It is up to each person to decide whether he or she would like to get a fifth Covid-19 jab as they have received vaccine doses for more than a year, top virologist Dr Yong Poovorawan said on Thursday.
Citing a study on a volunteer who had five Covid-19 jabs, he said the volunteer’s immunity against the virus rose sharply two weeks after receiving the booster before declining.
However, vaccinated people develop mild symptoms and recover from Covid-19 quickly as their “body memory” helps boost immunity once they are infected, Yong made clear.
He said everyone should receive at least three jabs, while at least four should be administered to those with chronic diseases and frontline medical staff so they can deal with virus mutations, especially Omicron.
Yong also advised people to get their next Covid jab four to six months after the third or fourth shots as immunity against the virus drops sharply during that time.
He expected people, especially the vulnerable, would need annual Covid-19 doses, just as in the case of influenza.
Cannabis can impact the nervous system and liver, apart from affecting mental health, an expert at Siriraj Hospital’s Faculty of Medicine said on Wednesday.
The faculty’s dean for informatics, Clinical Prof Dr Adune Ratanawichitrasin, explained that the decriminalised herb’s effect on the nervous system includes widening of the blood vessels, a slow or fast heart rate, and irritable bowel syndrome.
He also pointed out that people who eat or smoke cannabis could suffer from its effect on the nervous system.
Adune said people could also be at risk of drug overdose due to the herb’s effect on liver functions, especially enzymes which help mitigate effects of the drug.
He went on to say people who use anticoagulants, diabetes drugs, lipid-lowering agents and sleeping pills after consuming cannabis are at risk of drug overdose.
Adune warned that using cannabis as a food additive without informing consumers would trigger risks especially for those with chronic diseases who consume various drugs.
Restaurants or food stalls which add cannabis to food can’t blame consumers who suffer from the effects of the herb, he added.
Roche Thailand has introduced a new method in lung cancer diagnosis using a low dose computerised tomography scan which provides accurate diagnosis in the vital early stage of the dreaded disease.
The company announced the novel method at a seminar on May 27 titled “Did you know? You could be at risk of lung cancer” to promote public awareness regarding the risks of lung cancer and other diseases related to smoking on the occasion of World No Tobacco Day on May 31.
Key speakers at the seminar included Vichaiyut Hospital respiratory specialist Dr Manoon Leechawengwongs and Dr Narinthorn Surasinthon, anti-aging and regenerative medicine specialist from Bumrungrad International Hospital. The session also featured two guest speakers, one who had been diagnosed with early-stage lung cancer after having smoked for some time but had kicked the habit for years and another, whose mother had never smoked before, to share their experiences in diagnosis and treatment.
Statistics from the World Health Organisation’s Global Cancer Observatory report showed lung cancer was the second highest cause of death from cancer in Thailand in 2021, with 23,717 new cases reported – an average of 65 patients per day.
Last year 20,395 Thais died due to lung cancer, or an average of 56 persons per day, putting Thailand in 18th place of disease severity.
Despite the high rate of cases, the number of patients being diagnosed in the early stages in Thailand is relatively low compared to those in developed countries such as the United States, United Kingdom, France, Space, Italy and Japan.
“Since the success in treating cancer largely depends on how early a patient is diagnosed with it and receives treatment, it is evident that challenges in reducing the mortality rate from lung cancer in Thailand lies in providing persons at risk of this disease with a fast, accurate and affordable screening test,” said Manoon.
“If patients are diagnosed when they are in the fourth stage, or the spreading stage of lung cancer, they will have a 0-10 per cent chance of surviving more than five years after treatment. However, the chance of survival improves to 13-36 per cent if cancer is detected in the third stage, and to 53-92 per cent if it is found during the second or first stage,” he explained.
Thailand has an early-stage lung cancer detection rate of only 15 per cent, Manoon said.
He therefore urged people in high risk groups, like those who have been smoking or exposed to cigarette smoke or other chemicals that cause cancer to get tested immediately if they have the following persisting symptoms: hoarse voice, change in voice, chronic coughing, blood in phlegm, wheezing, prolonged chest pain, pain when swallowing, or lung infection.
“Healthy people could also be at risk of getting lung cancer as the risk factors of this disease could be heredity. If your family members have a history of chronic lung diseases and emphysema, you could inherit a faulty gene that may cause lung cancer,” he warned.
“However, the heredity factor is responsible for only 20 per cent of lung cancer patients, while 80 per cent developed the disease due to their behaviour and the environment – for example, smoking more than 20 packs of cigarettes per year, being exposed to asbestos, nickel and chromium due to an industrial work environment, riding a motorcycle in areas with PM2.5 dust particles, or burning incense sticks regularly.”
During the seminar, Arun Thepkaew shared his experience after he was diagnosed with second stage lung cancer at 68 years of age. Arun had been smoking two packs of cigarettes a day for 13 years but had quit the habit for 35 years.
Arun had been smoking two packs of cigarettes a day for 13 years but had quit the habit for 35 years
“Last year I went to a doctor after experiencing chronic coughing, and was diagnosed with lung cancer,” he said. “This helped me get treatment at an early stage and the result has been satisfactory. I can live a normal life without being a burden to others. I vowed to follow the doctor’s orders in reducing risky behaviour and avoiding environments that could worsen my condition.”
Yod Kusolmanosuk shared the story of his mother Kimtiang, 72, who had been diagnosed with first stage lung cancer despite never having smoked.
“My mom often burned incense sticks while praying before going to bed,” he said. “Ten years ago, she was also diagnosed with the spreading stage of colon cancer. Last year, I took her for an annual physical check-up, in which the doctor suggested that she get a low dose CT scan since her heredity factor indicates she could be at risk of lung cancer. The scan revealed she had first stage lung cancer, which is lucky for us as treating it in this stage means a high chance of success, compared to colon cancer in later stages that she has had to deal with.”
Bumrungrad’s Dr Narinthorn said there are three methods of screening for lung cancer: chest X-ray, a CT scan and low dose CT scan.
“Chest X-ray is often included in annual physical check-ups as it is fast and inexpensive,” he said. “However, it is inefficient in detecting cancer cells in the early stage because the cells are too small for X-rays to pick up,” he explained.
“The CT scan has higher accuracy, but it is expensive and not many hospitals have the equipment, which results in patients having to wait for a long time to get scanned,” the doctor said.
“But the low dose computerised tomography scan, or in short low dose CT scan, is six times more accurate than chest X-rays and can therefore detect cancer cells early, allowing for quicker treatment, which will help reduce patient mortality from lung cancer by 20 per cent,” he said.
“The low dose CT scan for lung cancer screening is both fast and efficient. Therefore, all patients in risk groups should go in for this.”
The US National Comprehensive Cancer Network suggests people over 50 and those who have been smoking more than 20 packs a year should get low dose CT scan every year as a precaution against lung cancer, Narinthorn pointed out.
“Those who have never smoked but carry other risk factors, or even health-conscious people, can consult their physician to get a low dose CT scan, as detecting this cancer at an early stage will significantly increase the success rate of treatment and reduce the chance of cancer recurring,” he strongly advised.
Children aged 5 to 11 should get a booster dose as the immunity from two doses of vaccines is not enough, a top virologist said, citing a yet-to-be-published study.
In a Facebook post on Monday, Dr Yong Poovorawan talked about the study on administering vaccines to children aged 5 to 11 by Chulalongkorn University’s Centre of Excellence in Clinical Virology.
He highlighted seven points from the study:
1. Children who received the Sinovac vaccine as the first dose, followed by the Pfizer vaccine a month later had similar immunity as children who had received two doses of the Pfizer vaccine at two-month intervals.
Yong explained the results of this formula to the higher spike in immunoglobulin G as compared to the Pfizer formula, but the overall immunity offered by the Pfizer formula is higher.
2. The interval between doses of the Sinovac-Pfizer formula is four weeks while the interval between Pfizer doses is eight weeks.
He explained that the immunity would be higher if the interval were to be longer. He added that the immunity from the Sinovac-Pfizer formula with a one-month interval is effective quicker than the Pfizer formula with a two-month interval.
3. Children’s bodies respond to immunity significantly better than adults.
4. Children aged 5 to 11 who received two doses of inactivated vaccines (Sinovac or Sinopharm) and Pfizer vaccine as the booster dose got the same high immunity as adults and the immunity is enough to protect against the Omicron variant.
5. Children who received two doses of Sinovac got higher immunity than children who received two doses of Sinopharm vaccines, the same result as in the study with adults.
6. According to past information, two doses of any vaccine are not enough so the booster dose might be necessary.
7. Administering inactivated vaccines is a way of reducing the number of mRNA vaccine doses while side-effects from mRNA vaccines are likely to occur in the second or third doses more than in the first dose.
Yong said that the study would be completed soon, as the centre is waiting for lab results. It will be published in an international journal later.
Removing Covid-19 from the list of dangerous communicable diseases would be the first step toward declaring it endemic, a top virologist suggested.
In a Facebook post on Saturday, Dr Yong Poovorawan said that the daily Covid-19 caseload is lower than the actual number because patients with mild or no symptoms choose not to report their infection.
According to the Communicable Diseases Act, those who contract dangerous diseases must contact related authorities within 24 hours. However, he said, patients who fail to register their infection end up violating the law unintentionally.
To avoid this, he said, Covid-19 should be listed as a communicable disease under surveillance, which has far more relaxed measures.
Yong pointed out that people have been fighting against Covid for more than two years now, and most have developed some level of immunity against the disease.
To ensure Covid-19 is declared endemic, some regulations will have to be changed and widely accepted, as they were for influenza or foot-and-mouth disease, he said.
Thailand’s caseload on Saturday came in at 2,501 new patients and 28 fatalities, dropping from 2,836 new infections on Friday.
Thailand should be able to declare Covid-19 endemic soon as most citizens have developed an immunity to the virus either from vaccines or infection, expert virologist Dr Yong Poovorawan said on Friday.
He pointed out that most Covid-19 cases officially reported nowadays are people who test positive via RT-PCR tests. He reckons most patients who have not been included in the daily case report are either asymptomatic or have mild symptoms.
Thailand recorded 2,836 infections and 24 deaths on Friday.
He added that 20 per cent of unvaccinated five-year-olds in Bangkok have contracted Covid-19 and half of them developed symptoms.
“Most citizens have developed immunity against Covid-19 from vaccines and/or infection, which has helped reduce the disease’s severity,” he said.
He said deaths due to Covid-19 in Thailand should settle at around 0.1 per cent or one among 1,000 people, adding that most deaths are among the elderly and people with chronic diseases who have not received their third jab.
Dr Yong also expects the quarantine period to be reduced to seven days as most have been vaccinated and will recover faster than those who have not been vaccinated.
He said in Singapore, students who have contracted Covid-19 and have symptoms can stay home for seven days, while the asymptomatic can continue attending classes.
He pointed out that children usually do not have severe symptoms from Covid-19, except infants as they have not been vaccinated and do not attend school.
Sick leave and the period of school closures should be shortened once most students have developed immunity against Covid-19 he said.
He said fully vaccinated students who have contracted the virus should take online classes for seven days.
A leading virologist explained there are differences between the spread of monkeypox in Africa and in Europe.
Dr Yong Poovorawan went on Facebook to highlight four differences in the alarming spread of the virus on the two continents.
1. Age
Africa – found in every age group from children aged over 1 to elders aged over 60
Europe – found in individuals aged between 20 and 50
2. Gender
Africa – Two-thirds are male patients, one-third female
Europe – 98-99 per cent of cases are male, 1-2 per cent female
3. Transmission
Africa – from animals to humans, especially via rodents such as rats
Europe – No reports of animal-to-human transmissions, only human-to-human; some studies reported that the disease could spread through sexual intercourse
4. Lesions
Africa – found on parts of the body outside clothes such as hands, feet, face and necks
Europe – found on parts of the body concealed under clothes, with 30 per cent reporting lesions in sexual organs.
A leading virologist has revealed 10 facts about Covid-19 vaccines and the protection they offer according to the number of doses.
Dr Yong Poovorawan posted the information, which was drawn from vaccine studies around the world, on Facebook on Saturday.
The information can be summarised in the following 10 points:
1. Vaccine efficiency depends on the number of doses received. One or two doses are not enough to protect recipients from the Omicron variant or prevent severe symptoms.
2. Being fully vaccinated means receiving two doses of primary vaccine and another booster dose, or three doses in total.
3. Unless medically exempt, people should receive at least three doses of vaccine.
4. People in risk groups – such as seniors aged over 60, those with underlying conditions, or people with low immunity – should receive at least four doses.
5. The key to boosting immunity is the number of doses, not the vaccine brand or regimen.
6. For Covid-19 to be declared endemic in Thailand, most people should have received at least three doses to reduce severity of symptoms, plus hospitalisations and deaths.
7. A previous Covid-19 infection offers about the same immunity as one dose of vaccine. People who have received two doses of vaccine and are infected later should be considered “fully vaccinated” with three doses.
8. People who have received two vaccine doses and are then infected can get a booster (fourth dose) six months after their infection.
9. Unvaccinated people who have been infected should receive the booster dose one to three months after recovering.
10. Though Covid-19 does not cause severe illness in most children aged over five, they should still receive three doses of vaccine so that schools can reopen safely.
A leading virologist has offered good news and bad news about Thailand’s effort to prevent an outbreak of monkeypox after the disease spread to more than 30 countries on Thursday.
Dr Yong Poovorawan said Thais aged over 48 may have some immunity against monkeypox but anyone born after 1974 was unlikely to have protection.
Yong explained that this was because Thailand’s mass vaccination with smallpox vaccine – which is known to be effective against monkeypox – ended around that year.
But with the country now facing a surge of overseas arrivals, including from countries where monkeypox has been detected, the government last week asked the World Health Organisation for a fresh supply of smallpox vaccine. As of Friday, there had been no reports of monkeypox cases in Thailand.
Yong said Thailand’s vaccination campaign against smallpox was reduced in 1974 before being scrapped completely in 1980, when the disease was eradicated from the world.
He recounted his own experience as a new paediatrics graduate in 1974 and 1975, explaining that Chulalongkorn University had already stopped administering smallpox vaccine by that time.
His nephews were born in 1975, 1977, and 1980 and received only tuberculosis vaccine but not smallpox vaccine.
However, he added that he had administered smallpox vaccine to Thai-Chinese children at a clinic in 1978, because the procedure was still popular with the Thai-Chinese community.
A new vaccine could help fight the third generation of smallpox and monkeypox, a leading virologist explained.
Dr Yong Poovorawan posted on his Facebook on Wednesday that vaccine manufacturer Bavarian Nordic had come up with the MVA-BN vaccine from Modified vaccinia Ankara, modified from vaccinia virus. It is a live, non-replicating vaccine for smallpox and monkeypox.
The vaccine is administered by subcutaneous injection to create immunity, but it will not cause pustules. It is as efficient as vaccines in the past, he said.
It could be administered to people with low immunity while it is not completely forbidden for pregnant or breastfeeding women.
People will be administered two doses at an interval of four weeks between each dose. However, people who have been vaccinated against smallpox only need one dose of the vaccine.
People who have been infected could receive the vaccine within four days to prevent the disease or reduce the symptoms.
The vaccine is called Imvanex in Europe and Jynneos in the US, but it has not been registered yet in Thailand.
Arun had been smoking two packs of cigarettes a day for 13 years but had quit the habit for 35 years
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