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

The Oxford Vaccine

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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Shortness of Breath Causes: From Common Triggers to Serious Health Conditions

Shortness of breath, medically known as dyspnea, is a symptom that ranges from mild discomfort during exertion to a distressing sensation of not getting enough air. In India, increasing air pollution, lifestyle diseases and respiratory infections have made breathlessness a frequent complaint across age groups. Understanding shortness of breath causes is essential to identify when it is harmless and when it signals a medical emergency.

What Is Shortness of Breath?

Shortness of breath refers to difficulty breathing or a feeling of air hunger.

It may present as:

rapid breathing
shallow breathing
tightness in the chest
inability to take a deep breath

The sensation can develop suddenly or gradually.

Common and Benign Causes of Shortness of Breath

Physical Exertion

During exercise, the body demands more oxygen.

Temporary breathlessness during:

climbing stairs
running
heavy physical work

is normal and resolves with rest.

Anxiety and Panic Attacks

Stress and anxiety alter breathing patterns.

Symptoms include:

rapid breathing
chest tightness
dizziness

These episodes often resolve with calming techniques.

Respiratory Causes of Shortness of Breath

Asthma

Asthma causes airway narrowing and inflammation.

Symptoms include:

wheezing
chest tightness
breathlessness during exertion or at night

Asthma is a leading cause of chronic breathlessness.

Chronic Obstructive Pulmonary Disease

COPD includes chronic bronchitis and emphysema.

Risk factors include:

smoking
indoor air pollution
occupational exposure

WHO identifies COPD as a major cause of breathlessness in adults.

Respiratory Infections

Infections such as pneumonia and bronchitis reduce lung capacity.

Breathlessness may be accompanied by:

cough
fever
chest pain

Severe infections require urgent treatment.

Heart-Related Causes of Shortness of Breath

Heart Failure

The heart fails to pump blood efficiently.

This leads to:

fluid accumulation in lungs
breathlessness on exertion
breathlessness while lying flat

ICMR data shows heart disease as a major contributor to unexplained breathlessness.

Coronary Artery Disease

Reduced blood supply to the heart can cause:

breathlessness
chest discomfort
fatigue

This may occur even without chest pain in some individuals.

Blood and Metabolic Causes

Anemia

Low hemoglobin reduces oxygen delivery.

Common symptoms include:

fatigue
breathlessness on mild activity
pale skin

NFHS-5 highlights anemia as highly prevalent in India.

Thyroid Disorders

Hyperthyroidism increases metabolic demand, causing breathlessness.

Hypothyroidism may contribute indirectly through weight gain and reduced stamina.

Lung Circulation Disorders

Pulmonary Embolism

A blood clot in the lungs causes sudden, severe breathlessness.

This is a medical emergency and may be accompanied by:

chest pain
coughing blood
fainting

Immediate treatment is critical.

Lifestyle-Related Causes

Obesity

Excess body weight restricts lung expansion.

Breathlessness occurs due to:

increased oxygen demand
reduced lung volumes

Weight management improves breathing efficiency.

Sedentary Lifestyle

Poor physical conditioning reduces respiratory muscle strength.

Even mild exertion may cause breathlessness.

Environmental and Occupational Factors

Air Pollution

Pollutants irritate airways and reduce lung function.

Urban populations experience higher rates of breathlessness.

Workplace Exposure

Dust, chemicals and fumes increase respiratory risk.

Protective measures are essential in high-risk occupations.

When Shortness of Breath Is a Warning Sign

Seek urgent care if breathlessness:

starts suddenly
worsens rapidly
occurs at rest
is associated with chest pain, bluish lips or confusion

These may indicate life-threatening conditions.

How Shortness of Breath Is Diagnosed

Evaluation may include:

physical examination
chest imaging
blood tests
lung function tests
heart evaluation

Diagnosis focuses on identifying the root cause.

Preventive Measures and Lifestyle Care

Prevention includes:

regular physical activity
pollution protection
smoking cessation
weight control
managing chronic conditions

Preventive healthcare reduces long-term risk.

Importance of Early Medical Evaluation

Delayed diagnosis can worsen outcomes, especially in:

heart disease
lung infections
anemia

Early care improves treatment success.

Conclusion

Shortness of breath causes range from temporary exertion and anxiety to serious heart, lung and blood disorders. While occasional breathlessness may be harmless, persistent or sudden symptoms should never be ignored. Understanding the underlying causes and seeking timely medical evaluation can prevent complications and save lives. Paying attention to changes in breathing is an essential step toward protecting overall health and wellbeing.

References

Indian Council of Medical Research (ICMR) – Respiratory and Cardiac Health Reports
World Health Organization (WHO) – Breathlessness and Chronic Disease Guidelines
National Family Health Survey (NFHS-5) – Anemia and Respiratory Health Data
Lancet – Dyspnea Evaluation and Outcomes Research
NITI Aayog – Non-Communicable Disease Prevention Reports
Statista – Respiratory Disease and Air Pollution Trends

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