The vaccine is coming back

Octavian Dan
English Section / 22 august 2023

The vaccine is coming back

Versiunea în limba română

The nightmare of humanity from the past three years is resurfacing this autumn. The pandemic and vaccination have managed to disturb, divide, and isolate humanity in recent years. Just as visible and invisible wounds had started to heal, the issue is back in focus. For the approaching autumn, there is talk of a new vaccination campaign, blame being placed on some brand-new variants of the coronavirus. As we have learned, nothing is too far-fetched in this story, and the fact that a vaccination campaign is being prepared in the US doesn't provide enough distance to spare us from questioning. The Biden administration intends to urge all Americans to receive an additional coronavirus vaccine this fall to counteract a new wave of infections, according to a White House official, as reported by Reuters. The official noted that although the Centers for Disease Control and Prevention report an increase in the number of infections and hospitalizations due to the virus, the overall level remains low. Last week, Moderna (MRNA.O) announced that preliminary data showed its updated COVID-19 vaccine is effective against the "Eris" and "Fornax" subvariants in humans. Moderna and other COVID-19 vaccine manufacturers, such as Novavax (NVAX.O), Pfizer (PFE.N), and the German partner BioNTech SE (22UAy.DE), have created versions of their vaccines targeting the XBB.1.5 subvariant. Pending approval from health regulatory authorities in the United States and Europe, companies expect the updated vaccines to be available in the coming weeks for the autumn vaccination season.

On the other hand, the World Health Organization and the US Centers for Disease Control and Prevention (CDC) have announced that they are monitoring a new variant, BA.2.86, which carries multiple mutations of the virus causing COVID-19. At the same time, another variant named Eris is beginning to gain prevalence among infections in the US and Europe, with an apparent increase in hospitalizations. Reuters briefly outlines what is known about the two new subvariants of the Omicron strain. Cases of BA.2.86 infection have been detected in four countries since the end of July. Scientists are keeping an eye on this subvariant as it possesses 36 mutations that differentiate it from the dominant XBB.1.5 variant.

So far, there is no evidence that BA.2.86 spreads faster or causes a more severe illness than previous Omicron variants, and the CDC has stated that its COVID protection advice remains the same. COVID infections and hospitalizations have increased in the US, Europe, and Asia, with several cases in recent months attributed to the EG.5 "Eris" subvariant, a descendant of the Omicron lineage that first appeared in November 2021. In this situation, the trajectory of BA.2.86 "does not look good at this moment," given the speed at which new cases are being identified, according to Dr. Eric Topol, a genomics expert and director of the Scripps Research Translational Institute in La Jolla, California. Its numerous mutations make BA.2.86 "radically different in its structure" compared to previous variants, Topol emphasized. The main question, the researcher added, is whether BA.2.86 will prove to be highly transmissible. Doctors have reported that patients seen in recent weeks, as the Eris variant has spread, are not more seriously ill than those treated during previous waves of the pandemic. A broader spread of BA.2.86 would likely cause more illnesses and deaths among vulnerable populations, warns Dr. Topol. However, it is too early to determine if BA.2.86 will cause a more severe form of the disease.

Vaccination Seen as the Only Solution

Due to pandemic restrictions, it's possible that a year or more has passed since many individuals were either previously infected or vaccinated against COVID. "The vaccine will still provide you with significant protection against the disease and death," says Dr. Long. Updated booster vaccines for COVID that are currently in development are designed to target the Omicron XBB.1.5 subvariant. Moderna has stated that preliminary test data suggest its latest vaccine version is promising against both Eris and a related variant called Fornax, which has begun to circulate in the US. Pfizer, in turn, has reported that its updated COVID-19 vaccine has shown neutralizing activity against the Eris subvariant in a mouse study.

The World Health Organization has classified the EG.5 coronavirus strain circulating in the United States, China, and European countries, including the UK, as a "variant of interest," but noted that it does not seem to pose a greater threat to public health than other variants. The rapidly spreading variant, which is now the most prevalent in the United States, accounting for an estimated over 17% of cases, has caused increases in hospitalizations across the country, according to the latest estimates from the US Centers for Disease Control and Prevention (CDC). The EG.5 variant has also been detected in China, South Korea, Japan, Canada, and European countries such as the UK, Ireland, and France, as reported by Reuters. "Available evidence does not suggest that EG.5 presents additional risks to public health compared to the other Omicron sublineages currently circulating," stated WHO in a risk assessment declaration. A more comprehensive risk assessment of EG.5 is necessary, the Agency noted. However, there is hope that this wave of new cases won't be as severe, says Dr. Anne Hahn, a postdoctoral associate in the Department of Microbial Disease Epidemiology at the Yale School of Public Health.

Virus levels detected in wastewater in August are approximately the same as in March, according to Biobot Analytics data. WHO Director-General Tedros Adhanom Ghebreyesus lamented the fact that many countries have not reported Covid-19 data to the Agency. He stated that only 11% have reported virus-related hospitalizations and intensive care admissions. In response, WHO issued a set of ongoing Covid recommendations, urging countries to continue reporting data, especially mortality data, morbidity data, and to maintain vaccination programs.

The Covid-19 pandemic has killed over 6.9 million people worldwide, with over 768 million confirmed cases since the virus's emergence. WHO declared the outbreak a pandemic in March 2020 and ended the global emergency status for Covid-19 in May of this year.

A New Pandemic in 2028

Scientists are already preparing for a possible future coronavirus pandemic that could strike in 2028, suggesting a seven-year cycle predicted since 2004. Meanwhile, researchers have discovered a new target for the development of more effective drugs against current and future coronaviruses. The Covid-19 pandemic is still ongoing, but scientists are already preparing for the next one, if the worrying trend continues. Researchers from Northwestern University's Feinberg School of Medicine believe there is a pattern, with a seven-year cycle starting from 2004 with the severe acute respiratory syndrome (SARS) epidemic in China, followed by the Middle East respiratory syndrome (MERS) epidemic, and then Covid-19. This pattern suggests that another coronavirus epidemic could arrive in 2028. Despite these unsettling assessments, the study's authors have identified a new target in the fight against Covid-19 and future coronaviruses. "We hope we don't need it, but we will be prepared," said Karla Satchell, a professor of microbiology and immunology at Feinberg, who leads an international team of scientists analyzing critical virus structures. The Northwestern team previously mapped the structure of a virus protein called nsp16, present in all coronaviruses. This new study provides crucial insights that could aid in the development of drugs against future coronaviruses, including SARS-CoV-2. The study reveals a key pocket in a specific protein that helps these viruses function and infect humans. Researchers believe that developing drugs targeting this pocket could prevent future coronavirus strains from becoming lethal. "The idea is that this future drug would act early in the infection. If someone you're close to gets infected with a coronavirus, you could run to the pharmacy to get a drug that needs to be taken for three or four days, and if you do get infected, the disease won't be severe," explained Prof. Satchell.

The international team mapped three new proteins using 3D technology to understand which structures are important for these pathogens. They discovered a "hidden pocket" with suitable properties for binding a ligand in the internal functioning of the virus, allowing it to evade the human immune system. This specific coronavirus pocket resides in the nsp16 protein, which is present in all coronavirus strains, not just SARS-CoV-2. This pocket binds a fragment of the virus's genome, held in place by a metal ion. The virus uses this fragment as a template for all its viral components. The study's authors believe there is a good chance of creating drugs that target this pocket and block the function of the nsp16 protein, without affecting the function of normal human proteins that lack this compartment. Nsp16 is considered one of the key viral proteins that could be inhibited by drugs to stop the virus shortly after a person is exposed. The aim is to halt the virus early, before people become seriously ill. With few studies done on nsp16, Prof. Satchell's team worked to generate critical information about this protein and collaborates with chemists who will use this information to design drugs against the protein. While some coronavirus proteins vary greatly, nsp16 is almost the same in most of them. Moreover, the unique pocket discovered by Satchell's group is present in all different members of the coronavirus family. This means that drugs designed to fit this pocket should work against all coronaviruses, including against a virus that will emerge in the future. And it should work against the common cold caused by a coronavirus. Researchers anticipate that any drug developed following their discovery of the coronavirus pocket will be part of a treatment cocktail taken by patients at the early stages of disease progression.

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