Everything you need to know about Covid-19 vaccines: how they work, how long they last & who should get one

by Dr Carmen, #MomDoc
Baby Yum Yum - everything you need to know about the covid 19 vaccine in south africa
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Which Covid-19 vaccines are available in South Africa? How many people need to be vaccinated in order to create herd immunity? Is the vaccine safe for pregnant women? Is the vaccine safe? BabyYumYum spoke to Dr Carmen #MomDoc who has been working on the Covid-19 vaccine and she answered all our questions.

What are the different types of vaccines and how do they work?

To date, 5 vaccine manufacturers have released their data; Pfizer-BioNTech, Moderna, AstraZeneca-Oxford, Novavax and Janssen-Johnson & Johnson.

The main difference between them is how they have been made, however all vaccines work the same. They work by priming the immune system so that when the body is faced with the real germ in the future, the immune system can act quickly and much more effectively than if it was seeing the germ for the first time.

Which vaccines are available in SA?

We need to consider the South African context and look at which vaccines are more suitable for us. The mRNA vaccines by Pfizer and Moderna need to be stored at extremely cold temperatures, which could be a logistic challenge for South Africa in terms of transportation and storage.

The other three vaccines can be stored at fridge temperature, which is more suitable, especially for rural settings and primary healthcare facilities.

The first batch of COVID-19 vaccines has already arrived in the country and this is the AstraZeneca/Oxford vaccine. I believe the other vaccines will soon follow suit should the funds become available. The Johnson & Johnson vaccine is also very favourable because it is a single vaccine, which will make it most affordable.

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What does the rollout timeline look like for us?

The South African Department of Health has outlined the country’s rollout plan here.

Is the vaccine still safe if you have underlying medical conditions like diabetes?

Yes! Vaccinating people with comorbidities like diabetes is crucial because these individuals are at highest risk for severe COVID-19 disease. For this reason vaccine clinical trials included these people in their trials.

What percentage of the population would need to be vaccinated to create herd immunity?

According to the Government’s rollout plan they are looking at vaccinating 67% of its population to achieve herd, also known as population, immunity.

Many people worry the vaccine research has been rushed. Do you think enough research has gone into it?

Since I am currently working on a number of COVID-19 vaccine clinical trials I can guarantee that they are not being ‘rushed’. While the timelines for these vaccines has been accelerated, it hasn’t been at the expense of quality.

There has been a lot of money spent, more staff working on the studies, many more volunteers willing to get involved, a higher incidence of disease allowing end points to be reached more quickly and, very importantly, less red tape than usual. This has all helped move COVID-19 vaccine development along much faster.

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Will it offer long-term protection?

We know that immunity following COVID-19 disease (natural immunity) varies from person to person and evidence suggests it is not life long. With this in mind, we can assume that vaccine-induced immunity might also decline over time and require boosters.

Researchers still need to figure out which type of immunity is more protective against the virus. Is it our cellular or antibody mediated immunity? If antibodies are more important then what is the lowest concentration needed to protect against infection? Once we have more data on these immune responses, vaccines can be better designed to offer more long-term protection.

coronavirus testing station

If someone has already had Covid, should they still be vaccinated?

Yes. Immunity to SARS-CoV-2 is not life long so people can become reinfected.

Is the vaccine safe for pregnant women? 

There is limited data about the safety of COVID-19 vaccines in pregnant women since the clinical trials did not include pregnant women. For this reason the COVID19 vaccines are not recommended in pregnancy.

However, pregnant women are at increased risk of severe COVID19 disease and/or pregnancy-related complications and this is why pregnant women need to weigh up the benefits and risks after discussing these with their doctor.

There is no evidence to suggest the vaccines affect fertility. Getting vaccinated before you fall pregnant may protect you from getting COVID19 in pregnancy and having severe illness or any complications.

As a medical professional, did you get the vaccine?

Absolutely! COVID19 is a novel disease and we are still learning so much every day, so the sooner we can be protected against it with vaccines and boosters, the better. This will also enable me to stay healthy and continue to help out as a healthcare professional in this pandemic.

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Do you think children should get the vaccine? 

Currently none of the COVID-19 vaccines, which have been approved, are recommended for children. This is because there is no available data on how these vaccines affect children. The COVID-19 vaccine clinical trials have to date only been tested in adults. Researchers would need to look at the doses and interval between doses in children specifically, since their immune systems are not as mature as adults.

Children should definitely not be excluded from getting the vaccines but only once we have enough safety and efficacy data. When this becomes available I will most definitely be vaccinating my child.

Should we be double-masking?

First we need to talk about what makes a ‘good’ mask. A good mask depends on the fabric, fit and number of layers. A good mask should have 3 layers, two layers of tightly woven fabric, which does not wet easily, with an inner layer, preferably some kind of non-woven material to enhance the barrier function. The mask should also fit the face snugly. There should be no air leaks from around the nose, side of the face and jaw. If you have a mask that fulfills all these criteria then you do not need to double mask. If, however, you have a single layer, 2 layer and even an ill fitting 3 layer mask you can add another layer of protection by adding another mask.

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