Covid vaccines, a triumph of science and public health

Dossier Five years with covid Desplega

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How have the sectors most affected by the pandemic changed?

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Covid vaccines, a triumph of science and public health

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"Madrid manipulated the Covid data as it does with the waiting lists"

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Developed in record time, SARS-CoV-2 vaccines changed the course of the Covid pandemic that ravaged the world five years ago. In the first year of administration alone, they prevented 14.4 million deaths in 185 countries and regions, according to a study by Imperial College London published in The Lancet. This data was added to another later work by the WHO which estimated that these prophylactic drugs had prevented half of the hospitalizations due to covid in Europe, as well as 50% of the serious cases of the disease and deaths.

These vaccines reached society much faster than even the scientists themselves expected. Only one year after the SARS-CoV-2 virus had been identified as the cause of the disease, doses were already being distributed throughout the planet.

This was possible thanks to all the basic science research that had been done for years on the coronavirus, a family of pathogens capable of causing everything from minor illnesses, such as the common cold, to serious life-threatening diseases, such as covid-19 or MERS. Years of prior basic research at centres such as the Catalan Animal Health Research Centre of the Institute for Agrifood Research and Technology (IRTA-CReSA) had made it possible to determine which protein was crucial to use in a vaccine.

Added to this was the fact that messenger RNA technology was mature, which is what led to prophylactics based on this technology, which offered very high protection, 94%, against severe disease, beginning to be administered to the population in December 2020. ~BK_ lin Karikó and the American immunologist Drew Weissman, who will be awarded the Nobel Prize in Medicine in 2023, had worked to develop messenger RNA – a small molecule that ensures that the information in DNA is translated into proteins that perform the necessary functions of cells within the cells more efficiently.

This technology made it possible to develop the Pfizer/BioNTech vaccine, of European origin, and the Moderna vaccine, developed in the USA. Until then, says Julià Blanco, head of the virology and cellular immunology group at IrsiCaixa and who led the project to find a vaccine against SARS-CoV-2, it had not yet found a place in the clinic because it was more expensive. "With Covid, the perfect conditions were met: a vaccine was needed that was very quick to produce and mRNA vaccines allow it to be done on a large scale, as well as being very effective," says this immunologist.

However, these preventive drugs had a major drawback, which was that they had to be stored at -80 °C, which made their distribution difficult. "They needed to be ultra-frozen, which made it very difficult to get them to emerging countries," says Blanco, who recalls how the freezers at the blood bank at the Germans Trias i Pujol Hospital in Badalona, ​​​​where IrsiCaixa is located, were full of vaccine doses. "The logistics that the Department of Health set up from scratch and very quickly to be able to get the vaccines to the last corner of Catalonia was impeccable," he acknowledges.

Also shadows

Although at the beginning of the vaccination the results of the mRNA vaccines were "excessively good", because they protected not only against serious illness but also against infection, which "made us dream that we had achieved the perfect vaccine", months later it was seen that the protection they offered, as is the case with most of these.

In addition to the mRNA vaccines, others were also developed such as those from AstraZeneca, Janssen, Sanofi or the Catalan Hipra, although, although they all protect against serious illness, none reached the effectiveness of the mRNA vaccines.

Likewise, vaccines, despite being a triumph of science and public health, and as with all drugs, have also been seen to cause side effects, rare but some serious and also long-term, such as fatigue, brain fog, tinnitus and dizziness. This is what is known as post-vaccination syndrome, which is currently the subject of several studies. Changes in the menstrual cycle of women have also been identified.

Towards personalized medicine

The pandemic revolutionized vaccine research and accelerated investment in different technologies and mechanisms of action that also paved the way for therapies for other diseases. For example, mRNA vaccines were already used in cancer, but the boost in research provided by Covid has allowed them to be used more quickly in cancer. "They offer a lot of flexibility to be able to adapt to each person," says Blanco, who explains that "neoantigens are used, which are the mutated proteins of tumor cells that are targeted by the immune system." Thus, once the mutation is identified, "they allow a personalized mRNA vaccine to be generated very quickly," he adds.

They are also being used in other infections, such as HIV or Zika, in autoimmune diseases and even in genetic alterations.