Stand Together and Write History | Tachles

tachles: The Oxford vaccine study is making headlines worldwide. Her study leader Andrew Pollard has a first breakthrough for a possible vaccination. Will the results of this study ultimately defeat Corona?
Georg Holländer: All hopes for a single vaccine today are too risky at the moment and are therefore not justified. The primary goal should be to have developed and produced enough different vaccines to vaccinate all those who are at increased risk of disease or exposure – health workers, people living in hot spots and people with underlying conditions who are at risk for represent a severe course of the disease. Only then would countries and professional groups be added that show a lower risk of coming into contact with or getting the virus.

Researchers worldwide have announced that a vaccine against Covid-19 should be on the market by the end of the year. Otherwise it takes much longer to develop a vaccine. Will the corona vaccination be of poor quality?
It is clear that no state and no health authority allows a vaccine on the market that can result in significant side effects or even an unfavorable course of the disease after infection. In the mid-1950s, the so-called cutter case occurred in the United States, in which insufficiently inactivated batches of vaccine were administered as part of the polio vaccination campaign, which in reality could even cause polio. Such a catastrophe must not happen again. We now have new knowledge in biotechnology and vaccine research that should make such events impossible.

What does that mean for the Covid 19 vaccine?
Just a few weeks after isolation of the Covid 19 pathogen, its genetic code was made publicly available. At the same time, the design of vaccination studies was adapted to the need to achieve reliable results more quickly. In this way, the time span in which the data of a test phase test was evaluated and assessed by the authorities could be shortened. In addition, the classic study phases I and II or II and III are occasionally combined. However, this more dynamic and flexible implementation of vaccination studies does not mean that clarifications regarding the safety of the vaccine have been restricted or that the knowledge gained has been reduced.

What are the primary differences between the different vaccines?
Various vaccines are being developed against Covid-19, which are supposed to trigger a protective immune response in different ways. Three types of vaccines are well advanced: those that pack RNA into the smallest particles, then vaccines that have inserted genetically important material from SARS-CoV-2 into a non-disease-causing virus that is no longer able to reproduce, and SARS-CoV- 2-dead vaccines. All of these vaccines have their advantages and disadvantages, including production and distribution. Interestingly, no RNA vaccines for any indication have been successfully launched to date.

There are better and worse vaccines. Can those that should be available by the end of the year already be compared?
A direct comparison of vaccines for which animal or clinical results are already available is difficult. The individual studies differ among other things with regard to vaccine dose, frequency of administration of the vaccine, age group of the vaccinated, time of detection of neutralizing antibodies and whether and which antigen-specific T cells could be detected. At the moment, these are primarily snapshots. It is not yet possible to finally assess which vaccine is better and which is worse. For example, a vaccine that initially stimulates a moderate vaccine response could offer the best antibodies and T cell response in the long term. This can be determined at the earliest in a few months. The appropriate protection against Covid-19 can only be finally assessed by field trials, in which it is determined how many of the vaccinated are not affected by Covid-19 despite exposure to SARS-CoV-2.

International cooperation is part of science. With Corona in particular, however, we see a kind of nationalist government struggle for the vaccine.
I actually have the impression that developing a vaccine has become a politically important factor for some nations. Political capital may be raised from this and certain countries or leading politicians intend to increase their reputation globally. Of course, none of this makes sense, because, as already mentioned, the open exchange of information across national borders guarantees fast and effective vaccine development. In parallel with efforts to produce hundreds of millions of batches of the Covid-19 vaccine, it will also be necessary to continue to provide other vaccines, such as those against the flu.

Corona viruses are not new. Why didn’t SARS and MERS lead to vaccines earlier?
Although no vaccines for the two coronavirus-induced diseases have been clinically tested, they have been developed and researched in animals. The fact that they were never developed to market maturity can best be explained by the health measures that have been introduced and a portion of luck that prevented a SARS or MERS pandemic.

Does current research benefit from the results of that time?
The fact that progress has been made so quickly and that successes can already be celebrated can be attributed to this – and here I am speaking in particular for the vaccines developed in China and Oxford – that important knowledge about coronavirus vaccines has already been gained in the past, which the development of a vaccine against SARS-CoV-2 will now benefit. It should also be mentioned that SARS-CoV-2 belongs to a subfamily of coronaviruses, the other members of which are responsible for colds. It seems that a higher percentage of individuals in the population have T cells against these “cold viruses”, which thanks to a cross-reaction can also detect SARS-CoV-2 in the laboratory without these people ever having Covid-19.

The mutation remains a major challenge for all viruses and when looking for the vaccine.
Depending on the vaccine production method used, mutations can and will be reacted to more quickly. Above all, RNA viruses – which are corona viruses – change relatively quickly and continuously. However, such changes are always under pressure that the virus must remain “fit” enough to infect cells and multiply in them. Otherwise the virus will become uncompetitive. Mutations are beneficial for the virus if they can bypass the immune defense. Theoretically, the more structures of SARS-CoV-2 are used in a vaccine, the greater the probability that the vaccine response will still be able to recognize and eliminate the virus despite some mutations.

Vaccine opponents have become stronger in recent years.
The anti-vaccination movement is a shocking phenomenon for me. In a recent survey in the United States, half of the respondents said they would not be vaccinated even if a vaccine against Covid-19 was available. Unfortunately, I have no clever answer to the question of how to inform vaccinees that they can contribute rationally and scientifically to the vaccine discussion. What is evident is that opponents of vaccination have a much more agile and adaptive communication strategy on social media than vaccine advocates. The information can spread there uncontrollably and quickly. Neither of these platforms has a practical approach that can quickly prevent the spread of misinformation.

How should you react?
As a pediatrician, I occasionally hear: “What does vaccination actually do? It could be harmful and trigger autism, for example.” These and other causalities cited by opponents of vaccination have not been scientifically proven. It is frightening how wrong information serves as a justification for denying vaccine for preventable infectious disease to those who could benefit. At the same time, so-called responsibility for the consequences of a harmful infection of others, including one’s own children, is taken over. The paradox here is that often these parents were vaccinated in their childhood. Anyone who has seen the fate of children who are seriously ill with a vaccine-preventable infection or who are aware of the number of children who die from such diseases worldwide will never again question the benefits of vaccination. Vaccinators also benefit from herd immunity from the vaccinated and are therefore opportune free-riders.

If certain people refuse to vaccinate, is a certain percentage enough to defeat the SARS-CoV-2 virus?
A certain, but relatively high percentage of the infection rate appears to be sufficient, although the exact figures are not yet known. From other viral diseases such as measles, we know that around 95 percent of the population should be immune to have such a herd immunity.

How confident are you that one or more vaccines will be available soon?
I am very confident. My hope is also that 2021 will go down in history as the year in which a wide-ranging vaccine campaign for Covid-19 was possible because you had different vaccines and because the international community learned its lesson from the past, and less so too to make it available to wealthy countries. Let us surprise you with the better part of the human being, so that we can say: Humanity came together in the context of a crisis and contributed collectively to the solution. With polio, it took 60 years for a vaccine to be on the market, and if we can do it in twelve months, it is certainly a success.

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