Ghana, West Africa, July 2020: the news is welcomed with total amazement. More than 2,000 health care workers have been infected with the All New coronavirus since the pandemic broke out in the country, announces the Director General of Public Health Services1. In France, within mid summer, a few days later, more than 260 children playing in a summer camp got infected. The same thing happened at another summer camp in the state of Georgia in the United States. This tragedy, which affects the entire planet, threatens the human species. In a newspaper article in Les Echos, dated July 18, 2020, a severe warning is underlined about the possibility of uprisings to be feared throughout the world2. For the coronavirus pandemic that has spread since December 2019 all over the planet, threatens not only lives, but also the world economy. The rising number of millions of unemployed could lead to social conflicts and unrest that could last up to 3 years, warns Maplecroft, a global risk and strategy consulting firm. We have to realize that this is not the time for useless and theoretical polemics, but for an awareness to find the most pragmatic solutions.
For coronavirus, as soon as the media started talking about the vaccine, the usual anti-vaccine movements took place. Conspiracy theories and misinformation, spread massively on social networks, invaded minds to the extent that an estimated 20 percent of the population in the United States categorically refused a coronavirus vaccine3. In a study published as early as 2019 by the American polling institute Gallup, it is clear that France leads the list of the most vaccine skeptical countries.
The tuberculosis vaccine is a weakened vaccine known as Bacille de Calmette Guerin (BCG). It contains a strain of the bacteria called Mycobacteruim bovis. This strain is attenuated, i.e., its aggressiveness is reduced for use as a vaccine. A manufacturing incident led to a serious accident that killed 73 children in Germany. This happened on the premises of the hospital in Lübeck, Germany. This event damaged the reputation of the vaccine for decades9. In 1929, 251 newborns were orally vaccinated with the new BCG vaccine, accidentally contaminated with Mycobactrium tuberculosis, the virulent strain of the bacterium. Within 3 months after vaccination, children began to die. The investigation will show that both strains were stored in the same premises and that the hospital did not have standards that would allow for the manufacture of BCG vaccines. It was not the vaccine itself that was at issue, but the way it was manufactured that led to the Lübeck tragedy. This accident led to the cessation of BCG vaccination in most countries until the 1960s. The formulation of the vaccine was revised. Oral administration was abandoned for an intradermal form to be inoculated under the skin. The intradermal form requires a low dose of attenuated bacteria (compared to the oral form which requires large doses of attenuated bacteria) and induces a good immunization lasting more than 5 years10. Only one injection is needed to vaccinate a child.
Without hesitation, the Lübeck disaster describes well, how the non respect of manufacturing standards can lead to dramatic accidents. It was the understanding of the causes of the accident that spared BCG. At a time when the number of new cases of tuberculosis in the world has reached 10 million, when we are constantly on the move around the planet, and when precariousness is gaining ground, there is an absolute necessity, not to lose sight of the interest of BCG.
Polio is a highly contagious disease caused by a poliovirus. The disease manifests itself as muscle paralysis that incapacitates the lower limbs. When the disease affects the lungs, it can lead fairly quickly to death by asphyxiation. As a reminder, this disease has affected many personalities such as filmmaker Francis Ford Coppola or long suspected in President Franklin Delano Roosevelt. It is a disease that is transmitted through the digestive tract, through contaminated food and water. Contamination can be extremely rapid if you come into contact with an infected person. The disease has claimed millions of victims worldwide. In 1953, salvation came from Edwards Salk, an American biologist who developed an inactivated vaccine against the virus and successfully tested it in the United States. A great humanist, he renounced the patent on his invention and left his discovery freely accessible to companies interested in producing vaccines.
The development of the yellow fever vaccine is full of twists and turns that have led to major breakthroughs in vaccine safety. Yellow fever is a disease caused by a virus transmitted to humans through mosquito bites. It is widespread in Africa and South America. It is characterized by a fatal fever. This disease was a brake on colonial expansion in the 19th century. The massive death of more than 700 Europeans in Senegal in 1878, or the 20,000 deaths during the construction of the Panama Canal, consolidated the historical and fatal reputation of this disease. The availability of a vaccine was a strategic imperative. In 1934, Dr. Max Theiler, M.D., embarked on the development of an attenuated vaccine. He chose a highly virulent strain called the Asibi strain in reference to the region of present-day Nigeria in which it was discovered. Max Theiler manages to culture the virus, attenuate it, and rid it of its ability to penetrate the nerves of the brain by passing it 89 to 114 times on cells from chicken embryos. In 1937, a major vaccination campaign began in Brazil, which was plagued by yellow fever epidemics. More than 2 million people were vaccinated. 95% of those vaccinated had antibodies against yellow fever. Starting in 1941, a few days after being vaccinated, more than 250 children developed fevers, convulsions and one case of death was recorded. Investigations revealed that by producing batches of vaccine by re-culturing the attenuated Asibi strain, the manufacturer eventually reactivated it and gave it the ability to attack brain cells again. The findings will now change the way all vaccines are made, requiring the use of an attenuated and blocked strain at a specific stage. The search for scientific truth has led to the understanding of Brazil’s accident and saved vaccines that save millions of lives. Still with the yellow fever vaccine and at the same time in 1941, some U.S. servicemen vaccinated during World War II developed jaundice. For a long time, the yellow fever vaccine kept this bad reputation, since the same phenomenon had been observed in Brazil in 1939. It was only later, with the knowledge of the hepatitis B virus, that experts understood what had happened. Batches of vaccine from the Second World War were contaminated with the hepatitis B virus. How did the hepatitis B virus get into the yellow fever vaccines?
Mistrust of vaccines, autoimmune diseases in the absence or presence of vaccination end up leading some parents to reject vaccination outright. It is no longer possible to distinguish between the different vaccines. Let’s take the example of Elliot, who is a 6-year-old boy, very cheerful and moving all the time. One weekend, he goes with his parents to visit his grandparents’ farm in Oregon, and as usual he has fun running around the big dirt road in the allotment garden. After he slipped, he made a small wound on his forehead, which his parents immediately washed away. Nothing serious. 6 days later, little Elliot, usually in a good mood, started to cry without explanation and with his mouth closed. The whole jaw remains fixed. He is then taken by muscular spasms at the level of the trunk and gradually the whole of his body becomes rigid. Any attempt of movement is impossible for him, and triggers unbearable screams. His parents immediately call the nearest hospital. The child is evacuated by helicopter. The doctors had no difficulty in diagnosing tetanus by observing the stiffness of his jaws. He is taken into intensive care with powerful sedatives and will be fed by infusion for several days. In intensive care, he is vaccinated against tetanus and other diseases. He will be put on a respirator and will have different infusions for more than a month to relieve his pain and calm the tetanus. Gradually, he recovers his muscular functions and benefits from a re-education of his limbs. As the days go by, he regains full health.
Vaccines produced by genetic engineering and, more technically, by recombinant vaccine technology are the most advanced for COVID19. These vaccines are prepared in virus strains that may be unrelated to the coronavirus. The viruses that have proven themselves in the manufacture of vaccines are viruses called adenoviruses and rid of their virulence or “aggressiveness”. Why are adenoviruses used? Adenoviruses are viruses whose genes can be arranged to produce protein S. There are many strains of adenovirus.
Breastfeeding helps the newborn to cope well with the vaccination.
For a woman who has just had a baby, breastfeeding is a good way to prepare the baby for vaccination. The first vaccinations are given from the second month of life. Breastfeeding quickly gives infants the means to defend themselves. The antibodies and all the nutrients contained in breast milk allow infants to develop good antibody levels following vaccination. The observation of 2 groups of children shows that those who are fed breast milk for 2 months develop higher levels of protective antibodies than those who are fed with enriched milk powders. 56. This child protection is particularly marked for vaccines against poliomyelitis and rotaviruses, which are viruses that cause episodes of gastroenteritis during the winter.
The quality of bacteria in the gut influences the response to vaccination.
We are not always aware of this, but if we spread our intestine out on a flat surface, it would cover exactly a tennis court. And this surface is lined with an impressive number of bacteria. Billions of bacteria in our digestive tract are involved in the functioning of the immune system. The quality of this intestinal flora is essential for a good reactivity of the immune system. The flora starts to build up in the newborn baby, when it passes through the vagina at the time of birth. Birth by caesarean section considerably delays the colonisation of the newborn’s intestines by the good bacteria of the lactobacillus type. This leads to colonisation by clostridium bacteria, which are involved in various diseases. 57. When the integrity of the digestive mucosa is affected, with significant destruction of the bacteria of the intestinal flora, the intestinal immune function breaks down completely 58. This immune function allows for the elimination of any agent that could cause the body to malfunction. The effect of bacteria on immunity is so important that some people describe the bacteria of the digestive flora as natural immunity enhancers. 59. This function of the intestinal flora is confirmed by studies carried out on humans during mass vaccination campaigns 60 61. Individuals who are vaccinated and have high proportions of bacteroidetes and actinobacteria in their faeces develop a good vaccine response 62. Good bacteria promote a good vaccine response. To encourage the proliferation of these bacteria, it is necessary to favour the regular consumption of fruit and vegetables rich in dietary fibre.