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Immunity to the coronavirus can be acquired in two ways: by illness or by vaccination.
As for the first method, according to prof. L. Griškevičius, a number of clinical studies have already shown that after the onset of COVID-19 infection, more than 90% of patients have antibodies in their blood that fight the infection. These biomarkers indicate that patients develop so-called humoral immunity.
The so-called cellular immunity also develops. This means that the immune cells, which are directed against cells infected by viruses, are activated and participate in the control of the infection.
“Immunity has been shown to develop in the vast majority of COVID-19 patients. Studies show that in older patients it does not form much weaker than in younger patients.
It is known that patients with more serious illnesses have more antibodies and those with more severe illnesses have fewer. However, this does not necessarily mean that patients who get sick more easily will be less protected, ”said L. Griškevičius.
People who have had COVID-19 have also been shown to re-infect themselves. According to the interviewee, at least three clinical trials were conducted comparing individuals with antibodies in the blood with those without antibodies in the blood.
A comparison of the two groups showed that those who had antibodies against the virus had a re-infection rate ten times lower than those who did not have those antibodies. Mild symptoms of COVID-19 recurrence were seen in about a third of the subjects and were not seen in severe case studies. In one study, people were followed for four months and in another for five months.
“This shows that people who have had COVID-19 develop an immunity that lasts for at least four to five months, and its effectiveness is about 90 percent. It is almost the same as immunity after a vaccine. Of course, vaccines are a much safer way to get immunity than COVID-19, ”explained L. Griškevičius.
There are two opinions about vaccinated patients
One of the most important questions to ask yourself after starting vaccination is whether vaccinated people should be vaccinated. There is no simple answer to this question, because in vaccine clinical trials, according to a professor at the VU School of Medicine, sick people were not included.
Therefore, other data is taken into account when making a decision. Prof. L. Griškevičius noted that the follow-up of the re-infection resistance studies in relapsed persons was longer (four to five months) than in those who participated in clinical trials of the vaccine (lasting two months).
“Studies on the resistance of COVID-19 survivors to reinfection show that this resistance persists for at least 4-5 months, so vaccination of people with relapses in the last three months is not appropriate, especially in absence of the vaccine.
Therefore, following the advice of a team of experts, the director of operations decided not to vaccinate people who had become ill in the last three months. If a person wants to be vaccinated, they must have an antibody test. If no IgG class antibodies against the virus are detected in the blood, the person should be vaccinated, ”explained L. Griškevičius.
Experts are also still deciding when it would make sense to repeat the antibody test for those in whose blood they are found.
“We plan to repeat the test in people whose blood is currently detected with antibodies in early summer or before next season, late summer, early fall, to see if they need to be vaccinated again,” Griškevičius said.
Vaccines are primarily for those for whom the virus is most dangerous.
A member of the expert advisory board explained that in Lithuania, as in many other European Union countries, the priorities of who gets the first chance to get vaccinated depends on the criteria. The first is the risk of dying from COVID-19 infection and the second is the ability to provide services to those who have COVID-19 or are at the highest risk of developing COVID-19.
One of the factors that makes you more likely to die from COVID-19 infection is age.
“For example, people over the age of 80 are about twenty times more likely to die than COVID-19 compared to fifty, more than six times more in the 70-80 and 3-60 age groups combined. The older a person, the higher he is on the priority list. The Board of Experts has already recommended starting in the 70s and vaccinating elderly patients “, – explained L. Griškevičius.
The second factor mentioned by the professor is the various medical conditions.
“The highest risk of death from COVID-19 is found in organ transplant recipients due to their immunosuppressive therapy. There are still oncohematological patients because their blood disease and its treatment have a strong negative effect on the immune system. In addition, these people are often hospitalized and therefore at risk of infection and infection.
Patients undergoing renal replacement therapy are at risk due to their medical condition and the fact that they also receive a wide range of health services, have many close contacts in hemodialysis centers, and have a high probability of becoming infected.
The fourth category is other patients receiving immunosuppressive therapy (eg, oncological, autoimmune diseases). These categories have been claimed for inclusion in the priority list ”, taught L. Griškevičius.
According to him, another group of people who are given the vaccine as a priority are those who treat or care for these people, as well as emergency specialists who treat patients with COVID-19. These are doctors and social workers.
When asked who could not be vaccinated against the coronavirus, the specialist replied that the only contraindication was an allergy to the vaccine or its ingredients. A reader has asked Delfi if, for example, a pregnancy can be planned after a vaccination against the coronavirus, and the doctor answers that it is possible.
“Can. I think unvaccinated women are at higher risk for complications from COVID-19 during pregnancy than serious complications from vaccination,” taught L. Griškevičius.
Efficiency issues
According to the professor, the efficacy of mRNA vaccines currently registered in the EU is around 90 percent. Information on the efficacy of the vaccine has come to light in cases of coronavirus after the first vaccination, both abroad and in Lithuania.
Prof. L. Griškevičius warned that there were falsehoods in which the vaccine was questioned and assumed to be ineffective or that people got sick from it.
“For the vaccine to be effective, immunity must develop. It takes at least two weeks for immunity to develop. As a result, there is little reduction in a person’s risk over two weeks.
People who get sick during the first week can often get infected before the first dose of the vaccine. About two weeks after the first dose, the protection starts to work and the number of new cases starts to decrease compared to unvaccinated people, ”said the interviewee.
This week, 79 doctors who received the first dose of the vaccine were reported to have COVID-19 at the Santara clinics. The doctor explained how it happened.
“Doctors at the Santara clinics are constantly undergoing prophylactic tests to prevent patients from becoming infected. In this way, asymptomatic cases of COVID-19 are detected. For many of these 79 doctors, the SARS-CoV-2 virus is detected immediately after the first dose of the vaccine, so it is likely that the virus was infected before vaccination, ”explained L. Griškevičius.
Doctors do not have an unequivocal answer to the question of whether a second dose of the vaccine should be given to those who become ill after the first vaccination. Some say vaccination should continue, others say that after recovery, an antibody test should be done in two weeks and a response has been received.
“If we follow the description of the drug, the former are right. But if we follow studies that show strong immunity after illness, a second dose of the vaccine may not be needed. At the Santara clinics we will conduct a test for antibodies to doctors who have become ill
symptomatically and we will decide on the advisability of the second dose of the vaccine, ”said L. Griškevičius.
The risk of infection has not been ruled out.
Another relevant question is whether a patient can continue to carry the virus. As Delfi has already written, the chances of someone else getting infected after a vaccine remain. You can read more here.
“In a study of 20,000 people in the UK, people who had SAR-CoV-2 antibodies were compared to those who did not. The study showed that people with the disease were about 10 times more likely to get COVID-19 again. Of those who got sick, only a third had symptoms. Patients have undergone PCR testing and SARS-CoV-2 virus has been detected in the nasopharynx, suggesting that some patients may re-infect others.
This is especially true for physicians who work with immunosuppressed patients, those who work in care facilities. Therefore, even with immunity, it is necessary to wear protective equipment, ”explained L. Griškevičius.
Life will increasingly depend on having immunity
When asked if he supported the idea of a “vaccination passport,” the doctor replied that one way or another, certain activities would have to be adapted depending on whether or not people had immunity.
“Many believe that the ‘vaccine passport’ will provide benefits in the first place. Currently, a ‘Vaccine Passport’ is required when planning work in medical institutions. Already, doctors who are immune to the SARS-CoV-2 virus to They are often selected to work with COVID-19 patients. Only immunosuppressed patients and wards should be able to work with the virus. Of course, everyone should wear personal protective equipment, “said L. Griškevičius.
On the other hand, there are reports that some countries, such as Australia, New Zealand and Israel, will start to require a “Vaccination Passport” upon arrival in the country, and the President of the European Commission Ursula von der Leyen also mentioned the vaccination passport. “said L. Griškevičius.
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