“Medicine does not offer 100% or 0% sure answers and public opinion must also get used to this relativity, especially today, when we frequently talk about health issues due to the pandemic. Last week there was a lot of discussion about the concerns expressed by some colleagues about vaccines, but an unnecessary fuss was raised. It's no wonder that Professor Crisanti, before getting vaccinated, wants to read the studies on the subject and I want to do it too. Honestly, however, if I were offered the possibility of an anti-Covid 19 vaccine now, I would exploit it. I am very confident in the enormous work that is being done".
Maria Carla King, professor of microbiology, head of one of the most important laboratories for the diagnosis of Sars-CoV-2 in Emilia-Romagna, takes stock with FIRSTonline on the vaccine response to the pandemic nine months after the first wave of Covid which overwhelmed the Italian health system as a tsunami. Are vaccines safe? Should we do them? Should they be mandatory? These are some of the questions we asked the Bolognese virologist.
Professor Re, you say you would get vaccinated, but the controversies on the subject, the conflicting news, do not help citizens choose how to behave in the face of such a big news. To get out of the Covid emergency, do you think it will be necessary to make the vaccine mandatory for everyone?
“I am in favor of vaccines and the concept of prevention and at the moment, I am very happy with the silence of the no-Vaxes. And yes, I believe that anti-Covid should be made mandatory, but not immediately, it will take at least some time to evaluate everything. If the path of persuasion has no results, in my opinion it will be necessary to work on the obligation. Assuming that a vaccine is ready at the end of December as some claim or in January, or even later, various phases will start from that moment. First the purchases and distribution, then a part of the vaccinated population will have to be monitored to understand how the protection works and if one or more boosters are necessary. So we'll see how long the antibodies produced last, because we know that natural ones decrease over time. Here, there will be a lot to verify ”.
Will our lifestyle go back to what it used to be in a few months?
“No, I think not, it will be a long thing. We cannot delude ourselves that the vaccine is coming and we throw away the mask. Some healthy habits we have taken, such as frequent hand washing and the mask will keep us company for quite some time. This virus will not go away."
Companies such as Pfizer and Biontech, Moderna, Astrazeneca have announced, with a certain emphasis, the effectiveness of their anti-Covid products, at the end of phase 3 of the experimentation. Astrazeneca has signaled that it will have to investigate further, but in short, has the famous light at the end of the tunnel turned on or not?
“There is certainly great excitement, many research centers are working on the goal and there are so many hopes. But verifying whether a vaccine will be protective, long-lasting and without side effects requires pre-established times. I understand that today, when we are experiencing a dramatic situation, we would all like to have the answers already in hand, yet, I repeat, we need time to verify whether the antibodies that will be produced will be protective, i.e. neutralizing, how long they will last and more. Even if they lasted for a limited time, it won't be a negative fact because one or more boosters can be expected after the first dose. It happens with many other vaccine preparations. Producing a vaccine is always a long and complicated process."
There is some alarm about the spread of Sars-CoV-2 among minks (starting from Denmark). Is the virus mutating?
“This is an RNA virus so it is a virus that is able, during its replicative cycle, to constantly mutate and is ready to jump species. The mink problem caused quite a stir when Dutch authorities announced that a mink had transmitted the virus to a farm employee. The World Health Organization has announced that since June 2020 there have been 214 human cases of Covid 19 in Denmark with variants associated with farmed mink. The mink could therefore function as a reservoir but also a spill-back from man to the mink cannot be excluded. The risk that an animal population could contribute to amplifying the spread of the virus exists and remains. From the moment a virus or the virus moves between man and animal or between animal and man, genetic modifications can take place and these genetic modifications must be clearly identified and studied. We are well aware that viruses, including SARS-CoV-2, change over time and recent discoveries still need to be well studied in order to understand the impact of new mutations in terms of diffusion, clinical impact, therapy and vaccines. At the basis of everything is the adaptive capacity of viruses. We have to fight with all our strength and use this terrible experience to improve. Human health is closely related to animal and environmental health. Today there is a lot of talk about ONE HEALTH which must involve the collaborative effort of multiple disciplines - working locally, nationally and globally - to achieve optimal health for people, animals and the environment".
What is the consequence of the mutations?
“Simply stated: if the virus were stable, the immunity produced would allow us to have protection against subsequent contacts with the same pathogen. Instead, RNA viruses are viruses prone to mutations, which could be the basis of a varied spectrum of infections. In this regard, it should not surprise us that some scientific works begin to certify a genetic diversity between some viral strains that present a different pattern of mutations, and we will have to verify the situation over time to understand its real/eventual evolution".
Will vaccines also protect us from mutated viruses?
“I am confident, because a constant part of the virus, highly immunogenic, has been used in the vaccine. There are already some experimental works on animals focused precisely on new variants and vaccine efficacy".
Has Professor Re noticed that today many citizens criticize, even heavily, doctors and health professionals who, in the first phase, were considered heroes? How do you explain these behaviors?
“Honestly, I expected it. The quantity of positive elements for human health resulting from research in recent decades is such that public opinion has become accustomed and is no longer surprised by the enormous successes that the healthcare world achieves and their great, positive effects on the health of the man. Indeed, when a clinical situation does not evolve positively, as in general expectations, as if it were a foregone conclusion, then public opinion is immediately ready to bring up the accusation of medical malpractice. Instead, we must realize that we are still far from possessing the necessary and sufficient knowledge to control all pathological situations and that the continuous evolution of uses and customs, the globalization of trade in goods and populations, the continuous change of climatic conditions, places us faced with new causes of disease. In recent months, doctors and health professionals have worked and are working exhaustingly. And this is not today, in this second wave, but since the beginning, demonstrating a great level of professionalism and a sense of duty. Maybe someone doesn't realize what has been done and is still being done. Everyone lent a hand, made themselves available, never looking at the clock and caring for the patients. I think none of the health professionals deserve the criticisms that have been circulated ”.
