Vaccines can in some cases trigger more serious illness when exposed to an unrelated virus, via a process known as virus interference.
A question that has lingered since the 2009 mass vaccination campaign against pandemic H1N1 swine flu is whether seasonal influenza vaccination might make pandemic infections worse or more prevalent. That concern has come into sharp focus as studies raise questions about vaccine rollouts for COVID-19 and research points to the potential of problematic viral interference.
To help understand that, it’s helpful to first understand a more common, beneficial virus interference.
This kind can be a boost to our fight against invading pathogens. Normal viral interference occurs when a prior viral infection offers neighboring cells a kind of protection. In a way, the original invader blocks the subsequent viral invaders from taking hold.
“We show that human rhinovirus triggers an interferon response that blocks SARS-CoV-2 replication. Mathematical simulations show that this virus–virus interaction is likely to have a population-wide effect as an increasing prevalence of rhinovirus will reduce the number of new COVID-19 cases.”
Unfortunately, research has found that vaccines may produce a counterproductive type of viral interference that makes people more, rather than less susceptible to viruses besides the one they are being vaccinated against.
“There may be a direct vaccine effect in which the seasonal vaccine induced some cross-reactive antibodies that recognized pandemic H1N1 virus, but those antibodies were at low levels and were not effective at neutralizing the virus. Instead of killing the new virus it actually may facilitate its entry into the cells.”
“We may be perversely setting ourselves up that if something really new and nasty comes along, that people who have been vaccinated may in fact be more susceptible compared to getting this natural infection.”
Flu Vaccination Raises Unspecified Coronavirus Infection
A study published in the Jan. 10, 2020, issue of the journal Vaccine found people were more likely to get some form of coronavirus infection if they had been vaccinated against influenza.“Receiving influenza vaccination may increase the risk of other respiratory viruses, a phenomenon known as virus interference. ... This study aimed to investigate virus interference by comparing respiratory virus status among Department of Defense personnel based on their influenza vaccination status.”
“Unspecified” means that the virus was of the coronavirus family but not a specific type of coronavirus, like SARS-CoV-2, which was still unknown at the time this study was conducted.
Influenza Vaccination Linked to Higher COVID Death Rates
On Oct. 1, 2020, professor Christian Wehenkel, an academic editor for PeerJ, published a data analysis in that same journal, in which he reports finding a “positive association between COVID-19 deaths and influenza vaccination rates in elderly people worldwide.”In other words, areas with the highest vaccination rates among elderly people also had the highest COVID-19 death rates. To be fair, the publisher’s note points out that correlation doesn’t equal causation:
“What does that mean? By way of example, in some cities increased ice cream sales correlate with increased murder rates. But that doesn’t mean that if more ice creams are sold, then murder rates will increase. There is some other factor at play—the weather temperature.
“Similarly, this article should not be taken to suggest that receiving the influenza vaccination results in an increased risk of death for an individual with COVID-19 as there may be many confounding factors at play (including, for example, socioeconomic factors).”
“A negative association was expected,” Wehenkel writes in PeerJ.
But that’s not what he found:
The study looked at data sets from 39 countries with more than a half-million inhabitants and used a sophisticated ranking to mitigate the effects of confounding variables, including geographical and socioeconomic variables as well as variables related to non-pharmaceutical intervention.
What Might Account for Vaccination–Mortality Link?
In the discussion section of the paper, Wehenkel points out that previous explanations for how flu vaccination might reduce COVID-19 deaths aren’t supported by the data he collected.For example, he cites research attributing the beneficial effect of flu vaccination to improved prevention of influenza and SARS-CoV-2 coinfections, and another that suggested the flu vaccine might improve SARS-CoV-2 clearance.
The Flu Vaccine Paradox
Since Wehenkel’s analysis focuses on the flu vaccine’s impact on COVID-19 mortality among the elderly, it can be useful to take a look at information presented at a World Health Organization workshop in 2012. On page 6 of the workshop presentation in question, the presenter discusses “a paradox from trends studies” showing that “influenza-related mortality increased in U.S. elderly while vaccine coverage rose from 15 percent to 65 percent.”On page 7, he further notes that while a decline in mortality of 35 percent would be expected with that increase in vaccine uptake, assuming the vaccine is 60 percent to 70 percent effective, the mortality rate has risen instead, although not exactly in tandem with vaccination coverage.
Seeing how the elderly are the most likely to die due to influenza, and the flu accounts for 5 percent to 10 percent of all winter deaths, a “50 percent mortality savings [is] just not possible,” the presenter states. He then highlights studies showing evidence of bias in studies that estimate influenza vaccine effectiveness in the elderly. When that bias is adjusted for, vaccine effectiveness among seniors is discouraging.
Interestingly, the document points out that immunologists have long known that vaccine effectiveness in the elderly would be low, thanks to senescent immune response, i.e., the natural decline in immune function that occurs with age. This is why influenza “remains a significant problem in elderly despite widespread influenza vaccination programs,” the presenter notes.