When you experience a pandemic due to a new virus and wish to administer a vaccine to people in an effort to reduce the impact of this virus on the population, you need to take the long term impact of this vaccine on the evolutionary trajectory of the virus into consideration. I began to warn about this a bit over a year ago, around the same time as Fauci came out and proclaimed that we weren’t going to see the sort of waves anymore that we’ve seen in the past:
I would say that if you go back and read the posts I wrote about the COVID vaccines, they have proven to be generally quite accurate. The evolutionary dynamics ensured that the vaccines rapidly lost their effectiveness, eventually culminating in negative efficacy, first against infection risk, now also against risk of hospitalization and death. We have constant reinfections, hospitalization waves as large as before the vaccines and excess mortality as bad as before anyone had any sort of immunity to this virus, whether natural or vaccine induced.
If you look at the current situation, it’s obvious that the vaccines haven’t just failed, but rather, through their failure have created a situation in which an effective vaccine is now impossible too. Genetic diversity of this virus has increased so dramatically that attempting to vaccinate people against any particular strain will just cause another strain of this virus to infect us instead.
As an example, we’re now getting vaccines against BA.1, even though we’re in the middle of a wave of BA.5. But even a vaccine against BA.5 can’t work, as we already have BA.2.75, which preferentially spreads through the demographic of people who just had BA.5. I think we can all agree that you don’t want to end up in a situation like that with a virus like monkeypox.
And so in that context, I feel like giving a warning once more: The smallpox vaccines are not going to work to suppress this monkeypox outbreak on their own. And if in fact monkeypox manages to become yet another virus that establishes itself in our species, then you will ultimately come to find that widespread vaccination with the currently available vaccines makes the evolutionary trajectory of this pandemic worse too.
Monkeypox is different from SARS-COV-2 in a number of important ways. To start with, by the time we began taking SARS-COV-2 seriously, it had been silently spreading for months. We never had a serious chance to contain this virus. It’s also different in the age demographics it affects. It’s a far more dangerous virus for young children to catch than SARS-COV-2.
Whether we can cope with constant SARS-COV-2 reinfections is a question we’re going to find the answer to in the years ahead. On the other hand, when it comes to endemic monkeypox, I’ll happily offer you the answer: You don’t want this virus to spread freely through the population. Your hospitals are not equipped to cope with the pressure and you don’t want kids to get this virus. You’ve only really seen so far how it behaves in healthy young gay men. You have seen very little of how it behaves in the elderly, children and pregnant women.
What we know about how orthopox viruses spread themselves also suggests that virulence will increase over time: Orthopox viruses have little incentive to keep you alive, they spread by causing your body to be covered by numerous scabs and producing more of such scabs allows them to use you to infect more people. Smallpox was a relatively mild disease for most of its history, but after a few centuries it turned more aggressive.
We’ve talked here on this blog before about how the 85% effectiveness claim came into existence: People in Congo in the 80’s were observed during a monkeypox outbreak and there they arrived at an estimated effectiveness of 85%. That’s one study. If you go back you’ll find other studies that suggested a lower effectiveness, but that’s not my main concern right now.
Rather, we’re comparing apples to oranges again. We’re comparing a population that was vaccinated with a replication competent vaccine, to people who are being vaccinated with the non-replicating JYNNEOS vaccines. And what we observe is that although antibody levels are similar, effectiveness in preventing infection is much lower for the non-replicating JYNNEOS vaccines.
As you may have noticed, there are already numerous breakthrough infections from monkeypox being observed in people who received the first shot of the JYNNEOS vaccine. Such breakthrough infections are also observed in animals who received two doses of the vaccine, even at the peak of the immune response.
In other words, these vaccines are never going to accomplish what we need to accomplish. Rather, they will just facilitate something that shouldn’t be happening: Gay men thinking they can now safely practice anonymous sex with multiple partners and end up with a mild monkeypox infection. It appears we have already seen the first cases, not just of vaccinated men getting this virus, but vaccinated men getting it and passing it on to other vaccinated men.
And so I’m going to say it again: You need to get down to zero cases of human to human monkeypox transmission if you don’t want to end up burying your own children, or leaving your children a world behind where they will have to bury their own children again. Infections in Africa, where they have animal reservoirs, are probably unavoidable, but human to human transmission needs to stop if you don’t want vast human misery.
The longer it takes before people realize they need to eradicate this virus, the more painful the measures that will be necessary to accomplish it. Right now you could get below r0 with relatively simple measures like implementing proper quarantines for infected people, proper contact tracing and preventing mass gatherings like Southern Decadence. As time goes on almost every factor starts to work against us, so if it’s not contained very soon, it won’t be contained.
But rather than taking the approach we took with the previous monkeypox outbreak in the US, or the Ebola outbreak in West Africa, we’re YOLOing this virus. We’re giving people a vaccine, where we have no clue how effective it really is and thereby we give them a false sense of protection. The kind of people lining up to receive these vaccines don’t have very in depth scientific knowledge of how vaccination works, or how orthopox viruses behave, or how mass vaccination with non-replicating vaccines affect the evolutionary trajectory of pandemics. They just want to get back to sodomizing each other, without having to worry about getting sick.
And just in case you’re thinking this is me coming up with another crackpot theory, I would recommend you to listen to an African virologist, who has experience on the ground with this virus. He is explicitly warning the world: You can not deal with this virus by simply vaccinating people at high risk, that’s the wrong strategy.
The crackpot theories are ideas like “monkeypox is actually just shingles from the COVID vaccines” that circulate on Twitter. The sad reality we are faced with is as following: We’re witnessing exponential spread of a virus that is related to smallpox. Deploying replication incompetent vaccines designed for smallpox, as the recipients are being exposed to this virus, is how you give this virus the opportunity to look at our battle strategy, which allows this virus to adjust its own battle strategy through evolution.
It would be questionable enough if we were vaccinating people with these vaccines against monkeypox with no good evidence of their effectiveness, but what makes it doubly stupid is that we’re vaccinating them as they are busy catching this virus. That’s how you give it the opportunity to train itself against our antibodies. You’re right now in the process of making any hypothetical future mass vaccination program against this virus more difficult.
You’ve seen how this has worked with SARS-COV-2: We now have a cocktail of widely diverging variants, all spreading across the globe, all largely resistant to the vaccines that people received three or even four shots of.
But as you might have figured out by now, the stupidity is always worse than it looks. The US has insufficient doses of this vaccine for every dude who wants a shot, so they came up with a new solution to that: They’re going to split the dose in five parts and inject it less deep into your arm, so they can vaccinate five times as many people. For these intradermal administrations, the long-term immune response proved to be lower than for the regular full dose administration.
And so you can already anticipate what the disaster scenario would look like: We give the high risk demographics these mediocre vaccines, we YOLO the administration route, we find out after a few months that the virus isn’t dying out, the breakthrough infections have led to increased genetic diversity and even increased intrinsic virulence (Marek’s disease), we begin developing better vaccines specific for monkeypox, but by the time those better vaccines are deployed genetic diversity has increased so much that we still get plenty of breakthrough infections.
So why didn’t this happen with smallpox, why did we manage to genuinely eliminate smallpox instead of giving rise to all sort of vaccine evasive variants? Well for a number of reasons:
-We used live replicating vaccines, rather than the non-replicating JYNNEOS vaccine.
-Only a small share of the population consisting of young children were vaccinated at any given time, most people would already have been vaccinated decades earlier, or were survivors with natural immunity.
-When people were vaccinated, they were not directly being exposed to the virus. We’re now going to start vaccinating droves of people, as they’re being exposed to monkeypox. That’s how it gets plenty of opportunity to develop new variants of itself.
-People could very rarely be reinfected with smallpox, but only when exposed to a very high infectious dose. We’re now going to have people who get this virus, recover and end up having anal sex with men with active infections again soon afterwards. In an era in which people were in monogamous and heterosexual marriages and the vast majority of the population had immunity, reinfection was thus very rare. But with monkeypox? The WHO is already warning people to avoid getting infected again.
In other words, although the eradication of smallpox through vaccination was a success, that doesn’t mean vaccines are going to be a Get Out of Jail Free card when it comes to a novel virus jumping into a largely immunologically naïve population.
So is that the solution then, for us to vaccinate everyone with the old ACAM2000 vaccines? Not really, because that’s not possible in the current situation either. Remember, it was almost always young healthy children who we vaccinated. We now have droves of immunocompromised people: The elderly, obese people, people with HIV, etc. When we were busy eradicating smallpox, we didn’t have that situation. The replicating vaccines are a danger to immunocompromised people and could even give birth to two orthopox viruses spreading through the population simultaneously.
When you receive the ACAM2000 vaccines, you’re supposed to isolate yourself from immunocompromised people, so vaccinating droves of people with that vaccine isn’t going to work. Remember, these vaccines were not designed with the idea of bailing us out after we screwed up during the exponential spread of a monkeypox strain. They were designed so people in biolabs can toy with these viruses without dropping dead when they screw up.
You might think I’m being hysterical, but that’s because you grew up in an era with a 0.5% infant mortality rate. If your great-grandparents had an IQ above 100, were well read and could have heard about this virus now spreading through Western nations, they would take it seriously. And yet, as all of this is going on, we’re seeing plans for hundreds of thousands of gay men to gather together in New Orleans, a guaranteed superspreader event.
But let’s pretend for a moment that we manage to develop effective vaccines against monkeypox. A year from now we start deploying them. How long do you think it will take, before the people in the slums of Peru get access to these vaccines? How long until Lagos, Nigeria gets them? How long until you get these vaccines to active warzones, like Syria or Eastern Ukraine? It took us centuries to eradicate smallpox, with constant setbacks along the way.
And unlike smallpox, which had completely zoomed in on our species and evolved into a specialist for causing human misery and had no known animal reservoirs, monkeypox is still a generalist. It’s readily infecting people’s dogs as we speak, the first medically confirmed case has already been spotted. Eradicating a human virus with animal reservoirs hasn’t been done before.
You need to get down to zero cases of monkeypox. These vaccines are not going to get you there. Rather, these vaccines are going to leave gay men with little scientific knowledge but high trust in authorities under the impression that they’re now safe to do as they please again. You don’t need any fancy theories about original antigenic sin or ADE to see the problem: If you take the simple fact that vaccination gives people a false sense of safety that translates into behavioral changes, then you’re already potentially looking at negative efficacy.
Note by the way, what I’m not saying: I’m not saying that these vaccines are per definition bad as a prophylactic treatment for people who have recently been exposed. If you’re dealing with a young kid who was exposed at a daycare to this virus then you have other worries than the evolutionary dynamics of this virus or how people’s behavior will change. Rather, I’m saying that these vaccines are being used as a false solution that will end up making the problem worse. You don’t want to “manage” this virus, or “reduce your risk”. You want to exterminate it, while you still can.