Why The Vaccine May Not Be The Holy Grail For Opening Of Borders

Unless you are an anti-vaxxer or a Covid sceptic, the news of a number of effective vaccines against Covid-19 was universally welcomed.

Many in the travel and tourism industries joined the celebrations with the hope that a vaccine would allow borders to re-open again.

Experts in Malaysia have warned of a US$24.5 billion hit to the tourist economy this year with similar warnings from Vietnam suggesting a US$23 billion impact. Thailand, despite offering tourist visas, on a very restricted basis, saw just 1,200 visitors in October and is likely to be closed to general tourists until at least April 2021.

The talk of Covid passports to re-open the travel industry is an exciting development but is it all good news?

The reality is that the primary aim of a vaccine is to stop illness, not stopping people getting the infection. Therefore a vaccine alone will not stop the spread of the virus and illness will still occur in people who have not received the vaccine.

Many western countries have bought large quantities of a number of vaccines to ensure that their population is protected. This may mean that many countries will find early access to a vaccine almost impossible, especially poorer countries.

COVID-19 Vaccine. Credit Daniel Schludi on Unsplash

The BBC have today reported that the People’s Vaccine Alliance is warning that in nearly 70 lower-income countries they will only have enough doses for 10% of the population. Rich nations around the world account for 14% of the world’s population but have bought 53% of the most promising vaccines.

“No-one should be blocked from getting a life-saving vaccine because of the country they live in or the amount of money in their pocket,”

“But unless something changes dramatically, billions of people around the world will not receive a safe and effective vaccine for Covid-19 for years to come.”

Anna Marriott. Health Policy Manager, Oxfam via BBC News.

It is unlikely that countries will start to re-open their borders more freely unless they are able to vaccinate large proportions of their own population to protect against people entering the country who have had the vaccine but are asymptomatic carriers.

How Do We Re-open Borders

It is likely therefore that the only way to re-start travel in any numbers will require a combination of actions:

  • Vaccination with an approved vaccine – this may vary if countries cannot agree which vaccines they recognise
  • Pre-travel, negative Covid tests. At the moment it is generally a PCR test that is required by countries allowing travel. This test can take 2 or 3 days for results. The faster, LAMP, tests are generally cheaper and can give results in a very short period of time. However they are, at the moment, much less accurate.
  • Post- arrival, negative tests. Depending on the type of test used this could mean that travellers would have to self-isolate for 2 or 3 days until results are available.

Most countries will have to make the difficult decision between supporting the tourism economy, which can account for more than 20% of GDP in some countries, and protecting the population.

Quarantine is very unpopular with most tourists who travel for only short periods of time and generally do not want to be limited to one location during their stay.

There have also been cases of locals attempting to flout the quarantine requirements. Thailand has had an influx of new cases following illegal crossings of Thai workers from Myanmar trying to avoid quarantine, while Vietnam is also concerned at the prospect of illegal crossings.

If they make entry conditions too strict, they will see tourists numbers drop as they will become too complicated and expensive.

If they have few restrictions they will risk infection of travellers and locals as well as discouraging many travellers who will not feel safe traveling to that country.

Herd Immunity Hope

There could be hope of greater protection however.

A report in The Times this morning stated that one of the vaccines, the Oxford-AstraZeneca vaccine, has shown success in protection against symptomatic illness and, crucially, asymptomatic infection.

The findings are complicated due to some issues during the testing process of the vaccine.

Some of the test subjects were given, by accident, a half dose followed by a full dose, instead of two full doses.

restaurant in Pattaya, Thailand. Credit Kseniia Ilinykh on Unsplash

The subjects given the half dose had better results than those given the correct dosage with an estimated 90% protection against symptomatic illness and 60% protection against asymptomatic infection. Those receiving the correct dose had around a 62% protection against symptomatic illness but no protection against asymptomatic infection.

Protection against asymptomatic infection would be a big step in moving toward a herd immunity against the virus.

“What we should take away from it is that the vaccine is safe, it’s highly effective and one really important finding is that from 21 days after being given the first dose of the vaccine, nobody was admitted to hospital with Covid or had severe Covid disease.”

Sarah Gilbert. BBC Radio 4, Today programme.

The issue lies with the nature of testing and that the better results were not part of the full study. It means that regulators will need to decide on how they recommend the vaccine be given.

Studies are also being planned on a mix and match approach.

Vaccines such as the Pfizer/BioNTech, a mRNA vaccine, which has started to be given in the UK are expensive and needs to be stored at -70°C / -94°F. The Oxford-AstraZeneca is a more conventional vaccine and can be stored more easily.

Once additional vaccines are approved, work will begin on giving one dose of one vaccine, followed by a dose of a different vaccine. The hope is that this will identify a more effective symptomatic illness and asymptomatic infection solution.

Main picture credit CDC on Unsplash

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Published by flyingdogtravel

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