How are we developing vaccines for the future?
Bill Gates recently announced that he has teamed up with Larry Page, the co-founder of Google, to provide funding for the development of a universal flu vaccine.
Efforts are already being made to develop a universal vaccine that protects against all strains of flu but Bill Gates has challenged scientists to go one step further. He has asked them to develop a vaccine that will protect against current and emerging strains for three to five years.
He did this as we mark 100 years since the deadliest flu pandemic. Since then we have had several other flu pandemics with the latest killing at least 18,000 people in 2009, although some estimate the real death toll could be more than 284,000.
When he made the announcement at the end of April, Bill Gates said: “This should concern us all, because if history has taught us anything, it’s that there will be another deadly global pandemic.”
Although annual flu vaccinations still save lives, their success rate falls short of many other vaccines. Flu vaccines are approximately 40 to 60% effective compared to others like MMR which have success rates as high as 97%. This is partly because flu strains mutate quickly and it takes time to develop and manufacture new vaccines.
Flu is just one of several illnesses that are proving difficult to develop vaccines for. Scientists are now dealing with more complex diseases and conditions than in the past, like malaria, cancer, AIDS and Alzheimer’s. Certain pandemics, like the Zika and Ebola outbreaks, can also spread faster than we can develop new vaccines.
To tackle these challenges, some new trends in developing future vaccines are emerging.
A new type of vaccine
More productive and quicker ways of manufacturing new vaccines are already growing in popularity. This includes using more efficient methods of vaccine propagation.
For example, some cell-based vaccines have been approved in recent years as an alternative to traditional egg-based vaccines. Such vaccines are faster and easier to produce and also overcome the issue of egg allergies.
Egg-based flu vaccines have been criticised for being inefficient for a number of reasons including poor antibody-antigen binding affinity.
Live recombinant vaccines that use attenuated viruses (or bacterial strains) as vectors for immunogens are another alternative. Recombinant vaccines are quicker to produce, more effective and have fewer side effects than traditional alternatives.
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Because recombinant and cell-based vaccines can be produced more quickly, they are better suited to responding to a pandemic.
DNA vaccines are a promising new area of development too. DNA vaccines take the DNA which encodes a particular antigen and injects it directly into the muscle or skin.
DNA vaccines are relatively easy to produce and provide long-lasting immunity with few side effects. They are also cheaper than other vaccines and easier to transport which is particularly useful when they are needed in developing countries.
However, DNA vaccines have not yet been found to produce a strong enough immune response, so further development needs to be done in this area. Adjuvants that assist DNA to enter cells or target it towards specific cells could be one way to improve the efficacy of such vaccines.
Exploring new delivery methods
Future vaccines are also likely to be delivered in a variety of ways.
Nasal sprays are already being used as a pain-free way to deliver the flu vaccine to children and in the future we may see other pain-free vaccines.
Patches which deliver vaccines through a matrix of extremely tiny needles are one alternative in development. They don’t need to be delivered by a health professional which makes them ideal for use in remote areas.
Vaccines which overcome the cold-chain problem are also needed. Many vaccines need to be stored at cold temperatures to remain viable which can create a problem when transporting them. When the Icelandic volcano Eyjafjallajokull erupted in 2010, it grounded planes carrying 15 million doses of polio vaccine, which caused concerns that the disease would spread.
We must understand the immune system more
Undoubtedly, if new vaccines are to be developed, a better understanding of the immune system is also necessary. Advances in areas like genomics, bioinformatics and artificial intelligence can help scientists unravel the complexities of the immune system and develop more innovative vaccines.
Although developing new vaccines is challenging, their potential to save millions of lives throughout the world makes the effort and costs involved worthwhile.
Long haul Covid, the brain and digital therapies
It is estimated that around 10% of people who get Covid-19 develop long haul Covid, a debilitating condition that can last many months and cause breathlessness, exhaustion and pain.
Research is underway to find out who is more likely to get it and how to treat it. Here neuroplasticity expert and owner of Harley Street Solutions in London Ashok Gupta tells us how the condition affects the brain.
What is long Covid exactly?
Long Covid is when patients who have experienced Covid-19 go on to have continuing symptoms for weeks and months afterwards. These symptoms can include breathlessness, exhaustion, brain fog, gastric issues, pain, and post-exertional malaise. It is estimated that around 10% of Covid-19 infections may result in developing long haul symptoms, and in the USA, this may be affecting over 3 million people.
How does it affect the brain?
Here at our clinic, we hypothesise that it is due to a malfunction in the unconscious brain, creating a conditioned response that keeps the body in a hyper-aroused state of defensiveness. At the core of this hypothesis is the idea that we are here because our nervous system and immune system have evolved to survive. We are survival machines!
When we encounter something such as Covid-19, the brain perceives it as life threatening, and rightly so. And in the era of the pandemic, with more stress, anxiety and social isolation, our immunity may be compromised, and therefore it may take longer for the immune system to fight off the virus and recover.
If the brain makes the decision that this is potentially life threatening and we get to the stage where we’re overcoming the virus, a legacy is left in the brain; it keeps over-responding to anything that reminds us of the virus. Even if we’ve fought off the virus, the brain will react in a precautionary way to stimuli reminiscent of the virus.
The brain may get stuck in that overprotective response, and keeps stimulating our nervous system and our immune system, just in case the virus may still be present.
What symptoms does this cause?
These signals cause a cascade of symptoms including breathlessness, extreme fatigue, brain fog, loss of taste or smell, headaches, and many others. And these are caused by our own immunes system.
In the case of long-haul Covid, symptoms in the body get detected by a hypersensitive brain which thinks we’re still in danger. The brain then chronically stimulates the immune and nervous systems, and then we have a continuation of a chronic set of symptoms.
This isn’t unique to long-haul Covid. Many patients develop chronic fatigue syndrome, sometimes known as “ME”, for example, after the flu, a stomach bug, or respiratory illness. Covid-19 may be a severe trigger of a form of chronic fatigue syndrome or ME.
How does long-haul Covid affect mental health?
Anxiety is a very common symptom in long haulers. It can be frightening to wonder about what may be happening in your body, and what the prognosis is going to be for one’s long term health. Reaching out for support for mental health is crucial for long-haulers.
How does neuroplasticity treatment work for long-haul COVID patients?
We have been working with patients for two decades with a brain retraining programme using neuroplasticity or “limbic retraining.”
We believe that through neural rewiring, the brain can be “persuaded” that we are no longer in danger and to come back to homeostasis. But to be very clear, we are not saying it is psychological in any way, but we believe there are novel ways of accessing the unconscious brain.
We recently worked successfully with a 56-year-old male with long-haul Covid, who prior to contracting Covid-19 in March of 2020 was running half-marathons and cycling, but afterwards he struggled to get off the sofa for months. Within 3 months he’s now back to 100% and running half marathons again.
At our clinic, we train the patient to be able to recognise those subtle unconscious danger signals on the periphery of consciousness. This, coupled with supportive techniques and the natural hallmarks of good health such as sleep and diet help prepare the patient to respond to perceived threats that might trigger the response.
The natural state of our brain is to default to protection. The brain prioritises survival and passing on our genes to the next generation, over any other impulse. It cares more about that than you feeling healthy and well. Protective responses are evolutionary, and are the right thing for the brain to do – it’s survival.
What digital therapies or apps are proving effective at treating long-haul Covid?
It seems that long haul patients are availing themselves of many online therapies and services, including meditation apps and wellness websites. We have an online neuroplasticity “brain retraining” video course called the “Gupta Program” which hosts 15 interactive videos and many audio exercises. This is proving very popular with long haul patients, and we are currently conducting a trial to test the effectiveness of this therapy.
What is the danger of leaving long-haul Covid untreated?
The longer it goes untreated, we hypothesise that it may become more entrenched in the brain, and become chronic in the longer term. Therefore we advise all patients to get help and advice as soon as possible.