"Non-specific effects" of vaccines go beyond the specific protective effects against the targeted diseases. They, if real, could theoretically be beneficial, neutral or negative.
This article intends ...to answer the following questions:
Do the non-specific effects of vaccines exist? Almost certainly yes, and they can be important in low-income countries
Are non-specific effects also present in high-income countries? At least to some extent, it seems quite logical
Can non-specific effects be systematically identified by the current systems of side effects/unintended reactions monitoring? Most likely not
Could the Institute of Medicine proposals and some ongoing attempts solve the issue? It seems unlikely
Could there be better, feasible and ethically acceptable ways to achieve the aforementioned objective?
A proposal is presented about this issue, with the potential both to solve the problem with the most valid methods, and to overcome the ethical problems that have so far precluded the adoption of RCTs to study possible vaccine non-specific effects, monitored by long follow-up.
Systematic reviews have shown a prevalence close to 20% of gastrointestinal symptoms in COVID-19 positive patients, with nearly 40% of patients shedding viral RNA in their faeces, even if it may not ...be infectious, possibly because of inactivation by colonic fluid.According to current evidence, this virus is primarily transmitted by respiratory droplets and contact routes, including contaminated surfaces. The virus is quite stable on stainless steel, being detected up to 48-72 hours after application. Therefore, some individuals can be infected touching common contaminated surfaces, such as bathroom taps. Taps can be underestimated critical points in the transmission chain of the infection. Indeed, just by turning the knob, people leave germs on it, especially after coughing over their hands, sneezing, and/or blowing their nose. After handwashing with soap, user take back their germs when turning the knob. Paradoxically, the following user collects the germs back on his/her fingers by implementing a preventive measure, maybe before putting food into the mouth or wearing contact lenses.The Italian National Institute of Health recommends to clean and disinfect high-touched surfaces, but it is unrealistic and inefficient to do so after each tap use. As an alternative, new toilets should install long elbow-levers - or at least short levers - provided that people are educated to close them with the forearm or the side of the hand. This is already a standard measure in hospitals, but it is particularly important also in high-risk communities, such as retirement homes and prisons. It would be important also in schools, in workplaces, and even in families, contributing to the prevention both of orofaecal and respiratory infections.In the meantime, people should be educated to close existing knobs with disposable paper towel wipes or with toilet paper sheets.
Can we trust trials with such features? Donzelli, Alberto; Giudicatti, Giulia; Sghedoni, Donatella
Epidemiologia e prevenzione,
2022 Jan-Apr, Letnik:
46, Številka:
1-2
Journal Article
PDF
