Vanden Bossche’s Dangerous Fallacy: En Mass Vaccination, Not Natural Infection, As The Source of COVID-19 Variants.

Dr. Geert Vanden Bossche is making a fundamental and dangerous logical error in his argument that mass COVID-19 vaccination should be stopped.

Dr. Geert Vanden Bossche has been promoting the idea that population level COVID-19 vaccination can cause emergence of dangerous SARS-CoV-2 mutant variants capable of immune evasion. Therefore, he proposes that the world should abandon en masse COVID-19 vaccination.

This is potentially catastrophic error in scientific reasoning.

Vanden Bossche’s idea is captured in his statement that “any intervention that increases the population’s immune pressure on the virus *without eradicating the virus* will inevitably lead to selective viral immune escape.”

So Vanden Bossche’s argument goes something like this: because mass vaccination increases “immunological pressure” on the virus it leads to selection of variants capable of evading the immune response. He tries to make an analogy to antibiotic resistant bacteria, which emerge because of the inappropriate overuse of antibiotics.

But these are straw-man arguments Vanden Bossche is making in order to ultimately drive the point that the world should abandon mass vaccinations in response to the COVID-19 pandemic.

This is a profoundly dangerous public health argument, because a logical error sits at its core: That the immunological selective pressure introduced by vaccine immunity is the dominant source of mutant variants.

This assumption is simply false.

Let me explain.

In a pandemic scenario, it is NOT the selective pressure from vaccination that is the primary driver of new variants.

Rather, it is the sheer massive number of naturally infected persons within a relatively short span of time that is the primary force driving the emergence of new variants capable of “immune escape”.

So, Vanden Bossche is totally confusing the primacy of the mutation source (i.e., the population of naturally infected persons) with the selective pressure (i.e., vaccine immunity) leading to expansion of any given mutant. And though the latter is clearly important, in a pandemic scenario the former is the dominant driver of new mutants emerging.

Dr. Vanden Bossche’s error is that he believes that a partially vaccinated population would select for variants that could bypass the vaccine — or worse become resistant to all vaccines. Much like antibiotic resistance occurs.

But the antibiotic resistance analogy is truly a flawed one. Because unlike our antibiotic arsenal, which are limited in numbers and not amenable to updating to fit new bacterial variants, vaccine targets can be updated relatively rapidly — and especially in the case of mRNA vaccines, for which new sequences can be VERY rapidly produced.

So, Vanden Bossche’s dooms day scenario of mass vaccinations causing the emergence of aggressive and unmanageably virulent new variants really borders in fear mongering. I’m sure he is a well intentioned man, but Vanden Bossche is making a very fundamental error.

Let me entertain the Vanden Bossche fallacy for a moment.

It is, indeed, likely that if a vaccine evasive variant of SARS-CoV-2 arises, it will prey selectively on the pool of vaccinated persons, preferentially, and thus become more dominant. He is not wrong. But, such vaccine evasion would not be evidence of vaccine failure. It is an expected phenomenon we deal with annually in the case of the Influenza virus.

In a pandemic where billions of people are susceptible to natural infections, the rise of new variants is more dominantly a function of how many persons are naturally infected. So every infected person is the potential factory where the next new variant could arise.

Fundamentally, I think that Dr. Vanden Bossche is erroneously and vastly over-estimating the importance of the “selective pressure” the population of vaccinated people will exert and conflates it with the mutation source. He almost entirely ignores the actual source of the viable mutants: That is, the number of naturally infected persons.

In fact, it is not a terrible concern when/if vaccine immunity from the current vaccine is bypassed by a new variants. This is what we deal with annually with the Influenza virus. And to solve the problem we adjust the vaccine’s sequence annually.

So, once the SARS-CoV-2 virus drops to endemic levels with, hopefully a cyclical annual metronome like the Flu, we will be able to adjust vaccine sequences as necessary.

My bottom line argument is that the sheer number of persons susceptible to infection and serving as factories for new viral polymorphisms, far outweighs the selective pressure exerted by any single static vaccine. Especially in the current setting, where the present vaccines we have can, and do, protect against infection by the majority of the dominant variants in circulation.

Following Dr. Vanden Bossche’s suggestion to abandon vaccinations based on his “immun evasion” argument will only lead to a higher mortality rate from natural infections in the near term — but it will also lead to the generation of a vast array of new variants from billions of unvaccinated persons who will become naturally infected. This serious error would create what will likely become an impenetrable repertoire of virulent Coronaviruses that will plague humanity for centuries.

In the final analysis, I believe that Dr. Vanden Bossche is genuine and authentic in his belief. But his belief contains a fundamental and highly dangerous error: It assumes that selective evolutionary pressures are more important than the actual source of new mutants.

In my opinion, Vanden Bossche’s main idea is not well thought out and is very dangerous if blindly followed by enough people worldwide. He must reconsider, amend or retract his opinion. Because as it stands, he is posing a serious danger to public health globally — and history will not be kind.

(Please also read my initial critique of Dr. Vanden Bossche’s dangerous idea to abandon en mass COVID-19 vaccination during this pandemic, HERE.)

Hooman Noorchashm MD, PhD is a physician-scientist. He is an advocate for ethics, patient safety and women’s health. He and his 6 children live in Pennsylvania.

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