Science-by-committee: compromising the immunocompromised?

It sounds like a no brainer. Why would you want to further compromise the immune system of someone whose immune system is already compromised? And yet that is what the “expert” committees all around the globe are advocating with their “science-by-committee” advice recommending booster COVID vaccination.  

Science-by-committee lacks any proven clinical benefit

There just isn’t enough data yet to prove an additional benefit to COVID vaccine booster shots. It’s not about the risk – benefit ratio, because how can the benefit of a booster outweigh the risk when there is no evidence to support any benefit at all in people who already have challenged immune systems?  The immune systems of those with immunodeficiencies are first weakened by their underlying conditions, and then twice more by COVID vaccines, which deplete their already compromised defence mechanisms.  

Immune system deficiencies are unfortunately quite common. Immunodeficiency is generally acquired as the consequence of an immunological problem (e.g., multiple sclerosis), infectious diseases (such as HIV), cancer (especially blood cancers such as leukaemia) or by drugs designed to suppress hyperactive immune systems as when steroids are used to treat severe asthma and arthritis.

To really determine whether a booster will make a difference in keeping an individual out of the hospital is complex and requires a range of costly tests and some expert interpretation – not available everywhere. These studies would be very specific to individuals and so are not currently underway.  Besides, it is difficult to recruit patients who are already very sick into clinical vaccine trials – especially if the patients are functioning on a reduced immune system.

Then there is the vexatious issue of efficacy, which I have written about before.

To be of any use, the booster will have to help a patient mount at least the same response as before for a third time and then hope that what little immunity these patients have returns for a third time. 

“Science-by-committee” is not clinical science. Whether it is motivated by legitimate public health concerns or cynical political considerations, the potential negative effect on those with immune deficiencies will be the same.  There are many of us who remember similar misdirections that have occurred in the practice of medicine. For example, in the mid-twentieth century, it was the consensus view that stomach ulcers were caused by eating certain foods. We now know that a bacterium, Helicobacter, is the primary culprit. The ground-breaking discovery was made by two doctors working in a clinical setting, not by a committee of scientists being pressured by lay government officials who answer to a COVID-weary electorate. 

Caring for individuals with complex problems should not be controlled by unproven fears about the effects on public health. As clinicians, we promise to care for individuals. It is time for individuals and their personal clinicians to do what they do best. Work together and make conjoined decisions based on the history and needs of that particular patient. 

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