Luigi Hay explains the science, anti-science and the politics of vaccines.
What is a vaccine?
All cells have molecules, mostly proteins, sticking out of their membranes (or cell walls for non-animal cells) for various reasons, e.g controlling what can enter and leave the cell. These are known as antigens and they can vary depending upon the type of cell and the organism they belong to. The mammalian immune system, and we are mammals, can distinguish between antigens which belong to the body’s own cells and those which do not, particularly those from disease-causing organisms known as pathogens. Although viruses do not have cells they are basically genetic material (DNA or RNA) contained in a distinctive protein coat, thus allowing them to be recognised as ‘alien’ to the body. In auto-immune diseases the immune system has a kind of hangover and is unable to distinguish this difference, these diseases can be fatal. Without going into too much detail, when a pathogen enters the body past a series of first line defences, there is a type of white blood cell known as a B-lymphocyte which can produce chemicals which bind to the antigens on a specific invading pathogen. These are known as antibodies and they assist in destroying the pathogens. When a B-lymphocyte successfully produces an antibody to a pathogen it is stimulated to produce clones of itself (Plasma cells) which ramp up the immune response to wipe out the pathogen. These cells remain in the blood for some time afterwards (sometimes pretty much for life). If the same pathogen infects the body again then these plasma cells quickly multiply and produce antibodies so destroying the pathogen before it can make us ill, we are immune to the disease.
A vaccine works by introducing the antigens into the body without the pathogen itself. This can be by a weakened or dead form of the bacteria or virus, or sometimes by bits of the pathogen with the appropriate antigens on, the Oxford team working on Covid-19 is using spikes from the outer coat. This stimulates the production of the specific plasma cells and so makes us immune to the disease. The problem with coronaviruses is that immunity doesn’t always last long, sometimes just for a few months, and no one really knows yet how long immunity to SARS-CoV-2 (the name of the virus that causes the Covid-19 disease) will last. The cold is caused by four coronaviruses and immunity is relatively short-lived.
How are vaccines developed, and how long does it take?
Thankfully, gone are the days when pharmaceutical companies could just test out a drug or vaccine in the population. Medical drugs have to go through a series of testing stages to make sure they are not going to kill the people they are given to, following some well-publicised cases, including the 2006 first stage human trial of Theralizumab by the German pharmaceutical company TeGenero which very nearly killed the 6 volunteers.
Vaccines have to go through a similarly lengthy process and usually take about 10 years to be publicly available. First, they are tested for toxicity on human cells, followed by animal testing, sometimes on transgenic animals with more human characteristics. Secondly testing is carried out on a small number of healthy volunteers, with a similar number being given a placebo which looks like the vaccine but has nothing in it (a bit like a tribute band, looks the same but not). Here they will check for antibody production or for any obvious signs of illness. The trial is usually followed up by a larger group trial. Finally, there has to be a large trial to see if it protects against the disease itself, which means that the participants have to be exposed to the pathogen. Obviously, this is an ethical minefield and volunteers are usually paid or offered some other kind of recompense. There is a trial of 15,000 people starting in the UAE with lifting travel visa restrictions as one of the star prizes. Developing a vaccine takes a lot of money, research is mostly carried out at the behest of pharmaceutical companies who will look to recoup this outlay big time. The EU has already pledged 8 million Euros for Covid-19 research and ‘Big Pharma’ will take as much as they can from governments to increase their profits. Pfizer is working with biotechnology firm BioNTech to produce a vaccine for public use by the end of 2020 and they have clearly stated that they ‘expect to profit’ and project to charge $39 for a 2 dose vaccine in the US and $3-4 in Holland, Germany, France and Italy. US firm Moderna is anticipating charging $60 in ‘high-income’ countries. Both the Oxford University group, in conjunction with Astrazeneca, and the Gates Foundation are proposing to produce a vaccine at under $3 in conjunction with the Serum Institute of India.
The Gates project is for 100 million doses and is spending $150 million to develop it, so will probably still make a tidy sum. Of course if the research groups were sharing information and cooperating, as they would in a logical world, then this would hasten the development of a vaccine and would also reduce costs, but Big Pharma all want a big slice of the pie. Even if they produce the vaccine at cost initially there will be a lot of money to be made for subsequent treatments, especially if immunity is short lived. To my knowledge, the only freely shared information has been the genetic sequencing of the Covid-19 virus by China (take note Trump). As well as the money, there is also the incentive that share prices in companies producing a vaccine are likely to rise and the enhanced reputation that comes with such a breakthrough is likely to see further lucrative contracts to develop other vaccines and drugs: the involvement of the Serum Institute may turn out to be a way of breaking into Western markets. Socialists need to be wary of identifying ‘good’ capitalist pharmaceutical companies: they are all in it for the money.
Are vaccines dangerous?
People will have seen gatherings recently by anti-vaccination groups (anti-vaxxers) who claim that vaccinations are dangerous. It is easy to simply be dismissive of these people and to sneer at them, but this attitude merely fuels people’s opinions that here is something to hide. Certainly, Victorian England saw attempts to make smallpox vaccination compulsory, and the Leicester Anti-vaccination League was formed in 1869 and is still going. There are also spurious claims on the internet about groups which claim that vaccines are designed to control people’s minds, but I couldn’t find any groups claiming this in my investigations. Of course, there are small risks involved, more of that later, and often individual cases are cited to back up these concerns. Also, some senior figures in established health organisations, such as the Centre for Disease Control (CDC) in the US, also seem to want to make vaccination compulsory as well, and this further inflames the opinions of many anti-vaxxers. Indeed in the UK after the MMR (measles-mumps-rubella triple vaccine)-autism link scare in 1998 the Blair government refused to allow people to receive the three vaccines separately and Tony Blair famously refused to confirm or deny if his own children had had the MMR jab or the individual vaccines. But let’s not get too carried away with this and look at some of the arguments put forward by anti-vaxxers (for the first four see: Medical News Today, and for the fifth, see: Healthline).
- Vaccines weaken or compromise a child’s immune system. Children’s immune systems can be overwhelmed by vaccination.
There is no evidence at all that this is the case. Children constantly come into contact with potential pathogens and cope pretty well in most cases. There are a small number of adverse reactions: e.g in the Australian measles vaccination drive in 1998, 1.7 million kids were given a vaccine and in 5.42 out of every 100,000 cases there was an adverse reaction. This represents 0.005% of the cohort. According to the CDC in the US, only 1 in a million vaccinations (0.0001%) results in a life-threatening anaphylactic allergic reaction. Compare this to the 2018 measles outbreak in Europe where 82,500 cases were recorded with 72 deaths (0.1%) in a part of the world where medical care is generally well developed.
- Natural immunity is better than immunity through vaccination.
Again, there is a tiny element of truth in this. Getting a full on disease will stimulate the immune system more than having a vaccination, largely because pathogens use the host to reproduce themselves. However, the likelihood of serious complications from dangerous diseases far outweighs any advantages. Covid-19 seems to have a fatality rate of more than 1%, exact figures are difficult to assess but over 50,000 excess deaths in the UK give some idea of how dangerous it is. Sorry to harp on about measles again, but globally the death rate is about 1.5%; around 5% of infected children develop pneumonia with around 25% of infected people requiring some form of hospital treatment. Global cases in 2018 were estimated at 10 million with 140,000 deaths. The World Health Organisation (WHO) estimates that the measles vaccination programme from 2000 up to 2017 reduced measles related death by 80%. Smallpox used to be a deadly disease but a sustained vaccination program has eradicated it completely across the globe. When I was a kid there was no MMR vaccine and I have had measles (pretty nasty) and mumps twice (also pretty nasty), the last time aged 29: so much for natural immunity being better than immunity through vaccination!
- Vaccines can cause autism.
A paper written by a gastroenterologist suggested that there may be a link between the MMR vaccine and the development of autism spectrum disorder (ASD) in children (published in The Lancet 28/02/1998). The paper indicated that the development of ‘neuropsychiatric dysfunction’ was mostly after the administration of the MMR vaccine. Some sections of the media leapt on this and the parents of some of the children involved were happy to see this storm of publicity. Generally speaking, the signs of autism tend to emerge around the time children are receiving the MMR vaccine, and many scientific commentators have suggested that autism is part of the natural range of human neurological characteristics. Often the anti-vaxxer arguments are based on seeing autism as a disease which requires treatment, or eradication. However, the study was of only 12 children and many subsequent studies have refuted the link. In fairness the paper does also say that ‘We did not prove an association between measles, mumps and rubella vaccine and the syndrome described’. The article was officially retracted in full by The Lancet in 2010 and the main author was also struck off the Medical Register after an investigation by the General Medical Council, which has led to claims of an establishment cover-up by some anti-vaxxers.
4. Vaccines are unsafe because they contain toxins.
It may be true that the high cost of some vaccines encourages unscrupulous semi-criminal elements (or entrepreneurs are they are also known) to sell badly made substitutes to poor and desperate people, and it is also true that vaccines often do contain substances which are are toxic over a certain concentration, such as mercury, formaldehyde and aluminium. The quantities used in vaccines are very small and usually considerably less than you would take in from eating food, not to say that all food is unsullied of course, or from a safe household environment. Aluminium is in many types of cling film for instance.
- There are natural or homeopathic remedies for diseases, which are more effective at protecting people from dangerous infections.
For this one, I have to ask which planet these people are on. It is certainly true that eating a well balanced diet, getting exercise and not smoking like a chimney will generally slightly improve your chances of surviving infections, they will not stop them killing you if they are serious diseases and you catch them. They will not stop your children dying from measles, malaria or Covid-19. Homeopathy is based on finding something which will give you similar, if hopefully milder, symptoms to a disease and then diluting it so massively that there is none left in the vain hope that the water molecules will somehow remember it and be an effective treatment against the disease…. Exactly!!!
In conclusion, the problems we face in finding a vaccine for Covid-19 are exacerbated by the structures of a capitalist world, especially in the neoliberal era. Competition between pharmaceutical giants delays the development of a vaccine and could potentially make it inaccessible to the poorest people in the world. It is undoubtedly true that governments of many political types are more than capable of lying to the population to protect the profits of large multinationals and that this can lead to significant numbers of people believing that somehow there are better alternatives to vaccination when trying to protect themselves against a pandemic of the sort we are facing now: fancy a bleach injection anyone?
One recent opinion poll found that a third of US adults would not take a Covid-19 vaccine, even if it was free. In a logical caring world where people’s health came before profit, the main priority would be to find a vaccine as quickly as possible by pooling intellectual and physical resources. Such a world would be very different to the one we live in: a socialist world.