In a recent paper by Gogoi et al (See Gogoi et al, The Age of Cyclic Dinucleotide Vaccine Adjuvants, Vaccines, 2020, 8, 433), the authors note:
Most of the available vaccines confer an humoral antibody response but are unable to generate long-lived memory T cell responses, especially CD8+ T cell response against viral infections. For instance, the need for the cytotoxic T lymphocyte (CTL) responses in an antiviral response is undisputable. Yet, in the current COVID-19 vaccine development, most efforts aim to generate neutralizing antibodies against the SARS-CoV-2, rather than promoting the long-lived, potential cross-protective antiviral memory CD8+ T cells responses. The reason mostly lies in the lack of vaccine technology, e.g., adjuvants, that triggers the memory CD8+ T cell response during vaccination. Equally important, current vaccines are administered, i.m., or i.d. or s.c., and fail to generate vaccine protections on the mucosal surface. Most infectious agents enter the body on mucosal surfaces. Effective vaccines should not merely reduce the severity of the disease but prevent people from catching the infection, achieving sterile immunity. Only the induction of mucosal vaccine protection, i.e., the generation of mucosal IgA and mucosal tissue-resident memory T cells (TRM), can prevent the initiation, progression, and transmission of respiratory infections. For example, the oral administered Sabin poliovirus vaccine is effective because it elicits a strong mucosal IgA response and provides intestinal immunity, the site of primary poliovirus infection. In contrast, the injected Salk polio vaccine does not produce intestinal immunity and therefore is less effective at preventing the spread of poliovirus in a population.
Now what does all of this have to do with COVID. First, the COVID vaccines do not prevent the disease nor do they prevent even getting "infected". They mitigate the infection. Thus the Omicron explosion is almost all in vaccinated individuals, most just a head cold. In addition a vaccinated person can still get infected and spread the infection. They may just not get very ill. Also most of the vaccines have no adjuvants and thus have a waning level of protection. Second most COVID vaccines have no adjuvants and this has fleeting immunity.
In effect the current vaccines a useful for a transition to a longer lasting vaccine set. The problem is simply that we have poor communications from the "leaders" in this field, especially the batch of Government folks leading the marching band.
Admittedly viral infections, vaccines, and the immune system are not well understood by most physicians not to mention the public at large. I would argue that if one asked people to describe DNA and RNA you would get a mess of horrible responses. But that is the fault of our grossly incompetent educators in Secondary schools.
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