Stop Vaccination NOW???

An earnest, slightly manic anti-vaxxer (is there any other kind?) shoved  this across the virtual desk at me yesterday. Van den Bossche thinks you shouldn’t mass-vaccinate in a pandemic because you create a selective environment that favours vaccine escape mutants, somewhat by analogy with antibiotic resistance, I suspect.

There have been learned critiques of his virology and immunology (though he is, one is assured, an eminent authority putting his reputation on the line (sounds familiar … 🤔). I’ll leave that to others; my main criticism is his grasp of evolution. It seems fundamentally wrong to create a situation in which there will be more mutations occurring (mutation rate being a function of number of replications) if your objective is to avoid mutations. Of course his defence would be that he is avoiding a selective scenario – but he’s not even doing that. If the concern is an advantage given to vaccine escape mutants, switching to ‘natural infection’ simply transfers that advantage to mutants in the unvaccinated arena – both primary and secondary infection routes can be exploited for advantage, so it is even worse.
.
Here’s something I wrote on this to answer a question on Quora:
.

It is predicated on some dodgy assumptions — principally, that vaccinated individuals still transmit at the same rate as the unvaccinated, that ‘naturally immune’ individuals somehow by contrast do suppress transmission, and that the natural infection route does not select for mutants at the same (or higher) rate.

The biggest problem — and it’s a general one — is the first. I’m sick of seeing people claim that ‘the vaccine does not stop transmission’. It was never definitively demonstrated anyway, despite being widely circulated as categorical truth, and is a common misunderstanding of the scientifically cautious ‘we don’t know if …’. Well, we now have data. The vaccines have all been shown to substantially reduce transmission. If one wants to be a pedant, one could say ‘reduce’ doesn’t mean ‘stop’, but if fewer individuals shed viable virus in the vaccinated than unvaccinated group, it has clearly STOPped transmission in a greater number of individuals in that group. It’s not that it’s generated the same number of transmitting individuals but with lower levels per individual; there are fewer transmitting individuals. That matters. Those individuals are invisible to the virus. It has the same effect as reducing population density.

Much of what can be said about vaccine can also be said about ‘natural immunity’. Yet one never hears a parallel uncertainty over transmission from previously infected individuals. Well, as it happens, data shows that this too is reduced (or ‘stopped in more individuals’) for reinfection of the original strain. There’s the rub. There are worrying signs that the Brazil mutant can reinfect individuals. If reinfection is occurring, the Brazil mutant is not a ‘vaccine escape mutant’; it is a ‘natural immunity escape’. So the thing he’s worried about actually results from the strategy he advocates.

The key to reducing mutations is to reduce replications. You can create a selective pressure by doing that, but you also reduce the opportunity for mutations that can respond to it. The optimum would be to vaccinate (or infect) everyone in a day! That would knock it on the head for sure (at huge cost of life and health in the second case). Failing that, mass vaccination should proceed as fast as possible. It gives the opportunity of creating hundreds of thousands of ‘pseudo-infections’ per day without the health costs and, crucially, without the replications. It would be neither possible nor desirable to hit the same numbers ‘the natural way’. ‘Letting the disease rip’ creates a substantial excess of replications over vaccination, hence more opportunities for mutation and selection.

This is not really the way to do science: by non-peer-reviewed ‘open letter’, uncritically leapt upon by the vaccine-skeptic community with neither the knowledge base nor the appropriate scientific skepticism needed to evaluate his claims. I’m no expert, but I think his strategy would be disastrous.

 

 

+1

30 thoughts on “Stop Vaccination NOW???

  1. Neil Rickert,

    Indeed. The lady who shoved this at me was one of two in a discussion on a local MP’s Facebook. Both utterly insistent that ‘wild-type’ Covid was causing no real problems – it’s all BBC lies, and counting car crash and cancer victims as Covid deaths. Having a daughter who’s watched these people die and certified their deaths, it’s pretty maddening to be confronted with that wilful ignorance and intransigence. Even though I’ve been on UD …

    0
  2. it is a ‘natural immunity escape’. So the thing he’s worried about actually results from the strategy he advocates.

    Yeah, the notion that there is some difference between selection pressures due to vaccination and our “natural immunity” is a bit weird. Both are going to result in more infectious variants. Restricting the pool of available variation by vaccination is a good strategy for slowing down its evolution.

    +1
  3. Corneel,

    Yep. The Quora question I was responding to above has a particularly vigorous contributor who insists he’s half-right: we should not vaccinate kids ‘because they are asymptomatic super-spreaders who will generate vaccine-evading mutants’. He’s failing to separate mutation and selection. The kids therefore generate the bulk of the population’s mutants, which drift until they hit the adaptive jackpot, which may or may not be in the group they arose in.

    (Just rechecked, and the bastard has deleted my comment to him on the matter. He claims he was trying to ‘get my attention’. That is an outrage!)

    0
  4. Alan Fox,

    I think they’ve pledged to restart next week – a wholly unnecessary delay which will cost lives. I get the caution, but 30 clots in a population that would normally experience 300 in a month, against a disease that cause clots in at least 30% of hospital cases …

    0
  5. This smacks of asking the wrong question. [puts on decision support hat].
    The best way to ensure that a particular vaccine is as effective as possible for as long as possible, is to administer the vaccine to everyone when there are ~zero active infections. This is how one achieves ‘eradication’.4
    Cool. But not really an option right now; not really relevant at all, in fact.
    Given that there is currently a pandemic, then the approach should be to vaccinate as many people as possible as fast as possible, especially people who, if infectious, would infect many others. [People administering Covid tests and vaccinations come to mind here…Cashiers, and ER staff too. Bus drivers?]
    The main selection is going to be around whatever we do — the pressure to be more transmissible (D614G, B.1.1.7). As the pandemic and vaccination progresses and a greater proportion of the population has natural immunity or vaccine-mediated immunity, then there is a second pressure: to evade immunity. Best defence: rollout vaccination fast, and wear the effing mask!
    One useful property of the mRNA vaccines: they are really easy to re-tool to address vaccine-escape variants.

    0
  6. DNA_Jock,

    I think the particular danger of Van den Bossche’s approach (besides all the dead people, of course, and the vastly more efficient generation of mutations) is that he creates a selective scenario for primary infection as well as immune escape. There is no primary infection in the vaccination case; you get your antibodies without it, so nothing for the virus to adapt to.

    As to occupation targeting, that would be useful but depends on that data being captured. I don’t know if it is, or if it is it won’t be very up to date. The merit would also depend on effect on transmission, which at the time we were ramping up was uncertain, so we prioritised protection: we’ve gone for age and certain conditions. I did get my jab on my first shift as a marshalling volunteer at a vaccination centre though, so I’m alright, Jack [clutches chest comedically].

    0
  7. +1 for a vague understanding of evolutionary theory, though. I’ve no idea how an IDist, having spent years arguing against the malleability of protein binding or the reality of selection, would go about choosing a side in this debate. 😁

    +1
  8. Allan Miller,

    That, at least, is good news. Macron and von der Leyen will still unrepentently continue to cock things up I guess. Von der Leyen seems untouchable, a classic upwards failer.

    0
  9. Allan Miller: I’ve no idea how an IDist, having spent years arguing against the malleability of protein binding or the reality of selection, would go about choosing a side in this debate.

    My guess is that an IDist will just choose what appeals most to them and rationalize that decision afterwards, looking for facts that support their position, ignoring what does not. If they feel uncomfortable with vaccination, they will not waste time arguing about protein binding: they will just deny that COVID-19 is a dangerous disease.

    Geert van den Bossche has allowed himself to be recruited into the ranks of the denialists. My bet is that most of them do not even believe that SARS-CoV-2 is a grave concern, like he does, but they will wield a stick to beat when they find it.

    0
  10. Allan Miller: I think they’ve pledged to restart next week – a wholly unnecessary delay which will cost lives. I get the caution, but 30 clots in a population that would normally experience 300 in a month, against a disease that cause clots in at least 30% of hospital cases …

    You seem unable to appraise what effect public perception has on the success of the vaccination project. I think the time-out was a good move; it inspires public confidence in the care and attention of the health care system. That will sure pay itself back in reduced numbers of vaccine refusals.

    0
  11. Corneel: . That will sure pay itself back in reduced numbers of vaccine refusals.

    The chance to refuse is not an option here in France currently.

    0
  12. Corneel: You seem unable to appraise what effect public perception has on the success of the vaccination project. I think the time-out was a good move; it inspires public confidence in the care and attention of the health care system. That will sure pay itself back in reduced numbers of vaccine refusals.

    No, I’m very mindful of public perception. I’m just not as confident as you that, having flung mud at AZ (‘ineffective in o/65’s!’ ‘Clots!’) people will respond to reassurances from above – “hang on, everything’s fine”. I think France in particular has a massive uphill struggle ahead.

    0
  13. Corneel: Geert van den Bossche has allowed himself to be recruited into the ranks of the denialists. My bet is that most of them do not even believe that SARS-CoV-2 is a grave concern, like he does, but they will wield a stick to beat when they find it.

    Yes. The lady who first made me aware of him was of the ‘hoax’ persuasion. My mentioning of the horrors my daughter has encountered professionally were countered by her own second-hand authority who’d seen nuthin’!

    Obviously the subtleties of the evolutionary arguments are not going to get through either way, but I do feel that non-existent diseases and ineffective vaccines tend to exert pretty mild selection pressures! The parallels with Creationist argumentation are legion – credential mongering, importing arguments they can’t defend, cherry picking, manufactured offence, Gish galloping …

    0
  14. Alan Fox,

    Yes, Campbell’s a good communicator – though I tend to prefer a 5 minute read to a 30 minute vid! I have to discipline myself to avoid comments; there are some anti Vax regulars and I struggle to stay away from the light!

    0
  15. Alan Fox:

    I’ve been gloated at.

    Anyone who might have been gloat-inclined long ago unfollowed or unfriended me for my Brexit-hostile views!

    0
  16. I do a bit of volunteering at a couple of local mass-vac centres; nearly all appointments have been kept. I’ve been checking off names at the door; maybe one no-show per page of 50. These appointments would have been booked a few weeks ago, before the doubts crept in. We have no confidence in our government, but high confidence in our health professionals. Maybe a bit of nationalist pride in there too; we’re dispensing AZ (which nonetheless might have actually been made in India!).

    +1
  17. Cécilia Arraiano has appeared on Portuguese TV suggesting a new approach “turning the wolf into a dog” presumably reducing the lethalness of the virus in some way and spreading it so everyone catches a “cold” rather than the full-blown CoVid but develops resistance to CoVid. A bit like cowpox and smallpox perhaps. Arraiano seems legit. But then so was Didier Raoult.

    0
  18. Alan Fox:
    Allan Miller,

    I didn’t realise there were transcripts. I’m not a great fan of video either.

    There aren’t transcripts, unfortunately – just a general preference.

    0
  19. Alan Fox: You say this as if it is a bad thing!

    Haha, not at all – just ironic in light of any patriotic preference. I think there may be manufacture in Belgium too (which didn’t follow others in suspension).

    0
  20. I think mathematicians have been talking up the effectiveness of (highly) transmissible vaccines for years, but when the proposed target population switches from bats to humans, it’s the biologists who go all Jeff Goldblum “Life finds a way” to point out that they don’t want to be responsible if their virus mutates…

    0
  21. DNA_Jock,

    It would certainly create an interesting stir among the anti Vax community. Mind you, they think the virus (that “doesn’t do anything that flu doesn’t”) was designed anyway (to be a wholly ineffective biological agent!).

    But it would be ethically dubious even outside that arena. The vaccine would need a higher R number than currently transmitting strains to be an effective weapon, causing a large economic impact even if disease is ‘mild’. Nobody would have a choice about being infected with it; it would not respect national or personal policies on the matter. Nor species boundaries. And how do you even test it? All my instincts scream NOOOO!!! We shouldn’t be playing God. Leave the design of agents of potentially great suffering and misery to deities, I say!

    0
  22. Seeing that a lot of the internet quacks have switched from chloroquine to ivermectin. It’s a tricky area because there are some promising signs in some cases, but definitely not enough research to justify mass prophylaxis in place of vaccination, as the snake-oilers are advocating (and parts of India did, rendering some certain that is the reason for their light case load with classic correlation-causation eagerness).

    It’s ironic when people bigging-up the possible problems with vaccine gaily advocate off-label use of the latest fad without further ado. It is safe enough, but does have significant side-effects which need consideration if dosing millions over the long term against a possible condition. Even though a legit medication, in the hands of internet enthusiasts it is a vaguely more respectable version of dietary cures for cancer. And of course, there’s a conspiracy against its use. What Doctors Don’t Want You To Know.

    What I find odd is the range of usage. It combats several parasites from different phyla, applied both externally and internally, and now is supposed to be a possible antiviral too? 🤔 No doubt sorts your drains out and brings your marigolds on a treat as well. The Snibbo of the drug world.

    0

Leave a Reply

This site uses Akismet to reduce spam. Learn how your comment data is processed.