COVID-19: UPDATE ON VACCINES - WHAT IF?

In business, preparing financial forecasts, and considering the topics that need to be in a legal agreement, it is important to ask the question "What if?":

• What if such and such happens?
• In particular, what if this goes wrong?

With vaccines, the scientists have been at pains to point out there might never be a vaccine, and in any case Spring 2021 at the earliest.  Why is this?

A vaccine, just like a drug, needs to be both effective and safe, by comparison to the illness being treated.  So, for example, cancer treatments have a lower threshold on safety.

For a COVID-19 vaccine, two key questions come to mind:

1. What if immunity is only achieved for less than a year?  Would more regular injections (or other delivery mechanism) be effective and sensible, given the cost?
2. What if the vaccine causes an over-reaction, such as a cytokine storm, in even a small proportion of people given the vaccine?  COVID-19 is notorious for having a 'second wind' after an initial recovery, which can put people into hospital, such as happened to PM Johnson

The second question in particular would make a vaccine more trouble than it is worth.  The only way either question can be reliably answered is to have a prolonged period of testing.  Months not weeks.

Should any vaccine fail either one of these tests, or indeed many others, it would not be licensed for use.  There are corners which simply cannot be sensibly cut.

CORONAVIRUS COMMON COLDS AS A VACCINE?

There are four types of coronaviruses that cause common cold symptoms, and do not pose a serious threat to health.  I wrote over two months ago about cross-immunity, because there is some evidence that people who have had one or more of these types of colds do not display symptoms of COVID-19 if they become infected with the virus.

The human immune system is complex, and it is thought that T-cells are responsible for this effect, rather than antibodies (produced by B-cells).

Cross-immunity may explain:

• Why around half of people contracting the virus do not display symptoms
• The reduction in infection rates in Sweden suggests there is immunity in the population well beyond what would be expected from the extent of COVID-19 infections

Cross-immunity would potentially open up two options for vaccines:

• People could be given a dose of the relevant cold virus(es) as a vaccine, or
  
• Given in combination with a new vaccine, perhaps a week or two beforehand, to boost the effect
  

I've been keeping my ear to the ground on these concepts, but little.  Anyone heard of any initiatives around coronavirus common colds, especially use as a vaccine?

WOULD A VACCINE BE A PANACEA?

Total eradication of COVID-19 worldwide would take years, if ever.  Vaccinations would need to be made across all populations in all countries.  Otherwise there would always be a threat of infections reappearing in our country.

We already have a vaccine for influenza, but still have thousands of deaths a year in the UK, mainly in the elderly.

Unlike influenza, COVID-19 causes LongCOVID symptoms in all ages, including children when it is called Mutlisystem Inflammatory Syndrome, MIS-C.  Vaccines would therefore need to be given to a much wider group of people than influenza jabs.  Costly, as well as a big logistics issue.

So although a vaccine would make a big change to how we can live with COVID-19:

• We'll still have to live with the threat of COVID-19
• In the coming months before a vaccine we need to adopt other measures

Hence the idea of a series of Enhanced Firebreaks, far enough apart for the economy to thrive in between.