Jab joy: Who wouldn’t want to become ‘superhuman’?

Dr Raj Persaud

THE popularity of comic-book stars such as Superman or blockbuster Hollywood franchises such as The Avengers are testa­ment to the appeal in the popular imagi­nation of having superpowers.

However, the reality is we struggle away in the gym just to lose a little bit of weight, and no matter how many abdominal crunches we do, we never seem to attain the six-pack of our latex-clad heroes.

Surely, we want to get fitter – at least partly – so we can beat back the bugs?

Charles Atlas became the most famous bodybuilder of his day when a series of fa­mous comic-book-style ads ran in newspa­pers across the US. The cartoon followed the story of a seven-stone weakling, humili­ated in front of his girlfriend by having sand kicked in his face by a well-built hunk on the beach. Sick of being pushed around, the skinny kid takes up the Charles Atlas sys­tem for building muscles, returning to the seaside to kick the crap out of the original beach bully.

But what if you were told that there is a very simple, practically painless way to take a giant leap into ‘superhuman’ status, and it doesn’t involve any of the exertions re­quired by the Charles Atlas system?

This is the argument of a recent investi­gation entitled Toward superhuman SARS-CoV-2 immunity?1 published by two eminent scientists, Dennis Burton, professor of im­munology and microbiology and Eric Topol, professor of molecular medicine, both from the Scripps Research Institute, USA.

In their analysis published in the prestig­ious journal Nature Medicine, the two re­searchers’ argument that in many cases, “natural infection gives better immunity than vaccination” is, in fact, true.

As long as you survive the infection, there are certainly many germs for which natural infection induces stronger immune responses and more long-lived immunity than does vaccination.

Measles is a good example. While there is a clear risk of death, severe inflammation of the brain and pneumonia from the infection, before there was a vaccine, if you survived, you did gain robust lifelong immunity.

Vaccination against measles, on the oth­er hand, requires two shots and may not offer complete lifelong protection. But it has proven to be good enough to keep the disease at bay when widely implemented.

In the case of measles, vaccination is bet­ter than just waiting to get infected with the actual disease because it is safer and also prevents transmission, so more effectively stifles the spread of the dangerous and highly infectious bug.

However, in contrast to the measles vi­rus, there are a number of germs for which vaccination generates stronger immune re­sponses and more-effective protection against disease than does natural infection.

In these cases, these scientists argue, man-made vaccines render you, in a sense, ‘superhuman’; that is, it gives immune re­sponses superior to those generated by mere mortals, in response to infection.

Vaccines in a sense, make you ‘bionic’, to refer to a famous TV series from the 1970s, The Six Million Dollar Man. Steve Austin is an astronaut who, after being seriously in­jured, undergoes surgery which rebuilds damaged bits of his body with machine parts, rendering him better, faster, stronger, than merely human.

The bacterium that causes tetanus is a good example of this ability of vaccines to render you ‘bionic’. Spores of tetanus bacte­ria are everywhere in the environment, in­cluding soil, dust, and manure. They de­velop into bacteria when they enter the body through breaks in the skin, such as in cuts contaminated with dirt, faeces, or sali­va, in particular.

People often call tetanus “lockjaw” be­cause one of the most common symptoms is a frightening tightening of the jaw mus­cles, leading to being unable to open your mouth, and resulting in severe difficulty swallowing and breathing. Two in 10 cases can be fatal and it is a horrible way to die.

Infection results in production of the highly potent tetanus toxin in small amounts that are sufficient to cause severe disease, but not enough to generate a strong immune response.

The current UK immunisation policy recommends five doses of tetanus and diphtheria vaccines, starting at two months and ending between 13 and 18 years of age.

The vaccine renders you superhuman in the face of tetanus; your body kicks sand in the face of this bacterium every time it comes at you, because you stepped on something sharp penetrating your skin.

Among viruses, two classic cases where vaccines generate immunity superior to that generated by natural infection are the varicella zoster virus (chickenpox), which can lead to shingles; and human papillo­mavirus (HPV), some strains of which cause various cancers, including cervical, penile and throat malignancies.

Did you not know you can get vaccinated against cancer? If you can no longer get certain cancers because of a vaccine, has it not, in a sense, made you ‘superhuman’?

The varicella zoster virus, or chicken pox, can get re-activated in later life, where it can then lead to shingles. Immunity aris­ing from the primary infection does not prevent the disease in those who develop shingles. After you have had chickenpox, the virus lies inactive in nerve tissue near to spinal cord and brain. If you become im­mune suppressed for some reason, it can reactivate, causing very painful lesions and, in some cases, permanent scarring of the cornea and glaucoma is the result. One in 100 people over the age of 80 get shingles.

However, the recently developed vac­cines, Zostavax and Shingrix, do offer pro­tection against shingles. Effective vaccines are administered to those over 50 years of age in many countries.

Perhaps the best example of immunity superior to that induced by infection is the vaccine against HPV. The strains that cause genital cancers enter the body via skin con­tact, and the immune responses induced are weak and take a long time to develop.

In contrast, intramuscular injections of one of the vaccines against HPV induce potent neutralising immune responses, blocking entry of the virus into target cells. The vaccines against HPV have been shown to offer complete protection against cervi­cal cancer, the fourth most frequent cancer in women.

Jo’s Cervical Cancer Trust2 explains that HPV is a common virus that most of us will have at some point in our lives. There are over 200 types, each with its own number. There are 13 HPV types linked to cancer, called high-risk HPV. The HPV vaccine aims to stop you getting some high-risk types. The HPV vaccine could prevent two-thirds of cervical cancers in women young­er than 30 by 2025. But this will only hap­pen if at least eight in 10 (80 per cent) peo­ple have the HPV vaccine when offered.

The NHS HPV vaccination drive in schools started in 2008 and was only offered to girls. It was thought this would also be of enough benefit to boys, as they would be protected indirectly thanks to girls being vaccinated (sometimes called herd protection).

In 2018, the Joint Committee on Vaccina­tion and Immunisation (JCVI), which ad­vises UK health departments on immunisa­tion, decided the HPV vaccine should also be offered to boys. The evidence shows that offering boys the HPV vaccine will help protect against a number of HPV-related cancers and conditions, including head and neck (oropharyngeal) cancers, penile and anal cancer, as well as genital warts. It will also strengthen herd protection – this means helping protect anyone who is not vaccinated or is has not had all the doses.

Among Asians, there are fears that vac­cinating adolescent girls against HPV infec­tion will encourage sex due to the protec­tion against sexually transmitted HPV. Vac­cinating young adolescent children against HPV appears to more sexually conservative Asians to condone early sexual initiation3.

The HPV vaccine is best given before the onset of sexual activity and the evidence shows no increase in the promiscuity of those who have received the HPV vaccine, compared to unvaccinated girls.

Where does the coronavirus responsible for the current pandemic, referred to as SARS-CoV-2, lie along the spectrum of nat­ural infection versus vaccine-induced pro­tective efficacy?

The initial results from interim analyses by Pfizer/BioNTech and Moderna of mRNA vaccines showing a reduction in infections of around 95 per cent are very encouraging.

So, if you want to become superhuman, fast, forget the gym. A suitable vaccine can deliver much more powerful immunity than if you got an infection naturally and relied on your body mounting its normal response to future attacks. Vaccines turn you into a superhuman in just weeks, and you don’t have to undergo the Charles Atas muscle strengthening system.

If you don’t want the jab, if you prefer to remain that seven-stone weakling, then re­member there are bugs, and buggers, out there, waiting to kick sand in your face.

References: 1Burton, DR, Topol, EJ Toward superhuman SARS-CoV-2 immunity?. Nat Med 27, 5–6 (2021). https://doi.org/10.1038/s41591-020-01180-x 2

2Jo’s Cervical Cancer Trust: www.jostrust.org.uk.