Published on TrialSite (August 25, 2021)
My name is Geert Vanden Bossche. I received my PhD in Virology at the University of Hohenheim, Germany, and I have held adjunct faculty appointments at universities in Germany and Belgium. I also have worked in R&D and vaccine development for GSK, Novartis, and Solvay Biologicals. Next I was a Senior Program Officer for the Gates Foundation’s Global Health Discovery team, and from there went to the Global Alliance for Vaccines and Immunizations (GAVI) and was the Senior Ebola Program Manager. Then I joined the German Center for Infection Research as head of the Vaccine Development Office. Currently, I work as a consultant on biotech/vaccine issues, and I also do my own research on “natural killer” cell-based vaccines. I have argued that immune escape due to the current COVID-19 vaccines is driving new variants as the virus evolves its way around the inoculation. Dr. David Gorski is a Wayne State University of Medicine (Detroit) associate professor in oncology and surgery. He is also chief of the breast surgery division. Gorski has launched several “hit pieces” about me and my views. In one article, he attacks the notion that vaccines have a part in driving variants. He also has criticized YouTuber/intellectual Brett Weinstein for supporting the use of ivermectin in our pandemic.
Lack of Expertise
In my view, Gorski is both stigmatizing honest scientists and seemingly trying to create socially-dangerous tensions between the vaxed and the unvaxed and between medical experts who hold different views on our current vaccines. Gorski creates false dichotomies wherein one is good (pro-vaccine, put faith in government) or bad (anti-vaccine, open to alternate views and arguments), and this type of discourse and rhetoric is incompatible with science.
Gorski is also largely scientifically illiterate in the fields of virology, immunology, vaccines, and evolutionary biology. He cannot see that both the vaccinated and the unvaccinated are involved in the evolutionary dynamics of the pandemic; his effort to blame the latter category is unfair and potentially dangerous. Dr. Gorski is quick to mix up unrelated topics to create parallels that don’t make sense. He unscientifically conflates or compares data about: live vaccines and inactivated vaccines; epidemics and pandemics; measles and SARS-CoV-2; herd immunity and vaccine coverage rates; efficacy with effectiveness in vaccines; and sterilizing immunity with transmission-reducing immunity.
He also unfairly lumps me in with antivaxxers when I am pro (beneficial) vaccines. Much of this is likely based on the fact that Gorski’s expertise is largely lacking. His professional expertise in breast surgery seemingly does not allow him to opine intelligently about the topics at hand. And he regularly gets tangled up in his own misunderstandings and contradicts himself. Also, he sets himself up as a maximal “pro-vaxer” despite the noted lack of expertise in the various disciplines that apply to vaccination during a pandemic.
Gorski possesses no understanding of the workings of innate immunity, i.e., innate oligospecific antibodies or natural killer cells. He does not know the difference between innate (i.e., polyreactive) and naturally-acquired (i.e., antigen-specific) antibodies. This is clearly reflected by Gorski’s list of ‘factors proposed to explain the difference in severity of COVID-19 in children and adults’. None of these factors could explain why not only children, but any young and healthy individual, could become susceptible to Covid-19 disease only a few months after they got asymptomatically infected. This can only be explained as a result of suppression of protective, innate antibodies by spike-specific antibodies (including vaccinal antibodies) as the latter outcompete innate antibodies for binding to SARSs-CoV-2. Gorski’s list, therefore, is completely irrelevant in regard of the overarching mechanism of natural immune protection against Covid-19.
He doesn’t have the wherewithal to understand the difference between naturally acquired immunity’s sterilizing cell-mediated immunity (CMI) and the S-based vaccines’ lack of CMI. He fails to see that there is currently no evidence of population-level immune selection pressure on CMI-mediated, sterilizing immunity induced in previously symptomatically infected persons. He doesn’t seem to realize that only a minor fraction of the population acquires protective immunity against COVID-19, whereas the vast majority are naturally protected by their first line of innate immune defense (a notion, he obviously didn’t even hear about).
Gorski specifically claims that younger people are now getting infected more because, “the variant is so much more transmissible and, therefore, the higher the percentage of the population that needs to be immune.” He doesn’t even seem to realize that these younger (<65 years) and healthy people (i.e., the majority of the population) proved to be immune during the previous waves. So why would they all of a sudden lose their immunity a few months later? Further hurting his credibility, Gorski refers to ivermectin as an “anti-worm” drug and wildly misrepresents the evidence so far showing that it can help with COVID-19. Again pushing the false either/or paradigm, he puts ivermectin in the “bad” category without any nuances.
Contradictio in Terminis
The doctor seems to miss the fact that, “spreading” SARS-CoV-2 relates to infection or pathogens, not to the disease they may potentially cause. Gorski seems to forget that despite the fact that all knew that the efficacy of these vaccines was not 100%, the primary goal of these mass vaccination campaigns was to generate herd immunity. Now, maybe Gorski doesn’t really understand what herd immunity is about, but it suffices to remind him that it relates to the observation that unimmunized people can be protected provided the vaccine coverage rate in the population is high enough to prevent viral transmission. Gorski is trying to make people believe that herd immunity would imply vaccination of the total population, which is almost a contradictio in terminis.
By going to ridiculous extremes to make his case, Gorki is basically just making himself ridiculous. He also lumps me in with folks claiming that stray spike proteins from the vaccinated are causing major harm, when I have never taken that view. He thinks that because a virus has a somewhat higher infectiousness, it will in no time dominate all other circulating variants, no matter the pressure that is exerted by the human population. All of the more infectious variants were isolated before end 2020. So why is it that only quite recently have the more competitive ones started to spread widely? For somebody who obviously has big holes in his knowledge of virology and basic immunology, it can, indeed, be difficult to understand that viral spread in a population is determined by the interplay between viral infectious pressure and population-level immune pressure. The most blatant example of this is where he contradicts himself in saying: ‘Vaccines is a selective pressure’. Per definition, though, selective pressure is known to drive immune escape. And thus, according to Gorski, ‘vaccinating as many people as possible as fast as possible’ is the way to go!
“Quo vadis, homo sapiens?”
It is simply impossible to achieve herd immunity with these vaccines for reasons I clearly explained in my contribution titled, “Quo vadis, homo sapiens?” No matter the level of uptake of these vaccines, they’ll never produce any kind of herd immunity, as they’re merely turning young and healthy people (who’re naturally capable of eliminating the virus) into asymptomatic spreaders. Secondarily, herd immunity has nothing to do with immune selection pressure. On the contrary: neither innate antibodies nor immunity induced by recovery from disease (i.e., the only 2 types of immunity that contribute to herd immunity) are spike (S)-directed, so they do not exert selection pressure on viral infectiousness (i.e., determined by S), in contrast to the immune response induced by vaccination. Gorki is among the many stubborn know-it-alls who pretend that further increasing vaccine coverage rates will stop the virus from spreading and further evolving. All this without any single scientific argument backing his statement. Substantial outbreaks are still taking place in countries with high vaccine coverage rates, clearly demonstrating that vaccine-induced herd immunity is a myth.
Gorski is also completely missing the point on the lambda variant. He stares at different variants in regard of their sensitivity to vaccine-induced neutralization whereas the key message of the publication I alluded to was that i) increased viral infectiousness is insufficient to ensure sustained viral transmission in a massively vaccinated human population (i.e., a population that exerts widespread spike-directed immune pressure on viral infectiousness and ii) that additional mutations in the N-terminal domain (NTD) of the spike protein may substantially contribute to the decreased neutralizing capacity of vaccine-induced antibodies against any given variant (as mutations in the RBD alone may not explain the decreased neutralizing titers). In other words, variants may incorporate additional mutations in the NTD to dramatically increase their resistance to vaccine-induced anti-S antibodies. This mechanism of escape neutralization is of course very problematic if it occurs in a variant that as already a high level of infectiousness (e.g., delta variant) as this may lead to a steep increase in morbidity and mortality rates in the population. Gorski’s conclusion that ‘there is plenty of reason to conclude that the vaccines offer considerable protection against at least severe disease from these variants’ is, therefore, anything but based on an understanding of the virus’ evolutionary adaptation to enhanced, widespread immune pressure on viral infectivity. As a matter of fact, a such dramatic combination of high infectiousness and complete resistance to wild-type spike vaccines has recently been reported https://www.biorxiv.org/content/10.1101/2021.08.22.457114v1.full.pdf.
We’re curious to learn about Gorski’s predictions on how much protection the vaccines are going to provide against highly infectious variants that are completely resistant against the vaccines…
Vaccine efficacy versus vaccine effectiveness
Regardless of the fact that Gorski does not understand the difference between vaccine efficacy and vaccine effectiveness, he doesn’t even realize that the main issue is not whether or not the vaccine protects 100% or less; the real issue is that imperfect vaccines will enhance propagation of naturally selected immune escape variants, especially if high infectious pressure is combined with widespread immune pressure (due to mass vaccination).
If Gorski is unable to make his point otherwise, he’ll rely on lies:
I never stated that the emergence of more infectious variants was caused by the vaccines as Gorski pretends
I never stated that vaccines are ineffective, dangerous and that they make the vaccinated dangerous to the unvaccinated as Gorski pretends