Health
What is the difference between COVID-19 vaccines?
Dr. Jeff Hirsch
Q: What is the difference between different COVID-19 vaccines?
A: Our immune system, both innate and adaptive, is a protein, whether on the surface of viruses, bacteria, fungi, parasites, other cells, or other proteins. It is designed to identify and attack the “self”. It is called an antigen. When these antigens attach to special receptors on certain special immune system cells, they stimulate the body’s immune response.
The innate immune system is a non-specific defense in which immune cells (natural killer cells and phagocytes) identify and destroy invaders directly (thus, this part of the immune system is particularly active in the skin and gastrointestinal tract. ).
Adaptation (acquisition or learning) systems utilize cells that produce antibodies (specific types of lymphocytes) to tag and destroy invading substances / cells (each antibody is specific for a specific antigen). , Swallowed by other cells of the immune system (macrophages). The immune system “remembers” this antigen (the length of this memory depends on many things), so the body is ready to fight this invader in the future. The goal is to have a neutralizing antibody that effectively destroys the invading antigen.
Vaccines work by “presenting” and “priming” antigens to the immune system, ready to initiate a response to a particular “intruder.” For the SARS-CoV-2 virus that causes COVID-19 disease, the spike protein on the surface of the coronavirus is an important candidate for the antigen used in the vaccine. So how are vaccine antigens “presented” to the immune system?
Inactivated / Inactivated Virus Vaccine: This approach uses an attenuated / attenuated (modified target virus that does not cause disease) or inactivated (“killed”) virus (the target virus is treated to invade cells and prevent it from multiplying) in the vaccine. To do. After injection, this engineered virus presents itself (and its surface proteins, etc.) to the immune system. It is used in annual influenza (because the influenza virus mutates rapidly each year), hepatitis A, inactivated poliovirus, rabies, MMR (measles / hump / rubella), chickenpox and many other vaccines. It’s an approach. The challenge with this approach is to inactivate / kill the virus so that the vaccine can stimulate a strong immune response.
Protein-based: This approach uses specific proteins in the vaccine to stimulate the immune system and is used in hepatitis B, shingles, human papillomavirus and many other vaccines. This approach can also be used to “prime” the immune system to react to disease-causing toxins produced by invading organisms (such as tetanus and diphtheria). The challenge for this approach is to select the right protein that will allow the vaccine to stimulate a strong immune response.
mRNA and DNA plasmid base: To understand this approach (a new new approach to vaccine development), we need to understand how cells produce proteins, the main products that control and execute cell functions. DNA in the nucleus of our cells (from DNA that enters the cell’s nucleus by transfer of our own DNA or DNA plasmid, or even from viruses that enter the nucleus) is a set of instructions on how to build proteins. Protein Code These instructions are transcribed (copied) into messenger RNA, mRNA, and transported from the nucleus to the ribosome (the site of protein production in cells). This information is then translated (read and decoded) so that the correct amino acid sequence can be produced (and then post-manufactured) to produce the protein of interest. When mRNA finishes its job, it breaks down.
This approach “teach” some of the body’s own cells to produce proteins that stimulate the body’s immune system. One of the advantages of this approach is that the virus can create mRNA / DNA plasmids simply by knowing the gene sequence of the pathogenic virus (and understanding the specific sequence that encodes the protein that makes the appropriate antigen). Is not created. There is no need to inactivate / kill or produce specific proteins in the laboratory. However, the particular protein you choose must be a protein that stimulates an appropriate immune response. And the details of how to transfer mRNA (mRNA must be encapsulated in lipid-covered nanoparticles) or DNA plasmid to some of the cells of the body are fairly new techniques (used successfully in other therapeutic approaches). Although).
Viral vector: This approach uses a modified (and therefore carries the DNA of the antigenic protein from the target virus), inactivated virus (not the pathogenic target virus) to infect parts of the body’s cells. It enters the nucleus of the cell, but the patient’s own DNA. Use a normal cellular protein production device (as described above) to create the protein of interest that stimulates the immune system. The viral vector of choice is one that most patients have never been exposed to in the past, so the immune system does not respond to the viral vector itself. Conceptually, this is similar to the mRNA / plasmid DNA approach described above, except that the cells are used to produce the appropriate antigenic protein to which the instructions have been transferred by the modified virus. This is also a fairly new approach to vaccines, but this technical approach has been used in other therapies for decades.
All four of these approaches are being pursued to develop a SARS-CoV-2 vaccine. These are the most distant approaches in the development process, especially in clinical trials used to validate vaccines, as all that is required to initiate the development of mRNA / DNA and viral vector approaches is the gene sequence of the pathogen virus. Is not surprising. It’s safe and effective.
Conclusion: Safe and effective vaccines may soon be approved. In that case, we recommend that you get vaccinated as soon as you get vaccinated. It’s clearly a way to get us out of this pandemic and return to a more normal situation.
correction: Due to a reporting error on my part, my column on December 2 misstated the number of nurses who died of COVID. The column should state that 1,700 health care workers, including 213 nurses, died from COVID. We apologize for the error. I haven’t scrutinized the source of the data enough.
Jeff Hersh, Ph.D., MD can contact Dr Hersh @ juno.com.
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