by Rubén Romero Lozano @rubenromeroloz
The race to discover, register, and commercialize the first vaccine approved to combat COVID-19 is happening right now. Russia, the United States, and China are the main opponents, but the race is crossed by nationalism, mistrust towards the safety of these studies, and the human rights criteria that are applied both during the development of the vaccine and in the phase in which it will be available for mass vaccination worldwide.
With the latest announcements from Russia about having the first vaccine registered, and the concerns of scientists, advocates, and the public about the side effects such a vaccine can have on health: Are we ready for immunization?; Does the vaccine mean the end of the pandemic?
[1] This is an essay created from the perspective of popular education, using news, opinions of experts and scientific evidence to build a simple body of concrete questions and answers for the public, human rights defenders and decision-makers, contributing to the promotion of rights and the debate around the relationship among these and the current world situation.
[2] Rubén Romero-Lozano is a writer, a human rights defender, a digital-activist, and a teacher. His area of expertise goes from the promotion of a culture of peace to persuasive communication and copywriting for social campaigns and fundraising tools, both of them at online and offline channels. He also develops projects about social innovation, his area of research includes the right to personal freedom and he has been mentoring young professionals dedicated to social fields, including social workers, lawyers, psychologists and project technicians.
[3] Since 2009, his career has been based on creating new government structures and policies, drafting legislation on violence prevention and vulnerable population’s care, also promoting bills about economic, social, and cultural rights, creating campaigns and educational programs on human rights for teachers, human rights defenders, indigenous people, HIV positive population, security and law enforcement agents, including police, firefighters, traffic officers and public administration employees, he has served as a university professor and author of specific programs on diversity, gender, peace and security with young adults, men who have perpetrated violent acts and also with allies and partners for gender equality.
Pandemic response and vaccination are crucial human rights issues.
The response to pandemics and the economic, social, and health consequences that this entire situation has on the world’s population is one of the most relevant human rights issues in recent times.
Poverty, racism, and inequality make the most vulnerable people, including indigenous peoples, less likely to survive if they fall ill with COVID-19, according to the World Health Organization (WHO) in a recent statement.
Therefore, it is clear that this is not a minor matter. We are experiencing a pandemic that has killed millions of people, and that has also wiped out millions of jobs and livelihoods.
But the pandemic is getting worse for the same reason that most social problems get worse: inequality.
Inequality is strongly exemplified in the response that governments have been having since the beginning of the pandemic.
We find ourselves in a divided world, on the one hand, the rich world and on the other, the poor world.
This distinction determines:
1- Who survives.
2- who has access to medications and treatments
3- who will have access to the vaccine first.
In a world so unequal, which has been unequal for centuries, but in which inequality has increased in recent years and especially since the beginning of the pandemic, with the world’s largest fortunes multiplying, along with poverty both urban and rural increasing, it is essential to propose a frank debate on vaccination as a human rights issue, this is the moment.
How is it evident that we are dealing with an important human rights issue?
The first thing: the right to life, which, under the principle of interdependence and indivisibility of human rights, is closely related to the right to health, but also the right to freedom, work, housing, and every other right, all related in this very moment with survival conditions for the human race.
The state has obligations to comply with regarding all these rights, which if they do not materialize, it is not possible for people to enjoy and exercise them properly.
So, this is the moment to defend human rights, right now.
Progress on the vaccine
According to data from the New York Times Coronavirus Vaccine Tracker,[1] There are between 135 and 165 vaccines in development, of which 19 are in phase 1, meaning that their safety and doses are being tested. Likewise, 11 are in phase 2, in expanded safety trials.
Of the total, 8 vaccines are in phase 3, in large-scale efficacy tests, and only 2 approved for early or limited use.
However, a vaccine may receive emergency use authorization before getting formal approval. This introduces the importance that vaccines for COVID-19, like any other, are safe and that the side effects of their application can be known.
The World Health Organization (WHO) has developed a Draft landscape of COVID-19 candidate vaccines.[2] This WHO’s draft landscape shows that only 28 vaccines are being clinically tested, while 139 candidate vaccines are still in the pre-clinical phase.
Most of these vaccines target the so-called spike proteins that cover the virus and help it invade human cells. The immune system can develop antibodies that latch onto spike proteins and stop the virus. A successful vaccine for the SARS-CoV-2 coronavirus would teach people’s immune systems to make antibodies against the virus without causing disease.[3]
But there are at least four different types of vaccines that are in development and each one works differently the main approaches:
1- Whole-Virus Vaccines that modify the entire coronavirus to provoke an immune response.
2- Genetic Vaccines that use part of the coronavirus’s genetic code (DNA or RNA genetic instructions for building a viral protein.
3- Viral Vector Vaccines that use a virus to deliver coronavirus genes into cells.
4- Protein-Based Vaccines that use a coronavirus protein or a protein fragment.
These approaches are essential because they allow us to understand how the vaccine works and what possible side effects it would have.
But, are we talking about the very end of the pandemic?
In a recent interview, Reggie Lo, emeritus Professor at the University of Guelph who focuses on vaccine development said: The public needs to deal with this ‘forever.’” “Anyone who thinks the epidemic is over with the development of a vaccine failed to grasp the enormity of the problem.”
“The global need for a vaccine and the enormous geographic diversity of the pandemic requires more than one effective approach to a vaccine,” wrote in an article for Science, the main authorities involved in the fight against the pandemic in the United States, among they include Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases (NIAID), and Francis Collins, director of the National Institute of Health (NIH).[4]
But cooperation is also key to guarantee “a high degree of safety” since it is necessary to try to vaccinate the entire population, because “there is a theoretical risk that vaccination could make the subsequent infection by SARS-CoV-2 More serious”.
Therefore, the vaccine proposal (several vaccines, speaking in the plural) would be a possible solution: “It is not likely that any vaccine platform alone will satisfy the global need, so a strategic approach is essential for the effort in several fronts “
“There is [also] an unparalleled need to manufacture and distribute a safe and effective number of vaccines to immunize an extraordinarily huge number of people to protect the entire global community from the continuing threat of morbidity and mortality caused by SARS. -CoV-2 “
This requires the industrial capacity to produce one or more doses necessary for – potentially – the 7,000 million human beings that inhabit the Earth.
Other scientists and philanthropists join the authorities that pronounce on the limitations that exist to immunize the entire world population and on the enormous effort that this requires but warning about the safety of the vaccine.
How about vaccine safety?
A study published by the scientific journal The Lancet, representing the first randomized controlled trial for assessment of the immunogenicity and safety of a candidate non-replicating adenovirus type-5 (Ad5) -vectored COVID-19 vaccine, aiming to determine an appropriate dose of the candidate vaccine for an efficacy study, indicates that requested adverse reactions were reported by 72% and 74% of participants in the groups, respectively. Severe adverse reactions were reported by 9% of participants in one group and 1% participant in the other.
However, no serious adverse reactions were documented.
In this particular study in a single center in Wuhan, China, the result indicates that the vaccine tested appears to be safe, and induced significant immune responses in the majority of recipients after a single immunization.
But is this going to be the vaccine that the majority of the world’s human population is going to use? It’s impossible to know at this point.
In this regard, Bill Gates warned: “In China and Russia they are moving at full speed. I bet there will be some vaccines somewhere in the world that will come out without a full review. “
“We’ll probably need three or four months just to analyze the side effects of phase 3,” explaining why he doubts the incredibly fast times being handled in some parts of the world.[5]
Also, Russia’s President Vladimir Putin announced on 11 August that the country’s health regulator had become the world’s first to approve a coronavirus vaccine for widespread use — but scientists worldwide have condemned the decision as dangerously rushed. Russia hasn’t completed large trials to test its safety and efficacy, and rolling out an inadequately vetted vaccine could put at risk people who receive it, researchers say.[6]
The Russian pharmaceutical companies themselves had asked to postpone the process, considering the number of clinical trials carried out insufficient.
A major concern is that the vaccine could cause an aggravated disease that occurs when antibodies generated by the vaccine carry the virus into cells.
Another issue could be an immune reaction similar to asthma that became a problem with some experimental vaccines against the SARS virus (severe acute respiratory syndrome). Detecting these reactions would require comparing thousands of people who received a vaccine or a placebo and potentially were exposed to SARS-CoV-2.[7]
We are talking about a human rights issue, so it must be vaccination compulsory?
Can the government compel people to be vaccinated?
Just as inevitably, some people will refuse a vaccine. As we have seen overseas with debates over the wearing of masks, and more generally with anti-vaccination activists everywhere, compulsion is not a simple matter.[8]
There are competing rights and duties on both sides. Forcing an individual to be vaccinated is a violation of their fundamental right to personal autonomy, which informs the more specific right to bodily integrity.
Basically, those rights mean every person can make decisions for themselves and what can and cannot be done to their bodies.
For example, in Germany, thousands of people have demonstrated against the future vaccine; and in Austria, 25% of the population have said that they do not want to be vaccinated when there is a COVID19 vaccine.[9]
But, as in most debates about whether or not something should become a mandatory policy of governments and states, there is no unambiguous answer.
Experts agree that selective vaccination strategies aimed at at-risk groups are necessary. But without a doubt, they point out that the best predictor of a patient’s vaccination is having received the recommendation of a healthcare professional.[10]
This point can be especially controversial and will be the subject of debate soon, so it is not possible to exhaust the discussion in this essay, but there are a significant number of organizations and individuals who oppose vaccination. One evidence of this is that 1.5 million children die annually from diseases such as diphtheria, measles, tetanus, whooping cough, diarrhea, or pneumonia, which can be prevented with a simple vaccine, according to information from UNICEF.
Likewise, since the 1990s we have gone from 20% to 84% of vaccinated children. But this breakthrough has stalled in the past five years because vaccination services are not reaching the most vulnerable children. In 2013, 21.8 million children under the age of one (1 in 5 worldwide) did not receive the vaccines that can save their lives and protect them from disease and disability.[11]
This does not mean that the statistical trend of lack of vaccination will become the norm regarding the control of the COVID-19 epidemic, but what is certain is: if the international community, states, and governments continue to act as they have been doing in recent years, we could anticipate that vaccines may not be accessible or available to everyone, which constitutes a clear violation of human rights at the collective level.
[1]https://www.nytimes.com/interactive/2020/science/coronavirus-vaccine-tracker.html?action=click&pgtype=Article&state=default&module=styln-coronavirus®ion=TOP_BANNER&context=storylines_menu
[2]https://www.who.int/publications/m/item/draft-landscape-of-covid-19-candidate-vaccines
[3]https://www.nytimes.com/interactive/2020/05/20/science/coronavirus-vaccine-development.html
[4],https://www.infobae.com/america/ciencia-america/2020/05/13/una-sola-vacuna-no-sera-suficiente-para-terminar-con-la-pandemia-de-coronavirus-el-plan-estrategico-global-que-proponen-anthony-fauci-y-otros-cientificos/
[5]https://www.infobae.com/america/eeuu/2020/08/08/bill-gates-preocupado-por-la-seguridad-de-las-vacunas-contra-el-coronavirus-apuesto-a-que-algunas-saldran-sin-la-revision-completa/
[6]https://www.nature.com/articles/d41586-020-02386-2
[7]https://www.20minutos.es/noticia/4350475/0/varios-cientificos-alertan-sobre-los-riesgos-de-la-vacuna-rusa-contra-el-convid-19-en-la-revista-nature/?autoref=true
[8]https://theconversation.com/should-a-covid-19-vaccine-be-compulsory-and-what-would-this-mean-for-anti-vaxxers-143742
[9]https://www.cope.es/programas/herrera-en-cope/noticias/infectologa-cope-puede-obligar-vacunarse-gente-haria-dudar-mas-poblacion-20200527_738078
[10]https://www.redaccionmedica.com/secciones/medicina/covid-19-los-medicos-valoran-dar-su-apoyo-a-la-vacunacion-obligatoria-9651
[11]https://www.unicef.es/prensa/15-millones-de-ninos-mueren-cada-ano-causa-de-enfermedades-prevenibles-con-una-vacuna
Human Rights Institute WJA 