al jazeera. ♪ >> you're watching al jazeera. a reminder of our top stories. the tele-band has captured afghanistan's third-largest city of herat. the 11th provincial capital to fall over the past week. the armed group gained control of a second city early on thursday as it pushed toward the capital, kabul. we have more. reporter: residents fear they tell a man -- te taliba -- the taliban had pushed through. they have been trying to get into the city for a month.

they broke into the prison, they got into the police compound, they got into the prison and release all the prisoners. they had prisoners -- one man said my relatives were in the prison, now they are in my house. you could hear gunfire, but they said a -- they said that gunfire is not coming from security forces. it is celebratory gunfire. >> the u.s. and the u.k. are sending 3600 troops to kabul to help pull out embassy staff and local interpreters. washington insists it's not a full evacuation in the embassy will remain open. votes are being counted in zambia's presidential and parliamentary elections. the president is seeking a controversial third term in what is thought to be an externally tight race. the former president could soon be in the hands -- the fate of the former president could soon be in the hands of the, no court

-- of the criminal courts. a cargo ship has spilled oil into japanese waters after breaking and have. the crimson polaris. all 21 chinese and filipino crewmembers have been rescued. samsung's vice chairman will be a free man inhe's been serving f year prison sentence for bribing a friend of south korea's former president. it's unclear if he can return to work. you can follow those stories on our website, aljazeera.com. up next, it's inside story -- "inside story." do stay with us. ♪ kim: is covid-19 herd immunity

becoming a myth? new virus variants and the unequal distribution of vaccines are making it more difficult to achieve that goal. so, will governments need new strategies to control the pandemic? this is "inside story." ♪ hello, and welcome to the program. i'm kim vinnell. scientists have long said so-called herd immunity is needed to slow down the spread of covid-19. that's when 70% or more of the population is protected from the virus, either by becoming infected, or by being vaccinated. but some experts now doubt it can be achieved. the head of the u.k.'s oxford vaccine group says that's because of the contagious delta variant. new infections and deaths are rising steadily in britain, despite three quarters of people being fully vaccinated.

andrew pollard had this warning to mps. -- to mp's. >> we know very clearly with the coronavirus that this current delta variant will still infect people who have been vaccinated. and that does mean that anyone who's still unvaccinated at some point will meet the virus. i think we are in a situation here with this current variant where herd immunity is not a possibility, because it still infects vaccinated individuals, and i suspect that what the virus will throw up next is a variant which is perhaps even better at transmitting in vaccinated populations. and so, that's an even more of a reason not to be making a vaccine program around herd immunity. kim: other countries with high vaccination rates are also struggling to contain the delta variant. israel, where 60% of adults are fully immunized, is reimposing limits on gatherings and

restricting indoor venues to those who have been vaccinated. in the u.s., 70% of adults have received at least one jab, but the pace of vaccination has slowed it down. -- has slowed down. the military, some hospitals, and businesses are now making jabs mandatory. and herd immunity is far from being achievable in the developing world. the university of oxford's data says only 1.2% of people in low-income countries have received at least one dose of the vaccine. ♪ okay, let's bring in our guests. from new york, we have wafaa el-sadr, professor of epidemiology and medicine at columbia university. in hong kong, we have john nicholls, clinical professor in pathology at the university of hong kong. and from johannesburg, helen rees, member of south africa's ministerial advisory committee for covid-19 and covid vaccines. a very warm welcome to you all. thank you for joining us. i'd like to begin with you, wafaa. at the start of the pandemic, we

were all saying herd immunity it -- we were all saying herd immunity, it was the buzzword. that's what we need, herd immunity. is that done and dusted now? is the cat out of the bag? >> i think we need at this point to really change the discourse and maybe change the narrative around what our goals are. and i think rather than using the term herd immunity, knowing that these vaccines we have, which are really superb vaccines, do not absolutely protect against every single infection, but yet, they protect against a severe illness, hospitalizations, and deaths. and maybe we should move to using more of a terminology of herd protection, rather than herd immunity, as much more of a feasible goal for all of us to try to achieve, to ultimately try to expand, scale up vaccination around the world, so we can protect as many people around the world as possible from the most severe effects of this virus. kim: mr. nichols, is that your

take as, well, that herd immunity is not an achievable goal? >> yes, i agree with what's been said before, and also, to pick up on what you also previously said, is that the two ways of achieving the herd immunity, either through natural infection or through the vaccination, i think the experience from northern europe last year has shown that basically doing it through the natural infection is not the way to go. it leads to an unacceptable mortality. so vaccination is the way to go, but the problem is tha,t because -- is that, because we're dealing with an rna virus, not a dna virus, it's always going to be mutating. and so, i don't think we are going to be able to get this level in the population of immunity that we would like to, with other dna vaccines. kim: mr. nichols, what does that mean for the future, though? i mean, will the virus then be here with us to stay in one form or another for the foreseeable future? >> i think, if we look at the

other rna viruses, which are around the world, influenza is a good model to use, because these are rna viruses, they are always mutating, and you don't get with vaccination a lifelong immunity or protection. so i think we are going to be seeing, like we've seen over the past year, we're going to be seeing variants of the virus evolving, and then we're going to be seeing that the fact that the vaccines, which we have, will not be able to give that complete protection. so i think if you look at the experience of the influenza, we've not been able to achieve herd immunity on that, and so, we're going to be looking at either annual vaccinations and the recognition that we're going to have to sort of adapt and live with advice in in the community. -- live with advice in the community. kim: on that point, helen rees, i'd like to bring you in, as well, as being a member of south africa's ministerial advisory committee for covid, you are also a member of the who strategic advisory group of experts on the covid-19 vaccine,

so you're very well placed to answer this question. is the world or global bodies, governments, are they pivoting in the way they should be to this new understanding, this new acceptance that herd immunity is not a goal that we should be looking for? >> i think the answer is yes. i also think that there's a technical definition of herd immunity, and i don't think that's what people are actually asking for. i think what communities are saying and countries are saying is, listen, we want to get back to some sort of normality. we want to protect health. we want to get our socioeconomic situation stabilized and incomes being earned again. but we also want to impact on transmission, and those things are not necessarily the same as achieving herd immunity. so i agree with my colleagues, that what we need to do is probably change what we're aiming for. i think we are aiming for a sort of normality, and in order to achieve that, we'd certainly need to get vaccine coverage

worldwide up much, much higher. and you mentioned the world . health organization and the dg of the world health organization has set a goal for 70% vaccination coverage by the middle of 2022. so that's the kind of thing that we we probably need to be discussing at the moment, and what would that mean in terms of getting countries and communities back to some sort of normality. kim: before we move on, i mean, that goal for the continent of africa, where i believe just 1.5 percent -- 1.5% of the one billion people on the continent have actually been vaccinated, is that even a realistic goal? >> well, the one good thing is that quite a lot of the countries in our region are looking towards both what the the covax facility, which is going to be providing the vaccines, and also the african union. and the vaccines are now starting to become available there. so we're very much hoping that in the next three months, that we're going to see a much larger flow of vaccines into these countries.

the bigger question for many countries, however, is that we're trying to introduce a brand new vaccine with a new target group, not children, which is what we normally do, into very weak health services, so the question is, will we be able to absorb those vaccines and distribute them and get them to the first set of populations who are most at risk, and then out to the broader population? so it's going to be a very big challenge. and the third thing is that we have to sustain this 70%, from under 2%, which is where we are. that is a huge jump. that will require a commitment not only from vaccine manufacturers, to also prioritize low middle-income countries, including our region, but also donors, to support the purchasing of these vaccines and support health services, so that we can roll them out. otherwise, we're not going to manage that. and if we don't manage that, we

won't be able to -- we have a whole continent where we are not able to get vaccination coverage of really significantly. we are not going to be able to break the back of this pandemic. kim: okay, wafaa, i'd like to come back to you. how is it that we've gotten to this point now, where we're looking to herd protection rather than herd immunity? is it a matter of the vaccination rollout just being too slow? the delta variant coming in? what are the factors that you see that have gotten us to this point? >> i think there are several factors, and some of them were touched on by my colleagues on this program. i think it is the nature of the infection itself, as well as the nature of the vaccines we have in hand. and i think what we know is that the vaccines do not provide full immunity, meaning protect people -- the recipient of the vaccine from getting infected. we know that vaccines are really good at preventing illness and preventing hospitalizations and deaths from covid-19. so because of the fact that they don't provide full immunity,

meaning protection against infection, it makes it very hard to aim for achieving herd immunity. so i think it is an appreciation -- a much more realistic appreciation of the nature of the virus itself. and its transmission, its high transmissibility, a very contagious virus, as well as the challenge with the evolution of new variants, and so on, and the nature of the vaccines, we have all of these mind together. -- tied together. it gives us pause in terms of aiming for herd immunity. i think what we need to focus on is, as helen mentioned, is we need to think about how can we use the vaccines we have at hand to be able to protect as many of our population, of the global population as possible from the severe consequences that can happen from covid-19, and that means we have to scale up the

vaccine availability and distribution and deployment to places around the world where this hasn't happened thus far. there's now a huge disparity that's become very evident, with the richer countries, with wealthier countries having access to vaccines, and while other countries around the world are still at 1% or 2% coverage with these vaccines. and this is just an untenable situation. and it is, i always say, if there's covid anywhere, there's covid everywhere, so we have to think, moving forward, about how do we protect the global community from the dire consequences of covid through the use of our vaccines? kim: mr. nichols, if we're not looking toward herd immunity, we're not looking toward elimination either, are we going to start to see people who are vaccinated getting sicker with the same virus, or with new mutations of this virus? >> i think the expenditures have

come and said the answer is no, right now, those who have been vaccinated -- they can get very mild infection. and it's not just infection, but the ability to actually transmit, because these people may be also asymptomatic or have very mild symptoms, which is going to mean that the chain of transmission is not going to be broken. but as the two previous speakers have already mentioned, the main function of the vaccination is to actually decrease mortality and morbidity. and i think that data which has come in, which has come from all parts of the world is that the icus and the hospitals -- it is the end vaccinated hor developing the severe disease. we are getting every now and then a very small number of cases of moderate disease in the vaccinated, but the main thing of the vaccination is, to decrease the mortality and the morbidity, to reduce the strain on the healthcare system,

[indiscernible] kim: i just want to interrupt you, because my question, i mean, the science is obviously very clear, getting vaccinated, you're much less likely to get very unwell. you're less likely to pass the virus on, even, but my question is, if the virus is still going around in the community, even with the vaccinated people, are we going to see new mutations? >> the answer is, unfortunately, yes, because with these rna viruses, the more you get a virus replicating, the greater the chance of mutations can be occurring. it's just by the sheer numbers. so if you can actually get those numbers down of the number being infected or the number of severe cases, which are producing more fast, we are going to be reducing that chance for these extra mutations to becoming an. so that's why we have been seeing where there is high rates of infections.

that's where the mutations have been arising. that is sort of the negative feedback, is that what you don't want to have is if you can keep those mutations coming down, then that means you don't need to come up every year with a new vaccine. if we can break down that cycle of more virus being produced, then that is where it's going to be occurring. in the regions where there is low vaccine coverage. in africa, also in parts of asia. so i feel the main emphasis is, this is what i feel quite strongly about, is instead of that booster dose, would be to actually have the vaccines where there is more of a chance of people getting the primary disease. so you can actually decrease that potential for more mutations to come about. kim: we will get to booster shots in a moment. first, i want to come back to helen. should we be investing more in therapies for people who are sick?

you know, we have tamiflu, if you've got the flu. what about for people who get covid but who are vaccinated and might get in a mild way? is there enough investment in your opinion and that side? >> no, i don't think there is. i think that is an excellent point. one of the reasons that people are individually very frightened of this virus, and as communities, we had to go into lockdowns repeatedly, is because we don't have good treatments. we don't have good treatments yet. we have some treatments, but they are limited for people who are seriously ill and hospitalized. and we don't have good preet -- and we don't have good treatments to stop serious disease. we could also do with some other interventions in addition to the masks and social distancing and ventilation we are recommending, to assist in preventing infection. we haven't invested i believe

nearly enough in those other therapies. the problem is that some of the things that have looked very promising and indeed, some of the things that how are being evaluated no for treatment of hospitalized patients are extremely expensive, and so once again, we are getting a secondary effect of access to therapies for rich countries, which simply would not be feasible to be either manufactured or introduced into resource limited settings, so in addition to investing much more in therapies, we also need to think about what are going to be appropriate therapies to both administer and to afford in resource limited settings. kim: wafaa, coming back to booster shots, israel is offering booster shots, the u.k. is planning to roll it out alongside the flu jab without -- for the vulnerable. talking about vaccine equality globally, which is a whole other issue in which we've dedicated a few programs to, but from from a science point of view, what

difference will boosters make to transmission? do we have any data? >> i think we have some data that doesn't support that for a specific population, specific groups of individuals, a boost -- a booster dose may be of value. we don't have data that support booster doses for the general population. so for example, there are some data that show that for some immunocompromised in the -- immuno compromised individuals, people with weakened immune systems, people who received organ transplants or people on hemodialysis, there are some data that tell us in those individuals, there can be some gains in terms of a booster. protective antibodies after receiving a third dose. after receiving another dose of the same vaccine they received before. so that is a subset of the population. and i think that, moving

forward, when we are discussing booster doses, the focus is to try to think about where we have the data and where the focus should be, rather than thinking about the need for a doses for the general population overall. not just issues of equity and accessibility, but based on the scientific data we have at hand. kim: mr. nichols, if we are not talking -- if we are giving up the idea of herd immunity and instead looking towards herd protection, what does this mean for countries like new zealand, that have basically attained elimination? they're going to open up new zealand -- it's going to open up to vaccinated travelers from low risk countries next year. but based on this assumption we are only going for herd protection, a global community is going to have to accept that the virus is going to come in and infect the population. >> that's right.

i suppose speaking as a new zealander, you've got a vested interest in that. but i think the reality is that what works well for one country will not work well for another. i think if you look across the water to australia, they seem to be doing very well. you just needed that one case to be brought into new south wales and now you've got well over 3000 people. the inverse relation is that the enthusiasm for vaccination is not as high. the vaccination rate is higher in regions and countries which have suffered major outbreaks. so i think the whole problem is that we found this in many parts of asia. we did very well relatively the first part of last year. so the enthusiasm for taking up the vaccine was not as high as

in parts of europe. that's a really big problem. we were still getting that stubborn 25%-30%, no matter what the government can do, the advertising, which is saying basically we don't want the vaccination, so i think that's one to be the challenge for new zealand and those other countries. how do you sort of convince that susceptible population? because those are the ones, you just need that one case, then that 25%-30%, and also the countries where you've got 15%, 20% of the pediatric population, about the vaccination strategies for them, because what we're seeing is that where the virus is spreading is in the pediatric and young adult population. that is a group that have not been vaccinated. they are spreading it to the parents and then to the

grandparents. it goes forth. that is what happened and influence, that pediatric population, which i think is going to be very challenging, to get those numbers up to for a -- numbers up for sufficient protection. kim: i think you're very right on the earlier point, it's a very different ball game for those countries that don't have that experience of, you know, everyone knows somebody who's had covid or has had covid themselves or has seen their local hospital overwhelmed, very different for countries that haven't had that. i'd like to come back to you on that front. helen rees, what is the best incentive for people to get vaccinated from a public policy point of view? what do we know works to get people out and to get those jabs? >> well, i think there's several things. one is that and i think everyone's familiar with the anti-vaxx expression, now that's a minority, a small minority, and those people existed before covid, and they will exist after covid. they don't like vaccines, and have many reasons that are given for that, but the majority

of those sort of 30% that we just mentioned are people who are nervous or people who do not see themselves at risk. many young people in their 20's don't necessarily see themselves at risk. many of the reasons are things like, have we developed the vaccines to quickly? and so we have to be able to explain about things like compressing the timeline for vaccine development and monitoring for vaccine safety. people who want to see the vaccines rolled out to other people first before it goes to them. you've got scientists here with you saying, do a better job from the public health perspective at persuading those people in that category to have the confidence to come forward. the second thing is that it is a sort of carrot and stick, and

we are beginning to see this in a number of countries, an example in france, if you are not vaccinated, there's a risk. there's a risk if you want to go into a restaurant or nightclub. it is both the carrot and the stick, if you like, and i think we're going to see more and more of those incentives. but the incentives in a way are also the stick because if you don't do it, he won't be able to do certain things. and the third thing obviously under what discussion is whether for some jobs, it needs to be compulsory. we've seen in kenya discussion public servants -- discussion about public servants, health care workers. so if you are in a job like an old age home environment, do you have a responsibility and this government have a restaurant's to ensure you are vaccinated? kim: i think countries around

the world are grappling with exactly that. hey, we're gonna have to leave it there for time. thank you very much to all of our guests, wafaa el-sadr, john nicholls, and helen rees. and thank you for watching. you can see the program again anytime by visiting our website, aljazeera.com. and for further discussion, go to our facebook page -- that's facebook.com/ajinsidestory. you can also join the conversation on twitter. our handle is @ajinsidestory. from me, kim vinnell, and the whole team here in doha, bye for now. ♪ [captioning performed by the national captioning institute, which is responsible for its caption content and accuracy. visit ncicap.org]

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