For Delano’s first Live Chat of the year on 20 January, journalist Jess Bauldry spoke to Markus Ollert, head of Luxembourg’s Institute of Health’s infection and immunity department.

He responded to some of the most common questions related to the new covid-19 vaccines, in terms of their safety, and effectiveness and how soon life can return to normal.

A normal Christmas in 2021?

We have to achieve 70% vaccination to develop herd immunity. But vaccine production has been slow because of production delays. Professor Ollert said these bottlenecks will likely be eased through collaborations between bio technology players, such as Sanofi, allowing producers like Pfizer/BionTech to use their production facilities.

He said: “Today’s projections are based on what is production now. But there is potential to increase that using production sites of companies that don’t have a valid product. Hopefully that will happen soon.”

He added that it was likely “that by the second part of this year we will have vaccinated enough people and reach a scenario where we can have a normal Christmas this year.”

Was safety compromised in developing vaccines?

On average vaccines take 10-15 years to develop. The covid-19 vaccines were brought out within a year, as predicted by Professor Ollert a year ago. What changed, beside the fact funding was more readily available, was developers put 2 phases of clinical development together. “They did a roll-over evaluation, so regulatory bodies in the US and Europe were constantly informed about everything going on in these studies,” Ollert stated on 20 January. “Yes, it’s done at a speed never seen before. On the other hand, safety hasn’t been compromised.”

How rare are side effects?

Dr Ollert pointed out that there are expected side effects of all vaccines, which is normally because their goal is to “induce an immune response and to do so you need to have an immune system that is working and is active. If the immune system works, in some people it runs in the background, you don’t see it. And you can still work in the foreground. Sometimes for certain programme updates, your working capacity in the foreground might be affected. Those are people who have certain side effect to be expected, that you have pain at the injection, fever, headache, being fatigued.”

There are some very rare, severe side effects, which are allergic reactions. These happen in 1-3 cases in 1 million injections of vaccines. Ollert said: “In covid vaccines it’s happening a little bit more often, we think it’s 11 cases per 1 million injections. In Luxembourg, we would expect 10 reactions in Luxembourg to such a vaccine.”

How risky is it for people with severe allergies to get vaccinated?

It is recommended that vaccinated people wait 15 minutes after the injection to see if there is a reaction before going home. People with severe allergies are advised to stay 30 minutes.

In the past, the UK authorities said anyone with a severe allergy, should not receive the Pfizer/BionTech vaccine. This recommendation has since been revised and removed from the recommendations. People with an allergy to the specific ingredients only should speak with an allergy specialist.

“We know what’s causing the allergic reactions, it’s a specific chemical used in drugs and a food ingredient to stabilize,” Ollert said.

What killed those elderly people in Norway?

Norway reported 23 deaths among frail and elderly people who received the first dose of the Pfizer/BionTech vaccine. While investigations are ongoing, Ollert believes it likely they were still exposed to the virus while not fully protected--“we know the first injection only brings a protection rate of max 50%.”

Dr Ollert said: “Maybe there were false assumptions after the first doses that they were protected. And safety measures weren’t taken seriously. We have to wait for the results of this investigation. But this is the most likely reason for these deaths.”

The professor said that it takes 10-14 days to build up immunity in a way that is sustainable and strong enough. Patients have to be careful after the first shot, as they are not protected right away.

Can I still pass on the virus if I get vaccinated?

It is not yet known if vaccinated people can pass the virus. So far, studies have only examined whether the vaccine stopped serious disease from developing. Ollert said: “Certainly Pfizer/BionTech and Moderna did a great job protecting almost 95% of people from getting the disease. We can be quite sure about that. But when it comes to transmission of the virus, we don’t have enough data yet. There are initial results from Israel this might happen. But it’s too early. We have to see what vaccination campaign in different countries will show us.”

How effective are these vaccines against variants and for how long?

Up to now ten virus variants have been detected in Luxembourg with the South African and UK mutations prompting the most concern. Prof Ollert said researchers were closely observing these mutations to ensure vaccines can protect against them. Duration of immunity in infected people varies depending on the severity of the infection. An asymptomatic person may have a weaker antibody response and so will lose that immunity within three months. Patients who had a strong immune response are protected for at least six months.

The mRNA vaccines activate the immune system and studies suggest the response lasts longer than even patients who were severely infected and hospitalized. Ollert said: “There’s good hope these levels will stay high a significant amount of time but we can’t tell how long it will last. That’s something we’ll have to see.”

How to combat vaccine hesitancy?

Surveys show low vaccine readiness in Luxembourg. Ollert stressed: “You’ve two chances, either you wait in seclusion until the world is normal again or you get naturally infected and hope that you build up an immune response that’s as effective as the vaccine response. Or the safest way is to get vaccinated and trust in these developments that have been done and hopefully are part of that population that can return to a normal life as soon as possible.”

He believes that the more people get vaccinated, the greater trust there will be in them. “Once we have data coming out that hopefully virus transmission can be stopped then hopefully people will want to participate in this act of solidarity by getting vaccinated,” he said.

Should vaccines be made mandatory?

Western European governments do not support compulsory vaccinations though they could become indirectly mandatory for certain parts of public life, for instance, if airlines request a vaccine passport.

Ollert said: “I think mandatory vaccination at this point, from what I see politically, it’s not what we will see in the near future. It will still be something you have to opt in. From that point of view I wouldn’t support making it mandatory. From a medical point of view it might be the best situation but I could see this wouldn’t be supported in society.”

Where can I find out more?

For further information, Prof Ollert recommended reading the New York Times Coronavirus Vaccine Tracker and the World Health Organization website.