Alexander Panchin: ‘A vaccine is the most inoffensive virus one can imagine’

“Not the most competent experts delivered speeches on federal TV channels at the onset of the pandemic”

Why have so few people been vaccinated against COVID-19 in Russia, though the mass vaccination kicked off as early as in January? For instance, as of 2 April, 141,600 out of nearly 4 million people in Tatarstan were inoculated with the Sputnik V.

I was vaccinated with the Sputnik V in a Moscow polyclinic. It was very convenient and comfortable. But I was astonished that there was no queue for vaccination, which could be expected, in the polyclinic. I made an appointment for the vaccine literally the next day after my call. This says that people, indeed, don’t want to be vaccinated for some reasons.

Why?

Of course, I don’t have an accurate answer for you. But it seems to me that the fact that not the most competent experts delivered speeches on federal TV channels at the onset of the pandemic became one of the factors of the failure of the coronavirus vaccination PR campaign in Russia. They claimed that there was no epidemic and coronavirus wasn’t more dangerous than the usual cold. In other words, the key rhetoric was comforting. Amid this background, it is hard to expect that people will be eager to receive a vaccine.

It seems to me that the fact that not the most competent experts delivered speeches on federal TV channels at the onset of the beginning became one of the factors of the failure of the coronavirus vaccination PR campaign in Russia. They claimed that there was no epidemic and coronavirus wasn’t more dangerous than the usual cold

Because if people realise the dangers and risks if they are told that the total mortality rate in Moscow in December was 1,5 times higher than last year’s indicators, this can motivate people to think about their and their relatives’ health. It is necessary to say that besides deaths from COVID-19, there are cases of long-term damages to the respiratory, cardiovascular systems. It is suspected that this can affect the nervous system too.

If people were more aware of the consequences of the coronavirus infection and how serious this problem is, the number of people who would wish to receive a vaccine would be bigger. In fact, people didn’t treat the lockdowns well for the same reason. Because, on the one hand, it is allegedly said on TV that there is nothing to fear, while the authorities are closing all schools, restaurants and so on.

Secondly, it is the way the Sputnik V vaccine itself was presented. Look, we were the first in the world to make it. But such a patriotic statement was made even before phase III clinical trials ended. And some people felt like if it wasn’t approved too early and if people didn’t start to be vaccinated with this medicine too early, though there is a shortage of data. But then this data appeared, it was two publications in The Lancet about phases II and III clinical trials. But people already know much less about these crucial publications. It is a problem of communication.

As it seems to me, we shouldn’t have shouted with gusto that we were the first but should have shown that Russia addressed the creation of vaccines responsibly, examined all data. We should have written about the clinical trials in detail so that people would understand what exactly was done.

Because, as it turned out in the end, in the case of the Sputnik V, everything was done at a good international level — both timely, quickly and the idea of the vaccine happened to be correct. But this information wasn’t delivered in the best way, and it didn’t manage to persuade sceptical people that they should be vaccinated.

Thirdly, the Sputnik V vaccination is available in Moscow now. As far as I am concerned, the situation isn’t the same in all Russian regions. In some regions, the vaccine isn’t widely available, where it is harder to store because it requires special fridges. There are some logistical problems in regions related to the delivery of this vaccine.

As it turned out in the end, in the case of the Sputnik V, everything was done at a good international level — both timely, quickly and the idea of the vaccine happened to be correct. But this information wasn’t delivered in the best way, and it didn’t manage to persuade sceptical people that they should be vaccinated

“There are serious doubts that the EpiVacCorona will work”

Does the authorisation of three COVID-19 vaccines in Russia somehow influence the vaccination pace?

Though three vaccines against coronavirus were announced in Russia, only the Sputnik V vaccine has normal data on its efficacy. As for the Vector Centre’s EpiVacCorona, the scientific community in general (and I particularly) have a lot of questions and serious doubts that it will work. Nothing is clear about the Chumakov Centre’s vaccine — we still should have a look at the data of clinical trials.

Why does the EpiVacCorona raise such doubts?

The major issues are related to the way the vaccine works. There is the coronavirus S protein a person has antibodies to. It is known what parts of the S protein the antibodies a person starts to produce when he is infected with coronavirus binds with. The Sputnik V vaccine allows our cells to synthesise the S protein completely, like the original one. While the Vector is a peptide vaccine that contains parts of the coronavirus S protein, its particles. And according to the information that was made public, these particles that were selected don’t match the particles to which antibodies normally should produce.

This is why it is feared that the antibodies to the EpiVacCorona won’t simply recognise the coronavirus. This is the reason why (though Vector is amazing as an organisation) a lot of scientists question that this vaccine will turn out effective. Clearly, clinical trials will make the final verdict, but these are the fears.

At the same time, all functionaries who have something to do with the vaccination claim that all the three Russian coronavirus vaccines are effective and safe...

As for safety, I admit that all of them can be safe. As for the efficacy, there are questions. And people should be explained. And they should have choice about which vaccine to receive.

There is a probability that some foreign vaccines can appear in Russia. For instance, the Chinese vaccine is undergoing clinical trials now. It is also a vector vaccine created according to the principle of the Sputnik V. Perhaps, somebody will want to receive it if it is available.

First of all, people should be informed that a third wave of the coronavirus infection is starting around the world. It seems that it hasn’t yet begun in Russia, but this can happen with delay too

“I would recommend receiving the Sputnik V”

What key steps would you take to change the tendency and accelerate the mass coronavirus vaccination?

First of all, people should be informed that a third wave of the coronavirus infection is starting around the world. It seems that it hasn’t yet begun in Russia, but this can happen with delay too. At the same time, more dangerous coronavirus strains appeared, for instance, the so-called British strain whose mortality rate is approximately 1,5 times higher than that of the original strain. It isn’t a joke but a serious epidemiological situation. At the same time, people should understand that we don’t have effective coronavirus medicines. The idea of vaccination is very correct for one’s own safety and the safety of people around.

It is necessary to explain to people who the Sputnik V vaccine works because I would recommend receiving precisely this vaccine. It is a vector vaccine. It has a vector, a carrier, the lining of the natural virus that causes very mild cold-related diseases. At the same time, the virus is devoid of everything that makes it a virus, that’s to say, it can’t copy itself, cause some diseases, it is just a lining. And it has the only gen of the coronavirus S protein built in. This is the spike, the protein of the coronavirus’s lining it uses to penetrate our cells. In fact, antibodies are produced to it.

In fact, the vaccine is the most inoffensive virus one can imagine in general. It is the virus that is divested of the basics of the virus. It is a virus that can’t divide, multiply, it can do nothing. Everything it can do is to make some of our cells produce the S protein, as a result of which antibodies that will train the organism to meet the real virus will appear.

If we are talking about the safety of vaccination, it is safer to receive the vaccine out of purely theoretical consideration than having the mildest case of the cold. A high temperature on the first day (some have a high temperature longer), some discomfort, a pain in the arm are the side effects that might appear after the vaccination. I had a temperature for a day after both doses of the Sputnik V vaccine. I had a temperature a bit longer after the second dose than after the first one, around 38 degrees. And it was a euphoric and strange state as if they had poured something in it (it is a joke). Clearly, if a person is going to receive the vaccine, it is better to consider not going to work the next day.

So there is absolutely nothing to fear. Moreover, 20,000 people participated in the clinical trials of the Sputnik V vaccine. 15,000 of them received the vaccine, and 5,000 received a placebo. This sampling showed that the vaccination significantly reduces the probability of contracting coronavirus. Moreover, we don’t see any serious side effects that might be related to the action of the vaccine.

Moreover, 20,000 people participated in the clinical trials of the Sputnik V vaccine. 15,000 of them received the vaccine, and 5,000 received a placebo. This sampling showed that the vaccination significantly reduces the probability of contracting coronavirus

“A visit to the polyclinic to receive a vaccine isn’t more dangerous than going to the supermarket or using the metro

A lot of people are afraid for some reason that the vaccination might affect fertility...

We don’t have any data suggesting that vaccination can harm fertility.

We should compare the risk of complications after a vaccine with the risk after having the coronavirus infection. The fact that the real disease can impact all the systems causes much more reasons for concern. People don’t always realise this weighing up the risks. We can’t talk about the risk of vaccination excluding the risks of infection the vaccine protects from.

I made up such a metaphor. Imagine a remote bright future where medicine is developed so much that people do not fall ill at all because all diseases were defeated, there are vaccines and medicines for everything. At the same time, some of these medicines have side effects. This is why people’s all misfortunes are linked with medicine. People come and say: ‘How bad medicine is, all problems stem from there’, but they ignore the fact that nobody falls ill thanks to medicine. The same happens to vaccines. People are afraid of side effects. But look at the consequences of the coronavirus infection, how many people die, how many of them end up with serious damages to the respiratory system. People can stay in hospital for weeks even though the case won’t be fatal. Some turn out on a ventilator, moreover, COVID-19 hospitals were full at the peak of the pandemic where people were saved from the consequences of the coronavirus infection. Here one doesn’t even have to be a specialist to assess all factors and understand that potential risks are tiny against this backdrop.

Some people consider that they should for foreign vaccines, not receive the Sputnik V, which is available now. But the more a person delays the vaccination, the higher the risk that he will contract this coronavirus infection and infect others.

There is no real foundation to consider some of the foreign vaccines significantly better than the Sputnik V. The expected win is very questionable. While the expected defeat for a person from losing time and not receiving the vaccine on time, which will consequently make its contribution to the third coronavirus wave, is very obvious.

After vaccination, a person can feel certain alleviation. I mean he poses a smaller threat for people around, and people around pose a smaller threat to him. He can calmly go to work and so on. But if a person is vaccinated, it doesn’t mean that he should neglect other measures preventing infection because no vaccine provides a hundred per cent protection from the coronavirus infection. It is anyway recommended to wear masks in crowded places, keep a social distance. But people inevitably go to work, go shopping, and it is much safer to do this for vaccinated people.

After vaccination, a person can feel certain alleviation. I mean he poses a smaller threat for people around, and people around pose a smaller threat to him

Many are still scared that they can be infected with coronavirus due to the vaccination...

The vaccine itself can’t cause the coronavirus infection. This fear is fair only because all anti-COVID-19 measures are not always taken in polyclinics where the vaccination is held. And I admit that there might be cases when a person went to receive a vaccine and contracted coronavirus from some of the people in the queue who were ill asymptomatically. We just should understand that there is such a risk.

And going to receive a vaccine, a person should not forget to put a mask on, one can put gloves on too, keep a social distance, wash his hands with soap after one gets home. At the same time, obviously, a visit to the polyclinic to receive a vaccine isn’t more dangerous than going to the supermarket or using the metro. By the way, one can receive the vaccine in some shopping malls too.

“If I were the Russian president, I would have received the Sputnik V on camera”

Perhaps, an illustrative vaccination of top officials of the country on camera would have a big influence on the population’s mood in such a country as ours. And what was done with Vladimir Putin’s vaccination recently doesn’t look very convincing...

If I were the Russian president, I would have received the Sputnik V on camera after phase III clinical trials ended and the article was published in The Lancet. I would have arranged the vaccination of the top official at that moment. And the story that we don’t want to single out a vaccine is a bit unnatural. Moreover, there is foundation to think that not all three Russian vaccines are equally good.

And now people suspect that the Russian president wasn’t immunised with a Russian vaccine. It would be strange because the professional scientific community isn’t convinced that the same Pfizer vaccine is better than the Sputnik V from a perspective of safety and efficacy. They are really similar according to the published data. So here an opportunity for doing a social good was clearly missed.

But it is good that Putin was vaccinated in general. This will unlikely influence devoted anti-vaxxers. What’s more, they will say that all this is a fake. But Putin’s vaccination anyway can influence some people who are in doubt. They will say: ‘Fine, vaccines aren’t so scary.’

Some health workers haven’t received the vaccine yet. I take this philosophically: unfortunately, not all health workers in Russia are responsible and competent enough

Why do you think even health workers aren’t rushing to receive the vaccine?

A lot of health workers demonstratively received the vaccine as soon as such an opportunity appeared. Some public people drew attention to the necessity of vaccination with such an act. It is quite a correct urge of a high-profile person no matter if he has a degree in medicine or not. It is normal to receive a vaccine and write about this experience: ‘Here I am, alive, not dead, I am fine, the reproductive system functions normally.’

You are right, some health workers haven’t received the vaccine yet. I take this philosophically: unfortunately, not all health workers in Russia are responsible and competent enough. We still have health workers who prescribe patients homoeopathic medicines, that’s to say, the medicines that don’t contain an active ingredient. It turned out so that medical education is often far from scientific education. Now there is a trend for evidence-based medicine. And a doctor should know English well, know how to read international publications, evaluate the quality of evidence of the efficacy of some medicine or interference. There is a myriad of amazing doctors who stick to these ideals. But also, some doctors are very far from this topic.

“It is not terrible for people who recovered to receive a vaccine”

You recommended everybody to receive the Sputnik V. Do you think this vaccine can be used again? Because there is a fear that there will already be immunity to the adenovirus vector.

This question is still open. The authors of the vaccine provided different arguments. I don’t dare to comment on this now because we should look at the results of research.

But a person anyway gains time if he receives the Sputnik V. Other effective vaccines can appear in Russia by that moment. This is why now one should be vaccinated with what we have, and then it is great if there is data that the Sputnik V can be used for re-vaccination. If it turns out that another vaccine is needed, one will have to receive it. At this moment, there is certainly no reason to refuse the vaccination with the Sputnik V because the vaccine can be used only once.

Can vaccines protect from new COVID-19 strains that are appearing?

In general it seems that vaccines protect from new strains too. Some of the vaccines that are available now in the world don’t protect as well as they do from the original strain. But in any case, it is better with the vaccine than without it. There are a lot of strains, and they are different. And it is hard to forecast which strain a person will catch. It is necessary to vaccinate in general. There aren’t yet many cases of secondary infection, this is good news. There are cases of infections after vaccines because no vaccine is a hundred per cent effective, but the number of these cases is not so big.

Given that the cases of secondary infection aren’t almost registered, what should people who recovered from COVID-19 do?

It is assumed that coronavirus weakens the immunity system. This is why the immunity of people who had the disease is even worse than those who received a jab. On the other hand, the number of people who have the disease again is small enough. So those who had coronavirus don’t need the vaccine as much as those who haven’t yet faced coronavirus. In any case, a vaccine won’t harm. It is not terrible for people who recovered to receive a vaccine. But those who haven’t had the disease should do this first of all, especially amid a shortage of the vaccine.

“The situation when health workers, including those who receive patients from the risk group, haven’t been vaccinated themselves is horrible”

What do you think about mandatory vaccination for all people?

I am afraid everything works this way in Russia. If you try to make the vaccination mandatory, people will start buying certificates saying that they are immunised. The question is correct but rather sociological: how to make more people receive the vaccine and how effective mandatory vaccination is. Isn’t it better to use incentives? For instance, to provide vaccinated people with benefits, not fine those who have not been vaccinated?

Of course, the situation when health workers, including those who receive patients from the risk group, haven’t been vaccinated themselves is horrible. But how to solve this problem is a tough question.

What do you expect when we manage to immunise Russia’s population against coronavirus? What are your forecasts for the further development of the pandemic?

Unfortunately, I don’t see the picture of vaccination optimistically. Neither do I see what miracle has to work for the vaccination pace to accelerate many times, which would be necessary to prevent the third wave. I am afraid that we will have new cases, so severe consequences of the epidemic will go on. And what will happen next... People who are receiving the vaccine will protect themselves in some way. I have received a vaccine, my parents have been vaccinated too.

Of course, the situation when health workers, including those who receive patients from the risk group, haven’t been vaccinated themselves is horrible. But how to solve this problem is a tough question

It isn’t yet clear what will happen to coronavirus later. We know that the Spanish flu was limited to three waves. But we also know the examples of seasonal viral diseases that come back every year. As for the seasonal flu virus, of course, it evolves faster than the SARS-CoV-2, which causes COVID-19. This is why it might turn out that this coronavirus will not have enough evolutionary pace to make it a regular seasonal problem.

Partly, the probability of such a positive scenario will depend on us too because every person who has coronavirus is a kind of guinea pig for the virus. If there is a strain that immunity will not be able to recognise and learns to infect those who already had the disease, we will face serious consequences. The more people infected with coronavirus, the worse the outlook on the epidemic. The fewer people catch the virus, the higher the chances a super-dangerous strain that’s worse than the existing ones will not appear.