The theme of this article is that it is critically important to view the human immune system---both our individual immune systems and our collective immune systems---as ecosystems, and to view the COVID-19 situation through the lens of a concerned immune system ecologist. This requires a deep appreciation of the complexity and delicacy of our individual and collective immune ecosystems and the importance of protecting these ecosystems from harmful human interventions, including interventions that many citizens, initially, might think are appropriate and wise.
Primarily, this article represents a review and summary of Dr. Geert Vanden Bossche’s recently published book: The Inescapable Immune Escape Pandemic. In his book Dr. Vanden Bossche shares an extraordinarily deep and wise understanding of the immunology, virology, vaccinology, evolutionary biology, glycosylation biology, and immune system ecology involved in the COVID-19 situation.
According to the leaders and promoters of the prevailing COVID-19 narrative and its mass vaccination campaign, the COVID-19 pandemic is currently subsiding, coming under control, heading into a relatively harmless endemic phase, and can be kept under control with further mass vaccination. Dr. Vanden Bossche disagrees. According to his understanding of the science involved, we have (in recent months) been experiencing a falsely reassuring “calm before the storm.” This “calm” is due to partially protective immune system adjustments that, however, are weak, fragile, unsustainable, and are, therefore, at high risk of being subverted by a newly emerging SARS-CoV-2 (SC-2) variant. This would inevitably result in enhanced viral virulence.
In Dr. Vanden Bossche’s view, this precarious state is due to the COVID mass vaccination campaign itself and would not have occurred in the absence of this campaign. The mass vaccination campaign has prolonged the pandemic by turning it into an “immune escape pandemic.” This vaccination campaign has, predictably, disrupted the immune ecosystem, and has predictably made the pandemic more dangerous. Dr. Vanden Bossche is deeply concerned that a surge, due to enhanced virulence of a new emerging variant, is highly likely, is imminent, and will likely result in a catastrophic number of hospitalizations and deaths, particularly among the vaccinated, particularly in the most highly vaccinated countries. He urges all to prepare for this surge.
Dr. Vanden Bossche is deeply concerned that the COVID mass vaccination campaign will ultimately result in more lives being lost, cumulatively, than if the COVID-19 pandemic had been managed without such a mass vaccination campaign.
The scientific bases for the above statements and concerns are extensively explained in his book, The Inescapable Immune Escape Pandemic.
Uniquely, Dr. Vanden Bossche views the COVID-19 pandemic through the lens of an experienced immune system ecologist. Specifically, he understands the effects of the COVID-19 mass vaccination campaign on the complex interactions between the virus and the immune system---at both an individual level and the population level. He understands how misguided vaccination efforts can adversely affect viral evolution by perturbing the natural balance between the virus and the population’s immunity. Large-scale perturbation of this ecosystem has caused the virus to exhibit a high level of viral infectiousness and has profoundly altered the type of adaptive immune response. This is because enhanced viral infectiousness drives vaccine breakthrough infections, which lead to poor functionality of the adaptive immune response and, therefore, expedites immune escape. The advent of Omicron has, therefore, not been a blessing but a scourge.
The over-arching theme of his book is that it is a huge mistake to try to end an active pandemic like the COVID-19 pandemic by implementing, in the midst of that pandemic, a mass vaccination campaign (across all age groups) that uses vaccines (like the COVID-19 vaccines) that do not adequately prevent replication and transmission of the virus, do not produce sterilizing immunity, and, thereby, do not contribute to herd immunity. Such a mass vaccination campaign puts tremendous immune pressure on the virus, at a population level, and predictably results in a prolonged series of new dominant SC-2 variants, each being more infectious and more vaccine-resistant than its predecessors; and is highly likely to eventually result in the emergence of an SC-2 variant that is more virulent than all predecessors.
The leaders and supporters of the mass vaccination campaign apparently either do not understand the above, or disagree with the above, or both. Lack of public awareness of Dr. Vanden Bossche’s concerns has prevented citizens from proactively making “anticipatory” preparations (individually and collectively) to protect themselves from the highly virulent SC-2 variant that Dr. Vanden Bossche anticipates. Sadly, citizens, physicians, and health care institutions will, therefore, be caught by surprise and will be ill-prepared when a highly virulent variant predictably emerges and dominantly propagates. Citizens and their physicians need and deserve to be fully informed of Dr. Vanden Bossche’s understandings and concerns, so that they can optimally prepare.
For further background, please see earlier articles written by Dr. Vanden Bossche [1-9] and access his website: www.voiceforscienceandsolidarity.org
Also, the reader may click on the seven links below to access companion articles that provide further explanations and references for the statements made in this article. For example, the Open Letter to Parents and Pediatricians---Part 1 has 1078 references.
Additional companion articles [10-14] may be found on Dr. Rennebohm’s website: www.notesfromthesocialclinic.org
Ecologists who have carefully studied ecosystems in Nature---e.g., the ecosystems of lakes, rivers, forests, prairies, marshes---are well aware of the unfortunate outcomes that can occur when misguided manipulations of natural ecosystems are implemented.
For example, in the 1950s and 60s mysis shrimp were introduced to (placed in) pristine fresh water lakes in the US, Canada, and Sweden to serve as a food source for Rainbow Trout, Kokanee salmon, and Arctic char. This was touted as a great way to increase the size of individual fish as well as the number of fish---results that would benefit the lake fisheries industry and sports fishermen. Unfortunately, what the promoters of this plan did not understand is that the mysis shrimp and Kokanee salmon compete, existentially, for the same food---zooplankton. The mysis shrimp eventually won that competition---as evidenced by the fact that by the 1970s Kokanee populations were markedly declining. By 1980 the placement of mysis shrimp in lakes was recognized as an ecological disaster and was wisely stopped.
Particularly instructive are the unfortunate consequences noted in Flathead Lake (Montana). Mysis shrimp were flourishing mightily by 1985, and by 1987 no Kokanee were caught. The mysis shrimp had thoroughly outcompeted the Kokanee for zooplankton. An additional consequence was that Lake Trout, who, like mysis shrimp, prefer the deepest water (unlike Kokanee, who prefer higher, warmer water), started to thrive on the continuous and abundant supply of mysis shrimp. These deep dwelling Lake Trout grew into large fish-eating hunters who ate Kokanee, thereby putting further pressure on Kokanee populations. Furthermore, the Lake Trout out competed native Bull Trout, which led to Bull Trout being placed on the federal Threatened and Endangered Species list in 1998. Furthermore, Bald eagles and mammals who had depended on Kokanee salmon in Flathead Lake had to leave the area in order to find their preferred food.
The cascading adverse effects of the mysis shrimp experiment have continued to the present day. The Lake Trout population in Flathead Lake is still out of control. The consequences have been far reaching. Not only have the Bull Trout and Kokanee salmon been threatened as species, but other species have also been threatened, biodiversity has been diminished, and even the human economy (the lake fisheries industry) has been affected. Perhaps, some people do not think it matters that Bull Trout might become extinct or that optimal and natural biodiversity are important. But thoughtful ecologists now know the critical importance of natural biodiversity and the rights of all species to live naturally.
The promoters of the mysis shrimp campaign thought it was a great idea. At the time, were there at least some good ecologists who knew better? If so, were they asked? If not asked, did they speak up? Or did they remain silent? If some spoke up, was their “inconvenient truth” ignored? Or was the field of ecology so young in the 1950s and 60s that only a few people, at most, might have had sufficient ecological awareness and insight to provide wise guidance?
Carp are a family of fish native to Europe and Asia. The common carp was introduced to the US over 100 years ago. Black carp, grass carp, bighead carp, and silver carp are the newest carp to appear in US waters. These four species of carp were deliberately introduced to the U.S. in the 1970's to control algae, weeds, and parasite growth in aquatic farms. Unfortunately, some of these carp eventually escaped into the Mississippi River basin and established breeding populations in those waters.
The problem is that Asian carp cause serious damage to native fish populations because they out-compete other fish for food and space. They also lower water quality, to the detriment of sensitive native small organisms. So, lake and river ecosystems have been ravaged by the introduction and overgrowth of carp.
The promoters of the carp campaign initially thought it was a great idea.
Zebra mussels originate from the lakes of southern Russia and Ukraine and are not native to North American waters. They have been accidentally introduced to numerous countries, where they have become extremely invasive. Since the 1980s, zebra mussels have invaded the Great Lakes in the US.
Zebra mussels are filter-feeding organisms. They are capable of removing huge quantities of unwanted particles from water. Since the arrival of zebra mussels in heavily polluted Lake Erie, water quality/visibility in some areas has increased from 6 inches to up to three feet. While this might seem to be a good thing, Zebra mussels severely disrupt ecosystems, and their sheer numbers damage waterways and ships, and clog water-treatment and power plants. Zebra mussels are responsible for the near extinction of many species in the Great Lakes by outcompeting native species for food and by growing over and suffocating native mollusks. Zebra mussels are also believed to be the source of deadly avian botulism poisoning that has killed tens of thousands of birds in the Great Lakes since the late 1990s.
Initially, it was thought that the presence of Zebra mussels was a great way to improve water quality/visibility in heavily polluted Lake Erie.
Why did the above ecological blunders occur? Why were they stopped only after immense harm had occurred? Answers to these questions are critically important, if we are to prevent similar ecological disasters in the future.
Among the many factors responsible for these blunders was a lack (on the part of the plan’s promoters) of understanding and appreciation of the science of ecology, including the fundamental principles of evolution developed by Darwin more than 160 years ago. Many of the promoters of these misguided experiments were well-meaning but did not understand the ecological science involved and did not have ecological common sense. Many were short on the practice of “anticipatory thinking,” meaning that they made and implemented simplistic plans without, first, anticipating and imagining what the adverse consequences (the side effects) might be. Perhaps, they were not inclined to seek advice from those who might have deeper knowledge of ecological science, greater experience with ecological phenomena, and/or greater ecological common sense. Perhaps, they did not engage in scientific dialogue that would have at least raised questions about the wisdom of their proposed interventions and might have halted the implementation of those interventions. Perhaps, at the time, the science of ecology was so young that few ecologists were available for consultation. (The field of ecology is a relatively new science that did not come into prominence until the second half of the 20th century.)
Others involved in the planning, implementation, or ongoing promotion of these blunders may have been less innocent. They may have been at least vaguely aware of the ecological science involved but chose to proceed anyway. Perhaps dreams of personal gain prevailed over concerns about adverse consequences. Perhaps conflicts of interest clouded their ecological common sense. Perhaps their ecological conscience and ecological compassion were quite small. Perhaps some of these proponents even sought to censor or otherwise demonize and marginalize more knowledgeable, properly motivated ecological scientists. Arrogance and hubris, coupled with IGnorance and igNORance, predictably worsen such situations.
In summary, the following factors probably contributed to these ecological blunders: insufficient awareness and practice of ecological science and ecological thinking; insufficient ecological conscience, ecological compassion, and ecological common sense; lack of “anticipatory thinking;” conflict of interest; lack of scientific dialogue; failure to do appropriate homework; and failure to listen to those with ecological knowledge, conscience, compassion, and common sense.
The key to preventing these ecological disasters, or halting them once they are put in motion, is healthy, respectful, rigorous scientific and public dialogue. This is a basic principle of science, medicine, and democracy.
Dr. Geert Vanden Bossche is, in essence, an immune system ecologist. He does not refer to himself as such but that is what he is. In addition to deeply understanding the immunology, virology, vaccinology, evolutionary biology, glycosylation biology, and physical-chemistry of the COVID-19 situation, he understands and appreciates the immune system as a complex natural ecosystem. He understands not only the complexity of the immune system itself, but also the complexity of the immune system’s dynamic interactions with viruses---interactions that are always changing, as the virus forces reactions by the immune system, which are followed by counter-reactions by the virus, which are followed by counters to those counter-reactions---a continuing series of moves and counter-moves that ultimately protects humanity and often requires a wise compromise (between the immune system and the virus) that allows the virus to reside in the human host in a state of relatively harmless endemicity.
[NOTE: When discussing pandemic phenomena, there is a tendency to anthropomorphize the virus and the immune system, as if each has a brain and each consciously develops and executes a strategy. Although such anthropomorphizing can help convey teaching points, viruses and immune systems obviously do not have brains, and the moves and counter-moves they make are not based on conscious decisions. These moves represent natural reactions that are determined by predictable physical laws of nature---examples being “steric hindrance,” “competitive binding,” “conformational changes,” other physical-chemical laws, and Darwinian principles.]
Most importantly, Dr. Vanden Bossche comprehends how vaccines can affect the above complex interplay between the immune system and the virus. He understands how misguided vaccination efforts can adversely affect the immune ecosystem---by altering both the natural evolution of the immune response and the natural evolution of the virus---replacing both with unnatural, worrisome evolutions.
Because of his broad knowledge base, his extensive experience in the real world of vaccine development, and his deep appreciation of the immune system as an ecosystem, he has been able to imagine and predict the likely consequences of mis-guided manipulations of the immune ecosystem---just as excellent environmental ecologists who deeply appreciate natural ecosystems are able to imagine and predict what is likely to happen when natural environments are subjected to unwise human interventions. Just as we need environmental ecologists to help us protect nature’s ecosystems (lakes, rivers, etc. and the living creatures within them) by warning us of the likely consequences of misguided human interventions, we need immune system ecologists to warn us about the anticipated consequences of misguided manipulations of the human immune ecosystem. That is what Dr. Vanden Bossche has done is his new book, entitled “The Inescapable Immune Escape Pandemic.”
It is possible that Dr. Vanden Bossche is the world’s first true immune system ecologist---or at least the first immune system ecologist to elevate this field of study to prominence. In that sense, his work may be as historically important as the work of those environmental ecologists who increased awareness of the importance of understanding and respecting nature’s ecosystems.
What are the adverse effects of the COVID-19 mass vaccination campaign on the immune ecosystem? What sequence of adverse events could have been anticipated? What are the cascades of adverse events that Dr. Vanden Bossche foresaw, worried about, warned us about, has observed so far, and have given rise to his ultimate most worrisome concern for Humanity? Below is my best effort to understand and summarize the complex science that Dr. Vanden Bossche explains in his book.
A first fundamental principle, and an over-arching theme of his book, is that it is a huge mistake to try to end an active pandemic like the COVID-19 pandemic by implementing, in the midst of that pandemic, a mass vaccination campaign (across all age groups) that uses vaccines (like the COVID-19 vaccines) that do not adequately prevent replication and transmission of the virus, do not produce sterilizing immunity, and, thereby, do not contribute to herd immunity.
As Dr. Vanden Bossche explains in his book and in preceding writings [1-9], such a mass vaccination campaign puts tremendous immune pressure on the virus, at a population level, and predictably results in a prolonged series of new dominant SARS-CoV-2 (SC-2) variants, each being more infectious and more vaccine-resistant than its predecessors; and is highly likely to eventually result in the emergence of an SC-2 variant that is more virulent than all predecessors. [1, 2, 9-29] This is due to the predictable natural selection and dominant propagation of viral variants that are able to “escape” the intense immune pressures placed on the virus by the COVID-19 mass vaccination campaign and, thereby, become dominant variants---because these variants are more “fit” and, thereby, have a competitive advantage over less fit variants. The result is an “immune escape pandemic” that is more prolonged, more dangerous, and cumulatively claims more lives than if the same pandemic had been managed without such a mass vaccination campaign (as will be further explained later).
A second fundamental principle is that the innate immune system is an extremely valuable, critically important component of the human immune system. To review, the human immune system is comprised of two main components (or arms)---the innate immune system and the adaptive immune system.  The innate arm of the immune system is the first line of defense, and two of its main defenders are innate (natural) broad spectrum, non-specific antibodies (as opposed to narrowly focused, pathogen-specific antibodies) and broadly reactive natural killer cells (NK cells). The adaptive arm of the immune system is the second line of defense and is comprised of pathogen-specific T cells and B cells, the latter of which produce antibodies that are specific for a given pathogen (like the SC-2 virus).
When a person becomes infected with SC-2, the innate immune system is critically important for initial removal of the bulk of the viral load. The innate arm of the immune system often reduces the viral load so efficiently, completely, and quickly that the adaptive arm of the immune system needs not become more than minimally involved, sometimes not involved at all. Furthermore, the innate arm is not only capable of reacting quickly and successfully to the original strain of a virus (like the original Wuhan version of SC-2), but is also able to react successfully to subsequent more infectious variants of the original virus. Therefore, the last thing we would want to do is impair involvement of our innate immune system when we are confronted with a viral threat.
A third fundamental principle is that vaccines like the COVID-19 vaccines do not train the innate immune system. Instead, they train only the adaptive immune system. In fact, they sideline the innate immune system (as will be discussed further later). [9-13]
A fourth fundamental principle is that natural infection can (and usually does) result in “sterilizing immunity” and can, thereby, contribute to “herd immunity” but the COVID-19 vaccines do neither. [9-13] Sterilizing immunity is immunity that prevents replication and transmission of the virus from one person to another. Herd immunity is what ends a pandemic. The only way to achieve herd immunity is to achieve sterilizing immunity in an adequately high percentage of the population.
Unfortunately, the COVID-19 vaccines do not result in sterilizing immunity. Since the COVID-19 vaccines cannot and do not cause sterilizing immunity, they cannot and do not contribute to herd immunity. In fact they do the opposite: At a population level, the COVID mass vaccination campaign creates enormous “herd immune pressure” on the circulating SC-2 virus. This vaccine-induced herd immune pressure drives the development of “immune escape” variants that are resistant to the vaccines, are more infectious (more easily enter human cells), and become dominant because of their fitness advantage. At the same time, the COVID-19 vaccines actually interfere with development of sterilizing immunity (in large part, by sidelining the innate immune system). An early result of the mass vaccination campaign is an increase in the amount of virus circulating in the environment; and the eventual result of the campaign is a more prolonged and more dangerous pandemic.
A fifth fundamental principle is that, in general, naturally acquired immunity is far superior to vaccine-acquired immunity. This is particularly true regarding SC-2 and the COVID-19 vaccines.
A sixth principle is that when a virus that causes acute, self-limited respiratory illness (like SC-2 does) begins to cause an epidemic or pandemic, it sets into motion a series of step-wise interactions between the virus and the immune system---at the population level. The ultimate goal of the immune system is to protect humanity. The ultimate goal of the virus is to survive---i.e., to be able to continue optimal replication. As soon as the immune system recognizes the virus to be a threat, it develops an immune response that is designed to thwart the virus by either controlling or eliminating the virus. The virus then responds with a counter-move that is designed to evade the immune system’s initial response. This results in a counter-move by the immune system, which is followed by a counter-move by the virus. This dynamic interplay continues until, after additional moves and counter moves, the virus is either eliminated or a suitable compromise (i.e., a relatively harmless co-existence) is reached. What I have just described is what happens when an epidemic or pandemic plays out naturally. [Again, please excuse the anthropomorphizing.]
A seventh principle is that a misguided mass vaccination campaign has the potential to profoundly alter the above dynamic interplay between the virus and the immune system---such that the virus takes on characteristics that it otherwise would not have developed; the immune system is forced to do things it otherwise would not do (and is less able to do what it usually does); and the result is a more prolonged and dangerous pandemic.
An eighth fundamental principle of science is that challenges to prevailing understandings should be encouraged, and respectful scientific dialogue must occur. Without opportunity for challenges and genuine dialogue, mistakes go unrecognized, unacknowledged, or uncorrected.
A ninth principle of science is that scientific data must be of high quality and must be honestly and transparently presented. There is no place in science or medicine for low quality data, manipulation of data, falsification of data, hiding of data, or misleading presentation of data. Without quality data and honest presentation of it, dialogue is hampered, knowledge acquisition is slowed, consensus becomes difficult, and confusion reigns.
With the above fundamental principles in mind, let’s now review the sequence of “cascading adverse events” that the COVID-19 mass vaccination campaign put into motion. That is, how, exactly, has this campaign adversely affected the interplay between the virus and the immune system? How has the mass vaccination campaign disturbed the normal immune system ecosystem and resulted in harmful consequences?
Recall that the SC-2 virus is able to infect human cells (e.g., cells in our upper respiratory tract) because the spike protein on the surface of the virus is able to fit into ACE-2 receptors on the surface of human cells, and when this fit occurs the virus is able to freely enter the human cell.  The ACE-2 receptor is the “lock to the door” of the cell, and the spike protein (specifically the receptor binding domain of the spike protein) is the “key that unlocks that door” and allows the virus to enter. COVID-19 vaccines are designed to induce the human immune system to produce specific “neutralizing antibodies” that specifically block/prevent the SC-2 spike protein from fitting into the ACE-2 receptor---thereby, preventing the virus from “opening the door” and entering (infecting) human (host) cells.
Unfortunately, it takes time (a few weeks) for these vaccine-induced neutralizing antibodies to fully mature and become optimally neutralizing. In the meantime, the immature vaccine-induced neutralizing antibodies are sub-optimally neutralizing. They only partially and inadequately prevent infection.
During an active pandemic, a large amount of virus is circulating in the environment. When that virus encounters people with suboptimal neutralizing antibody titers, those antibodies do not prevent infection, but they at least make life more difficult for the virus. When this occurs at a population level, the virus experiences sufficient “immune pressure” to promote natural selection of viral variants that have the capacity to escape this suboptimal neutralization. Immune pressure, therefore, is characteristic of widely/highly COVID-19 vaccinated populations.
By the time the neutralizing antibodies have become fully mature, they are no longer adequately neutralizing because, in the meantime, the spike protein of SC-2 virions has already mutated to produce new SC-2 variants that are able to escape the immature (and, now, the mature) neutralizing vaccinal antibodies. Those variants developed a competitive advantage, because they are not neutralized by the neutralizing antibodies and, thereby, can freely enter human cells. Because of this competitive advantage, this new “immune escape” variant became the dominant variant circulating in the environment.
So one of the first things that predictably happened after initiation of the COVID-19 mass vaccination campaign in the midst of an active pandemic is that the sub-optimal immature vaccine-induced neutralizing antibodies pressured the virus into developing resistance to these neutralizing antibodies, including the eventual mature neutralizing antibodies. Accordingly, these mature neutralizing antibodies quickly became ineffective and obsolete.
A next thing that predictably happens is that, in addition to producing neutralizing antibodies, vaccinated individuals soon produce polyreactive non-neutralizing antibodies (PNNAbs) against the spike protein of the SC-2 virus. [A] These PNNAbs attach to a different part of the spike protein (the N-terminal domain, rather than the receptor-binding domain), and when they do so they cause a conformational change in the spike protein that enables the spike protein to more easily fit into the ACE-2 receptor of human cells. [9-13, 24, 27-29] This results in the virus becoming more infectious (better able to enter human cells). This phenomenon is referred to as PNNAb-dependent enhancement of infectiousness. This phenomenon comes into play and becomes particularly important when the vaccinal neutralizing antibody levels fall below a certain level.
So, now the vaccinal neutralizing antibodies are not working and the PNNAbs are making the virus more infectious. This is not good.
These “infection-enhancing” PNNAbs, however, have a temporary protective effect. Normally, when a respiratory virus enters the upper respiratory tract, some of that virus is adsorbed onto the surface of migratory dendritic cells. These virus-laden dendritic cells then migrate down to the lower respiratory tract, where the virus is able to trans-infect uninfected target cells in the lower respiratory tract and distal organs, often resulting in severe (virulent) lower respiratory tract infection (severe pneumonia). PNNAbs have the capacity to inhibit this process of dendritic cell-mediated trans-infection of the lower respiratory tract. They do so by binding to the virus that is tethered to the surface of the dendritic cells. This binding prevents the virus from being transferred to host cells in the lower respiratory tract. That is, the vaccinal PNNAbs are “virulence-inhibiting.” Via this mechanism they are at least modestly protective against severe disease and death.
So, the PNNAbs induced by vaccination have an undesirable “infection-enhancing” effect on the one hand but also have a protective “virulence-inhibiting” effect on the other hand.
Sidelining of the innate immune system: A next important concept to understand is that vaccinal antibodies sideline the innate immune system. In adolescents and adults, the enhanced viral infectiousness associated with the PNNAbs expedites the onset of viral replication and therefore sidelines the cell-based innate immune system ( i.e., hampers stimulation of NK cells).
In children, however, the vaccinal antibodies are sidelining the innate immune system by themselves. [3-5, 9-13] The reason for this is that the vaccinal antibodies outcompete the innate immune system’s innate (natural) antibodies for binding sites on the spike protein. This binding (of natural antibodies to the virus) is a necessary step in the foundational education of a young child’s innate immune system (most importantly, education of its NK cells) and the subsequent training of the cell-based innate immune system as the child grows and their natural antibodies disappear. In other words, the innate immune system becomes sidelined (loses opportunity for education/training and is excluded from participation in the immune response) when the innate immune system’s natural antibodies are unable to bind to the spike protein.
Sidelining of the innate immune response is a profoundly serious adverse effect of the vaccinal antibodies.
It follows that vaccinated individuals are predisposed to develop recurrent SC-2 break-through infections (BTI), either because of infection-enhancing PNNAbs (i.e., in the case of strongly diminished neutralization capacity) or because vaccinal antibodies outcompete broadly neutralizing natural antibodies (i.e. in young children). To deal with these BTIs, the immune system is forced to enhance activation of MHC class I-unrestricted cytolytic T lymphocytes (CTLs, for short). [B] These CTLs efficiently kill virus-infected cells. [9, 11-13] Whereas activation of CTLs normally enables recovery from COVID-19 disease, their sustained activation substantially decreases viral shedding and transmission and contributes to protection against COVID-19 disease.
Despite the infection-enhancing effects of the vaccine-induced PNNAbs and the resultant predisposition to recurrent BTIs, the combination of the PNNAB’s virulence-inhibiting effect and the activation of CTLs provides considerable protection from (severe) disease and actually reduces transmission of the virus (primarily because the CTLs are killing viral infected cells)---but this virulence-inhibiting protection (by PNNABs) is only temporary and the protection from frequently/continually activating CTLs is ultimately unsustainable and unhealthy.
Steric immune refocusing (SIR): Another very important set of moves and countermoves that occurs is this: Despite the fact that the original vaccinal neutralizing antibodies are no longer able to neutralize the part of the spike protein (in the receptor binding domain) that fits into the ACE-2 receptor (because of “immune escape” mutations that have developed in the spike protein), the vaccinal neutralizing antibodies, nevertheless, still bind to that part of the spike protein. This, sterically, masks (covers) that part of the spike protein and re-directs the immune system to produce neutralizing antibodies against a different part of the spike protein---namely, the N-terminal domain of the spike protein, which is a more conserved and less variable part of the spike protein. This re-direction of the immune system’s antibody response is referred to as “steric immune refocusing (SIR).” [C]
SIR results in production of new broadly neutralizing, less variant-specific, low-affinity, short-lived, sub-optimal antibodies that temporarily hamper the virus and reduce viral transmission. That is, SIR results in the immune system developing some new modest partial (suboptimal) neutralizing protection. This partially compensates for the loss of neutralizing effect of the original vaccinal neutralizing antibodies. But this move by the immune system is countered by the development and dominant propagation of SC-2 variants that are resistant to these new suboptimal SIR-created broadly neutralizing antibodies. In fact, the intense immune pressure that SIR-created antibodies place on the virus, at a population level, eventually spawns a wide array of many new SC-2 variants that are highly infectious---more infectious than all predecessors. This is what has been happening since onset of the Omicron era.
Despite the new protection provided by SIR-created broadly neutralizing antibodies, the net effect of SIR is an escalation of immune pressure, an escalation of immune escape, emergence of many new variants, increased infectiousness of the new variants, an escalation of BTIs, and, therefore, more sidelining of the innate immune system. It was during this Omicron era that the pace of immune escape escalated and the pandemic evolved into a self-catalyzing “inescapable immune escape pandemic.”
The current COVID-19 situation is that of large-scale immune escape, i.e., the emergence and co-circulation of many Omicron variants that are intrinsically highly infectious and resistant to vaccine-primed antibodies, while at the same time the immune system is using PNNAbs in an effort to reduce disease severity. Enhanced intrinsic infectiousness combined with strongly diminishing neutralization capacity results in enhanced activation of MHC class I-unrestricted CTLs. These CTLs, in particular, are thwarting shedding of the virus. The net effect of these most recent immune system adjustments is that the virus, despite being highly infectious (intrinsically), is now having a very difficult time replicating and propagating via transmission from one person to another.
When viral replication and transmission (from one infected person to another) is, thusly, being thwarted, then one of two things has to happen in order for the virus to survive (continue replicating): either an SC-2 variant must emerge that has a capacity to prevent CTLs from reducing viral transmission; or an SC-2 variant must emerge that has a capacity to overcome the virulence-inhibiting effect of the PNNAbs. The “first SC-2 variant” (one that is able to overcome CTL-mediated reduction of transmissibility) would quickly become extinct, because it would quickly cause massive lethal infection---i.e., too many hosts would quickly die and the virus would quickly die out as a result. The “second SC-2 variant” (one that overcomes the virulence inhibiting effect of the PNNAbs) would be relatively less lethal (compared to the first SC-2 variant) or at least less quickly lethal and this would at least delay its extinction---because the virus would be able to replicate extensively by spreading within the body of its host (within the lower respiratory tract and other organs), as opposed to depending on replicating via transmission to new hosts. In other words, the second SC-2 variant, compared to the first SC-2 variant, would be capable of considerable viral replication within the lower respiratory tract and other organs of the person infected, and would, thereby, compensate for insufficient person-to-person transmission.
Dr. Vanden Bossche emphasizes that at this point in the pandemic, the mass vaccination campaign is placing immense pressure on the virus to develop this second type of SC-2 variant (one that escapes the virulence inhibiting effect of the PNNAbs). Indeed, the most recent variants have already been shown to be more virulent in vitro. [22, 23] Dr. Vanden Bossche anticipates that a new more virulent SC-2 variant will thrive better than all other variants and will, thereby, become the dominant variant.
Dr. Vanden Bossche has, therefore, concluded that the next and ultimate step in the cascade of adverse events triggered by the mass vaccination campaign will be emergence of the second type of SC-2 variant(s) and that this will occur soon. Namely, he predicts that an SC-2 variant will soon emerge that is capable of escaping from the virulence-inhibiting effect of the PNNABs. This variant will be better able to carry out dendritic cell-mediated trans-infection of host cells in the lower respiratory tract. This variant will flourish and replicate in the lower respiratory tract. This variant will, thereby, be more intrinsically virulent (than all predecessors) and will cause much more severe disease (severe pneumonia, with syncytia formation). This variant will become the dominant variant. This strategy on the part of the virus will ultimately fail if the virus is so virulent that it kills those whom it infects. But this strategy will delay extinction of a virus whose opportunity to replicate via transmission (from one person to another) has been largely thwarted.
This has been Dr. Vanden Bossche’s greatest fear. This more virulent variant will have the potential to cause a catastrophic number of hospitalizations and deaths, particularly in people who have received multiple doses of a COVID-19 vaccine. Healthy, unvaccinated people will do well, because their innate immune systems have not been sidelined by COVID-19 vaccination but—on the contrary—have been trained to broadly resist a diversified spectrum of highly infectious variants. Our hope (which is most likely wishful thinking) is that the new, more virulent variant will be only moderately more virulent (at most) as opposed to catastrophically more virulent. While hoping for the former, we need to prepare for the latter.
For completeness, we should mention a few other adverse disturbances of the immune ecosystem that the COVID-19 mass vaccination campaign has caused. The sidelining of the innate immune system not only hampers the immune system’s ability to fight off SC-2 infection, but also diminishes a vaccinated person’s capacity to fight off other viruses, predisposes the vaccinee to autoimmunity, and impairs the immune system’s cancer surveillance efforts (which predisposes vaccinated people to development of malignancy). Furthermore, the frequent, almost constant activation of CTLs ultimately leads to “immune exhaustion” and escalating immune dysregulation.
For completeness we should also mention that the above-mentioned cascade of adverse changes in the immune ecosystem and in the virus would not have occurred in the absence of the COVID-19 mass vaccination campaign. If the COVID-19 pandemic had not been managed with the COVID-19 mass vaccination campaign and, instead, had been managed by common sense protective measures and reliance on the immune system to do what it knows to do, the following would have occurred: The innate immune system would have been free to train such as to provide its optimal and great degree of broad protection. The adaptive immune system would have developed appropriate and effective antibodies to the virus. Trained innate immunity or the combination of trained innate immunity and antigen-specific antibodies would have generated sterilizing immunity in those people who had become significantly infected. This would have eventuated in herd immunity, which, in turn, would have ended the pandemic within 1-2 years, depending on public health policies (e.g., Africa compared to China). Dominant propagation of more infectious immune-escape variants would not have occurred. PNNAb-mediated enhancement of infection would not have occurred to a significantly harmful degree. BTIs would have been far less common and would not have led to SIR. Dominant SC-2 variants would not have become more virulent than predecessors. And the immune ecosystem would not only have been left intact, but would have become better trained (through practice) to flexibly deal with new SC-2 variants and future similar viruses. The human immune ecosystem would have been left healthy and able to optimally carry out all of its many protective and regulatory functions.
Yes, if the COVID-19 pandemic had not been managed with the COVID-19 mass vaccination campaign and, instead, had been managed by deploying common sense protective measures (e.g., avoidance of overcrowding) and allowing the immune system to do what it knows to do (i.e., to recognize and attack foreign antigens), a relatively low percentage (0.05-0.12%) of the population (primarily elderly and frail people) would have died (probably a cumulative number comparable to, or slightly higher than, the number of people who die each year from influenza epidemics). But this cumulative number would have been far less than the eventual cumulative number of deaths that will accrue as direct and indirect results of the misguided COVID-19 mass vaccination campaign. History (if high quality data collection is permitted and honestly presented) will reveal that the COVID-19 mass vaccination campaign has transformed a natural COVID-19 pandemic into a much more prolonged and dangerous COVID-19 “immune escape pandemic” that will cumulatively claim far more lives than the natural COVID-19 pandemic would have claimed if the COVID-19 mass vaccination campaign had never been implemented.
It is important to emphasize, too, that many of the deaths that occurred during the first 9 months of the pandemic (before the COVID-19 vaccines were available) could have been prevented if accessible, affordable outpatient anti-viral treatment had been promptly provided and encouraged , if the hyperimmune phase of the illness had been promptly treated with appropriately aggressively immunosuppression , and if all patients had had prompt access to the careful anticipatory practice of medicine.
An experienced, dedicated, conscientious, altruistic immune system ecologist (like Dr. Vanden Bossche) is able to foresee the profound disturbances of the immune ecosystem that a misguided COVID-19 mass vaccination campaign is likely to create. Dr. Vanden Bossche foresaw these potential consequences as soon as the COVID-19 mass vaccination campaign was proposed. He has been warning of this likely immune system ecological disaster ever since. But his warnings have gone unheeded. The response of the promoters of the mass vaccination campaign has been silence and derision, not respectful dialogue.
Although Dr. Vanden Bossche is quite certain that his predictions will, unfortunately, come true, he cannot guarantee that his understandings and predictions are fully correct. He feels obligated, however, to honestly warn people about his concerns and what he thinks will most likely happen. At the very least, his concerns should be taken seriously and we should at least prepare for the possibility that his worst fears will be realized.
Leaders and supporters of the prevailing COVID-19 narrative and its mass vaccination campaign are currently emphasizing that the pandemic has “calmed down” and is “heading into an endemic phase.” They point out that COVID-19 case counts, hospitalizations, and deaths are declining, despite relaxation of mitigation measures (mask wearing, etc.) and opening up of society. Life has seemingly become “more normal” and seemingly more “stable.” Some are even saying that “the pandemic is over.”
They point out that the Omicron variants, though more infectious, have been causing only mild illness, usually no more than a mild cold. Many have suggested that Omicron has been a “blessing” in that it has allowed unvaccinated people to develop naturally acquired immunity and, in vaccinees, infection with Omicron has served as a natural booster of vaccine-induced immunity—while causing only mild illness in most people. Leaders of the mass vaccination campaign have attributed much of the subsidence of the pandemic to the achievement of “hybrid immunity,” a combination of naturally acquired immunity and vaccine-acquired immunity.` They reassure us that “we can live with” this new “endemic” level of COVID-19, particularly if people continue to get boosted. They are saying that soon only an annual booster dose will be necessary, as with influenza. They do not think a more virulent variant will emerge.
Dr. Vanden Bossche is saying the opposite. He is predicting the emergence of a highly virulent variant that will likely cause catastrophic numbers of hospitalizations and deaths. Why is there such a huge difference of opinion?
The short answer is that the leaders of the prevailing narrative are not viewing the pandemic through the lens of an experienced, deeply knowledgeable immune system ecologist. They are not understanding that the apparent improvement of the COVID-19 situation since emergence of Omicron variants has been due to the combination of the virulence-inhibiting effect of the PNNAbs, the protective effect of MHC-unrestricted CTLs, and the protection provided by SIR-related broad-spectrum neutralizing antibodies against conserved, subdominant regions of the spike protein. What they do not realize is that all three of these protective measures are suboptimal, are putting the virus under tremendous immune pressure at a population level, and will inevitably be overcome by the virus. These three protective phenomena are temporary, fragile, and unsustainable. Given the high level of infectiousness of the currently circulating variants, these immune mechanisms fail to confer sterilizing immunity and therefore prevent herd immunity from being established. Only herd immunity can make the virus transition into the endemic phase. The current situation, therefore, poses a serious threat to public health.
In addition, the leaders of the prevailing narrative do not seem to understand that the COVID-19 vaccines sideline the critically important cell-based activities of the innate immune system and that this has several devastating down-stream consequences. This situation, therefore, poses a serious threat to the health of the individual.
The reality is that, because of the COVID-19 mass vaccination campaign, the pandemic has turned into an “immune escape pandemic” and is, therefore, very unstable and nowhere close to being over. The dominant propagation of an SC-2 variant(s) that is capable of overcoming the virulence-inhibiting effect of PNNAbs is inevitable and imminent and will likely be catastrophic for those individuals who have been repeatedly vaccinated---particularly in those highly vaccinated countries that have used mRNA vaccines. As Dr. Vanden Bossche frequently emphasizes, “Africa will win,” because most African countries have wisely hesitated to embrace the COVID-19 mass vaccination campaign.
Finally, a word about so-called “hybrid immunity.” The leaders of the mass vaccination campaign in the USA have been promoting the notion that the pandemic is now under good control “because of a combination of naturally acquired immunity and vaccine-induced immunity---hybrid immunity.” Perhaps, an automobile analogy is helpful. The leaders of the mass vaccination campaign are selling the attractive (but false) notion that this “hybrid immunity” is as fantastic and wonderful as an excellent “hybrid car”---a car that partially runs on natural fuel (naturally acquired immunity) and partially runs on clean renewable high tech batteries (“modern vaccine”-induced immunity), the combination of which saves energy, saves the planet, and contributes to a sustainable future.
But what the car dealers either do not realize or are not telling the buyer is that the high tech batteries sideline and weaken the natural fuel, are toxic to the car, and are weak and short-lived (needing constant, unsustainable replacement). Furthermore, the car partly relies on old, used, obsolete parts (effete neutralizing antibodies to the Wuhan strain of SC-2). These cars will fall apart faster than a used 1968 Chevrolet Vega. Caveat emptor! (Buyer beware!)
Bottom Line: Contrary to the notion that the COVID-19 pandemic is subsiding, stabilizing, coming under control, and heading into endemicity, the reality is that we have been experiencing a falsely reassuring “calm before the storm.” The pandemic is dangerously unstable. The mass vaccination campaign has prolonged the pandemic by turning it into an “immune escape pandemic,” harmed the immune ecosystem, and made the pandemic more dangerous. A catastrophic result is highly likely and is imminent.
The obvious, common sense answer to this question is: We should think ecologically, and we should engage in healthy, respectful, careful, scientifically sound dialogue about these concerns---both among scientists/physicians and among citizens, including within families. During such dialogue, Dr. Vanden Bossche’s understandings and concerns could be critiqued, and the scientific merits of the mass vaccination campaign (or lack thereof) could also be scrutinized. Promoters of the mass vaccination campaign could learn from Dr. Vanden Bossche’s ecological approach, and Dr. Vanden Bossche would have an opportunity to learn from those who disagree with him. That is the purpose of scientific dialogue. Respectful back-and-forth dialogue is essential for advancement of science and medicine.
But the above dialogue has not occurred. Only one prevailing COVID-19 narrative has been allowed. Excellent scientists and physicians who have thoughtfully evaluated the COVID-19 mass vaccination campaign and have expressed deep concerns about it, have been demonized, silenced, censored, and punished as “deplorable purveyors of anti-science, anti-vaccination mis-information and disinformation.” Many physicians and scientists who, in their own minds, have questioned the scientific merits of the mass vaccination campaign have remained silent out of fear of reprisal (losing their job, their grant funding, their license to practice, their friendships, even their family relationships).
Unfortunately, immune system ecologists, like Dr. Vanden Bossche, appear to be rare. If they are not rare, why have the others not spoken up---either to support Dr. Vanden Bossche’s concerns or to explain what he is mis-understanding. No other immune system ecologist has done either. Perhaps, some immune system ecologists agree with him but are afraid to publicly say so, out of fear of reprisal. Perhaps, there are no other true immune system ecologists, or no other immune system ecologists with insights and experience comparable to Dr. Vanden Bossche’s. Perhaps other “experts” in virology, immunology, and vaccinology have not engaged in dialogue with Dr. Vanden Bossche because they do not think in ecological terms, or perhaps their knowledge of immune system ecology is insufficiently deep to generate scientifically-sound arguments against Dr. Vanden Bossche’s concerns.
I suspect that there are not many true immune system ecologists in the world, much less immune system ecologists with the depth of understanding and experience possessed by Dr. Vanden Bossche and, very importantly, with the scientific and ethical integrity he has exhibited. There are excellent virologists, excellent, immunologists, excellent vaccinologists, and excellent evolutionary biologists---but there are not many scientists who combine all of those abilities and are able to view the COVID-19 situation as immune system ecologists. Even excellent scientists and physicians who have been extremely critical of the prevailing COVID-19 narrative and its mass vaccination campaign have been slow to appreciate Dr. Vanden Bossche’s ecological understandings and warnings.
This has resulted in Dr. Vanden Bossche being a rare voice, whose ecological warnings have not been taken seriously and are not being heeded. This is similar to the stories of ecological disaster mentioned at the beginning of this article. Those disasters occurred because of a paucity of ecological insight and an absence of informed, respectful, healthy, dialogue. Important dissenting voices were either absent, not heard, or ignored. Ecological disaster resulted---including extinction of species, irreversible loss of biodiversity, and irreversible damage to ecosystems.
Let us not repeat the mistakes that have been made regarding natural ecosystems. Let us not add to those mistakes by disastrously manipulating and harming the human immune ecosystem.
Dr. Vanden Bossche has exemplified what it means to be a sensitive, compassionate, scientifically careful, ethical, altruistically-motivated immune system ecologist. We must learn from him, or at least listen to his concerns. Otherwise, we risk facing what threatened the Bull Trout and the Kokanee salmon---massive loss of lives.
Most of us care deeply about massive loss of lives and destruction of ecosystems. We need to apply that same careful concern and ecological thinking to evaluation of the COVID-19 mass vaccination campaign.
Although it is highly likely that an upcoming COVID-19 surge, due to a new highly virulent SC-2 variant, will be as devastating as Dr. Vanden Bossche fears it will be, there are some reasons for hope that the surge might not be as catastrophic as he has predicted:
Protection provided by development of natural immunity against SC-2 prior to being vaccinated: As already emphasized, naturally acquired immunity against COVID-19 is vastly superior to COVID-19 vaccinal immunity. In fact, healthy people who have not received any COVID-19 vaccine doses and have already experienced COVID-19 and developed natural immunity to it, will be able to handle an anticipated highly virulent variant quite well as there is no reason to believe such a variant will be more infectious than those currently circulating in the population.
During the first 9-12 months of the pandemic, before the COVID-19 vaccines were rolled out (the roll-out occurred in December 2020), it is possible that many people contracted SC-2 and developed considerable naturally acquired immunity to it. If so, such people, despite subsequently becoming vaccinated, will be better off (because they have at least some naturally acquired immunity, particularly innate immunity) than people who had no exposure and/or developed no natural immunity prior to vaccination. Of course, this would require PNNAbs to not enable the virus to sideline naturally acquired immunity.
Unfortunately, the promoters of the mass vaccination campaign did not develop and implement adequate testing to determine the extent to which people, prior to vaccination, had already acquired sterilizing natural immunity against COVID-19. Ideal testing for this requires more than just testing for antibodies (e.g., more than testing for antibodies against spike protein and nucleocapsid protein). Testing of relevant innate immune capacity (i.e., conferred by infection-experienced NK cells and natural IgM antibodies) would be extremely valuable as enhanced innate immune capacity—potentially complemented by recalled antigen-specific IgG antibodies---enables sterilizing immunity. A comprehensive profile of the extent to which a given person had already acquired the capacity to naturally develop sterilizing immunity against COVID-19, prior to being vaccinated, could have been mapped and would have been extremely helpful, but has not been available and is still unavailable. People who already have the capacity for sterilizing immunity (from natural infection) do not need COVID vaccination. [To confirm that vaccination is, indeed, preventing previously exposed individuals from exploiting their naturally acquired immune sterilizing capacity, it would make sense to compare the SC-2 sterilizing capacity of natural effector cells (i.e., NK cells and IgM-producing B cells) in plasma samples from vaccinees and infection-experienced unvaccinated individuals upon in vitro challenge with SC-2 variants.]
So we do not know how many people who have been vaccinated already had good naturally acquired immunity prior to their vaccination. If a considerable percentage of vaccinated people did, in fact, already have good naturally acquired immunity prior to vaccination, then at least some of those people would be better off than those who had not developed good naturally acquired immunity prior to vaccination. Unfortunately, we do not know how large this percentage is. If it is quite large, then the upcoming surge might be less catastrophic than anticipated, at least for those who can still rely on their first line of defense which they trained prior to their vaccination. It may be wishful thinking, however, that this is a large percentage. It is a shame that this percentage is unknown and that it is not currently possible for individuals to find out, definitively, if they had acquired natural immunity (particularly innate immunity to COVID-19) prior to vaccination and conserved its functionality after vaccination. Whether previously trained innate immunity remains functional after vaccination likely depends on several different factors, including the type of vaccine used (i.e., mRNA-based versus non-mRNA based) and the number of booster injections received.
Some vaccinated people may not have mounted a significant immune response to their vaccination: As Dr. Vanden Bossche has repeatedly explained, vaccinal non-neutralizing antibodies (PNNAbs) increase the vaccinee’s susceptibility to infection with SC-2 and sideline the vaccinee’s innate immune system. Both of these effects are detrimental to the vaccinee. To date, vaccinal non-neutralizing antibodies have been providing some protection against severe disease and death, but, as already mentioned, this immune response is weak, fragile, and will soon vanish. In line with Darwin’s theory, such immunologic characteristics likely promote natural selection of SC-2 variants that are capable of resisting or even overcoming the “virulence inhibiting” effect of the non-neutralizing antibodies.
Resistance to vaccine-primed neutralizing antibodies, combined with resistance to PNNAbs elicited as a result thereof, would leave vaccinated individuals without any protection against SC-2, unless their trained innate immune response has not been negatively impacted by their vaccination (see above). Furthermore, once a person has been vaccinated, they will recall the ineffective vaccinal antibodies every time they are “boosted” or become infected with the natural SC-2 virus, and they will eventually exhaust their antibody-producing capacity because of sustained activation of antigen-presenting cells by recurrent SC-2 infection. Moreover, it should be realized that vaccination is irreversible---one cannot become unprimed or de-primed.
Given the above unfortunate consequences of COVID-19 vaccination (i.e., the net detrimental effects of vaccinal antibodies with strongly diminished virus-neutralizing capacity in the long term), one hope would be that a significant percentage of vaccinated people failed to mount a significant immune response to the vaccine—i.e., they did not experience a “take” of the vaccine, for one of several conceivable reasons. For example, people on immunosuppressive medications may not be able to mount a usual response. The immune system of some healthy people may, for as yet unknown reasons, be relatively hyporesponsive to the COVID-19 vaccines. There has been some evidence that certain “batches” or “lot numbers” of the vaccine were more or less immunogenic than other batches/lot numbers--- perhaps due to manufacturing glitches and/or inadequate refrigeration resulting in loss of antigen/mRNA stability. Non-responders or people who received injections from batches/lots with little or no immunogenicity might have an immune status (regarding COVID-19) that is similar to or even the same as that of the “unvaccinated,” despite being “vaccinated.” (It is perfectly possible that vaccine non-responders develop natural immunity, for natural exposure involves live virus whereas COVID-19 vaccination does not.) Unfortunately, the percentage of people who did not experience a good “take” of the vaccine is unknown.
Two doses, without subsequent booster doses, are possibly less detrimental than multiple booster doses: It is also possible that, when a more virulent variant appears, people who received only the initial two mRNA vaccine doses (or just one in the case of the J & J vaccine), and no subsequent “booster” doses, might be better off than people who have received one or more booster doses. However, this is probably wishful thinking because two doses are probably already allowing sidelining of the innate immune system and already promoting immune escape due to SIR. (Please read Dr. Vanden Bossche’s book for a detailed explanation of the phenomenon of SIR.) Because of the already mentioned net detrimental effects of the COVID-19 vaccines, the people who will be in the worst position will be those who have had more than one booster dose and, on top of that, have taken the new bivalent vaccine (which will not provide net benefit and will only make matters worse, at both an individual and a population level). Of people vaccinated with mRNA vaccines, those who had only one dose (instead of two initial doses) and no booster doses will probably be better off than those who received two initial doses (and no booster doses).
The more virulent variant may prove to be only mild-moderately more virulent (intrinsically), rather than catastrophically more virulent: When a more virulent variant appears and becomes dominant, it is possible that it will be only moderately more virulent (intrinsically), rather than catastrophically more virulent. In other words, such a variant might cause substantially more disease in the lower respiratory tract (compared to current and past Omicron variants), such that it causes more hospitalizations (particularly in the elderly and those with co-morbidities), but not cause such severe disease that deaths catastrophically increase.
In other words, if/when a more virulent variant appears and becomes dominant, much depends on whether that variant (or variants) is only mild-moderately more virulent (intrinsically) or extremely-catastrophically more virulent, or somewhere in-between. A hope is that the new dominant more virulent variant(s) will be only moderately more virulent, at most. But we certainly cannot and should not count on this hope. Unfortunately, such a hope most likely represents wishful thinking.
The human immune system may be more ingenious than anticipated: Another hope would be that the human immune system possesses even more genius than we have dared imagine and will somehow figure out a way to protect all of us, even the fully vaccinated and repeatedly boosted, despite all the negative interference that the vaccines have created. That is, the immune system might creatively figure out a way to overcome the net harmful effects of the vaccines and protect us from a more virulent variant. Personally, I believe the immune system is capable of developing new ways to help us control a highly virulent variant and/or will mobilize effective capacities that it has never needed to use until now. (There may be a spiritual component to this hope.)
The more virulent virus might be more treatable than anticipated, if optimal treatment is promptly provided: Finally, even if a new variant proves to be extremely virulent, it is possible that such a virulent variant might be more treatable than we have imagined---if optimal outpatient and inpatient treatment are promptly provided, which is a big “if.” We need to realize that, to date, and particularly during the first year of the pandemic, COVID-19 has not been optimally treated, at least not universally. [30-31] For the most part, optimal early treatment of the acute viral phase has not routinely been provided (at least in the USA) , nor has prompt and optimal treatment of the hyperimmune phase.  It is also possible (but not highly likely) that new, safe, effective anti-viral therapies that are currently not available will become available in the near future.
Remember, a virus can be “more virulent” not simply because of its intrinsic virulence. It will also be “more virulent” (more threatening) if there is failure to provide optimal care. In other words, extrinsic factors (including a dysfunctional and/or miseducated health care system), in addition to intrinsic factors, can result in a virus being “more virulent.” It cannot be emphasized enough that an intrinsically more virulent variant may be more or less threatening, depending on how well it is treated. It is possible that thoughtful, informed, compassionate, anticipatory care that provides prompt, timely, appropriately aggressive treatment might render a variant that has intrinsic potential to be catastrophically virulent to be a much less severe (and more manageable) threat to the vast majority of people. Likewise, it is possible that a variant that is intrinsically only moderately virulent might become catastrophically virulent if clinical care is non-anticipatory, mis-informed, dispassionate, unthoughtful, uncaring, delayed, and inadequately aggressive.
If/when a person becomes ill with a highly virulent SC-2 variant, it would be ideal for that patient to have immediate access to a physician who: fully appreciates the bi-phasic nature of COVID-19; practices anticipatory, proactive medicine; is fully prepared and willing to consider prompt initiation of safe, effective, affordable anti-viral therapies; is fully prepared and willing to consider arranging for careful, anticipatory monitoring with timely serial outpatient lab studies and home pulse oximetry; is fully prepared to promptly recognize whether a patient is beginning to develop a hyperimmune reaction; is fully prepared to consider prompt prescription of outpatient prednisone (at appropriate dosage) and other appropriate therapies, if a hyperimmune reaction does evolve; and has compassionately reassured the patient long before the patient became ill that they (the physician) will be immediately and fully available to help them throughout their illness, if/when they (the patient) develop COVID-19. That anticipatory planning and reassurance can be therapeutic in and of itself, by proactively minimizing counter-therapeutic anxiety and panic that would otherwise tend to occur when the person does become ill with COVID-19.
It is reasonable to hope that with excellent clinical care (i.e., clinical care with the anticipatory characteristics outlined above) even an extremely virulent variant might be successfully managed in the vast majority of cases (with only the very elderly and already frail people being at great risk). People living in countries or communities where the vast majority of physicians are fully prepared and fully willing to compassionately and collaboratively provide excellent anticipatory care --- will likely have the greatest chance to do well. People living in countries or communities where the vast majority of physicians have not done sufficient homework; do not fully appreciate the biphasic nature of COVID-19; are reluctant (even refuse) to offer safe, affordable anti-viral therapies; are resistant to ordering outpatient lab monitoring; do not practice anticipatory medicine; are not promptly available; do not demonstrate a compassionate and collaborative approach to the patient; do not promptly recognize and react to danger signals; and are not fully prepared and willing to consider prompt and timely prescription of outpatient prednisone when indicated--- will likely be at a considerable disadvantage.
In my opinion, all people in all countries and all communities deserve to have immediate and affordable access to physicians who have done their homework, compassionately practice an anticipatory approach, and are readily available to help their patients throughout their illness. So, another hope is that if patients can receive optimal anticipatory care, then even a very virulent variant might be successfully treated.
All of the hopes mentioned above might represent wishful thinking. However, these hopes are not inappropriate and are certainly worth rooting for and preparing for. Personally, I am hopeful. There is a limit to how accurate scientific predictions can be--even the most thoughtful, rational, and scientifically-sound predictions. Nevertheless, we must not count on these hopes---we must prepare for the worst. We must take Dr. Vanden Bossche’s concerns very seriously. He is an extraordinarily gifted, thoughtful, and experienced immunologist-virologist-vaccinologist-evolutionary biologist-immune system ecologist. He has not made these predictions lightly. He has made them out of deep concern for Humanity. He is appropriately worried.
Dr. Vanden Bossche has provided a detailed scientific explanation for his warning that a highly virulent SC-2 variant will soon emerge and very likely to be devastating. Unfortunately, the leaders of the COVID-19 mass vaccination campaign have not adequately appreciated (or at least not honored) the complexity of normal interactions between the immune system and the virus. Worse, they have not adequately appreciated how, in very complex ways, a misguided mass vaccination campaign can adversely affect normal immune system-viral interactions and, thereby, profoundly disturb the immune ecosystem. The leaders of the mass vaccination campaign have not adequately appreciated (or at least not honored) the nine fundamental scientific principles outlined earlier in this article. In fact, they have grossly violated all nine of those fundamental principles. These failings have resulted in these leaders not appreciating Dr. Vanden Bossche’s concerns and not encouraging public awareness of these concerns. Lack of awareness of these concerns has prevented citizens from proactively making preparations (individually and collectively) to protect themselves from the highly virulent SC-2 variant that Dr. Vanden Bossche has been anticipating. Sadly, citizens and health care institutions will, therefore, be caught by surprise and will be ill-prepared when a highly virulent variant emerges and dominantly propagates.
We can address the above failings by urgently insisting that the public be provided with thorough, accurate, honest, scientifically sound, understandable, and demystifying education about COVID-19---particularly regarding COVID-19 vaccination and the concerns mentioned in Dr. Vanden Bossche’s book, this article, and in the companion articles cited [1-14, 30-36]. To date, in most countries, adequate education has not been provided by the promoters of the prevailing narrative and its mass vaccination campaign---but this can be corrected.
The Public can be helped to understand that the problem we are currently facing---the continuing appearance of a succession of new dominant SARS-CoV-2 variants that have become increasingly infectious and will likely soon become worrisomely virulent, especially for the vaccinated---is profoundly serious. The public must realize that this problem has been created by the misguided, scientifically unsound mass COVID-19 vaccination campaign, not by the lack of vaccination. That mass vaccination campaign must, therefore, be stopped, including the new “updated bi-valent vaccines” . Discontinuation of vaccination of the elderly should also be strongly considered, because, once the highly virulent variant arrives, the risks associated with vaccination of elderly people will clearly be far greater than any putative benefit.
The adverse effects that the COVID-19 mass vaccination campaign has had on the evolutionary biology of the SARS-CoV-2 virus (the predominance of more infectious and potentially more lethal variants) is the major reason and is sufficient reason, all by itself, for immediately shutting down the COVID-19 vaccination campaign. On top of that reason are the many adverse effects the vaccines have had on individuals---abnormal clotting, myocarditis/pericarditis, neurologic disease, sudden unexpected and unexplained death, etc. [11, 33, 34,36] Those side effects, on individuals, are also sufficient reason, by themselves, for immediately shutting down the vaccination campaign, certainly for children, but also for the elderly and otherwise vulnerable.
We must now shift to preparing for an emphasis on early anti-viral therapy (rather than vaccination), using anti-viral agents with the best-known benefit/risk ratio [31, 32] and an emphasis on prompt appropriately aggressive treatment of the hyperimmune phase of COVID.
For those who become infected, early (and accurate) outpatient diagnosis and early (timely) outpatient treatment with safe, effective, widely accessible, and affordable anti-viral therapies [31, 32] may help prevent escalation of disease. Regarding diagnosis, only PCR tests that have been proven by independent laboratory experts to be highly specific and sensitive for SC-2 should be used, and reports of all positive PCR results should disclose the PCR Ct value at which the test was positive . Furthermore, verification of COVID-19 by genomic sequencing may be important in selected instances. Regarding anti-viral therapies, global experience with ivermectin and other inexpensive anti-viral approaches need to be honored. [31, 32]. Paxlovid and Molnupiravir do not fulfill criteria for being widely accessible and affordable and, unfortunately, their safety and efficacy have not been adequately established. The safety and efficacy of Molnupiravir is particularly dubious.
In addition to promptly starting early outpatient anti-viral treatment, prompt initiation of careful monitoring can be immensely helpful---to document whether the patient is following a reassuring clinical course or is heading into a worrisome hyperimmune phase. It is helpful to follow: serial COVID-19 PCR Ct values (using only PCR tests of proven high quality) to document the extent to which the initial viral load is reassuringly decreasing, or not ; serial CBC (with differential and platelet count), blood chemistries, CRP, ESR, serum ferritin, and d-Dimer levels to document the extent to which the patient is or is not developing a hyperimmune reaction and/or hypercoagulable state ; and use of a home pulse oximeter to document the extent to which the patient is developing a drop in O2 saturation due to worrisome disease in the lungs.
For those who develop a hyperimmune/hyperinflammatory reaction (usually during the second and third weeks of illness, but possibly much sooner with new more virulent variants), prompt and appropriately aggressive immunosuppression (with, for example, appropriate use of corticosteroid and potential use of anti-cytokine therapies) and appropriate use of other supportive therapies may be critically important .
When a highly infectious and highly virulent SARS-CoV-2 variant appears, particularly in highly vaccinated communities/countries/populations, it may be necessary to treat virtually everyone prophylactically---or at least those who become infected---with prompt safe, effective, widely accessible, affordable anti-viral therapy (at appropriate doses), perhaps for several weeks, in an effort to thoroughly reduce the viral infectious pressure in these populations/communities and to interrupt the vicious cycle of high infectious pressure causing enhanced immune pressure on the viral life cycle and, hence, driving immune escape.
Good exercise, good nutrition (including immune-supporting vitamins and other nutraceuticals ), fresh air, sunshine, and good emotional health (including reduction of COVID-19-related mystery, confusion, anxiety, and cognitive dissonance) will help optimize people’s immune systems, particularly their innate immune systems. The angst of confusion, mystery, and frustration is counter-therapeutic. De-mystification and “having a specific proactive plan,” in advance of becoming infected, are therapeutic.
When the highly infectious and highly virulent variant appears, particularly in highly vaccinated communities/countries/populations, it may be necessary to consider moving elderly folks (particularly those who are most vulnerable) out of crowded nursing homes/retirement homes into single family dwellings (e.g. into the home of an elderly person’s son, daughter, or relative), to the extent possible/practical----or to designated small COVID-19 facilities that are properly staffed and protected.
It is important for physicians, health care officials, politicians, and citizens to appreciate the great complexity of the COVID-19 situation. Simplistic understandings that are not rooted in a deep appreciation of the complexities of immunology, virology, vaccinology, evolutionary biology, glycosylation biology, and immune system ecology are potentially dangerous and should be avoided. For example, the simplistic and misleading statement that the vaccines are “exceedingly safe and extremely effective; get vaccinated! It’s your social responsibility; do it for others, if not for yourself; our patience is growing thin!” is scientifically incorrect, dangerous, divisive, and abusive. These simplistic and incorrect directives need to stop.
It is critically important that the scientists and physicians who have been responsible for the prevailing COVID-19 narrative and its policies engage in respectful, healthy scientific dialogue with those scientists and physicians who have challenged the prevailing narrative and its policies. To date there has been very little such dialogue, despite pleas by Dr. Vanden Bossche and others for such dialogue. This must change. More than one narrative must be allowed. That is a fundamental principle of science and medicine. The demonization and persecution of those who have responsibly challenged the prevailing narrative must stop. If Dr. Vanden Bossche is wrong in his understandings and concerns, this needs to be established through thorough thoughtful scientific dialogue. If the promoters of the prevailing COVID-19 narrative have been wrong, especially regarding their COVID-19 vaccination campaign, this needs to be established through thorough extensive scientific dialogue, and their incorrect narrative must be publicly acknowledged and publicly corrected.
I would like to again emphasize that I would much prefer that the issues discussed in this article be addressed by a representative international panel of physicians and scientists with exemplary expertise in immunology, virology, vaccinology, evolutionary biology, glycosylation biology, epidemiology, and immune system ecology, who would engage in respectful, honest, objective, scientific, video-archived dialogue about these questions. Physicians, including me, need and deserve that help. Citizens and physicians could then view and listen to that dialogue and decide whose explanations make the most sense and whose recommendations seem wisest.
Unfortunately, the vast majority of physicians (at least in the USA, Canada, and Europe) have either supported the prevailing COVID-19 narrative and obediently executed its policies or, if they have disagreed with the prevailing narrative and its mass vaccination campaign, they have remained silent (often out of fear of reprisal if they challenge the prevailing narrative). It is imperative, now, for physicians to do their homework and speak up---for the sake of science, medicine, their patients, and Humanity. To facilitate that homework, please see the many COVID-19 articles posted on Dr. Vanden Bossche’s website and on the following educational website: www.notesfromthesocialclinic.org
In addition to promoting respectful, healthy, scientific dialogue among health care professionals, we must also promote such dialogue among citizens. We must promote dialogue and demystifying education that will elevate understanding of the complexity of the COVID-19 situation, create consensus, minimize chaos, bring people together, and unite people in positive, constructive efforts to do what is needed to preserve lives and end this pandemic.
It is important that the “vaccinated” and “unvaccinated” not be pitted against each other. This has never been a “pandemic of the unvaccinated,” nor is it helpful to view it as a “pandemic of the vaccinated.” It is a pandemic that has been prolonged and made worse by a misguided mass vaccination campaign. Vaccinated and unvaccinated citizens should kindly and sensitively work together to correct the many mistakes that have been made in the management of this pandemic.
Finally, it should be realized that (at least in the USA, Canada, and Europe) it is unlikely that the White House COVID-19 Task Force, the CDC, FDA, NIH, WHO, the medical establishment, pharmaceutical companies, and the conventional media (and equivalents in other countries) will honestly acknowledge and correct the mistakes they have made. More likely, they will espouse a new narrative (like the new false narrative mentioned below) and try to avoid accountability. Correction of these mistakes, therefore, will likely depend on the careful homework and thoughtful advocacy and altruism of ordinary citizens (both the vaccinated and the unvaccinated) and altruistic scientists and physicians.
If citizens, particularly mothers and pediatricians, unite to properly educate the Public and open the eyes and minds of unaware promoters of the COVID-19 mass vaccination campaign, then Humanity, particularly our children and grandchildren, will have a chance for a good outcome, despite the damage the mass vaccination campaign has done to the immune ecosystem and to individuals.
Summary of specific proactive plans: Individual citizens, individual physicians, and health care institutions should immediately start preparing to optimally practice the anticipatory medicine approach outlined above.
When the surge of severe COVID-19 arrives (due to the virulent variant that Dr. Vanden Bossche has predicted) and starts causing increased COVID-19 hospitalizations and COVID-19 deaths, it is easy to imagine that this frightening situation will be blamed (by at least some of the key promoters of the prevailing narrative and its mass vaccination campaign) on those who “failed to get fully vaccinated” and those who have “spread COVID-19 misinformation” that undermined confidence in the government’s COVID-19 policies. The worsening situation will be used to “vindicate and justify” the CDC’s policies to date. The worsening statistics will be blamed on loosening of restrictions and poor compliance with vaccination recommendations. This, in turn, will be used to justify a return to extreme mitigation measures and an escalation of the mass vaccination campaign.
The worsening situation will also be used to justify the punishment of “spreaders of misinformation” and punishment of the unvaccinated—-for “causing so many deaths.” The USA, Canada, Europe, Australia, and New Zealand will use the recent China experience (abandonment of the Zero-COVID-19 policy) to justify and vindicate their own COVID-19 policies to date, and urge return to past mitigation policies but not to the Zero-COVID-19 levels imposed in China. In fact, the governments and health authorities in the USA, Canada, Europe, Australia, and New Zealand will likely claim that they are implementing a “kinder, gentler” version of mitigation policies (compared to those in China) because they are more compassionate than leaders in China and are more sensitive to and respectful of the limits to which the citizenry can/will tolerate impositions. The worsening situation, globally, will also be used by the World Health Organization (WHO) to justify and encourage global escalation of the mass vaccination campaign and further crackdown on those “spreading misinformation.”
It is important for ordinary citizens in the USA, Canada, Europe, Australia, New Zealand, and elsewhere (India, e.g.) to be aware that the above new narrative might be rolled out. If such a narrative is rolled out, physicians and citizens need to see through it and counter it with scientifically sound information---like the information Dr. Vanden Bossche has been providing.
[A] Why does COVID-19 vaccination result in vaccine-induced PNNAbs, in addition to the vaccinal neutralizing antibodies? According to Dr. Vanden Bossche, When the neutralizing antibodies bind to heterologous variants, they trigger changes in colloidal viral properties that lead to the formation of weak viral aggregates that, in turn, stimulate production of PNNAbs.
[B] What triggers the activation of MHC Class I-unrestricted cytotoxic lymphocytes (CTLs)? These CTLs are activated as a result of enhanced uptake of neutralizing antibody-complexed progeny virions into tissue resident antigen presenting cells (APCs).
[C] Steric immune refocusing (SIR) is defined as re-orientation of the humoral S-directed immune response towards more conserved, immune subdominant S-associated epitopes as a result of steric masking of variable, immunodominant S protein-associated epitopes by pre-existing, low-affinity neutralizing antibodies.
For further reading, please see the “Notes on COVID-19” posted on the following website: www.notesfromthesocialclinic.org
For example, click on the following links to companion articles:
Robert Rennebohm, MD
Note regarding the artwork embedded in this article: The first is a drawing by Kathe Kollwitz (1867-1945). The last two are paintings by Honore Daumier (1808-1879).
Dr. Rennebohm is a pediatrician and pediatric rheumatologist. He is currently largely retired. In 2018 he officially retired from the pediatric rheumatology department at Cleveland Clinic, where he was also the Director of the International Susac Syndrome Consultation Service (2012-2018). Prior to that, he was at Alberta Children’s Hospital in Calgary, Canada, where he was Clinical Professor of Pediatrics and Pediatric Rheumatology (2008-2012); before that he was at Nationwide Children’s Hospital and Ohio State University in Columbus, Ohio, where he was Associate Professor of Pediatrics and Chief of Pediatric Rheumatology for 21 years; and before that he was a pediatric rheumatologist at Cincinnati Children’s Hospital Medical Center in Cincinnati, Ohio.
He went to medical school at the University of California San Diego (UCSD), at La Jolla, where he graduated with an MD degree in 1972. He completed his Pediatric Residency training at IWK Children’s Hospital/Dalhousie University in Halifax, Nova Scotia. He completed his Pediatric Rheumatology Fellowship training at Cincinnati Children’s Hospital Medical Center He has been a pediatrician for almost 50 years and a pediatric rheumatologist for about 42 years.
Although he is no longer in clinical practice or affiliated with a medical school or health care institution, he has continued his intense interests in pediatric rheumatology, Susac syndrome, and now COVID. In fact, throughout the past 2 years he has spent many hours per day on most days of most weeks intensively studying and writing about COVID---because he has realized how profoundly important and complex the COVID situation is.
He currently lives in Seattle, Washington. His clinical pediatrics activity is now limited to being on “first pediatric call” for his 9 grandchildren.