Here is the 5th article in the series written by Dr. Mathieu Millette, see the previous articles: My mother and SARS-COV-2, An excellent virus, The Empire strikes back and I have a dream…
In this beautiful spring afternoon, I calmly rock myself in front of the house. The sun deliciously caresses my skin. I hear the cries of joy from the children playing nearby. My beloved wife prepares the meatballs which I will cook on the BBQ later on. Life is Beautiful.
There is only one shadow across the board: the COVID-19 pandemic. As long as we each stay at home, there will be no issues, but we cannot live very long in this way. It was in the Middle Ages, that Saint Thomas Aquinas rediscovered and commented on the book, Politics by Aristotle. He mentions that humans are social animals. We have a visceral need to interact with our neighbors, whether family, friends, or colleagues at work. We must love and be loved in return. We must feel that we are part of a community (Hello Facebook community!). But before you can go back and reinvent the world over a drink of preference, you will have to settle the score with this COVID-19. The best way: everyone is immune to this terrible infection. Vaccination 101.
The immune system
The immune system is used to defend the body against invasion by microorganisms and to prevent foreign bodies from causing harm to us. In short, it is our watchdog. Just as an army is made up of various elite corps, each specialized in a specific task (infantry, navy, aviation, logistics, etc.); the immune system is also made up of several kinds of cells, each fulfilling a particular role. They are grouped under the name of white blood cells, cells that circulate almost everywhere in our body. The immune system is divided into two: the INNATE immune system and the ADAPTIVE immune system. The first allows immediate and non-specific defense of the organism. It is also a defense that can be overwhelmed when there is a breach or if there are too many invaders. Besides, it has no memory. If the same attacker attacks again, it has no plan to defend itself faster or more effectively. The adaptive immune system is slower to set up, but much more efficient and above all, it is specific, that is to say that each time a microorganism attacks, certain cells take note and build a file on it in order to remember it for the next time. It’s immune memory. The two components of the immune system each have strengths and weaknesses, but complement each other very well and ensure the survival of the organism. Vaccination seeks to stimulate the adaptive immune system, the one whose cells specifically recognize enemies, by producing antibodies to neutralize them. Antibodies, a kind of Y-shaped protein released by some white blood cells, recognize a piece of virus, put handcuffs on it, and other cells then inactivate viruses, which leads to healing.
Development of a COVID-19 vaccine
Several groups of researchers in Canada, the United States, Europe and Asia are currently developing a vaccine to prevent infections for SARS-CoV-2. As many researchers from academic circles, as pharmaceutical. Each group has a slightly different vaccine. Each group has its strategy. Some will target one or the other protein on the surface of the virus. Others will rather target the genetic material or use the complete but inactivated viruses (the old way of making vaccines, from the Louis Pasteur method). The Médicago company in Quebec makes a vaccine from tobacco plants! Each strategy has advantages and disadvantages. It’s a race. Not a sprint, but a marathon. The team that succeeds first in demonstrating in humans that their vaccine is effective in preventing coronavirus disease or reducing severity without too many side effects will be crowned champion with all due honors.
But why is it taking so long to develop this damn vaccine?
In life, everything is relative. Especially time. Sometimes it stretches like a long calm river, sometimes, like during the holidays, it spins at full speed.
The goal of the vaccination is to present the plan of a microscopic enemy to our immune system, in this case SARS-CoV-2, so that we can develop an immune memory. We teach our bodies to recognize the aggressor. We show them this portrait. Now it’s on file. It will no longer be able to pass through quiet customs. The virus will be intercepted and eliminated immediately without causing disease. This is what happens naturally when you “catch” the chickenpox virus, for example.
Slice of life…
I “caught” chickenpox at 22. It’s pretty old for a first episode of chickenpox. I had the highest fever of my life, sweating, muscle pain; it was hell for 24 hours. Then the itchy maculopapular rashes, or more simply, the red bumps appeared. All over! Face, back, chest, arms, and legs. It itched all the time. I was going crazy. The only thing that relieved me was soaking myself for hours in a bath with cow brand baking soda. While my immune system first discovered this virus, it decoded the plan and kept it in memory. It takes a few days to clear the virus the first time. On the other hand, if we come to meet the same virus again, our immune system recognizes it very quickly, prevents the virus from developing and from causing disease. For the rest of our lives (or almost), we are immune to this virus.
The vaccine replaces this first disastrous encounter; it confers immunity without causing disease and complications.
… Back to vaccine development
Unfortunately, the vaccine development program is very long. First you have to have a strategy and a viral target. Then you have to “build” the vaccine, that is, make the product that you would administer to humans. Normally, if it is a vaccine based on the live attenuated virus strategy, large amounts of virus must be produced, inactivated, concentrated and purified. Each step is a technological challenge; there are many uncertainties and obstacles to overcome. In the end, there is a large pile of viruses that cannot cause the disease, but which will be recognized by the immune system. Normally, an adjuvant is added to the vaccine. The adjuvant chosen is used to boost the immune system’s response. It’s like highlighting parts of the enemy’s plan that are very important in destroying it. When the vaccine is completed, you must find the right dosage and the number of times that you must vaccinate (booster doses) in animals (preclinical phase). If all goes well, we go to phase 1. The vaccine is then administered to healthy humans to see if there are any side effects and if the vaccine is effective in producing a large amount of protective antibodies against the virus. Next, the researchers organize a phase 2 clinical study which is used to validate the efficacy on a larger group of humans, to validate the dosage and the boosters. Finally, phase 3 is a large-scale study on hundreds or thousands of individuals to validate that the vaccine is effective, safe and that its effect can be generalized to a large part of the population. Planning, organizing, executing and analyzing each phase can take several weeks to several months. Right now, all groups of researchers are performing these steps very quickly, much faster than normal. Experts predict that it will take between 12 and 18 months to complete all phases of the development of the COVID-19 vaccine and receive approval from regulatory authorities. Both in the United States and in China, vaccines are already being studied on citizens. The timer has been set.
Who will benefit?
When the GO (not our Prime Minister, but the starting signal …) is given, there will not be enough doses of vaccine for all. Vaccination of populations will be done in order of priority according to risk factors. Frontline health care workers will be the first to receive it. Then, our seniors with risk factors for complications related to COVID-19 (read the column “An excellent virus” for more information on risk factors). Then all the people over 65 and finally the rest of the population. When a large part of the population is vaccinated or immunized against SARS-CoV-2, we will no longer have to fear the dire consequences of this damn virus.
Aristote on education
Aristotle thought long and hard about what education should be. Of course school education as we understand it today, but also life-long education. He calls it paideia and the goal is to study all forms of culture so that each citizen rises to their ideal of perfection. For the past few weeks, my wife and I have been discovering the joys (and challenges … for the sake of being polite), of homeschooling. We are guided by Ms. Émilie’s planed lessons (a great young teacher full of energy endowed with the patience of an angel), but I take this opportunity to teach certain values that are precious to me: perseverance, hard work , love yourself, respect yourself, respect others, take care of others and above all, always marvel at the beauties of Mother Nature. My son, I wish you a long life filled with learning, happiness and adventure surrounded by a crowd of friends within two meters!
Do not miss the next article in this series which will be online in the coming weeks!
Mathieu Millette, Ph.D. Mcb.A. Doctor in microbiology and member of the Association of Microbiologists of Quebec