The Vaccination Task Force rediscovers science (Part 1)

BAM!-DETOX*

Although Jean-Michel Dogné has not been as much in the media as other experts, he exerts no less influence on decisions relating to the health situation and vaccination campaigns, since he is a member of the Scientific Council and of the Vaccination Task Force. But we will come back to this in a second article, as this multiplicity of roles held by one and the same person deserves some clarification.

Certain passages of the webinar particularly caught our attention. We have therefore decided to comment on them in two parts.

No vaccination during an epidemic period

At the beginning of his presentation, Jean-Michel Dogné talks about vaccination strategy: “We too often forget that we always vaccinate at a time when the epidemic situation is as low as possible, to anticipate a wave that may or may not come. For example, we always vaccinate against flu in October for a wave that could come in January, February or March. We will no longer be able to keep up the strategy of rush vaccination every time there is a new variant.” (16^th minute).

Over the past two years, how many times have “fact-checkers” asked for the sources of this statement that one never vaccinates in the middle of an epidemic! As if this notion had to appear on a specific page of a medical textbook. Whereas it is a process of reasoning linking different aspects, which has resulted in a commonly accepted rule of good vaccination practice.

And now this basic principle reappears in the mouth of a representative of the Vaccination Task Force, who introduces it with the words: “We too often forget it”. Yet only certain experts seemed to have forgotten it, while others never stopped pointing it out, including on BAM!. But it seems that it took the obvious fact that mass vaccination is constantly overtaken by viral mutations becoming impossible to deny for this good practice to (once again) become the pillar of the strategy.

Variants

Next, Jean-Michel Dogné offers some explanations about the variant currently dominant in Belgium: “Today, it is the Omicron BA.5 variant that is in the majority. As with BA.1 and BA.2, there is a negative element, which is that transmission is greater, and a positive element, which is that it is less severe than the Delta variant. ”

This is reminiscent of one of the fundamental principles of virology, set out on 18 January 2022 in an article by the CovidRationnel group entitled: “Omicron, a game changer”^[3] in which we can read:

“Its evolution would in this case follow the law of the American bacteriologist Theobald Smith (1859-1934). According to this law, an agent introduced into a new host sees its initial pathogenicity decrease to the point of becoming harmless. In the history of viruses, we observe that mutations generally evolve towards a virus that is both more contagious and less dangerous for the host. This is entirely in keeping with the logic of natural selection: it must be more contagious to spread more quickly, but it has no advantage in attacking its host (human beings, in the case of SARS-CoV-2) too strongly ”.

Applied to respiratory viruses, this becomes obvious [see Figure - Source Prof M. Zizi, Twitter post]. A dead person no longer coughs and can NOT infect another. This is different from the Hepatitis B, HIV or Ebola viruses, where infection is possible from the infected person, even when dead.

A virus that spreads quickly and colonises the entire planet in a few weeks cannot be deadly, which does not mean that one cannot fall ill.

 

Cellular immunity

In the 20^th minute, Jean-Michel Dogné utters “cellular immunity”, words that are nonetheless taboo for certain experts… including Jean-Michel Dogné:

“We have only limited data on the effectiveness of current vaccines against the BA.4 and BA.5 variants. But the preliminary data seem to show the same type of protection as for BA.2, namely a less effective production of neutralising antibodies. People can therefore be re-infected even if they have been vaccinated 3 times. But effectiveness against severe forms remains good because it is less linked to neutralising antibodies and more linked to cellular immunity.”

The main argument in favour of the superiority of vaccine immunisation over immunisation through the disease has always been based until now on the level of neutralising antibodies, much higher after vaccination than after the disease. Without anyone ever being able to set a precise level to reach in order to be protected, this large quantity of vaccine-induced neutralising antibodies being a sort of Holy Grail unattainable through the disease. Going so far as to forget that it is perfectly normal – this is a basic concept in immunology – for an antibody level to decrease within a few months, because without this decrease, the thousands of different antibodies accumulated by each of us would leave no room in the blood for the rest of the plasma. At that point, the antibodies remain in reduced numbers but are very much present to constitute immune memory – via our cellular immunity.

Many scientists have nevertheless tried in vain to point out the existence of cellular immunity, that other component of immunity which comes on top of humoral immunity (via antibodies), as can be read in this CovidRationnel publication dated October 2021, which draws attention to the importance of this cellular immunity^[4]:

“Measuring anti-SARS-CoV-2 antibodies is only an approximate indicator of immune status because of individual variability and variability over time. Moreover, an important component of the immune response is cellular immunity, which is measured independently.”

Jean-Michel Dogné would have saved precious time if he had taken inspiration earlier from the opinions of people clearly better informed than him on the subject, since a little further on he mentions the impossibility of determining whether or not a person is protected on the basis of their antibody level, because each individual reacts differently and this level varies greatly over time.

Nevertheless, this notion of cellular immunity does not yet seem entirely clear to him, since later in the webinar he will nevertheless come back several times to the need to raise the level of neutralising antibodies with the 2^nd booster because the level decreases over time.

Around the 25^th minute, he says:

“Some people who go to the media say it is much better to get infected naturally. But we see that the level of neutralising antibodies also decreases over time in infected people.”

It would be interesting to ask the doctors who attended this webinar whether they noticed the contradiction in these remarks. Some probably did, but we wish to highlight this contradiction.

Let us therefore go over the sequence of statements:

• Vaccines remain effective against hospitalisations and severe forms despite the significant decrease in antibody levels, because this protection depends little on neutralising antibodies (humoral immunity) and more on cellular immunity.
• Vulnerable patients should be encouraged to have the second booster because a sharp decrease in neutralising antibodies is observed and, in studies, the second booster is seen to create a renewed increase in neutralising antibodies.
• Immunisation via the disease is not better than immunisation via the vaccine (and is therefore not desirable) because the level of neutralising antibodies also decreases in infected people.

Except that protection against hospitalisations and severe forms depends above all on cellular immunity and little on neutralising antibodies…

It is by rereading these three statements one after the other that one understands the origin of the unease felt when listening to them stated separately, with a certain delay between them. And this unease comes from the fact that the reasoning does not respect the principle of non-contradiction, which is the fundamental pillar of logical reasoning and could be summed up as follows: “it is impossible to affirm and deny the same thing”.

If protection against severe forms remains good despite the decrease in neutralising antibodies over time, it is because it depends above all on cellular immunity. The decrease in post-infection neutralising antibodies cannot be an argument for the ineffectiveness of immunisation through the disease. Nor can the decrease in post-vaccination antibodies be sufficient grounds for recommending the administration of a 2^nd booster.

Is it not therefore high time that the level of neutralising antibodies ceased to be the reference indicator guiding vaccination strategy, since it is a poor indicator of the quality of immunity?^[5]

Vaccination and immunosuppression

We take advantage of this subject of neutralising antibodies to leave the webinar report for a moment. At the beginning of August, Professor Martin Zizi asked Minister Christie Morreale a fundamental question about the merits of administering the 2^nd booster to immunosuppressed people. Knowing that vaccination can create a temporary immunosuppression of as yet unknown duration, it is legitimate to ask the question. Following the suspension of Prof. Martin Zizi’s account, an internet user took over.

Jean-Michel Dogné replied: “Yes, the immunosuppressed must be vaccinated as a priority” and backed up his answer by sharing a study showing that vaccination increases humoral immunity (antibodies) in the immunosuppressed^[6]. Minister Morreale endorsed this answer by liking it.

We will not look into the limitations of this study – which the authors themselves mention – but we wish to point out that once again, it is the level of neutralising antibodies that Jean-Michel Dogné uses to argue for the effectiveness of vaccination in immunosuppressed patients.

Yet if you read the study to the end, you find this passage: “Furthermore, the antibody response is only one component of the immune response to vaccines, therefore, antibody titer does not necessarily imply clinical protection.”, which means: “the antibody response is only one part of the immune response to vaccines, so the antibody titre does not necessarily mean clinical protection.”

Moreover, in many immunosuppressed patients (those included in the categories concerned by the 2^nd booster), the problem lies rather in a deficient cellular immune response, as explained in this article describing immune disorders in, for example, patients with kidney failure^[7], in whom a deficit and dysregulation of T lymphocytes is observed.

Not only does obtaining an increase in neutralising antibody levels through vaccination therefore in no way guarantee good protection for immunosuppressed patients, but for those in whom the vaccine causes additional immunosuppression^[8], it will even worsen their vulnerability to Sars-Cov 2 but also to many other viruses.

This is not the first time that a vaccine has caused a temporary drop in T lymphocytes, since the phenomenon is already known for the Measles-Mumps-Rubella vaccine^[9] as well as for certain flu vaccines^[10]. The pharmaceutical companies’ initial clinical studies^[11] in fact reported this decrease in T lymphocytes: “The largest changes from baseline in laboratory values were transient decreases in lymphocyte counts, which resolved within 1 week after vaccination.” (“In other words, the largest changes from baseline laboratory values were transient decreases in lymphocyte counts, which resolved within a week of vaccination.”)

Knowing about this phenomenon of decreased T lymphocytes occurring after the first dose, was it not imperative, on the one hand, to assess it as a priority in immunosuppressed patients (who were not included in the initial studies) and, on the other, to monitor how this phenomenon evolves as doses are administered?

Because, as anyone will readily agree, administering a product likely to create immunodeficiency, even temporary, in patients who are already immunosuppressed means exposing these patients to a risk of increased susceptibility to infections. Even if the high level of neutralising antibodies acquired through vaccination may be enough to protect them temporarily from severe SARS-CoV2 infection, to what other infectious agents are they being exposed? While the official figures show a decrease in the incidence of Covid hospitalisations among triple-vaccinated patients, there are no figures assessing the incidence of hospitalisations for other infections.

So the question to the Minister and her “like” of a medically incorrect answer remain a burning issue.

The hypothesis that the neutralising antibodies generated by vaccination can be compared to a medicine that acts as long as its concentration in the blood is high – a comparison used by Prof. Delfraissy^[12] – is a plausible hypothesis. But this temporary effectiveness must be weighed against the risks to which already immunosuppressed patients are exposed if this immunosuppression is worsened and if this phenomenon increases with each new dose administered, as suggested by the tolerance phenomenon.

Tolerance phenomenon

Let us return to the webinar report, in which, in the 34^th minute, Jean-Michel Dogné says this:

“The preliminary data on Omicron show that there is a tolerance phenomenon with the second booster (this was already the case with the first booster): effectiveness decreases over time and decreases more quickly. The second booster has an effect that lasts at least 6 weeks. There is an even more marked decrease after 2 months. But, in this period of circulating Covid, for the most vulnerable populations, it is worth gaining these two months before a possible additional vaccination.”

A fifth dose therefore already seems to be envisaged in the autumn for immunosuppressed patients, even though there are still no official data on the effects of cumulative doses on cellular immunity, and even though this tolerance phenomenon, which increases further with the second booster, is very probably due to an alteration of this cellular immunity. We will not go into details that go far beyond the scope of this article. For those who wish to go further, we recommend the study entitled: “The BNT162b2 mRNA vaccine against SARS-CoV-2 reprograms both adaptive and innate immune responses”^[13].

(Late) paradigm shift

Another passage of the webinar that also seems worth noting comes around the 28^th minute, as Jean-Michel Dogné uses the expression “change paradigm”:

“In the light of these observations, shouldn’t we change paradigm? Should we still continue to fund endless PCR tests to determine precisely the number of cases or the incidence of cases? Or should we rather move towards studying effectiveness on symptomatic forms and on hospitalisations?”

It is impossible to list exhaustively all the times independent experts have tried to draw attention to the uselessness and exorbitant cost of the mass testing strategy, as well as to the pointlessness of monitoring the number of “cases”, but we invite readers to reread certain very well-documented analyses such as this one:

Pour une stratégie de dépistage efficace et objective des personnes susceptibles de transmettre le SARS-CoV-2 – Le blog du #covidrationnel

in which we can read:

“ On the other hand, calibrated PCR tests should only be used for the clinical diagnosis of sick or symptomatic people in hospital or on a doctor’s advice; or possibly as part of specific screening or investigation (for example, in specific outbreaks of infection or “clusters”, but then with saliva PCR tests, which are faster and cheaper than nasopharyngeal ones.)”

The illusion of the stable variant

Around minute 33, Mr Dogné explains:

“Every 3-4 months, we see a new variant appear that becomes dominant within 4 weeks. We are always 3-4 months behind in everything we can anticipate. If we had had to adapt the vaccine each time, we would always have been late anyway. […] It is difficult to envisage adapted vaccines today given the fairly rapid evolution of the different variants, as long as we do not have a much more stable strain.”

Given the high frequency and speed of mutation of coronaviruses (around 20 thousand point mutations in 12 months, which have produced some thirty clinical variants), it was obviously foreseeable that it would be impossible to adapt the vaccines for each variant that becomes dominant. And envisaging a much more stable strain of SARS-CoV-2 is an illusion.

Transmission and mucosal immunity

Although there are still many points to note in this webinar, we will end this article on the effectiveness (or rather the ineffectiveness) of vaccination on transmission.

Because at the end of the session, when answering the questions asked in the chat, Jean-Michel Dogné had to address the subject that seemed to concern some of the participating doctors.

Around the 57^th minute, he says this:

“The current vaccines, it must be acknowledged [emphasis added by BAM! Detox], have shown a certain disappointment regarding transmission. This does not mean that it does not work but, depending on the variants, we have rarely had more than 40 to 50%. And for the Omicron variant, the effectiveness on transmission is less than 30%. The advantage of intranasal spray vaccines is that, through mucosal immunity and the local antibodies they develop to a greater extent, they block the entry of the virus and above all its exit. […] They will therefore be complementary, and injectable vaccines could be combined with intranasal vaccines.”

This passage cannot but remind us of the article written in January 2022 by Prof Bernard Rentier^[14], who explained:

“Do vaccines stimulate mucosal immunity? The exceptionally rapid large-scale development of vaccines against SARS-CoV-2 has taken precedence over the fundamental immunological work needed for a proper understanding of the essential characteristics of immunity against this virus, in particular its mucosal component. Vaccination with the BNT162b2 messenger RNA (Pfizer/BioNTech) triggers the production of neutralising antibodies in the blood, but not in saliva, which indicates that the immunity of the oro-nasal mucosa is little activated by this vaccination protocol, explaining why the virus remains infectious in vaccinated people. ”

It should also be recalled that for more than a year it has been reported – in publications in the journals Science and Nature^{[15] [16]} – that immunity through spontaneous immunisation by SARS infection gives rise to a broad and above all mucosal immune response, i.e. with appropriate antibodies in the mucous membranes of the bronchial tree – and these antibodies block transmission. This was seen in unvaccinated children in Israel^[17] and independently in a study published in the journal Science^[18], but which Dr Dognée seems not to have read.

Ultimately , this shows that normal immunity, unlike vaccine immunity, in the case of SARS, protects better and for longer and above all slows down transmission, and therefore that unvaccinated people were not the ones spreading the virus!

Back to more rational science?

Watching this first part of the webinar shows a shift in the discourse of an influential expert and suggests future management more in line with the basic principles of medicine.

In any case, it is more than legitimate to ask why it took so long to realise what many independent experts have been saying for a long time, and why the opinion of these independent experts was not heard and followed by the authorities.

This would have avoided a great deal of waste and disappointment.

While we cannot redo the past, it is curious that even today we do not find around the table the experts who got it right instead of those who were so often wrong…

 

By BAM!-DETOX

---

^[1] Actualité COVID-19 - SSMG

^[2] Jean-Michel Dogné, expert pharmacovigilance auprès de l’AFMPS, est nommé membre du Comité consultatif mondial de la sécurité vaccinale de l’Organisation mondiale de la Santé

^[3] Omicron, a game changer

^[4] De source sûre ! – Le blog du #covidrationnel

^[5] Understanding T cell responses to COVID-19 is essential for informing public health strategies | Science Immunology

^[6] Robust antibody response after a third BNT162b2 vaccine compared to the second among immunocompromised and healthy individuals, a prospective longitudinal cohort study - ScienceDirect

^[7] Dysrégulation immunitaire dans l’insuffisance rénale chronique - Encyclopédie médicale - Medix

^[8] Thinking beyond behavioural change as an explanation for increased COVID post vaccination | The BMJ

^[9] Depressed lymphocyte function after measles-mumps-rubella vaccination

^[10] The effect of killed influenza virus vaccine on the kinetics of normal human lymphocytes

^[11] Safety and Immunogenicity of Two RNA-Based Covid-19 Vaccine Candidates | NEJM

^[12] Covid-19 : le vaccin est "un peu un médicament" avec "une action formidable", pour Jean-François Delfraissy

^[13] The BNT162b2 mRNA vaccine against SARS-CoV-2 reprograms both adaptive and innate immune responses | medRxiv

^[14] Et l’immunité mucosale ? – Ouvertures immédiates / Immediate openings

^[15] Kids and COVID: why young immune systems are still on top

^[16] Delta reinfection risk low among unvaccinated children

^[17] IgA antibodies may protect unvaccinated people from COVID-19 infection

^[18] IgA antibodies seem to protect unvaccinated against COVID-19, study finds -- ScienceDaily

* BAM!-DETOX brings together university professors, doctors, people working in the pharmaceutical and medical field and independent journalists. BAM!-DETOX aims to analyse and verify the information circulated in the media and on social networks.

Photo source:
© BAM!