RIO DE JANEIRO, BRAZIL – Ricardo Palacios, Medical Director of Clinical Research at the Butantan Institute, had never seen so much interest in his and his fellow scientists’ work as that which has taken over his conversations with family and friends since the novel coronavirus pandemic swept across the world.
“We never dreamed that people would one day be so attentive to what different research stages, antibodies and words like these mean,” says the head of the clinical trial that will test the coronavirus vaccine developed by China‘s Sinovac Biotech laboratory on 9,000 volunteers. An agreement between the Butantan Institute, owned by the São Paulo state government, and the Chinese pharmaceutical company for the testing and production of the potential vaccine, was announced on June 11th, and on Thursday, July 16th, Palacios said that it is possible that priority groups – elderly, healthcare professionals and people with comorbidities – will be immunized as of the first quarter of 2021:
“If all goes well, considering the epidemiological progression, we may have the vaccine distributed to the priority groups as of the first quarter next year.”
Palacios views as “not very encouraging” the epidemiological projections for the pandemic in Brazil. “The pandemic will continue with great force in coming weeks. If it does, we hope that before the end of the year we will have some effective preliminary results,” said the researcher, whose bets for fighting the pandemic are limited to vaccine research developed around the world. He does not believe, as some colleagues do, in the so-called herd immunity in the case of SARS-CoV-2.
According to scientists, this herd immunity occurs when the number of people resistant to the virus reaches a fraction of the population high enough that the virus can no longer find individuals susceptible to infection.
“We know of four types of coronavirus that cause common colds. Most of us have already contracted these infectious agents, and after a while we become infected again, in a cycle that repeats itself. These coronaviruses will always be present in humankind for future generations,” argues Palacios, who believes the same will be true for the novel coronavirus.
“Existing research studies are showing that SARS-CoV-2 presents this same heterogeneity: not everyone who has been exposed to it will react the same way. Given this parameter, it is hard to believe that we will reach a point of ‘herd immunity’.”
Palacios uses the SARS epidemic in the early 2000s as an example: scientists proved that, six years later, only eight percent of people who developed the severe form of the disease had neutralizing antibodies. “The novel coronavirus is here to stay, the immune response is not like for measles, which you get once and then never again. Herd immunity is a mirage in the case of Covid-19; we will have to rely on a vaccine that will control the disease, but not the circulation of the virus,” he says.
The study coordinated by Butantan was approved last week by the National Commission on Ethics in Research (CONEP) and the National Health Regulatory Agency (ANVISA). To this end, 12 research centers were activated in São Paulo, Rio de Janeiro, the Federal District, Minas Gerais, Rio Grande do Sul and Paraná. The 9,000 volunteers must be healthcare professionals working to fight the coronavirus, but who have not been previously infected.
Palacios says the vaccine development is well advanced because Sinovac had already developed a similar process during the SARS epidemic in the early 2000s. The vaccine for Covid-19 is expected to be administered in two doses – the second between 14 and 28 days after the first. Research by the Butantan Institute and Sinovach will be the second in the world to enter the third and final stage of trials starting next week – the other in this stage is the vaccine developed by Oxford University, UK, in partnership with UNIFESP (São Paulo State University).
“Before the end of the year, we should have some effective preliminary study, which is absolutely unbelievable if you consider that we learned of the novel coronavirus in the last days of 2019. It’s something new and it shows that the scientists’ global coordination is working,” celebrates the researcher, who stresses that this technology will control the disease, but not the virus. “The great achievement of the influenza vaccine, for instance, was to prevent the person from being hospitalized or dying from the disease when contracting this virus,” he says. That is what we can expect from Covid-19 vaccines, he said. Yes, in the plural.
“Sinovac technology is very good in generating antibodies and neutralizing the virus. One question we have is how long these antibodies will last. We don’t know yet,” Palacios explains. He recalls that many vaccines, such as for Hepatitis B or HPV, have immunization boosters from time to time. “Maybe all those vaccines [against the coronavirus] need boosters. And it’s possible to cross-boost, that is, I’ll take Oxford’s and then Sinovac’s.” In addition to this issue, he stresses that “the world needs many vaccines”: in Latin America, only Brazil, Argentina, and Mexico have manufacturing plants capable of producing vaccines; on the African continent, only South Africa. “We should not only think about how to address Brazil’s needs, we need to address the rest of the region and Africa as well. These vaccines are here to stay.”
The researcher used the opportunity to underline the importance of Brazilian science and public institutions in the response to the coronavirus. Not only Butantan, but also the Oswaldo Cruz Foundation (Fiocruz), ANVISA, public universities… “And in the heart of all this, the SUS (National Health Service) has been enduring. We were not forced to decide who would live and who would die, as in Italy or New York, because of lack of ventilators”, he argues, although the situation is very unequal across the country and cities like Manaus, Fortaleza or Rio having had waiting lists for ICUs.
According to Palacios, people should “feel unprotected” by the dismantling of Brazilian science, which has been undermined by multiple cuts in budget and research grants in recent years. “Since 2009 we have had swine flu, zika, ebola, dengue fever, and yellow fever outbreaks… This is serious, it’s not casual. We are constantly eliminating outbreaks, and they are different emergencies,” he says. “Science, in the broadest sense, is an asset for a country. It’s what will differentiate which one progresses and which one stays behind.”
Source: El País