Uncover The Facts Behind COVID-19 Vaccine ( BEM KMFA UGM, Indonesia

UNCOVER THE FACTS BEHIND COVID-19 VACCINE WITH DR. DEWI KARTIKAWATI PARAMITA, DEPARTMENT OF HISTOLOGY & BIOLOGY, FACULTY OF MEDICINE, GADJAH MADA UNIVERSITY AMBASSADORS: JESSLYN NADIA, DEA PURNAMA PUTRI BEM KMFA UGM, INDONESIA

Could you explain to us the details of vaccines?

Vaccines are biological substances produced by living organisms or viruses, or the organisms or viruses themselves that are attenuated or inactivated, which are injected or administered orally to humans or animals, for increasing immunity against certain diseases.

Could you tell us what are the benefits of vaccines?

Vaccines will increase immunity against a disease. By administering a vaccine for the same germ that infects that person, a person will gain immunity without experiencing illness caused by the organism. For example the Covid-19 vaccination. With the SARS-Cov-2 vaccination, the immune system in our body will be induced to produce immunity without being preceded by an illness. In addition, because the vaccine dose is measured, the immunity produced will be sufficient to fight back infection.

Could you give us the reasons why people should be vaccinated, especially during this Covid-19 pandemic?

The first reason is that we have immunity to certain germs or diseases so we are protected from being infected, or if infected it won’t be severe or even asymptomatic. If a large proportion of the population already has immunity, most of them won’t get sick when they meet someone with the disease. For example, 80% of the population already has immunity to COVID-19. If 5 people meet someone who is sick with COVID-19, then 4 out of 5 people won’t become sick and won’t spread the disease. Therefore, vaccination is important not only for oneself, but also for the common good because it prevents the transmission of disease, and can even prevent the transmission of infection.

Could you give us confidence about the safety of vaccines?

The manufacture or development of vaccines is carried out through various stages. Starting from the preclinical stage in the laboratory (the in vitro level), then in vivo in experimental animals, after that it enters the clinical trial stage in humans which includes three phases. Since preclinical trials are in vitro and in experimental animals, safety becomes the main concern. Then in each phase of clinical trials, safety evaluation is always a priority in addition to the effectiveness and several other factors. If it passes all these tests, the vaccine will get permitted from competent authorities to be circulated and used. Therefore, the vaccine that has been circulating has passed the test for safety.

Vaccines can be derived from different components (SARS-Cov-2 virus, inactivated virus, SARS-Cov-2 virus components, protein, mRNA, DNA), which will be processed in different ways in our body. For RNA and DNA vaccines, a protein formation process that is encoded by RNA or DNA will be carried out first. After the protein is formed and given the SARS-Cov-2 inactivated virus, the protein or virus will be taken up by dendritic cells and processed into small components (peptides). The peptides will be presented to T cells by dendritic cells, especially T helper cells who are going to activate the B cells. The activated B cells will differentiate into plasma cells and produce specific antibodies against SARS-Cov-2. These antibodies can detect and catch the virus when it enters the cells. On the other hand, if the protein encoded by the SARS-Cov-2 RNA or DNA vaccine is formed, the protein processed by the dendritic cell will activate the T cell and become a cytotoxic T cell (can kill virus-infected cells), dendritic cells, T cells (helper and cytotoxic), and B cells (immune cells).

Could you give us an explanation of why those who have been vaccinated still possibly get infected?

One of the antibodies that is expected to be formed after vaccination is neutralising antibodies, whose function is to catch the virus before it enters the body, for example it’s still in the respiratory tract cavity. However, there aren’t enough studies showing whether vaccination produces neutralising antibodies or not. In addition, the SARS-Cov2 virus has a mechanism to escape from the immune system, in this case it escapes from neutralising antibodies. People who have been vaccinated are more protected, even if infected, usually the symptoms are milder or have no infectious symptoms.

Why does each type of vaccine have different levels of effectiveness?

Because each type of vaccine comes from a different main component (e.g. live attenuated germs, inactivated germs, their components, e.g. proteins, mRNA, DNA). In addition to the main components, vaccines also contain other components, such as adjuvant, whose function is to strengthen the antigens in the vaccine. The main and additional components in this vaccine will be processed by the immune system differently. Theoretically and proven in research, vaccines with different components can induce an immune response. However, because the components are different, different results are also very possible. The vaccine must have an efficacy of more than 50% to be approved by the competent authority to be used. Once approved and used, active monitoring of effectiveness and safety continues. Why does each type of vaccine have different side effects?

When the vaccine is injected or inserted into the body, the immune system will be activated in the body. The reaction that will occur is an inflammatory reaction, which can be local, but systemic reactions can occur. Generally, the effects (post-technical follow-up conditions/AEFI) from various types of vaccines are basically the same, which are pain, swelling, fatigue, dizziness, fever, pain in muscles or joints, and maybe some other symptoms. Symptoms of vaccine side effects usually disappear within 1 or 2 days. Serious or fatal side effects are few. If so, there may have to be a concomitant condition.

Could you explain why the Astrazeneca vaccine has pre-vaccine effects difference for those who are under 30 years old and over 30 years old?

In the UK, it was found that 79 people who have been vaccinated suffered from blood clots and 19 of them died. Of those 19 people who died, 3 of them were under 30 years old. After being analysed, people who are under 30 are predicted to have the highest risk of vaccine side effects or in Indonesian kejadian ikutan pasca imunisasi (KIPI).

Vaccinations for COVID-19 are vaccines that are being developed with the acceleration of time. Due to pandemic conditions, a Covid-19 vaccine was developed within 18 months while vaccine development usually takes up to 10 years under normal conditions. Therefore, there was no clinical trial data for those under 18 years old, because clinical trials of the Covid-19 vaccine initially only included participants aged 18 years and over. However, along with the increasing time and need, a Covid-19 vaccination study proved that vaccination for children under 18 years old is safe and effective.

Does the third dose of vaccine with a different type have any side effects?

Side effects that may arise are similar to the first or second vaccine.

If someone is exposed to Covid-19 infection and then declared cured, does the second vaccine have to wait three months after being declared cured? How will the second dose of vaccine affect Covid-19 survivors?

In such cases, and coincidentally various studies were carried out on mRNA vaccines, these survivors only need one vaccination, not twice. Up to about 3 months after recovering from COVID-19, they still have immunity. Therefore, it is recommended to get vaccinated again after 3 months. In cases like those asked, it is better to get a second vaccine after 3 months of recovering from Covid-19. In several studies that I conveyed to Covid-19 survivors, vaccination can increase antibody levels several times.

Is there a possibility of a prolonged effect on someone who has been declared cured of COVID-19?

If someone is infected with the SARS-Cov2 virus, they can suffer from COVID-19 with symptoms the at can be mild to severe or even fatal to death. If the illness is severe enough, when it recovers, there is a possibility of leaving defects or abnormalities. When we recover, our immune system is induced to produce immunity against SARS-Cov2.

Is there any possible consequence when someone who is infected with Coronavirus gets vaccinated?

In general, immunisation or vaccination must be carried out in healthy conditions because the principle of vaccination is to introduce germs or components of germs into the body. The body will react in the form of inflammatory reactions to induce the immune system. If a person is positive for Covid-19, that means an inflammatory reaction is also taking place in their body. If this person is vaccinated, it will cause a severe inflammatory reaction and may be bad.

In your opinion, what strategies can be used for overcoming public doubts about the Covid-19 vaccine after hearing news about the severe side effects?

Education. Medical personnel must understand well about the principle of vaccination, how to give it, how it works and its side effects. In addition, medical personnel should be also provided with simple counselling on how to convey a persuasive but good message. So that people get the right information in the right way.