Vaccine hesitancy and childhood trauma: More than just correlation
Also, why are some vaccinated people getting infected and showing severe symptoms whilst others aren’t? Why self-testing is statistically misleading and what we need to know about XE.
Thought I might address a couple of topics that were relevant these last couple of weeks. One were the results of several studies into the psychological roots of anti-authoritarian vaccine hesitancy, carried out on both sides of the planet. Then I wanted to address clinical work done by previous colleagues of mine at my alma mater in London, Imperial College, regarding the phenomenon of “never Covid” patients, individuals who get exposed, infected but don’t appear to show any symptoms of the disease at all. The findings are logical from an immunological perspective, but still puzzling from an epidemiological one. And finally I wanted to address the new Covid variant of interest, XE, which seems to account for the bulk of new infections in the UK and Europe.
Trust in authority wanes through negative childhood experiences
Not to harp on about the obvious, but the covid pandemic has been a challenging public health threat for the last two years, as such governments were concerned that people conform to life saving adjustments in behaviour, be that mask wearing, social distancing, hygiene conformity and most recently readiness to get inoculated with the covid vaccine. Seeing that large portions of populations (25% of the US, 15% in NZ and Australia and 10% in the UK) have not only refused to take this vaccine, but have gone on the offensive and protested loudly and tried to influence others with their own beliefs and “internet research”.
The question is why? Why this ardent anti-government, anti-technology stance? It turns out that the findings from these longitudinal studies in people with anti-vax sentiments, has shown that they are 3 times more likely than the general population to have experienced negative traumatic events in early childhood. In July 2021, right after the first vaccine batches became available, the researchers sent questionnaires to the 1037 participants (born between 1971-1972) in the world’s longest running longitudinal study, called the Dunedin Study, carried out by researchers at Otago University. Of the 1037 participants in the study, living all around the world by now, 13% were found to respond negatively. The researchers then went back and analysed various findings including adverse childhood experiences (ACE,) socioeconomic factors and self-professed trauma by the participants. The correlations between childhood trauma and resistance to the Covid vaccine was too great to be purely correlational, there seemed to be a causative factor at work. As German born associate director of the Dunedin Study, Professor Moffit says:
“adverse childhood experiences that foster mistrust, longstanding mental-health problems that foster misinterpretation of messaging, and early-emerging personality traits including tendencies toward extreme negative emotions, shutting down mentally under stress, nonconformism, and fatalism about health.”
These findings seem to rationalise this behaviour which has been a nuisance to deal with for people that were willing to take part in the nation-wide vaccination drives. Seeing people protesting, holding signs at busy intersections, people would roll their eyes and indict the protestors with some type of mental deficiency. Without considering the deeper causes of these issues.
In her published paper here, Moffit goes on to say:
“What they appear to learn during childhood is if anyone comes to you with authority, they’re just trying to get something, and they don’t care about you, they’ll take advantage,”
So it seems, the result of these findings appear to suggest a greater form of empathy and compassion on behalf of health authorities and others who are dealing directly with people who have antivax sentiments. To not loosely invoke “it’s not their fault” but there does seem to be some reasonable argument for being even more quiet and understanding with these individuals, seeing that their counterposition is deeply rooted in their own trauma.
To add to the causative speculation sprung from the Dunedin longitudinal study, the results were corroborated in an adjunct study carried out in Bangor, Wales, that enrolled people who had openly expressed emotions against vaccination. The findings were 100% in accordance with the findings from the Otago University study. People who were resistant to the vaccination were overwhelmingly reporting adverse childhood events in their personal history.
So yes, in conclusion, greater compassion is required and from a public health policy perspective, perhaps it would be wise to offer free counseling to those people who fail to see the benefit of vaccination or worse, have an active mistrust in authority.
Just an idea.
Why are certain people not getting sick after Covid infection: Is it just in the genes?
You may have all met people like this, the ones who live in a household where multiple people get the symptoms of Covid but these individuals don’t get infected and never develop symptoms. These people have been aptly termed “Never Covid” individuals.
Whilst the more intricate biological details are still being worked out, the consensus is now that the answer to this conundrum lies in genetics. Particularly genetic factors that relate to areas of our genome termed Human Leukocyte Antigen (or HLA.) These are long stretches of DNA that we inherit, that contain information regarding viral and bacterial peptides that have previously been encountered in your genetic lineage. Whilst they are still trying to identify the gene clusters that result in “No Covid” people, one area in particular has been noticed to be expressed at a higher frequency in people who show severe symptoms, particularly people with the HLA-DRB1*1302 allele appear to be more symptomatic than the general public.
On top of this genetic factor, two other major contributors to people being relatively asymptomatic to covid infections has to do with our prior immunological encounters to any one of 4 common cold coronaviruses which have been circulating in our populations for some decades. These prior immunological interactions have resulted in memory B and T cells to certain peptide epitopes (receptors) that may confer cross-reactivity to these new Covid strains. This manifests itself in two ways, on one hand the cross reactive antibodies (produced by the memory B cells) and T cells are directly linked to controlling any potential Covid infection and furthermore they may help the immune system accommodate the mRNA vaccine much more efficiently - hereby producing more viable cell lines to combat future infection.
To discover more about this “Non-Covid” phenomenon researchers at Imperial also analysed over 78 000 individuals presenting with Covid and Covid related symptoms globally and found some interesting differences between countries, in terms of reporting frequency and symptom severity and variation between countries. The findings are reported in The Lancet here.
In another study led by Imperial College, the British Human challenge, 36 young and healthy individuals were deliberately infected. A puzzling result of these inoculations were that 50% of the participants had symptoms and 50% did not. Of the 18 people who showed more severe symptoms, 16 people had mild infections, whereas 2 had more severe infections. It is out of this study where Imperial researchers are hoping to find the genetic markers that lead to a favourable Covid outcome. Another interesting finding was the incubation time, previously put at 6 days, was discovered to be significantly shorter at 42 hours, a finding as with other evidence, that could potentially alter our public health approach with Covid moving forward.
An unassuming and untrained public starts testing en masse
From the beginning of the self-testing epoch of this pandemic I was adamant with everyone I spoke to that they should be swabbing the back of their throats and not just inside the nose. The reasoning of this was obvious to me, a veteran of diagnostic testing. What I discovered in my years of testing for bacteria and viruses at both the military and hospitals was that when it comes to diagnostics, luck favours certain outcomes, unless you are rigorous. I was always skeptical about letting the general public loose on these self-test kits as I was acutely aware that swab sampling was an art form. And lo and behold this Imperial study exposed some other interesting findings, namely in the time the infections were peaking. The average was around 5 days, but in some of the participants, higher levels were found after 9 days and in some even after 12 days post infection.
These results seem to contradict the common consensus and could warrant a closer look at our public health policy.
Interesting was the times at which the virus was first detectable in the body. The throat for instance had significantly elevated levels nearly a whole day before the nose started showing viral particles, again going against the consensus. It appears that 40 hours post infection, the virus is detectable in the throat versus 58 hours, when it was found in the nose (where the majority of self-testing kits were instructing their users to swab.)
I go into more detail about the future of testing and some of its pitfalls in this article “Test, test, testing, 1, 2, 3 is this thing on? Are covid tests reliable enough for us to proceed with business-as-usual?” - have a read if you want more information about why testing is crucial but a bit misplaced in a clueless public.
What is XE and should we be worried?
XE is a variant of omicron whose spread has still been contained and as such hasn’t warranted the allocation of a greek letter yet by the WHO. It is essentially omicron but with some altered genes from delta that had not been seen previously.
As for how these different strains come about, you may want to revisit my article “Why do viruses mutate” but in short, when multiple different viruses are present in the same host cells, the genes may successfully recombine to form a new mutation - it’s relatively rare as in most circumstances, the virus gets eliminated by the immune system before the varying species have the ability to form recombinant genomes but every now and then it does happen.
The good news about the XE variant, is that its surface receptor, the part of the virus we encounter first - and the part the vaccine has primed our immune system for - is stil relatively identical to omicron, which is good news for a country like New Zealand where over 90% of our cases are due to this variant. So it is something to keep an eye on but nothing to get too worked up about.
Hope you enjoyed this article, let me know any queries or questions in the Comments section below. Thanks for reading and sharing.
REFERENCES
Associations between adverse childhood experiences, attitudes towards COVID-19 restrictions and vaccine hesitancy: a cross-sectional study (British Medical Journal - BMJ)
Deep-seated psychological histories of COVID-19 vaccine hesitance and resistance (Proceedings of the National Academy of Sciences - PNAS)
Scientists deliberately gave people COVID — here’s what they learnt (NATURE)
COVID-19 mapper reveals symptom variation between countries and health status (IMPERIAL COLLEGE NEWS)
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Do you have any information I could pass on to an acquaintance who has some anxiety around the flu vaccine & how it is checked for safety each year when the virus strains are changed?