It’s one of the Most reputable virologists and vaccine researchers on an international level. Alfredo García Sastre (Burgos, 1964) was in Valencia a few days ago at the ninth summit of the European Influenza Working Group (ESWI), a meeting at the highest level to debate this virus, but also other respiratory viruses such as syncytial (RSV) or SARS-CoV-2 and advances in immunization.
What can we expect from SARS-CoV-2 after three years of coexistence?
It is going to become another respiratory virus. It is a matter of seeing how much disease it generates compared to the other two big ones, RSV (the cause of bronchiolitis) and the flu because it is still not clear if it will be the same as the flu or worse. Certainly not much worse. The amount of severe disease that the virus causes in the presence of a population that has already been immunologically exposed is much less than what it caused at the beginning. Most people are immunized with a vaccine and with infection and that immunity, although the new variants are capable of overcoming it, do not do so enough to be able to generate a lot of serious illness. And in those who are not vaccinated or who have not seen the virus, newborns, since we already know that the amount of severe disease is very small.
Is a great evolutionary leap of the virus to be expected?
It is not expected, but it can never be said with complete certainty that it cannot happen. That’s the problem there is. But it can also happen with the flu, right? And with any other virus. It is not expected because it is not selectable. Viruses adapt to be able to reproduce as best they can and to do so they have to be transmitted. For a respiratory virus to be transmitted, it must do so from secretions that come mainly from the upper respiratory tract. And if the disease is caused in the lower respiratory tract or if it goes to the brain, it cannot be transmitted from there.
What virus will generate the next pandemic?
We are once again targeting bird flu, what we were before. I still think there is going to be a flu pandemic. But we have been wrong twice already so it is very difficult to predict. The 2009 pandemic was an H1 and no one thought it would be an H1. The H5 have a lot of risk because there is a lot of variability and a lot of viruses circulating right now in animals, that’s why they have more risk, but it could be any other subtype.
What flu season will we have?
Normally the peak is in February, but now that there is one more virus circulating, things are also more complicated. We will see if the peak (of covid) will coincide with the flu peak or not and if annual vaccination against SARS-CoV-2 will also be needed. If they were coincident, both vaccines could be given at the same time, but how are they combined? Because flu vaccines are not RNA but those most used for coronaviruses are.
“We once again point to avian flu (as the generator of another pandemic) but we have already been wrong twice.”
Adolfo García Sastre
This is the date on which the flu-covid vaccination will begin in C.Valenciana
Now they are given at the same time but they are two different vaccines. Is the future a single vaccine?
In the same syringe. If in the end the annual covid vaccine is done, it would be what one would want. It is easier. It depends on whether the SARS-CoV-2 vaccine is done annually or not and the type of vaccine platforms that continue to be used. Because the coronavirus vaccine, although it does not give rise to severe adverse effects, does have effects and if it is added to the flu vaccine, there may be people who do not want to take it simply because they will not have a fever one day. Improved vaccines may appear in the future. And if these improved vaccines are needed annually and can be given together with the flu, it would be a matter of trying to combine them, like the pediatric ones.
Is it already being considered?
We have debated it here, as well as the improvements that can be made in the covid vaccine because it has been very good but the ones that exist are not entirely optimal. One for reactogenicity: if they resulted in fewer side effects it would be better. Also because of the duration of immunity because it is not very long. Even if the virus did not change, surely they would still have to be used on an annual basis and the third is to avoid not only severe illness, but also infection and transmission. That would be the ideal.
Health prepares its largest flu vaccination campaign by including 200,000 “healthy” children
This year is the first that children will be vaccinated against the flu. What can you expect?
The main consequence is the decrease in circulation (of the virus), because it is very clear that those who really carry the flu infection are children. They get infected more easily, they have milder symptoms but they transmit the virus very well to their parents, their grandparents… and that is why it often coincides with the start of the school calendar with the start of the flu and then after Christmas When they return to school, the peak occurs. And if children are vaccinated, that peak could be reduced.
Convincing parents just thinking about avoiding transmission is difficult…
Vaccines need to provide a personal benefit to those who use them, not just a social benefit, and luckily, there is one. There are not many children who have severe flu illness, but right now there are more children dying from the flu than from covid. In the United States there is a non-profit association of parents who have lost a son or daughter due to the flu. They try to raise awareness among the population that your children can die from the flu, as has happened to them, and that, therefore, vaccination is very important. Also, the intranasal one, children take it very well, there is no needle.
It is also the first year that all infants are given the “vaccine” for bronchiolitis. Could it be a change of scenery?
Improved antibodies have been achieved, although it has taken a long time, that are also capable of being used at different ages and not only in premature babies. But yes, it can be a change of scenery. The only thing is that it is still an expensive therapy. It saves lives but is very difficult to implement in poorer countries.
2023-10-02 05:00:20
#children #die #flu #covid #Vaccinating #important
