Introductory comments regarding the type of vaccine the Nigeria authority plans for her citizens: Sputnik V COVID-19 vaccine acceptance is a case in point

By Ezeakukwu Emmanuel Nsoedo (PhD)

The Nigeria government officials have been making pronouncements that Nigerian citizens will be receiving tens of millions of covid-19 vaccines to help her citizens fight off the coronavirus diseases, and possibly deaths.

In all these pronouncements, none of the officials had indicated where the vaccines would be coming from. It is established that several vaccine makers are having problems filling the quantity that some countries ordered, occasioning various threats to the rules of engagement. A typical example is the case of the European Union and the United Kingdom over the allocation of the vaccines produced by AstraZeneca, “a British multinational pharmaceutical and biopharmaceutical company”.

Any company manufacturing vaccine for countries are scrutinized thoroughly by the relevant health agencies, including the scholars in the relevant field. Even the all-powerful Pfizer took a lot of flak for not being able to meet its planned production output, which the company has cut to half.

The question is, how did the Nigerian government officials get access to the vaccines? Which company/companies that produced the vaccines? Where does the company or companies that manufacture the covid vaccine domiciled?

Nigerians should know the name of the vaccine they are about to receive so that they can do their due diligence. Even if Nigeria is an alliance with other countries, it will be nice for Nigerians to know the countries they are collaborating with or the institutions. In other words, the authority ought to be absolutely transparent in its dealings to forestall the potential to boycott the vaccines.

Nigerian authority needs to do all things necessary to counter many wide-spread, and unfounded stories about the harm covid-19 will do to people. These stories receive a lot of steam in the social media that they could pose an obstacle to fight the dreaded covid-19 through mass vaccination.

It is already established worldwide the negative impact the covid-19 protocols has had on the world economy, the health sector, therefore, Nigeria needs to buckle up and pursue the preventive measure with all tools in her arsenal.

When Russia registered sputnik V Covid-19, many of the Western countries criticized them for launching the vaccine hastily, hence, it was not sufficient time to establish proper safety measures for the potential recipients.

It must be noted that money is also in consideration when it comes to nations racing to be the first to have the vaccine in wide circulation.

As the objection was on, Russia began the mass vaccination of her citizens, and the Western nations who are desperate for vaccine put Sputnik V to a wider scrutiny. Below is the peer-reviewed study of the Sputnik V vaccine, and it is incumbent upon Nigeria to look for a vaccine that has been scrutinized properly.

Sputnik V COVID-19 vaccine candidate appears safe and effective

• Ian Jone Polly Roy

Denis Logunov and colleagues¹ report their interim results from a phase 3 trial of the Sputnik V COVID-19 vaccine in The Lancet. The trial results show a consistent strong protective effect across all participant age groups. Also known as Gam-COVID-Vac, the vaccine uses a heterologous recombinant adenovirus approach using adenovirus 26 (Ad26) and adenovirus 5 (Ad5) as vectors for the expression of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike protein. The use of two varying serotypes, which are given 21 days apart, is intended to overcome any pre-existing adenovirus immunity in the population.² Among the major COVID vaccines in development to date, only Gam-COVID-Vac uses this approach; others, such as the Oxford–AstraZeneca vaccine, use the same material for both doses. The earlier vaccine for Ebola virus disease, also developed at Gamaleya National Research Centre for Epidemiology and Microbiology (Moscow, Russia), was similar, with Ad5 and vesicular stomatitis virus as the carrier viruses,³ and the general principle of prime boost with two different vectors has been widely used experimentally.⁴The recombinant adenovirus route to protection is shared with the Oxford–AstraZeneca vaccine, which uses a chimpanzee adenovirus (ChAdOx),⁵ the Johnson & Johnson vaccine that uses only Ad26⁶ whose detailed results are expected soon, and the CanSinoBIO-Beijing Institute of Biotechnology Ad5-based vaccine whose phase 3 trial began in September, 2020.⁷ The carrier viruses are modified and cannot initiate a productive infection; they enter cells, express the spike protein, and then stop (because they cannot continue the normal virus lifecycle), although a high-sensitivity analysis also showed that a few Ad genes were expressed, albeit at a low level.⁸ The vaccine-infected cells are eventually destroyed by the very immunity they are designed to elicit. Recombinant adenoviruses have been used widely as vaccine vectors because they can accommodate large genetic payloads and, although unable to replicate, they trigger the innate immunity sensors sufficiently to ensure robust immune system engagement.⁹ Consequently, they do not need an adjuvant and can provide immunity after just a single dose.⁴ Their physical robustness is thought to allow storage at temperatures around –18°C, which is feasible for many supply chains. The downside of recombinant adenovirus-based vaccines is that large doses are required, typically 10¹⁰ or 10¹¹ particles, which makes large demands on the manufacturing and quantitation required for rollout on a global scale.

• View related content for this articleWhat then of the Sputnik V COVID-19 vaccine data published here? The earlier phase 1/2 data published in September, 2020, showed promising safety results and gave an indication that the immune response was at a level consistent with protection.¹⁰ Recipients generated robust antibody responses to the spike protein, which included neutralising antibodies, the proportion of the total immunoglobulin that inhibits the virus binding to its receptor. They also showed evidence of T-cell responses, consistent with an immune response that should not quickly wane. The interim report of the phase 3 data now presented¹ includes results for more than 20 000 participants, 75% of whom were assigned to receive the vaccine, and the follow-up for adverse events and infection. With a planned study power of 85%, those recruited were aged 18 years and older, were about 60% male, and were almost all white. Comorbidities, a known risk for COVID-19 severity, were present in about a quarter of those who entered the trial. 62 (1·3%) of 4902 individuals in the placebo group and 16 (0·1%) of 14 964 participants in the vaccine group had confirmed SARS-CoV-2 infection from day 21 after first vaccine dose (the primary outcome). A time-resolved plot of the incidence rate in the two groups showed that the immunity required to prevent disease arose within 18 days of the first dose. That protection applied to all age groups, including those older than 60 years, and the anecdotal case histories of those vaccinated but infected suggest that the severity of disease decreases as immunity develops. Three fatalities occurred in the vaccine group in individuals with extensive comorbidities, and were deemed unrelated to the vaccine. No serious adverse events considered related to the vaccine were recorded, but serious adverse events unrelated to the vaccine were reported in 45 participants from the vaccine group and 23 participants from the placebo group. Vaccine efficacy, based on the numbers of confirmed COVID-19 cases from 21 days after the first dose of vaccine, is reported as 91·6% (95% CI 85·6–95·2), and the suggested lessening of disease severity after one dose is particularly encouraging for current dose-sparing strategies.

The development of the Sputnik V vaccine has been criticised for unseemly haste, corner cutting, and an absence of transparency.¹¹ But the outcome reported here is clear and the scientific principle of vaccination is demonstrated, which means another vaccine can now join the fight to reduce the incidence of COVID-19.We declare no competing interests.