COVID-19: should oral vaccination strategies be given more consideration?

Mehan, Aman; Venkatesh, A. Narasima; Girish, Milind

doi:10.1177/2515135520946503

Cited by 4 publications

(3 citation statements)

References 11 publications

(15 reference statements)

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“…Together, these reports suggest that IgA is the main type of immunoglobin induced by mucosal infection of SARS-CoV-2 and that IgA-mediated mucosal immunity plays a vital role in anti-SARS-CoV-2 infection. Notably, oral vaccination has also been discussed to prevent subsequent respiratory diseases by activating gut mucosal immunity 168 , 169 . Thus, whether oral administration of SARS-CoV-2 vaccines might achieve better efficacy and longer protection would be interesting to test.…”

Section: Resultsmentioning

confidence: 99%

Potential intestinal infection and faecal–oral transmission of SARS-CoV-2

Guo

Tao

Flavell

et al. 2021

Nat Rev Gastroenterol Hepatol

277

275

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Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread to more than 200 countries and regions globally. SARS-CoV-2 is thought to spread mainly through respiratory droplets and close contact. However, reports have shown that a notable proportion of patients with coronavirus disease 2019 (COVID-19) develop gastrointestinal symptoms and nearly half of patients confirmed to have COVID-19 have shown detectable SARS-CoV-2 RNA in their faecal samples. Moreover, SARS-CoV-2 infection reportedly alters intestinal microbiota, which correlated with the expression of inflammatory factors. Furthermore, multiple in vitro and in vivo animal studies have provided direct evidence of intestinal infection by SARS-CoV-2. These lines of evidence highlight the nature of SARS-CoV-2 gastrointestinal infection and its potential faecal–oral transmission. Here, we summarize the current findings on the gastrointestinal manifestations of COVID-19 and its possible mechanisms. We also discuss how SARS-CoV-2 gastrointestinal infection might occur and the current evidence and future studies needed to establish the occurrence of faecal–oral transmission.

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Section: Resultsmentioning

confidence: 99%

Potential intestinal infection and faecal–oral transmission of SARS-CoV-2

Guo

Tao

Flavell

et al. 2021

Nat Rev Gastroenterol Hepatol

277

275

View full text Add to dashboard Cite

show abstract

“…Importantly, IgA is present on surfaces and participates in upholding mucosal immunity. IgA produced by B cells shaped in the gut might therefore also lead to cross-protection of the mucosal surface of the respiratory tract and, consistently, oral vaccination strategies against SARS-CoV-2 have been advocated and are under development (24).…”

Section: Introductionmentioning

confidence: 99%

Circulating Adaptive Immune Cells Expressing the Gut Homing Marker α4β7 Integrin Are Decreased in COVID-19

et al. 2021

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BackgroundInfection with the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes a wide range of symptoms including gastrointestinal manifestations, and intestinal epithelial cells are a target of the virus. However, it is unknown how the intestinal immune system contributes to systemic immune responses in coronavirus disease 2019 (COVID-19).MethodsWe characterized peripheral blood lymphocytes from patients with active COVID-19 and convalescent patients as well as healthy controls by flow cytometry.ResultsThe frequency and absolute number of circulating memory T and B cells expressing the gut homing integrin α4β7 integrin was reduced during COVID-19, whether gastrointestinal symptoms were present or not. While total IgA-expressing B cells were increased, gut-imprinted B cells with IgA expression were stable.ConclusionCOVID-19 is associated with a decrease in circulating adaptive immune cells expressing the key gut homing marker α4β7 suggesting that these cells are preferentially recruited to extra-intestinal tissues independently of α4β7 or that the systemic immune response against SARS-CoV-2 is at least numerically dominated by extraintestinal, particularly pulmonary, immune cell priming.

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“…Until worldwide mass-scale vaccination is completed, preventive and diagnostic measures must be maintained in primary and secondary services based on national guidelines in order to suppress transmission of the virus. Looking ahead, oral inoculation is deemed a complementary and scalable option in preventing COVID-19 as oral vaccine formulation would ease vaccine distribution, manufacturing, and administration, which in turn shall expand immunization, especially in resource-limited populations [ 54 ]. We believe that local authorities responsible for healthcare are committed to ensuring equitable access to efficacious, affordable COVID-19 vaccines and diagnostics.…”

Section: Long-term Prediction: Being Prepared For Health and Dental Cmentioning

confidence: 99%

Proposal for Tier-Based Resumption of Dental Practice Determined by COVID-19 Rate, Testing and COVID-19 Vaccination: A Narrative Perspective

Farshidfar

Jafarpour

Hamedani

et al. 2021

JCM

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Since the emergence of the new coronavirus disease (COVID-19), profound alterations in general and specialist dental practice have been imposed to provide safe dental care. The guidelines introduced in response to the COVID-19 pandemic to mitigate healthcare disruption are inconsistent regarding the dental practice re-installation, particularly during a transitional time. Despite the successful mass vaccination campaigns rolled out in 2021, the presence of more than 80 genotypes of COVID-19, rapid neutralisation of antibodies within a short period of seropositivity, and the likelihood of recurrent infection raise some doubts on whether vaccination alone will provide long-term immunity against COVID-19 and its variants. Here, from this perspective, we aim to provide an initial proposal for dental services reinstallation, easily applicable in various care settings. We discuss the potential options for the transition of dental services, as well as challenges and opportunities to adapt to new circumstances after mass COVID-19 vaccination. The proposal of the universal three-tier system of dental services resumption, determined by regional COVID-19 rates, testing accessibility, and vaccination rollout has been presented. Following herd COVID-19 immunity enhancement, it would be prudent to confer various preventative measures until virus spread naturally diminishes or becomes less virulent. Based on modelling data, dental practices may not return to normal, routine operation even after global vaccination as there would still be a significant risk of outbreaks of infection. Variable, multi-level measures will still be required, depending on the local COVID-19 cases rate, to secure safe dental care provision, despite predicted success of vaccination agendas. This approach can be implemented by achievable, practical means as a part of risk assessment, altered work pattern, and re-arrange of dental surgery facilities. The adequate standard operating procedure, with the support of rapid point-of-care testing at workplace, would vastly intensify the uninterrupted recovery of the dental care sector.

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COVID-19: should oral vaccination strategies be given more consideration?

Cited by 4 publications

References 11 publications

Potential intestinal infection and faecal–oral transmission of SARS-CoV-2

Potential intestinal infection and faecal–oral transmission of SARS-CoV-2

Circulating Adaptive Immune Cells Expressing the Gut Homing Marker α4β7 Integrin Are Decreased in COVID-19

Proposal for Tier-Based Resumption of Dental Practice Determined by COVID-19 Rate, Testing and COVID-19 Vaccination: A Narrative Perspective

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