Autumn vaccination: where are the scientists at the CSS?
09/07/2023·A group of doctors
The Belgian Superior Health Council (CSS) has issued its opinion on the next COVID vaccination campaign, which will begin next autumn. A group of doctors formally disputes the conclusions of this opinion. We publish here a copy of their letter to the CSS and to the AVIQ (the Walloon health agency).
5 July 2023.
For the attention of the members of the Superior Health Council who drafted opinion 9766 on the Covid vaccination campaign for autumn-winter 2023-2024.
Ladies and Gentlemen of the CSS,
We have carefully read your latest opinion, in which you write that:
-1) “Vaccines adapted to the Omicron BA4/5 strains are at least as effective as previous versions against the strains currently in circulation”.
To justify your statement, you refer to 10 studies, of which, as listed in this table, only that of Zou et al, 2022 studied the effectiveness of the bivalent vaccine on the XBB variant. And even then, it concerns XBB.1, one of the first versions of this variant. None of the other 9 studies you cite as references studied the effectiveness of the bivalent vaccine on the XBB variant currently in circulation.
But that is not all. Indeed, even the study by Zou et al, 2022 shows that, when the bivalent vaccine is given to patients without prior infection, the neutralising antibody titre is 518 against BA.4/5 and only 55 against the XBB variant, almost 10 times lower.
It is therefore impossible for you to claim, on the basis of these studies, that vaccines adapted to the Omicron BA 4/5 strains are at least as effective as previous versions against the strains currently in circulation. Unless this is an indirect way for you to acknowledge that the earlier versions of the vaccines are also totally ineffective against the XBB variant, this statement is misleading. The decrease in neutralising antibodies generated by the original vaccine formula against the XBB variant is indeed very visible in this study, which you nevertheless do not include in your references. Low neutralization of SARS-CoV-2 Omicron BA.2.75.2, BQ.1.1 and XBB.1 by parental mRNA vaccine or a BA.5 bivalent booster | Nature Medicine
Claiming that the bivalent vaccine is at least as effective against the circulating XBB variant as previous versions that were not effective is such an astonishing wording that we can only believe it was deliberately chosen to mislead those who will not analyse your opinion in detail.
-2) In this opinion, you also say that: “The effectiveness of mRNA vaccines against the severe consequences of Omicron remains high, with strong and continuous protection against deaths, intensive care unit (ICU) admissions and hospitalisations 6 months after the booster, despite limited waning. »
Yet, on the basis of Belgian data from Sciensano’s open data (why do you use US data rather than analysing ours?), we see absolutely nothing of what you claim. Indeed, for people aged 65 and over, the target of the next vaccination campaign, the incidence of deaths follows the incidence of cases, as usual. There is no reduction in the incidence of cases after the boosters. Nor is there any reduction in the incidence of deaths. Any claim of a hypothetical effectiveness against severe forms and deaths is therefore purely untrue.
-3) In this report, you also write that: “At the time of writing these recommendations for the 2023-2024 season, (…) Factors that could require a rapid and urgent adaptation of these recommendations and of the vaccination campaign in Belgium for 2023-2024 would be (among others): the arrival of a new variant with massive immune escape.”
As explained in the first point, of the ten studies you reference, only one assessed the effectiveness of the bivalent vaccine on the XBB variant. And it shows that it generates 10 times fewer antibodies against XBB than against BA.4/5, the variant for which it was made. Ten times fewer.
A quick simple search turns up a whole series of studies that have assessed the in vitro effectiveness of the bivalent vaccine on the XBB variant, all of which report a marked decrease in neutralising antibody levels against this variant, and we provide you with a non-exhaustive list of studies in the appendix. You also know perfectly well that massive immune escape is far more likely to occur in a population vaccinated with a standardised product than in a population that has acquired natural polyclonal immunity.
All these elements prove massive immune escape by the XBB variant, and this therefore requires an urgent revision of your recommendation.
We are sending a copy of this letter to the AVIQ and also to the media, which will choose (or not) to publish it in order to inform the population widely of the total uselessness of this forthcoming booster campaign. Citizens should not have to bear the exorbitant costs of a useless public health measure.
Signatories:
Dr Allen Marie-Louise, General Practitioner Dr Alexandre Brigitte, Child Psychiatrist Dr Antoine Philippe, Psychiatrist Dr Bachelart Daniel, Paediatrician Dr Barudy Vasquez Jorge, Obstetrician-Gynaecologist Dr Baudoux Véronique, General Practitioner Dr Bernaerts François, General Practitioner Dr Boniver Isabelle, General Practitioner Dr Bonnivert Jacqueline, Obstetrician-Gynaecologist Dr Bureau Michel, Neurologist Dr Burlet Olivier, Radiologist Dr Caruso Frédéric, Anaesthetist and Intensive Care Physician Dr Chara Chayma, General Practitioner Dr Dale Anne-Marie, General Practitioner Dr Daubie Pascale, General Practitioner Dr Defays Véronique, Dentist Dr Depas Gisèle, Paediatrician and Nuclear Medicine Physician Dr Deprez Joël, Anaesthetist Dr Dery Ludivine, General Practitioner Dr Devos Philippe, Homeopathic Physician Dr Duchateau Édouard, Ophthalmologist Dr Espeel Benoît, Internist/Intensivist, adult and paediatric Dr Fernez Pascale, General Practitioner Dr Fox Marie-Aurore, Anaesthetist Dr Franchimont Anne, General Practitioner Dr Gans André, Gynaecologist Dr Gengoux Pierrette, Dermatologist and Homeopath Dr Glorieux Pierre, ENT Specialist Dr Goareguer Frédéric, Child Psychiatrist Dr Guilmot Damien, Psychiatrist Dr Guiot Françoise, Dermatologist Dr Hausmann Caroline, General Practitioner Dr Hennuy Véronique, Anaesthesia and Intensive Care Dr Hoang Philippe, Hand Surgeon Dr Kayser Laurence, Obstetrics and Gynaecology Dr Kint Inès, General Practitioner Dr Laschet Alexandra, Physical Medicine Dr Lambot Dany, Hand Surgeon Dr Laporte Marianne, Dermatologist Dr Letawe Caroline, Dermatologist Dr Lequeu Xavier, General Practitioner Dr Leyh Philippe, General Practitioner Dr Lhoest Olivier, Anaesthetist and Intensive Care Physician Dr Lipcsei Györgyike, Anatomical and Cytological Pathology Dr Locht Bénédicte, Ophthalmologist Dr Locquet Jean, Orthopaedist and Emergency Physician Dr Louis Frédéric, Anaesthetist Dr Marneffe Vincent, Neurosurgeon Dr Michaux Bernard, General Practitioner Dr Mulder Bernard, General Practitioner Dr Neuprez Audrey, Physical Medicine and Rehabilitation Dr Nicolay Benoît, Anaesthetist and Intensive Care Physician Dr Parent Florence, Public Health Physician Dr Perrier Jean-Charles, Occupational Physician Dr Petermans Marie-France, Paediatrician Dr Rassart Jacques, General Practitioner Dr Rémy Caroline, Physical Medicine and Rehabilitation Dr Renard Alain, General Practitioner Dr Résimont Stéphane, ENT Specialist Dr Robeyns Jean-Christophe, Radiologist Dr Ruelle Viviane, General Practitioner and Nutritionist Dr Skrzypek Benoît, General Practitioner Dr Theunissen Émilie, Physical Medicine and Rehabilitation Dr Thiry Sylviane, General Practitioner Dr Tinant France, Physical Medicine and Rehabilitation Dr Vermer Donald, Gastroenterologist Dr Wera Marie-Isabelle, Psychiatrist. Dr Wève Alain, Anaesthetist Dr Willemaers Valentine, Dermatologist Prof. Martin Zizi, former Director of the Epidemiology and Biostatistics Department at Defence, MD-PhD, biophysics and molecular biology, former chairman of an Ethics Committee
Appendix: non-exhaustive list of studies showing the decrease in neutralising antibody levels against XBB and massive immune escape:
