leaky vaccines, super-spreads, and variant acceleration

imperfect vaccines can make a virus more prevalent and more deadly. some questions on covid vaccines and their policy implications.

the rule of evolution is simple: make a copy of me and pass it on.

any species still around to notice is very, very good at this. that’s the test and it’s as simple as it is daunting.

this evolutionary selector creates pressures and these pressures shape evolution.

useful traits are conserved, traits that work against replication and propagation are selected against. this creates a simple evolutionary gradient for viruses: become more contagious, spread further, infect more hosts. many viruses and bacteria are incredibly good at this.

the good news is that harming the host is maladaptive. it’s like burning down your own house and your car with it. you soon have nowhere to live and no way to move around easily. so the selection process drives viruses AWAY from being deadly. ebola is a fearsome virus, but poorly evolved. it kills too quickly and spreads too slowly. that’s why outbreaks are small, rare, and (relatively) easy to manage.

people who feel sick stay home, they stop mingling and carrying the virus to where others are. it’s a built in societal and species level trait to mitigate pandemic.

but what if you could break that trait?

what if you could prevent a carrier from realizing it was infected?

well, then you’d spread virus far more effectively, wouldn’t you?

you could do A LOT of damage and the natural brake on the spread, harm, and lethality of a viral evolutionary vector would be removed. you’d supercharge a pandemic.

this is a long discussed and hypothesized problem with “leaky” vaccines.

a leaky vaccine is one that lacks sterilizing immunity. it prevents severe infection and perhaps death, but it does not stop infection and colonization by virus. so, the vaccinated become a carrier but remain unaware of it. this is a massive accelerator of disease spread and possibly/probably of overall fatality rates. you can see discussion here: (from 2015)

for those seeking an easier summary, this is a more accessible article. i strongly recommend reading the whole thing (and the study above it cites). this is another example of “science we tossed out the window this year” and is exactly the sort of thing the FDA should have been laser focused on from day one.

“But a chicken virus that represents one of the deadliest germs in history breaks from this conventional wisdom, thanks to an inadvertent effect from a vaccine. Chickens vaccinated against Marek’s disease rarely get sick. But the vaccine does not prevent them from spreading Marek’s to unvaccinated birds.

“With the hottest strains, every unvaccinated bird dies within 10 days. There is no human virus that is that hot. Ebola, for example, doesn’t kill everything in 10 days.”

In fact, rather than stop fowl from spreading the virus, the vaccine allows the disease to spread faster and longer than it normally would, a new study finds. The scientists now believe that this vaccine has helped this chicken virus become uniquely virulent.”

stop for a minute and absorb what this means. by turning the vaccinated into essentially perfect carriers of virus, it transformed them into a set of plague rats to infect the rest. a disease so deadly it would burn itself out rapidly becomes one capable of endemic spread so long at there are more vaccinated carriers around.

““Previously, a hot strain was so nasty, it wiped itself out. Now, you keep its host alive with a vaccine, then it can transmit and spread in the world,” Read said. “So it’s got an evolutionary future, which it didn’t have before.”

The virus spread to sentinel birds nine days faster if it came from a vaccinated chicken versus an unvaccinated one. In addition, sentinels died faster when exposed to vaccinated chickens versus unvaccinated chickens.

“One way to look at that experiment is that shows vaccinating birds kills unvaccinated birds. The vaccination of one group of birds leads to the transmission of a virus so hot that it kills the other birds, said Read said. “If you vaccinate the mothers, the same thing happens. The offspring are protected by the maternal antibodies of the mother and that allows the virus in the chicks to transmit before they kill the host. So they transmit and kill the other individuals.””

in such a case, your vaccine does not protect me, your vaccine puts me and everyone else at terrible risk and it is not the unvaccinated that need to be quarantined, but rather the vaccinated.

they become the dangerous vector and a monstrous amplifier of spread and risk.

not only do they spread disease unknowingly because they fail to acquire the symptoms that should tell them to reduce activity (stay home) but they also alter the evolutionary gradient of the virus by reducing the maladaptiveness of harming the host because these “superhosts” can harbor deadly virus yet not die or even become ill.

the functional line between this and viral weaponization gets perilously thin…

“leaky” vaccines pose a serious danger to populations and mistaking their societal benefit for that of a “perfect” vaccine (like measles, polio, smallpox etc) is like mistaking hemlock for gatorade. these are societally devastating, spread disease more rapidly, and breed for “hotter” deadlier disease.

now let’s talk about covid:

many have posited that some of the less efficacious vaccines (like flu or malaria) could be having this effect in humans. unfortunately, it looks to me like the covid vaccines should be added to this list as potential leaky vaccine risks.

the evidence that covid vaccines are non-sterilizing (not perfect) has now mounted to the point where it’s pretty hard to deny.

• these vaccines do not stop spread.

• they do not provide sterilizing immunity.

• even the CDC has said so itself.

• and lots of hard data supports it.

• efficacy rapidly wanes.

• even topol is agreeing.

this chart is the real clincher in this regard. SOURCE vaccinated people carry the same viral load as unvaccinated during the first 6-8 days of infection. this is the period of maximum contagiousness. they then clear the virus much more rapidly.

this is the classic profile of a leaky vaccine: you’re a spread vector that is not harmed by being a spread vector. this would turn vaccination into a massive epidemiological accelerator and a disease severity accelerator. that would be very, very bad especially given the size of the populations that have already been vaccinated. it would mean that in many places, the plague rats outnumber the villagers.

we see confirmation here. shedding of infectious covid virus is prevalent despite vaccination and viral load is nearly as high.

so, i think it’s more or less become impossible to claim that these vaccines are not leaky. the question is “how leaky?” and that does not look great either. all the “efficacy in preventing spread” data comes from using “case” counts that require symptomatic confirmation but the whole fear here is that vaccines are mitigating symptoms but not infection.

and even asymptomatic claim is increasingly not holding up. this is looking less and less like an issue with “new variants” as some exogenous issue and more like an issue with vaccine fade and vaccine selection for these variants.

it’s not virus having an effect on vaccine function, it’s leaky vaccine function having an effect on viral evolution and it’s not clear we’ve really even seen it yet.

delta was wild long before high vax rates. perhaps it spread more as a result (though india argues otherwise) but delta is not the nasty output of a vaccine inverted evolutionary gradient. it predates that. if such a thing is coming (and it might be), we have likely not seen it yet.

Yossi Gestetner @YossiGestetner

🚨 Reuters yesterday: “effectiveness of the Pfizer/BioNTech vaccine had fallen to 42%” in July in a study of patients in the Mayo system. 🚨 CNBC today: “the Pfizer-BioNTech Covid-19 vaccine was just 40.5% effective at preventing symptomatic disease” in a study by Israel gov.

August 10th 2021

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covid used to spread very poorly and rarely from the asymptomatic and mildly symptomatic, but this changes that. it would create a cohort of highly effective asymptomatic spreaders.

note that the strategy of vaccinating the weakest and oldest and most immuno-compromised first is exactly wrong in this scenario. that’s the cohort most likely to have breakthroughs and whose immune systems will be least effective at sterilizing immunity.

leaky vaccines look to make disease hotter and more deadly.

vaccines become a weapon for the virus, not a defense for the society.

if this is happening, we need to know because it would have profound policy implications. it means vaccines should be banned, not mandated. it means boosters are a societal risk accelerator not an attenuator.

it means that adults do not need to be shielded from school kids, it means that school kids need to be protected from vaccinated adults, including their teachers. that’s a startling inversion of general disease pathways.

this seems to be one of the most pressing questions in medicine right now.

so let’s look.

if one were seeing such a trend occurring, what would it look like?

this is, thus far, just theory. it’s a hypothesis with some sound looking basis, but we have no real evidence. we need some. so how could we test this?

simplest is to look at high vaccination areas and see how this is protecting them. if this is really a sterilizing vaccine, cases should drop year on year once we adjust for testing levels and seasonal signal. in fact, we’d expect cases to drop even in the absence of a sterilizing vaccine because of the recovered cohort with acquired immunity. thus, if such adjusted cases were to rise instead, this would be a fairly strong signal. if they were to do so out of season, it might be stronger still. unfortunately, this is JUST what we are seeing.

cases in highly vaxxed UK and israel are exploding. some of this is testing, but using % positive as a rough proxy for test adjusted can help us here. testing in both places is up about 2X on a per capita basis. but israeli cases are 648/mm vs 161 same time last year. UK are 420 vs 16 and are now spiking well out of season.

this is the result you’d predict from leaky vaccine spread.

(please note that this is consistent with that hypothesis, but does not prove it conclusively. that said, it’s also inconsistent with “vaccines are attenuating spread” and that in and of itself is a pretty powerful claim. this is messy data in complex systems, so let’s be very careful about what we can and cannot prove.)

we can test this in the US as well and i’ll do so using some graphs produced by longtime gatopal @Emily_Burns_V whose science and data chops have always been strong (you don’t get into a rockfeller PhD program by clowning around) and who has been noticing some of the same things: (data pulled from CDC using a tool built by @kerpen and is adjusted for testing levels (HUZZAH! finally!) to control for variation in sample rates)

here we see exactly what we’d expect from a leaky vaccine: more vaxx = more cases. even more provocative, we see this:

the predictable summer surge in southern states looks nearly 100% amplified vs last year, but look at the high vax states in the north: they are over 200% amplified vs last year AND are having an out of season surge.

this should be a low period for them and cases should be in summer decline. instead we see a rapid unseasonal rise. again, this looks strongly consistent with a leaky vaccine spreading virus more readily and strongly inconsistent with sterilizing vaccine. and lots and lots of people are starting to notice this.

so what are we supposed to do now?

firstly, we need more data. we need to get much deeper into this issue of societal spread and viral amplification by the vaccinated.

the FDA and NIH need to stop playing vaccine salesman and do their actual jobs. they never looked at safety here and they never looked at long term sterilizing immunity. if they pushed a seriously leaky vaccine into hundreds of millions, blame for this new surge lies 100% at their feet.

the fact that they are not all hands on deck assessing this issue is a disgrace. there is no higher priority in medicine right now and it’s time to get the politics out of it and let the actual scientists do their jobs. this needs to be studied forensically and it needs to be done right now.

second, we need to stop claiming variants are exogenously evolving to evade vaccine and start to look at the degree to which a leaky vaccine is driving this evolution and inverting the evolutionary gradient away from milder disease and toward more severe. this claim has been a flag of convenience to shield political choices and mandates and avoid 90% of western governments from having to admit they have spent all year handing anchors to drowning swimmers. but if they have, we need to know it. yesterday.

third, the idea that boosters are a path out of this and can mitigate new variants needs to be instantly abandoned. if this is correct, they will only make it worse. the short term immune activation will prevent the vaccinated from getting the mild covid that will finally give them sterilizing immunity. it keeps them active as a superspread and viral amplification vector longer. it’s also an unattractive risk reward for most people and the expectation that this harm ratio will intensify as patients get younger is by far the odds on bet. they have less to fear and are more likely to experience the auto-immune cascades for which mRNA vaccines have been notorious in animals.

you cannot live getting a booster every 4 months to re-active your immune system. it will grind you to dust and bury you under adverse events as you spend more and more
for less and less safety. it’s a down sloping disaster log curve.

this is made up science. it has no basis in fact and will be an unmitigated disaster for everyone except for pfizer and moderna even if vaccines are not causing leaky problems. this is politicians playing CYA, not health officials looking out for you.

crazy as it sounds, if the vaccinated are super spreaders and viral enhancers, the next booster should be actual covid. it’s the only way to protect the rest of us from them. it would be a rich irony to see all those who have hectored and vilified the unvaxxed suddenly refuse to take the risk that would protect society if it is revealed that they constitute the real threat.

fourth, ideas of vaccine passports need to be repudiated immediately. vaccines do not stop spread so, at best, this is a personal protection choice and, at worst, your vaxx is literally an attack on the rest of us. the data and science here supports that claim better than it supports societal protection. that means stop pushing vaccines and start pushing a move to evidence based medicine.

conclusion:

this is not a proven hypothesis. let’s be very clear about that.

but it is an increasingly well supported hypothesis and one that seems more consistent with the facts than claims that vaccines are protecting society from spread or even from severity in the long run. if this bears out, boosters are a recipe for epidemiological poison, not prevention. you’re putting out a fire with gasoline.

the time for petty politics is long past. these vaccines have significant shortcomings and were recklessly rushed to market which is how we find ourselves in a situation this poorly understood and potentially fraught. we need to figure this out immediately and health agencies and regulators need to stop playing silly “game of thrones” wargames for partisan profit and fief building and DO THEIR JOBS.

this is a stunning lapse in regulatory diligence and an abrogation of the role of these agencies. they have given short shrift to safety all along. no other vaccine in FDA history would have been allowed to launch with an adverse event profile like this and no other vaccine pushed so widely without even assessing the potential implications of leaky vaccine spread and viral amplification.

• cut corners and you get bad policy.

• ignore safety and you find yourselves possibly having made it worse.

• politics is the opposite of medicine.

• play stupid games, win stupid prizes.

so let’s stop, pause this out of control politico-health train, and figure out where it’s actually going. mistaking the gas for the brake is NOT a mistake we want to make here.