So I’m finally back, and in the 11 days that I’ve been gone the world has changed. The COVID-19 pandemic, caused by a virus dubbed SARS-CoV-2, has accelerated. Worse, it’s come to my neck of the woods, with the Detroit area currently being one of the COVID-19 hotspots in the US. It’s eerie at the hospital now. The outpatient clinics are slow because nonessential patient visits have been deferred. I’m not operating because elective surgeries have been canceled. We are even deferring some cancer operations in patients with low-risk cancers who can be given other treatments for several weeks until after the crisis passes. Meanwhile, hospitals are being inundated with COVID-19 patients. So I’ll start slow. There’s an antivaccine take on the COVID-19 pandemic going around, because, of course there is. What is that take? Well, take a look at this Tweet promoting an antivaccine lie about coronavirus and viral interference:
Matt Couch describes himself as a “Christian, Father of 2, Investigator, Founder The DC Patriot & America First Media Group, Razorback, Truth Slinger,” and has over 300K followers on Twitter. There are a lot of Tweets like this one:
And this one:
I touched on this claim abusing the concept of viral interference two months ago and so was way ahead of the curve, but, as is frequently the case, the antivaccine disinformation claiming that the flu vaccine increases your risk of coronavirus has mutated. Indeed, it’s become oddly specific, citing one study in particular and saying that the increased risk of coronavirus infection is 36%. So I think now is as good a time as any to discuss this issue.
It’s not clear what the original source of this particular meme implying that the flu vaccine increases the risk of COVID-19 through viral interference, but one prominent article shared on social media that came up again and again in my searches is an article posted to DisabledVeterans.org by someone named Benjamin Krause entitled Flu Vaccine Increases Coronavirus Risk 36% Says Military Study, which was published March 11:
A recent military study shows military personnel evaluated who received the flu vaccine were at 36 percent increased risk for coronavirus with varied benefit in preventing some strains of the flu.
“Examining noninfluenza viruses specifically, the odds of both coronavirus and human metapneumovirus in vaccinated individuals were significantly higher when compared to unvaccinated individuals (OR = 1.36 and 1.51, respectively) (Table 5).”
And more on this:
The column to focus on is “OR” in Table 5.
Coronavirus is 1.36 meaning 36% higher risk.
The influenza virus overall is 0.57 meaning the risk of contracting the flu was reduced overall. Three variants of flu did not receive a statistically significant reduction in risk.
Three of 8 evaluations noted a statistically insignificant benefit for the flu shot. Meanwhile, shot takers were at increased risk for coronavirus of 36%. I would bet $1 that this year, many Americans would likely rethink taking the vaccine with that bit of information.
Of course, the first thing to note is that the coronavirus in this study of viral interference was obviously not SARS-CoV-2. This study was carried out years before the emergence of COVID-19. No, the coronavirus examined in this study were your run-of-the-mill wimpy coronaviruses that can cause the common cold and that many of us have detectable in our bodies just because these viruses are everywhere. True, Krause does at one point mention that this study is “pre-COVID-19,” but it would still be easy for the reader to believe that the study has implications for SARS-CoV-2.
Before I deconstruct why the claim made by Krause is unjustified and unmitigated nonsense, who is Benjamin Krause? I had never heard of him before in antivaccine circles, but he bills himself as “a lawyer, investigative reporter and award-winning veterans advocate. He is author of the guide Voc Rehab Survival Guide for Veterans and chief editor of DisabledVeterans.org” and notes writing credits in “national publications as an authority on Department of Veterans Affairs policy such as Bloomberg News, Foreign Policy Magazine, Washington Times, Fox News, CBS, NBC, Star Tribune and more.” One thing I can say for sure about him, whatever expertise he might have in these areas, he’s clueless about science and medicine.
Another prominent quack parroting this claim is “functional medicine” doctor Dr. Serge Gregoire, who appears not to have an MD but only a PhD and bills himself as “the nutrition scientist.” Unsurprisingly, he is also antivaccine, as a quick perusal of his website makes abundantly clear. His article is the source of this particular meme:
The medical community strongly advises the population to get a flu shot to help combat the epidemic of this coronavirus.
Honestly, I never made any sense to me.
It is two different types of viruses.
So not now the flu shot works for all viruses?
Concerningly, the latest research shows that getting the flu vaccine increases the risk of getting the coronavirus by 36%!!!
Note that “Dr. Serge” doesn’t even make a passing mention that the coronavirus examined in the study in question was not SARS-CoV-2, but just run-of-the-mill coronavirus strains.
So what is being claimed here? The study being misused and abused by antivaxxers is this one by Greg G. Wolfe at the Armed Forces Health Surveillance Branch Air Force Satellite, Wright-Patterson Air Force Base in Ohio and entitled Influenza vaccination and respiratory virus interference among Department of Defense personnel during the 2017–2018 influenza season. The idea of viral interference is described in the introduction:
While influenza vaccination offers protection against influenza, natural influenza infection may reduce the risk of non-influenza respiratory viruses by providing temporary, non-specific immunity against these viruses , . On the other hand, recently published studies have described the phenomenon of vaccine-associated virus interference; that is, vaccinated individuals may be at increased risk for other respiratory viruses because they do not receive the non-specific immunity associated with natural infection , , , . There has been limited evidence that the influenza vaccine may actually be associated with the virus interference process , . Other studies have found no association between influenza vaccination and increased respiratory virus risk , .
The purpose of this study is to add to the general knowledge of influenza vaccine-related virus interference by comparing rates of non-influenza respiratory viruses to negative laboratory tests, and comparing vaccination status of influenza positive cases to controls among Department of Defense (DoD) personnel. The DoD provides a unique population for vaccination studies as mandatory vaccination against influenza is required by the DoD for all Active Duty and Reserve Component personnel . This study aims to examine the relationship between specific respiratory viruses and influenza vaccination.
Wolfe took advantage of the Department of Defense Global Respiratory Pathogen Surveillance Program (DoDGRS), DoD-wide program established by the Global Emerging Infections Surveillance and Response System (GEIS). It started as an influenza-only program but during the 2013-2014 flu season the program added respiratory Film Array for flu negative samples and began identifying other respiratory pathogen. During the 2017-2018 flu season the program added respiratory Film Array for flu negative samples and began identifying other respiratory pathogens. These specimens are now tested with a multiplex PCR panel for these pathogens: adenovirus, Chlmydia pneumoniae, coronavirus, human bocavirus, human metapnumovirus, Mycoplasma pneumoniae, parainfluenza, respiratory syncytial virus (RSV), rhinovirus/enterovirus, and co-infections.
All personnel submitting a respiratory specimen to DoDGRS for the 2017-2018 flu season, and those who tested positive for only Chlamydia pneumoniae and/or Mycoplasma pneumoniae were excluded because these illnesses are bacteriological in nature. People with influenza and non-influenza co-infections were excluded because they couldn’t be uniquely classified as influenza or non-influenza, as were people whose vaccination status couldn’t be confirmed. Finally, subjects who were ill before receiving vaccination were excluded as their vaccination status would be considered be unrelated to their illness.
Let’s go to the findings:
We compared vaccination status of 2880 people with non-influenza respiratory viruses to 3240 people with pan-negative results. Comparing accinated to non-vaccinated patients, the adjusted odds ratio for non-flu viruses was 0.97 (95% confidence interval (CI): 0.86, 1.09; p = 0.60). Additionally, the vaccination status of 3349 cases of influenza were compared to three different control groups: all controls (N = 6120), non-influenza positive controls (N = 2880), and pan-negative controls (N = 3240). The adjusted ORs for the comparisons among the three control groups did not vary much (range: 0.46–0.51).
Receipt of influenza vaccination was not associated with virus interference among our population. Examining virus interference by specific respiratory viruses showed mixed results. Vaccine derived virus interference was significantly associated with coronavirus and human metapneumovirus; however, significant protection with vaccination was associated not only with most influenza viruses, but also parainfluenza, RSV, and non-influenza virus coinfections.
Let me repeat that: Receipt of influenza vaccination was not associated with virus interference among our population. In other words, this is a negative study. The authors did not observe viral interference.
Then, in the conclusion:
The overall results of the study showed little to no evidence supporting the association of virus interference and influenza vaccination. Individual respiratory virus results were mixed, and some rebutted virus interference.
So how did antivaxxers come to the mistaken cherry picked conclusion that this study showed that, due to viral interference, the seasonal flu vaccine increases your risk of getting coronavirus by 36%, thus creating an antivax meme? It comes down to this table:
And this cherry-picked passage:
The odds of testing positive for individual respiratory viruses by vaccination status were also examined (Table 5). The influenza vaccine was sufficient at protecting all influenza virus results tested for at a significant level except two (Influenza B Victoria and Influenza coinfections) (Table 5). Both Influenza B Victoria and Influenza coinfections had reduced odds in the vaccinated cohort, but not at significant levels (Table 5). Examining non-influenza viruses specifically, the odds of both coronavirus and human metapneumovirus in vaccinated individuals were significantly higher when compared to unvaccinated individuals (OR = 1.36 and 1.51, respectively) (Table 5). Conversely, all other non-influenza respiratory viruses had decreased odds in the vaccinated population, including significantly decreased odds ratios in vaccinated people with parainfluenza, RSV, and non-influenza virus coinfections (Table 5). Additionally, the odds ratio in the no pathogen detected cohort was significantly higher in vaccinated versus unvaccinated individuals (OR = 1.51) (Table 5).
To reiterate what I’ve said before about this study, this what we’re almost certainly seeing: Noise. With the odds ratio of influenza virus significantly decreased (the odds ratios range from 0.39 to 0.88, depending on the specific influenza strain), the rest of the various viruses detected fluctuated around an odds ratio of 1.0 (no difference). Indeed, most of the non-influenza viruses tested for (6/8) demonstrated odds ratios lower than 1.0 (range: 0.67-1.51). Only coronavirus and human metapneumovirus showed odds ratios of more than 1.0 (1.36 and 1.51, respectively), with the rest all lower than 1.0. Moreover, the odds ratio of having no pathogen detected in the group receiving the flu vaccine was 1.59 (95% CI 1.44-1.75), meaning that those who had the flu vaccine were 59% more likely not to have any respiratory virus detectable at all. This is highly suggestive of nothing more than statistical noise. Basically, antivaxxers are citing what is, in essence, a negative study.
As I’ve mentioned before, I also can’t help but be amused by the inconsistency of antivaxxers. The flu vaccine is one of our less effective vaccines, a vaccine whose efficacy varies widely from season to season because an educated guess has to be made several months in advance every year as to which influenza strains will be the most common that season. Antivaxxers love to claim that the flu vaccine doesn’t work, that it’s completely ineffective. But if the flu vaccine doesn’t work, there isn’t even a chance that it could cause interference with other viruses.
So, the next time you see these memes, remember: This is a cherry picked number out of a negative study that didn’t show any good evidence for viral interference, and the study has no relevance to COVID-19 because it was performed more than two years before SARS-CoV-2 even appeared and looked only at run-of-the-mill coronavirus, the kind that doesn’t cause severe disease. Basically, it’s a lie.