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Friday, July 12, 2024
Dr. Brown — It’s time for universal vaccines for coronaviruses

Evidence from Israel last year suggested the immunity to the COVID virus created by two shots of a mRNA vaccine might begin to wane as early as three to four months following the second shot.

This conclusion was based on significant increases in the number of breakthrough infections among fully vaccinated Israelis, a few of whom developed symptoms severe enough to warrant medical attention. Those observations prompted Israel, and soon other countries, to offer the first booster shots.

Now, Israel has begun offering second booster shots roughly six months following the first one, which poses important questions.

Is the new norm in the management of this pandemic going to be an unending series of booster shots at three-to-six-month intervals? And, if so, with which vaccines – the original ones or vaccines updated to take account of the major variants so far, as AstraZeneca, Pfizer, Moderna and Johnson & Johnson propose? Or is there a better way?

In 2020, a proposal was made to the National Institutes of Health (NIH) in the United States to develop a universal coronavirus vaccine capable of taking on earlier coronaviruses such as SARS, MERS and any COVID variants likely to develop. The aim was to tackle closely related coronaviruses in wild and domesticated animals because those viruses could potentially jump to humans in the future.

Although the proposal for universal vaccines was considered “outstanding,” it wasn’t funded in those early days when the push was on to get simpler effective vaccines into the arms of the public as quickly as possible. Most of those programs were huge successes.

The Omicron variant prompted many scientists, including Dr. Anthony Fauci, the head of the National Institute of Allergy and Infectious Disease (NIAID) division of the NIH, to argue in a recent editorial in the New England Journal of Medicine that the time has come for a universal vaccine.

What a difference two years, several crippling waves and variants have made. What was a clever but unfunded proposal two years ago, is now center-stage and funded.

The reasoning behind the development of a universal vaccine is sound and based on evidence that all coronaviruses share certain highly conserved genomic components that are resistant to mutation, which makes them ideal targets for a universal shot.

These and other selected targets have the potential to create a truly universal vaccine, which would offer us the best chance to get a leg up on this virus without the current prospect of a continuing stream of variants, some of which might be as catchable as Omicron and in the worst case, as lethal as the original SARS.

Universal vaccines are more challenging to develop because they involve characterizing the genomes and proteins of many more coronaviruses than was the case for the far simpler mRNA and the AstraZeneca vaccines, which were based on the original COVID virus in China.

One clever idea is to attach representative antigenic protein components from previous coronaviruses (such as SARS and MERS, and all variants of the COVID virus), to some form of nanoparticle lattice.

It would be constructed so every antigenic protein has an equal opportunity to stimulate the immune system. It’s a bright idea viewed in three-dimensional thinking that perhaps has found its time.

Now that we’ve had a taste of what high-tech targeted COVID vaccines can and cannot do, it’s time to get on with developing universal vaccines. That doesn’t mean we should abandon current vaccines. Omicron has shown how effective the original vaccines have been in preventing serious disease.

The problem is that this virus continues to mutate and surprise us as it so clearly showed with the Delta and Omicron variants and who knows what variants to come.

There have been reports of a variant that combines genomic features of Delta and Omicron, which if true, would be very worrying and a further indication that we are a long way from corralling this virus.

And given the likelihood that sooner or later a really worrisome variant will emerge, it makes sense to develop broad-based, less likely to be circumvented, vaccines and stockpile them for future outbreaks that are sure to come, just as COVID followed SARS and MERS in this century.

The good news is that several universal vaccines are under development and one is in the first stage of the clinical trials process.

Fauci is right: we need universal vaccines.

Dr. William Brown is a professor of neurology at McMaster University and co-founder of the InfoHealth series at the Niagara-on-the-Lake Public Library.  

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