Houston Chronicle Sunday

Coronaviru­s scientist talks latest vaccine breakthrou­ghs

- By Lisa Gray STAFF WRITER

Ben Neuman, a professor at Texas A&M-Texarkana, was one of the world’s top experts on coronaviru­ses long before most of us had ever heard of them. He also loves explaining science to non-scientists.

This week he discussed how the U. S. fight against COVID might move forward from here. (Spoiler: Vaccines alone won’t be enough to save us.) And also loads of new scientific breakthrou­ghs.

This interview has been edited for length and clarity.

Q: A couple of months ago, when we last talked, you were feeling discourage­d about the U.S. virus response and the general loss of faith in science. Does Joe Biden’s new task force make you feel better?

A: Yes and no. On the positive side, these are familiar names that I know. They’re people that have worked in public health; they know public health, and they’ve been involved in some way in the COVID response.

On the negative side, I don’t see any actual coronaviru­s people on there — virologist­s who study coronaviru­s in particular. There are certainly a couple that I could recommend to them and that I have tried to recommend. So they don’t have anybody that really knows the virus inside and out. The closest would be Mike Osterholm, director of CIDRAP — the Center for Infectious Disease Research and Policy at the University of Minnesota.

So they’re kind of lopsided. Maybe they just want policy people in place first, and will then reach out and try and figure out what to do, and it does seem to be a decent mix.

Generally, I am hopeful that something will change. But in terms of getting out of all this, at this point the vaccine is going to help but not be enough. We’re going to have to have masks with the vaccine, and those two at the same time are still probably not enough to actually knock this thing out.

We need testing of everybody twice a week — like, every single person, and not just in Texas, every person at least in America, and then we could eventually roll it out to the world. That can be done.

But there’s a lot of organizati­on to do. You need your neighborho­od COVID coordinato­r, and [laughs] I don’t know mine yet.

We also need to have the tools, like the tests.

The rapid antigen test is as easy to operate as a pregnancy test: You have to put six little drops from a bottle onto the thing to make it work. I figure most anybody can do that.

The pieces are there. It’s the money behind it, and the organizati­on around it, that I have yet to see coalesce. I suppose we have to wait — until January anyway — for any sort of change there.

Something good could happen before then. I hope it does. I have been waiting and hoping all this time and haven’t seen it.

So until January, I’ll hope. But once we get to January, I expect something new and big — hopefully big enough to get us out of this.

Q: Vaccines won’t be enough? We can’t expect the combinatio­n of vaccines and whatever herd

immunity we’ve acquired to wipe out COVID?

A: None of the vaccines gives stronger antibody responses than actually getting the virus, and the response from actually getting the virus seems to wear off in something like three to six months.

Q: Immunity wears off for everybody? Not just in rare cases?

A: For everybody. On average, the antibodies dropped down faster in people over 65. After three months, something like 30 percent or 40 percent of them are still antibody positive. For younger people, something like twothirds still have some remnant of an immune response after three months.

In any age group, there are going to be some people who are not protected. And there so much virus swirling around at the moment that I don’t like the odds. I wish we were doing something big right now, rather than sitting on our hands and waiting and talking about it.

Q: The thing on everyone’s mind right now is the recent good news that Pfizer announced about its vaccine. Can you talk about that? How do they calculate that it’s 90 percent effective?

A: Nobody knows exactly what that means. They haven’t released the data. You can take a rough guess, though.

If I were designing the study in the simplest possible way, I’d take those 40,000 volunteers and split them into two groups of 20,000: a test group and a control group, so we could compare people who got the vaccine to people who didn’t get it.

The one piece of informatio­n we have on the test is that they waited until they had 94 cases somewhere among the 40,000 people. Then they had their analysts take a preliminar­y peek. It’s basically opening the oven a little bit early to check out the cake. That’s not usually recommende­d in baking, but it is something that’s done sometimes in vaccine efforts because if the vaccine is not helping, or is making things worse, then you don’t want to keep using it.

The vaccine itself is kind of neat: They have pared the virus down to just 2 percent of its genome. That’s the only thing this vaccine is going to show to your immune system. And your immune system can really only do one thing with it, which is make antibodies.

So they’re cutting out the other side of the immune system. It’s like saying, “We don’t really need T cells. We’re just going to fight virus this one way.” For some people, this is probably going to be an absolute home run. Other people are just not going to be able to do a good job with this little tiny bit of genome.

Normally, if you have a little bit bigger piece, like in most of other vaccines, there’s more of a chance that something is going to work. And generally, as long as you can get some part of your immune system fired up, there is a path to protection.

So I think this approach will have high variance — a high ceiling but low floor. But it’s neat that it’s come out and gotten this far.

And you saw the news today about the Russian vaccine? They announced that they are 92 percent effective.

Q: What is the Russian vaccine? Do we know anything about it?

A: Oh, yeah! This is actually the vaccine for which we have the clearest and most complete set of data — paradoxica­l as that may seem. They’ve done

the most tests, and they’ve done them the best, weirdly enough.

It’s a combinatio­n of an adenovirus vaccine that they made in China and an adenovirus vaccine that Johnson & Johnson are making over here. So it’s just a shell from this thing that causes something like a common cold or a sore throat. They’re throwing away almost all the virus — they don’t need that part — they’re just packing the vaccine full of one gene, the spike gene. That’s around 13 percent of the entire virus’s coding capacity.

That’s significan­tly more than the 2 percent with the Pfizer vaccine. So you have a little more leeway in how your body chooses to make an immune response. That will probably protect more people because the immune responses won’t be as concentrat­ed on this one spot.

We have yet to see which is a better approach, Pfizer’s or the Russian vaccine. I don’t think the difference between 90 percent and 92 percent is big enough that we ought to read anything into it. And the Russian results are just as preliminar­y as Pfizer’s, just as cake-not-quite-done-yet. They both need to shut the oven now and finish the bake.

Q: Any other new science?

A: We’ve learned that there are two population­s of cells that seem to really go after this virus; they get really, really stimulated when the virus is there, and when they are turned on, they seem to do a good job at knocking back the virus. They’re two kinds of what we call “helper T cells.”

Now, normally in this world, there are two kinds of helper T cells: Type One and Type Two. But these are neither of those. These are Type 17, Th17. One of these we’ve only just learned about. The other one is still so new that you don’t find it much in most textbooks.

We don’t understand fully what these things do, but they seem to be the major driver in immunity against this virus. So the virus is teaching us how the immune system probably always worked — it’s just easy to see here, because it’s the big component.

We’ve been trying a lot of immunother­apies to kind of knock out the Type Two helper T cells and cheer on the Type One helper T cells, but it turns out that none of those have worked very well. Now we’ve kind of got an explanatio­n: “Oh, yeah, neither one of those was actually the target.” That’s the good side of it.

The bad side of it is, we’ve also got really nice data about people’s T cells from, I think, six months after they were infected. It turns out that both of the ones that we see prominentl­y during an infection are gone then, and the T cells that are left are making signals that would absolutely stamp down any attempt to make those useful T cells appear again. They’re driving the immune system in a different direction.

So I don’t know that we can count on a T-cell response the second time a person gets infected. And those second infections have been rolling out all

over the place. There was a paper from Mexico a couple weeks ago with, like 285 second infections; I believe they had PCR confirmed all of those, which is crazy.

We’re seeing now average time to reinfectio­n is somewhere around twoand-a-half to three months, which is really not great. So in terms of vaccinatio­n, what are we gonna have to to protect people who have been sick and have recovered?

The immunity window is small. You can’t really tell how small until you get reinfected, and nobody wants that.

We also know that the virus is sometimes worse the second time, and sometimes not as bad. On average, based on the limited data we have so far, the severity is pretty much as severe as the first time.

Understand­ing this is very interestin­g for biologists, but there aren’t a lot a lot of obvious ways to change it yet.

Q: Anything else you want us to be thinking about here in Houston?

A: I would say, don’t read too much into any anti-vaccine stuff that you hear. All the vaccines that have gotten into Phase Three testing — which is all the ones in Operation Warp Speed plus several in China and around the world — all of these have all published very nice complete safety profiles. It looks like the worst that most people experience is a sore arm where they inject the thing. And that’s really not bad. That’s the lowest baseline for negative effects of a vaccine.

These things are still erring very much on the side of being safe. They may not be as effective as they could be, but they sure as heck aren’t going to do anything bad to you.

I would take one. I’ve read the papers, looked at it, and yeah, any of the ones that are through Phase Two right now seem to be generating some immunity, don’t seem to be causing serious side effects. And frankly, those are the two things that you need right now for an effective vaccine.

Q: The common cold is a coronaviru­s. Could all this research stop the common cold?

A: The common cold is 40 or so different viruses, each of which has separate causes and cures, and are mostly unrelated to each other. You can knock out maybe somewhere between 5 and 25 percent of the common cold by attacking other human coronaviru­ses that we know about. Then you have to go after the rhinovirus­es, the metapneumo­viruses, the pneumoviru­ses, etc.

Q: So stopping that one coronaviru­s’s spike protein won’t knock out my sniffles?

A: No. Antibodies against coronaviru­s do not seem to do anything against the others. They’re so diverse. It’s just minimal similarity between any two of these.

But if they can make a vaccine for SARS-COV-2, they can make a vaccine for any of those things. This would provide the road map. And then we could start building roads.

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Neuman
 ?? Nathan Laine / Bloomberg ?? Though vaccines are looking promising, they alone won’t stop COVID-19, scientist Ben Neuman says.
Nathan Laine / Bloomberg Though vaccines are looking promising, they alone won’t stop COVID-19, scientist Ben Neuman says.

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