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Dec 31, 2020
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Closer to the antibody. How long will the COVID-19 vaccine last?

They say that what doesn’t kill makes us stronger. Does this apply to the coronavirus?

Tells Doctor of Medical Sciences, Professor, Head of the Laboratory of Vaccine Prevention and Immunotherapy, Research Institute of Vaccines and Serums named after V.I. Mechnikova Mikhail Kostinov

Lydia Yudin, “AiF”: Mikhail Petrovich, can we say that those who have undergone coronavirus have stronger immunity?

Mikhail Kostinov: It depends on which patient we are talking about. Young and healthy people who do not have chronic diseases have a large number of naive T-lymphocytes (which have not yet encountered antigens) and regulatory cells in the body. When they encounter a virus, they activate and regulate immune responses, preventing inactivity or excessive immune response (which leads to the infamous cytokine storm). Therefore, acquaintance with the virus (especially if it has entered the body in a small concentration) trains and strengthens the immune system.

However, in middle age and the elderly, there is no question of any training of immunity. Any chronic disease depletes the immune system (since it is constantly fighting the disease), and therefore it is not able to cope with the new virus. Such people have two exits during the epidemic. Either strictly observe restrictive measures until the end of the circulation of the virus (i.e., indefinitely), or get vaccinated.

From fibrosis to cancer

– But vaccination of patients with chronic diseases is not planned yet.

– People with chronic diseases are recommended to be vaccinated “with caution” – that is, after consulting a doctor, who must familiarize himself with the medical history and find out the patient’s condition at the time of vaccination. The other day, vaccination of people aged 60+ was allowed. This is a very timely decision, considering the dangerous complications that develop in patients who have had an illness in moderate and severe form.

– What are these complications?

– The coronavirus affects all body systems. If there is a chronic disease, its course is guaranteed to worsen. With lung damage, fibrosis can form and respiratory function deteriorate (it is not yet known how long this condition persists).

Another alarming consequence of COVID is a violation of the blood coagulation system. Therefore, an increase in the number of heart attacks and strokes may become a distant consequence of the current epidemic. COVID-19 also negatively affects the nervous system. Due to prolonged hypoxia in patients after recovery, there are long-term disturbances in attention, memory, decreased performance, and chronic fatigue. But the main thing is that due to pronounced changes in the immune system in the long term, an increase in the risk of developing autoimmune diseases, including cancer, is predicted.

– A new virus strain has been found in Britain. Will this reduce the effectiveness of vaccination? After all, it was designed for the “old” coronavirus.

– The structure of the virus has not changed, mutations occurred in separate fragments – in particular, in the protein from which the coronavirus “spikes” are built, with which it enters the body (therefore, the infection has become more contagious).

The identified mutation will not in any way reduce the effectiveness of the vaccine. In addition, when assessing the immunogenicity of vaccinations, it is not enough to focus only on humoral immunity (antibody titers). Much more important is the cellular memory that forms after viral infections – it is much stronger than the level of post-infectious antibodies.

Lifetime protection

– Will there be a single vaccination against the “corona”, or will it, like the flu vaccine, have to be renewed every season?

– There is no answer to this question yet. But there is evidence that cellular memory lasts for decades. It is known that during the 2009 swine flu pandemic, the elderly either did not get sick with it or tolerated it easily. This is due to the fact that they retained the cellular memory of the flu, transferred in 1947-1956, which was similar to swine.

Even if the virus mutates significantly, those who have been ill and vaccinated will carry the disease much easier. In the same 2009, not a single person who was vaccinated against the usual seasonal virus died from swine flu (a vaccine against the current pandemic strain was developed later), and among the unvaccinated there were many deaths.

– Today, before vaccination, it is necessary to take an antibody test. Those who have already had a coronavirus are not shown the vaccine. It is believed that vaccination of those who have recovered will contribute to a more severe course of the disease.

– This issue has been carefully studied because there are vaccines that suppress the level of antibodies present (for example, the measles vaccine). A study by our foreign colleagues showed that after vaccination in people with initially low levels of antibodies (after an asymptomatic infection), titers rose in the same way as in vaccinated people who did not have antibodies. Those who had medium and high values ​​of antibodies, their level increased many times. This means that the vaccine does not compete with post-infectious immunity, but enhances it.

The vaccine certainly cannot cause disease. The vector vaccine does not contain a virus, but introduces a piece of genetic information about the S-protein (with which the virus is introduced) and forms an antigen inside the body.

There are contraindications. Be sure to consult your doctor

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