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By Pratiksha Bhattacharyya
2020 is one of the most unforgettable years in human history. Memories of this year will haunt all of us for a long time. At the beginning of this year, the human race was attacked by a virus named, COVID – 19. It has brought us some unprecedented times. The pandemic spread like wildfire and infected more than 125 million people. More than 2.75 million people lost their lives. Everything was shut down and social lives have come to a standstill. As if we were watching the extraterrestrial out of a dystopian movie. The only light in the tunnel has been the development of the vaccine. Vaccination of the people seems to be one of the ways to go back to have a normal life.
How does a virus infect our body?
Viruses are much smaller than cells. Outside of living in cells, it does not show any sign of life. Structurally, viruses have genetic material (DNA / RNA) covered by a protein envelope, capsid. Virus replication only happens inside living cells (host). The virus attaches itself to the host cell, injects its genetic material into the cell or sometimes takes itself inside the cell and starts governing the function of the cells. The cell then started replicating viral genetic material and synthesizing viral protein. Multiple copies of the virus are then made. It can then cause the cell membrane to rupture. The new viral copies can now and go infect other cells and the previous host cells die.
What is a Vaccine?
The basic objective of vaccination is to train the body with a controlled immune system response to a germ or antigen. So, if the body encounters the germ or antigen after vaccination, the body will trigger a strong immune response to combat, fights and eliminates the germ or antigen. Traditionally, the controlled immune response of vaccination is carried out by administering inactivated or killed or attenuated germs or antigens. This makes our body to learn and memorize the germ or antigen, so that it can provide strong protection against the germ or antigen, if encountered in the future. Normally, a healthy person easily tolerates the controlled immune response of vaccination but for people who are immunocompromised, there is a chance that vaccines could kick off a risky immune response and may cause adverse effects. This risk is more in case of attenuated germ administration.
New Technological approach for Covid -19 Vaccine:
1) mRNA Vaccines
mRNA mediated Coronavirus vaccine designed to use a messenger RNA (mRNA) enclosed in lipid evolve. This mRNA carries instructions or genetic code to the cells to produce more coronavirus “spike protein.”
This actually alarms and trains the body to recognize the spike protein on coronavirus germs as foreign antigens and induce immune system responses. The vaccines developed by Pfizer and Moderna are actually mRNA Vaccines.
2) Viral vector vaccines
In this type of vaccine a common virus, adenovirus (causes the common cold) is used to deliver the message or genetic material of coronavirus to the cells not mRNA. The delivery of the corona virus genetic material to the cells, tuned the cells to recognize the coronavirus spike protein of coronavirus infection much more efficiently. AstraZeneca and Johnson & Johnson developed this kind of vaccine called a viral vector vaccine.
Autoimmunity:
Normally our immune system recognizes our own protein and doesn’t elicit an immune response against self- antigens or proteins. In autoimmunity, the immune system of an organism develops immune responses against its own healthy cells, tissues and other body normal constituents. Any disease that results from such an aberrant immune response is termed as autoimmune disease. The actual mechanisms of autoimmunity are still obscure and debatable. One of the major causes is viral infection.
. COVID-19 Vaccine and Autoimmunity
It is already described that the COVID‐19 vaccine from Moderna is mRNA based, Pfizer uses a lipid nanoparticle enclosure for the mRNA, whereas AstraZeneca and Johnson & Johnson rely on an adenoviral vector, although in both cases the genetic sequences that encode the viral spike protein. Hence, it is not wrong to say this is going to be the first‐time vaccine based on gene therapy is going to deliver globally. Long‐term effects of gene therapy‐based vaccines are practically unknown. Recent reports demonstrated that COVID‐19 vaccines have shown more side effects i.e., with fever, headache, and fatigue being more common than in other vaccines, which strongly suggest the inflammatory nature of these vaccines.
Trial reports clearly demonstrated that these vaccines produce a predominant Th1 type response producing high levels of TNFa, IFNg, and IL2. This would mean enhanced vigilance for flares in diseases like psoriasis, atopic dermatitis, pemphigus vulgaris, lichen planus, vitiligo, acne vulgaris, neutrophilic dermatosis, and connective tissue diseases that have a proven Th1 role in their pathogenesis.
Even in the absence of specific data, specifically on rheumatologic and autoimmune diseases, the safe tag was given to these vaccines to control global health concern. There are two major concerns for the usage of these vaccines to the people living with inflammatory or autoimmune conditions such as rheumatoid arthritis, lupus, Crohn’s disease, psoriasis; and multiple sclerosis. Two most important concerns are-
● The vaccine might kick off unsafe, aggravated immune responses.
● Efficacy of vaccines may be significantly reduced due to immunosuppressant medications.
Some experts believe on the basis of their past knowledge and experience on other vaccines, that it is doubtful that COVID-19 vaccines may not work very well in the people who are taking immunosuppressive medications. However, that doesn’t mean that the COVID-19 vaccine doesn’t work at all in these groups of people. Let me explain the situation with an example, in a very cold day if you had to choose among an overcoat (fully effective vaccine), a spring jacket (less effective vaccine) and a shirt. What will you prefer? You would definitely go for an overcoat or spring jacket not the cotton shirt.
My only suggestion is to be careful about the unsafe immune reactions. Talk to your doctor(s) and be vigilant during post vaccination stages. At the same time, it is an appeal for the vaccine manufacturing companies and authorities such as WHO, FDA to publish the available data to inform the immunocompromised people about the pros and cons of vaccination.