Non-specific vaccine benefits

Interesting article about how vaccines do more than just protect against that one thing they were made for:

https://www.bbc.com/future/article/20200915-the-mystery-of-why-some-vaccines-are-doubly-beneficial

It was around a year after the vaccinations began that they made an extraordinary discovery: those who had been vaccinated against measles were 50% less likely to die than those who hadn’t. “It was stunning,” says Aaby – but not for the reasons you might at first think.

The thing is, measles was never killing anywhere near half of Guinea Bissau’s children. Based on the proportion who were dying of the disease originally, the vaccine should have been far less beneficial than it was. The numbers didn’t add up. “We were asking ourselves ‘How can this happen?’,” says Aaby.

In the large-scale trials that followed, it emerged that the vaccination was reducing the chances of children dying by a third (other studies led to significantly higher estimates) – while only 4% of this decline was explained by the fact that it was preventing them from catching measles. This is the power of a mysterious phenomenon Aaby has called “non-specific effects”.

The above was about the MMR vaccine, but other vaccines have had similar positive effects:

Research in Guinea-Bissau found that people with scars from the smallpox vaccine were up to 80% more likely to still be alive around three years after the study began, while in Denmark, scientists discovered that those who had the tuberculosis vaccine in childhood were 42% less likely to die of natural causes until they were 45 years old.

I need to find an article my boss shared with me about the MMR vaccine being protective against COVID-19.  Remember that Navy ship that turned back to shore because COVID was spreading like wildfire on board?  Hundreds were infected, but very few got seriously ill.  It helps to be young and strong, but apparently it's routine for every new sailor to get an MMR vaccine, regardless of their immunization status.  There's evidence that this made a difference...

The attenuated live vaccines may be more effective than killed vaccines in general, but I also saw a simple medical record study that showed hospitalized COVID patients who had gotten a flu shot (which is not a live vaccine) had better outcomes than COVID patients who had not gotten a flu shot.  

I find it interesting that vaccines can be good for you just in general.

I dont agree with the summary/finding.

those who (rich, educated, two-parent family, with European-ties) had been vaccinated against measles were 50% less likely to die than those who hadn’t.

I think that it is important to note that correlation is different from causation: I would hazard to say that the reason why those kids were less likely to die or go to college or pick up rockclimbing or sailing as a hobby has alot to more to do with their parents lifestyle and less to do with MMR vacines

S Bengi wrote:I dont agree with the summary/finding.

those who (rich, educated, two-parent family, with European-ties) had been vaccinated against measles were 50% less likely to die than those who hadn’t.

I think that it is important to note that correlation is different from causation: I would hazard to say that the reason why those kids were less likely to die or go to college or pick up rockclimbing or sailing as a hobby has alot to more to do with their parents lifestyle and less to do with MMR vacines

Not sure where you got the information that the children vaccinated were "rich, educated, two-parent family, with European-ties".  I read the study and it said 90% of the children there got it.  According to Wikipedia, the ethnic groups are as follows:  "The population of Guinea-Bissau is ethnically diverse and has many distinct languages, customs, and social structures.

Bissau-Guineans can be divided into the following ethnic groups:

Fula and the Mandinka-speaking people, who comprise the largest portion of the population and are concentrated in the north and northeast;
Balanta and Papel people, who live in the southern coastal regions; and
Manjaco and Mancanha, who occupy the central and northern coastal areas.
Most of the remainder are mestiços of mixed Portuguese and African descent.

Portuguese natives comprise a very small percentage of Bissau-Guineans. After Guinea-Bissau gained independence, most of the Portuguese nationals left the country. The country has a tiny Chinese population.[54] These include traders and merchants of mixed Portuguese and Chinese ancestry from the former Asian Portuguese colony of Macau."

Wikipedia also mentions their economic health and education:  "Guinea-Bissau's GDP per capita is one of the lowest in the world, and its Human Development Index is one of the lowest on earth. More than two-thirds of the population lives below the poverty line.[43] ".  "Education is compulsory from the age of 7 to 13."

That information leads me to believe that there is more to this than wealth and education saving these children's lives.

I have read several other articles that pointed out the same non-specific benefits to vaccines.  In the case of Covid, the TB vaccine seems to correlate strongly to less chance of infection.  Note that most people receiving the TB vaccine are poor, uneducated people in third-world nations.  

I reached out to some friends that work in a hospital to see if I could get it, but it is very hard to get the TB vaccine in the US.  I did get another MMR vaccine.  I have had it in the past, but a doctor I know was willing to give me a booster.  Whether or not it helps protect me from Covid is going to be pretty much impossible to determine I think.

Julia Winter wrote:Interesting article about how vaccines do more than just protect against that one thing they were made for:

https://www.bbc.com/future/article/20200915-the-mystery-of-why-some-vaccines-are-doubly-beneficial

It was around a year after the vaccinations began that they made an extraordinary discovery: those who had been vaccinated against measles were 50% less likely to die than those who hadn’t. “It was stunning,” says Aaby – but not for the reasons you might at first think.

The thing is, measles was never killing anywhere near half of Guinea Bissau’s children. Based on the proportion who were dying of the disease originally, the vaccine should have been far less beneficial than it was. The numbers didn’t add up. “We were asking ourselves ‘How can this happen?’,” says Aaby.

In the large-scale trials that followed, it emerged that the vaccination was reducing the chances of children dying by a third (other studies led to significantly higher estimates) – while only 4% of this decline was explained by the fact that it was preventing them from catching measles. This is the power of a mysterious phenomenon Aaby has called “non-specific effects”.

The above was about the MMR vaccine, but other vaccines have had similar positive effects:

Research in Guinea-Bissau found that people with scars from the smallpox vaccine were up to 80% more likely to still be alive around three years after the study began, while in Denmark, scientists discovered that those who had the tuberculosis vaccine in childhood were 42% less likely to die of natural causes until they were 45 years old.

I need to find an article my boss shared with me about the MMR vaccine being protective against COVID-19.  Remember that Navy ship that turned back to shore because COVID was spreading like wildfire on board?  Hundreds were infected, but very few got seriously ill.  It helps to be young and strong, but apparently it's routine for every new sailor to get an MMR vaccine, regardless of their immunization status.  There's evidence that this made a difference...

The attenuated live vaccines may be more effective than killed vaccines in general, but I also saw a simple medical record study that showed hospitalized COVID patients who had gotten a flu shot (which is not a live vaccine) had better outcomes than COVID patients who had not gotten a flu shot.  

I find it interesting that vaccines can be good for you just in general.

Great article, thanks for sharing!!

Please let me know if i am confused about the science, as i am far from a medical expert.

If i recall, one of the theories i have seen for these effects is how damaging some of their illnesses are to the immune system. So basically, you get measles  (i think measles was cited as one of the most damaging), it wipes out your immune system, and during the recovery over the next year or so, you die of something your immune system normally could handle. I know, for example, my aunt, who had diptheria and scarlet fever as a child, (possibly also tuberculosis? There are some translation issues)  has had a delicate immune system for the rest of her life, and took months to recover from those illnesses, stuck in a hospital. I am sure during those periods of recovery, she was far more susceptible to whatever disease was floating around.  (She was lucky, of my grandmas 4 kids, 2 died by age 3 of things we now vaccinate against, and several kids my dad knew were in a wheel chair from polio).

I think there was also some evidence about recent vaccination for tuberculosis being effective in reducing severity of infection from COVID, which was interesting.

One of the other interesting things about even incomplete vaccination success is the reduction of severity of infection. I am mildly immunocompromised, and ended up catching chicken pox as an adult, despite being vaccinated against it (we now know you need two doses for good long term immunity, i only got one). Instead of being this horrific experience as it often is for adult patients,  i had a few (<10) itchy bumps, far milder than even most childhood cases.

Trace Oswald wrote:Not sure where you got the information that the children vaccinated were "rich, educated, two-parent family, with European-ties".  I read the study and it said 90% of the children there got it.  According to Wikipedia, the ethnic groups are as follows:  "The population of Guinea-Bissau is ethnically diverse and has many distinct languages, customs, and social structures.

If 90% of the children received the vaccine, the correlations might relate more to the reasons the 10% were not willing, or able, to have their children vaccinated.

John Wolfram wrote:

Trace Oswald wrote:Not sure where you got the information that the children vaccinated were "rich, educated, two-parent family, with European-ties".  I read the study and it said 90% of the children there got it.  According to Wikipedia, the ethnic groups are as follows:  "The population of Guinea-Bissau is ethnically diverse and has many distinct languages, customs, and social structures.

If 90% of the children received the vaccine, the correlations might relate more to the reasons the 10% were not willing, or able, to have their children vaccinated.

According to the study, parents keep the children's vaccination cards.  In some cases they were lost or the parent wasn't available, so the child was considered not vaccinated, regardless of whether they were or not.  I'm sure there are other reasons as well, but it didn't specify those that I saw.

In a 3rd world country where the average person makes say US$6,000 per year. I would qualify someone who makes US9,000 per year as rich, educated, two-parent family, etc. Sure to us in 1st world countries US$9,000 for an entire year of hard work is nothing. But it is those folks who have resources like time, money, car, etc.


If we want to look at it from the other side, where the 10% of kids who were not able to get the vaccines due to their parents not knowing about, not having parents, half-homeless kids, abusive/neglectful parents, not having enough time to get the vaccine, etc.  I think that even if no virus existed those kids would still be twice as likely to die compared to the general population aka the other 90% due to all the struggles they would have to go thru growing up (starving, drinking dirty water) and other lifestyles they would have to employ to get resources (stealing and getting shot at, etc)

The Guinea-Bissau study that you brought up, only followed 367people. https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0000101
With such a small sample size. It might be hard to make country-wide generalization. But maybe we can.

Catie George wrote:
If i recall, one of the theories i have seen for these effects is how damaging some of their illnesses are to the immune system. So basically, you get measles  (i think measles was cited as one of the most damaging), it wipes out your immune system, and during the recovery over the next year or so, you die of something your immune system normally could handle. I know, for example, my aunt, who had diptheria and scarlet fever as a child, (possibly also tuberculosis? There are some translation issues)  has had a delicate immune system for the rest of her life, and took months to recover from those illnesses, stuck in a hospital. I am sure during those periods of recovery, she was far more susceptible to whatever disease was floating around.  (She was lucky, of my grandmas 4 kids, 2 died by age 3 of things we now vaccinate against, and several kids my dad knew were in a wheel chair from polio).

I think there was also some evidence about recent vaccination for tuberculosis being effective in reducing severity of infection from COVID, which was interesting.

One of the other interesting things about even incomplete vaccination success is the reduction of severity of infection. I am mildly immunocompromised, and ended up catching chicken pox as an adult, despite being vaccinated against it (we now know you need two doses for good long term immunity, i only got one). Instead of being this horrific experience as it often is for adult patients,  i had a few (<10) itchy bumps, far milder than even most childhood cases.

Yes, and that correlates to what I've seen with flu shots over the years.  I used to be very skeptical of flu shots because I knew that their efficacy was not high.  I got one every year because I had to, but I wasn't really pushing it for generally healthy kids.  Then in the past 7 years I've been in a private practice that is pretty good about giving flu vaccines to a significant number of the patients.  I have noticed that even though a kid who got the flu shot might still come in with a fever, get swabbed and be positive for influenza, the quality and severity of their illness, compared to a kid who didn't get a flu shot, is striking.

When I was in med school, long long ago before rapid flu tests, I remember a professor said "If you are trying to decide if your patient has influenza, ask the patient if they want to die."  The kids who come in unvaccinated with influenza are often just curled up in mom's lap, hiding their face on her chest or shoulder.  They look like everything hurts.  The kids who got a flu vaccine may say they have a headache (if they're old enough to talk), but they are interested in the toys, they're moving around the room.  It's the difference between a 105F fever and a 101.5F fever.  So, the kid who got a flu shot and then tested positive for the flu, technically that's a "fail" for the vaccine but experientially, they are having a much better time with it.

Similarly, your one varicella vaccine didn't give you complete immunity, but it made a difference.  I took a class on vaccine development in like 1989, and I think they said that 75-90% of people gain immunity from the first of a three shot series, the second shot brings that up to 95% and the third one up to 98%.  Every little bit helps, decisions about vaccine schedules are made based on public health calculations.