Mass vaccination is not always the solution

This week, new compelling evidence emerged that the ‘Epstein-Barr’ virus causes multiple sclerosis. The message was accompanied by ways in which Epstein-Barr can be vaccinated away. Earlier, Moderna announced that it has a vaccine in the starting blocks. That remains the understandable first reflex for many: multiple sclerosis is a terrible disease and Epstein-Barr is the cause. Hop, get rid of it. The only good virus is an eradicated virus.

Epstein-Barr belongs to the herpes viruses, a family of viruses that evolved with our bodies over millions of years, and which we carry around as our pets. Long before we were humans, we were already living with herpes viruses. It’s kind of an evolutionary experiment to live without. Infection sooner or later in life is the rule, the so-called ‘seroprevalence’ of some herpes viruses is one hundred percent in large parts of the world. Healthy people also carry the pathogens.

In the western world, we do a lot of these kinds of evolutionary experiments with a large number of viral or bacterial pets, through antibiotics and vaccines. In France, thanks to universal vaccination, chickenpox has become a rarity, as in the United States, Canada, Germany, Japan and Australia. When I was recently on the Paris metro with my two kids-with chickenpox, I kind of felt like I was going into the city as a native. Like you used to look at the last person with disabilities from polio. “Look mom, she’s been through it.”

Vaccination is one of the most life-saving inventions ever. And yet you have to ask yourself where to stop. These pets sometimes bite someone to death or make life very miserable. But how does our immune system, our body, function without them? People without Helicobacter may have had less stomach cancer, but more esophageal cancer. Do those herpes viruses also have a function?

Should We Vaccinate Against Epstein-Barr Viruses? Or should we mainly learn who gets sick and who doesn’t? This lack of knowledge also affects us with Covid. Who should we treat with antivirals? Does everyone really need to be boosted over and over again?

It is also well described for human papillomavirus infections that the bacteria in the environment are strongly associated with the result of the infection. In women with a vaginal microbiome with fewer lactic acid bacteria, the infection is cleared less well, and there is a higher risk of a early stage of cervical cancer develops. Introduction of the HPV vaccine could prevent hundreds of thousands of cases of cervical cancer worldwide every year. And yet it is scientifically unsatisfactory, and a rather clumsy way of doing microbiology.

There was a time when we thought: the only good bacteria is a dead bacteria. The habit of treating any urinary tract infection, ear infection or throat infection with antibiotics has resulted in antibiotic-resistant bacteria becoming a become a major public health problem.

In the Netherlands, we are at the forefront of conservative use of antibiotics, sometimes to the anger of Dutch people from a different health culture. We are also conservative with vaccinations. Chickenpox is tolerated. And Dutch pediatricians, unlike some American or British pediatricians, are quite nuanced about the urgency and necessity of vaccinating children against Covid. Moreover, unexpected indirect and non-specific effects of vaccines, both positive and negative, are far from taboo in virologists or vaccinologists.

And yet our nuanced approach comes under pressure. Now that we’ve been doing nothing but fighting the virus for two years now, I can see how the dogma “the only good virus is an eradicated virus” is gaining new momentum. You can count on the fact that both the Ministry of Health and the Health Council are drawing lessons from the avoidable excess mortality that followed the slow booster campaign.

The Covid generation of administrators and advisors has been tried and tested in fighting infectious diseases, and the best way to do that is to vaccinate early, massively, and repeatedly. How do we ever unlearn that?

Rosanne Hertzberger is a microbiologist.