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Becoming a citizen scientist in Pakistan’s COVID-19 vaccine trial

SAMAA Health staffer writes about her experience

SAMAA | and - Posted: Nov 19, 2020 | Last Updated: 1 year ago
Posted: Nov 19, 2020 | Last Updated: 1 year ago

Photo: SAMAA Digital

Photo: SAMAA Digital

Ever since the world learned of multiple vaccines being produced that could protect against COVID-19, I have been dying to get immunised. Well, maybe dying isn’t the right word to use considering how controversial vaccines are in Pakistan. But today (November 19), I finally got my wish.

I registered online for the AKU trial some two weeks back. In the morning, I got a call at work to visit the hospital between 12pm and 1pm, otherwise my name would be removed from the list of participants. 

I am taking part in the Global Phase III Trial of the Recombinant Novel Coronavirus Vaccine (Adenovirus Type 5 Vector) (Ad5-nCoV) in adults 18 and older. That’s the “short” title. Simply put, it’s the trial of the CanSino vaccine in Pakistan. 

This trial is taking place at the Aga Khan University Hospital (near Stadium Road) in the Services Building. Once you get to the building, there are signs leading all the way to the Clinical Trials Unit on the first floor–which was great for someone as scatterbrained as me. There’s also a help desk at the front of the building (which I had to consult despite the signs). 

Be prepared to dedicate between 1.5 to two hours as there are lots of steps before you get the jab.

Once I was inside, I had to register. For this you need to take your original CNIC and two photocopies. If you have an AKUH card, you can show your MR number for faster processing. 

I got my patient ID wristband and was guided to the waiting area. There was another person waiting there calmly, well over six feet away. I noticed none of the other volunteers looked nervous. In the unit I saw people young and old, from different socioeconomic backgrounds. A man had brought his house help to get vaccinated as well, who seemed quite excited. 

Then, I was called in for consultation with a doctor. She briefed me about the trial (details of which I had memorised by that time) and handed me a short booklet with all trial details and a consent form. The details are available in both English and Urdu.

Once I had given informed consent, she explained the procedure in great detail. I was asked about past illnesses, underlying conditions, allergies, any medicine I was taking, marital status and whether I’d had COVID-19 infection previously.

What saddened me was that as a participant in the trial, I can’t donate blood for a year (the year I’d decided to become a regular donor). I also cannot take part in another COVID-19 vaccine trial, and have to make sure I don’t undergo any medical or surgical procedures on the same day. 

As I’m a woman of “childbearing” age, I had to take the dreaded urine test; fortunately the bathroom was clean and spacious. I left my pee sample in a sample jar inside a little cabinet, like a small present for science. The test determines whether you’re pregnant or not.

After a little more waiting my vitals were measured and blood drawn to rule out HIV infection and assess whether my body has COVID-19 antibodies.

Now the part I had been looking forward to the most: the inoculation. This takes place inside a doctor’s room. My doctor was very pleasant and let me take a selfie while I was getting the vaccine. Here’s me with a strategically placed emoji:

Honestly, it was slightly underwhelming after months of anticipation. The vaccine is given through a smaller-than-normal syringe, which made me wonder out loud whether I was being given the placebo. But the doctor said both the placebo and injection are delivered through similar-sized syringes. Since it’s a double-blind study, neither the participants nor the doctors know who is getting the vaccine and who gets the placebo. 

To see whether I had any adverse reactions to the vaccine, I was asked to shift to a different waiting area for 30 minutes. Side effects that are expected include pain at the injection site, fever, tiredness, headache and muscle pain. It might just be psychosomatic but I do think I felt lethargic and had a slight headache during that half hour. Maybe I was given the vaccine after all. 

Interestingly, the doctors at the registration desk have to call the participants to check whether they’ve been given valid numbers. One of the doctors pointed to a pile of forms that had to be discarded because some people gave wrong numbers. It’s such a shame that even for something as serious as this, people have no qualms about wasting resources. 

What might entice future participants is that you’re compensated for the visit with Rs3,000 in cash.

Some points to note:

  • You can’t take part if you’re under 18 years of age, breastfeeding, pregnant, planning to be pregnant within the next three months (90 days) or have had COVID-19 previously
  • The vaccine in this trial is free of cost
  • You can withdraw from the trial at any point after informing the researchers
  • This is entirely voluntary 
  • You will be compensated financially

How the coronavirus vaccine trials are going in Pakistan

“There has been a highly positive response from people,” Dr Naseem Salahuddin of Indus Hospital told SAMAA Digital on Thursday. “There are 45 to 50 volunteers at Indus a day.”

Trials at Indus Hospital started on October 13 and are being conducted everyday from 9am to 8pm. So far, 1,125 subjects have received either the vaccine or placebo.

“All international standards and protocols are being followed very strictly in the trials,” Dr Salahuddin said.

She urged people to participate in the trials as the vaccine’s reliability can be better studied if there are more volunteers.

“It’s not everyday that you get to be a citizen scientist. I think it’s a great opportunity for people to take part in something useful instead of sending WhatsApp messages,” said Dr Faisal Mahmood, infectious diseases expert and principal investigator of the vaccine trial at AKU. 

He said people were initially hesitant but now more are coming in.

A total of 5,344 volunteers have participated in the trials as of Wednesday, November 18, 2020:

  • Indus Hospital, Karachi (1,125)
  • Aga Khan University Hospital, Karachi (653)
  • Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore (111)
  • Shifa International Hospital, Islamabad (2,415)
  • University of Health Sciences, Lahore (1,040)

The number of volunteers from Pakistan may be increased by 2,000 to 3,000 on CanSino Biologic’s instructions.

Dr Salahuddin said people with active infections, drug use, and no CNIC or telephone numbers are excluded from the trials.

The volunteers are paid Rs3,000 on their first visit, which will be raised to Rs5,000 at the end of the trials.

If the volunteers develop symptoms of COVID-19 14 days after being injected, they will be tested. If they test positive, they will be treated and regularly tested for 28 days, besides a compensation of Rs30,000.

Dr Mahmood said no unusual side effects had been observed during the one month the trial had been going on. 

‘No evidence of coronavirus mutation so far’

“So far there is no evidence of virus mutation,” confirmed Dr Mahmood.

He warns, however, that the situation can get worse than the first wave of COVID-19 if people continue to be complacent.

“I have patients messaging me every two to three hours saying they tested positive.”

This time around, hospitals are filled with patients other than those with COVID-19 admitted. Winter is already a busy season with flu and pneumonia.

AKU is also getting cases of COVID-19 reinfections. It’s a mixed picture, Dr Mahmood says, some are severe and some aren’t. A lot of those testing positive are people who had travelled recently. Some don’t know where they got it from while a handful were infected because their family members were.

We aren’t getting cases from schools, the infectious disease expert told SAMAA Digital.

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