Is there a vaccine against coronavirus and should we expect a second wave?

Where there is not enough information, a lot of speculation and rumors are always born. Especially in situations when it comes to health and life, and not just one person, but the entire population of the planet. The information is quite contradictory.

In social networks and in conversations with relatives and colleagues, you can hear this: how could a vaccine be developed so quickly? And even more so to check for effectiveness? Or do they want to instill us all with the placebo effect?

Even assuming that the vaccine works, will a person have time to develop immunity against the virus before the second wave arrives? We decided to ask all these questions to a specialist — an infectious disease specialist, associate professor of the Department of Infectious Diseases in Children of the Russian National Research Medical University. N. I. Pirogov of the Ministry of Health of the Russian Federation to Ivan Konovalov.

Psychologies: It was recently announced that Russian scientists have created a vaccine against COVID-19. And right there in social networks, in the information space, including among doctors, opinions were divided. Some are for the vaccine and believe in its effectiveness, some are against it. How do you feel about such discussions?

Ivan Konovalov: There is a vaccine, it entered the third stage of clinical trials. Accordingly, there can be no talk of any personal opinions on the part of people, simply because the vaccine is now used exclusively as part of the study and “just like that” it cannot be vaccinated.

How ready is she to use it? This is what worries people, the townsfolk, who argue like this: they haven’t really checked it yet, but they allegedly promise to use it in large quantities almost in the fall.

I repeat once again: it is in the third stage of clinical trials. What does «ready» mean? It has been prepared as a drug for a long time and is used unchanged. Now it is being tested, and its testing is expected in parallel in different countries. Not only in the Russian Federation.

I would like to highlight. People should not imitate the game of vaccinologists, virologists.

Namely, this is what many are doing, including those fueled by various unreliable sources of information. And if they initially do not trust someone or something, then no arguments will convince them. Here we are talking about the emotional coloring of information or an attempt to think out in the absence of this information. There are facts. The vaccine was developed in Russia. Similar drugs are being developed around the world. Vector technologies for the creation of medicines have been around for more than two decades.

Is it some kind of new type of vaccine or is it created in the image and likeness of existing ones?

There is a vaccine development technology and a corresponding platform or design. The platform that was used in this new vaccine was developed a long time ago. This is the use of viruses that are safe for people, which carry hereditary information so that the immune system perceives the protein synthesized in the body based on the altered genome of these viruses, which, in fact, enter the body with an injection into the shoulder.

What viruses are being used to create a vaccine against COVID-19? And explain what is called, on the fingers, how can a new vaccine be created on their basis?

There are adenoviruses, there are many variants, in this case the 5th and 26th are used. They are modified in such a way that when administered to the human body, they do not cause any pathological processes, they are not able to multiply. But at the same time, hereditary information is included in their composition, which encodes the protein of the new coronavirus. By itself, this protein (spike, or spike) is absolutely harmless. This is not a live coronavirus, so there is no imitation of COVID-19 when vaccinated.

Is it a vaccination that will need to be done every year, like for the flu?

Currently, the vaccine has been developed specifically against SARS-CoV-2, which is currently circulating. There are two scenarios. The first, more likely, is that a new type of coronavirus does not mutate as much as, for example, the flu virus. And then you do not have to constantly update the composition of the vaccine. A person was vaccinated twice with an interval of 3-4 weeks between injections — and his immunity is formed for a sufficiently long time (which one, it is difficult to say now, the vaccine is new). The second option, less likely, is that the coronavirus will continue to actively change and persist in the population and the vaccine will also have to be updated. However, according to current data, SARS-CoV-2 is less variable than the influenza virus.

What is your opinion on the possibility of a second wave?

The probability always exists until herd immunity is formed in the population. If you pay attention to the increase in incidence around the world, then even the so-called first wave has not reached its maximum. For example, the last millions of those infected around the world became infected in just a few days. The rate of growth of infection worldwide is only increasing. Therefore, the issue of the return of large-scale morbidity around the world is the issue of the return of a large number of uncontrolled sources of infection, for example, from other countries in which the epidemic process is currently ongoing — Latin America, North America, India, Israel, Spain — where the increase in incidence is higher than one or two months ago.

Is the vaccine you mentioned applicable to both children and adults?

I will repeat once again to convey the main idea: at the moment there is no vaccine as a drug available to any person! It exists as a registered immune drug, which is undergoing the third stage of clinical trials. Will the vaccine be applied to everyone at once? No, it will not. To say that this vaccine can be used by someone, except for the target groups on which the study is being conducted, is absolutely wrong.

That is, we can reassure readers that everything that is offered under the guise of some kind of vaccine is all untrue and one must be careful, it may be a scam. Do I get it right?

Yes, it could be a scam. This will include necessarily speculative attempts to import “vaccine candidates”, including foreign ones, because tests are also being carried out on them. Rather, under the guise of buying foreign vaccines, they can simply deceive people in bad faith, as was the case, for example, a few months ago with test systems and drugs. If your reader has a desire to test the vaccine on himself, he can enter the cohort of subjects — from 18 to 60 years old, healthy people. Accordingly, he can take part in clinical trials. You need to contact the institute. Gamaleya and the Russian Direct Investment Fund, which provide research*. An individual protocol is drawn up, according to which the participant is vaccinated and examined. This is not just like that — they took it and announced: “We vaccinate everyone!” This is a clear logged algorithm, planned in time.

In your experience, how long does it take to launch a vaccine into mass use? Next year or 2022?

There is no experience and cannot be, simply because the pandemic situation is categorically different from all previous stories. Nevertheless, the inclusion of the Russian vaccine in the research protocol in several countries in parallel allows us to hope that we will quickly receive tens of thousands of people who participated in the study, which will allow us to see the results of the third phase of clinical trials early enough — first on healthy adults, epidemiological risk groups — for example, resuscitators, and then include patients with chronic pathology, the elderly, who need this vaccine most. And, of course, mass immunization is possible only if vaccine production reaches the required volume. That is why the testing of various vaccine preparations is going on in parallel, not only the aforementioned Gam-Kovid-Vak.

I return to the topic that you raised at the beginning. About distrust. The fact that in Russia there has long been an anti-vaccination movement. And now it is even more active. According to statistics, according to your observations, how did the rejection of vaccinations affect the opponents of vaccinations? Maybe they were right now? Amid a pandemic, is it not necessary to put immunity to the test?

Several forces are involved in the formation and continuation of the anti-vaccination movement. First of all, these are people who benefit from a commercial position.

Vaccine opponents emerged as early as the days of the first vaccines—that is, in Jenner’s time, spreading the libels that vaccinia vaccines regrow tails, hooves, and horns. With modern informatization and the dissemination of information from unreliable sources, the scale of the movement has taken on a completely different turn. This problem exists not only in Russia.

In my opinion, this is a certain psychological manipulation of consciousness. In developed countries with good vaccination coverage, the movement is also parasitic on the fact that people think they can avoid vaccination because everyone around them is vaccinated. A separate aspect of modern society is the psychological setting of the priority of personal benefit (or its imitation) over issues of public benefit and health.

Today, in the context of a pandemic, we are seeing around the world in recent months a decrease in coverage with routine vaccinations by 10-30% (those introduced into the routine vaccination program). Of course, this is most of all due to quarantine measures. Thus, due to the accumulation, first of all, of children without vaccinations according to the plan and in terms of time, we can soon get outbreaks of those infections that were more or less controlled before. For example, the incidence of whooping cough and measles is actively continuing to grow both in Russia and abroad.

Do I understand correctly that against the backdrop of a pandemic, it is not necessary to abandon the so-called routine vaccinations? Can they be done, do they “do not interfere” with the coronavirus? This is not dangerous?

Not only possible, but necessary. Since access to medical care, including preventive care, may be limited, it is imperative to get vaccinated as soon as possible. There are also vaccinations that help reduce complications even from the coronavirus infection itself. First of all, these are vaccinations such as influenza and pneumococcal. Since pneumococcus often becomes an additional bacterium that affects the lungs, and the flu can cause complicated forms at the same time as the coronavirus even in practically healthy adults and children.

How to relieve anxiety, debunk the myths that give rise to fear?

I would like to convey to your readers: in order for you to have a stable picture instead of myths and fears, you need to find the doctor you trust. And receive confirmation or refutation of the information you have from him as an expert. It is the doctor who should explain what is really happening, instead of warming up your fears or saying that your fears are nonsense, devaluing them.

All fears are not born in a vacuum. We are all permeated with information flows. And only a qualified doctor whom you trust will be able to show you the truth or falsity of any conclusions. Therefore, the search for “your doctor” should take place not against the background of momentary requests for treatment, but as a separate, not always very simple event — the search for that specialist with whom you will communicate for a sufficiently long time, if we are talking about medical care, and not just about medical services (these are slightly different things). But it is always necessary to correlate the words of a doctor with what is recommended by official state organizations, in particular the Ministry of Health, Rospotrebnadzor, and, of course, to what extent this correlates with the opinion of world organizations, since there are fundamental contradictions in the approaches to diagnosis, prevention and treatment in our healthcare system and foreign as such, no.

^* *The Russian Direct Investment Fund (RDIF, the sovereign wealth fund of the Russian Federation) and the Research Institute of Epidemiology and Microbiology named after Honorary Academician N.F. Gamalei announce the launch of the first information website about the Russian coronavirus vaccine at www.sputnikvaccine.com.