THOMAS LIANG & ARPIT KUMAR

he/him | age 18 | Mississauga, ON

1st place in University of Alberta's Interdisciplinary Science Central Case Competition | 2nd place in Western University's High School Case Competition | AP Scholar Award

Edited by Angela Xu

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INTRODUCTION

With the recent onset of the coronavirus disease 2019 (COVID-19) Omicron variant, we are reminded of the utmost importance of mass vaccination during a pandemic. As of February 19, 2022, Ontario has reported the “lowest number of hospital admissions due to COVID-19” since early January (Neufield, 2022). Accordingly, the province plans to reduce COVID restrictions by lifting capacity limits and removing the vaccine-certification system. Thus, vaccinations have proven to be successful in slowing the spread of a pandemic, but how can we improve vaccine development in preparation for future pandemics? This paper will approach this topic through three main perspectives: the use of polymers in vaccines, the biomedical implications of vaccinations, and how computer science (CS) programming can be used to benefit the mass administration of vaccines.

USE OF POLYMERS IN VACCINES

Polymers are defined as natural or synthetic substances composed of multiple simpler molecules known as monomers. Natural and synthetic polymers are used ubiquitously in our model world, but they are created differently. Natural polymers are extracted from natural sources, which are usually water-soluble macromolecules. For instance, carbohydrates, fibers, fats, and proteins are all natural polymers that are essential to sustain life (Bhatia, 2016). In contrast, synthetic polymers are derived from their constituent monomers, either through derivation of petroleum oil or synthesis in a lab. They are also used extensively in our daily lives; some examples include polyethylene (plastic bottles), polyester (clothing), and teflon (kitchen utensils) (Bhatia, 2016). Polymers are used frequently to make medical equipment, such as sutures, cosmetic implants, and dental composites. However, there is a growing utilization of polymers in the microscopic world. This leads to the question: How might natural and synthetic polymers be used to make vaccines more effective?

Current literature suggests that the use of natural biodegradable polymers (also known as biopolymers) in vaccines improves immune response in comparison to vaccines made without these polymers. In contrast to classical alum-based adjuvants, biopolymers are actually present in the cell wall of various pathogens (e.g. bacteria and yeast) and present many advantages compared to synthetic polymers. For example, biopolymers dissolve biologically into non-toxic components inside the body and they are more readily available than its conventional counterparts. Pippa et al. (2021) express their support for biopolymer-based systems as drug delivery carriers, citing how their low toxicity, biodegradability of the polymers, and unique properties make them ideal candidates. They may also potentiate the immune response to associated antigens (Bose, 2020), and already present several advantages including “strong cellular immune responses, increased secretion of cytokines, co-loading and prolonged circulation of antigens, and increased levels of antibodies and antigen-specific antibodies” (Pippa et al., 2021). Overall, Han et al. (2018) and Bose et al. (2019) echo this sentiment, sharing that biodegradable polymer delivery systems have significant advantages in terms of biocompatibility, biodegradability, and minimal toxicity in different delivery systems. However, all sources agree that more research must be conducted to truly understand the implications and limitations of biopolymer-based nanovaccines.

NEUROLOGICAL IMPLICATIONS OF VACCINES

Vaccines usually take 10-15 years to be fully developed, regulated, and administered. The COVID-19 vaccine, however, was developed and released to the public in a record-breaking speed - just over a year. This reasonably leads to many people questioning the authenticity of the innovative vaccine, and how safe it truly is. As such, some studies have indicated that there are minor neurological implications of (1) inactivated, (2) viral vector, (3) protein subunit, and (4) nucleic acid vaccines; in particular, demyelinating diseases were found to be potentially associated with viral vector vaccines (Lu et al., 2021). In short, demyelinating diseases cause damage to the myelin sheath, a protective covering that surrounds the nerve fibers in your brain, eyes, and spinal cord; as a result, nerve impulses begin to slow down or stop, which may further lead to neurological issues (Swanson, 2022).

According to a review from Lu et al. (2021) and a study from Finsterer (2021), the most frequently reported neurological adverse effects are demyelinating diseases (e.g. multiple sclerosis (MS) and transverse myelitis), Guillain‐Barré syndrome (GBS), venous sinus thrombosis, encephalopathy, and seizure. Furthermore, the National Institute of Neurological Disorders and Stroke admitted that although it is a rare event, GBS, along with other neurological complications, has occurred in patients who have received the Janssen COVID-19 vaccine (2022). For context, GBS is a rare neurological disorder in which the body's immune system attacks its own nerve cells (National Institute of Neurological Disorders and Stroke, 2022). Some of the resulting symptoms include difficulty with eye muscles and vision, severe pain, and an abnormal heartbeat (National Institute of Neurological Disorders and Stroke, 2015). Although there is currently no cure for GBS, a variety of pharmacological and nonpharmacological treatments may be used.

Thus, this raises a valid concern of whether vaccines directly contribute to an increased risk of neurological disorders. However, the majority of the existing literature suggests that there is no relationship between different types of vaccines and MS, GBS, and other neurological disorders (Lu et al., 2021; DeStefano et al., 2003). Nevertheless, it is imperative for both healthcare professionals, especially neurologists, and the patient population to stay aware of the potential side effects and remain vigilant to recognize and treat them efficiently (Finsterer, 2021).

BENEFITS OF CS PROGRAMMING

The use of CS programming in the manufacturing, distributing, and supervising processes of vaccines in general would undoubtedly contribute to a straightforward, safer, and efficient vaccine rollout plan. When manufacturing and testing vaccines, an application based on machine learning and artificial intelligence (AI) can be implemented to test various versions of the vaccine prior to manufacturing prototypes. Using a simulation, various 3-D molecular arrangements of polymers and other compounds in the vaccine can be tested to determine their effectiveness. This allows scientists to save time, resources, and production costs. At the Idaho National Laboratory (2022), researchers used machine learning and AI to simulate modifications to chemical reactions and catalysts, which reduced the need to conduct physical experiments for modifications and increased the researchers’ safety when working.

Moreover, software programming may aid in social media promotions of vaccines. Advertisements of vaccines and its benefits towards reducing infections have already been posted on various social media platforms with the purpose of spreading awareness and thereby significantly increasing the number of vaccines administered. However, a qualitative study by Steffens et al. (2020) revealed that the promotion of vaccines on social media platforms did not prove to be as effective as anticipated by their respective organizations. To combat this, an algorithm can be developed and implemented to determine which groups of people are pro-vaccine based on user activity. Promoting specifically to this target audience will expand the number of people that view our advertisements, improving our chances of spreading the message, and therefore resulting in more vaccine administrations (Puri et al., 2020). On the other hand, to target those who are more vaccine-hesitant or anti-vaccination would experience repetitive viewing of positive vaccine-related content on social media, thus encouraging them to become vaccinated (Steffens et al., 2019).

An application will be developed where citizens can upload their health information, including their vaccination status and their contraction history. The app will be connected directly to the government’s healthcare database, and so users will be able to access their vaccine verification information directly from the application. Thus, people will have their vaccine status on hand, making it convenient for record-keeping purposes or to quickly check into establishments. In addition, the application will include a map of the user’s city which displays the virus’ hotspots. Subsequently, if a user contracts the virus and uploads this to the application, any users that were in proximity of the infected user will be notified to get tested for the virus. Looking at the application from a development viewpoint, strings (i.e. a sequence of characters) would be used throughout the application when displaying text. Users would be grouped in arrays depending on their vaccine status, and this would also be used when categorizing the active cases in different locations, and the locations that a user visits. A loop will be used to traverse and monitor all the positive users in a list, and if a user’s status is changed to negative, they will be removed from said list. For if/else statements, if a user has tested positive, the application will search for other users that were in proximity of the infected user and notify them to get tested.

Lastly, the ethical considerations would include the user’s vaccine status, infectious status (positive or negative), and proximate location. In addressing the privacy concerns, the app will have no way of knowing the user’s name, address, or any other identifying information. Here, the identity of the user is insignificant as the main purpose of the app is to recognize if there are any infectious individuals nearby, monitoring the general movement of the virus. Prior to completing registration, the user will be presented with the full terms and conditions of using the app, including the potential risks, implications, and consent agreements. At any point, if the user decides to withdraw their consent of sharing data, they are free to delete their account. Then, any related data will be destroyed within the app’s database system.

conclusion

Overall, the development of vaccines can be improved through biochemical, medicinal, and computer scientific means. The use of biodegradable polymers in vaccines should be thoroughly considered as it provides immense benefits, but the medical community must be well-informed and mindful of the potential neurological side effects such as GBS. Finally, the implementation of an application through the use of AI and machine learning can assist in the administration of vaccines and real-time tracking of positive COVID cases. Further research is required in each individual section to maximize improvement in vaccine effectiveness.

REFERENCES

Bhatia, S. (2016). Natural Polymers vs Synthetic Polymer. In: Natural Polymer Drug Delivery Systems. Springer, Cham. https://doi.org/10.1007/978-3-319-41129-3_3

Bose, R. J. C., Kim, M., Chang, J. H., Paulmurugan, R., Moon, J. J., Koh, W.-G., Lee, S.-H., & Park, H. (2019). Biodegradable polymers for modern vaccine development. Journal of Industrial and Engineering Chemistry, 77, 12–24. https://doi.org/10.1016/j.jiec.2019.04.044

DeStefano, F. (2003). Vaccinations and risk of central nervous system demyelinating diseases in adults. Archives of Neurology, 60(4), 504. https://doi.org/10.1001/archneur.60.4.504

Finsterer, J. (2021). Neurological side effects of sars‐cov‐2 vaccinations. Acta Neurologica Scandinavica, 145(1), 5–9. https://doi.org/10.1111/ane.13550

Han, J., Zhao, D., Li, D., Wang, X., Jin, Z., & Zhao, K. (2018). Polymer-based nanomaterials and applications for vaccines and Drugs. Polymers, 10(1), 31. https://doi.org/10.3390/polym10010031

Idaho National Laboratory. (2022). Learning to improve chemical reactions with artificial intelligence. INL. Retrieved February 20, 2022, from https://inl.gov/article/learning-to-improve-chemical-reactions-with-artificial-intelligence/

Lu, L., Xiong, W., Mu, J., Zhang, Q., Zhang, H., Zou, L., Li, W., He, L., Sander, J. W., & Zhou, D. (2021). The potential neurological effect of the COVID‐19 Vaccines: A Review. Acta Neurologica Scandinavica, 144(1), 3–12. https://doi.org/10.1111/ane.13417

National Institute of Neurological Disorders and Stroke. (2021). Guillain-Barré Syndrome fact sheet. NIH. Retrieved February 20, 2022, from https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Guillain-Barr%C3%A9-Syndrome-Fact-Sheet

National Institute of Neurological Disorders and Stroke. (2022). Coronavirus and the nervous system. NIH. Retrieved February 20, 2022, from https://www.ninds.nih.gov/Current-Research/Coronavirus-and-NINDS/nervous-system

Neufeld, A. (2022, February 19). Ontario continues to report reduced COVID-19 hospitalizations and ICU admissions, 14 additional deaths. Retrieved February 20, 2022, from https://toronto.ctvnews.ca/ontario-continues-to-report-reduced-covid-19-hospitalizations-and-icu-admissions-14-additional-deaths-1.5788338

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Steffens, M. S., Dunn, A. G., Wiley, K. E., & Leask, J. (2019). How organisations promoting vaccination respond to misinformation on social media: A qualitative investigation. BMC Public Health, 19(1). https://doi.org/10.1186/s12889-019-7659-3

Steffens, M. S., Dunn, A. G., Leask, J., & Wiley, K. E. (2020). Using social media for vaccination promotion: Practices and challenges. DIGITAL HEALTH, 6. https://doi.org/10.1177/2055207620970785

Swanson, J. (2022, June 9). Demyelinating disease: What can you do about it? Mayo Clinic. Retrieved November 18, 2022, from https://www.mayoclinic.org/diseases-conditions/multiple-sclerosis/expert-answers/demyelinating-disease/faq-20058521

Chemical, Biomedical, and Computer Science Considerations of Vaccine Development