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Vaccinology: time to change the paradigm?
Christine Stabell Benn1, Ane B Fisker2, Andreas Rieckmann3
1Bandim Health Project, Indepth Network, Bissau, Guinea-Bissau; Research Centre for Vitamins and Vaccines, Statens Serum Institut, Copenhagen, Denmark; Danish Institute of Advanced Science, University of Southern Denmark, Odense, Denmark.
The Lancet. Infectious Diseases
|July 10, 2020
Summary
Vaccines may have significant non-specific effects beyond targeting specific infections, influencing overall health and mortality. Emerging principles suggest live vaccines enhance immunity, while non-live vaccines may increase susceptibility in females, impacting public health strategies.
Area of Science:
- Immunology
- Epidemiology
- Public Health
Background:
- Traditional vaccine models assume specific protection against target infections.
- Epidemiological data reveal non-specific effects of vaccines on overall health and mortality.
- Contradictory observations challenge existing vaccine paradigms, particularly regarding sex-specific outcomes.
Purpose of the Study:
- To review current observations and contradictions regarding vaccine non-specific effects.
- To define emerging principles explaining these observed non-specific effects.
- To explore potential implications for child health and global vaccination strategies.
Main Methods:
- Review of epidemiological vaccine research and observational data.
- Analysis of studies reporting on all-cause mortality and vaccine administration.
- Synthesis of findings to propose new principles of vaccine action.
Main Results:
- Live vaccines demonstrate enhanced resistance to unrelated infections.
- Non-live vaccines are associated with increased susceptibility to infections in females.
- The timing and combination of vaccines, as well as co-interventions like vitamin A, influence non-specific effects.
- Maternal immunity can modulate beneficial non-specific effects of live vaccines in children.
Conclusions:
- Vaccines possess significant non-specific effects that impact overall health and mortality.
- Six emerging principles can help explain these non-specific effects.
- Optimizing vaccination strategies based on these principles could substantially reduce child mortality globally.
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