• Published on: Jul 22, 2020
  • 2 minute read
  • By: Dr Rajan Choudhary

The Oxford Vaccine

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Recently we wrote a blog on the success of an RNA vaccine against SARS-CoV-2, the virus responsible for COVID-19. Within just a few weeks of that incredible research breakthrough, researchers at Oxford University’s Jenner Institute have announced a COVID vaccine that has induced remarkable immune response against the virus.

This study was published in the Lancet, one of the most prestigious medical journals in the world, and a simple summary suggests the vaccine has no early safety concern and is able to induce a strong immune response with both T cells and B cell/antibodies.

THE VACCINE

ChAdOx1 nCoV-19, now known as AZD1222, was co-developed by the University of Oxford and one of its spin-off companies, Vaccitech. The vaccine uses a viral vector based on a common cold virus (adenovirus). This carries genetic material for the SARS-CoV-2 spike protein. In our previous blog, we saw how the spike proteins are used by the virus to target and fuse with our target cells, allowing the virus to invade, replicate and ultimately cause the disease known as COVID. It is also a good target for the human immune system to recognize and attack.

The viral vector delivers the genetic material inside our cells. The spike protein is then produced by our cells, recognized by the immune system as a viral target, and an immune response is created against it. This can be antibodies, which recognize, attach to and mark the virus in our blood, allowing for other white blood cells to destroy the virus.

In this case, the vaccine also produced a T cell response. T cells can recognize cells infected by a virus-based on the markers present on the surface of infected cells. They can tell an infected cell to destroy itself, thereby destroying the virus within without spreading the infection. They also have other functions that we will not discuss in this blog.

THE STUDY

This study was a Phase I/II trial that started in April using the vaccine named ChAdOx1 nCoV-19. This vaccine development started in January 2020, and progress on development has been incredibly rapid. Whilst our previous study had just 45 people, this study looked reviewed over 1,000 healthy adults. 10 of these participants received two doses of the vaccine.

In a study the more participants there are, the greater the power of the study. If the vaccine has any side effects, even ones that rarely occur, it is more likely to be picked up in studies with more people. Similarly having more people helps show that the vaccine is effective, and the strong responses are not merely a fluke or accident. Another benefit of this study is it was able to compare the vaccine against a control group. This shows the results were not simply a placebo and allowed comparison of side effects as well.

The majority of side effects were feeling feverish, chills, muscle ache, headache, and malaise, all symptoms treatable with paracetamol. None of the participants had any serious side effects. It took just 14 days to create a T cell response, and  28 days to make strong antibodies. In 91% of patients, this was enough to neutralize the COVID coronavirus. Receiving two doses gave an even stronger antibody response, and all participants were able to stop the virus.

 

WHAT NEXT

The news from the University of Oxford is needed, as infection rate and mortality continue to increase in countries such as the US and Brazil. The ability to induce an antibody response without causing harm to the patient shows we have made huge progress in the fight against COVID-19. Further Large scale Phase III trials been set up through a global partnership, and include studies in the US with over 30,000 patients, studies in children as well as some in low to middle-income countries.

If successful a vaccine would be essential in preventing a second wave of COVID in the winter when the elderly population is most at risk. And it would be the key to restarting the economy and getting our everyday lives back to where it was pre-pandemic.

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Yellowing

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

See all

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