The abrupt production and distribution of the COVID-19 vaccine has resulted in diverse speculation on the safety and acceptability of the vaccine in various communities globally, despite the growing negative effect of the pandemic. People have varied opinions on whether to accept or reject the vaccine as vaccination is optional and not yet a mandatory prerequisite in the Nigerian states. Therefore, this article discusses the newly developed COVID-19 vaccine and the perception of its acceptability amongst dissimilar social groups in Nigeria.
Generally, vaccination is defined as a simple, safe and effective way of protecting people against harmful diseases before they come into contact with infective agents such as the coronavirus. The importance of vaccines is that they reduce the risk of getting a disease by using the body’s natural defences to build resistance against specific infections and strengthen the immune system by training the immune system to create antibodies. Antibodies are proteins produced naturally by the immune system to fight diseases. So, if a vaccinated person is exposed to the coronavirus, those antibodies attack the virus. Vaccine development and testing is noted to be a long, complex process that can last for over ten years since it undergoes four phases of clinical trials. However, the COVID-19 vaccine was produced in less than one year by various pharmaceutical companies such as Pfizer/BioNTech, Oxford University–AstraZeneca, Moderna and Gamaleya (Sputnik V), which have contributed to debates on the acceptability of the vaccine by citizens of Nigeria.
What is the perception of the vaccine by healthcare workers?
I discussed the issue with three healthcare workers. A nurse disclosed her anxieties in receiving the vaccine due to the accelerated production processes, which may lead to there being a chance of unforeseen, long-term side effects that may not have been detected during the short clinical trial period. As the Oxford University– AstraZeneca vaccine was developed in under three months, starting the first human trials in Europe (Oxford) in April. Yet, BBC reports indicate that the AstraZeneca vaccine is effective based on a strong immune response (70%–90% efficacy level), while Gamaleya is 92% effective, and both vaccines can be stored at regular fridge temperature. The Pfizer/BioNTech and Moderna vaccines have similar efficacy levels of nearly 95%, however, the Pfizer vaccine needs to be stored at −75 degrees Celsius and expires after only five days. In contrast, the Moderna vaccine does not need to be kept at super-cold temperatures but rather at −20 degrees Celsius, and it can be stored for up to 30 days before it expires.
Another healthcare worker’s worries were prompted by recent reports produced by the National Primary Healthcare Development Agency, which indicated that Nigeria is supposed to receive 20 million doses of the COVID-19 vaccine from the end of January through to the first quarter of 2021, and frontline workers are required to take the vaccine first. It was reported that the anticipated first doses from Pfizer Inc. and AstraZeneca Plc are to be given to workers in the health sector and vulnerable citizens in Nigeria. The healthcare worker’s anxiety focuses on the logistics in receiving the vaccine, as Nigeria suffers an instability in electrical power supply which could alter the effectiveness of Pfizer’s vaccines if not maintained at a specific temperature before administration.
She could not understand why Nigeria still considers purchasing from Pfizer instead of concentrating on the recently Food and Drug Administration (FDA)-approved Moderna vaccine or the AstraZeneca and Sputnik V vaccines that can be stored at regular fridge temperature, which best suits the socio-economic conditions of Nigeria, given the fact that all adverse effects of the vaccine given at an unrecommended temperature have not been determined.
The third healthcare worker recalled the cutter incident of 1955 in the United States that resulted from the United States Public Service Act of 1944, which mandated that the federal government issue licences for vaccines, leading to polio vaccine incidents (40,000 cases of polio, 200 children with paralysis and ten deaths). Similarly, in Nigeria, the British Medical Journal (BMJ) reported that, in 1996, Pfizer also sent a team to Kano during an epidemic of meningococcal meningitis.
To test the efficacy of its new antibiotic trovafloxacin (Trovan) in 200 children, half of those children were given the gold standard treatment for meningitis, ceftriaxone, and half received trovafloxacin. Five of the children who were given trovafloxacin died, together with six others who were given ceftriaxone. The BMJ reported that ‘The Washington Post has been investigating the trial and alleges that at least one child was not taken off the experimental drug and given the standard drug when it was clear that her condition was not improving—which is against ethical guidelines. These reports led to the perception amongst professional working groups that Africa is the dumping ground for vaccine experimentation.
This claim is currently built on reports that the Melinda and Bill Gates foundation stated that black people should be a priority in receiving the COVID-19 vaccine once it is available. This angered health workers, irrespective of the reality that black people in America accounted for 30% of cases and 40% of corona-related deaths. However, Nigerian professionals feel that black people in America and Nigerians are experiencing different environmental conditions and that one’s immunity also plays a role in COVID-19-induced mortality rates. Similarly, a reported debate by BBC news featured Jean-Paul Mira, head of intensive care at Cochin Hospital in Paris, who suggested that the study of the coronavirus vaccine trials should be initiated in Africa. This also caused a dispute, which supports stories that indicate Africans are often used as guinea pigs in scientific trials.
Perception of vaccine by lower and upper social economic groups
I spoke to a day labourer who falls under the lower socio-economic group with limited education in Nigeria. He believes that COVID-19 does not exist and that the disease is a form of ‘racket’ formulated by healthcare workers and politicians. Racket is Nigerian slang for making fast, self-funded money. They believe hospitals purposely misinterpret every symptom of malaria for COVID-19 and that antimalaria medication is the cure for COVID-19.
However, another lower socio-economic group, grounded by the religious movement, believes that the coronavirus exists but that prayers are the solution to COVID-19 and that the insurgency happened for God to humble the world. They imply that prayer is the key to the disease, and they would not want to take the vaccine in Nigeria. Their beliefs are also in line and dictated by highly influential pastors such as pastor Chris Oyakhilome of Love World Incorporated (Christ embassy), and they believe that COVID-19 is a conspiracy theory and that there is a relationship between the coronavirus, the 5G network and the antichrist’s plan.
Also, the upper-class socio-economic groups with university education believe that, generally, vaccination is a safe and effective way to prevent disease and save lives. They believe that when a person gets vaccinated against a disease their risk of infection limits the transmission of the disease to others. It is believed that if more people in a community get vaccinated, there is less chance of passing the pathogen on from person to person, since fewer people remain vulnerable.
This suggests that Herd immunity (or community immunity) occurs as a high percentage of the Nigerian community will become immune to COVID-19 (through vaccination), making the spread of this disease from person to person unlikely. Even some individuals not vaccinated (such as newborns and the immunocompromised) are offered some protection because the coronavirus will have little opportunity to spread within the community. However, when asked if they would take the vaccine, they hesitated, saying that since it is too early to know if COVID-19 vaccines will provide long-term protection, they would rather wait for more clarity.
When I probed further, a professional in the maritime industry states that people still wanted clarity on the six deaths reported by the FDA during The Pfizer/BioNTech vaccine trials, irrespective of the fact that the FDA claims the deaths could be attributed to obesity and arteriosclerosis. He proposed that the manufacturer of the vaccines (i.e., Pfizer’s CEO) and supporting politicians like the American President Elect Joe Biden, Obama or the Nigerian Ngozi Okonjo-Iweala, who is Gavi’s board chair and also an African Union Special Envoy for mobilising resources for Africa’s fight against COVID-19, first take the vaccine on live media, after which he would then be encouraged to take the vaccine. However, more red flags were raised as Pfizer’s CEO Albert Bourla told CNBC that he and his executives will not be taking the vaccine now as he is not a frontline worker and in good health, instead proposing that he would take the vaccine at the appropriate time based on age and occupation.
This information may show the current level of trust in the acceptance of the vaccine within its manufacturers and the Nigerian community.
A social media influencer in Nigeria who falls in the middle social class spoke about his fears of the vaccine, which was prompted by circulated pictures on social media on how the vaccine caused Bell’s palsy and allergic reactions in people. He believed in the existence of the virus but showed scepticism in taking the vaccine, as there has been no vaccine developed for malaria, hepatitis or cancer for years, so the abrupt development of the COVID19 vaccine was suspicious. Most of his perceptions were similar among the younger age groups in Nigeria, as their beliefs are based on information gained from social media; he spoke about videos on the allegations against the Director of the National Institute of Allergy and Infectious Diseases, Anthony Stephen Fauci. An article on The Duran indicated that the United States Government, led by Fauci, funded a collaboration of Chinese scientists and the US military to produce the virus from a bio-weapons lab in Fort Detrick.
Also, information from the internet reported that research groups funded by Bill Gates engineered and patented the novel coronavirus and will profit from any future vaccine. This news supported his theory that the virus might have been a biological weapon and that the drug patents were already developed before the global outbreak, which justified the sudden release of the vaccine.
Conclusion
Most Nigerians are unenthusiastic in accepting the COVID-19 vaccine despite the rise in coronavirus cases. I believe that the WHO and its partners are committed to accelerating the development of a COVID-19 vaccine while trying to maintain the highest standards of safety, but most Nigerians in all social groups are still wary.
However, history indicates that, in the past, vaccines have been developed through a series of steps that could take many years, but the urgent need for a COVID-19 vaccine and scientific collaborations are changing how vaccines are developed. It would be proper to have a more transparent and powerful means of educating people about the vaccine’s safety for inoculation amongst communities in Nigeria. This means showing details of the steps taken in vaccine research and the development processes that are happening at the same time while maintaining strict clinical and safety standards through publication in the three major Nigerian languages, with information freely accessible to attract every social group or class in Nigeria.
The gatekeepers of communities should be involved in educating their members on how treatment can be effective as public health identifies that any successful treatment must be affordable, accessible and culturally acceptable by the community. Also, it may be proposed that state leaders who support the vaccine may first be inoculated to relieve fears among communities, and renowned heads like Ngozi Okonjo-Iweala must encourage informative inputs from indigenous public health specialists in Nigeria to advise on a suitable mode of enlightenment for the acceptance by the Nigerian people.
In conclusion, even though this article is not based on scientific research and its outcome may not make the study any less rigorous, it can indicate that further research is still needed in this field for general acceptance.
