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The Best Vaccine Is the One You Can Get

Ancha Baranova on COVID-19 vaccines

© Daniil Prokofyev/ HSE University

Ancha Baranova, professor at George Mason University (Virginia, USA), is well-known for her video lectures on YouTube about COVID-19. As HSE University rolls out its vaccination programme, the biologist spoke with HSE University Life about the latest scientific news regarding COVID-19 vaccines.

Of the vaccines currently available in the world, which one is the best? 

The best vaccine today is the one you can get. Unfortunately, there are vaccines in the world which didn’t prove very effective in clinical trials. For instance, the Chinese vaccine Sinovac was in fact a failure, with only 50% efficacy of the immune response in research groups. AstraZeneca’s vaccine is a little more effective, but it still demonstrates a more moderate rate. Meanwhile, Pfizer, Moderna, Novavax, and Sputnik V are good and effective vaccines. If you are eligible to get vaccinated with Sputnik, you should do so immediately, without waiting for other vaccines to be approved for public use. While waiting, you may fall ill with predictably bad consequences. 

People say that Sputnik has yet to pass all the necessary testing. What does that mean, and can it lead to any dangerous consequences? 

It is clear why the third phase of Sputnik’s clinical trials was quite dramatic: it was really hard to perform blind trials. Now that the third phase is over, manufacturers have complied with the required international standards. The statistics are yet to be published on trials of vaccines against new variants of coronavirus and for certain groups, including oncology patients after chemotherapy. Moderna, Pfizer, AstraZeneca and Novavax have released their data on the new strains—some of them on the British one, others even on the strain discovered in South Africa. The efficacy rate of these vaccines on the new variants of the virus are much lower. Sputnik has not yet released such data—it is delayed. I don’t believe in miracles and I think that its efficacy in combatting the new strains will be low, too. As far as the ordinary type of coronavirus is concerned, Sputnik’s rates are very good. Conversely, AstraZeneca’s rates are much worse: the average immune response is lower and its length is shorter. The same can be said about Johnson & Johnson, as this vaccine is equal to the first injection of Sputnik. It is a kind of a ‘Sputnik light’ option with weaker protection.

How long will the vaccinated person remain immune?

Nobody can say for sure. Moreover, it is not even clear whether each vaccinated person will get antibodies: I’ve seen analyses of some people who did not have any immune response after being injected with Moderna or Pfizer’s vaccines. This failure can happen to any vaccine due to either improper storage (which is quite possible in case of Pfizer), or the person’s individual characteristics. The older the person, the stronger the immune response is. The same is true about people suffering from autoimmune diseases and receiving suppressive therapy. 

I’ve heard it is good if you get a slight fever after vaccination because it means your body is mounting an immune response. Is this true? 

Yes and no. A rise in temperature is in fact a signal of your body mounting an immune response. However, high body temperature may be harmful. A few days of fever can have devastating consequences for elderly people. At the same time, we know that antipyretics, such as ibuprofen, not to mention antihistamines, reduce immune response. Yet, we need to find a balance between appropriate use and minimizing harm depending on each particular situation. What a young person can endure, an elderly person shouldn’t—a high temperature (higher than 380C) should be reduced. 

If you have gotten sick with Covid and recovered, how long should you wait before getting vaccinated?

After you recover, you should get tested for the presence of IgM/IgG antibodies. A positive IgM test indicates that you shouldn’t get vaccinated, and if your IgG is high, it will be long before you have to get vaccinated—not until the total amount of these antibodies drops down. The lifespan of antibodies depends on a person. You should get tested once a month to analyze your levels. You will be able to get vaccinated after your number of antibodies reduces sharply.

What conditions make it inadvisable for someone to get vaccinated? For instance, should an elderly person with diabetes or cancer get vaccinated? 

This is what your consulting doctor will decide, but I would say they should. The risk of getting coronavirus may be increased in people suffering from diabetes, and we all have plenty of dormant, undetected tumours. An elderly person with a history of cancer most often differs from their peers only in their level of awareness of the disease. I’d say that the real conditions people should look out for are infectious diseases suffered at the moment of vaccination, such as primary (congenital) immunodeficiency or various rare and serious autoimmune abnormalties, but not standard local problems with autoimmune reactions such as Hashimoto's thyroiditis. As 4% of the Russian population suffers from this disorder, I don’t think we should apply a ‘one-size-fits-all’ approach and confuse it with aggravations of systemic lupus erythematosus (SLE). 

Suppose I get vaccinated and I’ve got a high level of antibodies. Does it mean that I will not fall ill or infect my friends and family?

I wish I could say yes, but unfortunately that is not the case. The main vaccines—AstraZeneca, Pfizer, Moderna and Novavax—have already been studied in terms of how well they can protect people against new strains of the virus—the Brazilian, South African and British variants,—and the reduction in their level of protection is obvious. This means that a vaccinated person wearing a mask will not become infected by speaking to an infected person. The virus can be caught only if somebody sneezes into the vaccinated person’s face. In usual circumstances, however, no. Most likely, if they do catch it, they will not develop symptoms.

However, when it comes to carrying the virus asymptomatically, the situation is worse. Although antibodies are in our blood, mucous membranes, where viruses settle, are hardly ever protected. In other words, a vaccinated person may come into contact with the virus, it could settle on their mucous membranes, and they will not get sick, but they can still transmit the virus to others. I’d like to emphasize though that this matter has not been fully studied, and these are just our guesses. The vaccine manufacturers have warned that they cannot guarantee anything, and AstraZeneca has clearly stated that people can still be carriers. 

By that time the question of revaccination will be important in Russia. You cannot get with Sputnik a second time, can you? 

Yes, you can, but adenoviral vaccines are likely to demonstrate a weaker immune response in revaccination. Although Sputnik is an excellent choice to get vaccinated for the first time, the second round may be useless. This is quite a tricky question, which I think can be answered ‘on average, by population size’. You can certainly get revaccinated with Pfizer and Moderna, but it is not clear whether their alternatives will appear in Russia on time. EpiVacCorona is another promising option suitable for revaccination, but I would like to see the results on its protection, because the amount of antibodies it generates in the vaccinated people leaves much to be desired. As for the Chumakov Centre’s vaccine, the third phase has not been completed and we haven’t seen the results yet. Sputnik is likely to remain the leader, while Chumakov’s vaccine and Epivac will be good for those who for some reason cannot get vaccinated by Sputnik and need at least some protection against the serious disease.

The Chumakov Centre is developing a ‘live’ vaccine. Should we be concerned? 

The Chumakov Centre is developing two vaccines. The first one has been released for production. It is not a live vaccine, it is a killed vaccine similar to Chinese Sinovac: it was developed based on coronavirus multiplied in culture and then inactivated. I wouldn’t say our expectations of this vaccine are too high: its efficacy is likely to be in the range between 50 and 60%. The other vaccine is much more promising. The Centre has begun developing it, but it has not yet completed it. It takes a very long time to develop a live vaccine—for instance, it took twenty years to develop the polio vaccine.

As for whether this is cause for concern or not, I think that it is. Not because we should be scared of being injected with this kind of vaccine, but because it is risky to produce. Only four countries—China, Russia, India and Kazakhstan—have decided to develop an inactivated vaccine. To produce it, you need to get human cells which are easily infected by coronavirus. You put the cell into the reactor to grow them, then you infect them to create the best conditions for the virus so that it can multiply exponentially. If any equipment fails, the concentrated virus could get unleashed and people would regret the day we were born: no vaccine would save those who find themselves in the midst of this cloud. This virus likes cold weather. It will hardly live long in India where it is very hot, but the Moscow winter is quite a different story...

Given that vaccination has begun in many countries, what is your prediction for when the pandemic will end?

I don’t think you will like my answer. Given the current situation, the pandemic will last for at least another year. Vaccines will be available for developed countries, while it is estimated that other nations such as Pakistan and Afghanistan will not receive a sufficient amount of this protection until 2023. We share one world, and globalization is no joke.

HSE teachers and students can get vaccinated at the Pokrovka complex on Pokrovsky Boulevard. The vaccination centre is open from 9:00 am to 6:00 pm on weekdays. You can choose a day and time convenient for you by completing a special form online. Currently, the registration period is open until February 10.

Author: Ekaterina Drankina, February 05