I understand that the virus may evolve the way Geert has predicted andbecome more virulent and dangerous. However, is it also possible that the situationcalms and the virus simmers down? If so, how likely is that to happen?
Of course, after a huge wave of severe morbidity and death, the situation will calm down and the virus could even be eradicated for sufficient transmission. I don’t think this is the scenario you’re referring to. You probably refer to the evolutionary path of the virus abating rather than escalating. I don’t think we can fully rule out that possibility for the following reason:
In highly vaccinated populations, viral transmission is currently hampered by reduced shedding in vaccinees. As described in my book, The Inescapable Immune Escape Pandemic (http://drgeert.com),this is inextricably linked to enhanced immune selection pressure on viral virulence exerted by polyreactive, non-neutralizing antibodies (PNNAbs).Provided this condition persists long enough, a highly virulent variant capable of lifting the blockade on viral virulence could ultimately be selected and cause severe C-19 disease (thereby ensuring viral perpetuation!).
However, there is always a possibility that viral transmission in highly vaccinated populations becomes dramatically reduced before such a highly virulent variant emerges (and could therefore be selected). This could happen if vaccine-induced, potentially neutralizing antibodies (pNAbs) decline rather rapidly. Low concentrations of pNAbs that have largely lost their neutralizing capacity towards the circulating virus (Omicron descendants) will result in relatively low concentrations of PNNAbs (see book)and therefore, rapidly abrogate immune pressure on viral virulence. In this case, reduced viral transmission would not result in prolonged PNNAb-mediated immune pressure on viral virulence, and viral transmission could fall below the threshold required for viral perpetuation before a more virulent mutant gets selected. This might happen in countries with a relatively low vaccination or booster rate. However, there is also some uncertainty about the percentage of vaccinees who effectively develop measurable pNAb titers. As the vast majority of C-19 vaccinees in highly vaccinated countries are in the higher age groups (> 60Y), a substantial part of the population may not optimally respond to the vaccines (there are currently no detailed studies available on the % of non-responders in the elderly for lack of systematic serological surveys). Of course, if this is the case, many ‘highly vaccinated’ populations may not prove to be ‘highly vaccine-immunized’ and their impact on the evolution of the virus might be considerably overestimated.
In other words, a ‘simmer down’ effect might occur in vaccinated countries with a relatively low vaccination/ booster rate, or even more widely in ‘highly vaccinated’ industrialized countries because of the relatively high percentage of older age groups (comprising the majority of non-responders).
I am not ruling out the possibility that other scenarios for a ‘simmer down’ effect could also occur, but the two described above are those that came to my mind.
As for the second part of the question, how likely is this to happen? I don’t know! The problem is that we have no clue about the percentage of vaccinees that were effectively primed by those vaccines for lack of population-level serological data. This question is particularly valid given that this mass vaccination campaign has been focusing on the use of mRNA vaccines, primarily in elderly people.
It has also been shown that diminished neutralizing capacity elicits polyreactive non-neutralizing Absbut nobody seems to care about measuring those, let alone performing large-scale testing on the presence of these Abs.
These are the unknowns, simply because the situation is unprecedented (we’ve never been massively immunizing before our elderly people with mRNA-based vaccines and especially data on the latter type of vaccines are missing). Of course, everyone is focused on the virus, not realizing that the suboptimal immune pressure it gets exposed to is what’s driving its evolution.
So the question really is this: Will this immune pressure persist for long enough to allow selection of a more virulent (but also a more elaborated [glycan decoration!] virus) before enhanced CTL responses in vaccinees will have reduced viral shedding down to a level where viral transmission is no longer sufficient?
One cannot rule out that this may occur when high titers of pNAbs are rapidly falling on a background of highly infectious virus circulation. It doesn’t invalidate my hypothesis (catastrophic scenario); it simply indicates that the proposed scenario may not unfold if vaccines do not meet the usual requirements for a vaccine to be marketable (e.g., due to poor and/ or short-lived immune response as a result of poor immunogenicity in the target population). I am not even sure whether repeated boosters would improve, or rather deteriorate, the immune response in the case of poor immunogenicity. But again, ‘ other’ doses could be very immunogenic in ‘other’ people under ‘other’ conditions.
People also tend to forget that mRNA is very fragile, and that stability thereof in the vaccine formulation may be problematic if not frozen, conserved, or thawed properly (see Jessica Rose’s reports on missing QC data on the physical integrity of the mRNA strand) . Again, where are the systematic serological surveys (on neutralizing anti-S Abs) in vaccinees?? The fact that some vaccinees continue to have repetitive episodes of C-19 disease may indicate that the vaccine ‘take’ in these people has been lousy.
My key message is that my predictions should be taken very seriously. To make this message strong enough, it’s better and reasonable to assume that these vaccines are sufficiently immunogenic in the target population. Potential assumptions suggesting that these vaccines may not properly immunize the target population would flaw the message and make it even more likely that it won’t be taken seriously (as it sounds quite incredible to people anyway)
 as documented by research conducted by prof. Fantiniet al.; https://pubmed.ncbi.nlm.nih.gov/34384810/
Geert Vanden Bossche received his DVM from the University of Ghent, Belgium, and his PhD degree in Virology from the University of Hohenheim, Germany. He held adjunct faculty appointments at universities in Belgium and Germany. After his career in Academia, Geert joined several vaccine companies (GSK Biologicals, Novartis Vaccines, Solvay Biologicals) to serve various roles in vaccine R&D as well as in late vaccine development.
Geert then moved on to join the Bill & Melinda Gates Foundation’s Global Health Discovery team in Seattle (USA) as Senior Program Officer; he then worked with the Global Alliance for Vaccines and Immunization (GAVI) in Geneva as Senior Ebola Program Manager. At GAVI he tracked efforts to develop an Ebola vaccine. He also represented GAVI in fora with other partners, including WHO, to review progress on the fight against Ebola and to build plans for global pandemic preparedness.
Back in 2015, Geert scrutinized and questioned the safety of the Ebola vaccine that was used in ring vaccination trials conducted by WHO in Guinea. His critical scientific analysis and report on the data published by WHO in the Lancet in 2015 was sent to all international health and regulatory authorities involved in the Ebola vaccination program. After working for GAVI, Geert joined the German Center for Infection Research in Cologne as Head of the Vaccine Development Office. He is at present primarily serving as a Biotech / Vaccine consultant while also conducting his own research on Natural Killer cell-based vaccines.