Vaccines and hypersensitivity

[SecondCor521]

I'm generally quite pro-vaccine. I'm fully vaccinated against everything (including all the stuff you have to get to visit India), and my kids are also.

I had my annual physical yesterday and asked my doctor a question about how to determine which vaccine was best for me. I was mainly asking because I know that there are various vaccines in development that use different techniques and I thought he might think one kind was better than another.

He surprised me by recommending I hold off for about two years (!), not due to initial safety concerns or lack of initial efficacy, and not due to general anti-vaccination concerns. He specifically mentioned that sometimes a virus will have genetic drift over the course of a few years and then those who were vaccinated would have some sort of immune hypersensitivity to the virus which could be fatal. He either used the term "hypersensitivity" or "hyperactivity" - not sure which as he was in a hurry to get to his next patient.

I like to avoid fatal events as much as the next guy. I also am generally unimpressed by conspiracy theories and this sounded a bit conspiracy-theory-adjacent to me. I also think this guy is generally a good doctor, but I'm revisiting that opinion as well due to these comments.

Anyone know what he was referring to here, and know what the current medical knowledge and opinion is on this type of thing?

 

[cathy63]

Maybe he mentioned antigenic drift? https://en.wikipedia.org/wiki/Antigenic_drift

A couple of papers that may be reassuring:

A SARS-CoV-2 vaccine candidate would likely match all currently circulating variants https://www.pnas.org/content/117/38/23652

Low genetic diversity may be an Achilles heel of SARS-CoV-2 https://www.pnas.org/content/117/40/24614

 

[SecondCor521]

Thanks, cathy63.

The gist of his concern was not that the genetic drift (of whatever kind) of the virus would make a vaccine less effective. Rather, his concern was that somehow receiving the vaccine and then later being exposed to a slightly genetically different version of the virus would somehow result in the person's immune system going into overdrive and this overdriven immune response could result in a fatality. Metaphorically like blowing a car engine due to overheating, I suppose.

I'm not describing it well because it was a new concept to me and the doctor was rushing his explanation in order to get to his next patient. (In fairness to the doc it was my last question and he had already spent 45 minutes with me.)

It may help to know that he mentioned in his explanation that this effect had been seen with other vaccines and viruses (I think he mentioned MERS and SARS specifically). The effect would only show up years later, which is why he recommended waiting on the coronavirus vaccine.

 

[gerntz]

So if yo wait two years, shy couldn't the virus "drift" after that also?

 

[SecondCor521]

So if yo wait two years, shy couldn't the virus "drift" after that also?

Of course. I think his implication was that some vaccines had this problem and some didn't, so it was better to wait to see which ones did and which ones didn't. Or it could have been his position to at least wait and see if this problem occurs with these vaccines and this virus; if it does occur then it could affect one's risk/reward analysis and decision whether to be vaccinated.

Really I posted this thread hoping someone had at least also heard of this idea and could maybe point to some terms or articles or something so I could read more about it. I'm not defending the idea, just wanting to educate myself.

Anyone? Bueller?

 

[Aerides]

Your post sent me googling, and I found this from NIH about vaccines:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6602527/

As a non-medical person, it sort of sounds like how you know some people are sensitive to flu vaccines - and most are just barely (annoying/mild symptoms) but an incredibly small number experience serious symptoms (the article says something like 1.3 per million). It seems the article is lumping all vaccines together, but notes the flu as it's one of the bigger ones.

So to me it sounds like there's always going to be some risk with anything you put in your body, and, me personally, I'd take my odds with a vaccine vs getting covid (or staying home for another 2 years).

 

[SecondCor521]

Your post sent me googling, and I found this from NIH about vaccines:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6602527/

As a non-medical person, it sort of sounds like how you know some people are sensitive to flu vaccines - and most are just barely (annoying/mild symptoms) but an incredibly small number experience serious symptoms (the article says something like 1.3 per million). It seems the article is lumping all vaccines together, but notes the flu as it's one of the bigger ones.

So to me it sounds like there's always going to be some risk with anything you put in your body, and, me personally, I'd take my odds with a vaccine vs getting covid (or staying home for another 2 years).

Thanks for the link.

I think I just need to call the doctor's office back and ask them for the information that I'm trying to find through a post on an early retirement board. ;-)

I generally agree with your last paragraph.

 

[donheff]

I would not accept some random doctor's recommendation that is way out of line with the experts. Doctors can be dumb about stuff outside their immediate expertise just like the rest of us. It is certainly worth trying to stay up to date on research findings and I would not question anyone who wants to wait a bit to get vaccinated but on strange opinions like this I would get a second and third opinion.

 

[Koolau]

Back in my home town ("down town), they tore down a building that had experienced a fire. Next to the building was another building which still had an old painted bill board for cigarettes. Can't recall the exact message, but a doctor in full white coat and shiny reflector on his head was saying something like '4 out of 5 doctors choose XYXZX cigarettes.' IIRC the doc was holding a lit cigarette. My point, docs don't know everything. They have their opinions just like we do. Everything changes. AND YMMV.

I'll take the vaccine as soon as they will let me. I took one of the first polio vaccines so I guess it's in the blood. Again, YMMV.

 

[Brat]

% effective

The fact that the US vaccine program seems to set the bar at 60% bothers me a lot. The J&J vaccine was showing 100%, if that is approved that is what I would want.

 

[Koolau]

The fact that the US vaccine program seems to set the bar at 60% bothers me a lot. The J&J vaccine was showing 100%, if that is approved that is what I would want.

Is there someplace to look up this info? Not even sure what to google. I too would like to go with the most effective vaccine if there is a choice. Thanks!

 

[donheff]

If the vaccine ends up working at 60% like a flu vaccine we will all be hunkering down with masks until they get good therapies.

 

[JoeWras]

Can't recall the exact message, but a doctor in full white coat and shiny reflector on his head was saying something like '4 out of 5 doctors choose XYXZX cigarettes.' IIRC the doc was holding a lit cigarette. My point, docs don't know everything. They have their opinions just like we do. Everything changes. AND YMMV.

Wouldn't you trust this young handsome doctor?

 

[MichaelB]

Is there someplace to look up this info? Not even sure what to google. I too would like to go with the most effective vaccine if there is a choice. Thanks!

Here’s a recently published paper in Nature that gives an overview of vaccines in development. With so many candidates it may not be easy to decide. https://www.nature.com/articles/s41586-020-2798-3.pdf

there are currently more than 180 vaccines at various stages of development.

 

[gerntz]

The fact that the US vaccine program seems to set the bar at 60% bothers me a lot. The J&J vaccine was showing 100%, if that is approved that is what I would want.

My guess is you'll be able to get multiple, different virus "attack" design vaccines & we could wind up on an ongoing once/twice per year regimen.

 

[gerntz]

If the vaccine ends up working at 60% like a flu vaccine we will all be hunkering down with masks until they get good therapies.

Non-medical here, but isn't that low level due to the continuing, rapid mutations of the flu viruses? I.e., if this virus isn't so mutable, then I'd judge these vaccines would be more effective.

 

[Chuckanut]

From what I understand, nobody knows for certain or even a high percentage of certainty how effective any of these vaccines are.

Check out the 10/16/2020 Firing Line with Dr. Fauci.

This is one of the better and more thorough interviews of Dr. F that I have seen.

 

[JoeWras]

It's worth watching. He has a few inconsistencies, but I won't hold it against him and they are not worth discussing in a hot topic. I could have done without the snark from the interviewer once or twice, but overall, worth your time to watch.

One big take-away I had was that boosters may be needed. The good Dr. was humble to say multiple times he doesn't know everything and things are changing, but there's a good chance this virus may be one requiring boosters. This discussion came about because of the report of someone who got COVID a second time. This isn't the same as the yearly flu shot. It is more about reduced immune response as time goes on. Again, he was clear to point out this is all still being evaluated as we learn more. It is just one of many possibilities.

 

[ivinsfan]

I'm generally quite pro-vaccine. I'm fully vaccinated against everything (including all the stuff you have to get to visit India), and my kids are also.

I had my annual physical yesterday and asked my doctor a question about how to determine which vaccine was best for me. I was mainly asking because I know that there are various vaccines in development that use different techniques and I thought he might think one kind was better than another.

He surprised me by recommending I hold off for about two years (!), not due to initial safety concerns or lack of initial efficacy, and not due to general anti-vaccination concerns. He specifically mentioned that sometimes a virus will have genetic drift over the course of a few years and then those who were vaccinated would have some sort of immune hypersensitivity to the virus which could be fatal. He either used the term "hypersensitivity" or "hyperactivity" - not sure which as he was in a hurry to get to his next patient.

I like to avoid fatal events as much as the next guy. I also am generally unimpressed by conspiracy theories and this sounded a bit conspiracy-theory-adjacent to me. I also think this guy is generally a good doctor, but I'm revisiting that opinion as well due to these comments.

Anyone know what he was referring to here, and know what the current medical knowledge and opinion is on this type of thing?

Well I guess if you get the COVID and die in the two years you are waiting per doctor advice, the good Doc will say "my bad".

 

[Ian S]

Wouldn't you trust this young handsome doctor?

Interesting. our small town family doctor when I was growing up was a 2 pack a day Camel plain tip cigarette smoker for many years. Our families were neighbors and very close-knit. That doctor dropped dead of a heart attack in his late 50's in the local hospital of all places. They said he was dead before he hit the floor. My father never smoked but succumbed to a heart attack at age 65. My mother smoked socially for many years but gave it up decades ago. She'll turn 99 in March.

 

[braumeister]

But even then, opinions varied.

 

[Ian S]

He surprised me by recommending I hold off for about two years (!), not due to initial safety concerns or lack of initial efficacy, and not due to general anti-vaccination concerns. He specifically mentioned that sometimes a virus will have genetic drift over the course of a few years and then those who were vaccinated would have some sort of immune hypersensitivity to the virus which could be fatal. He either used the term "hypersensitivity" or "hyperactivity" - not sure which as he was in a hurry to get to his next patient.

Maybe he was referring to the problem with the Dengue fever vaccine where it is only recommended for those who have been previously infected: if it's administered to someone who has never been infected, it can actually increase the risk of severe Dengue infection. https://en.wikipedia.org/wiki/Dengue_vaccine

 

[Another Reader]

One of the concerns is Antibody-Dependent Enhancement (ADE), as the SARS CoV-2 virus is subject to mutation.

https://en.wikipedia.org/wiki/Antibody-dependent_enhancement

The sub-optimal antibody may actually help the virus enter the target cell.

 

[Koolau]

Wouldn't you trust this young handsome doctor?

Heh, heh, as I recall, "my" doc (on the wall) was quite a bit older - obviously much more trustworthy - especially to folks who had survived smoking for 40 years! It's interesting that the "health" effects of smoking - though probably never specifically stated in that time - WERE being "debated" at least at the consumer level. My folks both smoked WAY before the links to cancer were "proven." They KNEW there were health effects because my mom even cut back smoking when she (unexpectedly) became pregnant with my little sis, CA 1952.

But I've wandered far afield again. Returning you now to vaccines, et. Al. YMMV

 

[Koolau]

Here’s a recently published paper in Nature that gives an overview of vaccines in development. With so many candidates it may not be easy to decide. https://www.nature.com/articles/s41586-020-2798-3.pdf

Thanks so much!

Quite frankly, I'll no more than scan the article as my puny brain no longer digests such scholarly offerings. Still, it does show that there are a bunch of candidates. Some must, of necessity be better than others. I wonder if one candidate will eventually bob to the top and become "THE" vaccine or if we'll have our doctors telling us which is better (best) for us? Whoa! Talk about good news/bad news. SO many choices (maybe) and so little ability (at the consumer level) to evaluate (assuming we end up with a choice.) I could imagine a scenario where we get-what-we-get because there isn't enough of just one vaccine to go around. My, I'm getting a headache. Must be something I ate - I mean read!

Bottom line for me is that there truly are folks working feverishly on this issue of vaccines. I don't really care that they're mostly doing it to make money. Whatever works is good for me - I hope, but YMMV.