‘My main claim isn’t about the Sputnik V developers but those who hurriedly ‘registered’ it’

“The question of the duration of immunity remains open”

More than 300 vaccines against COVID-19 are developed around the world at the moment, 47 of them are in Phase 3 of clinical trials. Besides Pfizer, which is on everyone’s lip, it is vaccines of Johnson&Johnson, AstraZeneca, Novavax, Moderna and several vaccines from China and Russia. Which of them do you think are more promising and can save humankind from the coronavirus infection?

It is hard to judge it at the moment. The vaccines that are tested now have very different principles. And we don’t so far know which of them will turn out to be more promising.

mRNA vaccines are in the lead now. Two vaccines of this kind have shown very good effectiveness — more than 90%. It is vaccines made by Pfizer and Moderna.

Moreover, representatives of Pfizer (Editor’s Note: the interview was on 18 November) have claimed that they are applying for a permit to the FDA to use the vaccine in extreme conditions.

Does the fact that Pfizer’s vaccine must be stored and transported at a temperature of -70 degrees considerably complicate the distribution of the vaccine?

Without doubt, this complicates the process a bit but isn’t a problem. Such a temperature has to be maintained for long-term storage and transportation. But Pfizer’s vaccine can be stored in an ordinary fridge for at least 5 days. If you open the box with vaccines, this term is enough to use it completely. Moreover, Pfizer announced the development of special containers with dry ice with a GPS sensor that allows tracking the compliance with the necessary conditions. So they hope there won’t be problems with the transportation of the vaccine.

The vaccines that are tested now have very different principles. And we don’t so far know which of them will turn out to be more promising

You have already mentioned different vaccine development technologies. Pfizer and Moderna chose mRNA. Is it a new technology that has never been used? Can we forecast its performance in the future?

Its performance is already clear. Indeed, such vaccines have never been licensed and registered around the world — it is new technologies. However, according to the first results indicated in the company’s press release, the effectiveness reaches 95%. It is very good. Such indicators are above most experts’ expectations.

Of course, like with any vaccine, the question of the duration of immunity remains open, if the level of antibodies won’t fall in a few months. The first results have shown at the moment that everything is great during the first two months after vaccination. But only time will show what will happen next.

There are fears that immunity will be short-term on the basis of features of similar viruses and information that immunity to coronavirus doesn’t last long. But vaccines aren’t a natural infection. There is hope that immunity will be long-term but at the moment we can just wait.

“The permission to combine the Phase 1 and 2 is a standard model, it is quite common”

What’s wrong with the world’s first registered vaccine Sputnik V developed by Russia? Weren’t you confused by the decision to unite the Phase 1and 2 of development?

I can say nothing bad about the principle of the vaccine itself. Neither can I say anything about the vaccine. It is a new type of adenovirus vector vaccine. Such vaccines against any diseases have never been licensed around the world. So it is also a new thing.

The permission to combine the Phase 1and 2 is a standard model, it is quite common because it is sensible to examine the safety and simultaneously try to look at how immunogenic this vaccine is. Many are doing so now.

My claim is that this vaccine wasn’t tested in the Phase 3, they didn’t show if it is effective and “registered” it before that. I would put this word into brackets because I simply don’t understand what it means in this case because there was no data on its effectiveness when it was “registered”. My main claim isn’t about the developers of the vaccine but those who hurriedly “registered” it.

The first data the developers of the vaccine claim show that Sputnik V is 94,5% effective, as they said. Though I don’t understand where this number came from and how reliable it is. This conclusion was made with the help 10-15 cases, which is statistically wrong. But let’s see, the first results inspire hope. It might turn out quite a good vaccine. But the process that was used to promote it simply reeks of political underpinning: “We are the first!” Of course, the desire to be first is clear enough, but one should play following general rules. By “registering” the vaccine without examining its effectiveness, they simply made the whole world laugh and lowered the prestige of Russian science.

I would advise injecting the vaccine that is well-known as safe and effective. It is a risk to inject vaccines this information isn’t accurately known about

What would you recommend Russians in this situation? Should they take advantage of the available vaccine or wait for foreign vaccines to come one day?

I would advise injecting the vaccine that is well-known as safe and effective. It is a risk to inject vaccines this information isn’t accurately known about. Of course, its injection may not cause serious side effects.

But the problem with coronavirus vaccines is that it is seriously suspected that not all vaccines will provide reliable protection. And with time, this immunity may not only stop working but also lead to an aggravated disease. There are examples of when a vaccine worsens the course of the disease instead of protecting.

So the answer to the question can be obtained only after some time when there are accumulated information and sufficient statistics. No vaccine has it so far. Trials of Sputnik V are a bit late compared to other vaccines tested in the world because, for instance, Chinese began trials of their vaccine as early as in June. They haven’t published the results yet. Two American companies published results with a much bigger number of volunteers. For instance, Pfizer analysed 170 cases, of which 162 cases were in the placebo group. Whereas the group of vaccinated people had just 8 cases of the disease. This vaccine obviously protects at least during the first several months since vaccination. Undoubtedly, this vaccine is at a more advanced stage of trials than Sputnik V.

“Ideally, we need a vaccine that would stop the circulation of the virus”

Do you think that other vaccines should continue developing? Some groups of scientists who are still in their early stages are falling behind...

Sure. At least because we simply don’t know which of the principles used in these vaccines will turn out to be effective. The mRNA vaccines may be short-term. More serious shocks are probably necessary to shake the immune system to create long-term immunity. Moreover, the RNA vaccine has only one spike protein, while inactivated vaccines have the whole range of proteins and antigens that can help protect from the disease.

In one of your interviews you said that ideally, we need a vaccine that generates sterilising immunity. Could you explain what this means? What should the perfect vaccine be like? And is it possible to have such a vaccine against coronavirus?

In general it is possible. Sterilising immunity means that a person is not only protected from the clinical disease, that’s to say, contracting it himself but he also won’t be able to pass the virus to other people.

Some vaccines — not against coronavirus but against other diseases — amazingly protect from a disease, and the person never falls ill, but if he is vaccinated he can contract it, the virus will proliferate in him not causing the disease and pass to other people.

Ideally, we need a vaccine that would stop the circulation of the virus. So vaccinated people not only will not fall ill but also will not be able to contract and pass the virus to the neighbour. It is better than the situation in which the virus will keep circulating in the population and can affect the one who isn’t vaccinated. This is the principle of sterilising immunity.

Ideally, we need a vaccine that would stop the circulation of the virus. So vaccinated people not only will not fall ill but also will not be able to contract and pass the virus to the neighbour

At the beginning of the COVID-19 pandemic, you offered to use a live oral polio vaccine as protection from coronavirus. Your parents dealt with this vaccine. Hasn’t your proposal become a reality yet?

Unfortunately, I have nothing to add to this theory. Together with famous American virologist Robert Gallo (Editor’s Note: one of the discoverers of HIV as an infectious agent that’s responsible for AIDS, he developed the diagnostics of this disease and its further research), we tried to organise such trials in the USA. But we didn’t manage to raise enough money for the trials that promised to be quite massive — it was necessary to vaccinate over 10,000 volunteers. As all money and effort were used to create specific vaccines against coronavirus, we didn’t manage to do anything in America simply because of the competition for resources.

Now the trials we offered are held in India. They are classified, their results aren’t yet known. I hope the principle my mom Maria Voroshilova offered more than 30 years ago will be proved in trials in other countries.

“At the moment there is no foundation to think that the pathogenicity of the virus has decreased”

According to its nature, the virus usually mutates into a less aggressive form. While in Tatarstan, for instance, the number of critical cases has doubled (Editor’s Note: a rise in the number of patients aged 65+ is cited).

Any virus that passed to humans from some natural reservoir, from some animal is very aggressive. It adapts to the human organism with time: both the person and virus adapt. But this is quite a long process. This is what will happen in the historical perspective, but at the moment there is no foundation to think that the pathogenicity of the virus has decreased.

As for the severity of the disease, I think it is mainly determined by the quality of medical infrastructure and care, how correctly a person is treated. The coronavirus death rate in many developed countries is very low. For instance, it is tiny in Singapore — less than 0,1%. Simply because it has an ideal health care system.

The severity of the disease is determined by many factors, but mainly it is the development of health care as well as the average age of the population, genetic factors and so on.

So Tatarstan has a rise in severe cases probably because the health care system is in stress. It is unlikely that the virus has mutated.

“Anti-vaccine campaigners will maybe calm down a bit”

Did you doubt the natural origin of COVID-19?

Of course, coronavirus is of natural origin. I don’t see any foundation to assume it was created artificially by somebody “with evil intentions”. Of course, all viruses are natural.

Another question is where exactly it came from. Nobody knows if it came from the market where seafood or bats are sold or it was accidentally let go from a laboratory as a result of recklessness. Of course, some love to speculate, blame others that did something deliberately. But this requires certain facts we don’t have.

In the end, it doesn’t matter. We should fight this disease no matter where this virus came from.

I don’t know how it is in the USA but the population in Russia is endless stress because of the pandemic. Do you personally have optimism about the future of humankind in the fight against coronavirus?

Sure, we will go through it. But it will unlikely be forgotten quickly. And our life will change, of course. We will probably wear masks for long, we won’t shake our hands, we won’t kiss when meeting each other. But this will end sooner or later.

By the way, I don’t see great hysteria in the USA. People continue living and working. Another case is that most of our people who can work from home do this remotely. Some people have to go to the factory, to the plant, to the shop. But the employees who mainly work on a computer who are the majority now, I think, can do this from home, moreover, effectively enough. Thank God, means of communications turned out to be very effective, the economy keeps running, though with great pressure. And a lot of things are less available than before. But one can go to a restaurant here — it isn’t as full as it used to be, guests aren’t housed at neighbouring tables. And stores are open. There aren’t big restrictions.

The population is conscious enough about this. I see that 100% of people indoors are in masks and often with transparent screens on their faces, some have gloves. Many wear masks even outdoors. People think about sticking to the necessary rules, mostly this helped the situation in the USA didn’t get out of control. There are enough hospital beds for patients. So the situation isn’t critical yet.

I hope that when coronavirus vaccines are widely used, most people will consider them as something positive. Anti-vaccine campaigners will maybe calm down a bit

Has COVID-19 made your professional life as virologist more interesting?

More interesting and complicated, of course. I had never given anybody an interview before the pandemic, now I am doing this almost every day. The interest in the theme is huge. Now it feels like you do what matters. I have always known this, of course, it is pleasant to receive confirmation of this fact and satisfaction because the population will be more educated regarding vaccines. I hope that when coronavirus vaccines are widely used, most people will consider them as something positive. Anti-vaccine campaigners will maybe calm down a bit. I hope so.