More on Vaccine Side Effects

Derek Lowe's commentary on drug discovery and the pharma industry. An editorially independent blog from the publishers of Science Translational Medicine. All content is Derek’s own, and he does not in any way speak for his employer.

Back last summer, I was writing blog posts about possible side effects of mass vaccination. For readers who’ve shown up more recently and might have me filed as Defender of Vaccines, that might seem surprising, but remember, I’ve been in drug discovery for a long time now. All drugs, all therapies have side effects. It’s just a question of the risks and severity of those versus the benefits, and looking at either of those alone is a serious mistake.

One of the things I wondered about was Guillain-Barre syndrome. That’s because it’s already a known sequel to viral infections in general, and has also shown up response to vaccination. It’s an autoimmune disorder, which means that it’s going to be scattered around in the huge diversity of immune function from person to person, and it also means that it will be extremely difficult to predict who might be at risk. G-B involves an attack on a person’s own myelin sheaths around the nerves, which sounds very serious – and indeed, sometimes it’s severe enough that people need to be hospitalized while they recover. But fortunately the vast majority of patients do make strong recoveries – the immune response goes back down, and the body’s own remyelinating cells fix up the damage.

And now the FDA has issued a warning that there have been a few cases with the J&J vaccine. To the best of my knowledge, this has not been seen with the other vaccines, and that’s another illustration of the variability in the long tail of autoimmune side effects. You see these with small-molecules drugs as well, often when they can form covalent adducts and produce modified proteins that (in a few people) will set off the immune response, and this low-level idiosyncratic toxicity is a matter for constant surveillance.

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