Welcome to my anti-antivax blog. My pseudonym is Honey badger and I come from Slovakia (the small white spot on the map in the middle of Europe).
Believe or not, there are antivaxers in Slovakia, too. Slovakia is a small country, but it has a strong antivaccination movement. I cannot tell if it is because they are so good or because of a lot of stupid people who believe them here. Anyway, I couldn’t watch the amount of fail in this area, so I started writing this blog. At the top of this blog, there is a logo which is a parody of the logo on a Slovak antivaccination movement website (1). The motto there is a good one and it says: “Bullshit sticks to the people extremely quickly and adhesively, but scraping it off by facts is very hard if not impossible”.
Antivax
doesn’t see the forest for the trees
Have
you ever heard about the Th1/Th2 model of immunity? I guess the answer is yes.
Slovak and Czech antivax chiefs misuse it like you can see in this video (there
are English subtitles, too). It goes like this:
“Immunity is like a Th1/Th2 see-saw. Immunization enhances the Th2 part
and suppresses the Th1 part of immunity and that’s why it causes
immunosuppression, allergies, autoimmune disorders and cancer.” Pretty tricky, isn’t it? Let’s see what the science says.
The
Th1/Th2 model (2) emerged in 1980s from experiments on murine CD4+ cell clones.
From that time, a lot of new research has been done on mice and in humans,
complicating this initially simple hypothesis so much that it is nowadays often
called a paradigm (3, 4, 5, 6). One Czech homeopath and antivaxer, first named
Ludmila (the second person in the initial video) has explained to antivaxers
what the word “paradigm” means. She says that all doctors are living in old paradigmas
because they don’t use alternative “medicine”. That’s funny because she herself lives in a 30 years
old Th1/Th2 paradigm and misuses it to manipulate the masses (see in the
video).
According
to Th1/Th2 paradigm, one is healthy when there is a Th1/Th2 balance. If it
skews to the Th1, it can cause autoimmune diseases, if it skews to the Th2, it
can cause allergies (71 - scroll down for this reference).
However,
there have been a lot of other quite important T-lymphocytes discovered since
1980s, e. g. Th9, Th17, Th22, Tfh and many others, which we know or even don’t
know yet – so I am sorry, but the picture at the top on the right is also
misleading, but less than the antivax model of immunity. It is even more
complicated because these individual lymphocyte subpopulations can change their
profile (s. c. plasticity, 8). Other very important T-cell type include
regulatory T-lymphocytes (s. c. Tregs, 7) which regulate the immune response (22).
An
antigen is recognized by a small amount of lymphocytes out of a number of total
body lymphocytes. This small amount of them is activated thereafter (s. c.
clonal selection, 9) and so there is no Th1/Th2 see-saw in the body as a whole.
Similarly, there is no such a thing like aluminium adjuvants shocking the
immune system and totally disbalancing it as the antivaxer Bert Ehgartner says
(10, 72).
“Vaccination stimulates Th2 immunity
one-sidedly and weakens the Th1 immunity”:
According
to Th1/Th2 paradigm, Th1 suppresses Th2 via interferon gama (IFNgama) and on
the contrary, Th2 suppresses Th1 via interleukin 4 and 10 (IL4, IL10). However,
this antagonism is not absolute because Th1 produces IL2 which stimulates a lot
of lymphocyte subtypes (including both Th1 and Th2 lymphocytes) (11 – scroll
down for this reference). There are also other mechanisms of co-operation of
these T-cell subsets (12).
Also
Th2 does not solely mean only antibodies. Th2 type response enhances production
of IgG4, IgA and IgE antibodies, Th1 supports the production of IgG1 (13). Antibodies
connected to an antigen (s.c. opsonization) can be connected with their Fc part
to Fc-gama receptors of fagocytes which helps the Th1 immunity fight
encapsulated bacteria, e. g. hemophilus, pneumococcus or meningococcus. That
means, serological studies (antibody level) tell us not only about the Th2
immunity but also about Th1. Serological studies are made because they are
simpler and cheaper than Th1 immunity tests. Of course, there are studies on
Th1 immunity response and they say that vaccination strengthens not only Th2
but also Th1 immunity (14).
Allergies:
Besides
the Th2 cells, there are also other T-lymphocytes subtypes which contribute to
the pathogenesis of allergies, e. g. Th1, Th9, Th17, Th22, ILCs, etc (15, 16,
17, 18, 19). Tregs are very important,
too (20, 21). So asthma can be divided to Th2 mediated (the majority) which is
usually mild or moderate and responses well to the treatment, and non-Th2
asthma which is severe and does not response well to standard treatment (17,
18). On one hand, in acute atopic eczema, Th2 response is characteristic, on
the other hand, in the development of chronic atopic eczema, Th1 response plays
an important role (19).
Most
quality studies have not found a link between vaccination and increased risk of
allergies (23), also homeopaths following the results of epidemiological
studies dissociate themselves from this link (24) and moreover, there are
studies suggesting a protective impact of childhood vaccination on atopic
disorders (25, 26). I think that antivaxers, reading these sentences, are being
pissed off, but it is really not a cherry-pick because antigens-allergens with
aluminium adjuvants can be used as a causal treatment (while Ludmila’s
homeopathy is not causal and even not a treatment) of allergies in certain
indications. It is called allergen immunotherapy (27, 28). There are a lot of
studies, including randomized double blind placebo controlled ones, which show
its effectiveness (e. g. 29, 28) and safety (e. g. 31). The most serious side
effect is anaphylactic reaction which can occur more common than in “classic”
vaccination because of the principle of allergen immunotherapy. In spite of
that, this reaction is rare when the procedure is done lege artis (32, 33). Because
the antivaxers are uneducated, they often confuse vaccination and allergen
immunotherapy (34) and so, e. g. Slovak antivaxers use allergen immunotherapy
side effects as a proof that vaccination does harm. That’s so gross… The biggest difference is
that in allergen immunotherapy, an allergen is applied at low doses at the
beginning, then the dose is escalating gradually. The schedule is different
from immunization schedule (35). Allergen immunotherapy is a tertiary
prevention, immunization is a primary prevention (34). There are several
possible mechanisms how it works but the most important is an influence on the
activity of Tregs and modulating the activity of T-helpers (36, 37). Aluminium
can be used as an adjuvant and it has a depot function (38, 39).
Autoimmunity:
One
would probably say that autoimmunity is nothing but bad. To tell the truth,
autoimmunity at low level is useful, e. g. to eliminate old and damaged cells
or cancer cells (40). An autoimmune disease develops when the autoimmune
reaction leads to tissue damage. Our body has some tolerance mechanisms as
well, which prevent autoimmunity, and these mechanisms fail, when an
autoimmunity disorder occurs.
According
to Th1/Th2 paradigm, an excessive Th1 response leads to autoimmune diseases
(41, table 1). Now, it is funny to watch the antivax steps. One of the Slovak
antivax chiefs, Marian, sticks to the paradigm and says that vaccination causes
Th2 mediated autoimmune disorders (minority) such as SLE. However, even SLE is
not caused purely by the Th2 part of immunity (42, 43). Ludmila says that
vaccination causes autoimmunity in general, Th1, Th2, whatever, it must be the
vaccines.
The
mechanism will be made somehow. And it was, by who else than chronically famous
duo Lucija Tomljenovic and Chris Shaw (44). They suggest an LPS contamination
of vaccines as a factor which skews the immune response to Th1 and thus causing
autoimmune disorders (41). Is such a thing even possible? Yeas, it is…
Vaccination
can cause autoimmune diseases rarely, possibly via molecular mimicry mechanism
(47) or bystander effect (48, 73). E. g. GBS after swine influenza vaccine in 1976
or ITP after MMR vaccine (45, 46). However, infectious diseases themselves are
a bigger risk factor for autoimmune disorders, e. g. GBS (49) and e. g. viruses
like morbillivirus or mumps virus can be a risk factor for the development of
DM1 (50, 51, 52). Most of studies haven’t found a link between vaccines and DM1,
multiple sclerosis or IBD (23, 46).
I
would like to mention as well, that autoantibodies is not the same as
autoimmune diseases (AD). Autoantibodies can be found in healthy subjects as well
as autoantibodies need not be present in individuals with AD. Autoantibodies
support the diagnosis of an AD, but they need not be involved in the
pathogenesis of that disease. E. g. in Hashimoto’s thyroiditis, autoantibodies
against thyroid peroxidase can be detected, but in the pathogenesis of this
disease, autoreactive T-lymphocytes and not the autoantibodies themselves are
mainly important (53 – scroll down for this reference, 54).
Cancer:
Th1
immunity is very important in fighting cancer, Th2 is also not useless (55, 58
– scroll down for this reference). Th2 acts e. g. via ADCC (56) or complement
activation (57). Weak Th1 immunity can be a risk factor for the cancer development
and so some cancer treatment approaches on the base of this hypothesis has been
tested, e. g. IFNalpha or BCG vaccine. IFNalpha can be used, e. g. in the
treatment of hairy-cell leukemia or AIDS-related Kaposi’s sarcoma, but IFNgama is not used
because of its side effects (59). BCG vaccine is partly useful in the treatment
of bladder cancer (60, 11 – scroll down for this reference).
Saying
that vaccines cause cancer is an unconfirmed hypothesis till now, but when we
look at the other side, we can see the studies supporting the hypothesis that
vaccines prevents cancer so much that it is not a hypothesis any more. It is
the matter of HPV and HBV vaccine.
HPV
vaccine is effective in protection against infection with the most frequent and
pathogenic types of HPV virus, genital warts and precanceroses CIN, VIN, VaIN
and others (61, 62, 63, 64, 65, 66). Since the CIN is a precancerose of
cervical carcinoma, the incidence of this cancer is expected to decrease in the
next few years, studies are on the way.
Approximately
5% of HBV infections in adults progress to chronic infection. This percentage
is much higher, when the infection is contracted by children under 5 (30-50%)
and even higher in children under 1 year of age (90%). About 20% of people with
chronic HBV infection die prematurely because of cirrhosis or hepatocellular
carcinoma. Vaccination against HBV in some countries with higher incidence of
hepatitis B reduced significantly not only the incidence of this disease but
also its complications – including hepatocellular carcinoma (67, 68, 69, 70).
Conclusion:
Conclusion:
In
spite of criticizing the Th1/Th2 paradigm on the base of new studies, the aim
of this article is not to discredit this hypothesis totally. The aim of this
article is to point out that antivax chiefs “abuse” and fudge this hypothesis as they prefer and want regardless the new studies, thus manipulating antivax
members and blinding them, so they cannot see the forest for the trees.
References:
6. http://www.ncbi.nlm.nih.gov/pubmed/12946237
7. http://www.ebioscience.com/knowledge-center/cell-type/t-regulatory-cells.htm
7. http://www.ebioscience.com/knowledge-center/cell-type/t-regulatory-cells.htm
11.
Horejsi et al.: Immunology basics, 4th edition. 2009
21. http://www.ncbi.nlm.nih.gov/pubmed/16264056
22. http://www.who.int/immunization/documents/Elsevier_Vaccine_immunology.pdf
23. http://pediatrics.aappublications.org/content/111/3/653.full
22. http://www.who.int/immunization/documents/Elsevier_Vaccine_immunology.pdf
23. http://pediatrics.aappublications.org/content/111/3/653.full
41.
http://www.ncbi.nlm.nih.gov/pubmed/22235057 (table 1)
53.
Litzman et al.: Diagnostic basics in clinical immunology. 2007
58.
Robins et al.: Cancer immunology. 2001
59. http://en.wikipedia.org/wiki/Cancer_immunotherapy#Interferon
71.
Jesenak et al.: Vaccination in special situations. 2013
February 27 2014, Honey badger
