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Published on: Apr 04, 2020
3 minute read
By: Dr Rajan Choudhary

Developing A Vaccine For COVID-19? Part 1

It is often stated vaccination has made the greatest contribution to global health of any human discovery, other than clean water and sanitation, and their impact on everyday life is immediately evident. We have managed to completely eradicate two major infections from existence (smallpox and rinderpest) , and the WHO are working towards adding polio to that list.

In these cases the numbers speak for themselves. It is estimated that the eradication of smallpox in 1980 has saved 5 million lives per year, adding up to 150 to 200 million by 2018. Common vaccination programmes for polio, measles, mumps, rubella, rabies and hepatitis A have prevented nearly 200 million cases from occurring in the US alone over the past 50 years, and 4.5 billion instances of the diseases worldwide.

We have achieved a 99% immunisation rate against polio, preventing children from suffering crippling paralysis, and only 3 countries remain. Sadly, around 1.4 million children under 5 still die from preventable diseases each year as they do not have access to these life saving vaccines, but charities and public health organisations around the world are working hard to improve access.

So what are vaccines? And how will they help is in the face of the latest pandemic? Here we will go into the challenges behind making vaccines, and why a vaccine against COVID-19 is unlikely to be ready in the next few months, or even this year.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4024226/ contribution of vaccination

https://www.who.int/features/factfiles/polio/en/ polio eradication

https://www.sciencedaily.com/releases/2017/03/170303163208.htm study article

WHAT IS A VACCINE

The human body’s immune system is incredibly smart. It is able to distinguish between infective organisms, such as bacteria, viruses and parasites, from our own body’s cells, target these invaders for destruction and keep our bodies healthy. Even better, the body remembers any previous infections it has had before, recognise these previous infections even quicker and even eradicate the disease before we know we are infected.

Vaccines target the immune system’s memory by presenting them with pieces of these infective diseases. The small amounts do not cause any infective symptoms, but if the person is infected later in life their body will mount a quicker response and prevent them from falling ill. These vaccines can contain broken up parts of the organisms, “dead” organisms or “live” versions that have been severely weakened so they cannot cause any harm.

In summary, medicines treat us when we get an infection. Vaccines make sure we never suffer from an infection in the first place.

https://www.chop.edu/centers-programs/vaccine-education-center/making-vaccines/how-are-vaccines-made Making Vaccines

THE HURDLES WE FACE IN RESEARCH

Making a vaccine is a difficult process, one that can take 3–5 years and cost hundreds of millions of dollars, sometimes billions of dollars. This is because there are many difficult steps to be taken in the process of creating a vaccine that is effective, but more importantly one that is safe.

To start with the troubling organism has to be identified. For COVID-19 it took a few weeks to recognise the virus responsible, and some time more to understand its genetic code and grow the virus in lab conditions. We then have to understand the virus, how it infects, how it causes symptoms, and how it has mutated compared to the coronaviruses responsible for SARS and MERS.

After this, we have to isolate parts of the virus our immune system will recognise. This is usually the outside coat of the virus. The DNA responsible for making these parts need to be found in the virus’ genetic code, and put inside other “skeleton” viruses. This will force the dummy virus to look like coronavirus, without the ability to infect and kill someone.

These dummy viruses can be injected into animals to see if it causes an immune reaction, whether the immune system recognises it as the coronavirus responsible for COVID-19, and whether it will protect the animal from the real COVID-19. Up to now the research has likely cost a few million dollars. The next step is when the price inflates up to billions.

If the vaccine appears safe in animals, it can be tested in humans. This can be dangerous at first, since we don’t know whether a vaccine that works in an animal will work in a human. And we don’t know if there will be any side effects to the vaccine. Human testing has to be very thorough, very careful, and safe for use. If you give too much of the virus it might make the person sick, too little and it wont immunise the person. These clinical trials can take years, and if the vaccine fails at this point its back to the drawing board, to try another step.

https://www.theatlantic.com/politics/archive/2014/10/how-to-make-an-ebola-vaccine-5-simplified-steps/454443/ ebola vaccine

Now we have a basic understanding of what vaccines are and why it takes so long to make a vaccine. In the next part we will look at why viral vaccines can cause even more problems, and how far we have come with the COVID-19 vaccine,

Dr Rajan Choudhary, London UK

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Yellow Eyes and Skin Symptoms: Causes, Warning Signs and When to Seek Care

Yellowing of the eyes and skin is one of the most noticeable physical changes a person can experience. Often referred to as jaundice, this symptom is not a disease by itself but a sign of underlying health conditions. Understanding yellow eyes and skin symptoms is essential because they frequently indicate problems involving the liver, blood or bile ducts and may require urgent medical attention.

In India, jaundice is a common presentation across age groups due to infections, liver disease and metabolic disorders.

What Does Yellowing of Eyes and Skin Mean?

The yellow colour appears due to excess bilirubin in the blood.

Bilirubin is:

a yellow pigment
produced from the breakdown of red blood cells
processed and removed by the liver

When bilirubin builds up, it deposits in tissues, causing yellow discoloration.

Why the Eyes Turn Yellow First

The sclera, or white part of the eyes, contains elastic tissue that binds bilirubin easily.

This makes yellowing:

more visible in eyes
detectable before skin changes

Yellow eyes are often the earliest sign of jaundice.

Common Causes of Yellow Eyes and Skin

Liver-Related Causes

The liver plays a central role in bilirubin metabolism.

Common liver causes include:

viral hepatitis (A, B, C, E)
fatty liver disease
alcoholic liver disease
liver cirrhosis
drug-induced liver injury

ICMR reports viral hepatitis as a major cause of jaundice in India.

Bile Duct Obstruction

Blocked bile flow prevents bilirubin excretion.

Causes include:

gallstones
bile duct strictures
pancreatic or bile duct tumours

This type of jaundice is often associated with itching and pale stools.

Blood Disorders

Excess breakdown of red blood cells increases bilirubin production.

Conditions include:

hemolytic anemia
malaria
inherited blood disorders

The liver may be overwhelmed despite being healthy.

Infections

Certain infections directly affect liver function.

Examples include:

hepatitis viruses
leptospirosis
severe sepsis

WHO data highlights hepatitis as a leading infectious cause of jaundice globally.

Newborn and Pregnancy-Related Causes

While common in newborns, jaundice in adults always needs evaluation.

Pregnancy-related liver disorders can also cause yellowing.

Associated Symptoms That Provide Clues

Yellow eyes and skin are often accompanied by:

dark yellow or tea-coloured urine
pale or clay-coloured stools
itching
fatigue
abdominal pain
loss of appetite

These symptoms help identify the underlying cause.

When Yellowing Becomes Dangerous

Seek urgent medical care if yellowing is accompanied by:

high fever
severe abdominal pain
confusion or drowsiness
vomiting
rapid worsening of colour

These signs suggest severe liver or systemic disease.

Jaundice and Liver Function

The liver normally:

conjugates bilirubin
excretes it into bile

When liver cells are damaged, bilirubin accumulates.

Lancet studies confirm jaundice as a key marker of liver dysfunction.

Diagnostic Evaluation

Doctors evaluate jaundice using:

blood tests for bilirubin levels
liver function tests
viral markers
ultrasound or CT scans
additional tests based on findings

Early testing identifies reversible causes.

Impact on Daily Life

Persistent jaundice can affect:

energy levels
digestion
mental clarity
work performance

Untreated liver disease can progress silently.

Treatment Depends on the Cause

There is no single treatment for jaundice.

Management focuses on:

treating infection
relieving bile obstruction
stopping harmful medications
managing chronic liver disease

Self-medication can worsen liver injury.

Role of Preventive Healthcare

Preventive measures include:

hepatitis vaccination
safe drinking water
limiting alcohol intake
regular health checkups

NITI Aayog emphasises liver health in preventive care strategies.

Lifestyle Factors That Affect Liver Health

Risk factors include:

excessive alcohol
obesity
high-fat diets
unsafe injections

Addressing these reduces jaundice risk.

Importance of Early Detection

Early diagnosis:

prevents complications
improves recovery
reduces hospitalisation

Delays increase the risk of liver failure.

Jaundice Is a Symptom, Not a Diagnosis

Understanding this distinction is crucial.

Treating the symptom alone:

does not resolve the disease
may mask serious conditions

Medical evaluation is essential.

Conclusion

Yellow eyes and skin symptoms are visible warning signs that should never be ignored. Most often linked to jaundice, they reflect underlying problems involving the liver, bile ducts or blood. Early medical evaluation, accurate diagnosis and timely treatment are critical to prevent serious complications. Recognising these symptoms and seeking care promptly can protect liver health and save lives.

References

Indian Council of Medical Research (ICMR) – Hepatitis and Liver Disease Reports
World Health Organization (WHO) – Jaundice and Hepatitis Guidelines
National Family Health Survey (NFHS-5) – Liver and Metabolic Health Indicators
Lancet – Liver Function and Bilirubin Research
NITI Aayog – Non-Communicable Diseases and Liver Health
Statista – Liver Disease and Hepatitis Trends

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