“More children die from the flu than from COVID-19. It’s important to vaccinate them»

“More children die from the flu than from COVID-19. It’s important to vaccinate them»Fernando Bustamante

this is one of them Most renowned virologists and vaccine researchers at the international level. Alfredo Garcia Sastre (Burgos, 1964) Participated a few days ago in Valencia at the 9th Summit of the European Working Group on Influenza (ESWI), the highest level meeting to discuss this virus, but also other respiratory viruses such as Cytozoonvirus (RSV) or SARS-CoV-2 and advances in immunity.

What can we expect from SARS-CoV-2 after three years of coexistence?

It will become another respiratory virus. The question is how much illness it will produce compared to the other two major illnesses, RSV (the cause of bronchiolitis) and influenza, because it’s unclear whether it will be as bad or worse than influenza. Of course it won’t be much different. Among people who are already immune-exposed, the virus causes far fewer serious illnesses than it did in the first place. Most people are immunized through vaccines and infection, and while new variants are able to overcome this immunity, they are not strong enough to cause much serious illness. For those newborns who haven’t been vaccinated or haven’t seen the virus, because we already know that the amount of severe disease is very small.

Can giant evolutionary leaps in viruses be expected?

This was not expected, but it is not entirely certain that it will not happen. This is where the problem lies. But that can happen with the flu, right? and any other viruses. This is not desired because it is not selectable. Viruses are able to adapt and multiply as much as possible, and to do this they must spread. Respiratory viruses must be transmitted through secretions primarily from the upper respiratory tract. If the disease is caused in the lower respiratory tract, or if it enters the brain, it cannot spread from there.

Which virus will cause the next pandemic?

We are targeting bird flu again, just like before. I still think there will be a pandemic. But we’ve been wrong twice, so it’s hard to predict. The 2009 pandemic was H1, and no one thought it would be H1. H5 is a big risk because there’s a lot of variability and a lot of viruses in animals right now, which is why they’re a greater risk, but it could be any other subtype.

Which flu season are we going to have?

Normally, the peak is in February, but now there’s a new virus and the situation has become more complicated. We will learn whether the peak (of coronavirus) coincides with the peak of influenza and whether annual SARS-CoV-2 vaccination is required. If consistent, the two vaccines can be administered at the same time, but how to combine them? Because the flu vaccine is not RNA, but the vaccine most commonly used for coronavirus is RNA.

“Again we point to avian influenza[as the cause of another pandemic]but we’ve already been wrong twice.”

Adolfo Garcia Sastre

Now they are given at the same time, but they are two different vaccines. Is the future a single vaccine?

in the same syringe. This is what people would hope for if an annual COVID-19 vaccine is finally completed. It’s easier. This depends on whether the SARS-CoV-2 vaccine is administered annually and the type of vaccine platform that continues to be used. Because although the new coronavirus vaccine does not cause serious adverse reactions, it is indeed effective. If it is added to the flu vaccine, some people may not want to take it because they do not have a fever one day. . Improved vaccines may become available in the future. If these improved vaccines are required every year and can be given with influenza, then there is a need to try to combine them, as is the case with pediatric vaccines.

Already considering it?

We discuss this here, and the improvements that can be made to the COVID-19 vaccine, because it is very good, but the existing vaccines are not exactly optimal. One is reactogenicity: it would be better if they produced fewer side effects. Also because immunity does not last very long. Even if the virus does not change, it must still be used every year. The third thing is to not only avoid severe disease, but also avoid infection and transmission. That would be ideal.

Adolfo García Sastre, Valencia.

This year is the first time children will receive the flu vaccine. What can you expect?

The main consequence is reduced circulation because it’s clear that the people who really carry the flu virus are children. They’re more likely to get infected, have milder symptoms, but they can easily spread the virus to their parents, grandparents… That’s why flu often coincides with the start of the school calendar, the start of flu, and right after Christmas. The peak comes when they return to school. This peak may be reduced if children are vaccinated.

Convincing parents to just think about avoiding transmission is difficult…

Vaccines need to provide personal benefits to the people who use them, not just social benefits, and fortunately there are such benefits. Not many children get severe flu illness, but more children are currently dying from the flu than from COVID-19. In the United States, there is a non-profit association of parents who have lost a son or daughter to influenza. They are trying to raise awareness that your child can die from the flu, as happened to them, and therefore, vaccination is very important. Also, the intranasal one is very useful for children and does not require needles.

This was also the first year that all babies were given the bronchiolitis “vaccine.” Could it be that the scenery has changed?

Although it took a long time, improved antibodies have been achieved and can be used in different age groups, not just premature babies. But yes, it could be a change of scenery. The only problem is that it’s still an expensive treatment. It can save lives but is difficult to implement in poorer countries.

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