In an interview with New Zealand Pacific Beat, RMI Secretary of Health Jack Niedenthal talked about the success in using the Moderna vaccine in the urban atolls but he said they are waiting for the Johnson & Johnson vaccine to start vaccinating in the rural atolls. Thus far, 28-30% of the adult population has been vaccinated. 8000 people in Majuro and Ebeye have received at least one dose of the Moderna COVID-19 vaccine. 1700 people have completed the two-dose vaccine protocol. There are 2 central locations for vaccine distribution and 6-7 mobile teams who are going house to house offering the vaccine to anyone over 18. However, only group immunity through a vaccine has hope to end the spread of the virus. There is still no vaccine for children or adolescents and because such a large part of the population are under the age of 18, it’s impossible for the RMI to achieve herd immunity through vaccination. The requirements for short-term storage and subzero temperatures makes it logistically difficult to get the Moderna vaccine to the other atolls. The two-dose protocol also makes it expensive. So, the Ministry of Health plans to distribute the single-dose Johnson & Johnson vaccine when it is authorized and available for use. So far, the strict repatriation protocols have prevented any border cases of the coronavirus from entering the country.
Secretary Niedenthal reminded us that vaccination is optional and mentioned that some people in the RMI like in the US have taken a “wait and see” approach. He said that the most reluctance has come from people between ages 18-30. They know that people their age tend to have a mild response to the virus and that death is unlikely. Even though everyone there knows someone in the US who has died from covid, it is not an imminent danger there. Even though there is still no travel between islands or very controlled repatriation into the country, life in the RMI is mostly normal – everything is open and no one needs to wear a mask. Some people in Marshallese communities in the U.S. have had some questions about getting vaccinated too. When the vaccine was still new and we had yet to hear or see people we knew getting vaccinated, KNWA ran a misleading story saying that Marshallese people would be the hardest group to vaccinate. Chikin Melele started talking to different Marshallese doctors and healthcare workers to confirm that they were in fact able to get vaccinated. Everyone who could was getting vaccinated, but we did find a just a couple Marshallese healthcare workers who at the time had not decided to get vaccinated yet. One Fayetteville healthcare worker said that even though he had treated patients with covid and almost everyone else he worked with had gotten sick, he had not gotten sick yet. He expressed concern that the vaccine had not been approved by the Food and Drug Administration, only authorized. He didn’t want to be a “guinea pig” for the new vaccine but he also wanted to represent the Marshallese people when the news was falsely said Marshallese didn’t want the vaccine. He also was considering waiting for the “more traditional vaccine” that Johnson & Johnson has been developing.
We looked into what makes these new vaccines different from traditional vaccines, and we started by talking to Dr. Sheldon Riklon. The mRNA vaccine developed by Pfizer-BioNTech and Moderna are the first vaccines of its kind. When you get injected with the vaccine it prompts your body to make antibodies specifically for the spikes on the virus. Once the message spreads to all the cells, the body will be on the look out and have antibodies ready to fight the virus before it gets into the lungs. Dr. Riklon got the first dose at the end of December and the second dose in January. He posted videos on Facebook describing the expected side effects of the vaccine and explained also how it worked. He explained that after the first dose you start developing antibodies and the second dose pushes the protection level up above 94-95%. He assured us, “It’s a pretty smart technology, that you can make your own antibodies against a virus that you don’t actually get exposed to at all. In other vaccines you get what’s called an attenuated virus or live virus, but not this one. So that’s pretty smart.” Scientists have known how to deliver targeted material to cells for a while but they were using it more to fight diseases like cancer. The mRNA technology already existed and has been used to treat cancer, SARS and MERS. All the necessary steps in the development were done as required, and scientists were able to get results so quickly because the number of covid cases has been so high.
There are two kinds of genetically engineered vaccines that send a small code instead of a dead virus – on a single-stranded RNA or a double-stranded DNA adenovirus. The Pfizer/BioNTech and Moderna vaccines are mRNA vaccines. The single strand is fragile and needs to be stored at subzero temperatures and used quickly. Clinical trials showed that these vaccines are 95% effective at preventing infection and 100% effective at preventing severe cases and death. For a comparison, one dose of the MMR vaccine is only 78% effective against the mumps and 88% effective with a second dose. The AstraZeneca vaccine being used in the U.K. and India, the Sputnik V vaccine being used in Russia, and the Johnson & Johnson vaccine which has been submitted for authorization in the U.S. are adenovirus vaccines. Because the information is packaged in a double-stranded DNA, these vaccines only require a single dose and they can last for up to 6 months at normal refrigerated temperatures. Scientists have determined that the Johnson & Johnson vaccine is 85% effective at preventing severe cases of covid and 65% effective against moderate cases including new variants of the covid-virus. But, right now more than half of the world (130 countries) are still waiting for any kind of vaccine. Just 10 countries account for 75% of the vaccines distributed in the world. We are going to need both kinds of vaccines to overcome this worldwide disease and the other viruses that have been plaguing mankind too.