Asparuh Iliev: Covid-19 vaccines are well-established

SARS-CoV-2 mortality rate is between 10 and 50 times higher compared to that of the flu

Photo: Personal archive

Epidemiology has been a legitimate field of science going back centuries. Containing the spread of viruses transmissible by air invariably includes social distancing, isolation and personal protection equipment in combination with vaccines. In that sense, the strategy is pretty clear. We are extremely fortunate in this misfortune as the current pandemic does not involve a devastating virus such as the Spanish flu, says Bulgarian doctor and scientist Asparuh Iliev in an interview to BTA newswire.

A year and a half into the pandemic, we are facing yet another global surge in cases. What have scientists learnt about the novel coronavirus during that time?

In the early days of the pandemic, both professors and regular students were learning the same way about the characteristics of the SARS-CoV-2 virus and epidemic - on the fly. On the other hand, the coronaviruses are not a new phenomenon; we have known about them for decades. Having previously studied the Severe Acute Respiratory Syndrome (SARS) and the Middle East Respiratory Syndrome (MERS) viruses, we were able to make a giant leap in our response to the current outbreak. In a nutshell, we are dealing with a virus mutating at a moderate speed - it is transferred through the air in droplets or smaller aerosols and attacks primarily the blood vessel and lung cells but can also penetrate the brain. The human body is able to build up an effective immunity after recovery, which is something we utilised in the creation of vaccines. The actual disease has two stages - in the first, the patient develops symptoms affecting the lungs and the upper respiratory tract, and in the second (which starts about a week later) - the body's hyperactive immune system produces a large quantity of inflammatory substances that can cause damage in their own right. Patients develop the so-called interstitial pneumonia, which is typical for viral diseases. While we know for a fact that the virus originally came from bats, we are still uncertain as to how it developed the ability to infect people. While such mutations typically occur naturally (as was the case with the first SARS virus strain), with this virus there is some doubt as to whether there was human interference. However, this question is unlikely to ever be definitively answered. The SARS-CoV-2 mortality rate is between 10 and 50 times higher compared to that of the flu.

What is the best method of containing the spread of the virus?

Epidemiology has been a legitimate field of science going back centuries. Containing the spread of viruses transmissible by air invariably includes social distancing, isolation and personal protection equipment in combination with vaccines. In that sense, the strategy is pretty clear. We are extremely fortunate in this misfortune as the current pandemic does not involve a devastating virus such as the Spanish flu.

The sentiment of mistrust surrounding the vaccines stems from their relatively quick development and approval for use. What does the science say about this?

The reasons for this mistrust are complex and cannot be reduced to a single one. Certainly, the seemingly quick development process may look suspicious to some people. However, the truth is that both the mRNA and the viral vector vaccines rely on well-established technologies that are over 20 years old, extensively tested and researched. In some version or another, the mRNA technology has been tested in the development of cancer vaccines and other vaccines fighting infections. Earlier studies of the SARS and MERS coronaviruses taught us the weak spots that a future vaccine should target. When this current pandemic hit, we were fortunate enough to have the data and technologies to shorten the initial phase of vaccine development from years to days. This is the reason behind the lightning speed of development - no stage of testing or monitoring the safety of the vaccines was skipped or rushed.

What is the scientific community's response to mistrust bred by reports of severe and even fatal cases among fully vaccinated people across the world?

These are extremely rare instances observed mainly among elderly people with weakened immune systems or immune system disorders. Unfortunately, there will always be such cases. The science is very familiar with this phenomenon. However, it should not erode confidence in the vaccines in any way since the statistics are quite conclusive - almost all cases with a fatal outcome involve unvaccinated people.

How far along is the process of developing effective Covid-19 therapeutics?

Numerous companies are working on drugs intended to suppress the infection with the Covid-19 virus and the development of the disease. The process is pretty far along. The drugs approved so far are based on antibodies (very similar to those produced by the body after vaccination or recovery) that block the virus and prevent it from infecting other cells in the body. As you can imagine, the artificially created antibodies need to be introduced very early on in the infection (preferably, immediately after exposure to the virus). Unfortunately, those therapies are very expensive and the companies are yet to develop the necessary production capacity, which is why we cannot rely on them for large-scale treatment at this point in time.

The coming cold season is normally associated with the arrival of flu virus strains. Do experts advise people to take a flu shot as well? Are there studies on the compatibility of Covid-19 vaccines with flu shots?

Wearing masks and social distancing were quite effective measures in preventing a surge in flu cases last winter. As some scientific studies show, masks are especially effective in stopping flu viruses. There is no reason to be apprehensive when it comes to vaccine compatibility; the human immune system is remarkably flexible and cannot be overwhelmed by the presence of two vaccines. Babies are sometimes given vaccine shots protecting against seven microorganisms at once, and there are no issues with that. Waiting several days between taking the second vaccine is all the precaution you need. Many people got their flu shots last autumn and then got the Covid-19 vaccine several months later without issue. An interesting study among 74,000 people who had taken the flu shot showed that those people were far less likely to develop a severe case of Covid-19 - a result that was pretty unexpected and intriguing. I would like to remind that the flu is a seasonal virus, which is why vaccines against it are best taken in September/October.

(The interview was originally published by BTA)

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Born in 1975 in Sofia, Asparuh Iliev graduated from medical school in 2000. His career eventually took him to Germany and Switzerland. Presently, he heads a brain infection laboratory with the University of Bern. His scientific work is focused in the field of neuroimmunological and infectious diseases. In 2014, he worked as an expert at the department of vaccine safety with the German vaccine agency and the European Medicines Agency. He has academic ranks in two fields - pharmacology and toxicology (University of Würzburg, Germany) and anatomy and histology (University of Bern, Switzerland). Over the years, he has done clinical work in the field of internal diseases.

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