The Wrights and Wrongs of Vaccination.

 

 

I am reading a brilliant book recently written (2020)  by Matt Ridley entitled How Innovation Works in which he makes the point big changes in real life do not occur as they do through the back mirror of romantic history.  Invention and Innovation are two separate events.   Change is never linear and is always impacted by opportunity, trial and error, and a big dose of luck and circumstance.  The drivers of new ideas often toil for years, borrowing off the ideas of others, and rarely see the fruits of their vision.  Change, even life altering change is incremental.

He tells the story of Alexander Fleming working in his laboratory at St. Mary’s Hospital when he noted an interesting gap between the cultured colonies of Staphylococcus aureus and a contaminating colony of Penicillium.  That he noticed it was a moment of curiosity (and maybe brilliance) but points to how much luck and circumstance affected his (and our collective) fate and  future.  (Devine Intervention?)  If there had not been a fluctuating heat wave in London and if there was not floating fungus in the air which happened to land on a culture plate, then the  Penicillium would not have been there and would not have grown on the plate, and would not have exuded a compound that prevented the Staphylococci from growing onto the Penicillium.   But it did happen and Fleming did see it, and the world changed accordingly.

But there is another part to the story.   Fleming was working at the laboratory headed by Sir Almroth Wright, a brilliant mind who had involved in the development of typhoid vaccine for near 25 years.  Wright was absolutely convinced of the powers of vaccination.  In 1904 he studied how bacteria stimulated phagocytes with opsonins.  Unfortunately, so powerful was his passion for vaccines, he was totally resistant to the idea that any other approach such as medication would or could impact infections diseases, so much so that he discouraged Fleming’s interest in the pursuit of his Penicillin mould for more than 12 years.   

If was not by accident that many of Wright’s colleagues nicknamed him Sir Almost Right or Sir Always Wrong.  (George Bernard Shaw mocked and immortalized Wright in his plays The Doctor’s Dilemma, How These Doctors Love One Another! and Too True to Be Good).

Without the surreptitious efforts of  Fleming and friends like Florey and Chain in pursuing penicillin and the many many others, we might never had entered the era of survival of infections and the benefits of interventions like surgery, implants, transplants, or chemotherapy. 

It seems that today our lives are again being impacted by a new slew of Almoth Wrights.  Today we have people who are so convinced of the powers of vaccines, that they deeply and truly believe vaccine induced protection is better than natural immunity through infection.  Today we have people who measure “herd immunity” not by mass spread of infection, but by mass immunization, which includes the vast majority of healthy people under the age of 70 or 60 with virtually no risk or concern from infection from COVID-19 (including kids of school age and university.   

I am sure they are sure there is sound justification for requiring all people show proof of immunization regardless of prior infection, mild, moderate or severe, but I am less convinced.

Of personal interest, I am comforted by the knowledge that I am not alone in my concern.   For those with the time and facility I encourage you to read, the just published “Comparing SARS-CoV-2 natural immunity to vaccine-induced immunity: reinfections versus breakthrough infections” written by

Sivan Gazit and colleagues.  It was just published recently (August 24, 2021) in the journal medRxiv (pronounced Med Archive) preprint doi: https://doi.org/10.1101/2021.08.24.21262415; 
You can find it on PubMed (National Library of Medicine).

For those who will trust my reading and interpretation, the study looked at 3 groups of people (1) no infection, but protected by two doses of vaccine (2) evidence of prior infection and no vaccine and (3) evidence of infection but who also received one dose of vaccine. 

Regardless of age or underlying “comorbidities” the people with infection and no vaccine had a strongly significant reduction in break through infections (ie natural infection imparts better protection than vaccine). 

People with infection and one dose of vaccine had a marginal (but statistically significant) improvement compared to those with infection but no vaccine.   

The study did NOT look at side effects associated with vaccine in either the those with prior infection or not.