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Are There Clinically Meaningful Differences Between anti-COVID-19 Vaccines?

A health worker prepares to administer the COVID-19 vaccine to her colleague at a hospital in Mogadishu, Somalia.In a video message on May 24 to the World Health Assembly , the decision-making body of UN agency WHO, UN Secretary-General Antonio Guterres warned against the dangers of “a two-speed global response”, a concern he has frequently expressed. “Sadly, unless we act now, we face a situation in which rich countries vaccinate the majority of their people and open their economies, while the virus continues to cause deep suffering by circling and mutating in the poorest countries,” he said. Credit: UNICEF/Ismail Taxta

NEW JERSEY, USA, May 28 2021 (IPS) - Despite claims by the industry and some politicians, there are no clinically meaningful differences among the variety of vaccines approved under emergency use authorisation (EUA).

There are no significant differences in effectiveness between individual vaccines of different types: mRNA vaccines (e.g., Pfizer and Moderna), adenovirus vector vaccines (e.g., AZN, J&J, and Sputnik V) and inactivated SARS-CoV-2 virus vaccines (e.g., Sinovac and Valneva) in preventing severe complications and deaths.

If there is no contra-indication or a fundamental reason or belief for not vaccinating, considering the urgency, individuals should take the vaccine provided to them.

Efficacy of COVID vaccines:

As per global data, the COVID-19-related complication among the adult population needing hospitalisation is approximately 14%. As defined by preventing hospitalisation and deaths, the reported efficacy of mRNA vaccines is ~94%.

Therefore, the average efficacy of all COVID vaccines is approximately 90% (0.86/0.94 x 100). Nevertheless, none of these vaccines entirely prevents infection, transmission, lasting harm, or death.

The rate of complications can be significantly reduced by vitamin D supplementation before infection or at the time of hospitalisation (Mercola 2020; Wimalawansa, 2020) [vitamin D3 and ivermectin; latter also increases serum 25-hydroxyvitamin D [25(OH)D] concentration].

Most hospitalised COVID-19 patients have 25(OH)D levels less than 20 ng/mL, whilst the vast majority who died from COVID had levels below 10 ng/mL. It is noteworthy that over 50 ng/mL is required for the proper operation of autocrine (inside each cell) and paracrine (nearby cells) signalling and functions of immune cells.

These are required for rapid and well-regulated immune responses to combat pathogens. In the absence, people develop complications.

Types of SARS-CoV-2 vaccines:

mRNA vaccines for other diseases have never deployed for humans outside clinical trials. SARS-CoV-2 produces intense immune responses because the insertions within the micro-lipid particles allow generating large amounts of a portion of the viral spike protein. The human immune system attacks and eliminates these foreign proteins.

Spike proteins have a high affinity for ACE2 receptor protein located on human epithelial cell membranes in the lungs, gastrointestinal tract, blood vessels, etc. Due to sequence similarities of ACE2 and ACE2-SARS.CoV-2 complexes, antibodies generated against spike proteins could harm normal cells in the presence of an incompetent immune system.

Why are some developing complications, others are not?

Following natural infection and vaccination, different types of antibodies produced by immune cells. Some of these could cross-react with the ACE2 receptor protein. Vitamin D is critical for the proper functioning of the immune system. Vitamin D deficiency weakens innate and adaptive responses and allows harmful hyper-inflammatory (cytokine-storm) responses.

Therefore, people with weakened immune systems have a higher risk of antigenic cross-reactivity, generating autoimmune reactions, and auto-antibodies formation, increasing the risks of complications from SARS.CoV-2 (e.g., cytokine-storm and deaths).

Inactivated viral vaccines are used less in Western nations, despite the advantages of generating broader immune responses against the nucleocapsid protein and the spike protein. In contrast, the mRNA and adenoviral vector vaccines present only a portion of the spike proteins antigen to the immune system.

Therefore, antibodies generated by mRNA vaccines have a narrow specificity, which could be a disadvantage in the long run.

The efficacy of the groups of vaccines cannot be compared:

The conditions and the timing of the vaccine trials conducted were vastly different. No head-to-head comparative RCTs performed to compare mRNA or adenovirus vector vaccines against traditional inactivated viral vaccines, whose safety is better understood.

Heavy promotion, particularly by big investors and governments, of mRNA and viral vector vaccines companies are driven by the patents-based, higher profits of novel mechanisms. Despite claims by companies, pundits, and mass media, the efficacy of mRNA and viral vector vaccines cannot be assumed to be superior to those of traditional inactivated virus vaccines.

Vaccine RCTs conducted under differing conditions:

Obtaining approval for the mRNA vaccines for RCTs and EUA were straightforward. These RCTs were conducted in the USA during the summer and fall of 2020, before the emergence of COVID-19 variants. A few of these variants evolved mutant spike proteins with much greater affinity for the ACE2 receptor to facilitate their entrance into our cells.

As the vaccination program expands, variants continue to evolve, including double (e.g., Indian variant) and multi-mutants to evade immunity. Mutations generate differing spike-proteins sequences (A) to overcome recognition by antibodies and killer cells, and (B) to increase the infectiousness. The risks of such mutations are higher following mRNA and viral vector vaccines.

mRNA vaccine trials during summer and fall involved people having higher average vitamin D concentrations with fewer severe symptoms. In contrast, the viral vector vaccines and inactivated viral vaccines took longer to obtain EUAs due to complexities requiring multiple approvals.

These RCTs mainly were conducted outside the USA during fall and winter, after the emergence of multiple variants and when COVID-19 prevalence rose again.

Efficacy vs. adverse effects of vaccines:

There is no question about the benefits of COVID-vaccines in adults. Given the different nature of the RCTs and rushed deployments, there is insufficient comparable data to conclude that one vaccine is more effective than another.

Besides, incomplete reports and analysis of adverse reactions are a concern, especially potential longer-term adverse effects. For those who have mild to moderate risk of harm from COVID-19, such as children, these poorly characterised risks must be considered more carefully in the context of limited individual benefits of vaccination.

Ill-effects of vaccines are the subject of ongoing research and controversy, and therefore, dialogue should be allowed with the freedom of speech. Instead, such discussions are suppressed and maligned: administrators remove posts from social media sites on the pretext of reducing public confidence in COVID-19 vaccines.

People should be provided facts: they have the right to know the pros and cons and make their own decision. In addition to vitamin D deficiency, emerging data suggest ill-effects are specific to a particular vaccine group and, perhaps, underlying vulnerability and individual characteristics, such as sex and age.

Uncertainties of vaccines and duration of effectiveness:

Despite unfounded assertions by vaccine manufacturers and certain administrators in higher positions, claims of up to five-year duration of immunity after vaccination, are sheer speculation.

The duration of immunity from natural infection and COVID vaccines is uncertain. However, by extrapolating from the SARS experience, post-vaccination immunity may last no more than 18 months, which will impede developing global herd immunity.

Vitamin D sufficiency synergises vaccines benefits:

The most beneficial aspect of vaccines and vitamin D sufficiency is preventing hospitalisation, complications needing oxygen and ICU use, and deaths. Therefore, as with vitamin D sufficiency, vaccinations should also prevent the post-COVID syndrome, also known as ‘long COVID,’ which is a misnomer.

Post-COVID-19 syndrome primarily arises in the central nervous system or other locations where the SARS-CoV-2 virus can escape from incomplete immune responses, especially in those with severe vitamin D deficiency and, thus, having a less robust immune system.

Vitamin D sufficiency prevents post-COVID syndrome. Whether vaccines prevent post-COVID-19 syndrome remains to be seen, but it is optimistic.

*Sunil J. Wimalawansa, MD, PhD, MBA, DSc, is Professor of Medicine, Endocrinology & Nutrition, Director CardioMetabolic Institute, USA


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