♪ >> this is al jazeera and these are the headlines. the u.s., australia and the u.k. with partnerships as a strategy to counter china. the august alliance involves corporation in cyber and underwater defense. australia also got nuclear submarines with america and british help. pres. biden: it will bring together our sailors, scientists and industries to expand our military capabilities and

critical technologies such as cyber, artificial intelligence, quantum technologies and domains. as a key progress under this we are launching consultations with australia about acquisition of conventionally powered nuclear subregions. >> they have tested nuclear missiles. the north: railway born while the south launched them from a submarine. u.s. olympic gymnasts have accused the fbi of turning a wind i to sexual abuse -- blind eye to sexual abuse they suffered under the hands of dr. larry nassar. the testify to a committee. larry nassar is serving several life sentences. egypt says ethiopia must work toward reaching an agreement over a controversial dam on the nile river. after the security council

called for negotiations, ethiopia insists the dam is needed to make sure the majority of citizens get electricity. sudan and egypt see it as a potential threat to their water supply. ethiopia has spent years holding talks over the $5 billion project. the security counsel says all three countries should cooperate in a construction -- constructive manner. those of the headlines, stay with us, inside story is next. ♪ >> is a third shot needed?

is it enough? this is inside story. ♪ >> hello and welcome to the program. it is feared the winter season could seek coronavirus infections rise. british government wants to prepare for the worst. they have announced the rollout of a third dose of vaccine from next week. around 30 million people will be eligible, including everyone over 50, people with underlying conditions and health workers. they will be given at least six months after a person has had their second shot. the government says there are signs protection offered by vaccines reduces over time and by using boosters, high levels of immunity among the most vulnerable people can be maintained. officials say bertens vaccine

drive has reduced hospital admissions and help avoid lockdowns. prime minister boris johnson plans to reintroduce measures if needed. >> the result of this vaccination campaign is we have one of the most free societies and one of the most open economies in europe. that is why we are now sticking with our strategy. in essence, we are going to keep going. we will continue to offer testing, we will continue to urge everyone to be sensible, be responsible, wash your hands, use ventilation, consider wearing a face covering in crowded places with people that you don't know. stay-at-home if you feel unwell, download and use the app and we will keep further measures in reserve. plan b. >> the u.s. food and drug association committee have

debated shots later this week and a few other organizations recommend it. it is not recommended by the world health organization. it is asking rich nations to debate the program -- delay the program until every country has vaccinated at least that 40% of people. a group of leading scientists including experts from the u.s. and who wrote in a medical journal that booster shots for the general public are not needed at this time. vaccine effectiveness against mild disease may wane over time, but protection against severe disease remains. booster shots may eventually be needed for general populations if vaccine induced immunity wanes further or a new. bridges that can a beta protection. -- variant emerges that can evade protection. conditions and side effect like my pet artists -- myocarditis.

let us bring in our guests in cambridge, chris smith is a consultant virologist and editor of the good scientists. indo hall, patrick is a division -- in doha, patrick and a head of biotechnology lab at a medical school. thank you for joining us. i would like to begin with you, patrick 10. the advice from the who is we should hold off on booster shots until most of the world is vaccinated. wealthy countries are steaming ahead with booster jabs. is it needed? >> that is a very complicated question and i think when you say whether it is needed, we have to answer that at different levels where it is needed for prevention of infection, prevention of severe disease was -- or death, or prevention of

disruption to society and the economy. i think that question is complex and it has to be answered at all of those levels. at some levels it may not be needed and for other things it is very much needed. with the evidence, if we are talking only about the health care side of this, it definitely is needed because of waning immunity in certain groups of people. people that are immunocompromised that never established in the community to start with, the elderly and people who reside in long-term care facilities, and possibly as an extension, health care workers that care for such people. >> chris smith, is there harm in getting the booster if you are young and don't have any underlying health conditions? different countries are having different rules around who should be getting the booster.

is there a harm in getting it if it is offered? >> let us step back and ask the question, what is the purpose of a booster? a booster is intended to reinforce immunity. what is immunity? it means different things to different people in this disease is in some cases it means not getting severe disease. in other cases it means not getting infected at all. what we know, and have learned over the last 18 months, is the higher your level of antibodies, more defended and better ducted you are. and people with high levels of antibody appear not to get infected at all. people with lower levels do get infected, some of the time, they don't become severely unwell. what do we want to achieve? if we want to get too low rates of spread of the infection through a population, we need everyone to have the highest level of antibody we can muster. if we want to achieve low levels

of severe disease, we will need to tolerate some degree of spread through the population. that is probably -- but we are willing to tolerate some spread of the disease, that is probably not necessary. and since young people have high levels of immunity but they do spread it, you could argue whether they need it. which is why many countries are taking the approach of giving it to people over 50. will it do harm? all vaccines have side effect so a small number of people will get side effect which can be trivial or more severe. it comes down to who you are giving boosters to add what your a miss is at the end of the day. >> i would like to bring you and. what does the science say, what does reach desk -- research say about how much the efficacy of the vaccine wanes over time and

over what time period? >> we are having this discussion and the two leaders, leaders talk about that we don't need these shots for the global population. maybe we will need it for some specific persons, immuno compromised persons for example, or the front-line workers but we will definitely not needed for global population. in comparison, the who has for many weeks said we don't need this booster. to make it clear why, because to succeed in locally managing the pandemic, and being able to eradicate the virus, we cannot come out of it just by doing that in a few places and not around the world. for efficacy and the toxicity, i

think it is clear the efficacy of this vaccine and the third chart would be helpful. but i think when you are managing the pandemic, i would just give an example. if you are in the west and it is decided you will be given a third dose in new york, and not san francisco, that would be a problem. we have to manage the crisis in this way that we are one world and we have to give this efficient dose is to everybody. >> you raise an interesting point, i would like to bring that to you, patrick tan. some who have not been offered boosters are worried about immunity, particularly people who might have been given a vaccine that was less effective in the first place. should they be worried? are those concerns founded? >> for different people who are at different risk for severe to

be -- disease, that is where the question has to be. for people who are not at risk for severe disease, they don't have to be worried as much. but people in some of the higher risk groups, they do have to be more careful in terms of what they do, especially if they are having waning immunity, if they have had only one shot of certain vaccines or two shots of a less effective vaccine, it has to act accordingly. or wait for their government plan to roll out their jobs if necessary. >> you can understand the concern even from a messaging point of view of people trying to figure out what is best for them compared -- for them. so long the message was get vaccinated, you can die from covid, get vaccinated. people did that and now the messaging is coming up in different ways, now you may need

a booster. surely you can understand that some people might be concerned about figuring out what they should be doing. >> you are absolutely right. it is a very complicated sent to get out there and for many of us at the beginning of the rollout of the vaccine and as they were developed, probably they realized there might have to be boosters. and the vaccine schedule that was recommended where two shots are given in a three or four week. -- period, that would not be enough to give long-lasting protection to some people. it is to engage in the vaccine to take care of the emergency in front of us now, but with the delta variant and possibly others, where immunity needs to be very strong to prevent transmission of the virus and also event more severe disease,

i think it is important now that we change some of that messaging. i think people might be getting tired of this, that the message has changed many times the pandemic as we learn more about the virus and as it evolves. i think again we are going to have to do that to tell people that a third dose might be necessary for certain people, especially with the evolution of the virus into its current form. >> we will come to the evolution and mutation in a second. i want to come back to you chris. i believe the u.k., correct me if i'm wrong, is recommending a pfizer start for those over 50 and at risk regardless of what they got the first time. does that mean you can mix vaccines and it's on a problem? >> there is a long history of using combinations of different vaccines and that proves it when

you do that, you get a better immune spots for doing it. this is called -- you use one vaccine to prime the pump, as it were, and a different vaccine later or a different combination of vaccines to stress the system a bit and expand immune response. it seems to translate to a broader, more robust, more resilient and more effective response. it's not surprising we should find mixing and matching can lead to a better immune response. there have been a number of trials in the u.k., including one done at oxford and more recently the trial done at the university of southampton, which we are awaiting results from. they have tested many of the permutations of using different vaccines in different orders and roosting people with different vaccines off the back of prior treatment of other combinations.

what seems to emerge is the best reinforcement at least in the short term is to give whatever your first course of vaccination was a booster, which is a good compromise between practicality, cost, efficiency, efficacy and tolerability for the patient. that seems to be the best vaccine outcome. >> a lot of people are talking about how to move from this being a pandemic to being endemic. can you explain what that means and what it entails? does it mean we will get covid vaccines every year along with the flu? >> i have to remind everybody that is why we get vaccination. it is to protect people, not to be infected, you can be infected if you have been vaccinated. the purpose looks at the severe cases for covid and not to have this pressure on the health

system. so actually in a country that would get to a percentage of vaccination would be able to declare that, for example, covid-19 is an endemic disease, is not harming the health system. what we are doing is not the strategy of zero covid, it is limiting. when we see what is happening in australia, new zealand, what is going to happen is surviving the presence of this virus and living with it. and it can become endemic. we see that when people are saying you can live your life, and if you get covid-19 you have all the possibilities that the health care system will take care of you. that would be for everybody instead of looking at having zero-tolerance for covid-19.

>> a follow-up question for you. that is very well for nations that have high vaccination rates, saying we will just deal with it and the health system get overwhelmed. what about the countries where the vaccination rates remain low? africa, comparatively, the vaccination rates are very low. what does the trajectory look like there? >> actually, when you are talking about africa, when you say the number -- seeing the numbers in africa of the vaccinated population, we are at 2% of the population vaccinated. if you take out morocco, you are at 12%. at the who, there are arguments for strategy to come out of covid. we have to follow it because you have to get to a certain percentage in africa.

if we leave african countries without any vaccination, what is going to happen is a lot of people -- there will be new variants, and instead of using what we have now, we have to look for variant based boosters to get rid of the pandemic. i think the right way to do it is actually the strategy for vaccines for africa, to get enough act scenes and not let the virus develop and multiply. one example we can give and everyone will agree, if we have a lot of immunocompromised people, most likely what has happened with what is coming that is a new variants, most likely they will come for africa and we will come back to where zero and start all over again -- square zero and start all over again. >> speaking of coming back to the start, i want to talk about

israel. patrick, most israelis were vaccinated by march, but by the end of june they had the mask mandate reintroduced. what does that tell us about what is going to happen for everyone in the future. will vaccination be enough or will we be wearing masks from here until who knows when? >> i think israel is a unique situation. they were lucky enough to get the vaccine early and vaccinate a significant portion of the population early. with that, they did not get enough to achieve herd immunity but they got significant, about 60% of people vaccinated. they declared it was a success and dropped a lot of public health measures. it may have been too early and not anticipating a new variant such as the delta variant

emerging and getting it to the population. i think that is a unique situation where a lot of things converged and they are very unlucky to have a virus that was able to evade winning immunity in their population because they were vaccinated earlier than most other countries. and they have also dropped their mass mandates. with that, they had to take swift action and reverse some of the public health -- the things they had dropped. >> it is a careful balance. chris smith, a lot of kids or children are heading to school now. but children, at least in the u.s., represent more than a quarter of new weekly covid-19 cases. our kids getting sicker with delta, do we need to be worried about them getting infected and higher rates? >> that has been controversial in the u.k. as well. in the last couple of weeks we

have seen a back-and-forth with our politicians and advisory groups who decide on who should get what vaccines. they have been arguing, should we be offering vaccines to children. many countries around the world including the u.s., but many european countries, are proactively vaccinating their children. in some european countries they gotten to nearly 100% of children aged 12 to 15. we are beginning to embark on a journey in the u.k. and you get very large uptick -- or very large amounts of spread in that sector. those are the last groups to be offered vaccination so they are susceptible, there also likely to be socially networked, eating each other, and school, university, public transport, partying going to nightclubs. there is a higher risk in that group that they are going to

apple fire infection. many people are saying we should be actively intervening in this sector of society to blunt transmission because they are an amplifier. while children are very low risk and you asked about delta, you're still at very low risk of severe disease with coronavirus of any persuasion, it is about on par with being hit by lightning your chance of having severe covid. the risk of other syndromes is higher. because of the minority and long covid symptoms and the societal impact of the spread, that is why people are saying vaccinate them because you can protect all people. >> we touched on it but i want to come back to it, what is the likelihood the virus will mutate and our current vaccines will no longer be effective? is that a given? >> actually, we looked at that

in the paper when we looked at the waves of the virus through the pandemic in morocco. and it was always, and they were not related all of them to the presence of the variant. if we look at it now, three months and after we will get a new variant that could be eliminated. last time it was march or april, now we have had one in august in morocco. most likely we are looking at by three months to have another. simply for the population to know why, simply to keep the virus from multiplied by itself, -- it will make errors. if you combine this mutation in one part that is supportive of the virus, spike, you will need

a new characteristic and will get the new variant and he will ask the same question, is it spurting rapidly? is it more dangerous -- is it spreading more rapidly? is it more dangerous? and is this escaping immunity? we most likely will get a new variant and get a fifth or sixth wave coming our way. >> patrick, we are near the end of the program, i want to ask quickly the need for vaccine boosters has in some circles emboldened anti-vaxxers, people who don't want the vaccine or believe in it. as of now, what does the science say so we can be unequivocal about how much more likely you are to be hospitalized if you catch covid, if you are unvaccinated versus if you are fully vaccinated. >> it is unequivocal that the people that are vaccinated have a much lower chance of being --

of dying, being hospitalized, or having infection compared to the unvaccinated. from different estimates, there is at least 10 fold -- a tenfold decrease in your risk of dying from covid in a developed country. and that risk changes in different places. but there is the risk of vaccine, it is far less than the risk of getting covid and that has to be the message that has to be brought out. we have to be careful not to disparage the value of vaccines even as these variants emerge. no matter how much of the variant evolve, so far they have been able to give a high degree of protection against severe disease of all periods so far. >> thank you very much, thank you to all of our guests, chris

smith, patrick 10 -- and thank you for watching. you can join the discussion anytime at aljazeera.com, or our facebook page at facebook.com/inside story. you can also join the conversation on twitter @ajinsidestory. goodbye for now.

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