Got lots of interest in my RNA vaccine explainer yesterday. The most common follow up questions generally fell into two categories, well stated in the tweet below. I will answer both. 1/5
First, to paraphrase: “Isn’t it strange for the immune system to deal with a viral protein from RNA in host cells?” Actually, the human immune system has spent millions of years evolving to recognize viruses this way. (Really, vertebrates have spent 500 million years doing this!)
Viruses regularly express their proteins on infected human cells, and the immune system specifically recognizes those foreign viral molecules. Indeed, many viruses are RNA viruses (they use RNA as their genetic material!), so the immune system is specifically good at this job.
Second, “What about long term vaccine side effects?" @DrPaulOffit, one of the top vaccine safety experts in the country for decades, has pointed out that vaccines can cause rare, long-term side effects in people. But, (and this is key)
for every vaccine he could think of, any rare safety issue with a vaccine was apparent within two months of immunization. Hence, a reason for the FDA requesting two months of safety data for the RNA vaccines. This is the reason for confidence. 5/5
1/ Are RNA vaccines safe? I have gotten this question a lot lately, and it is a good question.
2/ First: RNA is messages. At any moment a human cell has 5000+ different RNA messages, and they are all temporary messages, like post-it notes that get torn up by the cells within minutes or hours after being read.
3/ Or, actually, RNA is like snapchat messages that expire. RNA vaccines do NOT become a permanent part of your body. They are temporary messages instructing cells to make one viral protein temporarily.
1/ This paper is the first significant evidence that recent infection with a common cold coronavirus could have a functional cross protective effect against severe COVID-19. “Recent endemic coronavirus infection is associated with less severe COVID-19" jci.org/articles/view/…
2/ The possibility of pre-existing (partial) immunity to COVID-19 has been a hot topic. The presence of cross-reactive memory T cells in a fraction of the population opened the possibility of some degree of pre-existing immunity in the population. nature.com/articles/s4157…
3/ Cross-reactive T cells can provide some degree of protective immunity in flu (Sridhar et al., 2013; Wilkinson et al., 2012). The different ways in which such immunity may manifest for SARS-CoV-2 infection are discussed in: nature.com/articles/s4157…
1/ This is one of the most interesting pre-prints I have seen this past month. I consider this study in two parts. biorxiv.org/content/10.110…
2/ In the first part, Nussenzweig and colleagues show compelling data that memory B cells specific for RBD (the target of neutralizing antibodies against SARS2) undergo affinity maturation over time.
3/ They demonstrate this by cloning mAbs from the memory B cells, sequencing the B cells to show SHM, and characterizing the improved binding capacity of the mAbs.
1/ This is a fantastic new paper in Cell from @PepperMarion showing immune memory to SARS-CoV-2 three months post-infection. doi.org/10.1016/j.cell…
2/ I particularly like that @PepperMarion made the effort to measure memory CD4 T cells and memory CD8 T cells and antibodies and memory B cells in the same people, instead of just a single component of immune memory.
3/ And yes, I am also happy the results are consistent with our pre-print examining COVID-19 immune memory out to 8 months.😀
2/ The AZ Oxford COVID-19 interim efficacy results are 70% overall. That is substantially less than the Pfizer and Moderna vaccines, over short time periods.
3/ There was a small AZ Oxford substudy with a half-dose 1st immunization and an interim efficacy of 90%. That study is much smaller than other studies, and details were not provided (cases etc.), so I don’t make much of that number for now.
2/ We assessed immune memory of all three branches of adaptive immunity (CD4+ T cell, CD8+ T cell, and humoral immunity—both antibodies and memory B cells) in a mixed cross-sectional and longitudinal study of 185 recovered COVID-19 cases, including 41 cases > 6 months post-COVID.
3/ Sources of protective immunity against SARS-CoV-2 may be multifaceted. Therefore, understanding immune memory in a coordinated manner is needed to see the potential complexities and gain insights into the likelihood of durability of protective immunity.