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For clarity, here is a summary of my question, per anongoodnurse's comment:

Does a lower peripheral lymphocyte count resulting from recent immunization render us more susceptible to infection by other viruses?


There are many bad-faith arguments circulating that suggest COVID-19 vaccines are doing more harm than good. One talking point is that COVID-19 vaccination leads to a temporary reduction in circulating white blood cells, leaving vaccinated individuals susceptible to infections in the short term. Former NYT reporter Alex Berenson has been making such claims on Twitter:

1/ The fact the mRNA vaccines transiently suppress lymphocytes after vaccination has come up repeatedly on the feed as a possible explanation for post-vaccination deaths. Fact check: This is TRUE. @BioNTech_Group acknowledged it its papers (both 162b1 and 162b2 did so)

2/ By the way, they also lead to a sharp rise in C-reactive protein. Would love immunologists or virologists to chime in on whether these changes may be in any way clinically meaningful

As sources, Berenson cites two papers detailing the results of phase I/II trials for mRNA vaccine candidates.1,2

Derek Thompson addresses this Tweet and other claims made by Berenson in an article in The Atlantic 3, in which Thompson asks experts to challenge the misinformation shared by Berenson. Regarding the Tweet above, virologist Shane Crotty said the following:

The claim he is making is simply fearmongering, connecting a simple physiological event with bogus claims of deaths ... The observation of lymphocyte numbers temporarily dropping in blood is actually a common phenomenon in immune responses ... The cells are not gone. They come back to the blood in a few days. It is generally a good sign of an immune response, not the opposite.

While Berenson's claims regarding post-vaccination deaths are derived from his (willful?) misinterpretation of the data, Crotty's response got me thinking about the immunological dynamics of vaccination. My question: Does the localization of lymphocytes to secondary lymphoid tissues lead to reduced circulating lymphocytes and a subsequent increase in susceptibility to secondary infections? By secondary infection, I mean a challenge from a pathogen that is different from the one for which the vaccine was received.

For example, a person receives a dose of one of the SARS-CoV-2 mRNA vaccines, then, sometime during the critical period when circulating lymphocytes localize to the site of vaccination, the same person comes into contact with an influenza strain for which they have no adaptive immunity. Would that person have a lower chance of contracting flu had they not received the SARS-CoV-2 vaccine, all other factors being equal?

I found one publication that shows reduced risk for infection by influenza in patients who already had SARS-CoV-2, though this is attributed to pathogenic competition.4 Considering total pathogen dosage, it is logical to me that challenge with two pathogens is more likely to lead to illness than challenge with a single pathogen, but is there anything in the literature that suggests co-infection by an immunogenic "mock" pathogen (vaccine) and a secondary pathogen leads to a greater incidence of infection by the secondary pathogen?


References

  1. Mulligan, M.J., Lyke, K.E., Kitchin, N. et al. Phase I/II study of COVID-19 RNA vaccine BNT162b1 in adults. Nature 586, 589–593 (2020).
  2. Sahin, U., Muik, A., Derhovanessian, E. et al. COVID-19 vaccine BNT162b1 elicits human antibody and TH1 T cell responses. Nature 586, 594–599 (2020).
  3. Derek Thompson. The Pandemic’s Wrongest Man. The Atlantic, 1 April 2021.
  4. Stowe, J., Tessier, E., Zhao, H. et al. Interactions between SARS-CoV-2 and Influenza and the impact of coinfection on disease severity: A test negative design. medRxiv 2020.09.18.20189647.
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    $\begingroup$ Not an answer because I'm no immunologist at all (virologist though...) but the lymphocytes don't localize to the vaccination site, rather to secondary lymphocytic tissues - see here. The lymphopenia is a common occurrence in infection and vaccination and does not affect the antigen presenting cells already present from previous infections, only the pre-differentiation cells $\endgroup$
    – bob1
    Apr 20 '21 at 20:54
  • $\begingroup$ Thanks for your insight, bob1! I'll correct my question. If you're willing to expand on this in an answer, there's a bounty up for grabs. $\endgroup$
    – acvill
    Apr 20 '21 at 21:57
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    $\begingroup$ Unfortunately that's about as far as my knowledge of immunological processes goes. However, I think you will find that the answer is likely no - we are constantly under challenge from pathogens - think of all the bugs in your gut (E. coli) and on skin (Staph infections), inside your throat (strep) etc., and we don't see a sudden rise in these infections with vaccine programs. Note that anti-viral responses (CD8 T-cell) are slightly different to bacterial (CD4), though I don't know at which stage these play a role, though I suspect after the antigen-presenting stage. $\endgroup$
    – bob1
    Apr 21 '21 at 8:32
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    $\begingroup$ @bob1 - I would imagine that a significant challenge (what I imagine the OP is alluding to) would pertain only to response to another viral illness, not a bacterial infection, though the NYT reporter may not be implying that. $\endgroup$ Apr 24 '21 at 2:32
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    $\begingroup$ @acvill - Your question is a tiny bit misleading; yes, the number of lymphocytes circulating in peripheral blood decreases, we know that. The question should be (imo), "Does a lower peripheral lymphocyte count resulting from recent immunization render us more susceptible to infection by other viruses?" I can't answer that authoritatively, but decades of clinical experience leads me to lean towards "no". Interferons may be part of the reason. (I'm neither immunologist nor virologist, just a lowly FP/EM.) +1 for a well presented question. $\endgroup$ Apr 24 '21 at 2:42

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