Vaccine Passports -- The Debate

Vaccine passports/certificates. Photo by Getty

"Given the reduced/no effectiveness of two doses, depending when the last dose was, there is a risk of these people having an infection, perhaps unknowingly, and transmitting to someone else in such a setting [places restricted to those with vaccine 'passports'."

"[The vaccinated are much likelier to have mild illness], So they may be more likely to be out and about, despite being infected. By excluding all the unvaccinated people from these places, we are in essence keeping them safer from the vaccinated people, who may be asymptomatically or pre-symptomatically infected with     COVID, but still able to transmit, especially when everyone is unmasked."

"If we drop the vaccine passports, the unvaccinated are going to go into those spaces. Right now, they may be living the life of a hermit, and have managed to stay safe that way. But if we get rid of vaccine certificates, they're like sitting ducks."

Dr.Jeff Kwong, epidemiologist, senior scientist, ICES (Institute for Clinical Evaluative Sciences)

"But the passports? They may be a good stick, but I'm not sure how effective they are for slowing transmission."

"We've seen it affecting families, splitting families apart. [Once vaccines became polarized], all reason went out the window."

Professor emeritus David Streiner, psychologist, McMaster University

"Because it makes people think that they are in a safe space [vaccine certificates may be harmful]; they were, pre-Omicron, but no longer."

"Vaccine certificates may prove valuable again at some point, but the two main purposes -- motivating people to get vaccinated and protecting people by keeping spaces confined to those at low likelihood of infection -- are clearly no longer relevant."

Dr.Andrew Morris, infectious diseases specialist, Toronto

"In the fall, when people were talking about implementing mandates, and some of my colleagues who were unvaccinated were facing termination, I thought to myself, what, exactly, is the risk reduction gained by terminating unvaccinated health-care workers."

"And that just led to a broader exploration for the actual numbers behind that."

"We were in these in-between phases of the waves. Obviously now infection risks are rising. It's a totally different situation."
"But I think we should think very carefully about whether or not, in a pluralistic democracy, we are sure that the benefits we may extract from [vaccine mandates and passports] outweigh the harm of creating a class of citizens who are not allowed to fully participate in society."

"We are starting to look at our fellow citizens in a way that they are not equal citizens to us, because they have made decisions that we don't agree with. And I think that's a very dangerous thing to do."

Aaron Prosser, psychiatry resident, McMaster University

Ontario had previously indicated that requiring proof of vaccines in settings such as restaurants, bars and cinemas would no longer be required after Jan.17, but a senior official said the government is taking that end date off the table. (Evan Mitsui/CBC)

 

This is a debate on reducing the risk of transmission of COVID-19. The debate over vaccines is long past. Their well acknowledged capacity to prevent severe disease, hospitalization and death in vulnerable adults is no longer open to debate. The value of the COVID vaccines has been proven time and again; not a 'cure' but a means to prevent a worse-scenario response to the incursion of a predatory pathogen that has cut a wide swath through the world's population in illness and in a massive death count globally.

 

A new study produced in Canada explores whether vaccines reduce transmission risk. And according to the study results they do. For a limited time frame. Two doses, the world now knows, are not likely to protect against infections by a virus that is highly contagious as Omicron has proven to be. Six months following the second dose "it kind of wanes down to, like, zero", stated Dr. Kwong, lead author of the study.

 

Updated data examined by his team indicated effectiveness against infection can recover following a third dose with an mRNA vaccine to about 60 percent. A higher rate of protection, he agrees, "but still not great", certainly not as high as had been the case with the previous, Delta strain. Based on two objectives; prevention of transmission, and keeping people out of hospitals and alive, the concept of vaccine passports gained recognition and became an important part of the anti-COVID arsenal.

 

Vaccines proved their usefulness in diminishing the worst-borne-out threats of COVID, but it was soon realized that they don't stop transmission and infections; all the more so with particularly wildly contagious Omicron. An observation that led to questions over whether passports remain relevant, and why the controversial issue hasn't been more fully addressed by the governments mandating their use. 

 

Making life a little more difficult for people who decline the shots, passports were seen as a method of encouraging vaccine uptake; no vaccination, no entry to settings such as gyms, theatres, restaurants, sports events or liquor and cannabis stores. Once Quebec expanded its vaccine certification scheme to cannabis and liquor stores the number of first-dose bookings quadrupled.

 

It is Dr.Kwong's contention that vaccine passports serve to protect the unvaccinated, at this juncture. His views are not universally shared; many health professionals feel the coercive use of passports to try to force the unvaccinated to comply divides people, creating adversaries out of the vaccinated and the vaccine-hesitant or -defiant. The question of the percentage in the population required to achieve 'herd immunity' with COVID goes answered as yet -- and how many people need to be excluded to result in prevention of one transmission?

"I think we're in this stage of producing fatigue about it: Okay, I've got my two shots, my booster. Enough already. Let me go on with my life", observed Dr.Streiner, professor in the department of psychiatry and behavioural neuroscience, McMaster University. The risk of public pushback concerns him. Dr.Streiner's study estimated in the pre-Omicron era, at least 1,000 unvaccinated people would be needed to be excluded in prevention of one SARS-CoV-2 transmission in most settings.

New data envisages a surge in daily hospitalizations in coming weeks amidst signs the Omicron wave may be peaking,  just as it appears to be doing in Britain and the United States. The variant may be running out of people to infect, according to The Associated Press. "It's going to come down as fast as it went up", commented Dr.Ali Mokdad, University of Washington scientist.

Omicron and Vaccine Boosters

"An 80 percent of epitopes in the spike protein recognized by CDS+ T-cells are not affected by the mutations in the omicron variant; two doses may still induce protection against severe disease."

Pfizer-BioNtech statement

"Our preliminary, first data set indicate that a third dose could still offer a sufficient level of protection from disease of any severity caused by the Omnicron variant."

"Broad vaccination and booster campaigns around the world could help us to beter protect people everywhere and to get through the winter season."

Dr.Ugur Sahin, CEO, BioNTech

The booster is said to improve the level of neutralizing antibodies  Reuters

 

With this assurance emanating from the two pharmaceutical producers whose mRNA vaccine has become the most trusted in the world, that their vaccine formula against contracting the SARS-CoV-2 virus causing COVID-19 can be relied upon to continue offering vital protection against severe illness and death, a huge sigh of relief must surely have emanated from government sources and medical scientists the world over.

They said it, and their reputation rests upon their assurance that three doses of the Pfizer-BioNTech COVID vaccine are seen to be effective against the Omnicron variant, the mutated strain with the most mutations of any that has yet been examined, the cause of global consternation and trepidation for what it might possibly lead to. That it is more virulently transmissible appears to be a given on the evidence, but that it leads to more serious health consequences and is able to evade the vaccines' protective assurances is only now beginning to play out in real time.

From the announcement by the two companies it would seem that boosted individuals boast the same level of protection against the new variant comparable to that of people with two doses had acquired against the original coronavirus. There has been a worldwide rush conducting neutralizing studies by scientists to gauge how pre-existing immunity from both vaccination and prior infection plays out, to determine whether Omicron would be able to sidestep those defences.

 

The variant's emergence in South Africa, identified with a daunting constellation of mutations warned scientists that it could be more infectious and more effective at avoiding the protection offered by vaccines.  Experiments have now produced early results which show the number of antibodies required to halt the replication of the virus in a test tube; an early indication how effective the new variant is in avoiding antibodies.

 

Pfizer's press release announced that two doses of its vaccine performed 25 times poorer for Omnicron in comparison with the original versions of the virus. Despite which, only real life, long-term data is capable of providing information on a direct reduction in vaccine effectiveness. Leading scientists to the conclusion that precise, reliable information can be expected to emerge within the next several weeks.

 

Pfizer-BioNTech stands by its conclusion indicating "two doses of (the Pfizer-BioNTech vaccine) may not be enough to protect against infections with the Omicron variant". At the same time, the company feels other aspects of the immune response activated by the vaccine as for example T-cells, are likely to be unaffected by the new variant, and still able to protect against severe disease. 

It was found by researchers examining people who had received three doses of the mRNA vaccine -- double-jabbed with a booster -- that the antibody effectiveness improved 25-fold, returning to approximately the same effectiveness level as two jabs for the original, wild-type virus.

 

Pfizer stands by its result indicating "two doses of (Pfizer)avirus.