COVID-19 epidemic is highly invective, dangerous to a relatively well defined demographics. Some cases of reinfection were already reported, suggesting post infection immunity is fleeting. A possible solution is administering adjuvat only to the infected in order to get an increasing section of immune population, and possibly cause intentional infection in consenting low risk individuals that wish to immune themselves. Do you know if such a strategy was ever used? What could go wrong? What possible avenues to failure do you see?
Maybe you know, a lot of 'immunomodulation" "drugs" was approved in Russia. Some ones using as adjuvants of vaccines (polyoxidonium).
I have a part in the vaccines development and my strong opinion is such: if you can make enough efficacy (and stability )vaccine without adjuvant you must do it. I think the immune system is very complicate and it has a wide range diverse features among population. Using immunomodulators can lead to multiply adverse reactions. For example You can amplify some auto-immune diseases. In generally i am against that approach.
I refer to a case of a Japanese woman that cot covid19 twice in 30 days or so. One case is anacdotal, but if you get a very short term immunity than I wonder how long the epidemic will stay. At some point this approach may be better than nothing, and if SARS and MERS are the model, it will not be seasonal... They close schools here in Israel, I wonder for how long, and what will happen afterwards. Getting some form of longterm immunity seems like a possible answer.
One case is not statistic. Unfortunately i don't have any verified information about crucial features of the virus. As it seems for me the virus is danger for people after 60 only. So I would not to use immuno-active drugs for people of all ages.
Excluding maybe immunoglobulins. Actually i think that using the normal immunoglobulin from human blood plasma can has efficacy.
On the topic of re-infection. A protective immunity does not mean you cannot be re-infected. You can always be re-infected. A protective response means that upon re-infection you won't progress to worse symptoms. And an N of 1 is a case study, not a starting point to bring doubts about long term memory.
Now... as for adjuvants... I mean without a specific antigen, what is the adjuvant going to be enhancing? Usually adjuvant(s) is paired with the target you are trying to generate the protective response, and different adjuvants can stimulate certain responses, mostly antibodies, but there are ones that can enhance T cell responses. If you just deliver the adjuvant without the target, then it'll spread its effect among a wide variety of antigens that exist in the host, which dilutes the purpose of vaccination.
As for how long it will last... to run the cycle...it'll take at least 3 months. if you use what data was gotten out of China. And also, (just my opinion looking at spread patterns and how respiratory pathogens are usually transmitted) I fully expect this to move into the Southern hemisphere in the summer and than round back up again to the north come next year's flu season. And that will probably be close to the end of it by next year (if nothing major changes with the pathogen).
Now... as for why SARS and MERS didn't make too much of an impact. Onset of disease was short upon infection (from what I remember) and high mortality. Remember only people who are infected but fine spread the disease, people who are sick or dying are usually confined and not walking among large groups of people. And this is why tuberculosis still kills about 1 million people every year and there are about the same number of newly infected people every year... And this is with a vaccine AND antibiotic therapy. Well....TB is also a special case....since it has been a human pathogen for thousands of years.
Thank you for the discussion. SARS started February if I am not mistaken, and was under control by June due to good public health practice, it transmitted in the tropics. MERC was treated similarly, but cases are still occurring by transmition from camels, itvtransmits in Saudi summer, again, not seasonal. The current virus infective while in long un symptomatic period makes this hard to control. IF it is not seasonal, and IF immunity after infection is fading quickly, than we have a problem that will not go away any time soon. I suggested adjuvant treatment to people that contracted the virus, as means to produce a large and permenently immune section of population.
There is one point yet.
It is very likely that covid19 can have a antibody-dependent mechanism of entry into a cell.
https://jvi.asm.org/content/94/5/e02015-19?fbclid=IwAR3f_eEwX4myKizFrPbrRiobqxLF-eTPXvzXGrlhMfZX13hpKWdQpOsZ69A
Maybe that case of reinfection was linked with the effect.
Hopes of an effective vaccines dashed because immunity after recovery from COVID-19 is short lived and may not be protective.
For more information, please read the article in the link:
https://www.medrxiv.org/content/10.1101/2020.06.13.20130252v1.full.pdf
It's more complicated than we first thought. We know that SARS-1 can develop antibody-dependent enhancement, because the binding of IgG to the receptor domain of Spike 1 can trigger exposure of Spike 2 and easier viral entry.
Also, antibodies tend to decline to low or even undetectable levels after 60 days following natural infection. There may be signalling defect in the Dendritic Cell-T4 follicular helper cell-plasma cell matrix to form lymph node germinal centers.
I'm not convinced that a vaccine focused solely on serum IgG to COVID Spike 1 is not the best solution.
The idea is very interseting. Animal model feasibility would be one approch. Also, are we know how we reinfect ourselves durind diseases to wich we are well accusomed. Perhaps reinfection leads to the installation of cross-protection and widens to new epitopes.
