We have explained in “waiting for Godot” that the development of a vaccine, its testing and the build up of industrial production facilities normally take a long time. Because of the high reward risk ratio, big pharma is willing to not only accelerate the testing, but also prepare production facilities ahead of tests results. In addition, because of the seriousness of the COVID-19 pandemic, the health regulators might fast-track some of these steps. There are therefore hopes that amongst the 125+ teams racing to develop a SARS-CoV-2 vaccine, at least one or may be several will be successful in creating an effective vaccine. Depending on which vaccines proves to be dependable, the production time may vary. The classical vaccines will demand more time to be available in large quantities than the technologically advanced but unproven ones. As we are dealing with a pandemic, we have to envisage the vaccination of the entire 8 Billion world, a daunting task. The rich nations that can be more prodigal in their health policies will joust for the first batches often at prices beyond normal costs. Given the experience with the testing rates for Covid-19, even when vaccines become available, it will take a long time to vaccinate large segments of the population. Due to the uncertainty as to the availability time frame and the effectiveness of the vaccines, and the possible mutation of the virus, we must consider alternative solutions. One is the substitute administration of existing vaccines that may offer a temporary protection against the virus by boosting the innate immune system which we will discuss now and the other is therapeutics, whose prospects we shall discuss in a future article.
In our previous article “a Matter of Performance”, we identified a statistical marked difference between European countries where the anti tuberculosis vaccine known as BCG was compulsory and those where the administration of this vaccine was left to individual choice. The infection rate on reported cases showed a marked difference 55%, but the death rate was spectacularly lower with a factor of more than 1 to 10.
A recent study by the Department of Biomedical Sciences, NYIT College of Osteopathic Medicine, New York Institute of Technology, seems to confirm Koumoundouros’ intuitive observation that the BCG vaccine reduces the incidence of cases and deaths.
The BCG (Bacillus Calmette Guerin) vaccine, that was developed over a hundred years ago by the French “Institut Pasteur”, has raised substantial renewed interest in the scientific world. Studies, well before the eruption of the new virus, indicated that the BCG vaccine demonstrated an ability to boost innate immunity which helps in providing protection against illnesses other than tuberculosis. As the sample studies done among adults also showed lower incidence of respiratory tract infections in those who were given the BCG vaccine, scientists have now hypothesised that it might have mitigating effects against the new SARS-CoV-2 coronavirus. The theory postulates that a live-attenuated vaccine of the BCG form, provides not only a protection against the specific pathogen for which it has been designed but also enables the immune system to show some response to a broad range of pathogens and in some cases offers a complete protection against a range of different diseases. New studies targeting the possible response to the new virus are carried out in university research centers in Holland under the guidance of Professor Mihai Netea at Radboud University, in Denmark under Christine Stabell Benn at the University of Southern Denmark and Australia under Nigel Curtis at the Murdoch Children’s Research Institute. The objective is to demonstrate that, although it may not prevent it, the vaccine will limit the severity or COVID-19.
A number of scientists also postulate that other live attenuated vaccines such as the as measles, oral polio vaccine and smallpox could also produce similar beneficial effect. Although these vaccines would not offer a specific protection against Covid-19, they could first reduce the risk of contracting it or reduce its severity.
A new study by the University of Cambridge claims that the MMR vaccine, associated with measles, mumps and rubella, could protect people from COVID-19. Dr Giorgos Modis and Professor Robin Franklin established a 29 percent structural similarity between the rubella and the SARS-CoV-2 viruses. The antibodies developed by COVID-19 patients matched with rubella antibodies and this could suggest ways in which the vaccine could provide protection to coronavirus patients. Possibly, a previous infection from the coronavirus could protect people from rubella, and vice versa. It will be interesting to see if their ongoing studies will substantiate similar relationships between the antibodies developed as a result of infections with the mumps or the measle viruses and those from the SARS-CoV-2.
Interestingly enough, on the other side of the Atlantic, surfacing out of the past, studies on the peripheral additional benefits of the oral polio vaccine are being resuscitated. The well known Dr Robert Gallo, the identifier of the retrovirus and one of the pioneers of the HIV initial discovery, and Dr. Konstantin Chumakov, have suggested the use of the existing and proven safe oral polio vaccine (OPV) as a preventive measure against SARS-CoV-2. . Non-specific protective effects of OPV have been demonstrated, several times against a broad set of different virus outbreaks in the 1960’s and 70’s, by the parents of Chumakov, themselves renown Soviet scientists. However, those scientific important validated observations had been buried in untranslated Russian scientific papers. It is expected that the prophylactic effects of this vaccine would be temporary, may be in the order of 3 months, but that in view of their safety there would not be any risk of retaking the vaccine until a specific effective vaccine against SARS-CoV-2 became available. The Institute of Human Virology at the University of Maryland School of Medicine, a GVN Center of Excellence, headed by Dr R. Gallo, submitted a proposal to the National Institute of Health (NIH) for an 11,000-person clinical trial to demonstrate and establish the efficacy of OPV against SARS-CoV-2.
We had alluded in our article about Performance to the celestial achievement of Vietnam in its fight against SARS-CoV-2. Unable to carry out testing on the massive Korean scale, they elected to take more drastic measures accompanied with selective testing. As soon as the first case was detected on January 23rd, all aerial traffic with China was suspended and they locked the 1000 kilometers border with China. Vietnamese returning from abroad were isolated whenever necessary. They also isolated several residential areas where cases had been identified. AS we write there have been only 342 reported cases of which only 17 are still active and 1 is in critical condition. So far not one single death has been reported. Could this be in part due to the extensive Vietnam’s Immunization Vaccine program which we reproduce below.
Table 2: Vietnam’s Immunization Vaccines Schedule
- BCG, HepB Birth
- Pentavalent, OPV 2 months
- Penta2, OPV2 3 months
- Penta3, OPV3 4 months
- IPV 5 months 6 Measles 9 months
- JE 2 doses in first 12 months
- DPT booster, MR 18 months
- Cholera (in specific geographical areas), JE3 2-5
- Typhoid (in specific geographical areas) 3-10 11 TT Pregnant women
We saw in “A Matter of Performance” that the regions where the BCG vaccine had been compulsory, had less infections and much lower morbidity and that, the Vietnam history was exceptional. It is too simplistic to relate all the figures to the application of one or several vaccines as many other factors come into play such as the age profile of the population, the genetic makeup of regions or subcontinents, the blood types. These may change considerably the incidence and severity of cases. In addition, the promptness in reacting to the threat and the hospital capacity to cater for the infected play a great role in the outcome results.
However, the fact that so many scientists are concentrating their efforts on studying the effects on innate immunity of non specific vaccines to resist the effects of SARS-CoV-2, should indicate to us, that there may be serious hope to impede the virus, until it disappears or that a safe vaccine is made available. Other scientists are looking at therapeutics to alleviate worse effects of COVID-19 and we shall review the progress so far in a further article.