British Society of Immunology
Devonshire House,
60 Goswell Road,
London EC1M 7AD, UK
Dear Sir/Madam,
We write to bring your attention to the brochure ‘Immunity to COVID-19’ released by the British Society for Immunology in collaboration with the UK Coronavirus Immunology Consortium (UKCIC), included below.
We are concerned by the content of the brochure, as it grossly misrepresents the data available on COVID-19 and immunology in general. There are statements and inferences in the brochure that are patently incorrect and appear, by their wording, intended to mislead. This risks bringing public health, vaccination policy in general, and the British Society for Immunology into disrepute. It seems unlikely that either the Society, or UKCIC, being professional bodies, can condone the content of the brochure on which their logos appear.
For clarity, we include the brochure and set out below our concerns with each section. We would appreciate your prompt reply, as we plan to publish the letter on our website per our common practice but believe it appropriate to enable the Society to correct the errors beforehand.
PANDA considers that the inclusion of misleading information on public documents such as this undermines the basic principles of informed consent and medical ethics, and so requires to be addressed with urgency.
We would be glad to discuss further.
Thank you
Sincerely
PANDA
Section 1: ‘What this means for you’
Severe illness from COVID-19 is confined to a small subset of the population, usually over the age of 65 years of age and with significant obesity and/or other chronic severe morbidities (e.g. diabetes mellitus, renal failure, cardiovascular disease).1,2,3 In well children, it occurs at less than 1 /million (less frequently than comparable diseases such as influenza). 4,5 ‘Long-COVID’, like other post-viral syndromes, is real but relatively uncommon, especially for children and adolescents.6
Infection results in immunity that is broader and longer-lasting than that acquired through vaccination,7,8 as it is formed against several immunogenic components of the virus (rather than only a section of the spike protein) and also elicits robust T-cell and IgA mucosal responses.9 ,10,11,12,13 To ignore post-infection immunity, and mention immunity only after vaccination, represents gross ignorance or deliberate misrepresentation.
Vaccination reduces severe COVID-19 from 7-14 days after the second dose.14,15,16 It induces an immune response by causing the synthesis and expression of spike protein near the injection site and in most organs of the body.17 The amount of spike protein will be highly variable as it relies on transcription from injected mRNA taken up by cells, and the immunogenic load from mRNA vaccines is therefore not well controlled. In this regard, they differ from previous vaccines, where a known amount of the immunogen itself is injected. The spike protein is associated with clotting abnormalities and myocarditis.18,19,20,21 and has higher recorded associated mortality in the VAERS database than all other vaccines combined over two decades.22,23 Medium- and long-term effects are not yet available as there is no prior experience with mRNA vaccines in humans. To say it “induces an immune response in a safe and controlled way” is therefore highly misleading. Omitting information about the unusually severe adverse event profile when recommending vaccination would constitute malpractice based on accepted medical ethics.
While it can be correct that vaccination ‘reduces spread’, the authors will be aware that this appears temporary, as UK PHE data shows that from early October those over 30 yo vaccinated were more likely to be infected than the unvaccinated in those age groups,24 and more heavily vaccinated societies are not seeing relative reduction in transmission.25 Informed consent standards would normally require this information to be included.
Section 2: ‘Immune Response’
The wording of this section clearly implies that vaccine-induced immunity is stronger and longer-lasting than post-infection immunity. This is incorrect, as published evidence very strongly indicates that the opposite is the case.26,27,28,29,30,31,32,33,34,35,36 This section appears intended to mislead and is therefore malpractice in a medical sense. It implies the opposite of what the available data indicates. As the Society and UKCIC know how immunity works and would be familiar with the published data, we assume this was published without technical review. Since it’s standard procedure in any health/science related organization for content to be technically reviewed prior to publishing, this content should not have been to the public without the false content being removed.
Section 3: ‘Length of protection’
The duration of protection from post-infection immunity is not known, as SARS-CoV-2 is newly recognized. However, it is known that immunity is very well maintained in most people for at least over 12 months,37,38 and that immunity from SARS-1 (which can reasonably be considered indicative) is detectable after 17 years.39
To emphasize that post-infection immunity ‘reduces over time’, while emphasizing ‘long-term protection’ for vaccination, is a reversal of what existing data overwhelmingly shows. 40,41,42,43,44,45,46,47,48,49,50 Post-infection immunity is as effective or more so, 51,52,53,54,55,56,57,58,59,60,61 and has broader activity against known variants.62,63 This is consistent with expectations of whole-virus exposure compared to a specific segment of a single protein that is known to exhibit high variability in the virus.
This section appears to be worded to deliberately mislead the reader, to an extent that, taking the two statements together, could commonly be considered to be ‘lying’. We assume this was an error, and the section was not technically vetted.
The contention that mild infection produces a weaker effective immune response (as distinct from lower antibody rise) should be verified – data is unclear. However, if correct, it will indicate that the person is relatively unaffected by the virus due to other factors which would be expected to persist, such as prior cross-immunity or a strong innate immune response. It is not therefore a relevant risk, except in people who subsequently become severely immunocompromised. However, immune responses to the vaccine are known to be weaker in older or immune-compromised people.64 To emphasize that ‘even older people’ produce a strong response would therefore appear to be deliberately misleading. Any failure of immunity is more likely in vaccination than in post-infection immunity.
Section 4: Variants
As noted above, post-infection immunity is more broadly active against variants than the vaccines, which are based on the spike protein of a single variant.65,66,67,68,69,70,71,72 This is also predicted by existing knowledge of the virus and how human immunity works. The statements in this section, taken together, therefore seem intended to deliberately mislead the reader, giving the exact opposite impression from what the truth is known to be. As this would constitute lying if written on knowledge of the available data, we assume this section is an error, not vetted by technical review.
Summary Footer
The summary at the bottom of the page includes two statements.
The first, as discussed above, is contrary to current evidence. It is a false statement. As the Society will know this, we again assume this was not written by society members with technical knowledge. The second statement lacks evidence. An antibody response to spike protein is recorded after vaccination of previously infected people. If there is strong evidence to back the claim that this provides significant additional clinical immunity – measurable protection from severe disease or prevention of transmission, it should be presented. Based on published data, there appears minimal advantage if any, but the same adverse events are expected. These adverse events could theoretically be more severe, as
the host will mount a more rapid immune response against their own cells that are producing spike protein, but this also is not well described.
References
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