Thankyou for this, it's very informative. I recall seeing some years ago some information about correlations between polio symptoms and the use of pesticides at the time of 'outbreaks' which occured in geo and temporal proximity. Unfortunately, I did not keep the information. Is this something that you have come across before?
The toxin theory is a mismatch for polio. Consider that polio rates were lower than 1944 in 2 of the following 3 years... even though, for the first time ever, millions of homes were sprayed with DDT in collaboration with the Public Health Service https://unglossed.substack.com/i/138451614/not-ddt This is an obvious find, so it tells you that anyone pretending to have positive evidence for the toxin theory is a sham
Thanks for this, it’s very interesting. Forgive my scatter gun of questions and if I’ve missed these details in preceding posts….!
Was it just the Salk (injected) introduced here? I don’t know when Salk v Sabin were used ( also I’m English and probably have seen data relevant to what we used here which may have been different) but have the general impression that Sabin (oral) should be more effective.
I understand that there are three strains of polio; does Salk cover all three and does Sabin cover all three?
Am I correct thinking a Salk vaccinee could still get the infection and shed it, but suffer less severe consequences for themselves?
Is it also correct that a Sabin vaccinee should be able to resist getting infected ( against the strains in the vaccine) in the first place and therefore not be a risk of shedding to others, except for the fact that during their initial exposure to the Sabin they can shed the vaccine strain ( which occasionally might dis-attenuate back to a dangerous version)?
In general my thinking has gone like this. Prior to 2020 I believed all vaccines worked except for occasional people with unusual immune systems and a tiny minority experienced some rare side effects ( of which death wasn’t one). Now I believe all vaccines have side effects in a much larger percentage than I was led to believe ( including death) and that some vaccines work and some don’t. But this is complicated by the fact that a vaccine working at one point in a persons lifetime doesn’t necessarily benefit them for their whole lifetime or benefit society as a whole as it changes the pattern of infection. Thinking in terms or risk/benefit ratios is determined by efficacy and prevalence.
The question that bugs me personally the most is that of meningitis vaccines (ACWY, Men B, HiB). I have a vague recollection of seeing a video presentation showing two studies that demonstrated benefit for 8 months or two years, but I can’t remember if that was for young children or teenagers. I also have a memory of it being shown that HiB vaccination reduced HiB meningitis in young children. Meningitis was the only serious infectious disease I saw as a junior doctor doing paediatrics, general medicine ( young adults only) and as a GP where patients were seriously injured or died. I saw one a month in paediatrics, one a week in general medicine and one case in 4 years as a GP.
Your polio vaccine impressions / assumptions are mostly all correct. Salk in US after 1955, Sabin transition begins experimentally in Middleton (Yale) in late fall, 1960; by 1962 Sabin is all over the place.
The only correction to offer is that the Salk IPV must have had a substantial effect of suppressing community prevalence, otherwise there is no explanation for the scale of declines observed after 1954. A paper by Salk from 1960 begs for consideration of this obvious fact - https://sci-hub.se/10.1177/146642405907900405 - his argument is that thanks to plumbing / hygiene, the main portal of transmission of polio in the US is pharynx in/out - and it *has* been shown that IPV reduces pharynx recovery of virus. I think this is plausible. The problem remains that IPV's reduction in this respect is only partial. You still have some number who give no resistance to the virus; they spread it, they experience paralysis. Epidemics still happen. I think they will soon happen again after 23 years of using eIPV instead of Sabin here in the US.
My impression is that the UK transition was also underway around the same time - 1962, exactly while the Salk IPV had already tamed recent trends. So there's not much difference in US / UK in fig 3 / 4 in https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2466564/
So the superiority of OPV is ultimately over-determined, imo. Yes, there's "tissue immunity" and a faster suppression of fecal shedding in recipients, but this might be less important than the original bolus of shed (often de-attenuated) OPV (fecally or orally, who knows) in first-time recipients - this gives a natural "booster" to everyone. OPV sort of wears the grin/sneer theatre mask in this respect - good because less shedding, good because more shedding. Ultimately, it worked great, who cares how, it was crazy to stop using it. Imo.
My perspective is, if natural immunity has a working value, artificial immunization probably has the same working value. So of course you can prevent some number of kids showing up somewhere with meningitis by artificial immunization for, eg, HiB. But there are probably other benefits to natural immunity that have to do with innate immune training, and are these benefits somehow magically retained for the 9,999 of 10,000 children who would not have shown up with meningitis, this seems implausible, in fact stupid.
Thankyou for this, it's very informative. I recall seeing some years ago some information about correlations between polio symptoms and the use of pesticides at the time of 'outbreaks' which occured in geo and temporal proximity. Unfortunately, I did not keep the information. Is this something that you have come across before?
The toxin theory is a mismatch for polio. Consider that polio rates were lower than 1944 in 2 of the following 3 years... even though, for the first time ever, millions of homes were sprayed with DDT in collaboration with the Public Health Service https://unglossed.substack.com/i/138451614/not-ddt This is an obvious find, so it tells you that anyone pretending to have positive evidence for the toxin theory is a sham
Thankyou Brian, your reply is appreciated. Happy new year to you and yours.
Thanks for this, it’s very interesting. Forgive my scatter gun of questions and if I’ve missed these details in preceding posts….!
Was it just the Salk (injected) introduced here? I don’t know when Salk v Sabin were used ( also I’m English and probably have seen data relevant to what we used here which may have been different) but have the general impression that Sabin (oral) should be more effective.
I understand that there are three strains of polio; does Salk cover all three and does Sabin cover all three?
Am I correct thinking a Salk vaccinee could still get the infection and shed it, but suffer less severe consequences for themselves?
Is it also correct that a Sabin vaccinee should be able to resist getting infected ( against the strains in the vaccine) in the first place and therefore not be a risk of shedding to others, except for the fact that during their initial exposure to the Sabin they can shed the vaccine strain ( which occasionally might dis-attenuate back to a dangerous version)?
In general my thinking has gone like this. Prior to 2020 I believed all vaccines worked except for occasional people with unusual immune systems and a tiny minority experienced some rare side effects ( of which death wasn’t one). Now I believe all vaccines have side effects in a much larger percentage than I was led to believe ( including death) and that some vaccines work and some don’t. But this is complicated by the fact that a vaccine working at one point in a persons lifetime doesn’t necessarily benefit them for their whole lifetime or benefit society as a whole as it changes the pattern of infection. Thinking in terms or risk/benefit ratios is determined by efficacy and prevalence.
The question that bugs me personally the most is that of meningitis vaccines (ACWY, Men B, HiB). I have a vague recollection of seeing a video presentation showing two studies that demonstrated benefit for 8 months or two years, but I can’t remember if that was for young children or teenagers. I also have a memory of it being shown that HiB vaccination reduced HiB meningitis in young children. Meningitis was the only serious infectious disease I saw as a junior doctor doing paediatrics, general medicine ( young adults only) and as a GP where patients were seriously injured or died. I saw one a month in paediatrics, one a week in general medicine and one case in 4 years as a GP.
Your polio vaccine impressions / assumptions are mostly all correct. Salk in US after 1955, Sabin transition begins experimentally in Middleton (Yale) in late fall, 1960; by 1962 Sabin is all over the place.
The only correction to offer is that the Salk IPV must have had a substantial effect of suppressing community prevalence, otherwise there is no explanation for the scale of declines observed after 1954. A paper by Salk from 1960 begs for consideration of this obvious fact - https://sci-hub.se/10.1177/146642405907900405 - his argument is that thanks to plumbing / hygiene, the main portal of transmission of polio in the US is pharynx in/out - and it *has* been shown that IPV reduces pharynx recovery of virus. I think this is plausible. The problem remains that IPV's reduction in this respect is only partial. You still have some number who give no resistance to the virus; they spread it, they experience paralysis. Epidemics still happen. I think they will soon happen again after 23 years of using eIPV instead of Sabin here in the US.
My impression is that the UK transition was also underway around the same time - 1962, exactly while the Salk IPV had already tamed recent trends. So there's not much difference in US / UK in fig 3 / 4 in https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2466564/
So the superiority of OPV is ultimately over-determined, imo. Yes, there's "tissue immunity" and a faster suppression of fecal shedding in recipients, but this might be less important than the original bolus of shed (often de-attenuated) OPV (fecally or orally, who knows) in first-time recipients - this gives a natural "booster" to everyone. OPV sort of wears the grin/sneer theatre mask in this respect - good because less shedding, good because more shedding. Ultimately, it worked great, who cares how, it was crazy to stop using it. Imo.
My perspective is, if natural immunity has a working value, artificial immunization probably has the same working value. So of course you can prevent some number of kids showing up somewhere with meningitis by artificial immunization for, eg, HiB. But there are probably other benefits to natural immunity that have to do with innate immune training, and are these benefits somehow magically retained for the 9,999 of 10,000 children who would not have shown up with meningitis, this seems implausible, in fact stupid.