In 1796 Edward Jenner hypothesized that a weakened version of a viral agent could work as a prevention for the severe disease caused by that agent. Jenner took serum from a pustule of a cow with smallpox which he subsequently injected into a child, effectively making him immune to the disease. Although rudimentary and dangerous, that experiment marks the beginning of modern vaccinology and has helped save millions of lives. The cardinal principle of vaccines is to prevent the severe form of the disease, but this is not always the case.
The threat of chronic infection
John Silver is a 37-year-old boy who in December 2020 (before the advent of vaccines) contracted Covid19, unfortunately a debilitating genetic disease prevents him from eliminating the virus efficiently and remains infected for 7 months in what comes termed a chronic infection.
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by Aureliano Stingi
Chronic infection, besides being extremely debilitating and dangerous, because it weakens the organism making it exposed to secondary infections, is the perfect ground for the formation of new variants. In fact, it is believed that the origin of the Omicron variant that emerged a few months ago in South Africa are seropositive immuno-compromised patients with AIDS and therefore unable to eliminate the virus efficiently.
From preventive to therapeutic
In the summer of 2021, antiviral drugs were not yet widespread or optimized so the doctors following the case of John Silver decided to use the Covid19 vaccine as a drug to treat the symptoms. The results were surprising, thanks to two doses of the mRNA vaccine the virus was completely eliminated from the boy’s body and the symptoms disappeared.
Why was the vaccine able to trigger an immune response and the infection not?
We know that the patient was suffering from a genetic disease that made the immune system less efficient in producing neutralizing antibodies and T lymphocytes, this created a kind of balance between viral replication and activation of the immune system. In practice, the virus was kept at bay by the boy’s immune system which, however, was unable to eliminate it.
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The vaccine with its combined action activated the innate and adaptive immune response and also the whole cell repertoire (B and T lymphocytes).
The vaccine acted as a catalyst, in fact the researchers observed an increase in neutralizing antibodies, T and B lymphocytes in the boy’s blood after the two inoculations.
Why is this story important?
Some researchers argue that the persistence of the virus in our bodies could explain some of the post-infection sequelae that fall under the name of Long-Covid. If John Silver’s case is confirmed, the use of the vaccine in people with Long-Covid could be a strategy to counteract the symptoms and effectively cure Long-Covid.
TAKE HOME MESSAGES:
- Vaccines are born to train our immune system and to prevent disease
- A 37-year-old patient with a genetic disease of the immune system had a chronic Sars-CoV2 infection for 7 months
- A double vaccination with mRNA vaccine eliminated the persistent virus in the boy’s body
- Therapeutic vaccination could treat or eliminate some symptoms of Long-Covid
REF:
https://www.scmp.com/news/world/africa/article/3158645/omicron-variant-likely-born-hiv-patient-says-south-african
https://it.wikipedia.org/wiki/Sindrome_di_Wiskott-Aldrich
https://link.springer.com/article/10.1007/s10875-021-01158-5
https://www.nature.com/articles/s41591-022-01766-7