Opinion – Atila Iamarino: Vaccines that can get us out of the pandemic

We’re on another wave. The rate of positive Covid tests already compares to the wave of January. Two waves powered by variants with enough immune escape to be very transmitted. Fortunately, hospitalizations and deaths still don’t come close to the numbers from the beginning of the year. But we have already recorded more than 54 thousand lives lost to Covid in 2022. In 2020, deaths from viral diseases such as dengue, yellow fever and HIV totaled less than 14 thousand, according to the Mortality Information System.

With the early abandonment of masks, vaccination has become the only barrier against the virus. Given our current situation, without even a federal strategy to combat Covid, it seems utopian to say that we are in a position to see much better numbers from now on. But we can still have a central position in the development and testing of vaccines with the potential to control the disease much more, such as RNA vaccines, nasal spray and universal vaccines.

We have already applied more than 1 billion doses of RNA vaccines around the world. They have an excellent safety and protection profile. The risk of myocarditis in vaccinees is rare, tends to resolve within days and is much lower than among those who have Covid. Of the vaccines in use, they are the most “upgradable” to bypass immune escape. Because they use a snippet of the virus’s genetic material, it can be revised to represent new variants.

These are the RNA vaccines that are at the most advanced stage of testing with specific doses for the omicron. But those tests haven’t been fast enough. The most advanced tests were done with the January Omicron variant and the BA.5 strain in circulation now partially escapes them.

We would need to shorten the time between observing the virus and vaccinating to a few months. And Brazil has the infrastructure and skilled labor to participate in this, as Chile and Israel do.

Nasal spray vaccines can be based on various strategies, such as RNA. The important thing is the place of application. Intranasal application awakens antibodies and the activation of immune cells in the nasal mucosa, the region that the coronavirus first colonizes. This localized immunity can stop the virus from entering the body. Thus, vaccinated would not even transmit the virus.

The spray dispenses needles, is cheaper, and may still be better accepted, especially for regular doses. Our research centers are able to develop and produce this type of vaccine, which is especially interesting for the constant supply of renewed doses.

The most universal vaccines are the Holy Grail for diseases like Covid and the flu. Ideally, they would be based on conserved and important regions that the virus cannot easily change, which has the potential to induce effective immunity against current and future viruses. They would be vaccines that protect us even against other coronaviruses that we don’t know about and could have prevented Covid as a whole if they were already available.

This would be the definitive barrier and every country with public health research like Brazil should mobilize to make it viable. That’s if the federal government were interested in using our infrastructure and expertise to actually promote vaccination and save lives. The low rates of childhood vaccination and the absurd cut of science funding show that this is not the case.

Getting out of the pandemic depends on collective attitudes and science. And it is a path that will still take years. Therefore, the vote we will make soon must take this into account. Returning to value and investing in science in Brazil would be one of the steps to make our new normal even more normal.

This column was written for the #scienceinelections campaign, which celebrates Science Month.