Vaccination against the SARS-CoV-2 coronavirus, unavoidable in respiratory patients

2023-11-03 11:00:29

Vaccination against coronavirus, unavoidable in respiratory patients

“Despite the clear recommendations of the National Health System, greater emphasis must be placed on the vaccination schedule, especially in the case of pulmonology patients, including those who suffer from COPD, bronchopulmonary dysplasia, cystic fibrosis. and asthma,” relates the director of the National Influenza V Centeralladolid NIC.

“Not only are we slow in providing ourselves with vaccines, but we are also delayed in administering them to the most vulnerable people,” emphasizes Dr. Eiros Bouza, head of the Microbiology Service of the Río Hortega Hospital.

“And all these people, like others at risk, must be candidates for periodic vaccination against SARS-CoV-2 with the plethora of vaccines that are available to doctors at all times, just as we do in the case of gripe“, he points out.

“In fact, and as a sample, almost 9% of the analyzes in the NIC Microbiology Service during the last week of October 2023 were cases of positive coronavirus infections (SARS-CoV-2),” exemplifies the Professor of Microbiology at the University of Valladolid (UVa).

The current variability of SARS-CoV-2 infections is so disparate that, in the first week of this month, the data stood at 21.3% of the samples analyzed; in the second week, 17.6%; and in the third, 11.1% positivity in the sentinel samples.

Today, the World Health Organization recommends the mandatory vaccination dose against the predominant omicron (XBB.1.5), especially with a monovalent vaccine, which generates a greater antibody response, but without neglecting vaccination against the primary strain. originated in Wuhan (China).

The necessary vaccination against SARS-coronavirus-2

“Global regulatory authorities recognize that bivalent and monovalent vaccines (mRNA, adenovirus vectors or recombinant proteins) against the different omicron variants offer protection against serious illness, hospitalization and death,” recalls Dr. Eiros.

Table of the 11 vaccines against SARS-CoV-2 approved in Spain along with the recent Bimervax from Laboratorios Hipra. Bimervax, a recombinant protein vaccine, received the support of the WHO in October 2023, a certificate that is added to that issued by the European Medicines Agency (EMA), the European Commission (EC) and the Agency for Medicines and Health Products of the Kingdom United Kingdom (MHRA).
“Likewise, the NIC considers that the adaptation of Bimervax to the omicron XBB.1.5 variant is reasonably good,” he says. Images facilitated by Dr. Eiros Bouza.

In June 2023, both the EMA and the European Center for Disease Prevention and Control (ECDC) advised that the vaccines for this 2023-2024 season be monovalent (a single serotype of a microorganism) against the XBB subvariant of the omicron strain. to ensure protection against circulating strains, specifically XBB.1.5.

And the National Health System (SNS) in Spain has established that seasonal vaccination against flu and COVID-19 be carried out for different target population groups:

People 60 years of age or older.

People five years or older admitted to centers for different abilities, as well as nursing homes and other social and health care institutions.

People over 60 years of age with risk pathologies, such as diabetes; Cushing’s syndrome; morbid obesity; chronic cardiovascular, neurological or respiratory; chronic kidney disease and nephrotic syndrome.

In addition, people who suffer from hemoglobinopathies, anemias, hemophilia and other bleeding and coagulation disorders; asplenia; chronic liver disease, including chronic alcoholism; and serious neuromuscular diseases.

As of September 2023, the original Comirnaty and Omicron BA.4-5 vaccines are available in Spain; Comirnaty omicron XBB.1.5; Spikevax orginal and omicron BA.1; Original Spikevax and Omicron BA.4-5; and Bimervax.

It should be noted that mRNA vaccines have become fashionable, again, because The Nobel Prize in Medicine has awarded the Hungarian Katalin Karikó and the American Drew Weissman for laying the foundations for the development of messenger RNA (mRNA) vaccines against covid-19 and other infectious diseases.

Their research has not only altered the understanding of “how messenger RNA interacts with our immune system,” but was “crucial” in obtaining effective vaccines at an “unprecedented” rate.

And so it happened during “one of the great threats to human health in modern times,” highlighted the Nobel Assembly of the Karolinska Institute in Stockholm.

Vaccines have saved millions of lives and, at the same time, prevented severe diseases in many more cases; allowing society as a whole to return to normal conditions in their daily lives.

The discoveries about nucleoside base modifications achieved by both researchers could be used in the near future to treat certain types of cancer and produce therapeutic proteins.

The presidency of the Nobel Committee for Medicine has focused on the fact that the success of vaccines against COVID-19 has had an enormous impact on the interest in technologies based on mRNA.

Among the applications, new vaccines against other viruses, such as influenza, are listed. This technology is a “fast and flexible” platform to carry them out, according to Sweden.

“A giant step for Humanity,” highlights José María Eiros Bouza.

The pandemic coronovirus of yesterday, today… and tomorrow

The SARS-CoV-2 infection, which causes the COVID-19 syndrome, is no longer a pandemic only because the WHO has established it, but not because of the intentions of the virus: to transmit and mutate to survive and multiply. Viruses are entities very capable of damaging our body.

We already experienced this in the case of MERS-CoV (Middle East respiratory syndrome) in 2012, with a fatality rate of 32%, since it affected 2,500 people, of which around 800 died.

The 2003 SARS-CoV (severe acute respiratory syndrome) spread from Southeast Asia to 29 countries. Almost 8,100 people were infected, of whom 774 died.

“Since then, we have learned many things about this microorganism, mainly through the lessons of veterinarians: there are seven types of coronaviruses that have been successful inside us through about 40 agents that infect livestock, birds, migratory and stabled, or small animals,” he explains.

We are talking about the Alphacoronavirus (229E and NL63) and the Betacoronavirus (Merbecovirus [OC43, HKU1 y MERS-CoV] y Sarbecovirus [SARS-CoV y SARS-CoV-2]). Indicate that the latter has 80% genetic similarity with SARS-1 and 50% with MERS.

“The coronavirus, from the point of view of its very large number of mutations (only the omicron variant has about 3,000 sublineages) is much more stable than the flu viral mutation, despite all the literature that has been generated and is being generated. . “Very good global news,” he considers.

Chronologically, the variants of the coronavirus SARS-2 that have most concerned the international scientific community since 2020 have been: “alpha or English (B.1.1.7)”, “beta or South African (B.1.351)”, “delta or Indian (B.1.617.2) )”, “gamma or Brazilian (P.1)”, the South African “ómicron (B.1.1.529)” and its sublineages BA.4, BA.5 and the reiterated XBB.1.5; to which those that come will have to be added.

And it should be noted that the vast majority of health organizations dedicated to research are focused on sequencing of the “S” protein gene of the spike, or envelope glycoprotein of the SARS-2 virus, which is the structure that binds to the receptor; that is, our candidate cell to be infected.

“In this research field, the NIC has good genomic results, since sequencing provides us with decisive information about whether the variants of the virus are more or less transmissible, if they generate greater or less severity or if they alter the immune response of individuals,” comments.

“Therefore, we work daily to improve the effectiveness of vaccines or the response of monoclonal drugs (proteins created in the laboratory) and antivirals (which reduce symptoms and complications),” he adds.

Based in Munich (Germany), GISAID offers open access to accredited research centers that provide genomic data on viruses, such as influenza and coronaviruses; an essential empirical basis for the development of vaccines and medicines.

In fact, for the good of the health of the world’s population, the National Flu Center of Valladolid, which carries out its work in a “modest” Autonomous Community, the Junta de Castilla y León, has managed to sequence almost 17% of all the Spanish contributions on the genome of the “S” protein.

“Joyfully, the inhabitants of planet Earth are nourished by the many sequences provided from Spain,” states Dr. Eiros Bouza with absolute medical humility.

The National Influenza Center of Valladolid investigates, identifies and analyzes a whole set of agents that cause different viral infectious diseases (influenza, RSV, rhinovirus, parainfluenza, coronavirus, metapneumovirus, bocavirus, adenovirus).

“Our scientific accreditation is based on the most demanding quality controls worldwide and on our contributions of systematic and vital research to the WHO, where the path of annual immunization against multiple microorganisms is marked,” emphasizes the also vice president of Asomega.

Towards combined vaccination against respiratory viruses

Dr. Eiros Bouza already said it to the journalist Ana Santiago on March 13, 2022 in an interview published in El Norte de Castilla: “It is easy for us to go to a multi-year vaccination model”… To which he adds today… “ And with combined vaccines.”

Not in vain, this microbiologist dedicated to the health and well-being of the population, with forty years of work under his eyes and on his back, “deeply believes in sustained prevention strategies and not in half measures.”

Vaccines have demonstrated their extraordinary medical function in the face of this coronavirus: saving millions of lives; But today we need to deepen its response capacity in the face of a very complex world of mutant viruses, which tend to minimize the preventive effect.

This is the future and probably the most important vaccine designs will be those that incorporate an asset against influenza, SARS-CoV-2, RSV (respiratory syncytial virus).

“Without marginalizing certain viruses that the scientific community in general consider to be of lesser significance, such as the parainfluenza virus (PIV) and human metapneumovirus (hMPV),” he emphasizes.

“The metapneumovirus, for example, has a genomic rearrangement that is very similar to the respiratory syncytial virus; a great candidate to complicate the prognosis of pulmonology patients, especially those in serious condition and those in the ICU,” he estimates.

In this sense, the development of projects in different phases of combined mRNA vaccines in adults and pediatric level is observed: COVID+flu (mRNA-1073), COVID+flu+RSV (mRNA-1230) and MPVh+PIV3 (mRNA- 1653), RSV+hMPV (mRNA-1365).

Also, in the clinical phase, the Novavax mRNA combination vaccine for SARS-CoV-2 and influenza.

The protection and control of respiratory infections is pursued with a single vaccine regimen (mRNA-1230) by incorporating mRNA-1273 (covid), 1010 (flu) and 1345 (syncytial).

Dr. José María Eiros Bouza concludes

This videoblog is a summary of the conference “Vaccination 2023 of respiratory patients” given by the microbiologist at the professional meeting “Visionaries, Innovation and Future in Respiratory Diseases”which took place on October 6, 2023 in the assembly hall of the La Princesa University Hospital in Madrid.