Gamaleya Center Director Alexander Gintsburg: I will bequeath my Covid-19 antibodies to posterity
Photo: Gamaleya Center
The world is on the brink of a third coronavirus wave, Western governments are imposing lockdowns, one after another, and a vaccine war is raging worldwide. No one can tell for sure when the madness will be over. Gamaleya Center Director Alexander Gintsburg talks with Interfax correspondents Andrei Novikov and Olga Gavrilyuk about the prospects for the fight against Covid-19, its new strains, and work on a new universal vaccine.
Question: If we may, let's start at the end, with the recent news that the Argentinean president got sick. In your opinion, has this incident dealt a blow to the reputation of the Sputnik V vaccine? Has it threatened its advancement?
Answer: I don't think so, because there was no actual disease. There was the infection, there was isolation, but he had no treatment and no symptoms during this infection. So this does not just fit into the vaccine's mechanism of action, but at the same time it also underlines the medicine's reliability, proves one of the main conclusions made in the Lancet publication – Sputnik V gives a 100% guarantee against serious diseases that require hospitalization. The Argentinean president is smart man, he made a public statement saying that he was very thankful to Russia and that he understood that had he not been vaccinated, the disease would have likely become grave.
Q.: Is a temperature not a symptom?
A.: 37.3, if it didn't go higher and it is likely that it didn't, is probably not a temperature that can be considered a factor limiting working capacity.
Q.: Much was said about the threat of new strains at the recent meeting of the coordination council for coronavirus response. Will Sputnik V protect against them? Recent studies indicate that the Russian vaccine shows low efficacy against the South African strain of Covid-19.
A.: Just recently we have seen an Argentinean-American publication which, based on a very wide selection of blood plasma samples taken in a number of laboratories in the United States from Argentineans vaccinated by Sputnik, studies the neutralizing activity of these sera for various strains – British, South African and the initial Wuhan. What are the conclusions from this publication, if neither the Gamaleya Institute nor Russian researchers had any relation to it and if they were unable to influence it in any way?
First of all, the vaccine's efficacy against the Wuhan strain has been confirmed 'to the decimal point.' It was also shown that of all vaccines currently in use worldwide, Sputnik V is the most active vaccine, which neutralizes the British strain well. Speaking of the South African strain, Sputnik V antigens are less efficacious against it, just like every other vaccine. However, the sera produced as a result of vaccination with Sputnik V demonstrate half the decline, compared to other vaccines. So, in this regard Sputnik V is far more preferable for vaccination.
Q.: You said that your institute is developing a kind of panacea, a vaccine that can be swiftly adjusted to any strain and even other viruses.
A.: In addition to a vector-based vaccine, we have effectively developed a new technology, which will make it possible to vaccinate people in a way that will induce immune responses not to one variant of, let's say the causative pathogen of Covid-19, but to four-five variants. So, there will be no need to make three, four, five various Sputnik V's. This will be a kind of a cluster warhead. Health Minister Mikhail Murashko backs these developments very strongly.
Q.: When will this universal vaccine appear?
A.: We are now conducting preclinical trials.
Q.: Recently, Sberbank published a study according to which the morbidity level may grow drastically in mid-April. Could you confirm these estimates?
A.: I have seen no well-tested mathematical forecast model. Should Sberbank have had some databases on the basis of which they could be making forecast, I would believe it. But I don't understand where they got the initial data from. And without that, such forecasts look like fortune-telling.
Q.: But still, should we be expecting a ‘third wave'?
A.: I don't like this division. But I can single out several stages of pandemic development. The first stage, if you like the first wave, is the imported infection. We all understood clearly that the sources of infection are international airports where our compatriots returned from foreign countries. Serious sanitary and epidemiological measures were taken; however, from my point of view they could have been even more energetic. People should have been 'fed' with Kagocel and Polyoxidonium, which were tested in 1970s-1980s in organized collectives, in fact on millions of soldiers. These medicines increase the level of interferons, and do it very well. Of course, people would have fallen ill, but there would have been far fewer serious cases.
Q.: But the next stage began.
A.: Yes, the infection began to spread across the country, local hotbeds flared up. We are coping with this thanks to the vaccine, but a new danger emerges and that is animals. The disease may become zoonotic. You see, this Covid-19 gets into various animals. Mink, cats, and dogs do of course get sick. There is a threat of a new variant of the virus emerging, which would be a whole third stage of the infection process; in that case, we will have breeding places for infection in our homes. This danger is obvious today.
Q.: Rosselkhoznadzor, the Federal Service for Veterinary and Phytosanitary Surveillance, has announced the development of coronavirus vaccine for animals. Do you think that their mass vaccination will be needed?
A.: It is likely to be needed. That's very likely. God grant the vaccine will be good and efficacious. However, safety requirements don't have to be that harsh. If a mink or a cat runs a fever for three days, there is nothing terrible about that. Maybe, Sputnik V would be suitable for animals, I have not checked this just yet, let us protect all the people first.
Q.: Could the coronavirus be gone in the future, or will it stay with us forever?
A.: It won't go away.
Q.: But where did Covid-19 come from?
A.: Why? From bats, we believe.
Q.: Not from a laboratory?
A.: In a laboratory you can reproduce the entire evolutionary process that exists in nature, and you won't be able to tell one virus from another.
Q.: Let's get back to Sputnik V. Half a year has passed since the vaccine was registered. Is there any new data on side effects, diseases of those vaccinated, and lethality?
A.: A lot of pharmacological supervision has now been organized for this vaccine. But as far as I know, there are no additional side effects associated with the use of the vaccine in civilian circulation, and we are already nearing 10 million doses or even more. No side effects were found after the first, second and third phases of the trials of this vaccine.
Q.: The thing is that a vaccinated person who got taken to hospital with a cardio-vascular disease starts to think that this is the result of vaccination. Especially, bearing in mind AstraZeneca scandals.
A.: There is no correlation today between what you have said, the possible growth in frequency of thrombembolia and vaccination. There are specialists in various spheres, including cardiologists, in the committee for post-registration observation and adverse effects. Let me say once again, no correlation between vaccination and thrombembolia has been registered in any case. At least not when Sputnik V was used.
Q.: You said that based on your own experience you can guarantee one year of sustainable immunity after Sputnik V inoculation. The Ebola vaccine gives hope for two-year immunity. How often should people be revaccinated?
A.: Things are slightly different here. We will as part of a special study revaccinate those whose level of antibodies has fallen - not to protect them from the coronavirus but to see how fast they develop antibody response. If their antibody response is restored to the protective level after two, three, four days, this means that they have got memory cells. This means their immune response was maintained after the initial vaccination. We will be conducting this research for 12-18 months. Generally speaking, I hope that the vaccine will be effective for not one or two years, but for life. Get jabbed twice, and live five, ten years, more. As I say, I will bequeath my Covid-19 antibodies to posterity.
Q.: When do you expect the registration of the Sputnik Light vaccine?
A.: Upon completion of all stages of the review at the Health Ministry. If everything is successful, it will probably happen around the May holidays.
Q.: Much is being written about the post-Covid syndrome. People showed no symptoms during the disease and then they face disastrous consequences.
A.: This syndrome is poorly studied in clinics. Clinical physicians should work here, but they are busy with other things. They work as ambulance doctors, they are saving people. Tentatively, it can be said to be a dangerous thing. Immune complexes affect blood vessels. Some get strokes, some cardiac arrests, pyelonephritis, or rheumatoid arthritis.
Q.: Why do people who got inoculated fall ill? Does this mean they didn't develop antibodies, is it something to do with their constitution, or did they encounter a more serious strain?
A.: In general, all of these explanations you have given are possible. It's no secret that the constitutions of not absolutely all of those vaccinated react to vaccination then same way. Yes, on average a good protective antibody titer is being established, but as we know, about 8% of people develop a protective level of antibodies not so high as to protect them in all life situations. For example, lengthy contact with an agent or high doses.
Q.: But how can we mere mortals determine whether the level of antibodies is sufficient? Where is the cut-off? What is the 'formula of success'?
A.: Regrettably, we don't have a unified scale, as there are different types of tests. I'm very familiar with two test systems – Nearmedic and Vector-Best. We think that if a person has antibodies 1:400, he is protected, when he has 1:200, he doesn't have antibody protection, and flu-like effects may evolve. But I would like to stress that if a person isn't protected with antibodies, this doesn't means that he isn't protected with memory cells. The level of antibodies may go down in five or six months, but if the vaccinated person initially had a high level, he may develop memory cells, which is one of the main features of the immune system and a goal of vaccination. So, at the second encounter with the agent the level of antibodies will get restored to the protective level within two or three days, rather than within two or three weeks as at the initial contact, and the agent won't have enough time to get from the nasopharynx to the lungs. This means this person, who has good memory cells, will have the disease with flu-like symptoms, rather than lung damage which requires hospitalization and further very unpleasant and serious medical intervention.
Q.: So, this means that a trained immunity evolves. Does this require vaccination? Isn't it better to train it without a vaccine?
A.: A good question. But you should have at least something to train. Let me draw a comparison. You are approaching a barbell weighing 70, 80, 100 kilograms and prior to this you didn't lift even 50 kilograms. As a result you will put your back out, break your spine or do something else. If you have something to train, then go ahead and train. This requires vaccination in order to have something to train.
Q.: Should for example those who had the disease check the level of antibodies before vaccination?
A.: It's possible not to check. You see, on the one hand such people could be protected, that is why they don't need the inoculation. On the other hand, if they get vaccinated the level of antibodies will go even higher. The inoculation will bring nothing bad, I can assure you. This is my honest answer to this question.
Q.: Could those vaccinated transmit the disease?
A.: A person with high antibody titers is a transmitter. If antibodies titers are falling, he may become a transmitter. People around him who aren't vaccinated should observe protective measures. Actually, all should observe them so they don’t fall ill.
Q.: For whom is vaccination ill-advised?
A.: As with other vaccines, for those who have unpredictable allergic complications like angioedema or acute anaphylaxis in their background.
Q.: Cancer, autoimmune diseases?
A.: No, no. Autoimmune diseases – no, but if you have hay fever, when flowering is under way, you shouldn't get inoculated during the exacerbation period, or you are allergic to house dust – don’t do it in winter, do it when you are on a deck-chair in the countryside.
As for cancer, you can do it. But if you are taking cytostatic agents, there will be no effect. You should pause for two or three weeks, so that all of these inhibitors get out.
Q.: Diabetes, cardio-vascular diseases?
A.: People with both diabetes and heart diseases are a priority. If there are stents installed, there will be no negative effect from the vaccination. Acute post-surgery period has passed, everything has healed, the doctor said everything is fine, go get inoculated the next day.
Q.: What will happen when the vaccination is over?
A.: When 60% of adults are vaccinated, then we'll breathe out. Our healthcare system will work absolutely normally. I hope lethal cases will stand daily at 10-12 rather than 300-350. They won't stop altogether, this is impossible, but they will be isolated cases. Herd immunity will allow us to live normally, lift all restrictions. In any case, the vast majority of them.
Q.: The panic over coronavirus worldwide, isn't it excessive?
A.: It is hard to tell. But the scientific element has gone over the past six months. The economic element has come to replace it, and now it's even a political one. Prime ministers are changing, governments resigning over the vaccine. Jules Verne couldn't think this up!