QUESTIONS PARENTS MIGHT WANT TO ASK THEIR PHYSICIANS:
Question 2: As parents, we would like to better understand the difference between the COVID vaccines and the usual childhood vaccines—such as the MMR, polio, chicken pox, Hemophilus influenzae B (HIB), and meningococcal vaccines. Although Dr. Vanden Bossche has warned that the COVID vaccination campaign has been unwise (for the reasons mentioned in Question 1, as well as other reasons), he thinks the usual childhood vaccines have been and still are wise—is that correct? Could you further clarify Dr. Vanden Bossche’s thoughts on this issue. Is the difference primarily (even solely) that the usual childhood vaccination programs have not represented examples of “rapid mass vaccination, across all age groups, using a suboptimal vaccine, in the midst of an active pandemic, involving a highly mutable and highly infectious respiratory virus?” Or are there other differences as well?
Response: You are correct—that Dr. Vanden Bossche is a strong supporter of thoughtful, careful childhood vaccination. He has devoted his entire career to development of safe and effective, judiciously used vaccines. He would insist, however, that all vaccines be honestly and altruistically developed and based on impeccably rigorous practice of science and concern for both short- and long-term safety, both at the individual level and at the population level.
I am also a supporter of thoughtful, careful childhood vaccination. I spent much of my pediatric residency (in the early 1970s) taking care of infants and toddlers who were being devastated by Hemophilus influenzae B meningitis. The subsequently developed Hemophilus influenza B (HIB) vaccine has dramatically reduced the incidence of Hemophilus sepsis and meningitis. Prior to the HIB vaccine 20,000 young children in the USA developed life-threatening Hemophilus B infection each year, and 1000 of those children (5%) died. Now severe Hemophilus B infection occurs in only 50 children annually in the USA. That represents a spectacular achievement. It would be a shame to return to the days of 20,000 severe infections per year!!
You are also correct—that an important difference between the usual childhood vaccines and COVID vaccines is that the childhood vaccines are not being given in the midst of an active pandemic. They are being used prophylactically—i.e. well in advance of the potential exposure. Since they are being used well in advance of the potential exposure, the vaccinated child’s immune system has usually had ample time to produce an ample amount of mature neutralizing antibody—so that when/if the child is exposed to the infectious agent the child has mature IgG vaccinal antibodies readily available.
But there are other major differences. Several of the usual childhood vaccines (e.g. the vaccines against measles, rubella, mumps, polio, and chicken pox) represent live-attenuated, replication-competent, prophylactic vaccines that result in sterilizing, long-lasting (even life- long) immunity and contribute to herd immunity. “Live-attenuated” means that the whole virus is used in the vaccine but its replication ability (within human cells) is either completely restricted (replication-incompetent) or markedly restricted (replication-competent but considerably subdued), such that the attenuated virus is either completely unable to cause disease in the vaccinated individual or is very unlikely to cause disease in the vaccinated individual. “Replication-competent” means that the live-attenuated virus can still replicate within human cells but at a much-subdued and usually safe rate. So, there are “live-attenuated, replication-incompetent” vaccines (i.e. replication is completely restricted) and there are “live- attenuated, replication-competent” vaccines (i.e. the attenuated virus is still able to replicate at a subdued and usually safe rate). “Sterilizing” immunity means that the immunity provided by the vaccine adequately contains the virus and prevents transmission.
The measles, rubella, mumps, polio (oral), and chicken pox vaccines are live-attenuated, replication-competent vaccines that are used prophylactically (meaning well in advance of anticipated exposure).
Live-attenuated, replication-competent vaccines are the most effective and durable vaccines that have so far been produced by the vaccine industry. These vaccines closely mimic natural infection, and stimulate a comprehensive immune reaction, involving both innate and adaptive immunity. Because they result in sterilizing, long-lasting immunity, they contribute to herd immunity.
The live-attenuated, replication-competent vaccines are much more “optimal” than the COVID vaccines. The COVID vaccines are not live-attenuated, replication-competent, sterilizing vaccines. The COVID vaccines are sub-optimal. They do not stimulate a comprehensive immune response. Instead, they stimulate a narrow antibody response. They do not prevent infection of human cells. They do not prevent transmission. They do not provide sterilizing immunity, and they do not contribute to herd immunity. And when used in the midst of an active pandemic involving a highly transmissible and highly mutable virus the COVID vaccines actually increase viral infectiousness, prolong the pandemic and make it more dangerous. (See Question 5.)
So, there are huge differences between the usual childhood vaccines and the COVID vaccines. Dr. Vanden Bossche’s greatest concerns about the COVID vaccines do not apply to the usual live-attenuated, replication-competent childhood vaccines. He, in fact, has great respect for the benefits of properly developed, properly tested, properly used childhood vaccines. In his view, the herd immunity created by the usual childhood vaccines—-for example, the live- attenuated, replication-competent vaccines (MMR, oral polio, chicken pox vaccines) and HIB vaccine—have been extremely important and life-saving for children. If these vaccines were stopped, herd immunity would ultimately be lost and many would suffer before herd immunity could be re-established by resumption of vaccination.
For completeness, let us explain that there are childhood vaccines that fall in-between the sub- optimal COVID vaccines at one end of the spectrum and the much more optimal live- attenuated, replication-competent vaccines at the other end of the spectrum. We have already mentioned live-attenuated, replication-incompetent vaccines, which are safer than the live- attenuated, replication-competent vaccines but considerably less effective. There are “inactivated” whole virus vaccines which use a killed version of the virus, which assures a complete loss of replication ability, but are less effective and less durable than live-attenuated, replication-competent vaccines—e.g. the Hepatitis A vaccine, influenza vaccines, the polio shot (as opposed to oral polio vaccine), and rabies vaccine. There are “sub-unit, recombinant, polysaccharide, conjugate” vaccines that use pieces of dead virus (or bacterium)—e.g. Hemophilus influenza (HIB) vaccine, Hepatitis B vaccine, pneumococcal vaccine, meningococcal vaccine, and whooping cough vaccine. And there are toxoid vaccines, such as Diphtheria and tetanus vaccines.
So, not all vaccines are the same. The COVID vaccines, and particularly the situation in which they are being used (i.e., in the midst of a pandemic), are completely different from the usual childhood vaccines. For the reasons explained above, Dr. Vanden Bossche is a strong advocate for properly developed and tested usual childhood vaccines, while being a strong advocate against the COVID vaccines.
To summarize: Compared to the COVID vaccines, the usual childhood vaccines (particularly the live-attenuated, replication-competent vaccines) are much more sterilizing (even completely
sterilizing), much more optimal, much more effective, much more durable, much more capable of contributing to herd immunity, and much safer than any of the COVID vaccines.