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07 October 2021 | Story André Damons
Dr Nicholas Pearce, Head of the Department of Surgery in the Faculty of Health Sciences at the UFS, Prof Adrian Puren, Acting Executive Director of the National Institute for Communicable Diseases (NICD), Prof Glenda Gray, President and CEO of the South African Medical Research Council (SAMRC), and Dr Angelique Coetzee, Chairperson of the South African Medical Association (SAMA), were the panellists at the University of the Free State (UFS) Thought-Leader webinar, themed Why vaccinate?

Panellists at the University of the Free State (UFS) Thought-Leader webinar, themed Why vaccinate, felt it was critical for everyone in South Africa to get vaccinated in order to return to a sense of normality and to a university environment where lectures and learning not only happen in the lecture room, but in the ‘informal’ academic environment. 
Large numbers of the community need to be vaccinated to halt the progression of the pandemic and to maintain non-pharmaceutical interventions. 

Dr Nicholas Pearce, Head of the Department of Surgery in the Faculty of Health Sciences at the UFS, Prof Adrian Puren, Acting Executive Director for the National Institute for Communicable Diseases (NICD), Prof Glenda Gray, President and CEO of the South African Medical Research Council (SAMRC), and Dr Angelique Coetzee, Chairperson of the South African Medical Association (SAMA), were the panellists. This was the fifth webinar (28 September 2021) in the series, which is part of the Free State Literature Festival’s online initiative, VrySpraak-digitaal. 

Critical that everyone get vaccinated to return to a sense of normality

Dr Pearce indicated that patients seemed hesitant to present to both private and state health-care facilities during the COVID-19 pandemic. This resulted in patients presenting in the final stages of cancer (stages 3 and 4 as opposed to stages 1 and 2). “The quicker we are able to exit the COVID-19 pandemic – and we will probably never totally eradicate it as it might become endemic – we can go back to treating other medical conditions that are currently not being optimally managed,” said Dr Pearce.

He is also concerned that the impact of the pandemic on other medical diseases (such as mental issues) will only become visible over a number of years. We must be careful that we do not forget about the non-COVID diseases, according to Dr Pearce. 

Dr Pearce said it was critical that everyone be vaccinated in order to return to a sense of normality. The COVID-19 protocols of social distancing and the wearing of masks have left a mental toll on us as a society. He said depression and suicide are on the rise, and if we want to go back to a sense of normality, a large number of people need to get vaccinated.

The economic problems caused by COVID-19 are huge, as a large number of people have stopped their medical aids in the Free State. Some of the other economic problems due to COVID-19 is that a larger number of the younger population got infected during the third wave, which means that many breadwinners lost their lives. In the medium and long term, this is going to have huge economic repercussions. 

Vaccine acceptance increased among South African adults

Armed with figures from a recent study by the Centre for Social Change at the University of Johannesburg (UJ) in collaboration with the Developmental, Capable and Ethical State research division of the Human Sciences Research Council (HSRC), Dr Coetzee illustrated the importance of getting vaccinated. 

The study found that even though hesitancy dropped by 5%, vaccine acceptance increased to 72% among South African adults.

She said according to the study, South Africa faces two significant challenges. “First, if all 72% were actually vaccinated, we would still be 8% short of the government’s target of 80%. So, we know that government has secured significant vaccines to vaccinate the entire adult population and that the supply of vaccines should no longer be a concern as we had seen earlier this year. What we need to do is to convince some of the people who are currently hesitating about the value of getting vaccinated.”

Acceptance among the older age group has risen substantially by 11% when comparing the results from round three (December 2020 to 6 January 2021) with round four (June 2021 to July 2021). Said Dr Coetzee: “But what is still concerning is that the acceptance among those aged 18 to 24 years has actually declined from 63% to 55%.”
The second challenge that came to the fore, continued Dr Coetzee, is one of access. “We have said many times before, vaccines should be brought to the people, and not the other way around. Finally, we are now seeing that this is starting to happen, but I think it is too slow – especially in the rural areas – and maybe a bit too late. Let’s see what is going to happen going forward.”

According to Dr Coetzee, the message must be clear: We need to vaccinate to save the health-care workers and to save lives and maintain the non-pharmaceutical interventions. She said it does not matter how many times people are told to get vaccinated, they still want to take their chances with the virus. 

Aim higher to achieve herd immunity

According to Prof Puren, the threshold for herd immunity of about 67% vaccinated adults in South Africa now seems to be more mythical. “We should be aiming higher than that, meaning 90% or higher in terms of the proportion of the population being vaccinated in order for us to have a more endemic control,” says Prof Puren. 

“A large number of people in South Africa have been infected with COVID-19, but there is still a significant proportion of people that have not experienced this virus. Herd immunity is about the indirect effect of protecting those individuals who are susceptible. So, it’s a particular threshold of the number of people who had an immune response.” 

Prof Puren said there will have to be a breakthrough in infections. Vaccines do work, they are effective. It is possible for us to achieve endemic control, and vaccines are the critical component to do that. 

Important benefits of vaccination are to gain control of the academic year

“The questions about the benefits of mandatory vaccination at university – to prevent hospitalisation and deaths.  With vaccination, you also impact isolation and quarantine challenges. If you have good coverage of vaccinations, institutions will not have to keep closing classrooms, or hostels. It will help keep the workforce open. 

“One of the important benefits of vaccinations is to gain control of the academic year. All the universities have suffered, having to move to online learning where a lot of students don’t have the luxury and privilege of having data available to them all the time.”

“The issue of hybrid learning is important, and you will still see a lot of hybrid learning going on as we go into different surges. But students still need interaction, they still need face-to-face teaching, and they still need the interaction, the socialisation. We have to maximise the university experience,” said Prof Gray.  

In answering the question – would it be beneficial for employees and institutions to formulate and implement a vaccination policy – Prof Gray said it was a critical move to open up academic institutions.  

She agreed with Prof Puren that the 70% is almost mythical, and that a higher level of vaccination will be needed to start controlling the pandemic. 

“Why should we vaccinate? Why should we try and control the transmissions in our country? We have to do that, because we need our economy to start, we see how we have been affected by being on the red lists of certain countries. This affects our economy, our tourism, and jobs. A lot of people have lost jobs. If we want to interface with the rest of the world, we are going to have a discussion around making sure citizens are vaccinated.”


• The recording of the webinar can be found here  

 Passcode: nJv%p7Rp

News Archive

Inaugural lecture: Prof Robert Bragg, Dept. of Microbial, Biochemical and Food Biotechnology
2006-05-17



Attending the inaugural lecture were in front from the left Prof Robert Bragg (lecturer at the Department of Microbial, Biochemical and Food Biotechnology) and Frederick Fourie (Rector and Vice-Chancellor).  At the back from the left were Prof James du Preez (Departmental Chairperson:  Department of Microbial, Biochemical and Food Biotechnology) and Prof Herman van Schalkwyk (Dean: Faculty of Natural and Agricultural Sciences). Photo: Stephen Collett
 

A summary of an inaugural lecture delivered by Prof Robert Bragg at the University of the Free State:

CONTROL OF INFECTIOUS AVIAN DISEASES – LESSONS FOR MAN?

Prof Robert R Bragg
Department of Microbial, Biochemical and Food Biotechnology
University of the Free State

“Many of the lessons learnt in disease control in poultry will have application on human medicine,” said Prof Robert Bragg, lecturer at the University of the Free State’s (UFS) Department of Microbial, Biochemical and Food Biotechnology during his inaugural lecture.

Prof Bragg said the development of vaccines remains the main stay of disease control in humans as well as in avian species.  Disease control can not rely on vaccination alone and other disease-control options must be examined.  

“With the increasing problems of antibiotic resistance, the use of disinfection and bio security are becoming more important,” he said.

“Avian influenza (AI) is an example of a disease which can spread from birds to humans.  Hopefully this virus will not develop human to human transmission,” said Prof Bragg.

According to Prof Bragg, South Africa is not on the migration route of water birds, which are the main transmitters of AI.  “This makes South Africa one of the countries less likely to get the disease,” he said.

If the AI virus does develop human to human transmission, it could make the 1918 flu pandemic pale into insignificance.  During the 1918 flu pandemic, the virus had a mortality rate of only 3%, yet more than 50 million people died.

Although the AI virus has not developed human-to-human transmission, all human cases have been related to direct contact with infected birds. The mortality rate in humans who have contracted this virus is 67%.

“Apart from the obvious fears for the human population, this virus is a very serious poultry pathogen and can cause 100% mortality in poultry populations.  Poultry meat and egg production is the staple protein source in most countries around the world. The virus is currently devastating the poultry industry world-wide,” said Prof Bragg.

Prof Bragg’s research activities on avian diseases started off with the investigation of diseases in poultry.  “The average life cycle of a broiler chicken is 42 days.  After this short time, they are slaughtered.  As a result of the short generation time in poultry, one can observe changes in microbial populations as a result of the use of vaccines, antibiotics and disinfectants,” said Prof Bragg.   

“Much of my research effort has been directed towards the control of infectious coryza in layers, which is caused by the bacterium Avibacterium paragallinarum.  This disease is a type of sinusitis in the layer chickens and can cause a drop in egg product of up to 40%,” said Prof Bragg.

The vaccines used around the world in an attempt to control this disease are all inactivated vaccines. One of the most important points is the selection of the correct strains of the bacterium to use in the vaccine.

Prof Bragg established that in South Africa, there are four different serovars of the bacterium and one of these, the serovar C-3 strain, was believed to be unique to Southern Africa. He also recently discovered this serovar for the first time in Israel, thus indicating that this serovar might have a wider distribution than originally believed.

Vaccines used in this country did not contain this serovar.  Prof Bragg established that the long term use of vaccines not containing the local South African strain resulted in a shift in the population distribution of the pathogen.

Prof Bragg’s research activities also include disease control in parrots and pigeons.   “One of the main research projects in my group is on the disease in parrots caused by the circovirus Beak and Feather Disease virus. This virus causes serious problems in the parrot breeding industry in this country. This virus is also threatening the highly endangered and endemic Cape Parrot,” said Prof Bragg.

Prof Bragg’s research group is currently working on the development of a DNA vaccine which will assist in the control of the disease, not only in the parrot breeding industry, but also to help the highly endangered Cape Parrot in its battle for survival.

“Not all of our research efforts are directed towards infectious coryza or the Beak and Feather Disease virus.  One of my Masters students is currently investigating the cell receptors involved in the binding of Newcastle Disease virus to cancerous cells and normal cells of humans. This work will also eventually lead to a possible treatment of cancer in humans and will assist with the development of a recombinant vaccine for Newcastle disease virus,” said Prof Bragg.

We are also currently investigating an “unknown” virus which causes disease problems in poultry in the Western Cape,” said Prof Bragg.
 
“Although disinfection has been extensively used in the poultry industry, it has only been done at the pre-placement stage. In other words, disinfectants are used before the birds are placed into the house. Once the birds are placed, all use of disinfectants stops,” said Prof Bragg.

“Disinfection and bio security can be seen as the ‘Cinderella’ of disease control in poultry.  This is also true for human medicine. One just has to look at the high numbers of people who die from hospital-acquired infections to realise that disinfection is not a concept which is really clear in human health care,” said Prof Bragg.

Much research has been done in the control of diseases through vaccination and through the use of antibiotics. “These pillars of disease control are, however, starting to crumble and more effort is needed on disinfection and bio security,” said Prof Bragg.

Prof Bragg has been working in close co-operation with a chemical manufacturing company in Stellenbosch to develop a unique disinfectant which his highly effective yet not toxic to the birds.

As a result of this unique product, he has developed the continual disinfection program for use in poultry. In this program the disinfectant is used throughout the production cycle of the birds. It is also used to ensure that there is excellent pre-placement disinfection.

“The program is extensively used for the control of infectious diseases in the parrot-breeding industry in South Africa and the product has been registered in 15 countries around the world with registration in the USA in the final process,” said Prof Bragg.

“Although the problem of plasmid mediated resistance to disinfectants is starting to rear its ugly head, this has allowed for the opening of a new research field which my group will hopefully exploit in the near future,” he said.

 

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