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At the Max Planck Institute for Infection Biology in Berlin, the old active ingredient has now been upgraded using genetic engineering methods so that it could be even more effective. During this time, this message suffices that Grode’s phone is no longer at a standstill. VPM1002 is the name of the successor to the well-known vaccine Bacille Calmette-Guérin (BCG), which was designed by the Berlin researchers and is the only vaccine against tuberculosis to date. BCG was developed by the French scientists Albert Calmette and Camille Guérin in the 1920s and contains the weakened pathogen of bovine tuberculosis. It is administered to young children in countries where tuberculosis is rampant.
Cheap but controversial
The syringe is cheap, but controversial: BCG only protects against the worst forms of tuberculosis, in which bacteria affect the entire body. “In these children, the vaccine works the way science intended,” explains Stefan Kaufmann, who has now retired as director of the Max Planck Institute for Infection Biology, but has driven further development there. BCG pretends an infection and thus stimulates the immune system. Suitable immune cells are formed, which switch on as soon as an infection actually occurs. But BCG can obviously do more: it also upgrades the non-specific or the innate immune defense. These are the cells that the body sends on patrol without knowing which pathogen is threatening it. The effect was first noticed by the Danish epidemiologists Peter Aaby and Christine Stapel Benn; BCG apparently protects against many pathogens. “They observed that vaccinated children died less frequently after years than the unvaccinated,” says Kaufmann. The two were laughed at for a long time.
In 2014, however, the World Health Organization decided that there was probably an effect. Two years later, the British Medical Journal published a review certifying BCG and measles vaccination to have a general protective effect against infections. The double effect has now been experimentally confirmed and the immunologist Mihai Netea from the Radboud Universitair Medisch Center in Nijmegen believes that he has understood the mechanism behind this phenomenon. His team found that BCG can still be found in the skin of the vaccinated even months after the vaccination. There, he says, activate the innate defense. In Greece, he started studies with the elderly to protect them from serious infections such as influenza. Further studies should actually start in the Netherlands shortly. Then Corona came – and everything changed.
This does not prevent infection
With epidemiologists Marc Bonten from the University Clinic in Utrecht, Netea will soon inoculate a thousand doctors and nurses in eight Dutch clinics with BCG in order to protect them from severe Covid 19 cases. The infection begins like other viral respiratory infections: with cough, shortness of breath, fever, sometimes mild, sometimes more serious. In some patients, however, this condition worsens in a second phase, and before that you want to protect medical personnel who are at very high risk of infection. “It’s not that vaccination can prevent infection,” said University of Toronto immunologist Eleanor Fish of Science magazine. But it could mitigate the course. If this turns out to be correct, it could even be an advantage if the vaccine does not completely prevent infection, says Kaufmann. In this way, the infection of the population and the associated protection for people at risk can be achieved somewhat more safely.
The main goal, however, is to offer an interim solution with BCG until a specific vaccine is developed. Medical teams in Australia and the UK have joined the Dutch and will also start clinical trials in the next few days. Germany will follow in three weeks with the upgraded vaccine: they would have incorporated a protein into BCG that would make it safer and more effective at the same time, explains Kaufmann. This has already been tested in studies, but the vaccine has not yet been approved. “That’s why the applications simply take a little more time,” says VPM boss Leander Grode. Until then, the fear of the virus will also increase among German nurses with the pictures from Italian and Spanish hospitals. In Italy, 2696 hospital employees have become infected, 8.3 percent of all infected people in the country.