Dr. Strioga – about antibodies: it is already known how many of them contribute 80 percent. protection

– You recently announced that you could get vaccinated against flu and coronavirus on the same day, one vaccine in one hand and the other in the other. In the past, there has been a growing debate about whether it takes a month or a few weeks to inject these vaccines. As it is now, is there anything new here?

– In fact, this is not new, since it is known according to general principles that many vaccines, even 10 or 12 vaccines, can be administered in different places. Our immune system is capable of responding to many threats and it will be able to do so here. This is sometimes done, for example, when a person wants to travel and needs to be vaccinated before traveling to exotic countries. There is an exception if we are vaccinated with live attenuated vaccines when they contain the agent, but it is attenuated to such an extent that it can no longer cause disease. Such vaccines are mRNA vaccines against mumps and measles, rubella.

There should be a 4 week interval between live vaccines. It happens that when a vaccine is live, it induces a certain immune response of interferons that protects other cells from infection, and if we inject another live vaccine in a short time, the cells will not accept that virus. All killed vaccines can be combined in different ways and can be administered multiple times at the same time. Suppose a meningococcal B vaccine causes serious side effects, fever up to 40 degrees. The vaccination schedule even offers children to wait a while before and after this vaccination.

It is not yet known whether the effectiveness of the coronavirus vaccine will be affected if another vaccine is given on the same day, so a pause of at least 2 weeks has been suggested. Now that we have the data, it is clear that there are no safety or efficacy concerns and that coronavirus vaccines can be combined with all other vaccines. If there is a need for concomitant vaccination against pneumococcus, one can be vaccinated against influenza or tick-borne encephalitis.

– Exactly what about tick-borne encephalitis?

– Can. But people always have to judge the situation for themselves. Again, people must assess the situation for themselves. If the response to the previous dose of COVID-19 was stronger, a break can be taken between different vaccines just for human comfort. Not because it harms the human body or if the immune response suffers, but just because the person does not experience so many unpleasant experiences.

– In Lithuania, the third dose of COVID-19 is already being vaccinated. As of January 1, all citizens with less than 250 antibodies should be able to get vaccinated, does this mean that we can already tell how safe the antibodies are?

– Empirical data has already appeared. Protective antibody titers that can provide 70-80% for 4-6 months. protection is already known, measured in standard units BAU per milliliter. If we want 80 percent. or greater protection, there must be at least 500 if 70% or more – not less than 250 BAU / ml. The United States does not recommend antibody testing, but this is for other reasons: there are several companies, institutions, and individuals who do not distinguish between antibodies to protein S, who show immunity after a vaccine or a relapse, and where there are antibodies against the N protein. Antibodies against it are only obtained after a natural infection. As a result, it often happens that people get vaccinated, take an antibody test against protein N, and find no antibodies. The accumulated data suggest that both total and neutralizing antibody titers correlate with the protection generated. Clearly, the T-cell response is also important. But determining the response of T lymphocytes is much more complex, and standardized tests are not as widely available. For many years, we have evaluated the protection of vaccines against antibodies.

– Some “experts” on Facebook say that antibodies are stronger after illness than after vaccination. How would you respond to those statements?

– The immunity of the survivors is probably not inferior. The T lymphocyte response is formed against both S and M protein and against N. This immune response is likely to have a broader profile when infection is natural. We cannot undermine the natural immune response. However, we do not know how we get this disease. The young men are now in resuscitation. This is not the case that natural immunization is the first option. As previously said about measles, it is better to get sick. And now the measles virus has been observed to do a lot of damage to a child’s immune system, erasing about 60-70 percent. immune experience against various pathogens. And dying in the next few years is not from measles, but from other infections against which the child had immunity, but was destroyed. As a result, vaccines have been developed to prevent natural infections.

I used to call anti-vaccine skeptics of vaccines, but after all the discussion, now I also say they are anti-vaccines. I really tried to explain honestly, I replied. But they can explain what they want, they are immediately attacked by a group, the insults begin. They don’t want to listen. I can tell the consequences. There is a patient with us who has come for chemotherapy, but we cannot prescribe it because there is a bacterial infection and an exacerbation of chronic heart failure. We can’t treat him with chemotherapy, let’s take him home too. They called him to the hospitals to pick him up because they couldn’t discharge him for treatment at home. Nobody can accept because outbreaks in hospitals everywhere. He says, well, if we take such an immunosuppressive patient and he becomes infected, what will happen? I approach the patient and ask him: has he been vaccinated? No, not vaccinated. And what to do now? We are looking perhaps for some nursing hospital to accept. Here we have those cases. For that person, if we move it to a compartment that has coronavirus cases, it may be the last compartment.

And the question arises, and here with the Constitution and human rights? Where are the human rights to quality healthcare? Now, a person in their early 50s must be admitted to a nursing home due to coronavirus outbreaks elsewhere. So please, maybe those who keep talking about their rights, maybe they would like to accept such a person? Maybe they want to go to resuscitation to work?

[…] I posted on Facebook that I had been vaccinated with a third dose of the vaccine. As much as there was ridicule, even colleagues founded the institute. Don’t you want to think why I was given the third dose? I work in a cancer institute where half of the bedridden patients have complications. And sometimes those complications are such that the patient comes with 0 neutrophils, he has sepsis.

– What does this mean?

– It means that you do not have a nonspecific immune response at that time. If there are any bacteria, it will not stop. Two bacteria grow from the blood culture and three more from the respiratory tract. There is sepsis, septic shock. And so you run, between your department and resuscitation. Would it be ethical for me to go to such a person without getting vaccinated? And he made fun of me kicking, “sniffing” the fourth dose. After all, I’m not doing it just for myself. What if I infected such a patient? And that attitude from the audience … he used to shake my hand, but now I can’t find another word, just disgusting. The only word that can describe what is happening now.

– Imagine two healthy young men who undergo an antibody test after a vaccine and one gets a result: 100, the other 1000. What causes it?

– We all differ in eye color, height, talent, and the like. We are not saying that someone who does not know how to play football like Ronaldo or who does not sing like Pavarotis is incomplete. And this is normal. Depending on our set of genes, each of our immune systems has different capacities to respond to even the same pathogen. One person’s immune system will respond more intensely and efficiently, while another’s will not.

– Does this show anything about human health?

– Not much. It can show that a person is relatively more susceptible to certain infections because, initially, their immune system responds more slowly and calmly. That does not mean that the person has no protection. Protection is adequate, but not a powerhouse. And it is not surprising, we already know. Some have a choleric immune system, others phlegmatic. Clearly, there are cases where the system is already out of the norm, when certain links are missing in the immune system, then we have an immunodeficiency. The reverse is also true when the immune system responds in an inappropriate way, such as to pollen, then there are allergies or autoimmune diseases.

– What does it mean if a person has 5,000 or more antibodies? Does this mean that a person is already 100 percent? protected?

– Well, 100 percent. there is nothing. Clearly, if there is such a high amount of antibodies, it indicates an extremely strong antibody response. There are cases in which a person has 800 antibodies one month after vaccination and another month after 2000. Most likely, the person has become infected and has become ill without symptoms.

– Some say that the third dose should be adjusted for the delta strain because the current vaccine is based on the Wuhan variant. How do you think vaccines should be changed and the extra dose given before the new strain?

– Ideally, it would be very good. But we still do not have an updated vaccine, it is in development. Until then, we can also develop normal adequate protection with this vaccine.

– What message would you like to send to people who do not believe in science, say that they will not be vaccinated and that they will not?

– You cannot believe or believe in God, not in science. If I’m selfish, I say I don’t like it and I don’t want to. But we are part of society, where did this egocentricity come from? Most of those who say that vaccines are unconstitutional and that the Constitution protects their rights have never been interested in or read the Constitution itself. You never know when you may need to go to the hospital yourself and need more serious medical help. And then there will be no where to lie down because the hospitals are busy. And then he will also scream, where are my rights to normal medical care?