December 21, 2021
Started in February 2020, the SAJO blog is providing a thread through the pandemic with up-to-date information and suggestions around SARS-CoV-2.
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Once in a while people ask us about the in Germany falsely named “dead vaccines”. These seem to be all the rage for anxious lay virologists. Thus, here is a little history of vaccines.
The first agent against smallpox – variolation
For many centuries the smallpox (variola) was an immense scourge for mankind. Highly contagious and in most cases deadly. People were so frightened that they would prefer a means, called variolation, over the virus itself. What is variolation? For variolation, dried pustules of smallpox survivors were finely ground and then applied through the nose of the person to be “protected”. You should know that the characteristic rash in smallpox victims was chock-full of virus. The drying process inactivated most of the virus, but not all of it. We don’t talk of current medical application methods here. One in ten of those receiving a variolation developed the disease, and most of these died. However, the risk of dying from variolation still was lower than death from the “true” smallpox. That was the situation then. Today, no-one can imagine this.
In the late 18th century, an English country doctor observed that milkmaids (these were other times) did not die from smallpox. During their hard work with the cattle, they had acquired cowpox. Cowpox is a painful but not a deadly disease. Edward Jenner concluded that a bout of cowpox protected from smallpox. In an experiment which nowadays would be considered outrageous, he could prove this. From that moment on the process with the name vaccination was adopted widely across Europe. With great success. And with a small but up until today felt side effect. Vacca is Latin for cow. Hence, people then feared they would acquire attributes of the cow upon vaccination. There are countless pictures showing this. This was the origin of the antivaxxers. The “side effects” of an infection were duly ignored by these people. This is still the case today.
The vaccination with cowpox was done with a fully active virus. This virus caused a far milder disease than the much-feared deadly variola virus. The immune system mounted a defense against cowpox, which then protected those vaccinated from the close relative smallpox.
The end of this story is known. Today, there is no more variola in humans. Smallpox is the first infectious disease eradicated by vaccination. For decades now, children no longer receive a smallpox vaccine. We are old enough to see the scar in our upper arms. It accompanies us as a memento. We are virologists.
Two more viral pathogens afflicting humans may be eradicated in the coming years. This requires a global cooperation. What human pathogens can be eradicated? Only those who are limited to human hosts. There are some viruses that cannot infect other species. The smallpox belonged to this group. Two other members are measles virus and poliomyelitis virus.
Massive vaccination campaigns have put their numbers down significantly. Poliomyelitis, also called infantile paralysis, is now found only in two countries worldwide: In Pakistan and Afghanistan. With all the unrest and war this will continue to be the case. This cruel disease is called infantile paralysis because it is such an infectious agent, that it infects the youngest already.
And now, we come to the second vaccine story. In the 1950s Albert Sabin had developed a vaccine against Polio, which as the original cowpox vaccines would probably not get approval today. It was highly effective, though. The vaccine was not based on a closely related virus. It was the true pathogenic virus itself. However, it was changed through multiple rounds of passaging in tissue culture, thereby losing its pathogenicity. This process is called attenuation. The immune system now had enough time to mount a defense, erasing the virus before the onset of symptoms. Maybe you are old enough to remember the “oral vaccination”. A sugar cube rinsed with some liquid. One wanted side effect with this attenuated virus was its fecal transmission. Thus, other people got “vaccinated” with the attenuated virus.
This now leads us to the so called “dead vaccines” many of the self-proclaimed vaccination skeptics are talking about. Killed vaccines exist for bacterial pathogens. The pathogenic bacteria are being grown and then killed chemically. For viruses this term is senseless. There, correctly we are speaking of inactivated vaccines.
But let’s stick to the term, since it would include much more than inactivated viruses, “dead” comprises everything incapable of replication. Hence, the vaccines made by Johnson&Johnson, AstraZeneca, BioNTech/Pfizer, and Moderna are “dead vaccines”. They cannot multiply. The question now would be, what are all those preferring a “dead vaccine” waiting for? It is here, already!
Finally, a short explanation of vaccine effects. A chemically inactivated virus – no such vaccine is approved for COVID-19 in the EU – is deceiving the immune system by pretending being a pathogen, but without an infection of a cell. The vaccine is circulating, thus activating the immune system. This results in antibody production mainly. A vaccine which enters a cell is providing a huge advantage. The viral proteins are produced by the cells of the body in the same way as it happens with a true viral infection. A strong T-cell response is the bonus result. Such T-cells are killing infected cells. You then have a two-pronged attack against the intruder. This is the reason we prefer the mRNA vaccines. For kids as well.
The Omicron variant will rush through the young generation like a wildfire. Even with a lower average risk of severe disease in children, the sheer number of infections will tell a different story. Don’t fool yourself: While our neighbor countries are registering steep increases in Omicron cases, this is not found in Germany for one reason only: Too few positive PCR samples are being sequenced. In the US, last week only few Omicron cases had been reported. As of today, 70 % of positive samples register as Omicron. This variant is spreading at a scary pace.
Please, celebrate the holidays in safety. You know what to do, since you are reading our blog. Should you plan on a family event, all participants should get a PCR test two days in advance and stay home in self isolation until going to the party. Those tested positive cannot attend, as well as their whole household. Quick tests won’t give you the certainty you need. You don’t want to give viral presents.
In other words: For those of you who are uncertain: If your PCR-test is negative, and you do not have contacts until the feast, you may celebrate without N95-masks indoors. Required is a negative PCR test of all participants.
We wish you HAPPY HOLIDAYS and a HAPPY NEW YEAR!
Yours, Joerg and Sabine
SAJO – for a healthy and better future!
SAJO is consulting all around infectious diseases. We are applying our know-how, that we have acquired in more than 20 years. We do what we can to fight this pandemic.
We thank Oliver Hoogvliet for his wonderful cartoons. It is always a pleasure! ollihoo (https://hoogvliet.de).
This is post No. 206. To our delight our blog is receiving a lot of acceptance, we love to share our know-how and expertise. Please feel free to share the link – it is an informative tool to fight this pandemic. We would appreciate, if our German colleagues in medicine and politics cited us when retrieving information from here.
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