COVID convalescent plasma, a roundabout route towards immunity

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Dahlan Iskan former Minister of State-Owned Enterprises

IO – Many people are not aware of the wonders of convalescent plasma. Among others, it may generate immunity for those who have never contracted COVID-19.

But is that true?

It is,” said Dr. dr. Theresia M ica Rahardjo, the first physician in Indonesia to apply convalescent plasma therapy to COVID-19 patients. Yes, her first qualification is as an anesthetist. However, she is also an ICU expert consultant.

“Plasma cleansing is like a daily meal for me,” Monica said. “I studied viruses, DNA, RNA, and everything related to it. My Master’s thesis at the ITB, the Bandung Institute of Technology, dealt with genetics and molecular biology.”

However, Monica refused to discuss the generation of immunity via convalescence. “That’s a sensitive issue nowadays,” she said.

Naturally, Monica also refused when I asked her about dendritic cells – as in the ones used for the hotly debated Nusantara vaccine. She absolutely wants to concen trate on convalescent plasma ther apy (CPT), to ensure Indonesia’s record of a success in convalescent immunity. “I never thought that convalescent plasma therapy would be accepted so widely nowadays,” she said. “I remember that so many people were against convalescent immunity at first – and mostly it’s fellow doctors who reject it. But really, I don’t want to recall that, it’s too painful. What matters is that now it’s widely accepted by everyone.”

It is this very painful initial rejection that is suffered by the Nusantara vaccine team now: The permit for its Phase 2 Clinical Trials has not been issued for months. In fact, it is said that the National Food and Drug Control Agency (Badan Pengawas Obat dan Makanan – “BPOM”) has ordered that Testing be redone from scratch. No, not restarting the Phase 1 Clinical Trial – restarting even from Pre-trials!

But why allow convalescent plasma therapy to continue? That’s because Nusantara vaccine is a “vaccine”, while the other treatment is “convalescent plasma therapy”. In the end, it all hinged on the definition of a “vaccine”. This is not about the ability or inability to generate immunity. Nobody denies that either convalescent plasma or den dritic cells can generate immunity. It’s just that due to their process of generation, they cannot be called “vaccines”.

Virologists such as Prof. Dr. Choirul Anwar Nidom, the creator of the avian flu vaccine, are highly supportive of the Nusantara vaccine. He even went as far as to say that the process used in the Nusantara vaccine is better than the one in the convalescent plasma therapy. “The principle is actually similar, in that they both can generate or induce the creation of antibodies from the outside,” he said. “The first difference is that convalescent plasma therapy can generate a protein mismatch. The second difference is that immunity generated by the supply of convalescent plasma must be repeated, as the titration can decrease. However, you don’t need to repeat dendritic-based treatment, as the initial dendritic can bequeath immunity to their dendritic progeny.”

So that’s how it is widely bruited that “Nusantara vaccine is meant for a lifetime”. But more importantly, there are at least two other ways than vaccination to generate immunity: First, convalescent plasma, and second, dendritic cells.

Therefore, as a non-expert, I can only ask, “Why is it only vaccination is allowed for generating immunity?”

Convalescent plasma therapy is finally allowed – in America. This permit is granted because of factual proof – proof that’s fought for by Doctor Monica. But in the end, this method could only be tried after a long fight for the patient’s autonomy – to choose the method they want to be treated with. Luckily, many COVID-19 patients request convalescent plasma therapy…and their stubbornness is proven by the fact that their immunity really existed, thanks to CPT.

Does this mean that Nusantara vaccine must also take the same roundabout route as convalescent plasma therapy?

I don’t know.

If so, I will volunteer to seek people who will autonomously choose the “Nusantara vaccine” therapy, with the word “vaccine” here serving as a brand name of sorts instead of really describing a vaccine.

Let’s say that’s the route we’re taking, and then the efficacy is proven – then more and more people will undergo it. Finally, it will be permitted.

I suppose our people really do prefer the roundabout way of doing things – and this is why we’re so often lagging behind in everything.