine dose.

Based on this, the researchers have developed cumulative risk scores to calculate people’s risk of hospitalisation or death from COVID-19 following one, or two vaccination doses.

The researchers report that there were relatively few COVID-19 related hospitalisations or deaths in the group who had received the second dose of any vaccine, meaning that the study lacked the statistical power to determine if the groups listed above are more, or less, at risk following a second vaccine dose compared with following the first dose.

Furthermore, they did not distinguish between types of vaccination offered, and acknowledge that their study may have been limited by factors such as exposure, as an occupation for example is not something that is often recorded in general practice or hospital records.

Meanwhile, US Customs and Border Protection officials have seized more than 6,000 counterfeit COVID-19 vaccination cards across the country.

Two international mail packages from China with 70 fake cards were stopped in Pittsburgh last week, the news outlet reported. Both packages were intended for the same address, and an investigation is underway.

“Coronavirus and its variants continue to pose a serious health and safety threat to American citizens, and so do unscrupulous vendors who peddle counterfeit COVID vaccination cards,” William Fitting, the Pittsburgh port director, said in a statement.

“Customs and Border Protection will continue to intercept counterfeit goods, such as these fake vaccine cards, that threaten our nation, our people and our economy,” he said.

Customs officers screen international travelers, cargo, and shipments for illicit narcotics, unreported currency, weapons, counterfeit consumer goods, and prohibited agriculture.

Since mid-August, officers have seized thousands of fake COVID-19 cards at airports and shipping ports, including hubs in Anchorage, Alaska; Chicago; Cincinnati, Ohio; and Memphis, Tennessee.

At the Port of Cincinnati, officers have seized shipments with nearly 1,700 fake vaccine cards and more than 2,000 fake Pfizer stickers. The vaccine cards displayed a CDC logo but had substandard printing and misspelled words. The shipments originated in China and were being sent to non-medical people at private residences in Illinois, Maryland, Missouri, New York, and Texas.

“Creating or buying a fake COVID-19 vaccination card is illegal, not to mention dangerous,” Richard Gillespie, the Cincinnati port director, said in a statement.

The FBI has warned that buying, selling, or using counterfeit COVID-19 vaccine cards is illegal and breaks federal laws.

“Purchasing counterfeit cards supports criminals whose only concern is their bank account, not American security or the health of our citizens,” Gillespie said. “Counterfeiters will try to replicate anything to benefit themselves, with no thought to the innocent victims that may suffer from their actions.”

Also, a nationwide study of more than 3,600 adults found the Moderna vaccine does a better job at preventing COVID-19 hospitalizations than the two other vaccines being used in the United States, the Centers for Disease Control and Protection said.

“Among U.S. adults without immune-compromising conditions, vaccine effectiveness against COVID-19 hospitalization during March 11–August 15, 2021, was higher for the Moderna vaccine (93 per cent) than the Pfizer-BioNTech vaccine (88 per cent) and the Janssen vaccine (71 per cent),” the agency’s Morbidity and Mortality Weekly Report said. Jansen refers to the Johnson & Johnson vaccine.

The CDC said the data could help people make informed decisions.

“Understanding differences in VE (vaccine effectiveness) by vaccine product can guide individual choices and policy recommendations regarding vaccine boosters. All FDA-approved or authorized COVID-19 vaccines provide substantial protection against COVID-19 hospitalization,” the report said.

The study also broke down effectiveness for longer periods. Moderna came out on top again.

After 120 days, the Modern vaccine provided 92 per cent effectiveness against hospitalization, whereas the Pfizer vaccine’s effectiveness dropped to 77 per cent, the CDC said. There was no similar calculation for the Johnson & Johnson vaccine.

The CDC studied 3,689 adults at 21 hospitals in 18 states who got the two-shot Pfizer or Moderna vaccine or the one-shot Johnson & Johnson vaccine between March and August.

The agency noted some factors that could have come into play.

“Differences in vaccine effectiveness between the Moderna and Pfizer-BioNTech vaccine might be due to higher mRNA content in the Moderna vaccine, differences in timing between doses (three weeks for Pfizer-BioNTech versus four weeks for Moderna), or possible differences between groups that received each vaccine that were not accounted for in the analysis,” the report said.

The CDC noted limitations in the findings. Children, immuno-compromised adults, and vaccine effectiveness against COVID-19 that did not result in hospitalization were not studied.

Other studies have shown all three U.S. vaccines provide a high rate of protection against coronavirus.