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We should have a better idea soon. A number of trials are underway to test the potential of vaccine combinations, and the first results will be finalized this month. If these mixed regimes prove to be safe and effective, countries can continue to move the spread of vaccines, even if the supply of a vaccine is reduced due to manufacturing delays, unforeseen deficiencies or safety issues.
But there are other exciting solutions that could be a key component of our strategy in the future: vaccine disorders can lead to broader immunity and prevent viruses from trying to prevent our immune system. In the end, a mixed and matched approach may be the best way to protect ourselves.
Mixing test
The covid-19 vaccines currently in use protect against the virus in slightly different ways. Most target the coronavirus spike protein, which it uses to penetrate our cells. But some provide instructions for making proteins as RNA messengers (Pfizer, Moderna). Some deliver the same spike protein (Novavax). Some use another harmless virus for instructions on how to do it, such as the Trojan horse (Johnson & Johnson, Oxford-AstraZeneca, Sputnik V). Some offer a complete inactivated virus (Sinopharm, Sinovac).
In one research published in MarchResearchers at the National Institutes of Food and Drug Control in China tested combinations of four different kobid-19 vaccines in mice, and found that some improved their immune response. The rodents were given a vaccine based on an undamaged cold virus to smuggle instructions and then saw a second dose of another type of vaccine, higher antibody levels and a better T cell response. But when they reversed the order, when they were given the second viral vaccine, they saw no improvement.
Why combining plans can improve effectiveness is a bit of a mystery, says Shan Lu, a physician and vaccine researcher at the University of Massachusetts School of Medicine who was a pioneer in this blending strategy. “We can partially explain the mechanism, but we don’t fully understand it.” Different vaccines present the same information in slightly different ways. These differences can awaken different parts of the immune system or sharpen the immune response. This strategy can last longer.
It remains to be seen whether these results will return to humans. Researchers at Oxford University have launched a human trial to test how the mixture might work. A study called Com-CoV provides participants with a close-up of Pfizer or Oxford-AstraZeneca. For the second dose, they will get the same vaccine or a shot of Moderna or Novavax. The first results should be available in the coming weeks.
Other research is also underway. In Spain, where Oxford-AstraZeneca is currently only given to people over the age of 60, researchers want to hire 600 people to study whether the first dose of the shot can be compared to the second dose of Pfizer. According to El País, one million people received the first dose of the vaccine, but are not old enough to take the second dose. Health officials are awaiting the results of this investigation before making recommendations for this group, but it is still unclear whether a participant has been hired.
Late last year, Oxford-AstraZeneca announced that it would be collaborating with the Russian Gamaleya Institute, which developed the Sputnik V vaccine to test whether the two shots work together. The trial was set to begin in March and yield provisional results in May, but it is unclear whether it has actually begun. Chinese officials have suggested that they study the vaccine mix to increase the effectiveness of their shots.
The biggest results could be vaccines with less effective vaccines. Pfizer and Moderna’s mRNA vaccines provide excellent protection. “I don’t think there’s any reason to confuse that,” says Columbia University immunologist Donna Farber. But the disorder may improve the protection of some vaccines that have been reported to have a lower level of protection, such as Oxford-AstraZeneca and Johnson & Johnson, as well as some Chinese vaccines. Many of these vaccines work quite well, but the mix will help them work even better.
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