Do face masks act as a crude coronavirus proto-vaccine? Some researchers think it's possible.

Peter Weber

Even if a coronavirus vaccine is approved on an emergency use basis this year, it wouldn't be available for the general public until mid-2021, two industry vaccine experts tell The Washington Post. And that's if everything goes right. But a group of researchers suggested in a New England Journal of Medicine commentary Tuesday that face masks might stand in as a crude substitute until a vaccine is available.

The unproven theory "is inspired by the age-old concept of variolation, the deliberate exposure to a pathogen to generate a protective immune response," The New York Times reports. Before the smallpox vaccine, for example, some doctors would rub smallpox scabs or pus on healthy people to stimulate a more mild case and an immune response to protect against re-infection. With COVID-19, the speculation is that a mask cuts down on the number of viruses that enter a person's airway, and if a small number slip through or around the mask, it may prompt strong and enduring immunity.

There is some research on hamsters and observational studies of humans that lend credence to the ideas that masks block out just enough virus to encourage mild or asymptomatic infections, and that such low-grade infections spark a protective immune response. But trying to prove the theory of masks as proto-vaccine through clinical trials would be unethical, the Times reports.

Some infectious disease experts told the Times they are skeptical masks would even work in that way, and all of the researchers warned against trying to intentionally infect yourself with small amounts of the coronavirus. "People definitely got smallpox and died from variolation," notes Columbia University virologist Angela Rasmussen. But Dr. Monica Gandhi, an infectious disease doctor at U.C. San Francisco and coauthor of the NEJM commentary, said people should wear masks anyway, so "why not drive up the possibility of not getting sick and having some immunity while we're waiting for the vaccine?"

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