Apologies warranted to the immunocompromised

Could all those who blamed large-scale circulation of SARS-CoV-2 immune escape variants on immunocompromised patients please apologize?

Both the stakeholders of the mass vaccination campaign and some influential opponents continued to insist time and time again that I was wrong with my claim that the cause of the widespread immune escape characterizing the Covid-19 (C-19) pandemic should be sought in the mass vaccination of populations during a pandemic. They persisted, vehemently asserting that it is immunocompromised patients who generate and widely spread these circulating mutants. On top of my argument that such a theory is not based on a sound scientific analysis or conclusive immunological evidence (https://www.voiceforscienceandsolidarity.org/scientific-blog/immunocompromised-patients-are-not-a- potential-breeding-ground-for-highly-mutated-sars-cov-2-variants), a recent study unequivocally demonstrated that these stubborn know-it-alls are profoundly mistaken https://www.thelancet.com/journals/lanmic/article/PIIS2666-5247(23)00336-1/fulltext).

I quote:

“The observed evolutionary dynamics in our surveillance cohort might differ from what was reported earlier in the pandemic. Many published cases of prolonged SARS-CoV-2 infection were in patients who had received convalescent plasma or early generation monoclonal antibodies, both of which tend to select for the same escape mutations (e.g., N-terminal domain mutations, Glu484Lys, and others) as infection- induced or vaccine-induced antibodies. In patients who are immunocompromised and treated with therapeutic antibodies, SARS-CoV-2 is likely to encounter intensified selective pressures similar to those at the global scale. However, in the absence of treatment many patients who are immunocompromised will have little antibody pressure on the spike protein, and the within-host and current global selective pressures might not align.”

As the authors report that mutations shared by multiple individuals were rare and no onward transmission occurred, the alignment of escape mutations in immunocompromised patients with those found in globally circulating variants does not imply that these patients were the source of the global spread of those variants.

Perhaps the so-called ‘experts’ should thoroughly go through this publication?

I consider myself too unimportant to convince them to apologize to me. However, this does not apply to the immunocompromised patients whom they have stigmatized and blamed with their uninformed statements. It is outright scandalous and shameful that, without even understanding the basics of selective immune pressure, some influential ‘experts’ get themselves noticed with sensational statements at the expense of a very vulnerable group, adhering to a theory that makes no sense whatsoever.

I strongly urge them to publicly – via social media – offer their sincere apologies to all those they have hurt with their arrogant yet incorrect claims.
 
This publication also once again makes it clear that those who believe that cross-reactive memory T cells from COVID-19 vaccinated individuals can provide long-lived protection against re-exposure and contribute to pandemic control are equally mistaken.

The authors conclude:

“Although we enrolled 59 patients with solid organ transplantation or HSCT with ongoing T-cell immunosuppression, only one had infection lasting longer than 56 days. These findings highlight the importance of antibodies in SARS-CoV-2 clearance, both consistent with what has been seen in other viruses, and with emerging evidence of antibodies as correlates of protection in SARS-CoV-2.”

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