This factor will increasingly determine: what does science know about immunity after a coronavirus has become ill or vaccinated?



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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, several clinical studies have already shown that after COVID-19 infection, more than 90% of patients have antibodies in their blood that fight 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 are less protected, ”said L. Griškevičius.

People with COVID-19 have also been monitored for recurring infections. According to the interviewee, at least three clinical trials were carried out, comparing individuals with antibodies in the blood with those without antibodies in the blood.

A comparison of the two groups showed that people who had antibodies to the virus had a reinfection rate ten times lower than those who did not have those antibodies. After reinfection, mild COVID-19 symptoms occurred in about a third of people, and no severe cases were seen in studies. In one study, people were followed for four months and another for five months.

“This shows that people who have had COVID-19 develop immunity and last at least four to five months, with an efficiency of around 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 (two months).

“Studies of resistance of COVID-19 patients to reinfection show that this resistance persists for at least 4 to 5 months, so it is not appropriate to vaccinate people who have been infected in the last three months, especially in the absence of vaccine.

On the advice of a panel of experts, the operations manager decided not to vaccinate people who had become ill in the past three months. If a person wants to be vaccinated, they must have an antibody test. If IgG class antibodies against the virus are not found 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 with antibodies in early summer or before next season, late summer, early fall, to see if they need to be vaccinated again,” said L. Griškevičius.

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 a COVID-19 infection, and the second is the ability to provide a service to those who have COVID-19 or are at increased 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 more than twenty times more likely to die from COVID-19 than in their fifties, and more than six times more likely to die in groups between the ages of 70 and 80, and more than three times more between the ages of 60 and 69. The older a person is, 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 in organ transplant recipients due to the immunosuppressive treatment they require. Then, 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, as well as because they receive a wide range of health services, have many close contacts in hemodialysis centers, and have a high probability of infection.

The fourth category is other patients requiring immunosuppressive therapy (eg, Oncology, autoimmune diseases). It is recommended to include these categories in the priority list ”, taught L. Griškevičius.

According to him, the other group to be vaccinated on a priority basis 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. Delfi has asked the reader if, for example, a pregnancy can be planned after a vaccination against the coronavirus. The doctor responds 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 noted that falsehoods appeared: the vaccine is questioned and it is assumed that it is ineffective or that people have generally gotten sick from it.

“For the vaccine to be effective, immunity must be developed. It takes at least two weeks for immunity to develop. As a result, the risk of getting sick for two weeks is slightly decreased.

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. This identifies asymptomatic cases of COVID-19. For many of these 79 doctors, the SARS-CoV-2 virus was 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 that the vaccination should continue, others say that after two weeks of recovery, an antibody test should be done and a response should be given.

“If we follow the description of the drug, the former are right. But if studies show that strong immunity develops after illness, a second dose of the vaccine may not be needed. At the Santara clinics, we will conduct an antibody test for physicians who have become symptomatic and will decide whether the second dose of the vaccine is appropriate, ”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 felt symptoms. The patients underwent PCR testing and the SARS-CoV-2 virus was found in the nasopharynx, suggesting that some of the 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 immunity

When asked if he supported the idea of ​​a vaccine passport, the doctor said that one way or another, certain activities would have to be tailored depending on whether or not people had immunity.

“Many believe that the vaccine passport will provide benefits in the first place. Currently, a vaccination passport is required when planning work in medical facilities. Already, doctors who are immune to the SARS-CoV-2 virus are often selected for working with COVID-19 patients. Only immunosuppressed and immunosuppressed patients should be allowed 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, and the President of the European Commission Ursula von der Leyen also mentioned the vaccination passport, ”said L. Griškevičius .

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