By Ademola Adeleye
As the scientific community continues to beat down the emerging variance of the COVID 19 virus, early scientific reports are showing immunity in unborn children of infected mothers. In this interview with Georgina Odaibo, a renowned professor of Virology and head of department at the University of Ibadan Teaching Hospital, UCH, talks about her journey into the field usually reserved for men and sheds light on administering COVID 19 Vaccines on pregnant women and the ongoing research to ensure safety for children less than 12 years.
The field of Virology is a rare field for women in Africa, can you share how you shattered that ceiling and excelled so wonderfully at the peak of academia in the field of Virology?
Yes you are right, there are fewer women in the area of Virology when you compare to men, but statistics have also shown that more women are now entering Virology related field, also in the area of academic. My upbringing was also a very important aspect of my decisions, while I was growing up, my father would tell me, that there is nothing impossible, and that there is nothing you cannot achieve if you put your mind to it, he would tell me that there will be challenges in life but with determination and hard work you will always overcome those challenges. I can remember my father saying those things to me.
I also attended a mission secondary school where hard work, dedication was emphasized; it was all girls secondary, we were told that there is nothing that you cannot achieve because you are a girl, so that was the kind of training I got while I was growing up. And then coming to the University, I studied Zoology, I had a first degree in Zoology, I learnt a lot of lessons, I discovered in my final year that I was so much interested in research, while others were struggling and running away from research work, I was really enjoying it, I also discovered I was interested in the area of Parasitology.
So from the area of Parasitology that was how I decided to go into the field of Virology, I did a Masters and then, I did a PhD. So I would say to excel in any field and for Virology, three key things played a role, the first is your dedication, commitment and hardwork, the next one is mentoring. I was privileged to have someone from day one who told me what I need to focus on in order to succeed in the academics, I also subjected myself to be mentored, with experience it is not everybody that likes to be mentored, some people want to run even before they can crawl, but for me; I got a good mentor and I was ready to be mentored. I also got family support; I went through my career ladder as a mother, a wife and a sister, so I had very good family support.
Let’s talk a bit about Vaccine; considering the complex production procedures of Vaccines, is it possible to introduce foreign agents into Vaccines, intentionally or unintentionally?
The process of Vaccine development to production and distribution is a very long one, starting from the exploratory phase to the research stage, the pre-clinical, to the clinical that has four different phases, phase one where you use very few individuals and then you will be looking at if the agent or the product is not harmful, then you determine the doses that is acceptable in the human system and then you go into the second phase where you use larger number of people to look at the safety of the drug and then phase three is also about safety, you use larger number of people to determine a wide range of parameters for you to have better information about safety and then phase four is the approval process and then production for mass distribution, so for each of these phases you are supposed to have quality control measures so that at the end whatever is produced is seen to be widely acceptable, even at the end of your production there is also a quality check. So it is a very long process and so many people are involved making sure that everything is safe, it is a process that is expected to be carried out under very high quality control measures but of course things can be introduced into Vaccines, that is what is called contamination but with the thorough process at all the stages, with quality control checks, it is expected that such contamination will be taken care of. That is why it is very important that while you are going to take the Vaccine, you must be sure of the source from which we are getting our Vaccines from, who is manufacturing the Vaccine? Where is it produced from? And all of that, it is like the ongoing discussions to remove the patent of COVID 19 Vaccines by the time that happens you are going to find a lot more companies producing Vaccines and making it available but then, it is the responsibility of government to ensure that what you are bringing into your country for your citizens to consume must be from credible sources and all the handling and processing must be done to ensure that there is no contamination.
We have been told that pregnant women are to be exempted from the COVID 19 Vaccine, why is this so?
What we have with the COVID 19 Vaccine is an emergency because in a trial of a Vaccine, it is expected that all of these would have been taken care of because you can’t consider a child the same way you consider an adult, you can’t consider a pregnant woman the same way you consider a non-pregnant woman, because in the pregnant woman there is a life going on in the woman and you don’t know what will be the effect of the drug or the Vaccine in the woman and the same with children; the doses for the medication of the Vaccine may be different, that is why in a trial, in that large scale trial, it is expected that the different group of people would have been included but because of the emergency nature in the way the COVID 19 Vaccine was produced, it was not included. But it is important to know that this Vaccine (COVID 19 Vaccine) is not going to cause harm to the pregnant woman and that is already known because the information that is available is already saying that pregnant women can take the Vaccine but the information that we may not yet know is if this Vaccine may have any effect on the child in the womb of the pregnant woman, that study is still on-going. As I said all these should have been covered in a comprehensive trial but because of the emergency need to get a Vaccine out in order to deal with a pandemic that was already getting out of control. And for the child, what dose? Is it the adult dose?
The adult dose may be too much for a child, so all of that is what the ongoing finding will determine, whether it is 6 months to 6years or 12years, children from 12 years and above can take this same Vaccine given to adults but 6months to 12 months we have to look at what dosage will be okay for the group of individuals, so that was why initially we advised against the use of this Vaccine for pregnant women because we were not sure of what the outcome may be but we also know that COVID 19 infection in pregnant women is so severe, it is much more severe and has higher risk of developing severe index, which is why it is better to take the Vaccine but what happens to the unborn baby is what is being investigated. For now we can’t say it is 100 percent okay for pregnant woman to take but from all that is available from scientific studies already conducted, the pregnant woman is allowed to take a decision whether she wants to take it or she doesn’t want to take it. It also shows that the infection is more severe if the pregnancy is in the third trimester, so there is a school of thought saying that pregnant women should endeavour to take it before they get to the stage of the third trimester in case they become infected, it will not be severe because becoming infected can lead to premature death and can lead to abortion. But the trial will give more specific information about what is required.
So in effect you are saying the study to determine what happens to the unborn child of COVID 19 infected mother is still ongoing?
Yes, it is still ongoing but so far, there is no report or information that suggests that it can be harmful but there is need for the conclusion of that study so that we can authoritatively make such pronouncements but some pregnant women have taken it and so far no harm have been reported, we have not had any cause for concern. One other important information that we are getting from the early stages of this study is that there are some children who have been born from mothers who were infected and they were born with antibodies, so they were born with anti-bodies against the virus. That is why one school of thought strongly recommends that pregnant women should take the Vaccine because their children will be born with immunity, for instance the mother will transfer antibodies to the child, that is why you don’t give measles Vaccines until nine months because the child should still have the maternal antibodies within him or her. So that is why it is advised that pregnant women should take it so that it can protect the unborn child.
What do you think is the reason for the deliberate misinformation or let’s say counter information among science community on the COVID 19 Vaccine?
Yes if you say scientific community, that is true, we are all scientists, but this is an area of Virology, it is not every scientist who know so much about Vaccines, so once a scientist speaks they say, oh! Yes the scientists have spoken but the depth of what is known by different scientists varies. The advent of COVID 19 has made sudden ‘experts’ from all kinds of people. So in the scientific community you have those who have in-depth knowledge of that area because that is their area of specialty and you have others who have general knowledge, they speak from level of knowledge that they have that is why you see it as conflicting information.
I think one of the things that has promoted this misinformation is that not much information was given out even while the Vaccine was under development , so you know in the absence of the right information the wrong information will take over, the nature of man will always want to hold on to some kind of information and the first information that presents itself will be broadcasted, so while the scientific community was busy with how to quickly get the Vaccine out, the information was not getting to the public, so the wrong information went out and now it is almost like we are battling to put back the right information so that people can absorb that and take it as the right information.
So it is for us to educate the public, those with the right knowledge should pass out the right information, they should begin to speak out with evidence because science is evidenced based. The Vaccine has been out for months now, are there evidences that all the speculations that came out at the beginning are real? Do we have such evidences? So those with the right knowledge should come and speak and pass out the right information because once the right information is out there with evidence, people are bound to accept and believe it as long as we don’t have such information, people will believe all the conspiracy theories flying around.
But it is never late; the scientific community can and should continue to communicate the success of the Vaccines so that people can see the truth for themselves with evidences. Most infections in the past have been taken care of with Vaccines so Vaccine is not new, it is just that the current technology may be different but Vaccine is not new, for viral infection, we know that the best way to control; to eradicate; and to prevent is through Vaccine, that is the best way to deal with viral infection; small pox today is eradicated because of Vaccine and then there was a lot of controversies even among the scientific world. That is the story of Vaccines today, all the viral infections that have been controlled have been through Vaccines and on Polio, Nigeria just celebrated Polio free; this is the result of Vaccine, the yellow fever Vaccine is there though we keep getting some infections here and there but it just shows that we need to Vaccinate more so that people will be protected.
I want you to discuss the current issues with incidences of re-infections and the other emerging strain of the Virus
Corona virus is an RnA virus, we know that RnA virus in the cause of their replication, there is lack of proofreading and that encourages mutation, at almost every round of replication there are some changes in the sequence of the virus, it is something very common with the RnA viruses, if you look at the virus of HIV for instance, you know how many strains we have; subtypes and sub-sub-types, and they can recombine, and that is the reason that we are yet to have the Vaccine against HIV today because of the number of variance and how quick the virus is able to mutate and bring out another type from the one that is there earlier.
For infection you expect that the body will respond and produce antibodies and these antibodies should be neutralizing in the sense that it prepares or sensitizes the immune cells so that if the pathogen comes into the body again your body should be able to recognize it and stimulate response, produce antibodies and all of that. So you can have a situation where the virus has infected an individual before, re-infects that individual because the antibodies that was produced is not neutralizing, but in a study that was done in China, only about 300 individual from millions of people re- tested were re-infected that is to show that a couple of individuals have antibodies but how long this antibodies will last is what we do not yet know.
So re-infection is a phenomena that is known, it can occur, it can occur if the individual did not develop enough neutralizing antibodies from the first infection or the virus infecting that individual is relatively different from the variant or the strain that caused the initial infection and that is what is being speculated for the current variant that is coming up but we do not yet have that much information to suggest that this variance will not be neutralized by the pre-existing antibodies. The information that we know now is that the virus is more transmissible, that is, the virus came into the human population, it is now well adapted in humans and so it is easier to move from one person to the other and the rate of spread is now becoming faster and you also know that to some level it causes a little more severe diseases than the original strain of the virus.
Why is more than one jab necessary to achieve herd immunity?
For the COVID Vaccine, the antibodies that is produced from the first jab is to sensitize, then it is when you bring the second exposure there is an exponential increase in the level of antibody, the first jab there will be a response but you may not get the required level of antibodies to prevent a natural infection so a second jab is brought in so that the system recognizes it and then you will have that exponential increase in the antibody level in the individual and with that when you are exposed to a natural infection like a virus, it neutralize the virus. Another Vaccine like that is the Hepatitis Vaccine, you have to take it in three doses, so all the sub-units Vaccines do not initiate that strong immune response at the beginning, you require a second dose that is usually an exponential increase in antibodies.
There is also the need to take the second dose within a time-frame because if you do not take the second dose within a time-frame, whatever response you have initially will be lost and when you are taking it again, it is like the a new exposure, so that is why there is a time-frame; say 6 weeks or 9 weeks or 3 months, it must be within that time-frame not too far from that.
How does the human body react to Vaccine?
The vaccine generally mimics a natural infection, in that, it comes in as agent and the immune system; the immune cells that has their role to play in addressing any foreign body in the system will perform their functions, in doing that it prepares the memory of the immune cells of the body such that if that foreign body comes in again it will be recognized almost instantly and be taken care of, so that is what the vaccine does, it makes the immune system of the body ready for any other attack by that pathogen.
Is this COVID 19 Vaccine preventive or curative?
Actually when you talk of Vaccine, it should be preventive in the real sense, though Vaccine can also serve as curative in the sense that the severity of the disease that comes after infection is ameliorated, it is reduced so in that sense you can consider it as curative, though curative in this instance is a word I really want to use very carefully, so for COVID Vaccine is supposed to do both from evidence available, it should prevent infection but what we now know from those who have received the Vaccine and still become re-infected we have reported less severe form of the disease which is what has also been reported by those naturally re-infected twice. So far, the current Vaccine that is available is supposed to preventive and in the situation when one becomes infected; it reduces the level of disease that the individual will experience if that individual was not vaccinated at all.
There is also need for us to continue to emphasize the non-pharmaceutical measures, the fact that you have been vaccinated does not guarantee that you will not be re-infected, even if you have been vaccinated you must continue to wear your mask, you must continue to wash your hand regularly, you must continue to maintain physical distancing, we must continue to emphasize on it, some think that when you are have been vaccinated you may not be infected again, no! one can still get infect