"Top of the iceberg": Academician Karaulov on cellular immunity and features of vaccination against COVID-19

- What is known today about immunity after COVID-19?

How long does it last, and what does it depend on?

- In case of a viral infection, the antibody, or humoral, immune response, which is so much talked about now, is by no means the leading one.

It is much more important to talk about the cellular immune response.

Including about T-lymphocytes - memory T-cells, which are formed in this case.

It is they that make it possible to effectively fight the virus when it re-enters the body.

In some of the COVID-19 patients, T-helpers were not found at all - T-cells that are specific for a significant fragment of the famous "thorn" of the coronavirus.

It would seem that everyone who has been ill should have them, but this is not at all the case.

- So the presence of antibodies is not an indicator of protection against coronavirus infection?

- Sechenov University, together with Vienna University, is conducting a study, according to which, in half of people, antibodies do not prevent the possibility of re-infection.

In Hong Kong, we saw a case of infection with two different variants of the virus that did not differ much.

However, so far not a single case of a repeated illness in a severe form has been registered.

That is, re-infection, if it happens, then it is not so critical for a person.

• The presence of antibodies is not a guarantee of protection against re-infection

• RIA News

• © Alexey Maishev

- In Russia and in the world, different anti-toxic vaccines are at different stages of development.

What can you say about domestic developments?

- We support the referral of our colleagues and friends from the N.F. Nizhny Novgorod Research Center for Epidemiology and Microbiology.

Gamalei.

Sputnik V is a well-known and secure platform.

This vaccine is already in its third phase of clinical trials.

Also, the Novosibirsk State Research Center "Vector" completed the first phase of clinical trials.

- Are the criteria for the upcoming vaccination already known?

“We believe that it is Sputnik V that will help define scientifically substantiated vaccination criteria and risk groups.

We also need to wait for the data from the Russian herd immunity study, which is assessed by the Ministry of Health and Rospotrebnadzor.

As for the coronavirus, it is very important to evaluate everything in a complex

We know many patients who were tested out of interest and identified as asymptomatic carriers.

But antibodies are a mute witness to the transferred infection, but nothing more.

- Is there already an understanding of how long the vaccine will work?

- There is a discussion on this issue now.

Six months or two years, for example.

To understand, it is necessary to look more at memory cells, at the mechanisms of cellular memory.

- What factors can be decisive for making a decision on vaccination?

And who exactly shouldn't be vaccinated?

- World practice shows that research on this topic should be continued.

Limitations may apply to small groups with primary immunodeficiencies.

At the same time, autoimmune, rheumatological and even oncological diseases will not be a contraindication.

First of all, we, of course, are guided by the instructions of the Ministry of Health after the third phase of vaccine research.

- What is known about the compatibility of influenza and COVID-19 vaccines?

- We recommend getting the flu shot now.

Because after four weeks, you can also vaccinate COVID-19.

Our vaccine ("Sputnik V"

) involves two injections 21 days apart.

Also, the pneumococcal vaccine, if someone from this risk group, can be vaccinated today.

- What else does science need to learn about coronavirus?

What tasks need to be solved in order to make it understandable and to deal with it most effectively?

- This is a very unusual virus, due to which we are faced with phenomena that have never been seen before.

First, with the escape mechanism of the coronavirus from the immune response.

The body reacts compensatory with excessive inflammation, which can be fatal.

Secondly, it is immunothrombosis - that is, increased blood clotting.

Leads to the death of many people from concomitant diseases.

And the third is a violation of the regulation of the peptide system through which the virus passes.

Hence, the symptoms are different, a severe course of infection with concomitant diseases and age.

Studying such a virus is an endless process.

It is associated with improving diagnosis and treatment.

It is no coincidence that our Ministry of Health has already issued eight temporary guidelines for the prevention, diagnosis and treatment of coronavirus infection.

And around the world, about 100 vaccines are being developed.

- Is this number of approaches beneficial?

- There is nothing wrong.

After all, we have different vaccines for influenza, and there are no problems.

Moreover, every year this vaccine is actually new.

So for COVID-19, we will look and compare the response in humoral and cellular immunity in those vaccinated with different vaccines, which memory cells will be produced.

- There is always a certain percentage of people who refuse vaccinations or believe that it is much "safer" to get sick naturally ...

- Vaccination is the safest method.

It is safer than the disease itself.

And post-vaccination immunity is certainly not inferior to natural immunity.

At the same time, systems for preventing infection, that is, primarily vaccination, are constantly being improved.

- How well do you think this will all end well?

For example, the story of HIV has been going on for many years, and there is no talk of an ultimate victory ...

- Very good question, thank you.

I was just working at that time at the Pasteur Institute in Paris in the laboratory of Luc Montagnier, when he discovered this virus (HIV.

).

I then won a UNESCO grant "Man against the virus" and went to Paris for an internship.

No one at that time imagined that we could defeat this infection.

At the WHO level, preventive recommendations on combating drug addiction, on safe transfusion of blood and various biological active fluids were developed.

Whatever effective vaccine we have, the problem cannot be solved without comprehensive prevention.

• According to the immunologist, the problem of COVID-19 cannot be solved without comprehensive prevention

• RIA News

• © Ilya Pitalev

Like HIV, the coronavirus is, you know, an iceberg.

And today we are only studying what is on top.

This is the tip of the iceberg.

Our colleagues work with patients with severe and moderate disease, only with a confirmed diagnosis.

And the underwater part is a large number with an asymptomatic course, with covid-like symptoms.

There is no doubt, we will certainly win.

Maybe not this year yet.

We all need to be very clear about these challenges now.

Change masks every two hours.

Until there is an effective vaccine and there is no vaccine population immunity, there is no other way.

I think the majority of our population will soon realize this.

We will be able to achieve significant reductions in mortality, and then we will have successes in introducing the vaccine into our daily lives.