Fernando Polack and Gonzalo Pérez Marc were in charge of managing the clinical trials of Pfizer's vaccine in the country.
Argentine physicians Fernando Polack and Gonzalo Pérez Marc, in triad with Romina Libster, were in charge of leading the world's most important clinical trials in pandemics; for example, for the validation of the Comirnaty vaccine (from Pfizer-BioNTech laboratories). They have thus become a reference in terms of volume and importance and promise more trials for new drugs and vaccines.
In one of the offices of the Central Military Hospital, in Buenos Aires, where a huge team of specialists continues with the tests, they told LA NACION that they believe that the pandemic is close to cease to be a problem and that most probably there will be a lot of flu during 2022 (due to the non-generation of defenses during the quarantines). They also gave details about the project that now excites them: a vaccine for adults against the respiratory syncytial virus, usually associated with bronchiolitis in children, but which infects and kills older adults like the flu (volunteers can sign up at www.vacuna60.com).
"Even with the new variants until today, all vaccines have shown a very high efficacy with two doses," they said regarding Covid's situation.
-How is the detail of this new vaccine?
Polack: We have been working on respiratory syncytial virus for 30 years. The idea is to look for a vaccine that works against the third disease that a senior citizen has to worry about, after Covid and influenza. Since there is already a vaccine against the other two, it is important to have the missing one.
Polack: Of course, because it is not usually detected in the elderly. At one point, [physicians] realized that if certain adult patients were tested, they were negative for influenza and positive for syncytial. And it is a virus that has the same risks as the flu.
Pérez Marc: Sometimes, without being hospitalized, it happens that there are people who are vaccinated against the flu, have flu-like symptoms and that is what the syncytial virus is: it predisposes to pneumonia, aggravates cardiac cases and decompensates diabetics. That is why we want to vaccinate this population over 60 years of age to avoid complications.
Polack: A key fact is that if you are infected with syncytial you have 250% more chance of having a heart attack in the following seven days, a number similar to the flu in people over 60 years of age; but if you are vaccinated you do not have that risk.
Pérez Marc: We are doing the Phase III trial, together with the United States, the Netherlands, South Africa, Japan and Finland. We are in the process of enrolling volunteers. It is a vaccine that in previous phases worked well. And it is progressing so far. This vaccine, also developed by Pfizer, is the first to reach the target against syncytial, and it will be only for adults over 60 years of age.
Respiratory ailments and the omicron variant
Pérez Marc: This year we already had a lot of syncytial in September, October and November. In the last six months, with the restart of classes, there was a lot of adenovirus, rotavirus, parvovirus, all respiratory viruses, things that do not usually occur all together.
Polack: As of today [the interview was on Monday], there is no data to give an opinion on the variant, three or four things are known, all in potential. It has many mutations, but in the protein where the mutations are of interest there are a total of 40 mutations in more than 1000 amino acids (that make it up), it is not that everything is different. The South Africans say that it gives mild symptoms and nobody has died.
Pérez Marc: It is like that, Omicron gives mild symptoms and we do not know anything else. In general, the response of the vaccines to all the variants is of very high efficacy, and we have to think that the waves of contagion do not translate into disease and death. Then, the virus begins to cease to be a problem, just like influenza and syncytial; that is to say, they are, but not of the magnitude that is given to it now. If the virus circulates a lot, but only causes discomfort for a couple of days and no more, it is not a concern. I tend to think that just like the delta variant, which spread rapidly, in places with vaccination it did not generate an increase in mortality and terrible damage to the health system. Something similar should happen now.
Pérez Marc: It is true that it is difficult to take measures, as much as not to take them; for example, if you are in Europe and you see how the rest of the countries are closing, you are not going to go against all the agencies in your continent.
Polack: It would be bad practice for us to judge a measure that is taken with little information. And it is true that we cannot completely relativize (the threat of new variants).
Pérez Marc: You have to be on the spot. These are pandemic decision-makers' sites, with the uncertainties that this implies. One can critically analyze what was done, but not make a severe moral judgment. Besides, medicine is not a science of results but of processes, of prevention according to the available evidence. The evidence can change, so you have to adapt, because nature is indeterminate. There was a healthcare system before the pandemic that was obviously not prepared anywhere for such an extraordinary situation.
Polack: I add some omicron and other possible variants. We tried to generate in the laboratory a variant that would evade all the antibodies and we did not succeed. It is not that easy. Otherwise, all viruses would kill us.
Pérez Marc: The two doses protect you from serious disease. That is why the morbidity-mortality rate falls the way it does in all the countries in the world that vaccinate. The third dose is for herd immunity, to have so many antibodies that you don't even get slightly sick and it is not transmitted so much. The third dose is essential for risk groups, such as immunocompromised people, or for medical personnel. For the rest of the population, it is more for the group than for the individual, by restricting the circulation of the virus.
Polack: For Omicron we do not know, but for all other variants, two doses are enough to avoid hospitalization and death in a high percentage. But in short, we agree with the vaccination strategy. Although I do not believe that annual vaccinations are necessary.
Polack: It is ending, it is ending.
Pérez Marc: The serious problem is ending. However, the virus will continue to circulate.
Polack: The only virus eradicated so far in history was smallpox; polio is almost, is on its way to, but not yet. We haven't taken any other viruses out of circulation. That's a very ambitious goal.
Perez Marc: It will probably be like measles, which is not completely over, but it hardly generates death as it did before.
Polack: In 2009, everyone was alarmed by the influenza A virus, which is still around now, but causes few problems. This week it is an asterisk, a stand by, by omicron, and in these days more will be known and the future will be clearer. What is certain, on the other hand, is that the number of variants is not infinite.
By Martín De Ambrosio-La Nación
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