Introduction:

 

Many or several newly developed vaccines were used for the past two months that were approved by the US-FDA for emergency use ( EUA ) as preventive measures for protection against CoViD19. 

And several peer-reviewed studies had shown that the new CoViD19 vaccines serve their purpose well enough but recently the effectiveness and efficacy of the vaccine were put to the test by the newly emerging variants of the SARS-CoV-2 virus. 

Thanks to the genomic surveillance monitoring of several scientific groups that keeps an alert eye on the genetic variations of the novel virus as it continues to circulate and infects people around the globe. As it is now observed that the newly developed vaccines had little or probably will not work against the newly emerging strains or variants of the novel virus.

Since the start of the novel pandemic last December of 2019, people around the world desperately clamored and wanted a definite treatment for CoViD19, and health authorities of many wealthy nations in collaboration with big pharmaceutical industries recently develop novel treatment strategies against SARS-CoV-2 such as antivirals, immune modulators,  monoclonal antibodies or mabs and especially the most awaited part which is the availability of the vaccines that can be used as more of a preventive approach. The new vaccines if given to the general population will result in the ultimate goal of ” herd immunity ” and that can protect us from the onslaught of the novel virus.

The general public is well aware of the fact that many repurposed drugs are used for the treatment of the novel disease and that the vaccines were made available to the population at lightning speed pace. Everybody relies too much on the availability and the effectiveness of the vaccines as a preventative approach in the mitigation of the viral spread. And as the newly developed vaccines were used and inoculated to the privileged recipients globally, multiple problems were encountered by health authorities in their respective locales.

 

Aside from the grim reality that many cannot avail of the vaccines may be due to the limited vaccine supply, its high price, hard-to-reach areas/locations, racial/ethnic disparities, non-availability of vaccine storage, or for any other reasons. But the big problem occurred from the serious adverse effect or event observed by some vaccinees post inoculation that was so serious enough that it kills the recipient/s although it was stated that the adverse event is very rare.

 

In anyways the vaccine strategy and protocol really does serve their purpose for many patients were saved from the disease and the benefits outweigh the risks. But as many had observed that the newly developed vaccines with regards to their effectiveness and efficacy wane over time as the new SARS-CoV-2 variants are emerging fast with a high transmission rate and causing more severe disease manifestation to the susceptible person. The big question now is how will the human race keep up with the emergence of a highly transmissible variant that causes increasing disease severity. Please keep reading as health experts and vaccine scientists devise a strategic plan to address such a problem.

 

Ingeniously, Innovatively Novel Vaccine Measure And Strategy Against Emerging SARS-CoV-2 Variants:

1.) Heterologous Prime Boosting.

Is an ingenious innovative strategy designed to increase the efficacy and effectiveness of the novel vaccines against the newly emerging SARS-CoV-2 variants that are now circulating and cause an increasing disease severity with a high person-to-person viral transmission rate.

Heterologous prime boosting is a countermeasure technique whereby using two alternating different CoViD19 vaccines. The patient or vaccinee will be given an initial CoViD19 vaccine to initially trigger or prime an immune response then after  4 to 12 weeks the vaccinee will receive another different type of vaccine as a second dose injection or as a booster injection to further mount a robust immune response. So the patient can receive an mRNA Astrazeneca vaccine as a first dose and then on the 4th to 12th week after the first vaccine injection the recipient will receive a Pfizer BioNTech or a Johnson & Johnson Janssen viral vector vaccine or a protein subunit vaccine in the form of Novavax injection considered as a second or booster dose vaccine injection. Heterologous Prime boosting or COM-COV 1 and 2 ( Comparing CoViD19 Vaccine Schedule Combinations ) Vaccine Trial 1 and 2 are currently being studied by the Oxford Vaccine Group in the United Kingdom. The Chief Investigator of the study is Associate Professor Matthew Snape and funded by the Vaccine Task Force and The National Institute for Health Research ( NIHR ).

 


A.) The COM-COV 1 Vaccine Trial enrolled 820 participants and uses two UK vaccines that were approved to stopped CoViD19 namely AstraZeneca ChadOx1 nCoV-19 ( weakened version of a common cold virus or adenovirus ) and Pfizer BioNTech BNT162b2 ( messenger RNA vaccine ) mRNA vaccine. 

The trial is designed to gather sufficient data with regards to the extent of how robust is the immune response or antibody production of the participants during the first or prime vaccine injection and then will subsequently receive a second dose or booster with a different vaccine on the 4th and 12th-week vaccine schedule. The study will also tell the investigators with regards to the varied side effects of the different vaccines given and will give important data that will improve the rollout of vaccine schedule including creating a flexible vaccination activity and strategic plan.

B.) The COM-CoV 2 study is a double-blinded clinical trial that approximately involved 1050 participants who were already vaccinized or have already received the first dose of either Pfizer BioNTech and AstraZeneca vaccines 8 to 12 weeks before. If the participants were able to pass the clinical trial’s screening process, then they will eventually receive the trial boost or second dose vaccine injection of either the Moderna, AstraZeneca, and Novavax vaccine and that is if the participant had already received an AstraZeneca vaccine as the prime initial dose. Then if the participant already received a Pfizer BionTech vaccine, the trial boost vaccines to be given are either Pfizer BionTech, Moderna, or a Novavax vaccine for that matter. It has also a similar purpose to COM-CoV 1 Trial.

 

My take-home message to you is, we cannot overemphasize the non-pharmacological approaches and strategies ( 6 feet physical distancing, proper washing of hands, wearing of face-mask and face-shield, avoid attending super-spreader events, self-isolation, and quarantines, etc…) as one of our measures in mitigating the CoViD19 viral spread and our experience the previous year of 2020 tells us that non-pharmacological measures were effective and the introduction of vaccines coincidentally happened in the time where there is some sort of an increase case rate or up-surge of CoViD19 infection and transmission of new variants of SARS-CoV-2. And due to the novel design of the vaccines, some health authorities speculate that the novel vaccines for CoViD19, when given to the recipients will result in an increase number of asymptomatic carrier and can transmit the virus to the unvaccinated population where it can cause CoViD19. Remember that new vaccines develop for CoViD19 can’t stop the viral transmission but can decrease the severity of the symptoms. The vaccines are there to protect, decrease hospitalization and death from the novel disease, thus lowering the heavy burden of our healthcare facilities and industry but if we lower our guard against CoVid then the novel CoViD19 vaccines won’t serve their purpose. And if possible it is a must to vaccinate the whole 70% of the population or more than that number to achieve ” herd immunity ” but it would be impossible because of the vaccine’s limited supply. And one of the solutions to that problem is to have a constant supply of cheap readily available vaccine in every country and locality, therefore it is highly recommended that there should be a facility or facilities in every locality or country that produce a cheap effective, and more stable vaccine especially nowadays were low-income countries are struggling to get CoViD19 vaccines from wealthier countries. But I think the development of a very new, cheap, highly resilient, and stable vaccine that uses chicken eggs to produce will solve the problem of limited CoViD19 vaccine supply. The most awaited CoViD19 vaccine…is the Newcastle disease virus-HXP-S or NDV-HXP-S or Hexapro vaccine was created by Dr. Jason Mclellan a structural biologist at the University of Texas at Austin USA. The vaccine is currently having ongoing studies in countries like Mexico, Vietnam, Thailand, and Brazil. These countries will have their own production of cheap and effective CoViD19 vaccines soon. Can we follow the footsteps of the above-mentioned countries? so that we can also have an effective, cheap, and stable supply of vaccines soon and in the future as preparation for the next pandemic. Self-reliance and sustainability is the most important keyword here. To reiterate…kindly don’t forget the innovative heterologous prime boosting measures or vaccine combination strategy.

Thank you for your time spent.

Keep safe Always…

Laertes B. Amihan MD